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Crohn's Disease- Pathophysiology and Conventional and Alternative Treatment Options

Crohn's Disease

Table 1: Subcategories of Crohn's Disease

Table 2: Signs and Symptoms of Crohn's Disease and Ulcerative Colitis

Risk Factors

Diagnosis

Etiopathogenesis:

    The Genetic Component of Crohn's Disease

    Stress in the Etiology of Crohn's Disease

    Microbial Factors

    Inflammation/Immune Response

    Intestinal Permeability

    Other Abnormalities Contributing to the Etiopathogenesis of Crohn's Disease

Conventional Treatment of Crohn's Disease

Table 5: Conventional Medications and their Mechanisms in Crohn's Disease

Nutrient Deficiences in Crohn's Disease

Table 6: nutrient Deficiencies Associated with Crohn's Disease

Dietary Interventions in Crohn's Disease

Table 7: Diet Therapies Compared to Steroid Medications in Crohn's Disease

Probiotics in the Treatment of Crohn's Disease

Fatty Acids for the Treatment of Crohn's Disease

Table 8: A Summary of Omega-3 Fatty Acid Studies in Crohn's Disease

Glutamine

N-acetyl Glucosamine

Remicade Increasing Risk of Cancer

Botanicals in the Treatment of Crohn's Disease

Dehydroepiandrosterone (DHEA

Potential Sequelae of Crohn's Disease

References




DHEA

Dehydroepiandrosterone (DHEA) is low in patients with Crohn's Disease. In a study of 115 Crohn's Disease patients compared to 66 healthy controls and 64 UC patients, both Crohn's Disease and Ulcerative Colitis patients had low serum DHEA-sulfate (DHEAS) levels compared to controls. In Crohn's Disease patients, but not Ulcerative Colitis patients, low DHEAS levels were correlated with high ESR, while high cortisol was associated with high ESR and CRP.258 Another study found a shift in the ratio of cortisol:DHEA in Crohn's Disease patients with active disease, with higher cortisol and lower DHEA levels. 259

Because Dehydroepiandrosterone can be deficient in patients with IBD and has also been shown to inhibit pro-inflammatory cytokines, a phase 2 pilot trial was conducted to evaluate its effect in IBD patients. Twenty patients (seven with Crohn's Disease; 13 with Ulcerative Colitis), ages 18-45, were given 200 mg Dehydroepiandrosterone orally once daily for 56 days. All patients were experiencing active disease, defined as CDAI > 150, refractory to other medications. All medications remained the same for two weeks prior to and during the study. One patient with Crohn's Disease (and four with Ulcerative Colitis) dropped out because of disease exacerbation or noncompliance. In the Crohn's Disease group, six of seven responded to treatment with a decrease in CDAI of 70 points or more. In all six responders, the CDAI dropped below 150, putting them into remission. The one patient who did not respond dropped out during the first week. Number of liquid stools, bloody diarrhea, abdominal pain, and CRP all decreased. One Crohn's Diseas patient relapsed on day 56. Patients were followed for eight weeks after the end of the study and no further Crohn's Disease relapses were reported.260



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