The difference is that without meds you could have uncontrolled inflammation, and get significantly worse. It would seem kind of dangerous if you are currently anemic or have strictures.
That being said, if you want to try going off meds, it can be done somewhat responsibly... If you monitor your situation and are willing to admit to yourself when you are getting worse. "Monitoring" would be regular blood tests and keeping a written diary of your pain, temperature, BM's, etc. If you include what you eat, then that may help you pinpoint any foods that make you worse.
I was officially diagnosed in January and am not taking meds yet. I am doing the above diary and monthly (most recently after only 3 weeks) blood tests to check CRP, ESR, white count, etc.
I'm also using EN...as in, currently "eating" only Nutren 1.5. I was doing well from Jan till last week (I started eating some food again), so now I'm back to just cans and hopefully things will settle down. My doctor says it's no way to live, but I am fine with it if it helps me to put off meds for a little while longer. There are other less drastic dietary changes, like SCD and I also am reading these books about
"inflammation-free diet plans."
July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Enteral Nutrition, SCD, Omega-3 (Fish and Flax Oil), Folic Acid, Probiotics, Vitamin E, Psyllium