How effective is the use of the elemental diet compared to corticosteroid therapy in the management of crohn's disease?

5^th Annual Congress on Gastroenterology & Hepatology

August 20-21, 2021 | Webinar

Salaam motin

Norwich medical school, NR4 7TJ, United Kingdom

Scientific Tracks Abstracts: cgj

Abstract :

Introduction: Crohn’s disease is an inflammatory bowel disease causing transmural inflammation within the gastrointestinal tract. Corticosteroid therapy is used to treat exacerbations of crohn’s but has many side effects. The elemental diet, containing essential basic nutrient forms is a recognised alternative treatment.1 This research explores its effectiveness and investigate potential mechanisms. Methods: Two randomised control trials found with 3 MESH terms (“Foods, Formulated”, “Crohn disease”, “steroids”, yielding 87 results) comparing the elemental diet and corticosteroids since RCTs provide the highest hierarchy of evidence. Both compared the two treatments for acute management, and one compares them for long term management too, making them useful to investigate the effectiveness of the elemental diet. The first involves 21 acutely ill patients with an exacerbation of crohn’s disease randomly allocated to receive prednisolone 0.75mg/kg/day or and elemental diet for 4 weeks.2 The second trial was similar, looking at 42 patients with active disease and built on the relationship by assessing the probability of maintaining remission at 6 months.4 Results: The elemental diet was observed to reduce disease activity in Crohn’s and there was no statistical difference compared to corticosteroids (p>0.05). However, the probability of retaining remission on the elemental diet at 6 months was 0.28 and 0.67 with prednisolone (p<0.05). Conclusions: Overall, both studies indicate that the elemental diet is as effective as corticosteroid therapy in the management of crohn’s disease through repairing immune barrier function, though the full mechanism is uncertain.4 However, larger study sizes with more follow up periods are needed.

Biography :

Salaam Motin is a 23 year old medical graduate from Norwich medical school (MBBS) and will start his role as a foundation year one junior doctor at Ipswich general hospital. He has a specialist interest in neurology and is currently undertaking a clinical audit at a large regional hospital in Norwich into improving the flow of services within the local Neurology department.