crohns treatment

Read and learn more about crohns treatment. For more, visit the Crohn’s Disease website DrCrohns.org

Q: Does anyone on here suffer with crohns and what treatment do you have?
I have had it for the last ten years it is no fun, especially trying to keep up with two kids. When I am feeling ****.

A: I find the best treatment is changing my diet. That’s the only thing that works to stop the pain and diarrhea.

As a general rule, the grain and cereal foods at the top of this list make the safest, easiest, and most versatile soluble fiber foundations for your meals and snacks.[1]

Rice
Pasta and noodles
Oatmeal
Barley
Fresh white breads such as French or sourdough (NOT whole wheat or whole grain)*
Rice cereals
Flour tortillas
Soy
Quinoa
Corn meal
Potatoes
Carrots
Yams
Sweet potatoes
Turnips
Rutabagas
Parsnips
Beets
Squash and pumpkins
Mushrooms
Chestnuts
Avocados (though they do have some fat)
Bananas
Applesauce
Mangoes
Papayas (also digestive aids that relieve gas and indigestion)

*Please choose a baked-daily, high quality, preservative-free brand. White bread does not mean Wonder.

Why is soluble fiber so special? Because unlike any other food category, it soothes and regulates the digestive tract, stabilizes the intestinal contractions resulting from the gastrocolic reflex, and normalizes bowel function from either extreme. That’s right – soluble fiber prevents and relieves BOTH diarrhea and constipation. Nothing else in the world will do this for you.

I’ve enclosed a link that will give you more information about how to change your diet. I know this works.

Q: I am currently undergoing treatment for Crohns disease which consists of Remicade infusions.?
I was also recently diagnosed with Graves disease and did the radioactive idione treatment. Well a few minutes ago my dog got in a fight with another dog and I broke it up and was bit by my dog. Its not a horrible bit a bit swollen and tender. It defenitly broke the skin. I called all my Doctors and there offices are closed. Should I go to the ER or wait until tomorrow. I just started Remicade and I don’t know all the side effects

A: hi jill, I am a female crohn’s like yourself. I had Remicade treatment for mine a few yrs.ago. The only side effects I remember are others stating at the Crohn’s & Colitis Foundation of America support group meetings were that at the time of infusion they developed heart palps or difficulty breathing. then the infusion was stopped. Others had a reaction after 2 or more infusions where it just didn’t work due to the pt. building up a resistance to the mouse antibodies in it. Now they premedicate pts. with benedryl to prevent that from happening.

I provided info for their site and hotline. They also have a live chat on their site that is run by healthcare professionals well versed in IBD M-F 9 am – 5 pm. (EST).

If you can’t get ahold of your GI, call your primary care MD. Here is the information from the drug company’s website on Remicade:

What are the possible side effects of infliximab?

Serious, even fatal, infections have been reported to occur during treatment with infliximab. Contact your doctor immediately if you develop signs of infection such as fever or chills; sore throat, coughing, congestion or other signs of infection; redness, pain, or swelling of a skin wound; or burning or difficult urination.

Treatment with an immunosuppressant such as infliximab may increase the risk of developing certain types of cancer (e.g., lymphoma). Treatment with infliximab may also increase the risk of developing an autoimmune disorder such as a lupus-like syndrome. Talk to your doctor about the risks and benefits of this medication.

If you experience any of the following serious side effects, stop using infliximab and seek emergency medical attention or contact your doctor immediately:
an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
chest pain, dizziness, or shortness of breath.
Other less serious side effects may be more likely to occur. Contact your doctor if you develop

headache;
muscle or joint pain;
rash or itching;
fatigue; or
nausea or vomiting.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect infliximab?

Do not receive “live” vaccinations during treatment with infliximab. Administration of a live vaccine may cause an infection or be ineffective during treatment with infliximab.

The administration of infliximab and anakinra (Kineret) may be associated with an increased risk of serious infections, and increased risk of serious side effects. Talk to your doctor before using infliximab if you are using anakinra (Kineret).

Other medications may interact with infliximab or affect your condition. Talk to your doctor or pharmacist before taking other prescription or over-the-counter medications, including herbal products, during treatment with infliximab.

Q: free nhs treatment for crohns and chronic diseases?
if you have chronic illness such as crohns, can u get free nhs prescriptions all your life?

A: As far as I’m aware, paying for an NHS prescription has nothing to do with what illness you have or what medications you recieve. If you are considered able to afford to pay for prescriptions, you do.

Q: Is treatment in a Hyperbolic chamber good for Crohns and Ankylosing Spondilitus?

A: I would think no. Hyperbaric works by adding more oxygen to the blood and increasing blood flow to bodily tissues. Those are diseases would not benefit from increased blood flow

Q: A treatment for Crohns, IBS, depression, schizophrenia, a positive approach to disease treatment: Probiotics?
Chemcial imbalances for many people is a common term for diseases of unknown origins, diseases or symptoms.

Well what can cause these chemcial imbalances, a bacteria, a virus, yes, but also this can be caused by a lack of ‘probiotics’ ( acidophilus) referring to the friendly bacteria that operates your digestive system.

When was the last time the doctor gave you bacteria, friendly bacteria ?

Modern medicine is all about attacking a problem.

What if the problem cannot be attacked, but cultivated, because the real problem is a lack of what is called friendly bacteria that processes food into chemicals. (yogurt, saurerkraut)

Since our body operates through bio-chemcial processes, then a lack of proper chemicals because we lack the ‘workers’ within the digestive system will cause many diseases, including cancer, or the breakdown of body cells; due in part because they don’t have the proper chemicals.

Have you heard of probiotics ?
Can this be the missing link ?
The “link” I mentioned referred to the probiotics.

If you are looking for a link, look up “parasites’, ‘’symptoms of parasites’, treatment for parasites.

Here is one:

http://www.abeautifuldifference.com/webdoc.535.html

A: Probiotics is very critcal for optimal health; however, there is only one product that guarantees that the microflora reach our intestines live (500 million) and that’s all-natural Optiflora (a patented process). Other products such as yogurt only indicate that the microflora are live at the time of manufacture not that they will be live when they reach our intestines. So, I agree that probiotics is essential for good health – use Optiflora!!!!

Best Wishes

Q: if you have crohns disease and the treatment isn’t successful. do you live?
my mom said that my dad might be having strokes and might have crohns disease. and im asking here. because right nwo im really scared because i dont kno wat will happen

A: There are many treatments for Crohn’s. Several types of medications are available to treat Crohn’s disease. There Anti-inflammatory drugs, Immune system suppressors, Antibiotics and several other medications.

If the drugs don’t work then there is an operation to do to give some relief. Once in awhile some people need a couple operations. So as you can see there are a lot of treatments avaliable. They can usually get it under control with one or the other. Sometimes a combination of surgery and medication will be used.

Stroke
A stroke occurs when the blood supply to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die.

Stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications.

The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke — high blood pressure, smoking and high cholesterol — is likely responsible for the decline.

Q: has anyone not had any success with this form of treatment for crohns disease?
eat organic fruits & steamed vegetables & rice. AVOID dairy, hard meats, processed foods (artificial flavor, colors, preservatives), fried foods, popcorn, ice cream, sweets, pop, & alcohol. TAKE slippery elm, marshmellow root, ginger, aloe juice, fiber supplement such as ‘fiber smart’, probiotics, and fish oil. can anyone with crohns honestly tell me that after following this strict regimine that their crohns is not cured? my doctor does not believe me when i tell him this is all i need & i do not need to take steriods or asacol anymore. i feel great and ive met other people with crohns.. given them this advice and they feel great now too. so i want to help you all out there with crohns disease. it may be hard to eat such a strict diet but after doing it for awhile, you wont want to eat anything else.. anything else will seem gross! i went from a HUGE sweet tooth, eating fast food all the time and now i can’t eat sweet stuff or crap. just looking at it makes me feel sick. try it!
oh and i forgot.. you need to avoid caffeine and any stimulant drugs like the plaque.

A: Hi! I don’t have Chrohn’s, but I plan on becoming a gastroenterologist… specializing in food intolerances and illnesses that many doctors cast aside. From what I have read, many illnesses start in the gut. Chrohn’s is exactly that… an illness based in the digestion system. It only makes clear, conducive sense that what you put into your digestive tract effects how it functions. If you put junk into your home pipes, obviously they stopped functioning as well with time. It is even moreso with the digestive tract because it is living and chemically and electrically sensitive. I have heard a doctor discuss how the small intestines are the 2nd organ with the most nuerotransmissions… 2nd to the brain. It is incredibly important that we eat the right things to keep it functioning properly.

I applaud your efforts for taking control of your health! I encourage you to seek medical advice from someone who views the body as a whole entity. There are more and more doctors in the USA who are MDs but also becoming Integrative practitioners. http://thenewmedicine.org/ I would consider looking for an integrative MD if I were you. They believe in drug therapy as well as the non-traditional methods such as diet, supplements, stress-reduction, etc.

Below I have included a great article from Dr. Weil (an integrative doctor)… about some Crohn’s research and how he prefers treating patients with it.

Good luck and keep up the GREAT work!!

Q: Giardia treatment: Best choice for intestinal problem ie IBS, Crohns, and others… ?
Intestinal problems ? Labelled with IBS, or Crohns ?

Did you know that many tests for bacterial infections are not 100% accurate, in fact giardia requires some 3-6 negative tests to prove you don’t have it. Most doctors believe one is sufficient.

Research into herbal treatments for giardia, and related symptoms, has shown several ancient herbal treatments.

Which ones do you believe or have tried to be the best ?

Garlic.
Ginger
Green Black Walnut Hulls
Grapefruit Seed Extract
Oregano Oil

Something else ?

Simple Herbal Treatments !

http://www.abeautifuldifference.com/webdoc.535.html

A: Hi:

Well I use a probiotic which is Acidophilus, I choose bland foods, I tend to eat less fiber when I have a flair up. I take grape seed extract2 X day, Fish oil caps, and I always carry with me different forms of peppermint as peppermints help with the cramping.

Be safe and be well

Q: What is the treatment for Crohns disease. Can it completely cured/?
This has refence colon bleeding, while clearing the bowls

A: Crohn’s disease is a chronic disease of the intestines, therefore there is no cure for it. There are measures that can be taken to alleviate the symptoms, which seems to work for some people. Surgery, diet, relaxation techniques, alternative therapies (acupuncture, massage, reflexology, etc.) probiotics, etc. have all been proven to help individual cases.

Q: Have you or anyone you know used IV treatments for Crohns disease?
What was the outcome and cost? Did insurance cover it? Any info would be helpful.
Thanks!

A: My older sister has Crohn’s. She has been managing the
illness for over twenty years.
It is possible for Crohn’s Disease to go into
remission. However, most flare-ups are handled with
oral meds, such as Lialda (a form of mesalamine)
Prendisone (such as Depo-Medrol), & Azulfadine.
There are many new drugs used today to treat Crohn’s.
My sister was only on IV meds once, and that was when
she was hospitalized and dehydrated.
Insurance does pay, your doctor has to tell them why you
need IV meds as opposed to the orals.
This was our expericence. Hope this info helps you.

Q: i was just diagnosed with crohns, anyone have it and have had the remicade treatment?

A: Sorry to hear that you have been diagnosed with such an awful disease. I have been on pretty much every treatment including remicade. I have to come off it though because of an adverse reaction I had during my Last treatment. I can not imagine that your gi would go to remicade as a first treatment though.. Usually you start off with the less harmful meds i started off with asacol (i know the name is just awful for use with ibd..LOL) and prednisone. Then went to imuran then 6mp and pentasa, then entocort and librax, then remicade, then back to a combination of other treatments.. I would talk to my gi and ask why they are wanting to start you on something like remicade first.. Here are some links that i am sure you will find more useful than yahoo answers when it comes to crohn’s disease.
http://ccfa.org/ – crohn’s and colitis foundation of america – they even have online chat with a nurse or you can call with questions about meds or whatever.
http://crohns-sanity.org/forum/index.php – great for forums
http://www.healingwell.com/community/default.aspx?f=17 – great forum also..
I also have a list of 30 or so sites that have been helpful to me that i can email you if you would like..
I hope I have atleast been a little helpful

Q: Are there any similarities in the treatments for Crohns Disease and Lupus?
Similar as in steroids and/or pain meds,antibiotics etc?

A: Yes–as they are both auto-immune diseases. Your immune system is out of whack and basically turns on you.

Inflamation is one of the main pain sources for both conditions and steroids are used for both to reduce this.

However, while both have common meds used in treatment the rest is done on an idividual basis upon evalution of symptoms and severity.

Q: Is anyone familiar with TSO for Crohns?? Can they be transported or pose any health risk to someone else?
Happy New year! I am not familiar with the experimental treatment of TSO for Crohns disease, although I have checked websites, I do not see any answers as to whether or not it can be of any detriment to a partner not taking it coming from someone that is. Also, what are some health risks to the person that is taking it?

A: They feed you helminths which are very small worms, but not the worms you are thinking of. It is thought that this will decrease the host’s inflammatory processes. If a host has crohn’s it is thought that the disease will subside. I found the following research article for you. Best of luck.

Background: Crohn’s disease is common in highly industrialised Western countries where helminths are rare and uncommon in less developed areas of the world where most people carry worms. Helminths diminish immune responsiveness in naturally colonised humans and reduce inflammation in experimental colitis. Thus exposure to helminths may help prevent or even ameliorate Crohn’s disease.

Aims: The aim of the study was to determine the safety and possible efficacy of the intestinal helminth Trichuris suis in the treatment of patients with active Crohn’s disease.

Patients: Twenty nine patients with active Crohn’s disease, defined by a Crohn’s disease activity index (CDAI) 220 were enrolled in this open label study.

Methods: All patients ingested 2500 live T suis ova every three weeks for 24 weeks, and disease activity was monitored by CDAI. Remission was defined as a decrease in CDAI to less than 150 while a response was defined as a decrease in CDAI of greater than 100.

Results: At week 24, 23 patients (79.3%) responded (decrease in CDAI >100 points or CDAI <150) and 21/29 (72.4%) remitted (CDAI <150). Mean CDAI of responders decreased 177.1 points below baseline. Analysis at week 12 yielded similar results. There were no adverse events.

Conclusions: This new therapy may offer a unique, safe, and efficacious alternative for Crohn’s disease management. These findings also support the premise that natural exposure to helminths such as T suis affords protection from immunological diseases like Crohn’s disease.

——————————————————————————–

Abbreviations: CDAI, Crohn’s disease activity index; 6-MP, 6-mercaptopurine; DNBS, ditrinitrobenzene sulphonic acid; TNBS, trinitrobenzene sulphonic acid

Keywords: Crohn’s disease; inflammatory bowel disease; helminths; immunomodulatory; Trichuris suis

Crohn’s disease is a chronic relapsing inflammatory reaction that may affect any part of the gastrointestinal tract. It is common in parts of the world where helminthic colonisation is rare and uncommon in those areas where most people carry worms.1 It appears to result from an inappropriate immune response to normal gut flora. Helminths down-modulate the host immune response to unrelated antigens,2–4 a property that could be beneficial in Crohn’s disease. Helminths reduce inflammation in experimental murine colitis.1,5–7Trichuris suis, the porcine whipworm, is similar to human whipworm T trichiura. Ingestion of T suis ova results in short term self limited colonisation of humans.8 We therefore conducted a 24 week clinical trial to evaluate the safety and possible efficacy of live T suis therapy in Crohn’s disease.

METHODS
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Patients were enrolled in a 24 week open label study after giving informed consent. The University of Iowa Institutional Review Board approved the protocol. Subjects with Crohn’s disease, as defined by standard clinical, radiological, and histological criteria, were recruited and followed at the University of Iowa and clinical practices in the State of Iowa. Patients 18–72 years old were eligible if they had a Crohn’s disease activity index (CDAI) between 220 and 450.9 A small bowel series and colonoscopy were required within the year before enrolment. Patients continued their Crohn’s disease medications if they met the following enrolment criteria: (1) mesalamine or derivatives if they had been receiving it for >8 weeks and the same dose for >4 weeks; (2) oral prednisone up to 25 mg/day if patients had been receiving it for >8 weeks and the same dose for >4 weeks; and (3) azathioprine or 6-mercaptopurine (6-MP) if patients had been receiving it for >6 months and the same dose for >8 weeks. Before enrolment, patients had to have a haemoglobin concentration of >10.0 g/dl, white blood count of 5000–15 000/mm3, platelet count >150 000/mm3, no iron or vitamin B12 deficiency, total bilirubin <1.5 mg/dl, aspartate aminotransferase and alanine aminotransferase <100 U/dl, alkaline phosphatase <250 U/dl, blood urea nitrogen <40 mg/dl, serum creatinine <2.0 mg/dl, and stool examination negative for pathogens or Clostridium difficile toxin. Women had a negative pregnancy test and practised birth control. Patients with ileostomy, colostomy, resection >50 cm, obstructive symptoms, or anticipated need for surgery were excluded. They were not enrolled if (1) treatment in the last 12 weeks included cyclosporine, methotrexate, infliximab, or other immunomodulatory agents, (2) treatment in the last two weeks included antibiotics, antifungal, or antiparasitic medications, and (3) they had other diseases that could interfere with compliance or interpretation of the results.

Specific pathogen free pigs were given T suis ova by gastric gavage. After allowing time for worm maturation, adult worms were isolated from the colon and cultured in vitro. Ova produced in vitro were collected and allowed to embryonate for 5–6 weeks in phosphate buffered saline containing penicillin/streptomycin/amphotericin B at 22°C. The embryonated ova were then made bacteria free using 0.2% K2Cr2O7, washed with sterile saline, and stored at 5°C in phosphate buffered saline. Standard viral and bacterial cultures were performed on aliquots of ova to assure that they contained no pathogens. Pigs were inoculated with stored ova at regular time intervals to assure that the ova remained infective. This analysis demonstrated that stored ova retained viability for at least nine months. Eggs were divided into individual aliquots of 2500. This number of ova was the same as that used in our earlier pilot study.10 Subjects returned every three weeks to drink the ova suspended in a commercial drink. The study coordinator witnessed that all of the subjects consumed the drink.

Patients kept daily diaries of clinical symptoms. Dosing of all other inflammatory bowel disease medications was held constant. The following were obtained at entry and every six weeks: medical history and physical examination, pregnancy test, complete blood count, liver profile, and stool examination for ova, pathogens, and C difficile toxin. Means (SD) are given. Medians are presented with interquartile range. The two tailed Fisher’s exact test was used to examine patient characteristics that might predict response or remission.

RESULTS
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METHODS
RESULTS
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A total of 29 patients were enrolled and their baseline characteristics are shown in table 1. Most patients had longstanding disease (median 3.9 (1.5–6.8) years) and were refractory to standard inflammatory bowel disease therapy before enrolment. Fourteen patients were on corticosteroids and/or azathioprine/6-MP. Only 5/29 (17%) were on no medications; of these, 10 previously had tried corticosteroids and/or other immunosuppressants (azathioprine, 6-MP, infliximab). Mean CDAI was 294, indicating that patients were moderately ill. The cohort included patients with anatomical disease distribution similar to that of the Crohn’s disease population at large.

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Table 1 Baseline characteristics of the patients*

Patients were compliant with the protocol; all patients completed their symptom diaries, attended all clinic visits, and received all doses of the ova. None was lost to follow up. Four withdrew at or before week 12 because of ongoing disease activity, and one withdrew between weeks 12 and 24 because of pregnancy. Ongoing disease activity was defined as failure to respond or achieve remission and these individuals are included in the analysis. There was no indication that the ova therapy made any patient more ill, and there were no side effects or complications attributable to therapy. Patients developed no new symptoms such as nausea, vomiting, abdominal pain, or worsening of diarrhoea. There was no deterioration in CDAI in the four patients that withdrew before week 12. Analysis of laboratory data collected during the study showed no significant changes in complete blood count or differential, blood urea nitrogen or creatinine, or aspartate aminotransferase, alanine aminotransferase, or alkaline phosphatase. All stool specimens were negative for ova and parasites.
At week 12, 22 patients (75.9%) responded (decrease in CDAI >100 points or CDAI <150) and 19/29 (65.5%) were in remission (CDAI <150). At week 24, 23 patients (79.3%) experienced a response and 21/29 (72.4%) were in remission (fig 1A). Mean initial CDAI of responders was 287.1 (47.8). It decreased to 92.0 (49.2) at week 12 and 99.9 (35.6) at week 24 (fig 1B). Thus the mean improvement in CDAI for these patients was 195.1 and 187.2 at weeks 12 and 24, respectively. There were six patients with a baseline CDAI between 250 and the minimum entry criterion of 220. All six achieved both a response (improvement in CDAI of >100) and remission (CDAI <150).

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Figure 1 (A) Percentage of patients achieving remission or response at week 12 or 24 after initiating ova therapy. (B) Mean change in Crohn’s disease activity index (CDAI, mean (SD)) for respondents to ova therapy. CDAI <150 is remission. p<0.0001, week 12 or week 24 compared with baseline (time 0).

We performed subset analysis of patient characteristics looking for predictors of outcomes. Sex, patient age, disease duration, smoking status, or disease location did not influence the frequency of response or remission. There was a trend for patients using immunosuppressive drugs to improve to a greater degree than those not using these agents (table 2). Also, patients with a prior history of terminal ileum resection were less responsive.

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Table 2 Subset analysis of patient characteristics for response and remission

DISCUSSION
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METHODS
RESULTS
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Human helminthic parasites were considered as a therapeutic option. Many could not be used because there are no available sources other than a human carrier. Eggs from such a source would risk inadvertent transmission of pathogenic microbial agents. Also, some human helminths have disease potential or raise public health concerns.
Trichuris species are helminths with favourable characteristics for therapeutic use. Their life cycle minimises the risk of inadvertent colonisation. Trichuris ova mature in the soil and are ingested by the host. Ova hatch in the duodenum, releasing larvae that ultimately grow in 6–8 weeks into adult worms. They migrate to the terminal ileum and colon but do not invade the host. Worms can remain viable for 1–2 years in the natural host. Adult worms release ova that are shed into the stool. These ova are immature and are not capable of colonising another host until they incubate in the soil for several weeks to allow embryonation.

We chose T suis as the helminth to colonise subjects in this study. T suis, the porcine whipworm, is genetically related to T trichiura, the human whipworm. T suis is not a natural human parasite but it has been shown experimentally to colonise humans briefly without causing disease.8 The ova can be produced using pathogen free pigs, and processed to assure absence of biological contaminants.

Treatment with T suis ova for 24 weeks yielded a response rate of nearly 80% and a remission rate of nearly 73%, which was much greater than the anticipated placebo effect.11–14 This was particularly notable as many patients had refractory disease. Thus T suis ova therapy may produce substantial and sustained improvement in active Crohn’s disease. However, the study was open label, and we cannot exclude a high placebo effect. The treatment caused no side effects or complications even in patients receiving multiple immunosuppressants (for example, corticosteroids and azathioprine/6-MP), suggesting a high safety profile.

Subset analysis of the data suggested that patients on immunosuppressive therapy faired better, as did patients with an intact terminal ileum. We can only speculate on the reason for these observations. It is possible that immunosuppressives could have influenced T suis colonisation. Also, there could have been a synergistic interaction between the immunomodulatory effect of the helminths and the immunosuppressive effect of the other drugs. Terminal ileal resection also could have affected worm colonisation, or perhaps residual symptoms from the surgery confounded CDAI scoring. Both of these observations need confirmation in a prospective trial to assure that they were not artefacts.

There is an immunological basis to expect that exposure to helminths such as T suis will prove beneficial in Crohn’s disease. Crohn’s disease involves over reactive Th1 pathways, and helminths blunt Th1 responses. For example, helminths attenuate intestinal inflammation in animal models of inflammatory bowel disease. Interleukin 10 deficient mice spontaneously develop a Th1-type colitis characterised by infiltration of the lamina propria with interferon producing CD4+ T cells.15 Colonisation with T muris or Heligmosomides polygyrus retards development of colitis in interleukin 10 deficient mice.1 Mice and rats treated with di- or trinitrobenzene sulphonic acid (DNBS, TNBS) develop a Th1 cytokine driven colitis that shares features with Crohn’s disease.16 Mice and rats exposed to Schistosoma mansoni are resistant to TNBS colitis.6,7 Colonisation of mice with Trichinella spiralis diminishes DNBS induced colits.5 This protection is associated with decreased systemic and colonic interferon and interleukin 12 expression, which are critically important Th1 cytokines.

Colonisation with helminths augments several immunoregulatory pathways that limit Th1-type inflammation. Helminths induce production of interleukin 4 and interleukin 13, which are Th2 cytokines. This Th2 response inhibits production of Th1 cytokines thereby reducing colitis severity.6 Helminths also induce regulatory T cells and immune regulatory substances such as transforming growth factor ß, interleukin 10, and prostaglandin E2 that assist in maintaining host mucosal homeostasis.4

In summary, T suis is well tolerated and appears efficacious for Crohn’s disease in this open label trial. Helminths probably inhibit intestinal inflammation by mechanisms different from current medications. Helminths may offer an easy to administer alternative or supplement to currently available therapeutic agents. These results justify a double blind controlled clinical trial. Furthermore, these results support the hypothesis that helminthic exposure provides protection against some immune mediated inflammatory disease like Crohn’s disease.

ACKNOWLEDGEMENTS

The authors gratefully acknowledge the support of Betty Musgrave, clinical research coordinator. Drs Miriam B Zimmerman and William Clarke, Department of Biostatistics provided assistance with study design, statistical methods, and data analysis. Additional participating University of Iowa gastroenterologists included Drs Jeffrey Field, Khurram Qadir, and David Ramkumar. Collaborating gastroenterologists from the State of Iowa included: Drs Dean Abramson, Nile Dusdieker, Joseph Ewing, Jon Gibson, Bernard Leman, Randall Lengeling, Sudhakar Misra, James Piros, Douglas Purdy, Leon Qiao, Surish Reddy, Robert Silber, Joseph Truszkowski, and Gary Weinman.

The Crohn’s and Colitis Foundation of America provided the primary support for this study. The Broad Medical Research Program of the Eli and Edythe L Broad Foundation, the Ed and Liliane Schneider Family Foundation, and the Thomas Irwin Memorial Fund also provided partial support. The study sponsors had no involvement in the study design, collection, analysis, and interpretation of the data, in the writing of the report; or in the decision to submit the paper for publication.

FOOTNOTES

Conflict of interest: None declared.

REFERENCES
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ABSTRACT
METHODS
RESULTS
DISCUSSION
REFERENCES

Elliott DE, Urban JF Jr, Argo CK, et al. Does the failure to acquire helminthic parasites predispose to Crohn’s disease? FASEB J 2000;14:1848–55.[Abstract/Free Full Text]
Sabin EA, Araujo MI, Carvalho EM, et al. Impairment of tetanus toxoid-specific Th1-like immune responses in humans infected with Schistosoma mansoni. J Infect Dis 1996;173:269–72.[Medline]
Borkow G , Leng Q, Weisman Z, et al. Chronic immune activation associated with intestinal helminth infections results in impaired signal transduction and anergy. J Clin Invest 2000;106:1053–60.[Abstract/Free Full Text]
Weinstock JV, Summers R, Elliott DE. Helminths and harmony. Gut 2004;53:7–9.[Free Full Text]
Khan WI, Blennerhasset PA, Varghese AK, et al. Intestinal nematode infection ameliorates experimental colitis in mice. Infect Immun 2002;70:5931–7.[Abstract/Free Full Text]
Elliott DE, Li J, Blum A, et al. Exposure to schistosome eggs protects mice from TNBS colitis. Am J Physiol 2003;284:G385–91.
Moreels TG, Nieuwendijk RJ, De Man JG, et al. Concurrent infection with Schistosoma mansoni attenuates inflammation induced changes in colonic morphology, cytokine levels, and smooth muscle contractility of trinitrobenzene sulphonic acid induced colitis in rats. Gut 2004;53:99–107.[Abstract/Free Full Text]
Beer RJ. The relationship between Trichuris trichiura (Linnaeus 1758) of man and Trichuris suis (Schrank 1788) of the pig. Res Vet Sci 1976;20:47–54.[Medline]
Best WR, Becktel JM, Singleton JW, et al. Development of a Crohn’s disease activity index. National Coorperative Crohn’s Disease Study. Gastroenterology 1976;70:439–44.[Medline]
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Q: Hi, I have Crones disease and Hepatitis B. What diet and treatment options are there?
I am 23 years old and have been living with Crohns disease since I was 16. I just recently got diagnosed with Hepatitis B. I have been really depressed and feeling totaly alone! Is there anyone that can relate to me and give me diet and just some basic information on the best ways to maintain a healthy life?

A: I hope you are seeing a gastroenterologist; they will be able to help you with both problems. I don’t know a lot about Chrone’s but for HBV (Hep b) you will need to abstain from alcohol. Most people clear HBV through their own immune response after a short period of time, so you will need further tests to see if you have cleared it or if it has become chonic. If it’s chronic, you will need to have a healthy lifestyle (diet, exercise) and discuss treatment options (lamivudine, pegasys) with the doctor. If left untreated, HBV is the leading cause of liver transplants. It can progress to cirhossis and liver cancer. If you take care of yourself, you can live a healthy life. I don’t want to scare you, but you need to know the facts. Hopefully, you will clear it naturally, as 90% of people do who become exposed to HBV. Best wishes.

Q: The NEW FDA approved ALLI pill and Crohns disease?
Could i take this pill if i have crohns disease? Just curious because of the treatment effects?

A: I would not suggest it as it can affect the digestive system. Check with your doc and I’d wait to see how it REALLY affects ppl first. FDA approval means squat these days.

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