Crohn’s disease

Crohn’s Disease

Hemarrhoid

Facts about Crohn’s Disease

  • Approximately 1.6 million Americans currently have IBD, a growth of about 200,000 since the last time CCFA reported this figure (in 2011).
  • As many as 70,000 new cases of IBD are diagnosed in the United States each year.
  • There may be as many as 80,000 children in the United States with IBD.

Research scope in Crohn’s Disease

  • Patients with active Crohn’s disease consume lower quantities of fructans and oligofructose than their inactive counterparts and healthy controls. The impact of lower intakes of prebiotic fructans on gut microbiota is unknown and warrants further research.
  • Potassium channels are potential immune modulatory targets in Crohn’s disease.
  • Etiology Crohn’s Disease is not completely understood.
  • The incidence of Crohn’s disease (CD) is increasing in Asia and Eastern Europe. Limited studies have reported on the frequency of upper gastrointestinal (GI) involvement in patients with CD in non-Western countries.
  • A coding polymorphism of human ATG16L1 (rs2241880; T300A) increases the risk of Crohn’s disease.

Treatment for Crohn’s Disease

  • Cipro exhibits a significant efficacy for the treatment of CD, in particular with perianal fistula
  • Certolizumab is effective and safe in treating Crohn’s disease
  • Ustekinumab: a novel therapeutic option in Crohn’s disease: is clinically efficacious and reasonably safe for induction and maintenance of remission
  • Infliximab (IFX) is a new therapeutic option for patients with intestinal BD, NBD, or VBD
  • There is no statistically significant differences in efficacy and safety between vedolizumab and certolizumab pegol.

Prevention of Crohn’s Disease

  • Intake of zinc was inversely associated with risk of CD but not UC
  • Breastfeeding is associated with lower risks of Crohn disease and ulcerative colitis.
  • High fiber and fruit intakes were associated with decreased CD risk, and high vegetable intake was associated with decreased UC risk.
  • Statins may have a protective effect against new onset IBD, CD, and UC.
  • Co-administration of curcumin with conventional drugs was effective, to be well-tolerated and treated as a safe medication for maintaining remission.

Risk factors for Crohn’s Disease

  • Smoking, family history, and oral contraceptive use, appears as risk factors for developing Crohn’s disease.
  • Sleep disturbance was associated with an increased risk of disease flares in CD (Crohn’s disease) but not ulcerative colitis [UC]).
  • Appendectomy is associated with an increased risk of Crohn’s disease that is dependent on the patient’s sex, age, and the diagnosis at operation.
  • Adolescent diet is associated with risk of CD, but not UC, offering insights into disease pathogenesis
  • Patients with Crohn’s disease had lower serum 25(OH)D concentrations compared with their healthy counterparts, and more than half of them have hypovitaminosis D
  • In children, the rs1893217 polymorphism appeared to confer susceptibility to CD (OR = 1.56, 95 % CI, 1.28-1.89, I (2) = 0 %)
  • Frequent use of NSAIDs but not aspirin seemed to be associated with increased absolute incidence of CD and UC.

Systematic reviews

  • Relative risk of colorectal and small bowel cancers are significantly raised in Crohn’s disease.
  • Antimycobacterial therapy is effective in maintaining remission in patients with Crohn’s disease after a course of corticosteroids combined with antimycobacterial therapy to induce remission.
  • Although the Heineke-Mikulicz technique is most often used for Crohn’s strictureplasty, outcome analysis revealed the Finney strictureplasty may reduce the reoperation rate.
  • Crohn disease was markedly higher for Leu1007fsinsC than for Arg702Trp and Gly908Arg.

Treatment with Medicinal Herbs

  • Marshmallow (Althaea officinalis) – Dose – 1 tsp leaf/cup water; 5 g leaf/day; 2-5 ml liquid leaf extract (1:1 in 25% ethanol) 3x/day; 5-6 g root 3x/day 
  • Witch Hazel (Hamamelis virginiana) – Dose – 2 g dry leaf, or in tea, 3x/day; 2-4 ml liquid bark extract (1:1 in 45% ethanol) 3x/day; 10-15 drops liquid bark extract 3x/day 

Reference: Handbook of Medicinal Herbs (2006)

Herbals

References

Risk scope

  • J Crohns Colitis. 2015 Nov;9(11):1024-31
  • Oncotarget. 2016 Jun 14: Altered calcium influx of peripheral Th2 cells in pediatric Crohn’s disease: infliximab may normalize activation patterns.
  • Immunobiology. 2016 Sep;221(9):927-33
  • J Crohns Colitis. 2016 Jun 9: Gastroduodenal involvement in asymptomatic Crohn’s disease patients in two areas of emerging disease: Asia and Eastern Europe
  • Nat Commun. 2016 Jun 8;7: The T300A Crohn’s disease risk polymorphism impairs function of the WD40 domain of ATG16L1

Risk factors

Prevention

Treatment