The attitudes and beliefs of Australasian pediatric gastroenterologists and dietitians toward the Crohn's disease exclusion diet.

Objectives: Nutritional therapy plays a crucial role in managing pediatric Crohn's disease (CD). Exclusive enteral nutrition (EEN) is the primary induction therapy, achieving high remission and mucosal healing rates. However, its restrictive nature poses psychological and practical challenges. The Crohn's disease exclusion diet (CDED), a solid food-based approach with partial enteral nutrition (PEN), has emerged as an alternative. This study examines Australasian pediatric gastroenterologists' and dietitians'perspectives on CDED implementation. Methods: A cross-sectional survey was conducted via an anonymized, 20-question online questionnaire distributed through Qualtrics to Australasian pediatric gastroenterologists and dietitians. The survey assessed demographics, familiarity with CDED, clinical application, and perceived benefits and barriers. Responses were analyzed using descriptive statistics (Microsoft Excel) and content analysis for open-ended responses. Results: Forty-five respondents (29 gastroenterologists, 16 dietitians) participated. Most (91.1%) were familiar with CDED, and 68.9% had used it in practice. While 45% considered CDED less effective than EEN, 37.5% viewed it as equally effective. Key barriers included preference for EEN (62.5%), resource limitations (33.3%), lack of guideline inclusion (25%), and insufficient evidence (20.8%). Additionally, 71.1% cited a shortage of trained dietitians as a major obstacle. Conclusion: CDED is gaining recognition but faces challenges in adoption due to limited training and evidence gaps. While considered less socially restrictive than EEN, concerns remain about dietary restrictions' psychological impact. Expanding dietitian training and generating robust clinical evidence could enhance CDED's integration into pediatric CD management in Australasia.