title: Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease.
abstract: To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD).
  
  
  
  IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation.
  
  
  
  Pediatric patients with mild to moderate IBD defined by pediatric Crohn's disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD. Patients started SCD with follow-up evaluations at 2, 4, 8, and 12 weeks. PCDAI/PUCAI, laboratory studies were assessed.
  
  
  
  Twelve patients, ages 10 to 17 years, were enrolled. Mean PCDAI decreased from 28.1±8.8 to 4.6±10.3 at 12 weeks. Mean PUCAI decreased from 28.3±23.1 to 6.7±11.6 at 12 weeks. Dietary therapy was ineffective for 2 patients while 2 individuals were unable to maintain the diet. Mean C-reactive protein decreased from 24.1±22.3 to 7.1±0.4 mg/L at 12 weeks in Seattle Cohort (nL<8.0 mg/L) and decreased from 20.7±10.9 to 4.8±4.5 mg/L at 12 weeks in Atlanta Cohort (nL<4.9 mg/L). Stool microbiome analysis showed a distinctive dysbiosis for each individual in most prediet microbiomes with significant changes in microbial composition after dietary change.
  
  
  
  SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: David L
authors.initials: DL
authors.lastname: Suskind
authors.affiliation: Children's Center for Digestive Health Care, and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Stanley A
authors.initials: SA
authors.lastname: Cohen
authors.affiliation: Departments of Microbiology.
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Brittnacher
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Wahbeh
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: Dale
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.|Center for Clinical and Translational Research, Seattle Children's Research Institute.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Shaffer
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Braly
authors.affiliation: Departments of Microbiology.
authors.forename: Hillary S
authors.initials: HS
authors.lastname: Hayden
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: Jani
authors.initials: J
authors.lastname: Klein
authors.affiliation: Children's Center for Digestive Health Care, and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gold
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Seattle Children's Hospital and University of Washington.
authors.forename: Matthew
authors.initials: M
authors.lastname: Giefer
authors.affiliation: Children's Center for Digestive Health Care, and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Angela
authors.initials: A
authors.lastname: Stallworth
authors.affiliation: Departments of Microbiology.|Laboratory Medicine.|Medicine.|Immunology.|Genome Sciences, University of Washington, Seattle, WA.
authors.forename: Samuel I
authors.initials: SI
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003093:Colitis, Ulcerative / Q000178:diet therapy* / Q000503:physiopathology; D003424:Crohn Disease / Q000178:diet therapy* / Q000503:physiopathology; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D064806:Dysbiosis / Q000178:diet therapy*; D005243:Feces / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D004040:Dietary Carbohydrates; D002097:C-Reactive Protein