Hypothesis summary
Crohn's disease (CD) is a chronic inflammatory condition with phases where the disease is active and other, where there are no symptoms. Exclusive enteral nutrition (EEN), a liquid only diet without allowance of any extra food, is the main treatment for children with active CD. However, when children stop the liquid diet and return to their normal diet, most of them will experience an increase in their gut inflammation, mostly without symptoms initially. The overarching hypothesis of this study is that the dietary components reintroduced after completion of EEN reactivate gut inflammation and trigger disease relapse. A secondary hypothesis is that the Crohn's Disease TReatment with EATing (CD-TREAT) diet, a food-based diet with similar nutritional profile and impact on gut microbiome as EEN, will moderate the rise in gut inflammation following treatment with EEN.
Primary objective:
Characterise the diet of children with CD during the early phase of food reintroduction, following completion of successful treatment with EEN, and explore relationships with faecal calprotectin (FCAL) rise, changes in host immune signatures and the gut microbiome and metabolome.
Secondary objectives:
A) Test whether CD-TREAT, an ordinary food-based diet with similar nutritional composition and effects on the gut microbiome as EEN could attenuate FCAL rise during food reintroduction, in comparison to a control group on unrestricted diet.
B) Compare changes in the faecal microbiome, metabolome and the host immune signatures between the two interventions.