title: Specific carbohydrate diet for pediatric inflammatory bowel disease in clinical practice within an academic IBD center.
abstract: OBJECTIVE
  Despite dietary factors being implicated in the pathogenesis of inflammatory bowel disease (IBD), nutritional therapy, outside of exclusive enteral nutrition (EEN), has not had a defined role within the treatment paradigm of pediatric IBD within IBD centers. Based on emerging data, Seattle Children's Hospital IBD Center has developed an integrated dietary program incorporating the specific carbohydrate diet (SCD) into its treatment paradigm. This treatment paradigm uses the SCD as primary therapy as well as adjunctive therapy for the treatment of IBD. The aim of this study was to evaluate the potential effects of the SCD on clinical outcomes and laboratory studies of pediatric patients with Crohn's disease (CD) and ulcerative colitis (UC).
  
  
  METHODS
  In this retrospective study, we reviewed the medical records of patients with IBD on SCD.
  
  
  RESULTS
  We analyzed 26 children on the SCD: 20 with CD and 6 with UC. Duration of the dietary therapy ranged from 3 to 48 mo. In patients with active CD (Pediatric Crohn's Disease activity index [PCDAI] >10), PCDAI dropped from 32.8 ± 13.2 at baseline to 20.8 ± 16.6 by 4 ± 2 wk, and to 8.8 ± 8.5 by 6 mo. The mean Pediatric Ulcerative Colitis Activity Index for patients with active UC decreased from a baseline of 28.3 ± 10.3 to 20.0 ± 17.3 at 4 ± 2 wk, to 18.3 ± 31.7 at 6 mo.
  
  
  CONCLUSIONS
  This retrospective review provides evidence that the SCD can be integrated into a tertiary care center and may improve clinical and laboratory parameters for pediatric patients with nonstructuring, nonpenetrating CD as well as UC. Further prospective studies are needed to fully assess the safety and efficacy of the SCD in pediatric patients with IBD.
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Chinonyelum
authors.initials: C
authors.lastname: Obih
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Wahbeh
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Dale
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Braly
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Giefer
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA; Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Shaffer
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Nielson
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA, USA. Electronic address: David.Suskind@seattlechildrens.org.
authors.forename: David L
authors.initials: DL
authors.lastname: Suskind
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000178:diet therapy*; D003424:Crohn Disease / Q000178:diet therapy*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates
keywords: CAM; Complementary and alternative medicine; Crohn's disease; Dietary therapy; IBD; Inflammatory bowel disease; Low complex carbohydrate; Nutritional therapy; Pediatrics; Specific carbohydrate diet; Ulcerative colitis