Crohn’s Disease Exclusion Diet with Partial Enteral Nutrition for Active Crohn’s Disease
Key points
- The Crohn’s Disease Exclusion Diet with partial enteral nutrition is a 3-phase diet therapy comprising of whole foods with nutrition supplement drinks
- Nutrition supplement drinks provide part of the diet’s essential nutrients
- This is a 12-week diet therapy that has been shown to reduce inflammation
This dietary resource developed by GI DREAM provides general dietary information for people with IBD.
CDED + PEN to Treat Inflammation
Crohn’s Disease Exclusion Diet (CDED) + partial enteral nutrition (PEN) is a partial whole-food alternative to exclusive enteral nutrition liquid diet. The purpose is to treat inflammation and induce remission. CDED + PEN is thought to help by removing foods that may change the bacteria in your gut and promote inflammation, while increasing other foods thought to help to reduce inflammation. The diet is prescriptive with strict guidelines of what to include and exclude initially then becomes less restrictive as you move through the 3-phases.
CDED + PEN Prescription
- Completed over 12 weeks, with 2 x 6-week phases and an optional 12-week phase 3
- Inclusion of high quality, lean animal proteins (mostly chicken and eggs)
- Inclusion of resistant starch and specific fibres (apples, bananas, potatoes)
- Inclusion of PEN (medical nutrition supplement drinks) to meet energy and protein needs
- Avoidance of excessive food additives and processed foods
- Mandatory list of whole foods for each phase with an accompanying shorter list of foods which are intermittently allowed
CDED + PEN phases and inclusions
| Phase 1 (0-6 weeks) | Phase 2 (7-12 weeks) | Phase 3 (13+ weeks) |
|---|---|---|
| 50% nutrition from PEN supplement drinks | 25% nutrition from PEN supplement drinks | Cease PEN supplement drinks * |
| Simple short list of mandatory foods including eggs, chicken breast, potatoes, apple, bananas Limited selection other fruit, veg, grains, herbs, oil | Continue phase 1 components Additional fruit and veg + some weekly additions such as oats and bread | Re-introduction of healthy, balanced diet as directed by your IBD Dietitian |
Starting CDED+PEN
Your gastroenterologist and IBD Dietitian are best placed to provide guidance on the appropriateness of commencing CDED. Your IBD team will monitor whether the diet is treating the inflammation as intended and to make sure you are meeting your nutrition needs. Your IBD Dietitian will be able to provide meal plans, recipes, food lists and a personalised prescription for the PEN supplement drinks.
Considerations
- Vitamin supplementation may be required
- Careful adjustments can be made by an IBD Dietitian for those with additional dietary requirements (including vegetarian, allergies and intolerances)
- CDED may not be appropriate for all people with active Crohn’s Disease, and its use should always be guided by your IBD specialist team.
Find an IBD Dietitian
For individualised nutrition advice ask your IBD team about seeing an IBD dietitian or find one at:
Acknowledgements:
This resource was developed in 2024 by the DECCAN Education Materials Working Group and reviewed by the GI DREAM Board in line with ECCO Consensus on Dietary Management of IBD (2025). Requests and enquiries about this document should be directed to [email protected] or website www.gidream.org. GI DREAM does not take any liability for any injury, loss or damage incurred by the use or reliance on this information. Reviewed August 2025. Date for review August 2027.