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There is ample evidence dietary interventions are helpful in ileal crohn's disease. But there's no evidence that diets or EN are helpful in UC. Nor is there evidence for crohn's colitis. It would be very surprising and difficult to explain if dietary interventions would be helpful for UC...

Most diets recommended for crohn's disease largely try to mimic EN. Low residue, SCD and low FODMAP diets all have the effect that undigested starches are limited. LOFFLEX diets limit hard to digest fats and fiber. Note that all these diets, including EN, aggressively limit resistant starch /...

We need a certain amount of carbohydrates for daily energy needs, there's no way around this. Protein can be broken down for fat storage and even glucose needs, but the ability of the liver to do this is very limited. Excess nitrogen from excess protein intake is very harmful for the liver...

The effect of TGF-β2 growth factor in some EN like Modulen is relevant if it is part of the mechanic of action of Modulen EN, because it indicates total intake matters. I am only aware of 1 study from Japan that compared different levels of intake of EN containing TGF-β2. Subjects that consumed...

To avoid any confusion you can just call the maltodextrin in EN glucose syrups. Several EN will say they contain glucose syrup, instead of maltodextrin. What type of maltodextrin is created depends on how long the hydrolysis process takes. Glucose syrups go through a lengthy process that causes...

It's the protein in maize that cause a reaction, not the starch. People with a corn allergy can consume maltodextrin made from corn starch no problem. The maltodextrin in EN is not resistant maltodextrin, they're glucose syrups with a high DE, they don't look anything like starches anymore. The...

Regarding the study showing the growth of E Coli in a maltodextrin petri dish. The type of Maltodextrin found in EN is so readily absorbed that I would be surprised if any of it ever reaches the distal small intestine to begin with. How EN is absorbed in the intestine and what happen in a petri...

Maltodextrin is a name that represents many entirely different substances. Maltodextrin is made by hydrolysing corn or rice starch. When you cook this starch and add enzymes, it will break that starch down into glucose syrup, the process is called hydrolysis. The resulting white powder is...

Tests are so cheap and readily available that you can to do them often enough to see a trend. Calprotectin levels in stool fluxuate throughout the day, neutrophils migrate to intestinal tissue daily due to the sheer number of lumen organisms and antigen present in food. Low grade inflammtion...

Nutrient deprivation of mucus colonizing bacteria by restricting fiber should be possible by simply altering diets towards low residue diets with higher bioavailability that are proximally as bioavailable as possible. I understand adherence to EN is not possible for everyone.

Generally you should eat a low-residue, low fiber diet. Food that is proximally aborbed, very bioavailable and lowers fecal content. The easiest way to do this is through the use of EN. The idea that you can find a "trigger food" or figure out an "elimination diet" is not something that makes...

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Fiber-deficient diet inhibits colitis through the regulation of the niche and metabolism of a gut pathobiont 14 November 2023 Department of Microbiology and Immunology, University of Michigan Department of Public Health and Preventive Medicine, Yamaguchi University, Japan Peter Kuffa, Joseph...

We're not very good dealing with stenosis and fistula. Crohn's disease is a penetrating disease for many. A lot of young kids with crohn's disease tend to now have an aggressive disease course, including penetrating disease, meaning they develop lots of fistulas early on. No organ is more...

Interesting to note is that biopsy tissue T4 cells from CD patients reacted to Saccharomyces boulardii, often used in probiotics. Probiotics have shown no benefit in crohn's disease, and could very well invoke strong immune response.

If they're correct and the fungi are coming from oral sources, then it's important to wrinse your mouth with water after you drank EN. Not because there's fungi in EN, there's obviously not, but becausing just leaving EN in the mouth is just a sure way to fuel candida, you also don't want EN to...

For what it's worth. Most of the weird immune terms being used and the implication of diet mentioned in the study. T helper cells, or CD4+ T cells, and their subgroups, Th1, Th2, and recently the newly discovered third subset and was named Th17. The cytokine Th17 releases is interleukin 17...

Nature Medicine University Medical Center Schleswig-Holstein, Kiel, Germany Cornell University, NY, USA 25 of september 2023

Especially regarding fungi the debate is not easy. The idea that fungi colonize the intestine is not shared by everyone. Fungi live in conditions that you generally don't have in the intestine, the intestine seems too hot, lacking in oxygen and lacking in the type of nutrients fungi rely on in...