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Research into two novel approaches to managing and treating Crohn’s disease may lead to dramatic improvements for children and young people with the condition
A new food-based dietary treatment for Crohn’s disease may help children and young people stay symptom-free for longer, a new clinical trial has found.
Children from Ireland and around the world took part in the major study, which investigated the role a Crohn’s disease exclusion diet (CDED) could play in the health of young patients with the condition.
“Crohn’s Disease can make life really hard for children, young people and their families,” said Prof Séamus Hussey, who is a Consultant Gastroenterologist at CHI and a researcher on the study.
“Until now, one of the best treatments we had to offer is called Exclusive Enteral Nutrition (EEN), where children drink only special liquid nutrition for six to eight weeks. This is a very effective treatment, kick starting a reduction in inflammation and a return to health in most children.
“These strict diets can be extremely hard for children and families to follow however, because of limited choices and bland tastes. Many families struggle to follow these strict diets, and symptoms can return.”
The study, which involved 56 children and was recently published in the journal Clinical Gastroenterology and Hepatology, found that just two weeks of EEN followed by CDED was effective in inducing remission in Crohn’s disease, with most CDED patients maintaining remission up to 24 weeks.
Prof Hussey added: “It is with huge thanks to our participating patients, families, staff and funders that, for the first time, we have shown that a longer-term dietary therapy helps to treat certain patients with Crohn’s disease. This takes our treatment options from the medicine cupboard to the kitchen table, which promises huge impact for children and their families.”
Meanwhile, a separate study found that a surgical approach first developed in Limerick could have a global impact on the treatment of the disease.
It is estimated that around 80 per cent of patients with Crohn’s will need surgery at some point to treat the condition. Around 40 per cent of those will require repeat surgery.
However, a new surgical approach, which involves the removal of the mesentery, has been shown to reduce the possibility that follow-up operations will be needed in around four per cent of patients.
The research was led by University of Limerick Professor of Surgery John Calvin Coffey, and was recently published in the journal Gastroenterology.
The findings build on the scientific advances the group made on the mesentery, an organ in which all digestive organs of the abdomen develop and then remain connected to.
The research looked at relapse of Crohn’s disease in the inner lining of the intestine, which generally occurs very quickly after initial surgery for the disease.
The randomised control trial found that patients who had conventional surgery tended to suffer high rates of relapse, but that patients who had surgery performed using the new approach, had lower relapse rates – from around 46 per cent down to just 23 per cent of patients.
The trial also looked at the severity of relapse in the inner lining and found that for each grade of severity, relapse was reduced in patients in whom the mesentery was also removed.
“The results mean the approach developed in Limerick could become standard practice in the management of patients with Crohn’s disease,” said Prof Coffey, who pointed out that Crohn’s patients requiring surgery are young adults. “As a result of the disease, they are committed to an awful reality during this very important time.
He added: “This study is further support for the fact that surgery in which the mesentery is removed reduces the need for readmissions, repeated medications and the requirement for reoperation in patients with Crohn’s disease. So this is very positive news indeed for patients with Crohn’s disease and for their families.” 
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