Healthcare cost reduction with the specific carbohydrate diet

<p><strong>Background</strong></p> <p>Crohn's disease (CD) is an immune mediated inflammatory disorder of the gastrointestinal tract. While the etiology is not fully elucidated, the intestinal microbiome is believed to initiate and maintain immune activation in CD. The intestinal microbiome is highly responsive to its environmental, including host dietary patterns. As such, dietary interventions have the potential to modulate intestinal microbiome composition and function, thereby improving clinical symptoms, reducing inflammatory burden and potentially impacting overall healthcare cost of managing inflammatory bowel disease (IBD).</p> <p><strong>Methods</strong></p> <p>We present a retrospective chart review of an adult male with complicated Crohn's disease non-responsive to medical management. Patient began and maintained the specific carbohydrate diet (SCD) for 42 months. MRE, colonoscopy, and laboratory evaluations were compared pre- and post-SCD. In addition, IBD associated healthcare costs were collected and analyzed covering 12 months pre-SCD and 42 months with SCD.</p> <p><strong>Results</strong></p> <p>Patient tolerated the initiation and maintenance of the SCD well. He has been asymptomatic for 42 months on the SCD. Stool fecal calprotectin (FCP) decreased from 493 ug/g at baseline, to 70 ug/g at month 3 of the SCD intervention and remained in the normal range thereafter. At month 12 of the SCD intervention, endoscopy showed normal histology in the colon and terminal ileum and MRE showed resolution of prior jejunal inflammation. IBD associated healthcare costs were $42,688 in the 12 months preceding the SCD intervention and $2,797/year with SCD.</p> <p><strong>Conclusion</strong></p> <p>The specific carbohydrate diet achieved long-term remission and resolution of inflammatory burden in an adult with Crohn's disease. The dietary intervention resulted in a 94% reduction in healthcare insurance costs and a 91% reduction in out-of-pocket patient expenses. This case highlights the rapid and sustainable benefits of dietary intervention in Crohn's disease from both a clinical and economic standpoint.</p>