title: Elemental diet in steroid-dependent and steroid-refractory Crohn's disease.
abstract: Sixteen patients with Crohn's disease who had symptoms uncontrolled by high-dose steroids (n = 11) or symptoms invariably appearing on reduction or withdrawal of immunosuppressive therapy (n = 5) were treated with elemental diet. After 4 wk of dietary treatment, 10 patients were in remission and off all medication. Seven continued to be well without treatment for a minimum of 6 months, and four for at least 1 yr. No patient who subsequently relapsed had further steroid-refractory symptoms. Of the six patients failing to respond to elemental diet, four with steroid-refractory disease required early resective surgery for symptom relief, and two continued with steroid therapy, one in much reduced dosage. Elemental diet can bring about a sustained remission in many patients with Crohn's disease dependent on or refractory to corticosteroids, and reduce the need for surgical intervention.
authors.affiliation: Gastroenterology Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Brien
authors.forename: M H
authors.initials: MH
authors.lastname: Giaffer
authors.forename: P A
authors.initials: PA
authors.lastname: Cann
authors.forename: C D
authors.initials: CD
authors.lastname: Holdsworth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D003424:Crohn Disease / Q000178:diet therapy* / Q000188:drug therapy; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005503:Food Additives / Q000008:administration & dosage; D005526:Food, Formulated; D006801:Humans; D008297:Male; D008875:Middle Aged; D009930:Organic Chemicals; D011239:Prednisolone / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D005503:Food Additives; D009930:Organic Chemicals; C011567:Vivonex; D011239:Prednisolone; D001379:Azathioprine