Dietary therapy for small bowel Crohn's disease

PURPOSE OF REVIEW: This review highlights the emerging role of dietary interventions for Crohn's disease (CD). RECENT FINDINGS: An overview of clinical data on dietary strategies for management of CD is presented, including exclusive enteral nutrition, the Crohn's disease exclusion diet (CDED) and the Mediterranean diet, among others. The methodological challenges in performing dietary randomized trials are outlined, including the difficulty in blinding, the multiple components inherent to food interventions and the heterogeneous nature of even 'similar' dietary constituents, collectively making it hard to delineate the responsible mechanism for any observed effect. We also review the data on food supplements explored for this CD treatment, such as vitamin D, omega-3 and combination curcumin-QingDai (CurQD). Novel strategies to integrate personalized nutrition with pharmacologic therapy are discussed and may ultimately improve disease control and patients' long term prognosis and quality of life. Dietary interventions as preventive measures in patients at risk of developing CD are particularly appealing, but are still backed only by association studies, thereby mandating further research before they can be strongly endorsed. SUMMARY: Emerging evidence suggests a range of dietary interventions as potentially effective and safe strategies for management of small bowel CD.