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


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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