Crohn’s disease (CD) is a chronic inflammatory bowel disease that can affect any region of the gastrointestinal tract, most commonly the terminal ileum and colon. In pediatric populations, the disease often presents more severely, with symptoms including abdominal pain, diarrhea, fatigue, bloating, and dermatologic changes. If left untreated, persistent inflammation may lead to complications such as intestinal stenosis, fistula formation, or abscess development, with research showing that up to 50% of patients develop complications within 20 years of diagnosis.

At a mechanistic level, CD is characterized by a dysregulated immune response to intestinal microbes and a breakdown of epithelial barrier integrity. As the mucosal barrier becomes compromised, microbial components and dietary antigens cross into underlying tissue, activating macrophages and T-helper lymphocytes and promoting the production of pro-inflammatory cytokines including TNF-α, IL-6, and IL-23. Because this inflammatory cascade drives disease progression, monitoring markers that reflect mucosal inflammation is critical. Diagnosis is typically established through endoscopy and cross-sectional imaging, which allow for direct visualization and biopsy of the affected tissue. However, fecal calprotectin (FC), a neutrophil-derived protein, has emerged as a clinically relevant and non-invasive biomarker that correlates positively with intestinal inflammation and CD-associated flare-ups, making it useful for monitoring disease activity and progression.

A recent case study published in the Journal of Food and Nutritional Sciences examined the effects of a personalized nutrition and nutraceutical intervention in a pediatric patient diagnosed with Crohn’s disease. An 11-year-old male was diagnosed with CD based on endoscopic and colonoscopic findings, along with an elevated fecal calprotectin level of 260 μg/g. He presented with abdominal pain triggered by eating and physical activity, bloating, fever, facial swelling, and occasional blood in the stool. While his physician recommended a TNF-α inhibitor, the family elected not to pursue pharmacologic treatment and instead chose a nutrition-centered approach.

Following diagnosis, a structured nine-week intervention was implemented. The initial phase consisted of a strict carnivore-style elimination diet designed to remove potential dietary triggers, including refined sugars and high-fiber carbohydrates, while minimizing antigen exposure during active inflammation. In addition to dietary modification, a targeted nutraceutical protocol was introduced to support mucosal integrity, immune modulation, and microbial balance. This protocol included demulcents such as deglycyrrhizinated licorice (DGL), aloe vera extract, slippery elm, marshmallow root, okra extract, and chamomile extract; mucosal support nutrients including L-glutamine, zinc from zinc L-carnosine, N-acetyl-D-glucosamine, citrus pectin, and mucin; serum-derived bovine immunoglobulins (ImmunoLin® providing IgG); ingredients that support healthy inflammatory responses such as quercetin, cat’s claw, methylsulfonylmethane (MSM), and omega-3 fatty acids (EPA and DHA) from fish oil; and a multi-strain probiotic blend containing Lactobacillus and Bifidobacterium species.

By the end of the nine-week intervention, the patient reported that abdominal pain, bloating, facial swelling, and blood in the stool had resolved completely, and stated that both energy and appetite had returned to normal. Additionally, fecal calprotectin decreased from 260 µg/g to 0 µg/g, indicating remission. For the following 22 months, the patient remained in generally good health. However, during a period of reduced dietary adherence, fecal calprotectin increased to 806 µg/g and mild dermatologic symptoms, including morning puffiness around the eyes, returned. Notably, gastrointestinal symptoms did not recur. As dietary consistency and nutraceutical adherence were reinforced, fecal calprotectin returned to normal, reading 141 µg/g eight months later. Dermatologic findings resolved, and the patient continued to report no gastrointestinal discomfort since the initial intervention more than two years prior. As of publication, no medications, hospitalizations, or emergency visits occurred, and the patient remained in stable health.

The findings from this case study suggest that a structured nutrition and nutraceutical approach may meaningfully help normalize the inflammatory response in pediatric Crohn’s disease. Through removal of potential dietary triggers and targeted support for the intestinal lining, microbiome balance, and immune regulation, the intervention was associated with both symptom resolution and normalization of fecal calprotectin.

While pharmacologic therapies remain the standard of care for Crohn’s disease, this case highlights the potential role of carefully supervised nutrition-based interventions as part of a comprehensive treatment strategy. As with any single case report, these findings reflect an individual response and may not be generalizable. Further research will help clarify how broadly this type of approach may apply in pediatric Crohn’s disease.

Learn more about gut health:

Probiotics and Children’s Gut Health

Gut and Immune Health: A Clinical Review of their Interconnected Systems

Discovery of a Critical Link between Crohn’s and the Gut Microbiome

Serum Bovine Immunoglobulin: Promoting Short-Chain Fatty Acid Production and Gut Microbiota Balance

By Jesse Martin, MS