Another possible cause of Crohn's

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/4/2008 1:37 PM (GMT -7)   
I thought that this was worth putting out for you all. It suggests that a specific bacteria may be responsible for initiating Crohn's. The cascade of complications after the initiation has made it hard to sort out, I guess. It talks about this bacteria having enzymes that mimic several collagen types and thus antibodies for those enzymes attack collagen in the body. Have a look at Clinical Rheumatology

There are other ideas about specific bacteria that cause Crohn's, but the collagen mimicking of the enzymes is suspicious, considering the association of Crohn's with RA and AS as well as various rashes and tissue inflammation throughout the body. There are known examples of Salmonella, Shigella and Yersinia all initiating arthritic symptoms, so it is probably not quite so simple as the abstract above suggests.

Post Edited (Keeper) : 10/4/2008 3:03:54 PM (GMT-6)


kim123
Veteran Member


Date Joined Jul 2006
Total Posts : 1201
   Posted 10/4/2008 3:44 PM (GMT -7)   

aoccc
Regular Member


Date Joined Feb 2005
Total Posts : 455
   Posted 10/4/2008 3:59 PM (GMT -7)   
so many things new in our everyday life in the last century, you could spend hours talking about what part of western lifestyles plays the part. Do a search, this topic comes up everyday at least once and everyone has a different theory. Sometimes i wonder if there is a company, government, etc that knows about what it is but are afraid to bring it out for fear of many lawsuits. I guess we have a lot of time to think don't we? lol
SCD since 01, remission since 01, occasional Arby's breaks :)


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 10/4/2008 4:00 PM (GMT -7)   
There are several doctors that have suggested this theory over the years. Dr. Ebringer has invested many years of research looking at the possible cause of ankylosing spondylitis. If you want to read more about Klebsiela and its possible role in AS, RA, and CD, check out this: http://www.kickas.org/medical/index.shtml I will say that the diet suggested to reduce Klebsiela's effect on the above diseases might be difficult for some with Crohn's to follow. On a personal note, now that my guts are in remission, I do better eating mostly fruits and protein with some veggies. Hmmm........


Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/4/2008 10:21 PM (GMT -7)   
My understanding of the current model for the development of Crohn's is something like this:

- some initiating factor causes the mucous membrane of the gut to become more porous. There are a number of known causes - gut infection, stress, NSAIDs, alcohol and any number of inflammation producing events.

- the mucosa then leak. This results in bacteria or other pathogens entering the blood or immune cells entering the gut contents.

- this initiates an immune response with inflammation and further increases in gut permeability. This is the phase where diarrhea occurs and painful abscesses and fistulas form.

- the immune system fails to terminate the gut permeability and inflammation. This normally stops on its own, but some individuals' immune systems have a stronger reaction and a weaker terminating response.

There is the possibility that those people have adapted to a gut bacteria ecology that tempers and shuts down the immune response. There are many gut bacteria that perform those functions. The problem arises when that gut bacteria ecology is disrupted. This can occur several ways: antibiotics; diarrheal disease; impaired digestion which supplies more food to bacteria that push out the moderating bacteria; other drugs or digestive insults (like liquor, for example) which disrupt the population of the gut. The result is that the gut's immune response is not sufficiently diminished by the remaining bacteria and fairly normal challenges result in a hypersensitive response which is not self-limiting without the influence of the moderating bacteria.

If the previous assumptions are accurate, the use of probiotics becomes extremely important. Probiotics are not the whole answer though - they are a partial replacement for the bacteria that have been lost, but the probiotics that are available do not multiply well enough in the gut. If they are not continuously used, they are displaced by other, less friendly bacteria.

Lactobacillus bacteria have been shown to displace several undesirable gut bacteria and they have immune modulating action, reducing a range of inflammation vector molecules. They even have been shown to produce antibiotics that help them evict other bacteria. L. casei has been shown to displace E. coli from binding sites on the mucosa and reduce the production of TNF, thereby interrupting the cycle of inflammation.

Probiotics are a useful tool, but they do not replace the lost gut bacteria that normally maintain stasis. There are over 500 bacterial species in the gut and only about 100 of them have been studied. It will be a number if years before we can expect to have a solution based on restoring balance in the gut ecology. In the meantime, there are some things that we can try to moderate the problems caused by hyperactive immune response.

- gut permeability: known aids that reduce gut permeability are Lactobacillus based probiotics; glutamine (normally stored in large amounts for tissue repair, but depleted by inflammation); zinc (50 mg per day has been used to reduce gut permeability).

- infection/abscess/fistula: prescription solutions include cipro, flagyl, xifaxan. Of these, the only moderately safe one is xifaxan. Other possibilities include bee propolis and turmeric capsules (turmeric may cause rectal irritation if taken with active D).

- TNF reduction: Several Lactobacillus bacteria and a number of other gut bacteria reduce the production of TNF. I have seen a suggestion that a Lactobacillus bacteria be genetically engineered to enhance its TNF suppression abilities (and allow it to be patented). I would be very nervous about trying such a method given the delicate balance of gut bacteria ecology. There are several pharmaceuticals including Remicade, Humira, Imuran and others that do this. They all seem to have serious potential side effects and I wonder why the mechanism of action of the bacteria has not been discovered - it does not seem to cause side effects. Naturals include turmeric - others I do not have information on.

MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted 10/5/2008 7:20 AM (GMT -7)   
One thing left off that list/progression is the strong likelihood of a genetic trigger or susceptibbility. Anumber of genes have been identified as being prevalent in CD patients, with the severity ofthe diseaseseemingly linked to the prepoderance of thosegenes. It does not appear that there is one clear "Crohns gene," but rather a series of genes in various combinatuions that set us up for the runaway immune response to gut bacteria. After all, everyone encounters those gut bacteria at some point -- they areall around us -- but only a few get Crohns.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 10/5/2008 11:07 AM (GMT -7)   
Yes, I think they've identified about 30 genes that are related specifically to crohn's, less genes are identified to UC.

:)
My bum is broken....there's a big crack down the middle of it! LOL :)


Osprey101
Regular Member


Date Joined Apr 2008
Total Posts : 227
   Posted 10/5/2008 11:54 AM (GMT -7)   
It's interesting that the Selby anti-mycobacterial protocol puts 95% of patients into remission, but once the course of drugs is done (1-2 years later), some 85% return to having Crohn's. This implies that mycobacteria are strongly involved somehow, which of course has been suspected for years. But they are either not purged, or the pre-existing conditions that make the gut habitable for them continue to exist after the course of drugs is done, and (of course) the genes of the host have not changed.

However, the folks on the SCD are restricting oligosaccharides and polysaccharides- carbohydrates that are too large for bacteria to chew on. Larger carbohydrates are the diet of fungi, not mycobacteria, which get their "food" from human cells directly.

Having recently read that slow intestinal bacterial overgrowth (SIBO) causes a similar set of symptoms in the canine (muscle wasting, diarrhea, malabsorption, etc.), which is then treated through application of antibiotics- and a low-carb diet- it seems conceivable that something similar is happening in humans. There's some sort of sugar-fed overgrowth that blocks absorption, and somehow fosters the growth of MAP or other organisms. Unless there is strict intervention, the host continues to suffer throughout their life.

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/5/2008 12:11 PM (GMT -7)   
I think that the genetic component rules the intensity and the poor termination of the immune response. I am guessing that in the parts of the world where Crohn's is less abundant, the people there are not exposed to antibiotics and other drugs that alter the gut ecology. I think that it is possible to be healthy with the genes that are associated with Crohn's if you have a gut bacteria population that regulates the immune response and allows more normal termination of gut inflammation. There are certainly several bacteria that have been shown to regulate immune molecules like TNF, and since they have a working knowledge of only 20% of gut bacteria, I am sure that there are many more that are not well known. It would be ideal if they could modify the bacterial mix so that the bacteria could control the problem, but they don't know enough yet to do that. Some day, maybe........

Osprey101
Regular Member


Date Joined Apr 2008
Total Posts : 227
   Posted 10/5/2008 12:16 PM (GMT -7)   
It's also interesting to note that in some parts of the world where there is a low incidence of Crohn's, that MAP is not well-established. For example, Africa (or at least the southern half) did not have MAP until some sheep were brought into the country. The population of animals with MAP is still fairly low. So, while some would attribute this to infection with hookworms (Necator americanus), it is conceivable that human populations in southern Africa simply don't have MAP. Or it may be that they consume less carbohydrates than those of us in the Western world.

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/5/2008 12:24 PM (GMT -7)   
Hi Osprey - Yeah, I think that there are results from SIBO that mess up the gut ecology and that results in the symptoms. My take on it is that the carbs are not being digested (enzyme insufficiency or actual damage to the gut from infection or food allergy and the like) and this results in unusual amounts of carbs reaching the colon where certain types of bacteria that are well adapted to digesting carbs then flourish. With an excess of those bacteria, they then begin to displace other bacteria from the gut by sheer numbers. This results in the loss of beneficial bacteria that regulate the gut's immune response. That's my story anyway.....

The long course of antibiotics just suppresses the overabundant bacteria and does not restore the balance of gut bacteria. The immune regulating bacteria need to be added back somehow.

Bacteria happily eat starches and fiber. If this were not the case, everyone would have a large population of yeasts in their guts since less than 80% of starches are digested at best.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 10/5/2008 1:25 PM (GMT -7)   
The lack of the XBP1 gene disables the normal communication between intestinal epithelial cells and gut bacteria, resulting in dysfunctional immune response and disease. And microbes definitely are linked to IBD according to researchers.

:)
My bum is broken....there's a big crack down the middle of it! LOL :)


EMom
Veteran Member


Date Joined Aug 2007
Total Posts : 990
   Posted 10/5/2008 2:29 PM (GMT -7)   
Well, I don't know about you guys, but be it MAP, Klebsiella microbes, candida (yeast), E. coli, or whatever, I'm thankful that a carb controlled diet and beneficial bacteria like Lactobacillus can make a big difference! yeah
Mom to 16 year old boy diagnosed in June, 2007.
Omega 3s, digestive enzymes, probiotics, vit. C, calcium w/D3, a good multivitamin and SCD legal yogurt
Started The Maker's Diet in Sept. '07. Gradually learning/using more SCD recipes, too! (cooking challenged)


kim123
Veteran Member


Date Joined Jul 2006
Total Posts : 1201
   Posted 10/5/2008 5:08 PM (GMT -7)   
All of this bacteria talk is very interesting. I don't think, however, you can underestimate the role of fungus in disease.

Fungus can and will cause gut permeability, destroy/penetrate mucous membranes; inflammation is the immune response to fungus (fungus is now implicated in chronic sinusitis-over 40 different kinds of fungi found among patients in one Mayo Clinic study); fungi cause leaky gut; fungi thrive and can only survive on carbs (grains, sugar),... (not sure what Osprey meant when said that larger carbs are the diet of fungi directly?); you can starve the fungi, and reduce intake of mycotoxins from following diets such as the SCD, and may get well; fungi DNA can incorporate with its host's (human) DNA, forming a hybrid cell, so I suppose that you can inherit DNA/genes that promote tendencies of disease; without removing the primary fuel of fungi -sugar- no amount of anti-fungal medications or supplements can yield adequate long-term effects (that may be why some protocols only alleviate symptoms for a short while before symptoms come back)

Yeast and bacteria live in your gut- they have a symbiotic relationship. When you take antibiotics, you are killing the good bacteria along with the bad. The yeast (which was kept in check by the good bacteria) is allowed to grow and proliferate in the absence of the good bacteria. Eating carbs like grains and sugar continue to feed the yeast, (causing symptoms to elevate?) When you take probiotics, you are putting good bacteria back into your gut, squeezing/killing out the yeast, restoring your bowel flora. Anyone here have their symptoms improve after starting a probiotic regimen?

Understanding bacteria, fungus, and the role diet plays, I agree with EMom- that although each of us have, and are entitled to, our own thoughts and opinions, I'm thankful that a carb-controlled diet and probiotics have given me my life back again.

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/5/2008 10:00 PM (GMT -7)   
It is true that fungi will do the same thing as bacteria in the gut, but there are a couple of difficulties with assigning them the role of villain. First, if you starve yeasts like candida and it is actively infecting the gut, it will grow through the gut wall looking for sugars from the blood. That would mean that enteral diets and the SCD plan would make the disease worse before it became better. Similarly, several people report great improvement using antibiotics like cipro and xifaxan. This would not touch fungi and would make the problem worse, not better, since antibiotics would remove bacteria that competed with fungi for food. Third, there are reports in the journals that several of the antibodies in the blood have been identified as being caused by different gut bacteria. If it were fungi that were penetrating the gut wall, you would expect that the antibodies would be targeting fungi.

I am sure that there are individual cases where fungi are involved in the disease - there are so many different experiences that it would almost be certain that someone has had a fungus involved and that may be why the usual solutions don't work for everyone. I am only trying to understand the causes of this DD so that I can make better choices for myself and offer good advice. I too have had good results from the SCD plan and probiotics. That is an excellent starting point, but can we improve on that? I think so, but a good understanding of the causes would be desirable.

Osprey101
Regular Member


Date Joined Apr 2008
Total Posts : 227
   Posted 10/5/2008 11:24 PM (GMT -7)   
Kim> What I meant by larger sugars is that fungi will function better on "larger" carbohydrates (higher polymer numbers) than bacteria. My day job is to grow organisms in axenic culture in controlled environments; bacteria prefer monosaccharides like glucose and fructose, but will also manage with disaccharides like sucrose. They can also grow on some higher sugars (trisaccharides and tetrasaccharides), but not nearly as well. MAP probably gets glucose directly from the blood, riding piggyback on the cells it inhabits as a facultative intracellular pathogen.

Fungi, on the other hand, do better with polymers that are of a higher order (6, 7, 8, or more monomers tacked together), like cellulose. This is why oligosaccharides (about 5-8 monomers) and polysaccharides (9 and more) must be excluded on the Gottschall diet: whatever it is that's making the mess is feeding handily on oligosaccharides and polysaccharides.

While it may seem the bacteria are chewing away on the fiber we consume, much of that is fungal and enzymatic. Moreover, it's not at all clear that this is the normal state for humans; like dogs, we have necrotic guts. This is in comparison with the fermentative gut of ruminants. It would seem likely that the human diet should not contain so much fermentable material, nor carbohydrates- both of which are alien to the type of gut that humans have. In short, we should be getting our calories largely from proteins and fats, not carbohydrates. Study after study has shown that individuals with Crohn's tend to consume larger quantities of their calories from carbs than other food sources.

Now for a big leap in logic: ruminants that normally get MAP also get disproportionate quantities of their nutritional calories from carbohydrates, versus fats and proteins. Now does it seem quite so wacky to say that a ruminant disease has become a zoonotic disease because humans are consuming a diet that is too similar to that of the animals from which this disorder is endemic? I'm unconvinced by the argument that this is coincidental.

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/6/2008 3:06 PM (GMT -7)   
The addition of fructo-oligosaccherides to probiotic supplements would imply that Lactobacillus bacteria digest it, since it is intended as a source of food for them. Given the variety of bacteria in the gut and the number of unknown species, I would not like to say that there are none that can compete with fungi in digesting complex sugars. On the other hand, a high sugar consumption is often associated with Candida infections, so it works both ways - fungi and bacteria compete for the same food. The simple sugars are preferred by both bacteria and fungi and different bacteria and fungi are specialized in digesting different complex polysaccherides. Since the population of fungi is normally small in the gut, it would seem that gut bacteria out-compete the fungi for the undigested complex starches in our diets. After all, we absorb simple sugars ourselves and not much of that reaches the gut, so gut bacteria must consume complex sugars.

ivy's mom
Regular Member


Date Joined Jul 2006
Total Posts : 62
   Posted 10/7/2008 6:29 AM (GMT -7)   
All I can say is wow!  I feel very ignorant about Crohn's disease.  My daughter still has symptoms but her colonoscopy biopsy came back good.  She has n&v d and stomach pain, occasional blood but it has improved on meds.  She has terrible joint pain and fatigue.  She also has bladder issues, ( leaking, pain and burning on urination) and goes to urologist also.  My question is how do I get her dr to give her the antibiotics?  Since biopsy was good how do I get him to try the antibiotics.  Should I go to her regular pediatrics dr.  Her urologist has suggested low dose of antibiotics for the bladder issues.  Even though my daughter suffers from n&v and d she is overweight and this bothers her so.  If you can give me any suggestions I am willing to try anything.  She has a first cousin with cd that is on remicade and I am scared of those drugs. 
 
Ivy's mom
Becky

EMom
Veteran Member


Date Joined Aug 2007
Total Posts : 990
   Posted 10/7/2008 8:27 AM (GMT -7)   
Hi ivy's mom... you mentioned you are willing to try anything. You don't say how old your daughter is, but is SHE willing to try anything? If she is, I would definitely recommend reading the book "Breaking the Vicious Cycle" by Elaine Gottschall and starting the Specific Carbohydrate Diet (SCD). Since you mentioned she's not happy with her weight, a great side benefit for her is that she can lose weight on the diet (my son has to eat frequent meals so as to NOT lose weight). Does she take a high quality probiotic? That would also be a great idea!

When you ask "how do I get her doctor to give her the antibiotics?", for what are you wanting the antibiotics? (i'm not familiar with n&v) For the micro-organisms we've been discussing? If so, keep in mind that that treatment, as I understand, has its own set of pitfalls. Taking a triple or quadruple antibiotic therapy for 2 to 4 years should not be entered into lightly--at least that's what a GI doctor here in the US told me when I was questioning him at length. That doctor is one of the very, very few in this country who uses the anti-MAP therapy, but prefers to use it as a last-ditch effort, when all else has failed. He also prefers to use it on "worse case scenario" patients, of which my son isn't.

And as Osprey101 pointed out, there is a large percentage of folks who undergo this treatment who end up back in the same boat. This suggests to me that we just don't have the right drugs for the job yet. It can't be emphasized enough *how very difficult MAP is to kill.* It's not a typical, run of the mill pathogen.

So is the problem MAP? I dunno. It could be fungal, Klebsiella, E. coli, or as our GI recently told us "a massive gut flora imbalance. Something that's supposed to be there, run amuk". Shoot, it could be ALL of those! Bottom line is, they just don't know.

So for us, until there is a real, true light on the horizon, we'll continue the SCD and probiotics.
Mom to 16 year old boy diagnosed in June, 2007.
Omega 3s, digestive enzymes, probiotics, vit. C, calcium w/D3, a good multivitamin and SCD legal yogurt
Started The Maker's Diet in Sept. '07. Gradually learning/using more SCD recipes, too! (cooking challenged)


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/7/2008 11:58 AM (GMT -7)   
N&v = nausea and vomiting? Anyway, antibiotics are really a last choice for me. The problem is that they generally knock out the beneficial bacteria and allow undesirables like klebsiella to dominate. The worst pathogenic types of gut bacteria are the ones that develop antibiotic resistance and survive to cause trouble once the antibiotics are stopped. Urethritis associated with Crohn's may be another mucous membrane manifestation of the gut inflammation. However, her symptoms indicate an infection. Ask your urologist about monitoring thyroid function while your daughter takes a saturated solution of potassium iodide (10 - 15 drops in water or juice, depending on weight) every three to four hours while awake. This will clear up a bladder infection, but there are a couple of potential hazards. First is the possibility of an allergic reaction. If you see a red rash after taking this, it indicates an allergic response which will go away when you stop taking the solution. The other problem is the possibility of thyroid suppression - this generally happens only after prolonged use and the urinary tract infection should be gone in a few days. Still it would be wise to alert your doctor to your intentions if you plan to try this.

As for the n&v and d, I second Emom about the diet approach and the use of probiotics. Probiotics can help to eliminate the bad bacteria and calm gut irritation.

Osprey101
Regular Member


Date Joined Apr 2008
Total Posts : 227
   Posted 10/7/2008 2:30 PM (GMT -7)   
Ivy's Mom> I would recommend reading "Life Without Bread." There are multiple copies on eBay, probably on Half.com and Bookfinder.com as well. There is an excellent section in there on management of Crohn's using diet alone, and it has certain implications for managing weight as well.

Good luck!
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, December 07, 2016 8:57 PM (GMT -7)
There are a total of 2,734,455 posts in 301,215 threads.
View Active Threads


Who's Online
This forum has 151331 registered members. Please welcome our newest member, Colorado76.
335 Guest(s), 6 Registered Member(s) are currently online.  Details
PeteZa, sheepguy, 0311, Teamchris, all4coop, Red_34


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer