Crohn’s disease is an inflammatory bowel disease that affects 700,000 people in the U.S. Men and women are diagnosed with Crohn’s disease in equal number, but the disease is more prevalent in adolescents and adults ages 15-35. Recent research on Crohn’s disease is uncovering more potential risk factors, causes, and potential treatments for this often-debilitating and chronic disease.
Crohn’s disease most commonly impacts the small intestine and beginning of the colon but can affect any part of the digestive tract. Unlike another inflammatory bowel disease that affects just the lining of the intestine (ulcerative colitis), Crohn’s disease can affect the entire thickness of the bowel wall. The diseased areas can be interspersed with areas of healthy bowel and colon.
Symptoms of Crohn’s disease include:
- Abdominal cramps and pain
- Persistent need to move bowels
- Feeling that bowels have not been completely evacuated
- Rectal bleeding
Other symptoms that are similar to ulcerative colitis can include fever, nausea, loss of appetite, fatigue, and irregular menstrual cycle or loss of cycle completely. Crohn’s disease can cause malnutrition and stunted growth in children.
Healthy intestines contain trillions of gut microbes that help with everything from digestion to immune system function. These microbes recognize unhealthy bacteria and work to move it through the body safely. In a person with Crohn’s disease, the immune system sees this helpful gut bacteria as harmful and mounts an intense response. This response eventually leads to chronic inflammation and damage to the intestine. In some people, this leads to thickening intestinal walls and a diagnosis of Crohn’s disease.
There are certain risk factors for Crohn’s disease, including:
- Genetics: People with a first-degree relative with Crohn’s (parent, child, or sibling) have a 5-20% increased chance of being diagnosed with Crohn’s. Even without this close genetic tie, Crohn’s disease tends to run in families.
- Geography: Eastern Europeans have a greater risk for being diagnosed with Crohn’s disease. There has also been a rise in diagnoses in the African American community. In addition, developed countries see more incidence of inflammatory bowel disease in general (and Crohn’s disease specifically). Urban areas have higher rates of diagnosis, and more cases are present in the northern hemisphere.
Recent research has been looking at these causes and risk factors in more depth, with some startling results.
1. Industrialized countries may be missing crucial gut microbes
A study of indigenous tribes found that they have a specific microbe in their gut flora that is missing in the guts of people living in industrialized nations. This missing microbe, Treponema, has been a part of human biology for millions of years. Scientists speculate that the absence of this crucial microbe may explain the rise of some inflammatory diseases such as Crohn’s. Cecil Lewis, co-director of the laboratories of molecular anthropology and microbiome research in the University of Oklahoma College of Arts and Sciences had this to say about the findings:
2. The gut may not heal itself quickly enough
Researchers in the UK found that in some patients with inflammatory bowel disease, the gut had an excess of the protein SOCS3. This protein helps limit inflammation, but in the case of IBD, the increase of SOCS3 had a negative effect on the epithelial lining of the intestinal tract. SOCS3 actually had an inhibitory effect on healing and allowed harmful bacteria to continue to damage the gut. Other research found that the deficit of another type of protein also hindered the gut’s ability to heal itself. It is clear that people with Crohn’s disease have an imbalance in the gut that does not foster protection from harmful bacteria.
3. The overall gut microbial biome is key
It has been well-established in the research on many different conditions that the gut microbial biome holds the key to good health. New research from Technische Universität München (TUM) further proves that it is balance of the gut biome overall that influences the chances of developing Crohn’s disease, not just the presence of a single beneficial or harmful type bacteria.
Researchers injected the gut microbes of sick mice into the gut of healthy mice and observed as the healthy mice began to exhibit symptoms of Crohn’s disease. Professor Dirk Haller, TUM chair of nutrition and immunology explained it this way:
Along with new research into causes, scientists are working on new potential treatments. Crohn’s disease is chronic with symptomatic periods and periods of remission. The goal with treatment is to increase periods of remission and to address symptoms during disease flare-ups. The drug thalidomide is showing promise in increasing periods of remission in children with Crohn’s disease. Vitamin D supplementation is also yielding good results in treating the disease.
While genetic predisposition increases the chances of developing Crohn’s disease, there are some types of foods to avoid to prevent flare-ups. Maintaining a healthy balance in the gut microbiome with fermented foods, proper nutrition, exercise, and lifestyle changes can also help for not only Crohn’s disease but also for overall health.
If you have symptoms of Crohn’s disease or another inflammatory bowel disease, talk to your doctor to discuss treatment options.