Nourishing remission: the role of Crohn's disease exclusion diet and partial enteral nutrition in pregnancy: a comprehensive review.

Abstract

The management of Crohn's disease during pregnancy presents significant challenges. Active Crohn's disease can be treated with corticosteroids or biologics. While these treatments are generally considered safe during pregnancy, they are not without potential side effects, leading to patient hesitancy in initiating therapy despite guidance from inflammatory bowel disease specialists. We present the case of a 34-year-old woman who was diagnosed with Crohn's disease 3 weeks before getting pregnant and who opted not to use medication during her pregnancy. For the initial 26-28 weeks, she received conservative treatment. Following a deterioration in her symptoms and an increase in calprotectin levels, she commenced the Crohn's disease exclusion diet (CDED) combined with partial enteral nutrition (PEN). This led to significant symptomatic improvement and a decrease in faecal calprotectin levels. At 40 weeks of gestation, she gave birth to a healthy baby. This case underscores the potential efficacy of CDED and PEN as dietary management strategies for Crohn's disease even during pregnancy, although further research is warranted to compare these approaches with conventional treatments. In addition, it emphasises the critical role of preconception counselling regarding medication safety and effective disease management during pregnancy.