Israeli Study Finds Nutrition More Effective Than Steroids for Treating Crohn’s Disease
A 15-year study by Israeli researchers found that nutrition is a more effective treatment for children with Crohn’s disease than the steroids commonly used.
Research leaders Luba Plotkin and Rona Kiden Photo by Shaarei Zedek
Crohn’s disease and the more severe ulcerative colitis cause inflammation of the tissues in the digestive tract. Symptoms can include abdominal pain, severe diarrhea, fatigue, weight loss, malnutrition, loss of appetite and bloody stools. It is characterized by periods of relaxation and periods of flare-ups which are traditionally managed by steroids and avoiding foods that can cause new outbursts.
In the US, around 90,000 children and 1.3 million adults are believed to suffer from Crohn’s and colitis. It’s not clear what the causes are, but genetic factors and problems with the immune system are widely attributed.
The study — which was carried out by the Children’s Gastroenterology Institute at Shaare Zedek Medical Center in Jerusalem — included all children diagnosed in Israel with Crohn’s in the last 15 years. Researchers examined the effect of nutritional therapy versus steroids on the course of the disease in the first two years from diagnosis.
In Israel, the prevalence of inflammatory bowel diseases is increasing and today stands at about 0.6% of the population, with about 17% being diagnosed in childhood, so growth impairment can be seen in about half of the children.
Of the 785 Israeli children diagnosed with Crohn’s in Israel and treated with nutrition or steroids, 232 were included in the analysis after pairing that allowed a comparison of patients with identical characteristics.
The results showed that children treated with nutrition had a lower chance of needing surgery in the first two years of the disease. On the other hand, the children treated with steroids needed more steroids and biological drugs (31% with a complex procedure compared to 17% with nutrition).
Children treated with steroids were more likely to be hospitalized (27% vs. 15%).
The researchers also found that children who were treated with nutrition showed a significant improvement in their height indices and not in the children who received steroids. Additionally, protein levels and the degree of anemia — which are measured in the blood and shed light on a child’s nutritional well-being — improved in the months after the intervention significantly more in those treated with nutrition compared to steroids.
For Israeli children and adults interested in nutritional therapy, a new Shaarei Zedek study on a “tasty and healthy” diet to manage the disease is recruiting patients, and is taking place at around 20 medical centers around Israel. A number of hospitals around the world are also participating.
