Researchers studied 60 children with Crohn’s disease, a condition that causes stomach inflammation and pain. They tested whether a special diet called CDED worked better when combined with a nutritional drink (PEN) compared to the diet alone. After 8 weeks, both groups showed improvements in their gut bacteria, but the group using the diet plus the nutrition drink had much better results. The good bacteria in their stomachs increased more, and the harmful bacteria decreased more. This suggests that combining the diet with the nutrition drink might be a practical way to help kids with Crohn’s disease feel better.

The Quick Take

  • What they studied: Whether a special diet for Crohn’s disease works better when kids also drink a medical nutrition supplement, and how these approaches change the bacteria living in their stomachs.
  • Who participated: 60 children with mild-to-moderate Crohn’s disease were split into two groups: one group followed a special diet only, and the other group followed the same diet plus drank a medical nutrition supplement for 8 weeks.
  • Key finding: Kids who used the diet plus the nutrition drink had much bigger improvements in their gut bacteria. The good bacteria increased 79% more in this group, and harmful bacteria decreased significantly more compared to diet alone.
  • What it means for you: If your child has Crohn’s disease, combining a special diet with a medical nutrition drink may help their stomach feel better by improving their gut bacteria. However, this is a small study, so talk to your doctor before making changes to your child’s treatment plan.

The Research Details

This was a randomized controlled trial, which is one of the strongest types of medical research. Researchers randomly divided 60 children with Crohn’s disease into two equal groups. One group followed a special diet called CDED (Crohn’s Disease Exclusion Diet) for 8 weeks. The other group followed the same CDED diet but also drank a medical nutrition supplement called PEN (Partial Enteral Nutrition) during the same 8 weeks. Before and after the 8-week period, researchers tested the children’s stool samples to count and identify the different types of bacteria living in their stomachs. They used a special lab technique called quantitative PCR to measure exactly how many bacteria of each type were present.

Understanding how diet changes the bacteria in the stomach is important because these bacteria affect how well the immune system works and how much inflammation happens in the gut. By measuring the bacteria directly, researchers can see if a treatment is actually working at the biological level, not just whether kids feel better. This helps doctors understand which treatments are most likely to help children with Crohn’s disease in the long term.

This study is a randomized controlled trial, which is a strong research design. The researchers randomly assigned children to groups, which reduces bias. However, the study only included 60 children and lasted only 8 weeks, which is relatively short. The results should be confirmed with larger studies that follow children for longer periods. The study was published in a peer-reviewed journal, meaning other scientists reviewed it before publication.

What the Results Show

Both groups of children showed improvements in their gut bacteria after 8 weeks, but the group using the diet plus nutrition drink had much better results. The most important good bacteria, called Faecalibacterium prausnitzii, increased in both groups, but increased 79% more in the diet-plus-drink group compared to the diet-only group. In the diet-plus-drink group, two other types of good bacteria called Bifidobacterium and Lactobacillus also increased significantly. In the diet-only group, Bifidobacterium actually decreased slightly, and Lactobacillus barely increased. Additionally, harmful bacteria called E. coli and Fusobacterium decreased much more in the diet-plus-drink group than in the diet-only group. These changes suggest that combining the diet with the nutrition drink creates a healthier balance of bacteria in the stomach.

Two other types of bacteria called Clostridium leptum and Ruminococcus showed only small changes in both groups, and these changes were not statistically significant. This means these bacteria didn’t respond much to either treatment. The overall pattern suggests that the combination of diet plus nutrition drink works better at promoting good bacteria and reducing harmful bacteria compared to diet alone.

This is the first study to directly compare the CDED diet alone with CDED plus a nutrition drink in children with Crohn’s disease by looking at gut bacteria. Previous research has shown that exclusive enteral nutrition (where children drink only medical nutrition and eat no food) can help Crohn’s disease, but it’s difficult for children to follow. This study suggests that combining a regular diet with a nutrition supplement might work almost as well and be easier for families to manage.

This study had several limitations. First, only 60 children participated, which is a relatively small number. Larger studies with more children would give more reliable results. Second, the study only lasted 8 weeks, which is a short time to see if benefits continue. Third, the study measured bacteria in stool samples but didn’t measure whether the children’s symptoms actually improved or whether they had fewer disease flare-ups. Finally, the study didn’t follow the children after the 8 weeks ended, so we don’t know if the improvements lasted.

The Bottom Line

For children with mild-to-moderate Crohn’s disease, combining the CDED diet with a medical nutrition supplement (PEN) appears to produce better changes in gut bacteria than the diet alone. However, this finding is based on one small study, so it should be considered preliminary. Parents should discuss these results with their child’s gastroenterologist before making treatment changes. The evidence suggests this approach is worth considering, but more research is needed to confirm these benefits and determine long-term outcomes.

This research is most relevant to children with mild-to-moderate Crohn’s disease and their families. It may also interest gastroenterologists and nutritionists who treat children with inflammatory bowel disease. People with other types of inflammatory bowel disease (like ulcerative colitis) should not assume these results apply to them without consulting their doctor. Adults with Crohn’s disease should also consult their doctor, as this study only included children.

The study showed changes in gut bacteria after 8 weeks. However, it’s unclear how long these improvements last or when children might notice symptom improvements like reduced pain or better digestion. Most children would likely need to follow this approach for at least several weeks to see benefits, but individual results may vary. Talk to your child’s doctor about realistic expectations for your specific situation.

Want to Apply This Research?

  • Track daily adherence to the CDED diet and nutrition supplement intake (yes/no for each day), plus weekly notes on digestive symptoms like stomach pain, bloating, and bowel movement frequency on a scale of 1-10.
  • If using an app to manage Crohn’s disease, set daily reminders to drink the medical nutrition supplement at the same time each day, and log which CDED-approved foods were eaten at each meal to ensure diet compliance.
  • Use the app to record weekly summaries of symptom changes and create a monthly report comparing symptoms to diet and supplement adherence. Share this data with your child’s doctor to track whether the combination approach is working for your specific situation.

This research describes findings from a single 8-week study in children with mild-to-moderate Crohn’s disease. These results should not be used to replace medical advice from your child’s doctor. Before making any changes to your child’s diet or treatment plan, including starting the CDED diet or a medical nutrition supplement, consult with your child’s gastroenterologist or healthcare provider. Individual results vary, and what works for one child may not work for another. This summary is for educational purposes only and is not medical advice.