Improving surgery for Crohn’s Disease and understanding its effects on diet

What this research is looking at 

Medicines can help to keep Crohn’s Disease under control (in remission). But surgery is also an important treatment option. Some people with Crohn’s may need surgery to remove part of their gut. It’s not known whether it’s better to have surgery earlier or later after diagnosis, or to have surgery after being treated with medicines first.

Crohn’s can have a huge impact on day-to-day social activities, including those involving eating. Some people with Crohn’s limit what they eat to help manage their symptoms. This, as well as the effects of active disease, may lead to malnutrition. Malnutrition is a serious condition that happens when you’re not getting enough nutrients from your food. Malnutrition increases the risk of problems after surgery.

A special liquid diet that provides all energy and nutrients can be prescribed to treat active Crohn’s. This involves stopping normal food and drink (except water) and only taking the prescribed liquid diet.

Dr Lomer and her research team are leading a clinical trial called OCEAN. This trial is looking at whether a special liquid diet before surgery improves outcomes after surgery. This research project is called COAST.  It will look at people with Crohn’s who are taking part in OCEAN to understand:

• Whether having surgery sooner or later after diagnosis results in better outcomes and quality of life for people who have Crohn’s in the end of their small bowel (terminal ileum).
• Whether having been prescribed more than one biologic medicine (or not) before surgery results in better outcomes and quality of life for people with Crohn’s.
• The diet and nutrition of people with Crohn’s who are having surgery. And whether a liquid diet for 6 weeks before surgery is better than standard care for their longer term dietary habits.

What researchers think this could mean for people with Crohn's  

The results from this study will:

• Improve the surgical pathway in Crohn’s.
• Support people with Crohn’s to make an informed decision on their treatment options and care.

Knowing when the best time to have surgery is, as well as how to improve nutrition for those having surgery, could reduce disease progression and enhance the quality of life of people with Crohn’s. This would increase our knowledge on how to best manage Crohn’s and reduce health-related costs.

Who is leading this research: Dr. Miranda Lomer, King’s College London

Our funding: £98,288

Duration: 36 months 

Official title of application: Crohn’s Optimisation And Surgical Timing (COAST)