Reverse-Engineering of Exclusive Enteral Nutrition (RE-EEN) in Crohn's Disease: A Multi-Center Trial

Inclusion Criteria:

• Age 8 -21 years old.

• Diagnosis of Crohn's disease within 24 months

• Elevation in objective inflammatory markers at enrollment: C-reactive protein (CRP),ESR, or fecal calprotectin

• Active Crohn's disease, as defined by Pediatric Crohn's Disease Activity Index (PCDAI) ≥10.

• Participant capable of giving informed consent, or if a minor the parent/guardian iscapable of giving informed consent.

Exclusion Criteria:

• History of surgery for Crohn's disease.

• Perianal disease as part of Crohn's disease phenotype.

• Recent use of:

• corticosteroids (within 4 weeks),

• dose adjustment of immunomodulator (within 8 week)

• azathioprine 4 weeks prior to study final visit (week 8)

• start or adjust methotrexate 3 weeks prior to final study visit.

• Prior use of biological medication

• Prior treatment with EEN or other dietary therapy for Crohn's disease.

• Prior treatment with antibiotics for Crohn's disease.

• Known allergies to any of the food components in the smoothie.

• Admission to hospital due to severity of Crohn's disease and associated symptoms.

• Unwillingness to provide informed consent.