Dr Konstantinos Gerasimidis

Crohn's disease.

Guts UK in collaboration with forCrohn’s were proud to fund Dr Gerasimidis’ research project starting in 2018, exploring the development of a solid food diet for those with Crohn’s disease. Now his research has finished, we caught up with Kostas to find out more.

One of the best treatments available now for Crohn’s disease (CD) is following a liquid diet (not normal food or drink) for 8 weeks. This liquid-only diet (called EEN) is however very restrictive. Patients, particularly adults, can find it difficult to stick to for a long time.

Kostas and his team developed a solid food diet using everyday foods (called CD-TREAT) and have shown that this diet changes the gut bacteria of healthy people in a similar way to the liquid-only diet. It also improved gut inflammation in animal experiments and in a pilot study in 5 children with active CD who received CD-TREAT for 8 weeks.

What can you tell us about this diet? Which food was given to your patients and did they like it? 

This diet uses a variety of ordinary table food including salmon, chicken, potatoes, and rice. With CD-TREAT we aim to develop dietary plans which will provide the same nutrients and food ingredients as does the treatment with the liquid diet, simply using table food. Most participants enjoyed the diet; others did not mind it at all, particularly when the alternative treatment option for them would have been the liquid-only diet or high dose of steroids; but very few also would not accept changing their habitual diet. In a questionnaire survey, that we have previously conducted, 70% of our patients preferred a solid food, like CD-TREAT, over a liquid-only diet. So, our real-life observations confirm the results of this previous survey.

Did you see any changes in the blood and stool samples that you collected from these children and adults? Did they show any changes in disease markers and gut bacteria?

Yes, we have observed a reduction in disease activity markers. Some patients showed better response than others; very similar to what we normally see with other treatments, including the liquid-only diet. Bacterial population and their metabolites changed to the same direction as with treatment with the liquid-only diet. This observation confirms our previous observation in healthy volunteers and animal with gut inflammation.

Did you see a reduction and/or resolution of the symptoms?

Yes, more than 67% of the children who completed the CD-TREAT diet had reduced symptoms,while 60% had complete symptoms resolution. In adults, 79% who took the CD-TREAT diet had reduced symptoms, while 71% had complete resolution.

Considering children’s diet needs are different than adults, have you considered this in your research, and can the CD-treat diet meet both needs?

Yes of course, CD-TREAT is tailored for the individual nutrient and energy needs of each child and adult.

How did people get on with following the diet? Was it easier for kids than adults?

The large majority of participants enjoyed the diet. We did not see any major differences according to age group.

Now you are recruiting new people to further test your hypothesis, are you going to make any changes in the meals you are going to propose to this new group of people?

Since we have initiated the study, we added more meals including a CD-TREAT style pizza, CD-TREAT fish and chips and CD-TREAT ice-cream. We increased our meal options based on the feedback we received from our study participants. We will carry on recruiting until we reach a maximum number of participants which will allow us to judge if CD-TREAT is working in some patients with CD and which are the characteristics of these patients.

You have successfully applied to other charities for further fundings to investigate the benefit of this diet in more people, can you tell us briefly what are your plans to carry on this study?

The original research on CD-TREAT was funded by various charities of children with Crohn’s disease. These included Guts UK with forCrohns and The Catherine McEwan Foundation, The Glasgow Children Hospital Charity and the Cure Crohn’s Colitis charity in Scotland.

We have recently received major funding from The Leona & Harry Helmsley Charitable Trust in the USA to test CD-treat in more patients. Recently the Crohn’s and Colitis Foundation in the USA has awarded us another grant to use CD-TREAT to investigate which food trigger CD and to see if this equally works as long-term diet- treatment following remission.

Although the initially favourable results need to be confirmed in the bigger study, can you please tell us how do you think CD-Treat could change the lives of people with CD?

If CD-TREAT is proven to be effective, we may be able to control disease symptoms and prevent flares with dietary treatment only, in some patients. We also hope that clinical teams will be able to decrease or even replace drugs with the diet at least for some patients. This could also have the potential added benefit for some CD patients to avoid drug side-effects or even surgery.

In a sentence, could you tell us why having this grant from Guts UK and forCrohns has been important for the success of this study?

The grant we received from Guts UK and forCrohns has offered us the opportunity and essential resources to pilot test CD-TREAT in patients with active Crohn’s disease.

Together we can do more. Together we can diagnose earlier, develop kinder treatments and ultimately find a cure for digestive diseases like IBD.