Seattle Children's Hospital and the SCD

Last week the Journal of Pediatric Gastroenterology and Nutrition published a paper titled Nutritional Therapy in Pediatric Crohn's Disease: The Specific Carbohydrate Diet.

This paper describes how doctors at the Seattle Children's Hospital evaluated the medical records of 7 children with Crohn's disease who used the SCD.  The ages of the children ranged from 7 to 16 years old.  The authors write:

"all symptoms were notably resolved at a routine clinic visit three months after initiating the diet [SCD]"

Resolution of all symptoms?  How were these children before starting the diet?  Since SCD studies are rare, this paper is definitely of interest to parents thinking of starting the diet. 

Information below describes the children's disease severity, medications (if any), and initial symptoms.  (Note: none of the patients had "penetrating or stricturing disease.")

Based on microscopic checks of their biopsies, the severity of the children's Crohn's inflammation was as follows:

  • 2 severe cases
  • 3 with moderate disease
  • 2 mild cases

In terms of medications, none of these patients received immunosuppressants (Remicade, Humira, Azathioprine, etc).  Levels of other medical treatment varied:

  • 3 started the SCD soon after diagnosis and received no other treatment
  • 2 patients received only entereal nutrition (tube feeding) for 2 months and then transitioned to the SCD
  • 1 began the SCD when mesalamine did not help
  • 1 began the SCD when neither prednisone nor mesalamine helped.  For this patient, the mesalamine was continued with the SCD

Regarding supplementation, the study notes that 2 patients took "over-the-counter supplements" but does not mention the types.   (Were they vitamins? probiotics? etc)

A list of initial symptoms included:

  • 4 suffering from abdominal pain
  • 4 children had lost weight
  • 4 had "blood per rectum"
  • 2 presented with chronic diarrhea
  • 3 complained of fatigue
  • All had at least one granuloma (cluster of inflammatory cells that confirm CD--they don't happen in ulcerative colitis)

This is a small study but it is notable in that:

  • The symptoms of all children resolved for a disease that supposedly cannot be helped by diet
  • All children had thorough medical tests (biopsies) and record checks

Suskind, D. L., Wahbeh, G., Gregory, N., Vendettuoli, H., & Christie, D. (2013). Nutritional Therapy in Pediatric Crohn’s Disease: The Specific Carbohydrate Diet. Journal of pediatric gastroenterology and nutrition, 98105. doi:10.1097/MPG.0000000000000103

http://www.ncbi.nlm.nih.gov/pubmed/24048168