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January 23, 2026Journal of Crohn s and Colitis0 citations

Dietary Advice Trial of the 4-SURE Diet for Ulcerative Colitis

P1131A randomised placebo-controlled dietary advice trial of the Four Strategies to SUlphide Reduction (4-SURE) diet in adults with mild-moderately active ulcerative colitis

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Authors

ADA DayLPL PortmannTGThomas M Goodsall

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Overview

Randomised trial compares clinical and endoscopic outcomes of 4-SURE diet vs Sham diet in UC, indicating no superiority found.

Key Points

  • This study investigates the efficacy of the 4-SURE diet in improving clinical and endoscopic responses in adults with mild-moderately active ulcerative colitis.
  • Double-blind placebo-controlled trial design
  • Participants randomly assigned to 4-SURE or Sham dietary advice
  • Primary endpoint measured clinical and endoscopic response at 8 weeks
  • Secondary endpoints included remission, segmental healing, and histological healing
  • Self-reported adherence and faecal hydrogen sulphide levels assessed
  • Both diets resulted in similar primary outcomes (15% success each, p = 0.95)
  • Clinical response rates were equivalent (54% vs 54%, p = 1.00)
  • Endoscopic healing rates showed no significant difference (25% vs 21%, p = 0.73)
  • Faecal hydrogen sulphide levels reduced significantly with 4-SURE (0.73 mmol/g, p = 0.009) while Sham showed no change
  • Total disease extent regressed with both diets (4-SURE: 7.4 cm; Sham: 7.2 cm, p = 0.036)

Cite This Study

Day et al. (2026) studied this question.

synapsesocial.com/papers/69730f59c8125b09b0d1f15ahttps://doi.org/10.1093/ecco-jcc/jjaf231.1312
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