I was not referring to that, but rather referring specifically to the Specific
Carbohydrate Diet you mentioned and referring specifically to the risks listed
at http://www.ccfa.org/about/news/scd :

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But he's also concerned about the potential for nutritional deficiencies on the
diet.

Excluding starchy vegetables and grains eliminates dietary sources of
short-chain fatty acids, the preferred fuel source for colon cells, he says.
"This is important because without that fuel source, those cells don't function
as well." In fact, he notes, in a condition called diversion colitis, which
sometimes occurs in any remaining colon after a colectomy, colon cells are
depleted of short-chain fatty acids. Restoring those nutrients through an enema
cures the diversion colitis. "Thus," he says, "this diet could make the colitis
worse. To exclude the dietary source of short-chain fatty acids without a
compelling reason just doesn't make sense to me."

The SCD does change the intestinal flora, Dr. Heller adds, but there may be
less extreme ways of doing the same thing. Many of his own patients do well on
probiotics, antibiotics, and moderate changes in diet – treatments he feels are
at least as effective as the SCD and far less intrusive into a person's
lifestyle.

Dr. Loftus' concern is that the low-calorie diet might create additional
problems for a patient who is already underweight, something he's seen in the
past. However, he notes, like most Americans today, IBD patients are
increasingly overweight, so that's probably not going to be a major problem –
at least not in adults. But when it comes to kids, a different picture emerges.

Athos Bousvaros, M.D., Associate Director of the IBD Center at Children's
Hospital in Boston, thinks the diet, while difficult to follow, is probably
safe. However, there is a risk that the SCD may not provide the calories
children need to grow and thrive. Calorie issues are more important than
vitamin issues, he believes. You can give a child a multivitamin supplement to
prevent deficiencies, but it can be challenging for a child to get enough
calories on such a restrictive diet.

"If you do decide to put your child on the diet," he says, "do it under the
guidance of an experienced nutritionist. Decide on a reasonable time frame –
say, three to four months – and don't do anything else new for the duration of
that period." That way, if your child's condition improves, you can be
reasonably sure that the diet is associated with that improvement.

Dr. Bousvaros warns, however, that imposing such a restrictive diet on a child
could be psychologically stressful. "Kids with IBD are already probably taking
15-20 pills a day," he says. "Now you're telling them they can't eat what they
like? That takes a toll on a child, and it could also fuel family tensions. To
avoid needless stress all around, it's important that parents and child agree
before taking on the diet as a family project. And remember to do so only under
medical supervision."

"Most doctors will condone the diet as long as the patient continues to be
monitored," adds Dr. Heller. In other words, don't start the diet and stop
other medical treatment. Unfortunately, he says, that often happens: "Patients
start the diet and then stop their medicine without the doctor knowing."

Still, he says, the diet "may be worth a try." After all, he notes, there are
much worse diets being touted in cyberspace and elsewhere. "But don't abandon
your conventional treatment," he warns, "and keep in touch with your doctor."

Dr. Loftus concurs. "From what I've read, it sounds like it would be awfully
difficult to follow. For instance, you couldn't eat any processed foods because
they all have carbs in them. But there may be something to it. It's not
unreasonable for motivated patients to give it a try."