Tag Archives: colitis

Crohn’s Disease Risks And Remedies

The chronic inflammatory bowl disease regional enteritis, or Crohn’s disease, is a condition that causes inflammation in the gastrointestinal tract. Although it can occur anywhere int he digestive tract, causing a correspondingly wide variety of symptoms, it most commonly is found in the ileum—the last section of the small intestine—and causes abdominal pain, bloody diarrhea, vomiting, and weight loss. While susceptibility to Crohn’s disease is inherited, the disease develops in response to environmental triggers and changes in the state of the microbes in the intestines that normally help with digestion. For example, antibiotic treatment can encourage the condition along, because it destroys beneficial gut bacteria, allowing other microflora to grow unchecked and upset the balance.

Crohn’s disease is generally believed to be an autoimmune disease, meaning the immune system treats a part of the body—in this case, the intestine—as an invader and responds accordingly. As with many autoimmune diseases, the industrialized world is involved in creating the environment in which the condition develops. The immune system is primed to attack parasites that are no longer prevalent, and locks on to the organs. Another view is that the immune system uses the parasites to practice on, and without having done so is poorly equipped to handle the gut microflora imbalance.

Risk factors for Crohn’s disease, in addition to a relatively clean upbringing and a family history of autoimmune disorders, include ethnic background (Ashkenazi Jews and French-Canadians are particularly prone to it) and cigarette smoking. Smoking not only increases the risk of Crohn’s, but it can worsen the disease when it does develop. Painkillers of the type called NSAIDs can also make it worse. Obesity is another factor, affecting "self-tolerance," or the immune system’s ability to recognize the organs as belonging there.

Treatment involves reducing inflammation, tamping down the immune system, and inhibiting the activity of a type of fat cell called TNF-α. A recent study determined that a class of drugs called thiopurines can be used to treat Crohn’s very successfully, reducing he need for surgery by more than 50 percent. Steroids are also used for the illness, though another study found evidence that steroidal treatment may increase the need for surgery, which may prompt a re-examination.

Colitis

The colon is the end of the digestive tract, and as such is part of the metabolic process—it mostly removes water from the waste left behind after the nutrients have been extracted from food by the small intestine. When it becomes inflamed, generally due to an autoimmune response in which the body’s immune system attacks healthy tissue, waste cannot properly pass out of the body. This can result in pain, bleeding or bloody stool, constipation, fatigue, and weight loss. Some forms of colitis can lead to dehydration and shock, and may even be fatal. Immediate medical attention is needed for people who have blood in the stool, ongoing diarrhea, or fever lasting more than a day or two.

The causes of colitis are not entirely clear. It’s an autoimmune disease, but researchers are still exploring what might trigger it. As with many autoimmune diseases, there appears to be a genetic component. A recent study fount that the absence of a protein called macrophage-stimulating protein receptor resulted in severe damage to the colon, signs of inflammation, and symptoms of colitis, such as weight loss.

Colitis is treated with corticosteroids and other drugs that help fight inflammation, but patients are also generally advised to modify their eating habits, adopting what are called "low-residue" diets so as to minimize the burden on the colon. That normally means avoiding dietary fiber. However, researchers have created a new type of dietary fiber that encourages the growth of important gut microflora and minimizing the effects of intestinal bowel disease. The gut microflora are benign bacteria living in the digestive tract that play a role in breaking down food to help the body metabolize it.

Another treatment being studied focuses on the role played by a cell adhesion molecule called CD146 in the development of colitis. As the name suggests, cell adhesion molecules ordinarily act as a sort of glue to help cells stay in place. CD146 is found in the inner walls of the blood vessels, in smooth muscle cells, and in the immune system and has been shown to help stop the progression of breast cancer. However, it also has a dark side—when produced in excess, CD146 is a part of inflammatory diseases such as colitis. A treatment that deactivates some of the CD146 has been shown in laboratory animals to have good potential to fight colitis.

Colon Cancer And Colitis

A recently discovered link between a common form of cancer and bowel disease is giving medical researchers insight into how to treat illness. Experimental animals with an analogue to human ulcerative colitis showed signs of reversal when given a drug called imatinib that has been used for some time to treat leukemia. The drug doesn’t directly repair damaged tissue, but it alleviates inflammation so that the colon can heal faster and more completely.

This treatment approach is based on the fact that a major contributing factor to the development of colitis—a chronic inflammatory bowel disease in which the colon is damaged and inflamed, leading to bleeding, cramping, pain, and weight loss—is a missing or malfunctioning gene whose primary function is tumor suppression. Many colitis patients go on to develop colorectal cancer. Imatinib supplies a substitute for the tumor suppressor gene, alleviating inflammation and helping lower cancer risk.

This is only the beginning of a line of investigation that could result in more effective treatment for colitis, or possibly even a full cure. That is particularly good news for people with one or more of the risk factors for colitis. The disease usually strikes people under age 30, but there’s no safe age and it can develop in patients who are over 60. Because colitis has a genetic component, people with a family history of the disease are more likely to develop it themselves. Certain acne medications also seem to be linked with colitis, though which ones and to what extent is not clear.

In addition to colon cancer, people with colitis are prone to developing kidney stones, osteoporosis, and sometimes fatal complications in the colon itself. These risks can be minimized with treatment, however. Current treatments include corticosteroids to reduce inflammation as well as other drugs that can help heal the colon. Immune suppressant medications are also sometimes prescribed for medication. In severe cases, surgery may be needed.

Bile Duct Cancer

More than one in ten liver cancer patients has a type called cholangiocarcinoma, or cancer of the bile ducts, though there are only estimated to be about 3,000 cases per year in the United States. Bile duct cancer is particularly prevalent in northeastern Thailand due to the common diet—the local fish, often eaten raw, are carriers of a parasite called liver fluke, which is related to cancerous conditions—but it can happen anywhere, and the prognosis is typically rather grim. The bile duct is responsible for draining the liver, taking the toxins that the liver removes from the blood and moving them to where they need to be to be eliminated from the body. Bile is also an important part of the digestive process, breaking down fats in the intestine.

bileduct

Bile duct cancer often strikes people who have had other illnesses in the area. Forms of ulcerative colitis are common culprits. Liver flukes are parasites; infestation leads to recurrent infections, disease, and liver damage, and that damage opens the door to cancer forming. People who suffer from some kind of chronic liver disease, including some types of hepatitis and cirrhosis of the liver, also have a higher risk of cholangiocarcinoma., and certain inherited genetic conditions are the same. In fact, recently scientists found genes that are specifically associated with cancer development in the bile duct.

As with any condition that blocks the bile duct, cholangiocarcinoma can lead to a yellowing of the skin known as jaundice. The blockage backs up bile in the body, coloring the skin, darkening the urine, and causing stool to be lighter in color. The bilirubin normally responsible for the color of stool will, if the bile duct is blocked, wind up in the urine instead. However, there are not always symptoms in the early stages. Other symptoms may include itching and abdominal pain, as well as the fever and weight loss that accompany a wide variety of medical conditions.

If the tumor is small, it may be possible for it to be surgically removed, though this is a difficult procedure. When surgery is not likely to be safe or effective, a stent may be used to bypass the blockage and restore some semblance of normal functioning. Radiation therapy and chemotherapy may also be used, though mostly for palliative purposes if a complete cure is deemed unlikely.

Bring out the Helminths

Gut bacteria—microbes that lie in the human intestine and help with digestion—are actually a sign of good health. In fact, when these microbes go away it can cause illness. Antibiotics, which kill beneficial as well as harmful bacteria, can cause health problems this way. Colitis, for example, seems to be associated with intestinal flora that are absent or not functioning. Fortunately, there may be a way to restore these bacteria and treat certain types of colitis: the eggs of certain types of parasitic worms, or helminths. are being researched as a treatment for colitis.

A type of helminth known as whipworm is estimated to infest one billion human beings, mostly in tropical areas. It can cause bloody diarrhea, leading to anemia and vitamin A deficiency. In severe cases, the wall of the rectum falls down, causing incontinence. However, whipworm is harmless in many cases, and can even provide some benefits, for example, by giving an overactive immune system something to attack.

Inflammatory bowel disease is most common in wealthy regions of the world. Those are the same areas where whipworm and other helminth infections are lowest. For example, in the United States, parasite infestations are highest in poor areas of the rural South, where climate and economic factors are especially favorable to parasite growth. Researchers suggest this isn’t a coincidence. Helminth treatment experiments in mice have shown that parasites can redirect immune system resources from the bodies organs, and even induce the body to repair the damage.

“The idea for treating colitis with worms is not new, but how this therapy might work remains unclear,” said NYU microbiologist P’ng Loke, PhD, an author of the study, in a statement. “Our findings suggest that exposure to helminths may improve symptoms by restoring the balance to the microbial communities that are attached to the intestinal wall.”

The researchers used the parasites to treat otherwise intractable chronic diarrhea in monkeys. The diarrhea often occurs in the animals, which are kept for research purposes. Researchers are in the process of starting human trials.

Out Of Control Microbe

Every healthy human being has what are called intestinal flora, microbes living in the gut that are of great importance in digestion and the immune response. These microorganisms are not a sign of disease; on the contrary, they are such an integral part of digestion that they are sometimes considered practically an organ in their own right, though the intestinal flora aren’t part of the body. However, when they get out of control, they can cause health problems just like any infectious agent.

For example, one of these microbes is Clostridium difficile. C. diff is normally present in the gut, but in limited numbers. However, when other gut bacteria are removed and C. diff is unchecked, it can cause serious illness. C. diff infection symptoms include watery diarrhea, fever, and nausea, and the infection can even lead to colitis.

In 2010, more than a third of a million people were hospitalized after developing a C. diff infection, and approximately another 150,000 were treated outside of hospitals. The condition is often spread in hospitals, where it is the most common cause of diarrhea. It leads to an estimated 30,000 deaths every year, directly or indirectly.

People are at risk for C. diff who are undergoing long-term antibiotic treatment, which can upset the balance of intestinal flora. Chemotherapy drugs and proton pump inhibitors (prescribed for chronic indigestion, GERD, and other conditions) can also make someone more prone to C. diff infection. In addition, people who have had one C. diff infection are more prone to another one.

The disease can be prevented with probiotics. Available as supplements or in some kinds of yogurt, probiotics help encourage the growth of the flora that help keep down C. diff. Administering probiotics to at-risk patients led to a 66 percent lower infection rate, according to a recent analysis of several studies.

If a patient does become infected, one available—though disgusting—treatments is called a fecal transplant. This is what it sounds like, unfortunately, though it is 90 percent successful. The idea is for the microbes from the donor help drive down the patient’s C. diff levels and fight back against the tide. A report last week suggested that this might soon be the standard treatment.

Crohn’s and Bacteria

A study at a research facility in Montreal has nearly doubled the number of genetic regions known to be involved in inflammatory bowel diseases, including Crohn’s disease. Many of these regions—163 are now known—are also associated with autoimmune disease. Genetic regions are areas of DNA normally associated with specific organs or functions; most of the ones known for IBD are part of the system for fighting microbial infections.

This finding suggests that Crohn’s disease and ulcerative colitis, another inflammatory bowel disease, are related. It also lends support to the notion that Crohn’s is the result of an excessive immune response to bacteria. In fact, another study, in Australia, has found specific bacteria that are believed to trigger the condition. Called Proteobacteria, they are a normal component of what doctors all intestinal flora but were found in elevated levels in people with Crohn’s. The researchers had found earlier that specific strains of a Proteobacteria species called Campylobacter concisus had infected the intestinal cells of Crohn’s patients.

In Crohn’s disease, the small intestine or colon becomes inflamed, which is believed to be an immune reaction to harmless intestinal flora. This causes painful abdominal cramping, as well as other symptoms, such as bloody diarrhea. Crohn’s is often accompanied by poor appetite and weight loss. In addition to the discomfort, the disease can cause ulceration and other damage to the intestines which in many cases needs to be repaired with surgery.

Fortunately, while bacteria are involved in causing the disease, French researchers may have found a way to use bacteria to treat it. Crohn’s patients tend to be deficient in a protein called elafin. The researchers created genetically altered lactic acid bacteria, the sort that maker milk into cheese, which is safe for human consumption. The genetic modification made it so that the bacteria would create the elafin protein. When given to mice with IBD symptoms, the lactobacilli reduced inflammation. The treatment hasn’t been tested in humans, but the bacteria did reduce inflammation in biopsied tissue from Crohn’s patients, a sign that it may be effective for people.

Cells Need Their Space

Healthy cells have a healthy respect for privacy. That’s the latest findings from the Huntsman Cancer Institute at the University of Utah. Researchers at the Institute found that, like many people, cells don’t like crowds.

This discovery could help fight the various varieties of cancer. In all cancers, cells shed their need for space and crowd together, growing uncontrollably and creating tumors.

Normally when cells in the epithelium, the outer and inner surface of the body where most cancers originate, get too close together, some are ejected to make more room. This occurs even to cells that haven’t undergone cell death.

Cancer grows by accumulating cells while not allowing any to die. If, as scientists believe, they are nonetheless vulnerable to extrusion, that could suggest an entirely new approach to curing cancer. Researchers aren’t yet sure why the normal extrusion method doesn’t work in tumors, or how best to induce it without disrupting healthy cells.

The research also revealed more about how cell death itself works, Dead cells must be immediately replaced. It was discovered that as they die, cells send out an alert so that gaps won’t form. Learning the mechanism behind that could also allow for better treatments for certain illnesses, such as colitis.