Mallory Little



Project title: Literature Review and Analysis: Treating Inflammatory Bowel Disease through the Specific Carbohydrate Diet

Degree: MPH | Program: Environmental and Occupational Health (EOH) | Project type: Practicum
Completed in: 2019 | Faculty advisor: Yue Cui

Abstract:

Inflammatory bowel disease (IBD) is an immune-mediated inflammatory disorder of the gastrointestinal tract. As of 2015, about 3 million adults in the United States suffer from IBD. Healthcare costs in IBD patients are about 4 times more than in non-IBD patients. Given the incomplete efficacy of medication therapy as well as a continuing rise in healthcare costs, a new focus on the environmental impact of disease has emerged with a focus on diet. The Specific Carbohydrate Diet (SCD) is used by physicians at Seattle Children’s Hospital during dietary treatment of pediatric patients with IBD. The presumed mechanism of action of the SCD is to improve the associated dysbiosis as well as mucosal integrity in IBD by eliminating specific foods. This practicum project aims to update the SCD with the latest IBD-relevant research by completing an A-Z listing of food items and additives on the NiMBAL website, which includes updates on whether they are allowed on the SCD or disallowed, as well as explanation for these designations, descriptions of the food or additive, and links to relevant research concerning the effect of the food on patients with IBD. Additionally, a written report in the form of a scholarly article focusing on the theory behind the SCD was produced, which focuses on categories of foods and additives eliminated or included in the SCD and the rationale and evidence for their effects on patients with IBD. This project resulted in an update to the NiMBAL website, as well as an update to the SCD on the level of specific food items and whether they are allowed or not, using scientific evidence as rationale. The updated SCD will need to be monitored as it is carried out in practice to ensure that patient results continue to improve.