Effective Use of An Exclusion Diet in Crohn's Disease Combined with Partial Enteral Nutrition in A Patient with Short Bowel Syndrome - A Case Report

Introduction: Short bowel syndrome (SBS) is a gastrointestinal disorder leading to significant impairment of nutrient absorption. Most often, short intestinal obstruction occurs through surgery, as a result of complications of Crohn's disease (CD). Patients with severe SBS often require constant access to parenteral nutrition because oral and enteral nutrition are not fully effective. In its guidelines, ESPEN recognized parenteral nutrition in SBS as a necessary and life-saving procedure. Case description: The presented case concerns a 33-year-old patient with severe SBS complicating Crohn's disease. At the time of nutritional intervention, the patient had only 90 cm of intestine and was unable to eat effectively using the digestive tract. Tolerance of Modulen IBD (Nestle Health Science) was tested. The patient tolerated the proposed product well. It was decided to try to include the patient in the ModuLife dietary program. ModuLife is a program based on the principles of the Crohn's Disease Exclusion Diet (CDED). Additionally, it uses Modulen IBD. After 12 weeks, the patient continued the recommended diet, gained weight, reported reduced abdominal pain, and parenteral nutrition could be reduced. Conclusions: Thanks to the immunomodulatory and nutritional effect of Modulen IBD and the implementation of an anti-inflammatory elimination diet in the patient, the nutritional status of intestinal epithelial cells, as well as intestinal motility and absorption, improved. We suggest that this type of dietary approach could be used in other cases of SBS.