FOOD INTOLERANCE AND CROHNS-DISEASE

It has been claimed that prolonged remissions of Crohn's disease can b e achieved after enteral or parenteral nutrition, by identifying and e xcluding foods that exacerbate a patient's symptoms. The occurrence of food intolerances were assessed after induction of remission with ele mental diet in 42 eligible patients to whom single foods were introduc ed over five days. Suspect foods were reinvestigated with open and if possible, double blind rechallenge. Fourteen patients (33%) dropped ou t of the study because of relapse of disease unrelated to food (n=8) o r because of difficulties in complying with the regimen (n=6). Twenty (48%) of the patients identified food sensitivities whereas eight (19% ) did not. Seventeen of the patients who identified food sensitivities had an open rechallenge with recurrence of symptoms in 10 (24% of tot al). Food sensitivity was confirmed in three patients on double blind challenge. There was no significant difference in the duration of remi ssion between patients who did or did not identify food sensitivities. During the study three cases of intolerance to the formula diet, and one of severe salicylate sensitivity were encountered. In conclusion f ood sensitivities are evident after treatment of Crohn's disease with elemental diet but are variable, often do not persist, and are of insu fficient importance to warrant putting all patients through eliminatio n diets.