Persistent symptoms in patients with Crohn’s disease in remission: An exploratory study on the role of diet

Abstract

Objectives: Patients with Crohn’s disease (CD) often report food hypersensitivities with gastrointestinal (GI) symptoms despite being in clinical remission. We aimed to identify the most frequent symptoms and dietary triggers in such patients, and also explored whether a strict elimination diet may reduce their GI symptoms.

Methods: We assessed GI symptoms and dietary triggers in 16 patients with CD in clinical remission. Of these, 12 patients subsequently participated in a dietary intervention trial: two weeks on a habitual diet including wheat and dairy products followed by two weeks of a strict elimination diet. The severity of seven symptoms (overall symptoms, abdominal pain, bloating, abnormal feces, wind, fatigue, and musculoskeletal pain) was measured by using visual analog scales throughout the four weeks intervention period.

Main results: The most common symptoms were abdominal pain, wind, bloating, odorous wind/feces, and diarrhea. Dairy and wheat products were reported as the most frequent dietary symptom triggers. All symptoms improved (p < .05) during the elimination diet period, especially in patients with small intestinal affection.

Conclusion: Our exploratory study suggests that dietary interventions such as an elimination diet may reduce GI symptoms in patients with CD in remission.

Keywords:

• Elimination diet
• FODMAP
• functional gastrointestinal disorders
• inflammatory bowel disease
• irritable bowel syndrome

Disclosure statement

The authors have no competing interests to declare. MJK designed the study, performed the data collection and statistical analyses, and drafted the manuscript. CS performed the statistical analyses and drafted the manuscript. TM-O supervised the study and contributed to data interpretation. POI supervised the study and drafted the manuscript. AGR initiated and supervised the study. JV supervised the study, contributed to data interpretation, and drafted the manuscript. All authors have revised the paper critically and approved the final version.

Additional information

Funding

The study was funded by Lovisenberg Diaconal Hospital.