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Adventures into the Unknown

Exploring the role of dietary therapy in treating Inflammatory Bowel Disease

Dr. David Suskind grew up in the age of Indiana Jones, a swashbuckling archeologist whose fictional heroics and trusty whip captured the imaginations of many. As a kid, he dreamed of being an archeologist with his own whip—just like Dr. Jones. Today, however, he pursues medical mysteries and does battle with an adversary of a different sort as a Pediatric Gastroenterologist at Seattle Children’s Hospital.

Dr. Suskind’s research and clinical focus has long been on Inflammatory Bowel Disease (IBD). The question driving him was why instances of IBD have increased substantially around the world during the last 60-100 years. Medical research had come to understand that the immune system was involved in the disease. But the human immune system hadn’t undergone any significant changes during that period. So, he wondered, what has?

The Role of Dietary Therapy for IBD

In 2010, Dr. Suskind turned his attention to environmental factors, particularly diet and food. He focused on the specific carbohydrate diet (SCD) as a dietary therapy strategy. SCD and other dietary therapies had been utilized for some time to address various disorders. But they lacked the data-driven understanding that comes with rigorous scientific research.

Convincing the research and clinical world of the potential value of dietary therapy was a daunting task. Until only recently, the western medical community has ignored this line of inquiry. A few years ago, however, that conversation began to open up. A new understanding was emerging about the relationship between diet and the microbiome of gut bacteria, including its effect on IBD. And if diet affects the microbiome, then it stands to reason that diet can play an important role in treating IBD.

“I thrive on what’s not known—the unanswered questions and their implications for research and treatment.”

Dietary therapy has the added advantage of allowing for the integration of research and clinical practice, and Dr. Suskind is currently treating more than 100 patients with dietary therapy. While he revels in the scientific rigor of a research setting, however, he appreciates how human psychology—especially under the duress of this disease—can affect his young patients and their families. Dr. Suskind believes that respecting their individual choices is vital to his ability to support their care. By allowing them to adapt SCD to their own circumstances, he also knows that the results of their individual practices—what does and doesn’t work—can be an illuminating source of learning for both his patients and the field.

Integrating Research and Clinical Practice

Over the years, Seattle Children’s Hospital has embraced the understanding that diet is important to many disease processes. The Hospital now trains its Gastrointestinal Dietitians in SCD, offers cooking classes to young patients, and offers SCD as a menu choice for patients. Dr. Suskind’s team is also exploring new frontiers with microbiome studies related to infectious disease, rheumatologic conditions, hematology and urology.

But that’s not all. Dr. Suskind is also pushing for resources to serve the ongoing needs of patients and other practitioners. He and his team have developed NiMBAL—Nutrition in Immune Imbalance—offering a website and YouTube channel to help patients with IBD integrate dietary therapy into their daily lives.

“I don’t believe in ‘challenges’—they’re just little bumps in the road.”

Time and again, Indiana Jones got lucky thanks to the creative interventions of action adventure movie-making. For Dr. Suskind, the source of his breakthroughs lies in a “phenomenal team” of researchers and clinicians and the support of Seattle Children’s Hospital. He made the point of adding one other crucial factor—the investment of the Kenneth Rainin Foundation, notably the only grantmaker to have a funding mechanism for nutrition and diet for IBD. This, he said, has put the foundation ahead of the curve in affecting true change in IBD management and treatment. Dr. Suskind hopes other funders will follow suit because as most explorers know, the greatest adventures are shared with others.

Learn more about Dr. Suskind’s nutritional therapy study in pediatric Crohn’s disease and see his published papers and research results.

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