[badfoot]

This article is from Medscape's GI page.M. avium Implicated in Crohn's Disease, Perhaps Also Irritable Bowel SyndromeBy Richard WoodmanLONDON (Reuters Health) Aug 06 - Researchers said on Wednesday they had found a "highly significant" link between Crohn's disease and a mycobacterium that can be passed to humans in milk.Professor John Hermon-Taylor and his research team at St. George's Hospital Medical School in London said they had detected Mycobacterium avium paratuberculosis (MAP) bacteria in 92% of ileocolonic biopsy specimens from patients with Crohn's disease but in only 26% of patients in a control group."The rate of detection of MAP in individuals with Crohn's disease is highly significant and implicates this pathogen in disease causation," they write in the July issue of the Journal of Clinical Microbiology."The problems caused by the MAP bug are a public health tragedy", said Dr. Hermon-Taylor, who has sent a copy of the paper to Britain's Chief Medical Officer, Liam Donaldson.The study was backed by the medical charity Action Research, which said previous findings showed live MAP bacteria is present in 2% of retail pasteurised milk cartons."The discovery that the MAP bug is present in the vast majority of Crohn's sufferers means it is almost certainly causing the intestinal inflammation," the charity said in a statement.It added: "Action Research does not recommend that anyone stops drinking milk. However, for those individuals with Crohn's disease or their close relatives, who may feel particularly at risk, it may be sensible to start drinking UHT milk. As UHT involves higher pasteurisation temperatures, it is probable that MAP is destroyed."The charity called for Crohn's disease to be made a reportable condition, for more stringent milk pasteurisation, for tests for MAP in dairy herds, and procedures for reducing MAP infection on farms.Hermon-Taylor said an unexpected finding of the research showed that patients with irritable bowel syndrome (IBS) were also infected with the MAP bug."In animals, MAP inflames the nerves of the gut," he said. "Recent work from Sweden shows that people with IBS also have inflamed gut nerves. There is a real chance that the MAP bug may be inflaming people's gut nerves and causing IBS."J Clin Microbiol 2003;41:2915-2923.

 

[gilly]

Wow! I don't mean to panic, but that is scarey.I hope we hear more and this is not hushed up.This is the third thing I've read about this in 2 days, and yet on the Australian crohns website I read that they have been doing clinical trials of antibiotics against this bug in Australian hospitals for 3 years! thanks gilly

 

[Pete]

So what would be the treatment?

 

[bonniei]

I did the Enterolab for milk sensitivity and I tested positive for milk immunological sensitvity and the doc said to stay away from milk as it might cause Crohn's

 

[gilly]

Pete,I dont know how to post links etc but there is a lot of info. on a website http://www.crohns.org/ it is called PARA, an organisation dedicated to awareness of this link to crohns. The antibiotic trials are on there.They are 3 very potent and long term antibiotics which only seem to be a last resort.Hope we hear more about this soon.Gilly

 

[Isis5244]

quote: "Recent work from Sweden shows that people with IBS also have inflamed gut nerves. There is a real chance that the MAP bug may be inflaming people's gut nerves and causing IBS."

This would be significant as well, since IBS is considered a functional disorder, not inflammatory. Does anyone have more info on this?

 

[rosie49]

Is there a test for MAP available that anyone knows of? This is very interesting. Reminds me of the discovry of H.Pylori that took so long to be accepted.Rosie

 

[betagirl]

Hey everyoneI suffer from crohn's and brought this research up to my GI, who is heavy into IBD research. He sort of smirked when I brought it up, as this theory has been around for a long time. He referenced the H. Pylori research as well, but contends that MAP is not the underlying cause of crohn's. He said that the evidence of immunological factors is too concrete, but acknowledged that MAP may be a trigger for people who are already predisposed to IBD. He also added that MAP is probably 1 of several normally benign bacteria in the world that trigger crohn's. To say it CAUSES it is a dangerous statement. He thinks that people who are treated with antibiotics to fight the MAP could get better, but will relapse once they either stop the antibiotics or the bacteria becomes resistant. The true target for crohn's treatment is the autoimmune response to whatever trigger exists in the guts. Apparently there is not the prevelance of Johne's disease in the US as there is in the UK either, so there may be an epidemiological factor that is different in the 2 regions. The current study also does not address people who have the MAP bacteria present, but do not have crohn's. It leaves that missing variable that they're still trying to find. (lord knows I wish they'd find it!) Of course I don't claim that he's the end all be all expert on crohn's, but I thought it'd be interesting to share. He is a leading researcher out of one of the top hospitals in the country, but nobody knows everything