Perceptions towards established and novel dietary therapies for Crohn’s disease management among adult patients: results from a questionnaire survey

Jatkowska, A., White, B., Jaskolski, P., Nichols, B., Brownson, E., Clowe, J., Seenan, J. P. , Gerasimidis, K. and Macdonald, J. (2024) Perceptions towards established and novel dietary therapies for Crohn’s disease management among adult patients: results from a questionnaire survey. Crohn's and Colitis 360, 6(1), otae008. (doi: 10.1093/crocol/otae008) (PMID:38464347) (PMCID:PMC10924435)

Abstract

Background: Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN) remain the only established dietary therapies in Crohn’s disease (CD) management. We conducted a questionnaire survey to evaluate the perceptions of adults with CD toward established and emerging food-based dietary therapies. Methods: A 26-question anonymous survey was mailed to 300 adults receiving biologic treatment. Two researchers independently conducted a thematic analysis of open-ended responses. Machine learning with the Random Forest–Recursive Feature Elimination algorithm identified predictors of willingness to try dietary therapies. Results: One hundred and sixty patients (53% female) completed and returned the survey. Forty-two percent were following some form of exclusion diet, with low-spice and low-fiber diets being the most popular. Although only a quarter of patients believed that EEN/PEN could help with their CD, more than half believed that diet could help, with another 13% already using diet for CD management. While half of the patients were willing to try EEN, the majority were willing to try PEN instead (51% vs. 79%; P < .001). Forty-two percent of patients preferred food-based dietary plans prepared at home over EEN/PEN options. The most important predictors for willingness to try dietary therapies were age (25–65 years), recent symptoms, previous exposure to EEN/PEN, and current exclusion diet use. The top concerns about PEN were taste/palatability, satiety/hunger, and taste fatigue. Conclusions: Most adults preferred to follow a food-based dietary therapy over EEN/PEN. The majority would try PEN though which allows for more flexibility to incorporate in habitual diet and may be easier to comply with than the EEN.

• Item Type: Articles
• Keywords: Crohn’s disease, enteral nutrition, exclusion diets, dietary therapies, patient-centred care.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: White, Ms Bernadette and Macdonald, Dr Jonathan and Clowe, Ms Jennifer and Seenan, Dr John and Jatkowska, Aleksandra and Brownson, Dr Emily and Nichols, Mr Ben and Gerasimidis, Professor Konstantinos
• Authors: Jatkowska, A., White, B., Jaskolski, P., Nichols, B., Brownson, E., Clowe, J., Seenan, J. P., Gerasimidis, K., and Macdonald, J.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Crohn's and Colitis 360
• Publisher: Oxford University Press
• ISSN: 2631-827X
• ISSN (Online): 2631-827X
• Published Online: 06 February 2024
• Copyright Holders: Copyright © The Author(s) 2024
• First Published: First published in Crohn's and Colitis 360 6(1):otae008
• Publisher Policy: Reproduced under a Creative Commons licence