A recent retrospective study (GT Wahbeh et al. JPGN 2017; 65: 289-92) examined seven patients who were receiving a modified specific carbohydrate diet (SCD). While this is a small stud,y there are several lessons in this report and the thoughtful editorial (pg 266-67): “Alas, Who and What Can We Trust? Patients, Parents, Surrogate Markers of the Specific Carbohydrate Diet” by Stan Cohen (one of my partners).
The participants in the study had a median age of 11 yrs and received their mSCD for a median duration of 26 months. Key finding: despite lack of symptoms, all subjects had ongoing active disease on endoscopy; the majority had normal biomarkers: CRP, albumin, and hematocrit and only mildly elevated calprotectin (median 201, range 65-312).
Dr. Cohen notes the following lessons from this study:
- “First, the SCD is very restrictive and young patients often find it difficult to perpetuate”
- “Families are often presumptive about how well they are doing. Significant signs of malnutrition and lack of weight gain may be ignored.”
- Patients often “underreport their symptoms and overrerport their adherence.”
- “Wahbeh et al have taught us…about the lack of effectiveness of a modified SCD [and]…we should use caution in gauging and interpreting patient-reported outcomes and surrogates as well.”
My take: The modified SCD appears to be only partly effective and how this impacts the long-term outcomes for patients is not clear.
Related article: A McCombie. JPGN 2017; 65: 311-13. Summer camp for IBD. This study of 36 participants: “most reported that camp improved their confidence (86%), acceptance (83%), and overall quality of life (75%). 72% endorsed meeting their fellow campers as the most beneficial experience. My take: Camp helps ease social isolation associated with a diagnosis of pediatric IBD.
Related blog posts:
- Camp Oasis: Don’t Tell Me the Sky’s the Limit
- Top Lecture: Enteral Nutrition for Crohn’s Disease | gutsandgrowth
- Practical Advice on Enteral Nutrition | gutsandgrowth
- Eat your veggies…if you don’t want to get sick
- Specific Carbohydrate Diet | gutsandgrowth
- Fiber intake and Crohn’s Disease
- Nutrition in Immune Balance Website