Clinical and mucosal improvements were seen in children with CD, who used SCD for 12 and 52 weeks. In addition, CE can monitor mucosal improvement in treatment trials for pediatric CD. Further studies are critically needed to understand the mechanisms underlying SCD's effectiveness in children with CD.

Goal To determine the effect of the specific carbohydrate diet (SCD) on active Inflammatory bowel disease(IBD) Background IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation. Study Pediatric patients with mild to moderate IBD defined by Pediatric Crohn’s disease activity index(PCDAI 10-45) or Pediatric Ulcerative colitis Activity Index(PUCAI 10 – 65) were enrolled into a prospective study of the SCD. Patients started SCD with follow up evaluations at 2, 4, 8 and 12 weeks. PCDAI/PUCAI, laboratory studies were assessed. Results Twelve patients, ages 10-17 years, were enrolled. Mean PCDAI decreased from 28.1 ± 8.8 to 4.6 ± 10.3 at 12 weeks. Mean PUCAI decreased from 28.3 ± 23.1 to 6.7 ± 11.6 at 12 weeks. Dietary therapy was ineffective for 2 patients while two individuals were unable to maintain the diet. Mean CRP decreased from 24.1 ± 22.3mg/L to 7.1 ±0.4mg/L at 12 weeks in Seattle Cohort (nl <8.0mg/L) and decreased from 20.7 ±10.9mg/L to 4.8 ±4.5mg/L at 12 weeks in Atlanta Cohort (nl <4.9mg/L). Stool microbiome analysis showed a distinctive dysbiosis for each individual in most pre diet microbiomes with significant changes in microbial composition after dietary change. Conclusion SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD.

CE is useful to diagnose SB disease in children. Even in a study population with a high prevalence of confirmed and suspected CD, the risk of retention remains small. The patency capsule may lessen that risk. CE may identify gastric or colonic disease even when SB lesions are not present.