OTSU, JAPAN. Crohn's disease is an inflammatory disease involving intestinal pain, diarrhea, and malabsorption of nutrients. The disease is characterized by periods of active disease interspersed with periods of remission. Elemental diet (ED) therapy is the preferred treatment in Japan. Conventional treatment with prednisone and salycylates has been only marginally successful in extending the periods of remission. The ED therapy involves tube feeding (enteral nutrition) a mixture of free amino acids, short-chain maltodextrins, and low levels of fat in the form of soybean oil. Not surprisingly, compliance with this diet is poor resulting in shorter periods of remission.
Medical researchers at the Shiga University of Medical Science now report that one of the three daily enteral meals can be replaced by a special meal eaten normally. This new CD (Crohn's disease) diet consists of rice, cooked fish, and soup. It is rich in polyunsaturated fatty acids and has an omega-3 to omega-6 fatty acid ratio of only 0.5. The researchers tried out the new diet regimen on 20 patients with Crohn's disease who had been using enteral ED therapy for over a month. The patients were allowed to eat the CD diet for lunch or dinner and continued with the ED regimen for the other 2 meals. They were also given nutritional education to emphasize the importance of following the diets. The results were very encouraging. Prior to the introduction of the CD diet 9 out of 10 patients experiences a relapse within one year; on the new regimen only 4 out of the 10 had a flare-up within one year. The researchers conclude that the combination ED and CD diet along with nutritional education is effective in extending the remission periods in Crohn's disease. They also point out that the inclusion of the CD diet prevents the development of nutritional deficiencies often seen in patients on the elemental diet alone.
Tsujikawa, Tomoyuki, et al. Clinical importance of n-3 fatty acid-rich diet and nutritional education for the maintenance of remission in Crohn's disease. Journal of Gastroenterology, Vol. 35, 2000, pp. 99-104