Exclusion diet may ease refractory ulcerative colitis

An ulcerative colitis exclusion diet (UCED) shows promise as an independent therapy for patients with refractory disease, according to a study published online Sept. 13 in the Journal of Crohn’s and Colitis.

Chen Sarbagili Shabat, from Tel Aviv University in Israel, and colleagues assessed whether integration of novel diets for donors and patients in addition to fecal transplantation (FT) could increase the FT remission rate in refractory ulcerative colitis.

The researchers found that at week 8, clinical steroid-free remission occurred in 11.8 percent of the group with a free diet for both donors and patients (group 1), 21.1 percent of the group with preconditioning of the donors and a UCED for the patients (group 2), and 40 percent of the group with UCED for both donors and patients (group 3). Endoscopic remission occurred in 12 percent of group 1, 16 percent of group 2, and 27 percent of group 3. Only group 3 showed mucosal healing (20 percent). The three groups experienced exacerbation of disease in 17.6, 21.1, and 6.7 percent, respectively.

“If the results of FT were a disappointment in this trial, the effect of the diet was the unexpected silver lining,” the authors write. “The UCED appeared to be quite effective in some of our patients as 40 percent of patients failing medical therapy entered clinical remission and only one patient had worsening of disease after starting the diet.”