Dr Konstantinos Gerasimidis (Crohn’s Disease)
Institution: University of Glasgow
Title: A pilot study to assess the clinical efficacy of the novel CD-TREAT diet in patients with active Crohn’s Disease.
Project start date: 10th December 2018
Completion date: 9th February 2020
A liquid-only diet (without any of a patient’s normal food or drink) for 8 weeks is the best initial treatment for cases of Crohn’s Disease (CD) that are causing symptoms. Dr Gerasimidis has shown previously that this liquid-only diet works by changing the bacteria (germs) in the gut. This liquid-only diet is however very restrictive and patients can find it difficult to stick to it for a long time, particularly if they are adults. Therefore, there is a lot of interest and enthusiasm from patients and their clinical teams to develop new diets that work as well as the liquid-only diet, but do not involve stopping all solid food. Such a solid food diet is more acceptable to most patients than a liquid-only diet. In a questionnaire survey, 70% of Dr Gerasimidis’ patients said they would prefer a solid food over a liquid-only diet. They also indicated they would be willing to participate in studies testing such diets.
Dr Gerasimidis and his collaborators have recently developed a solid food diet using everyday foods (called CD-TREAT), which they hope will work as well as the liquid-only diet. They have shown previously that CD-TREAT changes the gut bacteria of healthy people in a similar way to the liquid-only diet. The solid diet also improved gut inflammation in animal experiments. Dr Gerasimidis now wants to test CD-TREAT in Crohn’s Disease patients with symptoms, instead of using their standard medical treatment.
Dr Gerasimidis and his collaborators are planning to recruit 10 adults and 10 children with Crohn’s Disease who need treatment to help with their symptoms. They will provide patients with the CD-TREAT diet, as their only dietary source, for a maximum of 12 weeks. CD-TREAT meals will be prepared and provided to the patients free, using a food catering company. During treatment with CD-TREAT, Dr Gerasimidis will collect three to four blood and stool samples. He will use these samples to measure changes in disease markers and gut bacteria. He will also measure body weight changes, how easy patients can stick to CD-TREAT, and how they cope with daily activities and changes to their lifestyle. Dr Gerasimidis will repeat these tests before the start, during, and at the end of CD-TREAT. He will also compare the cost of CD-TREAT against the liquid-only diet.
Dr Gerasimidis has recently tried this approach in three patients as part of a student project, to make sure it is achievable. Encouragingly, in two of these patients, all Crohn’s Disease symptoms resolved and their blood results improved while on CD-TREAT. Dr Gerasimidis is keen to expand the study now that he is clear it can be done from a practical point of view.
Dr Gerasimidis is optimistic that CD-TREAT will work. If he proves this, doctors, nurses and dietitians will be able to decrease or replace harmful drugs and potentially avoid surgery in some patients.
My collaborators and I would like to thank Guts UK and forCrohn’s for their generous support of this project. If successful, CD-TREAT diet will have the potential to decrease or replace toxic and expensive drug therapies and surgery in some patients with Crohn’s disease and improve their quality of life. It could provide a drug-free induction of remission, based on diet-only treatment.Dr Konstantinos Gerasimidis