Effect of the Specific Carbohydrate Diet on Inflammatory Bowel Disease: A 5-Year Longitudinal Study

Abstract

Introduction: We previously reported the effects of the Specific Carbohydrate Diet (SCD), a low-complex carbohydrate diet that excludes grains, sugars and starches, in improving extraintestinal and intestinal manifestations of IBD in 12 patients who followed the diet for an average of 19 months. This study assesses the longitudinal effectiveness of the SCD in 8 patients who followed the diet for 66 months. Methods: We collected and analyzed data from 8 patients who followed the SCD for an average of 5.5 years (range 3-10 years). Patient characteristics are shown in Table 1. We used a modified version of the IBDQ, a validated, disease-specific questionnaire, to assess clinical manifestations of disease before and after SCD to determine the diet's impact on disease activity. We also evaluated the effects of the diet on ability to discontinue biologics and immunosuppressive medications. All 8 patients underwent endoscopic evaluation to assess mucosal healing.Table: Table. Patient CharacteristicsResults: The average improvement in modified IBDQ score after implementation of SCD was 62%. The average time to see improvement after starting the diet was 30 days (range 3 days to 4 months). 75% of the patients were compliant with the diet 80-100% of the time, while 25% of patients reported 60-80% compliance. 4 out of 8 patients were able to discontinue biologics or immunosuppressive therapy as a result of the diet. Colonoscopy showed complete mucosal healing in 3 out of 8 patients, and active inflammation but with improvement from pre-SCD colonoscopy in 5 out of 8 patients. Conclusion: Our data confirms that the Specific Carbohydrate Diet is an effective long-term treatment for IBD that can result in improvement of symptoms, mucosal healing, and discontinuation of biologic and immunosuppressive medications.