Original Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 28, 2010; 16(20): 2484-2495
Published online May 28, 2010. doi: 10.3748/wjg.v16.i20.2484
Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet
Mitsuro Chiba, Toru Abe, Hidehiko Tsuda, Takeshi Sugawara, Satoko Tsuda, Haruhiko Tozawa, Katsuhiko Fujiwara, Hideo Imai
Mitsuro Chiba, Toru Abe, Hidehiko Tsuda, Takeshi Sugawara, Satoko Tsuda, Haruhiko Tozawa, Katsuhiko Fujiwara, Hideo Imai, Division of Gastroenterology, Nakadori General Hospital, Akita 010-8577, Japan
Author contributions: Chiba M designed the study and wrote the paper; Abe T, Tsuda H, Sugawara T, Tsuda S, Tozawa H, Fujiwara K and Imai H equally contributed to the acquisition of data.
Correspondence to: Mitsuro Chiba, MD, Division of Gastroenterology, Nakadori General Hospital, 3-15, Misono-cho, Minami-dori, Akita 010-8577, Japan. mchiba@meiwakai.or.jp
Telephone: +81-18-8331122 Fax: +81-18-8375836
Received: January 4, 2010
Revised: February 1, 2010
Accepted: February 8, 2010
Published online: May 28, 2010

AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission, who are a high-risk group for relapse.

METHODS: A prospective, single center, 2-year clinical trial was conducted. Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease. The primary endpoint was clinical relapse defined as the appearance of active symptoms of CD. Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse. A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.

RESULTS: SVD was continued by 16 patients (compliance 73%). Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%) in the omnivorous group. Remission rate with SVD was 100% at 1 year and 92% at 2 years. SVD showed significant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003, log rank test). The concentration of C-reactive protein was normal at the final visit in more than half of the patients in remission who were taking an SVD, who maintained remission during the study (9/15; 60%), who terminated follow-up (8/12; 67%), and who completed 2 years follow-up (7/10; 70%). There was no untoward effect of SVD.

CONCLUSION: SVD was highly effective in preventing relapse in CD.

Keywords: Crohn’s disease, Inflammatory bowel disease, Vegetarian diet, Recurrence, Lifestyle