Cure For Crohn's: Eating Bark Help Crohn's?

I recently came across this story which talks about a woman named Marlene Barnes who is a 72 year old woman who has Crohn’s disease and has had it for 48 years. She got it when she was only 14 and had to get part of her colon removed.

This story gets interesting as Barnes cutting bark off trees, letting it dry, and grounding it up in her home.  I have a few issues with this story. First, her doctor claims she has “no evidence of the active disease”. This could just simply mean that her Crohn’s is in remission and is not active. What I would want a GI to do is to examine her colonoscopy compared to someone who doesn’t have Crohn’s and see how different they are. Second, this is only one person who has one body that is different from everybody else. I would want to see some large scale trials done to see the safety of this and whether or not it is effective. I do hope tree bark does help those with Crohn’s however until the data arrives I will be otherwise unconvinced.

This leads me to a larger point of people believing everything they here. As the commercial says “Where did you hear that? The Internet”. We can’t believe everything we see, hear, until there is some hard evidence to back it up and more than one trial to prove it was not just a fluke or luck. I hope the CCFA will look into this and possibly look at doing trails. Marlene Barnes could be sitting on a gold mine if this really works. I know I would be barking away if it was shown to be both effective and safe!  

Hyperbaric Oxygen for Crohn's?

Stumbling across some interesting research I discovered some work had been done on hyperbaric oxygen chambers and Crohn’s patients. This study looked at Crohn’s patients with perianal disease and said it may have a good clinical effect. Also interesting is that the TNF levels decreased. Since extra TNF is what is believed to cause inflammation. In this study that also looked at perianal Crohn’s disease with 75% of patients being healed and all the patients who got hyperbaric oxygen. Recently, there was this review done of all the studies related to hyperbaric oxygen for inflammatory bowel disease and “HBOT lowered markers of inflammation and oxidative stress and ameliorated IBD in both human and animal studies. One really neat study is what I call the Dead Sea Study which had 6 people go to the Dead Sea in Israel (lowest point where oxygen pressure is decreased and 50% of the patients had a great improvement. 33% (2/6) of patients were able to stop high dose corticosteroids.

Altitude actually may play a role in Crohn’s. This gets even more interesting because at this year’s Digestive Disease Week in San Diego a study looked at showed that patients who made trips to areas above 6,500 feet had more flare ups. These results were not peer reviewed and have not been published yet but seem somewhat interesting. 

Crohn's and Psoriasis: A Link?

In a recent study that looked at close to 175,000 nurses from the period of 1996-2008. It was concluded that people that suffer from psoriasis are at four times greater risk of developing Crohn’s. This shouldn’t be too surprising since both psoriasis and Crohn’s are autoimmune diseases and in some way have to be related.  The authors controlled for things like body mass index, physical activity, smoking, alcohol, and other things. The people who had a higher body mass index, were less physically active, consumed more alcohol, and those who smoked were more likely to get psoriasis. Of course in any study it is almost impossible to control for everything. Also an even more interesting study would be to study the genome of those people who started to see how their  genome changed from the time before they got Crohn’s and compare that to a normal person.

When the study was over there were 188 people who had Crohn’s and 240 who had ulcerative colitis. This would mean that the odds of getting inflammatory bowel disease are around .2%. Apparently interleukin-12 and interleukin are pathways of psoriasis and Crohn’s. This is why Humira works for both people with Crohn’s and psoriasis. Hopefully, this will allow researchers to figure out the relationship between the two and maybe help create more new novel therapies. 

Thalidomide For Crohn's

I came across an interesting study that showed that thalidomide may help against Crohn’s. Thalidomide was a controversial drug that woman took in the 1950’s for morning sickness. One drawback however was that it caused many birth defects.

This study in the December 1999 issue of Gastroenterology showed that when 14 patients were treated with thalidomide they all responded in some way to the drug. 67% had clinical remission with more than 50% in just 4 weeks. The study was done on patients who had not responded to any other therapies. It would be interesting to see how patients with mild-moderate would respond to thalidomide.When a 10 patient trial was done by Cedars-Sinai Medical Center 70% of the patients responded to the drug however only 20% had clinical remission.

In probably the only study to date published in the February issue of Journal of Pediatric Gastroenterology and Nutrition 5 patients were picked out of 96 (thalidomide was used as a last resort before surgery) 80% of patients were in remission even 19-24 months after treatment.I am really curious to see much larger scale trials done on thalidomide and see if there are any long term side-effects for both females and males. 

MAP Blood Test For Crohn's?

One news story that caught my eye was the development of a possible test for Crohns. The test lets doctors look at certain pathogens that can cause Crohn’s disease. The test works by taking blood from a Crohn’s patient and looking at microbes that often can’t be detected. One major advantage to this new test is that instead of waiting weeks or even months to treat a patient doctors can perform the test within hours. The test was created by Dr. Saleh Naser at University of Central Florida. Diagnosing Crohn’s is somewhat difficult. I remember when I was in the hospital I had stool tests done for the first couple of days, and blood tests just about every day. A resident believed I had celiac disease, however due to the fact that there isn’t a Crohn’s test it is hard to diagnose. Even a colonoscopy is 70% effective in diagnosing the Crohn’s.

One prevailing theory is that Crohn’s is created by bacteria called mycobacterium pratuberculosis (MAP).  It is estimated that around 40%-50% of Crohn’s patients have MAP in their bodies. A company called RedHill Biopharma is licensing Dr. Naser’s technology in order to develop a drug called RHB-104 to treat Crohn’s patients who have MAP in their bodies. However, one downside is that RHB-104 and the MAP test won’t be available until possible 2016. One way to treat MAP is by giving patients a combination of rifabutin, clarithromycin, and clofazimine. A trial of this course of treatment was done in 2006 entitled “Two-Year Combination Antibiotic Therapy With Clarithromycin, Rifabutin, and Clofazimine for Crohn’s Disease” concluded that there was no evidence of a sustained benefit over a 2 year period.  The study seemed to show an improved in those taking the cocktail (combination of all three drugs). However, once year two rolled around the benefit between the treatment and placebo (sugar pill) were similar. This may cast doubt on how much the new MAP test will help   

Time will tell how effective this new MAP test is. There is no doubt however that there needs to be more innovation in diagnosing Crohn’s. Figuring out the causes of Crohn’s I believe will help solve how to treat it and maybe even one day find a possible cure. Galieo once said “All truths are easy to understand once they are discovered; the point is to discover them”.