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Study Underway to Find an Alternative Cure for Crohn's Disease and Ulcerative Colitis

Rush University Medical Center Exploring the Effectiveness of Dietary and Mind/Body

Two research studies evaluating dietary changes and complementary medicine for the treatment of inflammatory bowel diseases (IBD) have been launched at Rush University Medical Center, Chicago. Funded by the National Institute of Health, one study will look at the impact of mind/body medicine on patients suffering from ulcerative colitis (UC) and the other will assess how diet impacts patients with Crohn’s Disease.

There are two main types of IBD, Crohn’s disease and UC, which afflict approximately one million Americans. These diseases cause chronic inflammation of the intestinal tract, causing a variety of symptoms such as abdominal pain, diarrhea and rectal bleeding.

"Both Crohn’s disease and ulcerative colitis are due to an autoimmune response to the bacteria or bacterial antigens inside the intestines," said Dr. Ali Keshavarzian, director of digestive diseases and nutrition at Rush and principal investigator and co-investigator on the studies. "Basically, the immune system is having an abnormally aggressive reaction to the bacteria."

"We want to control flare-ups of the diseases," said Keshavarzian. "Unfortunately, the treatments for IBD can be toxic and risky. There are increased risks of cancer, infection and even death as a result of IBD treatment. That’s why we’re looking at how diet as well as stress relate to the flare-ups. It may be that if we can lower stress and get the right diet, we may be able to control these illnesses."

Mind/Body Alternatives for Treating Ulcerative Colitis

One study is looking for participants suffering from UC in order to find out if complementary and alternative medicine techniques may help reduce the effects when conventional medicine has not been successful.

"We’re looking at the relationship between stress and ulcerative colitis flareups," said Dr. Sharon Jedel, clinical psychologist in the section of gastroenterology at Rush and the study’s co-investigator. "The trial includes education about stress and training individuals in certain stress reduction techniques using alternative therapies."

"Approximately 40 percent of patients with IBD use complementary and alternative medicine; however, there is a lack of scientific evidence of the efficacy," said Keshavarzian. "Complementary treatments and services are a large, yet hidden section of our health care system."

Rush is looking to enroll 100 subjects suffering from moderately severe UC who have experienced a flare-up in the last six months. Participants will be assigned randomly to one of two possible eight-week courses on mind/body medicine.

Research on Diet's Effect on Crohn's Disease

The second study which is a dietary trial is looking for 90 participants with Crohn's disease to see if diet adjustments as well as dietary food supplements promoting the growth of good bacteria might help control flare ups.

"We’re trying to get improve the mix of bacteria in the intestines of patients with IBD. Imagine making a picture with different colors," said Dr. Ece A. Mutlu, gastroenterologist at Rush and principal investigator on the study. "It could be terrible or harmonious depending on the composition and quantity of certain colors. We’re trying to create a harmonious environment in the intestines with the right types of bacteria."

"One of the many advantages of coming to Rush is that we’re looking for alternatives to IBD treatment that may have less side effects," says Mutlu. "Our hope is to find a number of solutions to control these debilitating diseases."

Complexities of Crohn's Disease Brought to Light

By: Madeline Ellis
Health News - July 2008

In what could be the largest study ever undertaken into the underlying genetics of common diseases, a team of scientists and clinicians have identified new genetic links that increase susceptibility to Crohn's disease, one of a group of diseases called inflammatory bowel disease (IBD) that causes inflammation, pain, and ulcers. The researchers hope that by understanding the underlying causes of the disease, they can identify targets for new drug therapies.

Previous studies have identified 11 genes and loci (regions of the genome typically including one or more genes) that increase susceptibility to Crohn's disease. After analyzing DNA samples from almost 12,000 people, researchers identified 21 additional genes. "We now know of more than 30 genetic regions that affect susceptibility to Crohn's disease," said Dr Jeffrey Barrett, lead researcher from the Wellcome Trust Centre for Human Genetics at the University of Oxford. "These explain only about a fifth of the genetic risk, which implies that there may be hundreds of genes implicated in the disease; each increasing susceptibility by a small amount."

Scientists have long known that genes, along with environmental factors, play a role in increasing the risk of people developing many common problems such as asthma, high blood pressure, cancer, rheumatoid arthritis, and heart disease.

Three of the individual genes linked to Crohn's have previously been shown to influence the risk of type 1 diabetes and asthma, which suggests a possible common genetic mechanism. However, one of the most promising links is thought to be the CCR6 gene, which scientists believe to be part of the signaling process that causes white blood cells in the intestines to become over-active, leading to inflammation. These same white blood cells are also present in inflamed joints, implying that CCR6 may play a role in rheumatoid arthritis as well.

But the most unexpected link was that of the ORMDL3 gene on chromosome 17. This gene was already known to be a genetic risk factor for childhood asthma, but until now, had not been linked to Crohn's disease. "It's too early for us to say how Crohn's disease and many of these other diseases, including asthma, are linked at a biological level," said Dr Miles Parkes, Consultant Gastroenterologist at Addenbrooke's Hospital and the University of Cambridge, who also worked on the study. "However, we are building up a picture of the biology underlying Crohn's disease, and the more we understand about the underlying biology of these diseases, the better equipped we will be to treat them."

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