Posted on February 7, 2017

Do you have or know someone with Crohn’s disease? I would like to show you why we need research to discover better treatments.

Crohn’s is a chronic inflammatory bowel disease (IBD) that can involve any part of the GI tract but most common in the distal small bowel (ileum). It can also affect eyes, skin, liver and joints (it is a system disease). There are 700,000 people with Crohn’s in the USA. Most Crohn’s cases often start between ages 15-35.

The exact cause of Crohn’s is unknown but may be a combination of factors (genetics, environment and an overactive immune system).  The immune system is your body’s way of fighting infection. In Crohn’s, something triggers the immune system to overreact releasing chemicals that promote inflammation. Risk factors include smoking or living in an industrialized nation. Being white and having a jewish heritage.

Symptoms may vary dependent on its location, but usually causes abdominal pain, fever, weight loss, loss of appetite and loss of energy. If the colon is involved, there is diarrhea with blood and pain. If the small bowel is involved, there is weight loss, possible obstruction and abdominal pain. 70% eventually need surgery.  Complications include perforation of the bowel, small bowel obstruction, fistulas connecting bowel to bladder, vagina, skin and adjacent bowel, and increased risk of colon cancer.

Crohn’s disease can be diagnosed by colonoscopy, CAT Scan, MRI, capsule endoscopy (swallow a small capsule that transmits pictures of the small bowel). There are also blood tests and stool studies. There are many different ways to treat Crohn’s, but they usually suppress the immune system resulting in possible infection and higher risk of cancer. Non drug treatment could include avoiding NSAIDS (Motrin, etc.) and avoiding high fiber if small bowel is involved. Some patients do better avoiding dairy products, gluten and limiting alcohol and caffeine.

Current treatments include:

  1. Oral 5 amino salicylates (Azulfidine, Asacol, Pentasa, Lialda, etc.)
  2. Steroids
  3. Immuno-suppressants (imuran and 6MP)
  4. TNF inhibitor (biologics) such as remade, Humira and Cimzia
  5. Methotrexate
  6. Entyvio (work on cells lining the gut to reduce lymphocyte migration and thus reduce inflammation)
  7. Stellar (inhibits IL12 and IL23 blocking inflammation cascade)
  8. Antibiotics (Flagyl, Cipro)
  9. Non prescription antidiarrheal, vitamins, supplements and probiotics

Our new treatment includes:

  1. Triple antibiotic to treat MAP (a bacteria similar to TB) that could be the trigger in some people causing Crohn’s
  2. Antisense drug to normalize rather than suppress the immune system

There is no cure but with treatment Crohn’s can go into remission.

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