Specific carbohydrate diet may improve symptoms for some IBD patients

A specific carbohydrate diet (SCD) and a modified SCD (MSCD) demonstrate inconsistent effectiveness for the improvement of symptoms in inflammatory bowel disease (IBD), with some patients benefitting and others not, reports a study.

“However, there are inherent difficulties in examining dietary changes that complicate study design and ultimately conclusions regarding effectiveness,” the researchers said.

Patients aged 7‒18 years with IBD and active inflammation were recruited across 19 sites for this study. Following a 2-week baseline (usual diet), participants were randomly assigned to one of two sequences of four alternating 8-week SCD and MSCD periods. Faecal calprotectin and patient-reported symptoms were the outcomes. The researchers reported posterior probabilities from Bayesian models comparing diets.

Of the patients, 21 (39 percent) completed the trial, nine (17 percent) completed a single crossover, and 24 (44 percent) withdrew. Early completion or withdrawal were common due to the following reasons: adverse events (n=11), lack of response (n=11), and not desiring to continue (n=6).

SCD and MSCD had similar effects for most participants, with an average of <1-percent probability of a clinically meaningful difference in IBD symptoms between the two interventions. The average treatment difference was ‒0.3 (95 percent credible interval [CI], ‒1.2 to 0.75).

No significant difference was noted in the ratio of faecal calprotectin geometric means between SCD and MSCD (0.77, 95 percent CI, 0.51‒1.10). Some patients showed improvement in symptoms and faecal calprotectin compared with usual diet, but others did not.