Diet to the Rescue: Cessation of Pharmacotherapy After Initiation of Exclusive Enteral Nutrition (EEN) Followed by Strict and Liberalized Specific Carbohydrate Diet (SCD) in Crohn’s Disease
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Case Presentation and Evolution
A 15-year-old male initially complained of chronic diarrhea for 4 months, mild mid-abdominal pain, and occasional rectal bleeding. Over time, the pain worsened, accompanied by the development of tenesmus and weight loss, despite good appetite. His family history was negative.
On physical examination, the patient was well appearing despite a body mass index (BMI) of 16.56 kg/m2. All systems were unremarkable, including abdominal examination, except for the presence of perianal skin tags. Routine laboratory analysis revealed anemia (hemoglobin 12.8 g/dL) and elevated positive inflammatory markers (erythrocyte sedimentation rate (ESR) 39 mm/h; C-reactive protein (C-RP) 3.8 mg/L; fecal calprotectin 1563.6 mcg/g), and a low inverse inflammatory marker albumin (2.6 g/dL). He underwent endoscopy and colonoscopy that revealed 2 small nodules at the antrum, multiple perianal skin tags, and scattered ulcers from the transverse colon to the rectum. Biopsies showed...
KeywordsCeliac Disease Fecal Calprotectin Aminosalicylates Exclusive Enteral Nutrition Inadequate Nutritional Intake
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