Crohn’s and Depression

I saw this recent story of a young man named Michael Isreal who was only 20 years old who suffered from Crohn’s and also suffered from prescription drug abuse. He committed suicide in May 2011. He was an architecture major at University of Buffalo. He suffered Crohn’s since he was 12 years old.

Once Michael turned 18 his prescriptions started to change. He took pill after pill and they never fixed his Crohn’s. Michael was taking 21 pills per day. Among these drugs were hydrocodone which can become addicted I am curious if he ever took Humira or Remicade which has actually helped people. He told his father about his addiction and enrolled in a detox program (however the detox program was out of beds). Right after this is when Michael Isreal took his life at only 20 years old.

In light of Michael’s death the family is pushing for the Internet System for Tracking Over Prescribing Act (I-STOP)  which would set up databases to give doctors information on prescription drugs that patients take. This would just create an underground market for drugs like hydrocodone and other pain medications which would make the problem worse. If anything we should be allowing more people to use these type of drugs in order to treat the addiction people have. If people really want to take their own life they will. If you make it harder to use prescription drugs people will commit suicide in other ways.

I did some research on any links between Crohn’s and depression or other mental illnesses. In this study found that Crohn’s patients had a greater chance of having psychiatric disorder and more had depression then the controls. Personally when I was younger I use to see a psychotherapist who helped me through some self esteem issues however that was when I was a young adolescent. The only other time I really filled down was right after I got Crohn’s. At first I had no idea what I had and when I was in the hospital felt good and then when I came out came to the realization of what I had and got down knowing I had a life long illnesses. A few of the first nights I cried and was kind of blue. Over time I came to realize I have to live life to the fullest and not let Crohn’s get in the way. After Humira I felt like I never had Crohn’s.

In this study it was found that lifetime prevalence for Crohn’s patients is 29% which is higher than ulcerative colitis (21%) or cystic fibrosis. It should be pointed out that this study was done in 1989 which was before Humira, Remicade, and other biologics were introduced. In an odd way if you get Crohn’s now is the time to get it given all the technological advances that have been made.  This doesn't even include the future things that will be discovered or created

I wonder if any genes are related to Crohn’s and depression. This would be an interesting study for researchers to undertake. Also who knows what advances they might make in treating depression. I have a feeling studying the genome, understanding of inflammatory bowel diseases, and understanding the immune system better will give patients a better shot of turning their frown upside down. 

Endometriosis and Crohn’s

In this study of 38,000 Danish women who were hospitalized between 1997 and 2007 and then tracked up to 13 years after their follow up. More women developed inflammatory bowel disease (ulcerative colitis at a rate for than double Crohn’s).  Women who have endometriosis were 50% more likely to get inflammatory bowel disease than the general population. The woman who had surgery to verify that they had endometriosis were 80% more likely to get inflammatory bowel disease than the general population.  In this study the percent chance of getting inflammatory bowel disease was .8%.

Even though women who have endometriosis are more likely to get inflammatory bowel disease a 50%-80% increase in a disease the disease would still affect relatively few women. Although, it is interesting if endometriosis is causing inflammatory bowel disease. When looking at these studies we have to be careful not to assume X cause Y since the human body is so complex and there are many factors involved. 

Sleep and Crohn’s?

This recent study came out and discussed the affects of sleep on the immune system. The main point of the article is that sleep can affect the immune system like physical stress. Since Crohn’s is does deal with the immune system it would be interesting to see how sleep affects Crohn’s patients or if Crohn’s patients have a history of sleep problems. I know for myself a few months before I was diagnosed with Crohn’s I was taking sleeping pills every so often because I had trouble falling asleep. Also I was taking Nyquil when I got stuffed up. Maybe this contributed to me getting Crohn’s I am not sure. I do know that when get enough sleep I feel a lot better and my pain seems to be a little less. Although, the exact same thing could be said for people who don’t have Crohn’s. An interesting study might be to see how sleep affect TNF levels.

Abdominal Fat and Crohn’s

A recent study from Loyola University in Chicago found that abdominal fat may help people may help regulate the immune system. The study as usual was done in mice by professor Makio Iwashima .The stomach fat is known as omentum which is just a fatty tissue that hangs down from the intestine. For some reason when omentum is attached to damaged organs the tissue heals.

This study may have something to it. For nearly all my life I have been thin BMI (body mass index) even on the low end even for the normal amount. There was a time when I was young where I was a little chubby but as I grew older I thinned out after I started working out once I was 16. Prior to Crohn’s I was working out every day burning 500-600 calories on an elliptical. I don’t know exactly how excessive work out effects the immune system but I have noticed a lot of articles about athletes are diagnosed with Crohn’s.  What I notice is that Crohn’s patients tend to be on the thin side even before they are diagnosed with Crohn’s. I haven’t seen too many overweight people diagnosed with Crohn’s.

Hopefully the effects of omentum on humans can be studied in order to devise some new therapies with fewer side effects then existing drugs for Crohn’s. Gaining weight though in order to get more abdominal fat should not be a policy recommendation since this would raise someone’s chances of getting a heart attack, Type II diabetes, and cancer. 

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. 

Saturated Milk Fats and Inflammatory Bowel Disease

This article that came out today from the University of Chicago that leads readers to believe that milk fats can change the bacteria in the intestines which may increase the risk of developing inflammatory bowel disease. The key word of course is “may”. In the experiment mice were fed diets that had were high in saturated milk fat and 60% of the mice that were fed high saturated milk fats developed ulcerative colitis compared to only 25%-30% who were fed low fat diets.

Of course, what we eat is only one factor in inflammatory bowel disease. Genes play a part too as well as the environment we live in. Also it is worth noting that trials in mice do not always translate into human results. One reason why I discount this study is for someone to explain to me how we have so many obese people yet so many fewer with inflammatory bowel disease? If diet has such a large role as many claim you would think there would be millions of people with inflammatory bowel disease as opposed to the 1.4 million that is estimated. I don’t discount that diet and what we eat can have a role in whether or not developing inflammatory bowel disease. However understanding what causes inflammatory bowel disease is complicated. What I would question is how much of an influence is diet into developing inflammatory bowel disease. Of course more research and experiments will have to be performed to figure this out.