Crohn's Disease
Crohn's Disease and Ulcerative Colitis are collectively known as Inflammatory Bowel Disease. Although there are no known medical cures, alternative approaches have proved to offer a lot of relief to many sufferers .....
Acupuncture Treats Crohns Disease
In a recent study conducted by researchers at the Shanghai University of Traditional Chinese Medicine and the Shanghai Research Institute of Acupuncture and Moxibustion, shows that acupuncture is an effective treatment for Crohn’s disease.
The study was published in the Journal of Acupuncture and Tuina Science. The purpose of the study was to determine the effects of acupuncture on intestinal fibrosis in cases of Crohn’s disease. The researchers considered the effects of acupuncture on basic fibroblast growth factor (bFGF) and type I collagen (Col I) in the intestines of laboratory rats with Crohn’s disease. After the use of acupuncture, the expressions of Col I and bFGF reduced markedly in rats with Crohn’s disease.
The research proved that Acupuncture treatment reduces abnormally high levels of these substances. By reducing the abonormally high levels of Col I and bFGF, acupuncture prevents fibrosis in the intestines of those with Crohn’s disease. Acupuncture Points Acupuncture was applied at points St25 (Tianshu) and CV6 (Qihai). Electroacupuncture and moxibustion were applied in different groups. A separate control group did not receive acupuncture. The electroacupuncture and moxibustion groups showed marked improvement whereas the control group did not.
The study shows that acupuncture and moxibustion reduce excessive deposition thereby treating fibrosis in patients with Crohn’s disease.
About Crohn's:
Crohn’s Disease (regional enteritis) is an inflammatory disease of the intestines. It can affect any area of the GI tract from the mouth to the anus. Common symptoms include diarrhea, abdominal bloating and pain, weight loss, arthritis, vomiting, eye disorders, dermatological disorders, and fatigue.
Crohn’s disease is considered to be an autoimmune system disorder of the GI tract. Genetics may play a role in its etiology, however, there is significant evidence that environmental factors contribute to this pathology. Smokers are approximately twice as likely to develop Crohn’s disease.
No western medicine cure exists for Crohn’s Disease and therefore most MD’s focus on controlling the symptoms. Crohn’s disease may cause growth failure in children and increases the risk of cancer in the affected regions of the intestines.
Ulcerative Colitis:
Crohn’s disease is often confused with ulcerative colitis. Crohn’s disease commonly affects the terminal ileum and the colon. Ulcerative colitis hardly ever affects the terminal ileum and always affects the colon.
Crohn’s disease commonly affects the anus and ulcerative colitis rarely affects the anus. Crohn’s disease causes patchy or serpiginous (snake-like) ulcerations of the intestines whereas ulcerative colitis causes a continuous area of ulceration. Ulceration is shallow with ulcerative colitis but is deep with Crohn’s disease.
As a result, Crohn’s disease may cause stenosis of the intestines. The study shows that Acupuncture prevents fibrosis of the intestines thereby helping to prevent stenosis.
Source:
www.healthcmi.com
14 March 2011
Are You an IBD Icon? Tell Us Your Story!
Have you achieved your dreams and goals despite living with Crohn's or Colitis? Tell us your story -- you could be the next "IBD Icon!"
CCFA has partnered with Janssen Biotech, Inc. and Season 10 American Idol finalist Casey Abrams to launch this new contest. The grand prize: Two winners will receive a trip to Las Vegas to see Casey perform at the Zappos.com Rock 'n' Roll Las Vegas Marathon and Half Marathon to benefit CCFA!
More about the IBD Icons contest:
•US citizens, age eighteen and older who are diagnosed with UC or Crohn's disease are encouraged to submit their story showcasing how they live beyond their disease now through August 26, 2011 at www.IBDIcons.com.
•Six finalists -- three with ulcerative colitis and three with Crohn's disease -- will be selected by a panel of judges from CCFA and announced on the website September 26th, at which time the public can vote for the finalist they find most inspiring. For every vote, Janssen Biotech, Inc. will donate $1 to CCFA, up to $10,000 for IBD research and education.
•After a national vote, one finalist with ulcerative colitis and one with Crohn’s disease will be named the 2011 IBD Icons.
Visit www.IBDIcons.com to enter for your chance to be named an IBD Icon or to register for the fan club and receive contest updates! Casey’s achieving his dreams -- share your IBD inspirational story today!
Contest deadline is August 26, 2011.
Source:
news@ccfa.org
3 August 2011
Climate Effects Inflammatory Bowel Disease
A large, new study shows that living in a sunny climate appears to reduce women’s risk of developing inflammatory bowel disease (IBD).
An estimated 1.4 million people live with an inflammatory bowel disease, either Crohn’s disease or ulcerative colitis, in the U.S. Both cause persistent diarrhea, fever, abdominal pain & cramping, and sometimes rectal bleeding. Symptoms can become severe & sometimes require surgery. Yet little is known about the causes of these diseases, which are thought to involve a dysfunction of the immune system.
For the study, which was published in the Journal Gut, researchers went through data on more than 238,000 women taking part in the long-running Nurses’ Health Study, which began in 1976. The study collected information on where the women were living at birth, age 15, & age 30.
It also recorded any diagnosis of an inflammatory bowel disease up to 2003. Researchers also followed up with women who reported having inflammatory bowel disease & verified their diagnoses through medical records.
They found that women who got a lot of sunshine & lived in Southern regions had a 52% lower risk of being diagnosed with Crohn’s disease by age 30 and a 38% lower risk of getting ulcerative colitis than those who lived in Northern regions.
That result held up even when researchers tried to rule out other things that might increase a person’s risk for an inflammatory bowel disease, like having a family history. “The differences are pretty drastic. That’s what surprised us the most. Especially when it comes to Crohn’s disease.
We’re seeing a 40% to 50% reduction in risk,” says researcher Hamed Khalili, MD, a gastroenterologist at Massachusetts General Hospital in Boston.
Shedding Light on IBD:
This study confirms previous research from Europe, and it suggests that the amount of UV light exposure from sunlight may play an important role in the development of inflammatory bowel disease, though researchers aren’t sure why.
One theory is that people in sunnier states may have higher exposure to UV light, leading to higher vitamin D levels. Vitamin D is known to help regulate immunity and inflammation. Regional differences in environmental pollution or infections could offer other explanations.
An expert on IBD, Amnon Sonnenberg, MD, MSc, a gastroenterologist at Oregon Health & Science University, Portland, who was not involved in the study comments, “The study was well done, the authors are to be commended. We know quite well that there is a north-south gradient, and this north-south gradient applies to the American continent as well as to Europe."
But he says the reasons behind the regional differences are far from clear cut. For example, he says, studies have shown that miners -- who spend their working hours underground & out of the sunlight -- have less inflammatory bowel disease.
For that reason, he cautions patients against thinking that taking more vitamin D might help their symptoms or lessen their risk if they have a family member who’s affected. People tend to think “vitamin D is going to protect me,” Sonnenberg says, “And there is absolutely no evidence for this.”
Source:
WebMD Health News
18 January, 2012
Common Parasite Uncovers Key Cause of Crohn's Disease
Immune systems have their sinister side, especially when they have not learned how hard to fight. Crohn's Disease and other inflammatory bowel diseases inflict more than a million Americans with unbearable pain and digestive turmoil because of uncontrolled immune responses in the gut.
It was a mystery until immunologists at Cornell's College of Veterinary Medicine caught a key culprit in Crohn's disease: a cell from our own immune forces.
With unconventional help from a common parasite, Eric Denkers, Professor of Immunology, and research associate Charlotte Egan identified a renegade cell responsible for this largely arcane and increasingly prevalent illness.
"Auto-immune diseases are on the rise in this country but their causes have remained largely unknown," said Denkers. "It's possible that these diseases are more common in the West because we're too clean. Exposure to germs trains immune systems how to respond to threats. Early protection from germs may contribute to the increasing prevalence of immune system overreactions in our population, leading to auto-immune problems like allergies and inflammatory bowel disease."
Similar symptoms arise when some hosts first face the prevalent Protozoan Toxoplasma Gondii. Denkers' lab studies this parasite's arsenal of host-manipulating powers, but recently they have steered Toxoplasma research in an entirely new direction.
"We noticed that the initial intestinal inflammation these parasites can cause looks very similar to what happens during Crohn's disease," said Denkers, one of the first to study this connection. "Our lab has started using Toxoplasma to model Crohn's disease in humans and help us find the pivotal perpetrator, which has turned out to be a cell from our own immune forces."
Specialized immune cells called intraepithelial lymphocytes patrol intestinal walls. Upon encountering invaders, they release messenger proteins that call more immune cells to the battleground. "Too many messenger proteins recruit too many immune cells, causing inflammation that can devastate the host's own tissue," Denkers explained. "Bad balance between good bacteria, bad bacteria, and immune interactions like inflammation cause Crohn's disease." Denkers states,
"For the first time we've discovered how infection can turn these immune cells pathogenic, stimulating them to cause disease, inflammation and necrosis in the small intestine. This marks a major leap toward understanding human Crohn's disease. Unveiling this kind of immunological interplay may lead to improved prevention and care in an array of auto-immune diseases."
Source:
www.rdmag.com
By Cornell University
February 22, 2011
Crohn's Disease Can Lead to Complications
Crohn's disease causes inflammation of the gastrointestinal tract, most commonly the lower part of the small intestine (the ileum).
The U.S. National Digestive Diseases Information Clearinghouse says potential complications of Crohn's include:
- A blocked intestine.
- Ulcers and fistulas, which are tunnel-like abnormal passageways that often become infected.
- Tiny tears, called fissures, in the membrane of the anus.
- Nutritional deficiencies.
- Arthritis.
- Skin problems.
- Gallstones or kidney stones.
- Inflammation of the eyes or mouth.
Source:
health.usnews.com
January 28, 2011
Crohn’s Disease Prevents Absorption Of Crucial Vitamin
Gastrointestinal health experts at the Boston University School of Medicine have found that Crohn's Disease, a chronic digestive condition, may prevent the body from absorbing Vitamin D, a nutrient crucial for maintaining bone health.
Their results appeared in the Journal Inflammatory Bowel Diseases (IBD).
Crohn's Disease is an autoimmune disorder that affects stomach and intestines but whose symptoms can also affect the skin, eyes and joints. Individuals afflicted with the disorder often have irritable bowels, skin rashes, achy joints, abdominal pain and fatigue.
Statistics published in the American Journal of Gastroenterology suggest that between 9 and 21 of every 100,000 Americans have Crohn's disease.
In the IBD, researchers found that gastric inflammation caused by the disease appears to prevent the body from absorbing Vitamin D. They suggested that patients with the disorder take daily vitamin supplements in order to try to mitigate vitamin deficiency.
In addition to potentially alleviating complications of Crohn's disease, Vitamin D supplements may improve bone and joint health. Studies have also shown that regular doses of vitamin D and Calcium can significantly reduce the severity of osteoporosis.
Source:
www.betterhealthresearch.com
January 19,2011
D Deficiency in Crohns
A novel vitamin D bioavailability test was employed by Boston Medical Center researchers investigating vitamin D deficiency in Crohn’s patients. Their findings are published online ahead of print in the Journal of Inflammatory Bowel Diseases, the official journal of the Crohn’s and Colitis Foundation of America.
Researchers tested the ability of normal adults and those with inactive Crohn’s disease to absorb vitamin D2; they also looked at the effect of disease location and prior surgery on D2 bioavailability.
The study included 10 normal subjects (50 percent female) and 37 patients with inactive Crohn’s (51 percent female) who had not recently received vitamin D2. After a baseline vitamin D bioavailability test was performed in all subjects, they were each given a single 50,000 IU oral dose of vitamin D2 in a capsule formulation and had their blood drawn 12 hours later to determine serum vitamin D2, which reflected their vitamin D2 absorption capacity.
Results showed 42 percent of Crohn’s patients were vitamin D-deficient(25-hydroxyvitamin D ≤20 ng/mL], while 29 percent were D-insufficient (25(OH)D between 21 and 29 ng/mL). Vitamin D2 levels rose significantly (0.7 ± 0.7 ng/mL (mean ± SEM) to 49.8 ± 3.0 ng/mL ) from baseline 12 hours after supplementation. In the same time frame, , D2 levels increased 0 ng/mL to 34.8 ± 2.8 ng/mL in Crohn’s patients.
Researchers also found a wide variability of vitamin D2 bioavailability in CD patients, who had an average 30-percent decrease in ability to absorb D2 (P=0.01). Analysis of variance (ANOVA) revealed no statistical difference of vitamin D2 bioavailability between patients in the Crohn’s subgroup stratified by the location of disease, the type of surgery, and receiving or not receiving surgery.
The researchers noted more than 70 percent of the patients with quiescent CD were vitamin D-deficient or insufficient. They concluded, “The ability to absorb vitamin D2 in CD patients is unpredictable and the only way to determine this is to perform a vitamin D bioavailability test. Use of this test may guide clinicians in administering the appropriate therapeutic dose of vitamin D for treating vitamin D deficiency in patients with Crohn’s disease.”
Source:
www.naturalproductinsider.com
January 11, 2011
Genes 'Linked to Multiple Diseases'
Scientists in Edinburgh have discovered that single genes can be linked to multiple diseases such as heart conditions & cancer.The Edinburgh University research suggested that one in five genes were linked to more than one disease. The study found genes responsible for Crohn's disease were linked with other conditions.They included prostate & breast cancer, Hodgkin's lymphoma, obesity & high cholesterol.
The researchers said people who carry particular genes - including some responsible for heart disease, Parkinson's disease & some cancers - could be at risk of developing other health problems. Knowing how diseases are genetically connected could aid efforts to develop medicines and could help predict & avoid potential side-effects.
Genetic testing:
Dr Evropi Theodoratou, of Edinburgh University's centre for population health sciences, said: "Showing that genes are linked to more than one disease is very important. "We have shown that this is a common finding and not just an exception. "Anyone who goes for genetic testing should be aware that in future any information they receive about individual genes could have wider implications than they or the clinician immediately realise. "They could also influence the risk of other conditions, so being aware of these wider effects is important."
The scientists also report new genetic links between those genes associated with certain fats that may lower cholesterol & the risk of gallstones. And the study supports earlier research that identified a link between fetal haemoglobin & risk of malaria.
The study is published online in the American Journal of Human Genetics.
Source:
www.bbc.co.uk
1 December 2011
Is The Way of The Future...."Fecal Transplants"?
There are so many ways to improve the makeup of bacteria in your gut, but one new solution, is the fecal transplant, which is proving to be incredibly effective.
It may sound sickening, but fecal microbiota transplant (FMT) is very simple. It entails taking the feces of the donor, who is typically a spouse or relative, then transferring it to the patient during a colonoscopy.
The benefit of this procedure? The patient receives a transplanted population of healthy flora that can go to work correcting any number of gastrointestinal & other health problems.
Dr. Mark Mellow, medical director of the Digestive Health Center at Integris Baptist Medical Center in Oklahoma City, presented research at the American College of Gastroenterology (ACG) annual meeting in Washington, D.C. that found fecal transplants led to rapid resolution of symptoms in 98% of patients with Clostridium difficile (these same patients had not responded to multiple previous treatments) -- an infection that is often resistant to antibiotics, is often unbearable & can be fatal.
On another instance, research found the transplants showed promise in the treatment of ulcerative colitis & Crohn's disease, with symptoms improving anything from days to weeks.
And preliminary research from the Netherlands found that transplanting fecal matter from healthy thin people into overweight people with metabolic syndrome led to an improvement in insulin sensitivity, which adds further credence to the immense role healthy gut bacteria can play in your health.
Source:
www.foodconsumer.org
19 January, 2012
Study Shows Metallothionein Genes has No Association with Crohn's Disease
Metallothioneins (MTs) are exceptional candidate genes for Inflammatory Bowel Disease (IBD) and have formerly been shown to have altered expression in both human & animal studies of Inflammatory Bowel Disease.
This is the first study to examine genetic variants within the Metallothionein genes & aims to determine whether such genetic variants have an important role in this disease.
28 tag SNPs in genes MT1 (subtypes A, B, E, F, G, H, M, X), MT2, MT3 and MT4 were selected for genotyping in a well-characterized New Zealand dataset consisting of 406 patients with Crohn's Disease and 638 controls. No evidence was found in association to Metallothionein genetic variation with crohns disease.
The lack of association indicates that genetic variants in the MT genes do not play a significant role in predisposing to Crohns Disease in the New Zealand population.
Source:
7thspace.com
31 January 2012
Treatment Uses Parasitic Worms to Fight Crohn's Disease
According to a report by the Boston Globe, the eggs of parasitic worms found in pigs could be used to treat Crohn's disease, which is an autoimmune condition that disrupts the intestinal tract.
Coronado Biosciences is filing an investigational drug application with the FDA for CNDO-201, which contains 2,500 eggs from a parasite found in pigs. The treatment follows the logic of the hygiene hypothesis, which holds that as the cleanliness of society has improved, autoimmune diseases have increased.
Read the Boston Globe report on use of parasitic worms to fight Crohn's disease.
Source:
Beckers ASC Review
22 August 2011
Bone Mass, Bone Formation Reduced in Quiescent Crohn’s
According to a study published in the January issue of Gastroenterology, bone analysis reveals a reduction in bone mass characterized by trabecular thinning and bone loss caused by reduced bone formation in patients with quiescent Crohn's disease.
Health Day News states that bone analysis shows a reduction in bone mass characterized by trabecular thinning and bone loss caused by reduced bone formation in patients with quiescent Crohn's disease (CD).
Angela E. Oostlander, of the VU University Medical Center in Amsterdam, Netherlands, and colleagues examined transiliac bone biopsy samples from 23 patients with quiescent CD. To better understand the pathogenesis of the bone loss known to occur in patients with CD, they compared results from histomorphometric analysis with data from age- and sex-matched healthy controls.
Trabecular bone volume was found to be significantly reduced in patients with CD, and the low bone volume was characterized by decreased trabecular thickness (120.61 versus 151.42 µm). Bone formation and resorption were reduced. Osteocyte density and apoptosis were found to be normal, whereas the percentage of empty lacunae in patients with CD was found to be higher than that of published values in controls.
In conclusion, in this study, for the first time a cohort of adult patients with quiescent CD was evaluated using bone histomorphometry. In these patients, bone mass is reduced as characterized by trabecular thinning.
Furthermore, results show that CD-associated bone loss is caused by a reduced bone formation at the tissue level, possibly as a consequence of decreased osteocyte viability in the past.
Source:
www.doctorslounge.com
February 2, 2011
Exercise may help soothe Irritable Bowels
Reuters Health reports that people with irritable bowel syndrome may be able to find some relief by getting regular exercise, a small clinical trial suggests. The study, of 102 adults with the disorder, found that those who were told to get some more exercise had better odds of seeing improvements in problems like cramps, bloating, constipation and diarrhea. After three months, 43 percent of the exercisers showed a "clinically significant" improvement in their symptoms -- meaning it was making a difference in their daily lives. That compared with a quarter of the participants who maintained their normal lifestyle.
For people who are currently less-than-active, even a moderate increase in exercise may curb irritable bowel symptoms, according to senior researcher Dr. Riadh Sadik, of the University of Gothenburg in Sweden. Researchers told those in the exercise group to get 20 to 60 minutes of moderate-to-vigorous exercise -- like brisk walking or biking -- on three to five days out of the week. That's a level that is generally safe and achievable. On top of that, the researcher added, "it will also improve your general health."
About 15 percent of Americans have irritable bowel syndrome, or IBS, which causes bouts of abdominal cramps, bloating and diarrhea or constipation. It is different from inflammatory bowel disease, which includes two digestive diseases -- ulcerative colitis and Crohn's disease -- that are believed to involve an abnormal immune system reaction in the intestines.
The exact cause of IBS is unknown, but people with the condition often find that they have certain symptom "triggers," such as particular foods, larger-than-normal meals or emotional stress. The typical treatment includes diet changes, as well as anti-diarrheal medication and, for constipation, laxatives or fiber supplements. There's also some evidence that behavioral therapy and stress-reduction tactics help some people.
According to Sadik, exercise may be helpful for several reasons. Past studies have shown that it can get things moving along in the gut, relieving gas and constipation. (Vigorous exercise, however, may worsen bouts of diarrhea.) Regular exercise may also have a positive influence on the nervous and hormonal systems that act on the digestive tract. None of the participants in the new study, reported in the American Journal of Gastroenterology, were regularly active at the outset.
The researchers randomly asked about half to begin exercising over a 12-week period, with advice from a physical therapist. The rest stuck with their normal lifestyle habits. At the end of the study, the exercise group reported greater improvements on a standard questionnaire on IBS symptoms. They were also less likely to show worsening symptoms. Of the exercise group, 8 percent had a clinically significant increase in IBS symptoms, versus 23 percent of the comparison group. That, according to Sadik, suggests that for a considerable number of people remaining sedentary may only worsen IBS. "If you have IBS, then you can increase your physical activity to improve your symptoms," Sadik said. "If you stay inactive, you should expect more symptoms."
SOURCE:
www.nature.com
January 4, 2011.
Crohns Genes
With new genetic links coming up every second day, genetics seems to be a burgeoning field.
Many genome-wide association researchers have unveiled that aim to offer fresh links between genetics and disease and human development.
Recently, a new research spearheaded by a Cambridge consultant has offered a new insight into Crohn’s disease.
The study, conducted by Dr. Miles Parkes, consultant gastroenterologist at Cambridge University Hospitals, found links of over 71 genes with Crohn’s disease.
The Crohn's research, deemed to be the world's largest genetic research into inflammatory bowel disease, involved over 22,000 patients from over 15 countries. Crohn's disease, which is an inflammatory gastrointestinal disease is claimed to engulf over 1 in every 500 people in the UK alone.
With the results of this novel study, the number of genes linked with Crohn’s are claimed to be a lot more compared to any other disease. The condition is characterized with inflammation of the gastrointestinal tract, pain, weight loss, vomiting and diarrhea.
Over 50% of the risk of Crohn's is associated with genetics and half environmental factors.
Cathy Elks at the MRC Epidemiology Unit in Cambridge posted: "It is interesting that several of the new genes for puberty timing have been linked in other studies to body weight gain and obesity”.
Source:
Olivia Conroy
11/22/2010
5 Genetic Regions Tied to Childhood IBD
Five newly identified genetic regions may help explain how childhood inflammatory bowel disease (IBD) develops.
A new study shows at least one of the five new gene regions associated with childhood IBD is directly involved in the biological process that causes the painful inflammation of the digestive tract associated with the disease.
Researcher Robert N. Baldassano, MD, director of the Center for Pediatric Inflammatory Bowel Disease at Children's Hospital, says in a news release, "This is an evolving story of discovering what genes tell us about the disease. Pinpointing how specific genes act on biological pathways provides a basis for ultimately personalizing medicine to an individual's genetic profile."
Inflammatory bowel disease affects about 2 million children and adults in the U.S. It is characterized by inflammation of the gastrointestinal lining, which causes damage and ulcerations. IBD includes Crohn's disease, which affects any part of the gastrointestinal (GI) tract, and ulcerative colitis, which is limited to the large intestine.
Researchers say childhood IBD tends to be more severe than the adult form of the disease, but until now most studies have only looked at the genes behind adult IBD.
The study, published in Nature Genetics, is the largest genetic analysis of childhood-onset inflammatory bowel disease. Researchers looked at DNA from more than 3,400 children and adolescents with IBD and compared their genetic structure to that of nearly 12,000 healthy children.
The results identified five genetic regions that increased the risk of childhood inflammatory bowel disease on chromosomes 16, 22, 10, 2, and 19.
Researchers say the most significant finding was in regard to the genetic region on chromosome 16, which is near the gene (IL27) that carries the code for a signaling protein involved in intestinal inflammation.
Source:
Jennifer Warner
WebMD Health News
Nov. 16, 2009
ACG: Smoking Limits Response to Biologics in Crohn's
Crohn's disease patients who smoke or use narcotics appear to be less likely to respond to treatment with biologic agents, researchers suggested here.
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In a retrospective study among 44 patients who were not responding to infliximab (Remicade), about 66% of those patients did not respond to subsequent treatment with adalimumab (Humira), said Ira Shafran, MD, medical director of the Shafran Gastroenterology Center Winter Park, Fla
When Shafran analyzed possible reasons for nonresponse, he noted that 45% of the nonresponding patients were smokers, while only 7% of responders were current smokers.
In addition, 55% of nonresponders were also taking narcotics, compared with 13% of the responders, Shafran told MedPage Today at his poster presentation during the annual meeting of the American College of Gastroenterology.
"I think we should advise our patients with Crohn's disease to stop smoking and to stop using narcotics if they are going to use biologic agents for this disease," Shafran said.
He said that nonresponders to infliximab therapy were more likely not to respond to subsequent treatment with adalimumab. Of the 44 patients in the study who did not respond to infliximab, 29 also did not respond to adalimumab.
"Infliximab is an effective therapy for Crohn's disease," Shafran explained, "but its chimeric nature may induce human antichimeric antibody responses, resulting in infusion reactions, elevated immune responses, and loss of efficacy in some patients." He said that as many as 40% of patients on infliximab may either become intolerant of the treatment or may stop responding to therapy.
His study group of 18 men and 26 women with a mean age of about 39 years had been treated for Crohn's disease for about 18 years.
In addition to smoking and narcotic use, Shafran said that presence of fibrostenotic disease and steroid use also indicated that patients were unlikely to respond to adalimumab.
He said that in his practice he recommends that:
Among other patients who were not responding to infliximab, however, Shafran said that treatment with adalimumab was able to induce and maintain remission of Crohn's disease symptoms.
Source:
American Journal of Gastroenterology
By Ed Susman
October 18, 2010
Accutane and Crohn’s Disease
For twenty seven years, innocent Americans unknowingly ingested the “miracle” acne treatment medication called Accutane.
Prescribed by physicians and taken orally, Accutane was created to reduce blemishes,pimples, zits and other acne via active ingredient Isotretinoin, which would increase Vitamin A, decrease oil and help skin to replenish itself.
But for many, the cost of clearer skin was too high. These people suffered a number of damaging Accutane side effects, and one of the worst were inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s Disease.
Some victims tolerated the side effects and had to have surgeries, even had to have their colon removed due to Accutane. However, many didn’t connect the cause and effect – until now.
Now, the lid is getting blown from the cover-ups and the outright neglect imposed by pharmaceutical company Roche Pharmaceuticals, a Swiss-based giant whose American headquarters are in New Jersey.
Accutane side effects victims are filing Accutane lawsuits or defective medication lawsuits versus the culpable drug manufacturer – and they’re winning.
So far, damages totaling $56 million have already been awarded to some Accutane acne medication victims. In February of 2010, just one Accutane victim from Alabama was awarded more than $25 million in Accutane side effects injury damages. He’d had 5 operations, including one which removed his colon, and all because he took Accutane.
Roche learned of Accutane’s damaging side effects, yet kept selling it anyway. Like other monstrously huge pharmaceutical behemoths, Roche was generating billions on its defective drug, but predicted having to pay litigation awards of millions, not billions. Thus, Accutane may remain successful for Roche, which has collected up to $1.2 billion in Accutane profits in 1 year.
Confronted with Accutane lawsuits and with inroads made by generic Accutane products after its patent expired, Roche in 2009 removed Accutane from the marketplace in America, though it still sells the defective drug in many other countries. Yet generic Accutane continues to be accessible in America, including Amnesteem, Claravis and Sotret. All Accutane type generics contain damaging Isotretinoin, the active ingredient of Accutane.
If you have taken Accutane and as a result, suffered with Crohns Disease or Ulcerative Colitis, please contact Greg Jones at 800 538-337 for possible financial compensation.
Side Effects of Accutane
Source:
bestpoconovacationhome.com
October 8, 2010
Broccoli and Crohns Disease
What do broccoli, plantains, and Crohn’s disease have in common?
A new study suggests there could be an important and beneficial relationship between them.
Crohn's Disease
crohns disease is an inflammatory condition of the digestive tract that most commonly affects the lower small intestine.
An estimated 500,000 people in the United States have the disease, and it can affect both men and women.
About 20 percent of people diagnosed with the disease have a blood relative with some form of inflammatory bowel disease.
The disease is characterized by chronic intestinal inflammation, pain, diarrhea, skin problems, inflammation in the eyes, fever, and rectal bleeding. Although the exact cause is not known, experts believe it is an autoimmune condition in which the immune system reacts to good bacteria and food by attacking the body’s healthy tissues in the intestinal tract. Environmental and hereditary factors are also believed to have a role.
Broccoli and Plantains
Previous research shows that individuals who have Crohn’s disease have elevated levels of a type of bacteria
(Escherichia coli) that can penetrate the intestinal wall via cells called M cells. In people with Crohn’s disease, this leads to chronic inflammation of the gut.
To help prevent E. coli from interacting with M cells, scientists have tested a medical food that contains soluble fibers from plantains. Jon Rhodes, a professor at the University of Liverpool, notes that Crohn’s disease is “much more prevalent in developed countries, where a diet of low fibre and processed foods is common.” He and his colleagues suggest there is a “link between the food that we eat and the transportation of bacteria in the body,” and that consumption of a medical food containing plantain fibers may have
a beneficial impact.
Dr. Barry Campbell, from the Institute for Translational Medicine, adds that their research on the effect of this medical food “shows that different dietary components can have powerful effects on the movement of bacteria through the bowel.”
Earlier studies have shown benefits of eating broccoli and plantains, “but until now we have not understood how they can boost the body’s natural defences against infection common in Crohn’s patients.”
To arrive at their conclusions, the scientists cultured M cells and tested whether preparations of plant soluble fibers from leeks, apples, broccoli, and plantains, as well as fat emulsifiers polysorbate 60 and 80 (used in the manufacture of processed foods) could affect the activity of E. coli across M cells. While plantain and broccoli fibers reduced E. coli activity by 45 to 82 percent, leeks and apples had no observable impact.
The authors suggest that people who have crohns disease may prevent relapse if they supplement their diet with broccoli and plantain fibers. While the scientists are working on a medical food for this purpose, it remains unclear how much actual
broccoli and plantains an individual should eat for this purpose.
SOURCE:
University of Liverpool
News Release August 26, 2010
Crohn's Disease and Acid Reflux
Does a GERD Pillow Really Work?
The National Institutes of Health reports that many patients are unsatisfied with conventional Crohn's Disease treatments for a variety of reasons and more than half of these people seek alternatives.
Symptoms of the disease are uncomfortable to live with and can greatly affect the quality of a person's life. As such, it is understandable that those who suffer from this condition would seek alternatives, especially when traditional therapies are often ineffective or cause unwanted side effects.
Recommended crohns disease treatments depend primarily on the severity of symptoms.
The cause of the disease is unknown still, but recent crohns disease information indicates that the disease may be caused by a bacterial infection. The most commonly accepted theory, however, is that crohns is the result of a dysfunction of the immune system.
Milder symptoms are usually experienced during the onset of the condition and, in such cases; crohns disease treatments may include an anti-diarrhea medication, aminosalicylates or corticosteroids. In the event these options fail, prescription medications that suppress the immune system may be prescribed by a physician.
Current crohns disease information indicates that symptoms are caused by inflammation; however, it’s not an open and shut case because non-steroidal, anti-inflammatory drugs have been linked to flare-ups as well.
Corticosteroids are used with other crohns disease treatments, such as dietary changes, to control and reduce inflammation. Corticosteroids, however, are not believed to be safe for prolonged use due to potentially serious side effects, such as increased blood pressure, osteoporosis and a heightened risk of infection.
Additionally, corticosteroids lose their effectiveness over time so they do not present a long term solution.
In some cases, crohns disease treatments with medications that work by suppressing the immune system have been effective. However, the problem here is that using these drugs increases a patient's risk of infection because of the compromised immune system with a compromised immune system; the body will find it more difficult to combat infection effectively.
In addition, the use of such medications may increase the risk of cancer. This is because the immune system’s function is to help the body attack and destroy abnormal cells. Such abnormal cells, if left unchecked, could progress into cancerous ones. The latest crohns disease information indicates that aminosalicylates alleviate symptoms for some Crohns sufferers; however, on the downside, they may reduce white blood cell counts. In short, aminosalicylates may also lower a person's resistance to infections and other diseases by compromising the immune system.
Current conventional crohns disease treatments, in summary, obviously have their fair share of drawbacks and downsides. Current crohns disease information lists surgical removal of the affected areas of the intestines as the only cure. And, it should go without saying that many people view surgery as an extreme, last resort measure. A compilation of crohns disease information published in August, 2006 concluded that conventional crohn's disease treatments were inappropriate 52% of the time.
A group of gastroenterologists, surgeons and general practitioners evaluated the treatment plans of their colleagues for appropriateness.
This is not told to alarm you, but it could be part of the reason why more and more people are choosing natural alternatives to alleviate crohns.
Some of the most prominent of these natural alternatives are: aloe, slippery elm, and mangosteen. If you have not heard of any of these, is important to know is that there is evidence that these substances may effectively reduce inflammation and relieve pain.
However, none of them have been proven in clinical studies to relive crohn's symptoms, but there are many anecdotal cases of people claiming they helped greatly.
What we do know is that slippery elm and mangosteen have a long history of use as digestive aids. Indeed, the Mangosteen in particular is referred to as “Queen of Fruits” in its native land for its many healing properities and uses, which include relieving diarrhea, pain and inflammation. Scientifically speaking, the mangosteen has been shown to harbor anti-inflammatories, which explains why it is sought out as a natural pain reliever.
Current crohns disease information indicates that reducing inflammation relieves abdominal pain and other symptoms. In the end, decisions about crohns disease treatments are a personal choice. But whichever way you choose — conventional or natural — make sure you tell your doctor of your intentions.
Recent crohns disease information indicates that patients sometimes do not inform their doctors about natural remedies they are using. Some doctors and researchers are concerned about this, because some botanicals and herbals have been known to interact with certain prescription medications.
One possible reason for patient non-disclosure may be that people are afraid of what their doctors will say about the use of a natural treatment, but increasingly, many doctors today are more open minded to natural alternatives.
Reference:
Source: MENTORING-UK COMMUNITY, Blogs from the Mentoring-uk.org.uk Community Portal, April 27th 2007
Crohn's Disease and IBD (Inflammatory Bowel Disease)
What's The Link Between IBD and Crohn's Disease ?
Sarah Jenkins in the article posted in www.imedicalvillage.com says "Inflammatory Bowel Disease (IBD) is a term used for a group of illnesses affecting the digestive system. With roughly one million sufferers in the United States, IBD is primarily composed of two disorders: Crohn's Disease and ulcerative colitis. "
She continues to say that what takes place with IBD, Crohn's, and ulcerative colitis is the body's immune system has an exaggerated response to an unknown bacteria or condition of the bowel system, releases a large number of white blood cells to the affected area, and as a result, the area becomes drastically inflamed. This swelling causes ulcerations and injury to the bowel, as well as various other negative side effects
Although extensive research has been done, it is unclear what causes the excessive immune response in IBD. Some believe it is the body's mistaken identification of good bacteria in the bowel as being dangerous, while others believe it is a foreign agent that triggers the Probiotics, digestive system, which in turn, does not shut down properly. Whatever the reason, this is a chronic condition which will continue to be a problem for sufferers for an extended period of time.
Sara also says that the primary difference between Crohn's Disease and Ulcerative Colitis is the location of the affected area. crohns Disease may affect any portion of the digestive system and may occur in patches, with unaffected areas in between. However, Crohn's Disease primarily affects the end of the small intestine and the beginning of the large intestine. On the other hand, ulcerative colitis only affects the colon. Often, it is very difficult to determine which form of IBD a patient is suffering from and misdiagnosis is common.
She mentions that symptoms common of Irritable Bowel Disorder are diarrhea, abdominal pain, rectal bleeding, and occasionally weight loss. These signs are often present with Crohn’s Disease, as well as uncreative colitis.
As a result of blood loss, many sufferers also become anemic. This can be especially devastating to pre-existing conditions. Likewise, complications can arise from blockages that occur due to excessive bowel swelling and the presence of scar tissue. For this reason, surgery is sometimes necessary to remove damaged areas of the digestive system to avoid obstructions. There are also side effects experienced in other areas of the body in addition to the digestive system.
Jenkins ends by saying " For the most part, IBD and Crohn's Disease are often used interchangeably. However, it should be understood that Irritable Bowel Disorder does not necessarily translate to Crohn's Disease. There are other forms of IBD that may affect sufferers in much the same way".
Reference:
Source: www.buzzle.com/editorials, published: January 14, 2006
Autor: Sarah Jenkins
Crohn's Disease & Genetics
Madeline Ellis writes about the complexities of Crohns' Disease in July 2008 Medical Updates. She says that in what could be the largest study ever undertaken into the underlying genetics of common diseases, a team of scientists and clinicians have identified new genetic links that increase susceptibility to Crohn's disease, one of a group of diseases called inflammatory bowel disease (IBS) that causes inflammation, pain, and ulcers. The researchers hope that by understanding the underlying causes of the disease, they can identify targets for new drug therapies.
She also mentions that previous studies have identified 11 genes and loci (regions of the genome typically including one or more genes) that increase susceptibility to Crohn's disease.
After analyzing DNA samples from almost 12,000 people, researchers identified 21 additional genes.
"We now know of more than 30 genetic regions that affect susceptibility to crohns Disease "said Dr Jeffrey Barrett, lead researcher from the Welcome Trust Centre for Human Genetics at the University of Oxford. "These explain only about a fifth of the genetic risk, which implies that there may be hundreds of genes implicated in the disease; each increasing susceptibility by a small amount."
Scientists have long known that genes, along with environmental factors, play a role in increasing the risk of people developing many common problems such as asthma, high blood pressure, cancer, rheumatoid arthritis, heart disease.
She continues to say three of the individual genes linked to Crohn's have previously been shown to influence the risk of type 1 diabetes and asthma, which suggests a possible common genetic mechanism. However, one of the most promising links is thought to be the CCR6 gene, which scientists believe to be part of the signaling process that causes white blood cells in the intestines to become over-active, leading to inflammation. These same white blood cells are also present in inflamed joints, implying that CCR6 may play a role in rheumatoid arthritis as well.
Ellis ends by saying that the most unexpected link was that of the ORMDL3 gene on chromosome 17. This gene was already known to be a genetic risk factor for childhood asthma, but until now, had not been linked to Crohn's disease. "It's too early for us to say how crohns Disease and many of these other diseases, including asthma, are linked at a biological level," said Dr Miles Parkes, Consultant Gastroenterologist at Addenbrooke's Hospital and the University of Cambridge, who also worked on the study. "However, we are building up a picture of the biology underlying Crohn's disease, and the more we understand about the underlying biology of these diseases, the better equipped we will be to treat them."
Reference:
Source: Medical Updates, Complexities of Crohn's Disease Brought to Light, Published July 13, 2008
Author: Madeline Ellis
Crohn's Disease Gene Discovered
Researchers at McGill University, Canada, have discovered DNA variations in a gene that increases susceptibility to developing Crohn's Disease.
Their study was published in the January issue of the Journal Nature Genetics.
The researchers pinpointed DNA sequence variants in a gene region called NLRP3 that are associated with increased susceptibility to Crohn's Disease.
"Although the exact cause of Crohns Disease is still unknown, both environmental and genetic factors are known to play a critical role in the pathogenesis of the disease," Dr. Franchimont said.
The 400 square metres of the intestinal absorptive area is the largest single surface in or on the human body, and it is covered by billions of bacteria of the intestinal microflora living in the gastrointestinal tract.
"The single layer of cells lining your intestinal digestive tract is thus constantly exposed to high levels of bacteria and pathogens," lead reseracher, Alexandra-Chloé Villani explained.
"These cells must recognize and respond appropriately to the harmful bacteria while maintaining tolerance to the non-pathogenic 'good' (probiotic) bacteria that make up your intestinal microbial flora. This is the central challenge of the digestive immune system, which needs to balance defence versus tolerance."
"The protein encoded by the Crohn's Disease susceptibility gene NLRP3, Cryopyrin, is an intracellular bacteria sensor that plays a key role in initiating immune response," explained Villani.
Based on their results, researchers theorize the bacterial sensor Cryopyrin is probably defective in some patients, and doesn't correctly recognize the presence of harmful bacteria.
Crohn's Disease Gene Discovered cont...
"When the digestive immune system's counter-attack is insufficient to clear the threat," Ms. Villani continued, "there is a bacterial infiltration in the intestinal wall through the first line of defense mechanisms.
The digestive immune system will again try to repel the threat, but the effort may not be sufficient, and this usually leads to a vicious cycle that results in chronic inflammation in the intestinal wall. And that is Crohn's Disease."
"This gene also plays a central role in the regulation of fever, which is one of the most primitive defense mechanisms that exists in humans to fight the surrounding pathogenic bacteria," Dr. Hudson added.
"DNA sequence variations in the NLRP3 gene are also known to be responsible for hereditary periodic fever syndromes."
"Previously published genome-wide association studies have already detected more than 30 distinct Crohns Disease genetic factors, but these only explain about one-fifth of Crohn's Disease heritability", said Dr. Franchimont.
Though these results will not lead to any new short-term treatments for Crohn's Disease, Dr. Franchimont is confident that in the longer term it will benefit crohns patients' care.
"Studies like this one give us a better understanding of key pathways and pathogenic mechanisms involved in Crohn's Disease," he said. "Now that we are aware of the role of bacterial sensors in the disease, steps can be taken to develop a new treatment strategy."
The Crohns study was supported by grants from the Canada Foundation for Innovation, the Canada Research Chair program, the Research Institute of the McGill University Health Centre and the Crohn's & Colitis Foundation of Canada (CCFC).
The study was led by McGill PhD candidate Alexandra-Chloé Villani under the supervision of Dr. Denis Franchimont and Dr. Thomas Hudson. Dr. Franchimont, now with the Erasme Hospital in Brussels, Belgium, was a Canada Research Chair formerly affiliated with the Gastroenterology Dept. of the MUHC.
Dr. Hudson, former Director of the McGill University and Génome Québec Innovation Centre, is now the President and Scientific Director of the Ontario Institute for Cancer Research (OICR), located in Toronto.
More about Crohn's Disease
Crohn's Disease, a chronic relapsing inflammatory disease of the digestive system, can affect any part of the gastrointestinal tract. Crohns Disease sufferers exhibit a number of different symptoms in various combinations. These include
- abdominal pain,
- bloody diarrhea,
- fever,
- vomiting and
- weight loss.
Rarer complications of Crohns Disease include skin manifestations, arthritis and eye inflammation.
Crohn's disease is found throughout the world.
It is most common in North America, Northern Europe, and Canada. Crohns Disease affects between 400,000 and 600,000 people in North America.
ScienceDaily (Jan. 10, 2009) — Adapted from materials provided by McGill University, via EurekAlert!, a service of AAAS.
Crohn's Disease and Ulcerative Colitis ... Alternative Cure
Two research studies evaluating dietary changes and complementary medicine for the treatment of inflammatory bowel diseases (IBS) have been launched at Rush University Medical Center. Funded by the National Institute of Health, one study will look at the impact of mind/body medicine on patients suffering from Ulcerative Colitis (UC) and the other will assess how diet impacts patients with Crohn’s Disease.
There are two main types of IBS, Crohns Disease and UC, which afflict approximately one million Americans. These diseases cause chronic inflammation of the intestinal tract, causing a variety of symptoms such as abdominal pain, diarrhea and rectal bleeding.
Both Crohn’s disease and ulcerative colitis are due to an autoimmune response to the bacteria or bacterial antigens inside the intestines,” said Dr. Ali Keshavarzian, director of digestive diseases and nutrition at Rush and principal investigator and co-investigator on the studies. “Basically, the immune system is having an abnormally aggressive reaction to the bacteria."
"We want to control flare-ups of the diseases," said Keshavarzian. "Unfortunately, the treatments for IBD can be toxic and risky. There are increased risks of cancer, infection and even death as a result of IBD treatment. That’s why we’re looking at how diet as well as stress relate to the flare-ups. It may be that if we can lower stress and get the right diet, we may be able to control these illnesses."
Mind/Body Alternatives for Treating Ulcerative Colitis
One study is looking for participants suffering from UC in order to find out if complementary and alternative medicine techniques may help reduce the effects when conventional medicine has not been successful.
"We’re looking at the relationship between stress and ulcerative colitis flare-ups,” said Dr. Sharon Jedel, clinical psychologist in the section of gastroenterology at Rush and the study’s co-investigator. "The trial includes education about stress and training individuals in certain stress reduction techniques using alternative therapies."
"Approximately 40 percent of patients with IBD use complementary and alternative medicine; however, there is a lack of scientific evidence of the efficacy," said Keshavarzian. "Complementary treatments and services are a large, yet hidden section of our health care system."
Rush is looking to enroll 100 subjects suffering from moderately severe UC who have experienced a flare-up in the last six months. Participants will be assigned randomly to one of two possible eight-week courses on mind/body medicine.
Research on Diet's Effect on Crohn's Disease
The second study which is a dietary trial is looking for 90 participants with Crohn's disease to see if diet adjustments as well as dietary food supplements promoting the growth of good bacteria might help control flare ups.
"We’re trying to get improve the mix of bacteria in the intestines of patients with IBD. Imagine making a picture with different colors," said Dr. Ece A. Mutlu, gastroenterologist at Rush and principal investigator on the study. "It could be terrible or harmonious depending on the composition and quantity of certain colors.
"We’re trying to create a harmonious environment in the intestines with the right types of bacteria."
"One of the many advantages of coming to Rush is that we’re looking for alternatives to IBD treatment that may have less side effects," says Mutlu. "Our hope is to find a number of solutions to control these debilitating diseases."
Reference:
Source: www.sciencedaily.com, Posted June 16, 2008
Author: Rush University Medical Center.
Article Name: Study Underway To Find An Alternative Cure For Crohn's Disease And Ulcerative Colitis.
Crohn's Disease? A possible Explanation
The latest study by Dr. Marcel A. Behr, of the Research Institute of the MUHC and McGill University, has provided new insight into the curious mutation of NOD2 gene, a mutation that is found in 25% of Crohn's disease patients. It is not precisely known how this mutation influences the disease.
When the NOD2 gene functions normally, it codes for a receptor that will recognize invading bacteria and then trigger the immune response. This study demonstrates that the NOD2 receptor preferentially recognizes a peptide called N-glycolyl-MDP, which is only found in a specific family of bacteria called mycobacteria. When mycobacteria invade the human body, they cause an immediate and very strong immune response via the NOD2 receptor.
"Now that we have a better understanding of the normal role of NOD2, we think that a mutation in this gene prevents mycobacteria from being properly recognized by the immune system," explained Dr. Behr. "If mycobacteria are not recognized, the body cannot effectively fight them off and then becomes persistently infected."
Researchers were already aware of the relationship between mycobacteria and Crohn's disease, but they did not know whether the presence of bacteria was a cause or a consequence of the disease. This new discovery associates the predisposition for Crohn's disease with both the NOD2 mutation and the presence of mycobacteria, but researchers must still determine the precise combination of these factors to understand how the disease develops.
More research is required to establish a complete explanation. From this, it is expected that new therapeutic approaches that fight the cause of Crohn's disease may be developed.
Source:
Journal of Experimental Medicine
Crohn's disease | Refrigerated Food Research
In a recent study published online in the latest edition of the journal PLoS ONE, scientists believe they've identified one of the environmental risk factors that cause the terrible Crohn's Disease (CD), about which very little is currently known.
They hypothesized that prolonged exposure to refrigerated food during childhood might have something to do with the onset of the affliction, so they conducted a pilot study aimed at discovering any potential connection between the two.
During the study, 199 CD patients were asked to fill in a number of questionnaires, as were 207 age-matched patients, suffering from irritable bowel syndrome (IBS), who were used as a control group. Fatemeh Malekzadeh, a CD expert from the University of Tehran Medical Sciences Digestive Disease Research Center, in Tehran, says that “Comparable results were obtained looking for the exposure to freezer at home. Finally, among the other recorded items reflecting the hygiene and comfort at home, we also found personal television, car and washing machine associated with CD.”
“This study supports the opinion that Crohns Disease is associated with exposure to domestic refrigeration, among other household factors, during childhood,” he adds.
“No differences were seen with regard to the living in rural/urban area, the presence of pets at home, the size of sibships or the number of children sharing the same bedroom. Interestingly, we obtained results comparable with those seen for the refrigerator when looking at the exposure to freezer at home. Indeed 65% of patients and 50% of controls were exposed since birth and patients were exposed earlier than controls,” the paper says.
Crohn's Disease affects the human digestive tract, causing chronic or relapsing inflammation, which can have serious consequences for patients. Other than cigarette smoke, there are as of yet no environmental factors that trigger the disease. On the other hand, several genetic factors have been discovered over the last years, and physicians now know that predisposition to the disease can be transmitted from mother to infant.
Crohns Disease Helped by Hypnotherapy
Crohn's disease is an inflammatory bowel disease. It affects about 2 to 7 in 100,000 people. The disease can be quite debilitating and sometimes life threatening when symptoms are not controlled. It causes the digestive tract to inflame and can cause severe abdominal pain, malnutrition, and diarrhea.
According to the Mayo Clinic, stress does not cause Crohn's disease, but it can cause symptoms to worsen or cause a flare up.
Hypnotherapy has long been used to help people cope with stress. No matter what the source of stress is, hypnosis is a relaxation technique that calms the mind and body into a deeper state of relaxation.
Research has shown that when stress is a contributing factor in a physical or physiological situation, hypnotherapy helps reduce symptoms associated with that ailment. Studies now show that hypnotherapy is very beneficial in treating people with Crohn's disease.
According to the University of Maryland Medical Center, managing the symptoms of Crohns Disease is possible through diet, lifestyle changes, and alternative therapies. The main goal is to prevent flare-ups and to remain in remission as long as possible. People with Crohn's disease have reported that stress makes their symptoms worsen.
Relaxation techniques are very helpful in reducing the symptoms of Crohn's disease. The University of Maryland Medical Center also promotes the use of hypnotherapy because studies have been shown that it improves immune function, decreases stress, increases relaxation, and eases feelings of anxiety.
A study conducted in Europe included 266 participants with Crohn's disease. The researchers found that hypnotherapy and psychotherapy improve the treatment of the disease. The study found that emotional conflicts such as stress, depression, and anorexia effect the transgression of the disease. Relaxation techniques used in hypnotherapy and psychotherapy were found to give patients greater control over their symptoms.
Crohns Disease helped by Vitamin D3
According to a recent trial reported in Alimentary Pharmacology & Therapeutics Journal, Vitamin D supplementation may not only address low vitamin D levels present in Crohn’s disease, but also reduce the risk of relapse.
Researchers from Aarhus University Hospital, in Denmark, Randers Hospital and Horsens Hospital conducted a randomized double-blind placebo-controlled trial featuring 108 patients with CD in remission (14 were later excluded.) The patients received either 1,200 IU vitamin D3 (n = 46) or placebo (n = 48) once daily for 12 months. The primary endpoint was clinical relapse.
The daily Vitamin D3 treatment increased serum 25-OH-vitamin D from mean 69 nmol/L (standard deviation (SD) was 31 nmol/L) to mean 96 nmol/l (SD=27 nmol/L) after three months. The relapse rate was lower among patients treated with vitamin D3 (13 percent) than among patients treated with placebo (29 percent).
The researchers concluded oral supplementation with 1,200 IU/d vitamin D3 significantly increased serum vitamin D levels and insignificantly reduced the risk of relapse from 29 percent to 13 percent. They suggested larger studies are needed to confirm and explain these findings.
Crohns and Diet
You have had Crohn's Disease for awhile or you have just been diagnosed. Perhaps it is time to look at your diet and see how this can affect your health. It can be very overwhelming. You have to learn about a new way of eating and you may not have any experience doing this.
If you are looking at how your diet can affect your Crohn's Disease, no matter what kind of diet you follow it is important to have a good resource of recipes that you can use. The reason its easy to fail on such a diet is that you may not have enough variety in the foods that you eat. When you only have a couple of recipes for the diet that you are following, it may make you feel deprived and then you land up eating the foods that you are trying to stay away from.
So, being well-informed about any eating plan that you intend to follow is critical, as this helps your success to be much easier. Have at least three recipes for each meal. This will give you the variety that you need, as well as the certainty of knowing that you have several choices at your disposal at any one meal.
One of the best ways to transition to a new diet is to find someone that has done it already, or is doing the diet you want to follow. This way you can learn from their experiences. Another way is to work with a natural therapist or nutritionist who has experience with this type of diet.
if you're doing it on your own, come up with a meal plan and consult several recipe books that are available. Keep track of what you're eating and the symptoms the are related; this will help you to see how you are getting on.
Being accountable, set your goals and bring yourself back to health, keeping the symptoms of Crohn's Disease under control.
Crohn’s disease trial uses stem cells taken from Placentas
Officials remark at the World Stem Cell Summit that a placenta provides a home for a baby, keeps the mom's body from rejecting it and soon could help patients suffering from Crohn's disease, multiple sclerosis and stroke.
Steven A. Fischkoff, vice president, clinical and medical affairs at Celgene Cellular Therapeutics says that patients with Crohn's disease, which inflames the digestive tract, have shown improvement with placenta-derived stem cells, which are adult stem cells.
The New Jersey-based biotech company is moving into the second phase of a Food and Drug Administration-approved clinical trial that uses placenta
stem cells in patients with Crohn's disease. It also is beginning a trial with patients suffering from multiple sclerosis.
Soon it is planning to seek FDA approval to use the placenta stem cells in patients suffering from stroke, based on the work of a neurology researcher at Henry Ford Health System.
"This could potentially affect a lot of people … and if we are successful, we will reduce the chances that people will have to go into nursing homes
or rely on someone for care," Fischkoff said during the last day of the World Stem Cell Summit. "What really scares people with a many of these
diseases is that they lose their independence."
Source:
Kim Kozlowski / The Detroit News
October 06. 2010
Gut Bacteria Fights Inflammatory Bowel Disease
HealthDay News reports: "It has long been known that the guts of humans and other mammals contain about 1,000 different species of bacteria that protect against infection and aid digestion. It has also been suspected that recent increases in asthma and certain food allergies may be due to disruptions in the delicate balance of the intestinal ecosystem, according to background information in the study".
They also mention that previous research has found that the sugar molecule polysaccharide A (PSA), which is produced by a species of intestinal bacteria called Bacteroides fragilis, boosted levels of immune system cells known to protect against Ulcerative Colitis and Crohn's Disease.
HealthDay News also mentions that in this new study, researchers at Harvard Medical School , Brigham and Women's Hospital, and the California Institute of Technology infected immune-suppressed mice with a harmful bacteria called Helicobacter hepaticus. The mice quickly developed IBD, Inflammatory Bowel Disease.
When Bacteroides fragilis was combined with H. hepaticus, the mice remained healthy. Further tests revealed that PSA produced by Bacteroides fragilis was a key factor in preventing Inflammatory Bowel Disease, IBD. The molecule does this by prompting immune cells to secrete an anti-inflammatory interleukin called IL-10, which suppresses the inflammation caused by IBD.
They end by saying, "The researchers said their finding demonstrates the potential for "good" bacteria to benefit human health."
Reference:
Source: HealthDay News Magazine
Article Name: Gut Bacteria Fights Inflammatory Bowel Disease
IBD - Dietary Supplements
If you have Inflammatory Bowel Disease, good nutrition can be difficult to achieve. Certain foods may irritate the gastrointestinal (GI) tract, and even if the diet is stellar, intestinal inflammation might prevent absorption of enough nutrients from the foods that are tolerated. If you have Crohn’s Disease or Ulcerative Colitis, consdier vitamin and mineral supplements.
Here is a list of nutrients, and their best sources, that may become deficient in Crohn’s Disease or Ulcerative Colitis as a result of medications, surgical treatment, or intestinal inflammation itself.
Crohn’s Disease
• Vitamin B12
Mollusks (especially clams and mussels), beef liver, fortified breakfast cereals, sockeye salmon, trout
• Folate (folk acid) Legumes, citrus fruits and juices, whole grains, wheat bran, dark green leafy vegetables, poultry pork, shellfish, liver
• Vitamin A
Beef liver, carrots, sweet potatoes, spinach, cantaloupe, kale, red peppers, broccoli, mangos, apricots
• Vitamin D
Butter; eggs, fish oils, fortified milk, beef or chicken liver, some fortified cereals
• Vitamin E
Wheat germ oil, almonds, safflower oil, corn oil, peanuts
• Vitamin K
Cabbage, cauliflower, spinach and other green lea’ vegetables, cereals, soybeans
• Magnesium
Halibut, nuts and nut butters, cereals, soybeans, spinach, potatoes (with skin), black-eyed peas
• Calcium
Low-fat milk products (if you can tolerate them), kale, collard greens, bok choy, broccoli, oranges, salmon, shrimp, molasses, calcium-fortified foods (check labels)
• Potassium
Sweet potatoes, potatoes, tomatoes and tomato products, beet greens, yogurt, molasses, white beans, soybeans, prune juice, bananas, watercress, winter squash
• Zinc
Red meat, poultry (dark meat), liver, shellfish, cheese (not processed), legumes, bran, nuts, green peas, whole grains
Ulcerative Colitis
It is recommended that people with ulcerative colitis follow the supplementation guidelines for Crohn’s Disease, with an emphasis on the following micronutrients (see the above chart for best food sources):
• Folate
• Vitamin B12
• Magnesium
• Calcium
• Potassium
Iron: Best sources include soybeans, chicken liver, oysters, grits, beef, clams, poultry, dried beans, dried fruits, egg yolks, whole grains, iron-fortified cereals, dark green leafy vegetables, and almonds.
Immune Drug used for Crohns linked to Cancer
US Food and Drug Administration has updated its warning for a group of drugs called TNF blockers, which it says may cause lymphoma and other cancers in children and adolescents. The drugs include Infliximab and Etanercept, which are used for the treatment of juvenile rheumatoid arthritis (JRA), Crohn’s disease and other inflammatory diseases.
The Food and Drug Administration (FDA) is responsible for the regulation of foods, dietary supplements, drugs, vaccines and medical devices, and for ongoing safety monitoring. In June last year the organisation announced that it was investigating the possible association between drugs to block tumour necrosis factor alpha (TNF-alpha), a protein involved in mediating the immune and inflammatory response, and the development of lymphoma (cancer of the lymph system), plus other cancers in children and young people.
Over a 10-year period the FDA received some 30 reports of these types of cancer in young people taking TNF blockers alongside other immune-suppressive medicines to treat JRA, Crohn’s disease or other conditions. They called for manufacturers to submit information on cancers in children also taking these drugs.
When the FDA began its investigation of these reports it stated that the potential benefits of the use of TNF blockers outweigh the potential risks in certain children and young adults. It called for manufacturers to submit reports on any cancer cases, which they included in their investigations.
August 4 2009, the FDA released a follow-up report asking for a change to the labelling of TNF blockers. They concluded that, based on analysis of 48 childhood cancer cases, “there is an increased risk of lymphoma and other cancers associated with the use of these drugs in children and adolescents”. There is also an increased risk of new psoriasis.
Manufacturers now have to add this information to drug literature in the form of a warning on the leaflet inserted into the medicines’ packaging. Patients and professionals are encouraged to report any adverse effects of TNF blockers to the FDA through the MedWatch reporting system that they have implemented.
The FDA reviewed case reports of 48 childhood cancers in young people also taking TNF blockers. Half of these were lymphomas, which included both Hodgkin’s and non-Hodgkin’s lymphoma. Other cancers included leukaemia and melanoma. Some rare cancers, like renal cell carcinoma, liver cancers and leiomyosarcoma (a soft tissue cancer starting in the smooth muscle tissue), were also reported. Unfortunately, 11 of these 48 children died.
In their analysis the FDA concludes that, overall, cases of lymphoma and malignancies in children and young people taking Infliximab were higher than would be expected. Children taking Etanercept had higher than expected rates of lymphomas, but overall rates of cancer were as expected. The TNF blockers Adalimumab and Certolizumab were not included in their analysis because these drugs are not often used in children.
The FDA says that, in the cases of childhood cancer that they investigated, the majority of the patients (88%) were also taking other immunosuppressive medicines such as Azathioprine or Methotrexate, which themselves carry warnings about increased cancer risk. It is, therefore, difficult to determine the possible causes of these cancers, but the role of TNF blockers cannot be excluded.
What are TNF blockers?
TNF blockers work by suppressing the immune system through blocking TNF, a substance that causes inflammation, which may lead to bone and tissue damage. This action makes them helpful for treating immune-related disease. The prescribing guidelines for the four TNF blockers that are currently available in the USA (Remicade, Enbrel, Humira and Cimzia) already contains a warning about the possible risk of cancer.
The FDA reports that manufacturers of these drugs are required to report any cases of cancer in children using these medications, so that the FDA can monitor the situation. In addition, the manufacturer of Cimzia will conduct a 10-year study starting in 2009 that will assess the impact of the drug, with particular reference to new cancers.
Source:
WebMD.com
August 7 2009
Read about natural alternatives for IBD.
Inflammatory bowel disease leads to post traumatic stress
A new research has indicated that the inflammatory bowel disorder Crohn's disease produces its own variant of post traumatic stress (PTSD).
PTSD creates a vicious circle by worsening the Crohn's symptoms, indicates the study.
Crohn's disease is incurable and can potentially affect the entire digestive tract, producing severe pain and diarrhoea. Its precise cause is not known, but its unpredictability makes it difficult to treat, and treatment is itself expensive, exhausting, and onerous, and carries its own risk of complications, say the authors.
The researchers tracked the health and psychological wellbeing of almost 600 adults over a period of 18 months. All of them had been diagnosed with Crohn's disease and lived in various different locations in Switzerland.
At the start of the study, each patient's mental health was assessed using a 17-item validated PTSD scale, which scores the degree of fear, suffering and impaired quality of life associated with PTSD from 0 to 51.
A score of 15 or more points is suggestive of post traumatic stress disorder, and almost one in five (19pc) of the patients achieved this score.
The worsening of symptoms was then monitored during the subsequent 18 months to see if there was any link with the scores and a diagnosis of PSTD.
The results showed that those individuals with PSTD were more than four times as likely to experience worsening symptoms as those who scored below this threshold, and more than 13 times as likely to do so as those scoring zero.
Post traumatic stress occurs in response to traumatic experiences, and is typically manifest in recurring dreams/thoughts, avoidance tactics, irritability and sleeping difficulties.
It is normally associated with violence, emergency situations and natural disasters, but increasingly, research indicates that particular illnesses, such as cancer and HIV infection, plus the diagnostic and treatment procedures that accompany them, also take a hefty emotional toll, say the authors.
They add that over the long term, post traumatic stress permanently changes the body's hormonal and immune responses, so making the sufferer potentially more prone to serious ill health.
"In most cases patients avoid talking about cures which remind them of having the disease...Such behaviour may unwillingly be encouraged by the usual shortness of consultation time and unfamiliarity of [gut specialists] in dealing with the psychological needs of their patients," warn the authors.
Crohn's disease can't be cured, but PTSD can, and doctors should be alert to the psychological fall-out and refer patients for appropriate therapy, they suggest.
Source:
Frontline Gastroenterology
December 2, 2010
Is it Crohns or Ulcerative Colitis?
In Lesli Paterson's blog she tells us that while both of these diseases may seem very similar on paper, there is a very subtle difference between Ulcerative Colitis and Crohn’s. She explains that the biggest difference between Ulcerative colitis (UC) and Crohn’s disease is the area of the body that it affects. In Crohns Disease, your entire intestinal tract can be affected but with ulcerative colitis it is only the large intestine that is affected.
Surgery is a very real option with ulcerative colitis because the disease can be isolated to a portion of the intestine that can be safely removed. This does, however, have some significant repercussions. It may result in the fact that the individual may never have a normal bowel movement again. Instead their stool will be passed in to a bag that they must carry with them.
Treating a flare up of Crohn’s Disease is far more difficult because it is difficult to track down what part of the intestine is being affected. Dietary changes is suggested and monitored for effective treatment. Surgery is often ineffective and may not be worth the risk.
While this is the biggest difference between ulcerative colitis and Crohn’s disease, it is not the only difference between ulcerative colitis and Crohn’s disease. Other differences include symptoms for ulcerative colitis that include bloody diarrhea. This is generally not found in Crohn’s Disease.
As you can see the important and subtle difference between ulcerative colitis and Crohn’s disease will have a huge affect on how the disease is treated. Each has different options for treatment and in many cases will use the same methods. When using natural methods, the treatments for the two diseases may be very similar.
Source:
Lesli Paterson
April 14th, 2010
Michigan Man Has Intestine Transplant
Detroit Doctors at Henry Ford Hospital have performed the first intestine transplant in Michigan.
The recipient,Brent Patterson, under went the 11-hour surgery on Aug. 21 and 22.
Patterson survived a kidney transplant five years ago and had been waiting for an intestinal transplant since April, after Crohn's disease had caused damage to his bowel,stomach and pancreas.
He had previously been through six surgeries to try to fix the damage.
Patterson said he can't express the amount of gratitude he feels for the donor and their family.
Watch: 1st Intestine Transplant Performed In Michigan
Henry Ford Hospital transplant surgeon Dr. Marwan Kazimi compared the surgery to piecing together an elaborate puzzle. "Prior to learning how to do this, I had never seen any operation in the abdomen quite this complex," Kazimi said.
Patterson said after years of being in and out of hospitals, being forced to sleep upright in a chair and living on intravenous nutrition, he's looking forward to the little things.
"I hope that I can sleep in a bed again, just little things like that ... be able to get a good night's sleep," he said.
He also said he'd like to take his wife to Florida to see the Daytona 500.
Patterson's wife of 29 years said she is also very grateful to the donor and doctors.
"Once the spring comes and he's feeling better, he gets his strength up, then I'll let him loose," she said.
Patterson's doctors said he has months of recovery ahead of him.
Source:
clickondetroit.com
September 22, 2010
Natural Remedies for Inflammatory Bowel Disease (IBD)
According to Philip B. Miner, Jr., M.D., President and Medical Director of the Oklahoma Foundation for Digestive Research, patients with Inflammatory Bowel Diseases are looking towards the National Center of Complementary Medicine because of:
- the side effects and, in some cases, ineffectiveness of conventional medical treatments,
- concerns around the nutritional value of the processed arid refined foods that have come to dominate the American diet,
- the presumed safety of natural remedies,
- concerns about surgery and
- the need to feel in greater control.
It is precisely because Dr. Miner’s patients are already using the National Center of Complementary Medicine that he supports the selective use of herbal supplements, functional foods, and other biologically-based approaches in a spirit of open, non-judgmental inquiry.
Dr. Miner has tracked hundreds of CAM studies, and his observations are both interesting and surprising. In a presentation he has offered to patients and medical colleagues around the country he focuses on seven biologically-based remedies that have been touted widely on the Internet as helpful in Crohn’s disease and ulcerative colitis, noting their pros and cons along the way:
Capsaicin, the active ingredient in chili peppers, is being used by some patients to relieve pain, cramps, bloating, and diarrhea The scientific evidence supporting its effectiveness has been scant so far, with one important exception: Because capsaicin is known to deplete substance P, a cellular component that’s involved in the transmission of pain from the skin to the spinal cord, and because of strong anecdotal evidence on behalf of its healing potential, Dr. Miner believes further studies of this functional food are warranted.
The Lemonade Diet has been around since 1941, and it has made a recent comeback as a “detox” plan appropriate for everything from weight loss to the alleviation of the symptoms of many chronic diseases. The diet excludes all solid food and requires its adherents to drink an exclusive mixture of mineral water, maple syrup, fresh lemon, and cayenne pepper (which, incidentally, contains capsaicin!). If you want to try the diet, says Dr. Miner, it won’t hurt you as long as you don’t stay on it for longer than ten days—but its benefits are questionable at best.
Garlic continues to be the natural remedy of choice for people suffering from a wide range of conditions. Although it has been shown to improve diarrhea, it can aggravate pain and fever two common symptoms of Crohn’s disease and ulcerative colitis. That’s because it actually activates the immune system—a distinct no-no for people with diseases caused by an immune system that is overactive. Dr. Miner warns that garlic is “high-risk, except in patients with diarrhea and minimal mucosal inflammation.”
Peppermint oil and peppermint tea seem to reduce abdominal pain, bloating, and the frequency of bowel movements in people with irritable bowel syndrome (IBS), according to some preliminary studies. Some believe that peppermint might help ease symptoms common to both IBS and IBD. More solid data exists, says Dr. Miner, around the addition of peppermint oil to barium enema preparations, which has been shown to relax the colon during a barium enema examination. Given these results, and despite its lowly association with gum, candy, and ice cream, peppermint should be the subject of serious scientific investigation, he contends.
Aloe Vera is widely used for wound healing and pain relief, but its benefits have not been confirmed in clinical studies. Some people with mild- to-moderate ulcerative colitis who take aloe vera juice have reported significantly reduced symptoms—but when DL Miner carried out a controlled trial of Acemannan, believed to be the active ingredient in aloe vera for wound healing, the substance did not distinguish itself from placebo and the study was halted. Further; Dr. Miner urges caution in light of aloe vera’s laxative effect and its qualities as an “immune booster.” Remember, he says, a person with Crohn’s disease or ulcerative colitis should be careful about treatments that can boost an already overactive immune system.
Evening primrose oil contains gamma-linolenic acid, an essential fatty acid needed by the body for growth and development. It is reputed to have anti-inflammatory effects, and because some people with rheumatoid arthritis (HA) claim to benefit from taking it, it has grown in popularity among patients with other inflammatory diseases. However; there is some evidence that borage oil, another plant- derived oil that contains gamma linolenic acid, is more effective in reducing the joint pain and swelling associated with RA than evening primrose oil. So if you’re on the fence, he says, choose borage over evening primrose.
Fish oils are the richest known source of omega-3 fatty acids, which have shown promise for the prevention and treatment of cardiovascular disease. They may also prove effective in Crohn’s disease and ulcerative colitis. Says Dr. Miner, “It’s too soon to tell whether their promise will be realized in the form of solid scientific evidence. What we know is that omega-3 fatty acids modulate a key molecular pathway that affects allergic reactions and the inflammatory response. So even though some clinical studies of fish oils have produced disappointing results, it’s a ‘smoking gun’ that’s worth further investigation.”
The more widely used biologically-based products for Inflammatory Bowel Disease:
- nutritional supplements, such as vitamins, minerals, and herbal formulas;
- prebiotics and probiotics;
- proteins and fatty acids;
- animal-derived extracts; and
- functional foods, defined as biologically active components of certain foods that carry potential benefits beyond their basic nutritive value.
Probiotics have entered the mainstream of medical treatment for patients with pouchitis—inflammation of the “neo-rectum” created during proctocolectomy, a commonly performed surgical procedure used for people with severe ulcerative colitis—and for prevention of antibiotic-associated diarrhea.
Dr. Miner is a physician with an attitude of openness and curiosity. Actually, medicinal herbs dating from the early Middle Ages, such as digitalis and quinine, form the basis for widely used modern drugs. As more complementary treatments cross over into mainstream medicine—and many experts predict that some of them will—the story of medicine and healing will continue to unfold.
Sources
wwv.nccam.nih.gov
• U.S. Food and Drug Administration
www.cochiane.org/reviews
• Natural Medicines Comprehensive Database
New Stem Cell Therapy for Crohn's Disease
Cellular therapy with stem cells is revolutionizing the focus of treatment of many serious diseases. Replacing the cells of damaged tissue with other new cells from the same patient is already a reality. This is the basis of cellular therapy and regenerative medicine, the latest great advance in biomedicine.
Hospital Clínic in Barcelona is exploring an innovative cellular therapy that uses stem cells to treat Crohn's disease, the chronic genetic disease that affects 1% of the population in Spain and which has considerable impact on the quality of life of the patients.
The procedure is based on an autologous bone-marrow transplant (when patients receive a transplant of their own stem cells) and now constitutes a treatment option to cure an intestinal disease that sometimes does not successfully respond to drugs and requires highly complex surgery that does not provide a cure.
With this therapy, in an average follow-up period of 6 years, 80% of transplant patients are in a phase of total remission of the disease and the remaining 20% have shown considerable improvement following the transplant, and are now responding favorably to drugs.
Dr. Julián Panés and Dr. Elena Ricart, at the Gastroenterology Department of Hospital Clínic, in Barcelona are the driving force behind this therapy in Spain and began to implement regenerative cellular therapy in patients with Crohn's disease in August 2008.
To date, a total of 6 patients are benefiting from this new treatment, of whom 3 already completed the process and are in the follow-up face, and a further 3 are at different stages of therapy. The transplant requires several weeks of admission to hospital before patients receive their own cells.
Cellular Therapy as a Strategy to Combat Crohn's Disease
Crohn's disease, together with Ulcerative Colitis, is included in what is called Inflammatory Bowel Disease (IBD). It is a chronic genetically linked, disease that occurs when the immune system loses tolerance to the patient's own intestinal flora, leading to an abnormal inflammatory response that continues over time. The results are inflammation and ulceration in different areas of the digestive tract, leading to the symptoms. The disease progresses in the form of unpredictable and variable outbreaks throughout the patient's life and the severity of the symptoms varies according to the level of involvement of the intestines and the patient's response to the assigned treatment.
Crohn's Disease often affects young people between the ages of 18 and 40 years, and approximately 2000 new cases are diagnosed in Spain every year. Diagnosis is often difficult because it presents symptoms similar to those of other diseases of the digestive tract: abdominal pain, diarrhea, vomiting, nausea, fever, general malaise, etc. Patients' quality of life is conditioned by the severity of the disease and, in the most severe cases, prevents them from leading a normal life, with a very high level of suffering due to the acuteness and frequency of the intestinal symptoms.
Hospital Clínic de Barcelona is one of the few hospitals in the world to instate cellular therapy using autologous stem-cell transplantation.
In the US, the treatment has been tested on 12 patients with severe Crohn's disease, of whom 11 have had very good results; in Italy, the treatment has been applied to 4 patients, 3 of whom are also showing excellent progress following the transplant. As Hospital Clínic, 6 patients with Crohn's disease are already included in the process and, following the international examples, increasing numbers of patients are expected to choose this option to treat the disease in a state that was, to date, practically untreatable.
In severe cases involving recurrent outbreaks (reactivation of the disease several times throughout the patient's life), Crohn's disease presents several treatment options.
To start off with, doctors select to use corticosteroids and immunosuppressant and biological drugs to control the inflammatory process and prevent complications of the disease such as stenosis (narrowing of the intestinal lumen) or fistulas (openings from the intestinal lumen to other organs, such as the intestine, bladder, vagina, or skin).
Over the course of the disease, as much as 70% of severe patients require surgery to remove segments affected by the disease, due to failure of the pharmacologic approach. The surgery is occasionally very aggressive for the patient, as it is sometimes necessary to remove the entire colon or large sections of the small intestine, thereby considerably affecting the absorption of food by the intestine, with a resulting deterioration in quality of life and body image (colostomy bag).
For this reason, new treatments are being developed for patients in whom this solution has not been an option to date.
Autologous Stem-Cell Transplant: Phases of the Procedure
When the case is detected (that does not respond to drugs or surgery), the patient undergoes an autologous stem-cell transplant, which is a bone-morrow transplant in which the immune system is reset to prevent it from attacking the intestinal flora. The process lasts approximately 2 months and consists of 6 phases:
Initial Chemotherapy (Cyclophosphamide + G-CSF).
In this initial phase, leukopenia or reduction of the number of leukocytes (immune-system cells) in the blood is induced in the patient.
Migration of Stem-Cells to the Blood.
Following the previous immunosuppression, the organism reacts by releasing stem cells from the bone marrow into the blood; these are the cells which will later be used for the transplant.
Collection of Stem Cells by means of Apheresis.
Apheresis is a technique that separates components of the blood. This is when the stem cells that previously migrated from the bone marrow are separated.
Cryopreservation of Stem Cells.
When the stem cells have been collected by apheresis, they are frozen and preserved until ready for transplant.
Second Chemotherapy.
In this phase, total leukopenia is induced; that is, the immune system is left devoid of leukocytes, ready to be reset with the stem-cell transplant.
Autologous Stem-Cell Transplant.
The patient receives the transplant by means of transfusion with his or her own stem cells. The immune system is reset, leading to remission or reduction of the abnormal inflammatory process of Crohn's disease.
Source:
As reported in Science Daily (Feb. 19, 2009)
New studies Highlight Obesity's impact on Gastrointestinal Health
IBD likely independent risk factor for coronary artery disease
The association between obesity and gastrointestinal-related cancers and coronary artery disease; the link between an overweight or obese body mass index and the severity of Crohn's disease; and whether inflammatory bowel disease is an independent risk factor for coronary artery disease, were among the highlights of new research that was presented this week at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio.
Obesity Linked to Increased Liver Cancer Risk, Adenoma Recurrence
Although liver cancer (hepatocellular carcinoma/HCC) in the absence of cirrhosis, fibrosis or hepatitis B is a rare occurrence, estimates show up to 10 percent of liver cancer occurs in non-cirrhotic livers.
"Previous studies have suggested that obesity and insulin resistance may be risk factors for non-cirrhotic hepatocellular carcinoma, prompting us to analyze data from a cohort of 12 patients with non-cirrhotic HCC who underwent partial hepatectomy between January 2008 and September 2009 at a single center," said researcher Benjamin Mitlyng, M.D., a fellow with the University of Minnesota's Division of Gastroenterology, Hepatology and Nutrition. "We evaluated preoperative data including age, gender, presence of liver disease, body mass index (BMI), number of lesions and other comorbidities; data related to the resection, such as background history, tumor size, and vascular invasion; as well as post-operative complications and mortality," Dr. Mitlyng explained.
The study, "Hepatocellular Carcinoma in the Non-Cirrhotic Liver is Associated With a High Body Mass Index Independent of Steatosis," found that patients with non-cirrhotic HCC had a high prevalence of diabetes and elevated BMIs despite a lack of steatosis. However, even with advanced disease, patients tolerated resection very well with minimal complications, no operative mortality and average tumor-free follow-up of 17.5 months, according to the study.
"These findings support previous data that there may be an association with non-cirrhotic HCC and an elevated BMI as well as diabetes independent of steatosis," said Dr. Mitlyng.
Body Mass Index was also linked with adenoma recurrence in the short and long-term, in another study unveiled today, "The Association of Obesity with Short and Long-Term Risk of Adenoma Recurrence: Analysis of the Polyp Prevention Trial and Continued Follow-Up Study."
"Previous prospective studies have evaluated the association between obesity and colorectal adenoma recurrence within four years of follow-up, a relatively short duration," said Adeyinka Laiyemo, M.D. "We aimed to examine long-term cumulative risk of adenoma recurrence in association with obesity among participants in the Polyp Prevention Trial (PPT), a multicenter, randomized controlled trial that evaluated the effect of a low fat, high fiber, fruits and vegetable diet on the risk of colorectal adenoma recurrence," explained Dr. Laiyemo.
The study, found that at baseline, approximately 50 percent of the 760 participants were overweight (BMI 25-29 kg/m2) and 25 percent were obese (BMI = 30 kg/m2). The mean age of participants was 59.7 years and 66 percent were males. The mean total duration of follow-up was 8.4 years (range 4.9 -12.4 years).
"When compared with participants with normal BMI, overweight and obese participants have an elevated risk of adenoma recurrence during both short and term and long-term," said Dr. Laiyemo. "Since BMI was positively associated with adenoma recurrence in short and long-term, lifestyle modification should be encouraged."
High Prevalence of Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease
With Non-Alcoholic Fatty Liver Disease (NAFLD) affecting up to 20 percent of adults and nearly five percent of children, researchers aimed to assess the prevalence and predictors of coronary artery disease (CAD) in patients with NAFLD. NAFLD is a very common disorder and refers to a group of conditions where there is accumulation of excess fat in the liver of people who drink little or no alcohol. Both NAFLD and CAD are complications of metabolic syndrome.
A total of 93 patients who had a suspicion of CAD and were scheduled for cardiac catheterization were included in the study, "High Prevalence of Coronary Artery Disease (CAD) in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)," which found that among the 60 patients with available abdominal imaging, the prevalence of NAFLD was 30 percent.
"These patients who were found to have NAFLD were older, more commonly male, had higher weight and were also more commonly diabetic, hypertensive and had hyperlipidemia," explained researcher Noreen Hossain, M.D., of the Center for Liver Diseases, Inova Fairfax Hospital, Fairfax, Va. "The prevalence of angiographically-proven coronary disease in the NAFLD cohort was 61 percent compared to 26 percent in the non-NAFLD controls," said Dr. Hossain.
"As a result, NAFLD is strongly associated with angiographically-proven CAD," explained Dr. Hossain. "We found that diabetes is independently associated with both NAFLD and CAD."
Is Inflammatory Bowel Disease A Risk Factor for Coronary Artery Disease?
The link between chronic bowel inflammation and coronary artery disease (CAD) was explored in another study, "Is Inflammatory Bowel Disease a Risk Factor for Coronary Artery Disease," which focused on 79 patients who had confirmed inflammatory bowel disease (IBD) and CAD diagnosis. Forty-six patients had ulcerative colitis and 52 percent were males in the study group, compared to 40 percent males in the control group. Using the Framingham risk score FRS), which is calculated based on age, sex, hypertension, diabetes, tobacco use, total cholesterol and HDL values, the study found that FRS was lower in patients with IBD and CAD compared with the control group of patients with just CAD, implying that IBD is an independent risk factor for CAD.
"Recurrent flares of intestinal mucosal inflammation leads to the presence of excess pro-inflammatory cytokines and serum soluble adhesion molecules in IBD that could promote atherosclerosis-related inflammation, alter lipid metabolism, and contribute to plaque instability and rupture," said researcher Tarun Rustagi, M.D., of the Department of Internal Medicine, University of Connecticut. "Our results are in accordance with those published by smaller studies." Dr. Rustig also explained that further prospective cohort studies are needed to accurately investigate the incidence of CAD in patients with IBD.
In other findings, Crohn's disease patients who are overweight or obese (BMI>25) are more likely to have more severe disease characterized by a higher likelihood of Vitamin D deficiency, stricturing ileocolonic disease, and are more likely to require surgery compared to normal weight patients (BMI < 24.9) with Crohn's disease, according to the study, "The Clinical Phenotype of Obese and Overweight Crohn's Disease Patients."
Source:
www.eurekalert.org
18-Oct-2010
Philips Research iPill for Crohns Disease Drug delivery
Digestive tract disorders such as Crohn's disease, colitis and colon cancer are becoming increasingly common, particularly in the western world. Crohn’s disease and colitis can be treated with drugs, notably steroids, but many of these drugs have adverse and unpleasant side effects for patients when administered systemically as whole-body doses.
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However, by delivering the required drugs directly to the site of disease, dose levels may be lowered and many of these side effects could be reduced.
It is this need for accurate delivery of drugs to specific sites in the intestinal tract that drove the development of Philips Research’s intelligent pill “iPill” for electronically controlled drug delivery. In addition to the potential benefits of this new technology to improve patient therapy, the iPill promises to be a valuable research tool for the development of any new drug that is delivered via the intestinal tract.
Capsules containing ultra-miniature cameras are already in use as diagnostic tools, but lack the ability to deliver drugs. The challenge for scientists at Philips Research was to find a way of navigating a drug-loaded pill capsule to the site of disease and then releasing a metered amount of drug into the gut at that location.
Resource:
Phiilps Research - Intelligent Pill
Small Intestinal Bacterial Overgrowth often mimics acute flare up in patients with Crohn's Disease
An abstract published by Jochen Klaus , Ulrike Spaniol , Guido Adler , Richard A Mason , Max Reinshagen and Christian von Tirpitz C published in BMC Gastroenterology investigates how bacterial overgrowth in the small intestine can mimic acute flare ups in peopel with Crohns Disease.
Background
Small intestinal bacterial overgrowth (SIBO) is characterized by excessive proliferation of colonic bacterial species in the small bowel. Potential causes of SIBO include fistulae, strictures or motility disturbances. Hence, patients with Crohn's Disease (CD) are especially predisposed to develop SIBO. As result, CD patients may experience malabsorption and report symptoms such as weight loss, watery diarrhea, meteorism, flatulence and abdominal pain, mimicking acute flare in these patients.
Methods
150 patients with CD reporting increased stool frequency, meteorism and/or abdominal pain were prospectively evaluated for SIBO with the Hydrogen Glucose Breath Test (HGBT).
Results
Thirty-eight patients (25.3%) were diagnosed with SIBO based on positive findings at HGBT. SIBO patients reported a higher rate of abdominal complaints and exhibited increased stool frequency (5.9 vs. 3.7 bowel movements/day, p=0.003) and lower body weight (63.6 vs 70.4 kg, p=0.014). There was no correlation with the Crohn's Disease Activity Index. SIBO was significantly more frequent in patients with partial resection of the colon or multiple intestinal surgeries; there was also a clear trend in patients with ileocecal resection that did not reach statistical significance. SIBO rate was also higher in patients with affection of both the colon and small bowel, while inflammation of the (neo)terminal ileum again showed only tendential association with the development of SIBO.
Conclusions
SIBO represents a frequently ignored yet clinically relevant complication in CD, often mimicking acute flare. Because symptoms of SIBO are often difficult to differentiate from those caused by the underlying disease, targeted work-up is recommended in patients with corresponding clinical signs and predisposing factors.
Source:
BMC Gastroenterology 2009, 9:61doi:10.1186/1471-230X-9-61
Published: 30 July 2009
The Bowel, Food Sensitivities and Asthma
A damaged bowel ecosystem and undiagnosed food sensitivities and mold allergy are the real causes of asthma, says Majid Au, MD.
“Exercise, stress, and environmental chemicals,” Dr. Ali writes, “in such cases simply act as the last triggers.”
A healthy immune system, inflammatory response, and detoxification depend upon healthy bowel ecosystem and function.
When treating asthma, Dr. Ali and colleagues at The Institute of Integrative Medicine use “a seed, feed, and occasionally weed approach [with antifungal drugs, if necessary]” to restore bowel ecology. He explains the process in his book - "The Canary and Chronic Fatigue".
Nutrients and herbs, along with therapies to support the blood ecosystem and liver, provide long-term management of asthma in many cases. Dr. Ali says that magnesium, glutathione, vitamin B12, protein and peptide protocols, pantetheine, essential oils (e.g., cold-pressed extra virgin olive oil, flaxseed oil, pumpkin oil, and sesame oil), and taurine are most important for asthma control.
The most beneficial herbs for people with asthma are uncooked ginger (a piece of chopped root, an inch or less long, eaten with food or taken with water), licorice, wild cherry, hawthorn berry, fennel seeds, bloodroot, and Ephedra.
Lobelia, valerian, skullcap, and St. John’s wort can ease anxiety that can trigger an asthma attack. Because asthma can be a life-threatening condition, Dr. Ali advises people with asthma to find an integrative physician.
Asthma is too serious to be managed through self-care, he says.
Addressing physical components of asthma is only part of recovery. Dr. Ali urges asthma sufferers to attend to the spiritual work of healing, as explained in his book Healing Miracles and the Bite of the Cray Dog.
“Constant thinking about one’s disease stands in the way of healing,” he writes. An “energy-over-mind approach,” not a mind-over-body approach, is needed.
www.garynull.com/Documents/AgingHealthlullylAsthma.htm.
February 4, 2008.
Vitamin D Good for Crohns Disease
A new study by Montreal researchers, published in the Journal of Biological Chemistry, suggests that Vitamin D might also prevent and fight Crohn's disease,
John White, an endocrinologist at the Research Institute of the McGill University Health Center says that their data suggests for the first time that Vitamin D deficiency can contribute to Crohn's disease.
White noted that people who live in northern climates, where there is less sunshine that is essential for the production of Vitamin D by the human body, are especially vulnerable to Crohn's disease.
White and his colleagues treated cancer cells in the lab with Vitamin D, and then carried out a micro-array or genetic analysis of those cells. They found that Vitamin D switched on two genes that are important in preventing or fighting Crohn's disease.
"It's reasonable to think that Vitamin D deficiency can contribute to the frequency of the disease," White said. "Siblings of patients with Crohn's disease that haven't yet developed the disease might be well advised to make sure they're Vitamin D sufficient."
As for whether taking Vitamin D could be an effective treatment for Crohn's, White was cautious, saying that would have to be demonstrated in a clinical trial.
"This discovery is exciting, since it shows how an over-the-counter supplement such as Vitamin D could help people defend themselves against Crohn's disease," said Servant, co-author and professor at the Universite de Montreal's faculty of pharmacy.
Source:
Journal of Biological Chemistry
April 2010
Vitamins Help Crohns Disease
Sharon Dobson says that one of the best ways to maintain a healthy body and avoid malnutrition is to ensure adequate vitamin and crohns supplement treatment.
Many studies that have been conducted on Crohn's sufferers have found that the vast majority of those with crohn's are generally deficient in
vitamins A,
vitmain B,
vitamin C,
vitamin D and
vitamin E
The natural deficiency of these vitamins is likely due to:
- dietary restrictions,
- medications, and
- poor nutrient absorption.
Its important to remember that Vitamin A is necessary for a healthy normal immune system function, which is required to maintain a healthy mucous membrane. The skin and mucosal cells that line the digestive tract, urinary tract and airways, create a barrier and are the body's initial defence against infection. Vitamin A also plays a vital role in immune response and in the proper function of the adrenal glands which control the way we respond to stress.