An estimated 3 million adults in the United States have inflammatory bowel disease (IBD), including Crohn’s disease, according to the Centers for Disease Control and Prevention. Crohn’s is a chronic disease of the digestive tract that can cause severe symptoms and complications, wreaking havoc on patients’ lives.
While there are medications that doctors can prescribe for the management of Crohn’s symptoms, it can be tricky to find one that works for you. Additionally, side effects can be challenging. Many people attempt to manage symptoms and avoid flares through their diet as well. But unfortunately, there’s no good evidence for a specific diet to help manage Crohn’s disease — yet.
Researchers have launched a clinical research study, funded by the Foundation and the Patient-Centered Outcomes Research Institute (PCORI), to help remedy this issue. The study, called DINE-CD, is the first-ever national randomized trial of two dietary interventions to treat Crohn’s disease.
HealthCentral spoke with James Lewis, M.D., the primary investigator of DINE-CD, about the study’s goals and the important role diet plays in Crohn’s treatment.
HealthCentral (HC): What are the goals of DINE-CD?
Dr. Lewis: As a physician who treats patients with IBD, [I see] patients come to the office all the time and say, “What should I be eating?” I don’t always know the answer to that question. In fact, I rarely know the answer to that question. So DINE-CD is trying to get us an answer.
Specifically, we’re going to compare head-to-head two different diets. One is an all organic, additive-free Mediterranean diet, [and one is] an all organic, additive-free, more restrictive diet referred to as specific carbohydrate diet. We’re going to find out whether one or the other diet is more effective at improving not just the symptoms but also the inflammation related to Crohn’s disease.
HC: What would be the impact of developing effective strategies to manage IBD through diet and without medication?
Dr. Lewis: That’s a great question. I think that diet, for many patients, will be an add-on to medication, but it may allow them to reduce the number of medications that they need to take. And for selective patients, we may be able to identify [some] who can manage their IBD with diet alone and not need to be on medications.
The real benefit in either of these scenarios is that most of the medications we use today suppress the immune system. And so to the extent that we can keep the disease under control without having to have as much suppression of the immune system, that would probably be better for everybody.
HC: How can Crohn’s patients get involved with the DINE-CD trial and other clinical trials?
Dr. Lewis: I think the most important thing that [a patient] can do is find one of our participating sites and enroll in the trial because we really need scientifically sound evidence to know how to manage Crohn’s using diet. And for that, they can go to ClinicalTrials.gov and put in the search term “DINE-CD” and it will show you the many potential sites that are participating.
HC: What is the timeline for the study?
Dr. Lewis: We’re in the middle of enrolling participants, and we anticipate enrolling participants for another [several] months, and then, like all research, it takes a little bit of time after that to get to the results. So hopefully, [in late 2019,] we’ll have some of the early results of the trial.
HC: While the study results won’t be compiled for some time, what can other people with Crohn’s safely do right now to manage their disease with diet and nutrition?
Dr. Lewis: [One] strategy is to basically keep track of those foods that seem to make you better or worse, and then gradually modify your diet starting with the things that you think make you feel better and adding in additional foods along the way.
[This interview has been condensed and edited.]