Dietary Treatment of Crohn's Disease

Inclusion Criteria

• Documented ileocolonic or colonic CD based on classical history and classical endoscopic or surgical findings and histology compatible with CD;
• Induction of remission with medical therapy within 9 months of the study;
• Inactive CD for at least 2 weeks with CDAI score less than 150;
• No change in IBD medication doses for 3 months;
• No change in smoking habits a month prior to enrollment (because smoking may exacerbate CD) and acceptance of not-changing smoking habits during the term of the study).

Exclusion Criteria

• Patients with history of bowel obstruction and/or known strictures (as the high fiber content may precipitate obstruction);
• Patients with extensive colonic or ileocolonic resection;
• Patients with ileostomies or colostomies with diverted fecal stream;
• Patients with isolated perianal/anorectal disease;
• Patients with surgically induced remission;
• Concomitant infection (e.g., C. difficile colitis);
• Use of antibiotics within 4 weeks, or steroids, herbal remedies or diet therapies within 2 weeks of the onset of the trial or during the study;
• Use of potential IBD exacerbators such as NSAIDs within 1 wk of the study;
• Acute illness requiring immediate hospitalization for CD or other reasons;
• Presence of symptomatic organic GI disease other than CD, hemorrhoids, hiatal hernia; GERD;
• Pre-existent organ failure or severe comorbidities as these may change Gl flora:
• Liver disease (cirrhosis or persistently abnormal AST or ALT that are 2X> normal);
• Kidney disease (creatinine>2.0 mg/dL);
• Uncontrolled psychiatric illness;
• Clinically important lung disease or heart failure;
• HIV disease;
• Alcoholism;
• Transplant recipients;
• Patients receiving other immunosuppressant medications for comorbidities (e.g. Enbrel for rheumatoid arthritis);
• Presence of short bowel syndrome or severe malnutrition with ideal body weight less than or equal to 90% or predicted;
• Estimated survival <1 year and Karnofsky performance status <50%;
• Desire to become pregnant during study or current pregnancy or nursing;
• Desire to change smoking-status during the study;
• Daily use of anticoagulation and antiplatelet medications;
• Complicated IBD with anticipation of imminent surgical intervention during the term of the study;
• Inability to have a regular follow-up and comply with study requirements.