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.Conclusion 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.
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The specific carbohydrate diet was developed in the 1930s for patients with celiac disease but is also employed to treat Crohn's disease, ulcerative colitis, diverticulitis, and chronic diarrhea.
“The SCD was developed in the 1930s as a dietary protocol intended for patients with celiac disease [111] but it is also employed to treat Crohn’s disease, ulcerative colitis, diverticulitis and chronic diarrhea [112,113,114].”
From Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions (2019) · cites this paper as [114]
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“However, further research is needed to investigate the use of the SCD with larger and more diverse samples, to assess its safety and efficacy, and to understand the mechanisms underlying its effects (Cohen et al., 2014; Obih et al., 2016; Suskind et al., 2014).”
BackgroundFood as Treatment of Inflammatory Bowel Diseases
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Let Food Be Thy Medicine—Its Role in Crohn’s Disease
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- Authors
- Obih, C., Wahbeh, G., Lee, D., Braly, K., Giefer, M., Shaffer, M. L., Nielson, H., & Suskind, D. L.
- Affiliations
- Seattle Children's Hospital (US)
- Corresponding author
- Suskind, David L.
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 32
- Issue
- 4
- Pages
- 418-425
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W1858794165
- Cited by
- 171
- References
- 23
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 14 · 2023: 19 · 2022: 16 · 2021: 17 · 2020: 12 · 2019: 26 · 2018: 12 · 2017: 23 · 2016: 10
- FWCI
- 10.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- specific carbohydrate diet, pediatric inflammatory bowel disease, Crohn's disease, ulcerative colitis, dietary therapy, nutritional therapy, Pediatric Crohn's Disease Activity Index, clinical outcomes
- MeSH terms
- Adolescent, Child, Child, Preschool, Colitis, Ulcerative, Crohn Disease, Diet, Dietary Carbohydrates, Female, Humans, Infant, Male, Retrospective Studies, Young Adult
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