Durable Clinical and Biochemical but Not Endoscopic Remission in Pediatric Crohn's Disease on Specific Carbohydrate Diet Monotherapy

The specific carbohydrate diet (SCD) is an exclusion diet that has gained increasing public attention as a treatment option for inflammatory bowel diseases (IBDs: Crohn's Disease (CD) and Ulcerative Colitis (UC)). Studies have demonstrated SCD leads to clinical and biochemical remission. Additional observations had controversial results when mucosal healing, or endoscopic remission was assessed in pediatric CD patients on partial SCD therapy, or SCD as adjunct treatment. There is currently a lack of mucosa-based assessments for pediatric IBD patients on SCD monotherapy. We report three pediatric CD patients who achieved clinical remission on SCD monotherapy, but failed to demonstrate complete mucosal healing with a minimum of one year follow up. This case report highlights that SCD monotherapy in male pediatric CD patients can sustain durable clinical and biochemical remission, but not full mucosal healing.