Researchers studied 34 people with Crohn’s disease who weren’t responding well to a newer medication called ustekinumab. They split the group into two: one taking just the medication, and another taking the medication plus a special partial nutrition diet (a mix of regular food and medical nutrition drinks). After 8 months, the group combining both treatments showed much better improvement in their symptoms and nutrition levels than the medication-only group. This suggests that adding a specialized diet might help people whose Crohn’s disease doesn’t improve with medication alone.

The Quick Take

  • What they studied: Whether adding a special partial nutrition diet to a Crohn’s disease medication (ustekinumab) works better than just taking the medication alone
  • Who participated: 34 adults with Crohn’s disease who weren’t getting better with ustekinumab alone, treated at one hospital in China over one year
  • Key finding: People who combined the medication with the special diet improved about 2.7 times more than those taking medication alone. Their disease activity scores dropped by 83 points compared to 30 points in the medication-only group
  • What it means for you: If you have Crohn’s disease and aren’t improving with medication, adding a specialized nutrition plan might help you feel better. However, talk to your doctor before making changes, as this was a small study and results may vary by person

The Research Details

This was a retrospective study, meaning researchers looked back at medical records from patients already treated at a hospital. They reviewed 34 people with Crohn’s disease who received ustekinumab treatment between March 2023 and March 2024. The patients were naturally divided into two groups based on what their doctors recommended: 23 people took just the medication, while 11 people took the medication plus a special partial enteral nutrition diet (PEN). The researchers compared how well each group did over 8 months, measuring disease symptoms, nutrition levels, and blood markers of inflammation.

Partial enteral nutrition is a medical diet that provides some nutrition through specially formulated drinks while allowing regular food intake. It’s designed to reduce inflammation in the digestive system while still providing necessary nutrients. The study measured multiple health markers at the beginning and end of the 8-month period to see which approach worked better.

This research approach matters because it reflects real-world medical practice. Many people with Crohn’s disease don’t respond well to medication alone, and doctors need practical solutions. By comparing two actual treatment approaches used in a real hospital, the study shows what might work in everyday medical care rather than just in controlled laboratory conditions.

This study has some important limitations to understand. It’s relatively small (34 people) and looked backward at existing medical records rather than randomly assigning people to treatments. The groups weren’t perfectly matched at the start, which could affect results. However, the study does show clear differences between groups and measured multiple health markers, which strengthens the findings. The results are encouraging but should be confirmed with larger, more controlled studies before making major treatment changes.

What the Results Show

The medication-only group showed improvement in their disease activity scores and protein levels (albumin) after 8 months. However, the group combining medication with the special diet showed much more dramatic improvements. Their disease activity scores dropped by an average of 83 points compared to 30 points in the medication-only group—nearly three times better.

The combination group also showed better improvements in blood markers related to nutrition and inflammation. Specifically, their hemoglobin (oxygen-carrying protein) and albumin (nutritional protein) levels improved significantly, and their inflammation markers improved more than the medication-only group.

The researchers also found that patients whose medication levels in the blood reached a certain threshold (1.975 micrograms per milliliter) had better outcomes. This suggests that the medication needs to reach adequate levels in the body to work effectively, and the special diet may help support this.

The special diet appeared to help reduce inflammation markers in the blood more effectively than medication alone. A specific inflammation marker called the Neutrophil-to-Lymphocyte Ratio improved significantly in the combination group but not in the medication-only group. This suggests the diet may have anti-inflammatory effects that complement the medication’s action.

Previous research has shown that partial enteral nutrition can help reduce inflammation in Crohn’s disease, but most studies focused on it as a standalone treatment. This research is novel because it combines the special diet with a newer biologic medication. The findings align with earlier research suggesting that nutrition-based approaches can support medication effectiveness, but this is one of the first studies specifically examining this combination with ustekinumab.

The study is relatively small with only 34 participants, which limits how much we can generalize the findings to all Crohn’s disease patients. The groups weren’t randomly assigned to treatments—instead, doctors chose which approach based on their judgment, which could introduce bias. The study only lasted 8 months, so we don’t know if benefits continue long-term. Additionally, the study was conducted at a single hospital in China, so results may differ in other populations or healthcare settings. Finally, the researchers didn’t measure patient compliance with the diet, so we don’t know if everyone followed the nutrition plan equally well.

The Bottom Line

If you have Crohn’s disease that isn’t responding well to ustekinumab alone, discuss with your gastroenterologist whether adding a partial enteral nutrition plan might help (moderate confidence based on this small study). The combination approach showed significantly better results than medication alone in this research. However, this should be done under medical supervision, as individual responses vary. Don’t stop or change your medication without talking to your doctor first.

This research is most relevant for people with Crohn’s disease who aren’t improving adequately with ustekinumab treatment alone. It may be less relevant for those responding well to medication or those with different types of inflammatory bowel disease. People with severe malnutrition or other medical conditions should discuss this approach with their healthcare team, as the special diet requires medical supervision.

Based on this study, improvements in disease activity and nutrition markers appeared within 8 months of starting the combined treatment. However, some benefits like improved blood protein levels may take several weeks to appear. Individual timelines vary, and you should expect to work with your doctor to monitor progress over months rather than weeks.

Want to Apply This Research?

  • Track your Crohn’s disease activity daily using a simple symptom score (1-10 scale for pain, bowel movements, and energy levels) and weekly nutrition markers like appetite and food tolerance. Compare these metrics monthly to see if the combined approach is working for you.
  • If your doctor recommends this approach, use the app to log your partial enteral nutrition intake (the medical nutrition drinks and food combinations), medication timing, and daily symptoms. Set reminders for medication doses and nutrition drink consumption to ensure consistency, which appears important for success.
  • Create a monthly dashboard showing trends in symptom severity, nutrition intake compliance, and energy levels. Share this data with your healthcare provider during appointments to help them assess whether the combination treatment is working and make adjustments if needed. Track any side effects or challenges with the special diet to discuss with your medical team.

This research describes a small study of 34 patients and should not replace professional medical advice. If you have Crohn’s disease, consult your gastroenterologist before making any changes to your treatment plan, including adding nutritional interventions. The findings are promising but need confirmation in larger studies. Individual responses to treatment vary significantly, and what works for one person may not work for another. Never stop or modify prescribed medications without medical supervision. This information is for educational purposes and does not constitute medical advice.