Emulsifier content has no influence on disease activity over 4 weeks in patients with CD.

[kiny]

 

[kiny]

 

[kiny]

Emulsifiers and stabilizers are commonly found in EN for crohn's disease. They are in Modulen, they are in 028. They have no no impact on remission rates whatsoever and EN with less emulsifiers are not any more effective.

I have pointed this out several times, https://crohnsforum.com/threads/pre...fibre-do-not-impact-effectivness-of-en.87321/

Emulsifiers and ultra-processed foods have been blamed for crohn's disease worldwide, even though most data contradicts this. Highly processed EN full of additives are highly effective in inducing remission.

 

[longzhiwu]

Emulsifier restriction is an effective therapy for active Crohn’s disease: the ADDapt trial - a multi-centre, randomised, double-blind, placebo-controlled, re-supplementation trial in 154 patients

https://academic.oup.com/ecco-jcc/article/19/Supplement_1/i262/7967009?searchresult=1

The result of this research is different, and it recruits more patients.How to understand the difference ?

 

[kiny]

https://academic.oup.com/ecco-jcc/article/19/Supplement_1/i262/7967009?searchresult=1

The result of this research is different, and it recruits more patients.How to understand the difference ?

This study had no disease location restrictions. I believe studies that involve dietary interventions should focus on ileal phenotypes as it is the primary site for nutrient absorption. EN works very well for ileal disease, it does not work well for crohn's collitis.

Dietary studies reporting a positive response in patients with colonic disease don't make much sense to me, as the colon is not involved in nutrient absorption.

Many large-scale studies on processed foods and emulsifiers are too broad to be relevant and I don't post them and generally critique them, the mechanisms of ileal Crohn's disease is distinct, it is the only phenotype that consistently responds to EN.

Recruiting patients for dietary interventions is difficult, few people are willing to put up with dietary restrictions for weeks. The only way to recruit more patients is to include more phenotypes, which ironically undermines the results because nutrient absorption is phenotype specific.