CROHN'S DISEASE
Report #7107; 8/1/97
When doctors evaluate a patient for persistent diarrhea and cramping and find ulcers and scarring in the intestines or colon and they can't find a cause, they often diagnose Crohn's disease or ulcerative colitis.
The most common theory is that this condition is caused by a person's immunity attacking and killing the inner lining of the intestines and colon and punching holes in them. Unfortunately, the medications used to treat these conditions suppress immunity and don't always work. Surgery is not a cure (1). The immunities of these patients may not be so stupid that they attack and kill their own intestinal cells. They could be attacking and trying unsuccessfully to kill a germ in the intestines. It is very difficult to find germs that cause intestinal cramping/ because intestines are loaded with millions of germs/ and most belong there and do not cause symptoms.
Colitis may be contagious as people married to partners with ulcerative colitis are more likely to develop that disease themselves (2). Dr. Joel Taurog of the University of Texas in Dallas, has shown that a bacteria called bacteroides causes ulcerative colitis and Crohn's disease in mice who are genetically programmed to have a HLA-B27, a special gene that causes arthritis (3,4). Other researchers show that metronidazole, an antibiotic that kills bacteroides, can stop the symptoms of these two conditions (5). Special tissue staining techniques show that tissue taken from patients with Crohn's disease and ulcerative colitis contain parts of two common bacteria called E. Coli and streptococci. (6) An antibiotic called Cipro has cured some cases of colitis.(7) The antibiotic, metronidazole (8), and the combination of that drug and Ciprofloxacin may control the symptoms of ulcerative colitis and Crohn's disease (9). Studies are going on right now to see if Crohn's disease can be controlled by taking 500 mg of Cipro daily and metronidazole 250 mg four times a day on alternate weeks.
By Gabe Mirkin, M.D., for CBS Radio News
1) RS Walmsley, CD Gillen, RN Allan. Prognosis and management of Crohn's disease in the over-55 age group. Postgraduate Medical Journal 73: 858 (APR 1997):225-229. "Medical treatment (corticosteriod therapy, with or without azathioprine) was usually effective initially for treatment of symptomatic colonic Crohn's disease, but sustained remission was rare. Those patients with persistent symptoms were restored to good health with surgical treatment but at a price, in that nearly half eventually required a permanent stoma.
2) MC Comes, C Gowerrousseau, JF Colombel, J Belaiche, HJ Vankruiningen, MC Nuttens, A Cortot. Inflammatory bowel disease in married couples: 10 cases in Nord Pas de Calais region of France and Liege county of Belgium. Gut 35: 9 (SEP 1994):1316-1318.
3) Joel Taurog. J of Experimental Medicine. December, 1994.
4) Journal of Clinical Investigation. August, 1996.
5) unpublished results R Balfour Sartor of the University of North Carolina in Chapel Hill.
6) HJ Vankruiningen. On the use of antibiotics in Crohn's disease. Journal of Clinical Gastroenterology 20: 4 (JUN 1995):310-316.
7) MJ Spirt. Antibiotics in inflammatory bowel disease: New choices for an old disease. American Journal of Gastroenterology 89: 7 (JUL 1994):974-978.
8) P Rutgeerts, M Hiele, K Geboes, M Peeters, F Penninckx. Kerremans. Controlled trial of metronidazole treatment for prevention of Crohn's recurrence after ileal resection. Gastroenterology 108: 6 (JUN1995):1617-1621.
9) C Prantera, F Zannoni, ML Scribano, E Berto, A Andreoli, A Kohn, C Luzi. An antibiotic regimen for the treatment of active Crohn's disease: A randomized, controlled clinical trial of metronidazole plus ciprofloxacin. American Journal of Gastroenterology 91: 2 (FEB 1996):328-332.
10)P Disdier, L Swiader, JR Harle, JF Pellissier, D Figarellabranger, V Veit, A Gerolami, P Arlet, PJ Weiller.Crohn's disease and gastrocnemius vasculitis: Two new cases. American Journal of Gastroenterology 92: 5 (MAY 1997):880-882.
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