The Inflammatory Bowel Diseases (IBD) — Crohn’s disease and ulcerative colitis — affect 1.6 million Americans. According to the Crohn’s and Colitis Foundation of America (CCFA):
These chronic diseases tend to run in families and they affect males and females equally. While IBD can affect anyone, Caucasians are more likely than other ethnic groups to have IBD.The diseases are especially prevalent in Jews of European descent (Ashkenazi Jews). African Americans and Hispanics in the United States are increasingly affected.
Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract and may affect any part from the mouth to the anus.
Ulcerative colitis is a chronic inflammatory condition limited to the colon, otherwise known as the large intestine.
Symptoms of diarrhea, constipation, rectal bleeding, and chronic abdominal pain and cramping can lead to diminished appetite, weight loss, fatigue, fever, and intestinal obstruction. In children, poor growth is commonly seen on the height, weight, and BMI growth curves. (Early on in its course, growth delay may be the presenting feature of IBD.) IBD is an auto-immune disorder: a person’s immune system mistakenly targets normal, healthy organs — instead of invading infectious organisms or environmental agents — for destruction. Damage due to chronic inflammation to the lining of the gastrointestinal tract (and through the full thickness of the wall of the intestine in the case of Crohn’s disease) leads to the symptoms described above.
Lifestyle changes — including dietary adjustments — and expensive medications (often several) taken daily are required to achieve remission and to prevent flareups of symptoms. Approximately 70% of patients with Crohn’s disease will at some point require surgery for one or more complication. Amy Norton looks at a very small study that recognizes the “astounding success” of fecal transplants in patients with severe C. difficile colitis and applies it to patients with Crohn’s disease. Instead of suppressing the immune system, like medications do, fecal transplants work by manipulating the recipient’s own microbiome in order to counter inflammation:
Like the name implies, a fecal transplant involves transferring stool from a donor into a Crohn’s patient’s digestive tract. The idea is to change the bacterial composition of the gut, and hopefully quiet the inflammation that causes symptoms.
And for most kids in the new study, it seemed to work. Within two weeks, seven of nine children were showing few to no Crohn’s symptoms. Five were still in remission after 12 weeks, with no additional therapy, the researchers reported in a recent issue of the journal Inflammatory Bowel Diseases.
That’s not all. Another small study published recently looked at the use of a patient’s own stem cells to help treat a common complication of Crohn’s disease: fistulas:
Fistulas are tunnels that connect one loop of intestine to another, or that run beyond the intestines, connecting to the bladder or skin, for example.
The current treatments for fistulas — antibiotics, biologic drugs, “glues” and surgery — rarely banish the problem, Swaminath said.
So these researchers, led by Dr. Chang Sik Yu, tried a new approach: They took stem cells from the patient’s own fat tissue, then injected the cells, combined with glue, into the fistula during surgery.
Of 36 patients who were followed for two years, 75 percent were still doing well, with the fistula completely closed, Yu’s team reported in the journal Stem Cells Translational Medicine.
The one-year success rate with current therapies for fistulas is currently 36%. This novel treatment using “stem cell glue” more than doubles that!
More studies will no doubt be done in pursuit of more effective treatments for the chronic and debilitating symptoms of IBD. It appears that researchers are on the right track!