Clinical Case Database / Category: Patient Management

Treating Crohn's disease with diet and antifungals

Publication details

S Pouria
Foundation Years Journal, volume 7, issue 8, p.28 (123Doc Education, London, August 2013)


The case of a patient with Crohn's disease is reported where treatment with dietary measures as well as intraluminal anti-fungal medication for underlying changes to the gut flora resulted in clinical and radiological remission. The potential role of the microbiome in particular the gut microflora is discussed in the context of inflammatory bowel disease. In particular, it is speculated that due to the high burden of antibiotic use both in medical practice and through exposure to food produced on farms where routine use of antibiotics enter the food chain, fungal type dysbiosis may compound the symptoms and progression of inflammatory bowel diseases such as Crohn's disease. It follows that treatment with simple dietary protocols and antifungals may in a subset of patients alter the clinical course and natural history of the condition.

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S Pouria



1. Serikov I, Russell SL, Antunes LCM, and Brett Finlay B. Gut Microbiota in Health and Disease Physiol Rev 90: 859-904, 2010.
2. Erickson AR, Cantarel BL, Lamendella R, Darzi Y, Mongodin EF, Pan C, Shah M, Halfvarson J, Tysk C, Henrissat B, Raes J, Verberkmoes NC, Fraser CM, Hettich RL, Jansson JK. Integrated metagenomics/metaproteomics reveals human host-microbiota signatures of Crohn's disease. PLoS One. 2012;7(11):e49138. doi: 10.1371/journal.pone.0049138. Epub 2012 Nov 28.
3. Ott SJ, Kuehbacher T, Musfeldt M, Rosenstiel P, Hellmig S, Rehman A, Drews O, Weichert W, Timmis KN, Schreiber S. Fungi and inflammatory bowel diseases: Alterations of composition and diversity. Scand J Gastroenterol. 2008;43(7):831-41.
4. Rehaume LM, Jouault T, Chamaillard M. Lessons from the inflammasome: a molecular sentry linking Candida and Crohn's disease. Trends Immunol. 2010 May; 31(5):171-5.
5. Standaert-Vitse A, Jouault T, Vandewalle P, Mille C, Seddik M, Sendid B, Mallet JM, Colombel JF, Poulain D. Candida albicans is an immunogen for anti-Saccharomyces cerevisiae antibody markers of Crohn's disease. Gastroenterology. 2006 May;130(6):1764-75.
6. Schaffer T, Mueller S, Flogerzi B, Seibold-Schmid B, Schoepfer AM, Seibold F. Anti-Saccharomyces cerevisiae mannan antibodies (ASCA) of Crohn's patients crossreact with mannan from other yeast strains, and murine ASCA IgM can be experimentally induced with Candida albicans. Inflamm Bowel Dis. 2007 Nov;13(11):1339-46.
7. Pineton de Chambrun G, Colombel JF, Poulain D, Darfeuille-Michaud A. Pathogenic agents in inflammatory bowel diseases. Curr Opin Gastroenterol. 2008 Jul;24(4):440-7
8. Kroker GF Chronic Candidiasis and Allergy. In BrostoffJ, Challacombe SJ eds). Food Allergy and Intolerance. London: Balliere Tindall, 1987: 850-72.
9. Truss CO The Missing Diagnosis 2nd Edition Birmingham, AL 1986.
10. Borody TJ, Campbell J. Fecal microbiota transplantation: techniques, applications, and issues. Gastroenterol Clin North Am. 2012 Dec;41(4):781-803.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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