P452 Increasing interobserver agreement on IBD endoscopic scoring systems: results from the IGIBDEndo educational program

Background: Exclusive enteral nutrition is an effective method for inducing remission in active pediatric Crohn’s disease. Success appears to depend primarily on exclusion of free diet. Multiple dietary components may alter the microbiome, induce intestinal permeability affect the mucous layer or allow translocation of bacteria in animal models or cell lines. We hypothesized that the effect of EEN is due to exclusion of dietary components that may alter the microbiome or generate an acquired bacterial clearance defect. We developed a diet based on exclusion of these dietary components (Crohn’s Disease Exclusion Diet). Methods: Children and young adults with luminal active disease defined as a pediatric Crohn’s disease activity index (PCDAI) >7.5 and 3 received a 12 week structured diet that allowed free access to specific unprocessed fresh foods and restricted exposure all other foods. Patients received 50% of calories from a polymeric formula. PCDAI, HBI, CRP and ESR were reevaluated at 6 weeks. The primary endpoint was clinical remission at 6 weeks defined as PCDAI