Posts Tagged ‘Crohn S Disease’

Excercise and Crohns Disease

02.14.10

Canadian researchers found that for people with mild Crohns disease, taking a walk a few times per week helped boost their well-being and quality of life.Crohns disease is a chronic disorder that causes inflammation throughout the digestive tract.

Symptoms, which include diarrhea, abdominal pain and rectal bleeding, tend to flare-up periodically, and then go into periods of remission.There has been some concern that exercise could exacerbate these problems because of its potential effects on functioning in the digestive tract. However, studies have not shown this to be true.For the new study, Victor Ng and colleagues at the University of Western Ontario recruited 32 adults with Crohns disease.

All were either in remission or were suffering only mild symptoms.For three months, half of the study participants walked for 30 minutes, three days per week. The rest maintained their usual lifestyle. At the beginning and end of the study, all patients completed questionnaires on their symptoms, overall well-being and quality of life.At the end of the trial, the researchers found, the exercise group reported improved symptoms and gave higher ratings to their quality of life. In contrast, symptoms worsened in the comparison group.

The findings are published in the Clinical Journal of Sports Medicine.

“Exercise benefits almost everyone and chronic disease patients are no exception,” study co-author Dr. Wanda Millard told Reuters Health.

Though some doctors have been hesitant to recommend exercise for Crohns disease, light exercise like moderate walking is unlikely to have significant effects on patients’ intestinal function, Millard noted.She pointed out that there are several professional athletes with Crohns disease.

That being said, however, Millard cautioned that this and other studies of exercise and Crohns disease have included only patients in remission or with mild symptoms.

“Patients with moderate or severe symptoms of their Crohns disease should not engage in an exercise program until their symptoms are better controlled,” she advised. Most people are successful with the basic formula of dieting and exercise. A smaller number need the addition of medication. A small percentage fail in all of those methods. So the big question is what should those who are overweight do to get back to an acceptable weight?
Unfortunately, there is no easy answer.

Those who have failed exercise, dieting and weight loss medication have a big problem to overcome. They most likely have problems exercising because of their weight or other health problems. It can likely help manage it, if for nothing else it can reduce stress.Depression is often an issue because of failing weight loss programs. Medications either have too many side effects or just are not working.

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Early Stage Symptoms of Crohns

02.06.10

The most common early symptoms of Crohns disease are chronic diarrhea (which sometimes is bloody), crampy abdominal pain, fever, loss of appetite, and weight loss. Symptoms may continue for days or weeks and may resolve without treatment.

Complete and permanent recovery after a single attack is extremely rare. Crohns disease almost always flares up at irregular intervals throughout a person’s life. Flare-ups can be mild or severe, brief or prolonged. Severe flare-ups can lead to intense pain, dehydration, and blood loss. Why the symptoms come and go and what triggers new flare-ups or determines their severity is not known. Recurrent inflammation tends to appear in the same area of the intestine, but it may spread to adjacent areas after a diseased segment has been removed surgically.

Common complications of inflammation include scarring that can produce intestinal blockage (obstruction) and deep ulcers penetrating through the bowel wall that can create pus-filled pockets of infection (abscesses) or abnormal connecting channels between the intestine and other organs (fistulas). Fistulas may connect two different parts of the intestine. Fistulas also may connect the intestine and bladder or the intestine and the skin surface, especially around the anus.

Although fistulas from the small intestine are common, wide-open holes (perforations) are rare. When the large intestine is affected extensively by Crohns disease, rectal bleeding commonly occurs. After many years, the risk of colon cancer (cancer of the large intestine) is greatly increased. About one third of people who develop Crohns disease have problems around the anus, especially fistulas and cracks (fissures) in the lining of the mucus membrane of the anus.

Crohns disease may lead to complications in other parts of the body. These complications include gallstones, inadequate absorption of nutrients, urinary tract infections, kidney stones, and deposits of the protein amyloid in several organs (amyloidosis). When Crohns disease causes a flare-up of gastrointestinal symptoms, the person may also experience inflammation of the joints (arthritis), inflammation of the whites of the eyes (episcleritis), mouth sores (aphthous stomatitis), inflamed skin nodules on the arms and legs (erythema nodosum), and blue-red skin sores containing pus (pyoderma gangrenosum). Even when Crohns disease is not causing a flare-up of gastrointestinal symptoms, the person still may experience pyoderma gangrenosum, while inflammation of the spine (ankylosing spondylitis), inflammation of the pelvic joints (sacroiliitis), inflammation inside the eye (uveitis), or inflammation of the bile ducts (primary sclerosing cholangitis) are liable to occur entirely without relation to the clinical activity of the bowel disease.

In children, gastrointestinal symptoms such as abdominal pain and diarrhea often are not the main symptoms and may not appear at all. Instead, the main symptoms may be slow growth, joint inflammation, fever, or weakness and fatigue resulting from anemia.

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Crohns Disease and Zofran

01.29.10

Zofran is VERY effective for severe nausea. The only downside is the cost, its expensive. I get so nauseated that I cannot move or talk. Zofran is the only medicine that works.

Best of all, I had no side effects with Zofran. When I was in the hospital, the doctors were aware that I was allergic to Compazine. In the ER I was given Zofran in my IV. When I was admitted to the hospital, I told the doctors several times that I could not tolerate Compazine. Then I started throwing up (later found Crohn’s to be in my esphogus and I have gastroparesis).

The doctor told me “You can take the Compazine or put up with the symptoms. It’s up to you to decide what is worse.” I could not move, I could not talk, even breathing was causing me to heave.

So I took the Compazine–never again! I started loosing all feeling in my body. I got disorientated. I felt like I was floating, and had no control of myself. This lasted for at least 8 hours until the drug wore off.  Then the doctors put me on Phenegran–yuck! I took half a tablet and was so tired, that I slept for 12 hours.

I could not keep my eyes open! I only would trust Zofran. I am not messing with any other medicine. Zofran works and is worth every penny. I have Crohns disease and I find that MMJ helps with the vomitting and the stomach cramps. MMJ has even kept me out of the hospital several times.

I often find it helps better than other prescibed medicines, such as prednisone or zofran, What do other crohn’s or GI patients think? mikessss, usually heavy indicas and indica concentrates do the trick for me, they stop the symptoms in their tracks, unfortunately I am still on lots of meds, hoping to taper of some in the coming months. Zofran is used to treat or prevent the nausea and vomiting that may occur after therapy with anticancer medicines (chemotherapy) or radiation, or after surgery.

If you vomit within 30 minutes after taking this medicine, take the same amount of medicine again. If vomiting continues, check with your doctor. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Chest pain, pain, redness, or burning at place of injection, shortness of breath, skin rash, hives, and/or itching, tightness in chest, troubled breathing, wheezing.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Constipation, diarrhea, fever, headache
Less common

Abdominal pain or stomach cramps, burning, tingling, or prickling sensations, dizziness or lightheadedness , drowsiness, dryness of mouth, feeling cold, itching , unusual tiredness or weakness
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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Crohns Disease Surgery

01.17.10

Crohns disease can cause a variety of symptoms of gastrointestinal distress.

The three classic (though not specific) symptoms of inflammatory bowel disease are:
•    Persistent or recurrent diarrhea (possibly with blood, mucus, or pus)
•    Abdominal pain
•    Fever

There also may be signs and symptoms unrelated to the gastrointestinal tract. A doctor will obtain a complete medical history and perform a thorough physical examination, along with laboratory and diagnostic tests, to diagnose Crohns disease. The examination and other tests are necessary to rule out a number of transient conditions, such as viral, bacterial, or parasitic infection, that cause symptoms similar to Crohns disease.

Diarrhea
In cases of Crohns disease, patients often experience frequent loose or watery bowel movements. The stool is occasionally accompanied by thick, dark blood (not bright red smears of blood, which usually result from a bleeding hemorrhoid). There is less mucus or pus in the stool than in cases of ulcerative colitis.

Pain
Patients may experience crampy, achy, or even sharp pain in the affected area. Most often, patients with Crohns disease feel pain on the lower right side of the abdomen (lower right quadrant) and just below the bellybutton. This is because the majority of cases of Crohns disease involve disease in the terminal ileum, where the small intestine meets the large intestine. The terminal ileum crosses from left to right just above the beltline, and joins the large intestine in the lower right quadrant. The type of pain associated with Crohns disease depends on what part of the GI tract is affected. Disease in the terminal ileum generally causes sharp pain, while disease in the colon causes more crampy pain, similar to that that of ulcerative colitis. Pain is sometimes relieved (temporarily) after a bowel movement.

Fever
Crohn’s is an inflammatory disease, and one of the key characteristics of the inflammatory process is fever. (The others are pain, swelling, and redness.) Some individuals with Crohns disease suffer a high fever, especially during the acute phase of a flare-up. Others run a persistent, low-grade fever. Fever may be accompanied by irritability and fatigue. Sometimes, the fever recurs each day, especially late in the day, then repeatedly breaks during sleep, causing night sweats.

Signs and Symptoms Unrelated To The GI Tract
A number of signs and symptoms that do not involve the gastrointestinal tract can occur with Crohns disease. These may occur at the same time as the intestinal symptoms, or may be experienced weeks or even months before any intestinal symptoms are noticed. If your doctor suspects inflammatory bowel disease, he or she will ask you detailed questions about whether or not these extra-intestinal symptoms have appeared:
•    Reddening and inflammation of the eye (iritis)
•    Joint pain (usually in the large joints of the knees, ankles, elbows, wrists, and shoulders), which sometimes migrates from one joint to another (migrating arthralgia)
•    Skin lesions, including tender red nodules on the shins or calves (erythema nodosum)
•    Sores inside the mouth (aphthous ulcers)

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Crohns Disease Surgery

01.08.10

Two-thirds to three-quarters of patients with Crohn’s disease will require surgery at some point during their lives. Surgery becomes necessary in Crohn’s disease when medications can no longer control the symptoms. It may also be performed to repair a fistula or fissure.

Another indication for surgery is the presence of an intestinal obstruction or other complication, such as an intestinal abscess. In most cases, the diseased segment of bowel and any associated abscess is removed; this is called a resection. The two ends of healthy bowel are then joined together in a procedure called an anastomosis. While resection and anastomosis may allow many symptom-free years, this surgery is not considered a cure for Crohn’s disease, because the disease frequently recurs at or near the site of anastomosis.

An ileostomy also may be required when surgery is performed for Crohn’s disease of the colon. After the surgeon removes the colon, he brings the small bowel to the skin, so that waste products may be emptied into a pouch attached to the abdomen. This procedure is needed if the rectum is diseased and cannot be used for an anastomosis.

The overall goal of surgery in Crohn’s disease is to conserve bowel and return the individual to the best possible quality of life. Surgery does not cure Crohn’s disease, but corrects an immediate problem that cannot be resolved using medication. Four types of surgery are commonly performed on individuals with Crohn’s disease:
•    Partial bowel resection, to remove a diseased portion of intestine
•    Strictureplasty
•    Correction of fistulas
•    Draining of an abscess

It is estimated that about 75% of individuals who live with Crohn’s disease will require surgery at some point in their lives, and that 75% of those who have one surgery will need at least one subsequent surgery.

Partial Bowel Resection
Resection is usually performed when a portion of intestine has been so damaged by disease that a permanent partial obstruction has formed. The most common areas removed are the terminal ileum, the ileocecal valve, and a small portion of the large intestine. Usually, the surgeon will attach (anastomose) the healthy ends of intestine together during the procedure.

Sometimes, however, there is mild inflammation throughout the intestine, preventing such reattachment. In these cases, a temporary ostomy is created. The ostomy allows intestinal contents to drain directly out of the body into a collecting bag through the abdominal wall. The ostomy is usually closed and the bowel reattached six to eight weeks after the initial surgery.After surgery, disease tends to occur above

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Crohns Disease Statistics

12.31.09

Crohn’s Disease is a chronic inflammation of the digestive track.

The digestive track covers the following:
•    Mouth
•    Esophagus
•    Stomach
•    Small Intestine
•    Large Intestine
•    Rectum
•    Anus

Crohn’s can affect any of those areas, but most commonly attacks the ileum or the lower small intestine. The swelling of the affected area will cause pain and diarrhea.

Statistics
Crohn’s can be found in both men and women. It may run in families, 20% of people diagnosed with the disease have a blood relative with some form of inflammatory bowel disease. It is usually diagnosed between the ages of 20 to 30, although people of all ages can suffer from Crohn’s. People of Jewish heritage have a greater risk of developing the disease while people of African American heritage have less of a risk.

Prevalance of Crohn’s disease: 500,000 Americans

Prevalance Rate: approx 1 in 544 or 0.18% or 500,000 people in

Hospitalization statistics for Crohn’s disease: The following are statistics from various sources about hospitalizations and Crohn’s disease:
•    0.17% (21,634) of hospital consultant episodes were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    82% of hospital consultant episodes for crohn’s disease required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    42% of hospital consultant episodes for crohn’s disease were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    58% of hospital consultant episodes for crohn’s disease were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    35% of hospital consultant episodes for crohn’s disease required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    9.6 days was the mean length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    6 days was the median length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    39 was the mean age of patients hospitalised for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    78% of hospital consultant episodes for crohn’s disease occurred in 15-59 year olds in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    5% of hospital consultant episodes for crohn’s disease occurred in people over 75 in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    36% of hospital consultant episodes for crohn’s disease were single day episodes in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    0.18% (93,538) of hospital bed days were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)

Crohns Disease Research

12.23.09

In the early 1900’s, the disease we call today “Crohns disease” was characterized as an infectious disease, specifically intestinal tuberculosis. However, by the early 1930’s, definitive classification (proof) that this disease was infectious was not forthcoming. More specifically, when Dr. Burrill B. Crohn failed to prove an infectious cause in 1932, the disease became formally known as “Crohns disease” (named after Dr. Crohn) and the search for an infectious cause was largely discontinued.

As a result, Crohns disease research has for many years been almost exclusively concentrated in “immunology” – and finding ways to “calm the overactive immune system” in Crohn’s patients – immune systems which were overactive due to “no known cause.”

Research Beginning in the 1980’s
Nevertheless, beginning in the 1980’s, a small core of highly regarded and dedicated researchers in the United States, United Kingdom, Australia and other countries valiantly began again – in the face of contrary opinion in the medical community, and despite low-level to nonexistent funding – the search for an infectious cause for Crohns disease.

Over the intervening years this small core of researchers has slowly grown, and despite all obstacles has continued to painstakingly and relentlessly amass scientific evidence that suggests an etiological connection between Mycobacterium avium subspecies paratuberculosis (MAP), and Crohns disease. On behalf of Crohn’s patients everywhere, PARA highly commends and offers a heartfelt “Thank You” to the dedicated researchers who, in the 1980’s, valiantly began again, and have henceforth, with slowly growing ranks, relentlessly continued the search for an infectious cause of Crohns disease.

Current Research – National Institutes of Health (NIH)
On December 14 1998, the National Institute of Allergy and Infectious Diseases (NIAID) hosted a workshop entitled “Crohn’s Disease:- Is there a microbial etiology? Recommendations for a research agenda.”

The workshop brought together researchers from multiple disciplines, including, but not limited to, mycobacteriology, molecular biology, immunology, gastroenterology, and veterinary medicine, etc., to discuss a potential infectious cause for Crohns disease. As the culmination of workshop deliberations and on-going NIAID research and efforts, in May 1999, the NIAID published a highly significant historical document – a comprehensive document setting forth an entirely new research agenda to place the search for an infectious cause for Crohns disease at the forefront of Crohn’s research, and to set forth the critical and rigorous research necessary to determine the relationship between Crohns disease and microbial infection, in particular infection with the bacterium Mycobacterium avium subspecies paratuberculosis (MAP).

The NIAID’s historic “Research Recommendations” document has been reproduced in its entirety on this web site. Please read it on the page entitled NIAID Research Agenda. In mid 2002 NIAID funded the first significant research in the United States, targeting MAP as a cause of Crohns disease.  At this same time National Institute of Diabetes Digestive and Kidney Diseases (NIDDK) also stepped to the plate to fund Crohns disease/MAP research.

For further information on NIH efforts, visit PARA’s Report – “PARA’s Efforts Benefits Crohn’s Sufferers.”PARA commends the NIH for significant efforts to determine the cause of Crohns disease.

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Crohns Disease Recipes

12.14.09

The role of diet and nutrition is very significant in Crohn’s disease. A proper diet is important in addition to medical therapies for maintaining and correcting any nutritional deficiencies and for reducing disease activity. Just like everyone else, people with Crohn’s disease need to take in enough protein, calories, vitamins, minerals such as calcium, iron, and zinc, and other nutrients to stay healthy.

People with Crohn’s may have increased nutritional requirements to make up for the nutrients they lose. Generally, the patient is advised to have a nutritious, well-balanced diet, with adequate proteins and calories. Crohn’s disease is a tough condition to deal with and to add to your frustrations you may have to do away with your favorite dishes if your doctor advises so.

Some Crohn’s disease friendly recipes that patients may try out include banana bread, lactose free pumpkin cookies, pumpkin bread, soy cheese and macaroni, banana muffins, mashed potato and meat casserole, almond crusted chicken, barbequed chicken, chicken sausage, roasted chicken, pot roast, butternut squash soup, grilled turkey breast, microwave broccoli, oven French fries and raspberry ring.

You can come across delicious, easy to prepare low-fiber and non-dairy recipes for those with Crohn’s disease in most magazines as well as the Internet. There are no foods known to essentially injure the bowel. However, during an acute stage of the Crohn’s disease, bulky foods, milk, and milk products may add to diarrhea and cramping. Diet may have to be restricted based on the symptoms or complications.

Patients with strictures should try to avoid recipes high in fiber content. Patients should keep away from recipes that they know would bother them and seek specific recommendations from their physician. Instead of eating heavy meals, patients should eat small meals throughout the day. Many nutrition counselors recommend that patients with Crohn’s disease eat five or six half-sized meals a day.

This should be done evenly at regular intervals and probably the last meal should be consumed at least three hours prior to bedtime. In addition to eating sufficiently, you also need to drink adequate fluids to keep your body well hydrated. ) is a strict grain-free, lactose-free, and sucrose-free dietary regimen intended for those suffering from Crohn’s disease and ulcerative colitis (both forms of IBD), celiac disease, IBS, cystic fibrosis, and autism. It is based on the work of Elaine Gottschall, who wrote Breaking the Vicious Cycle, which introduces the SCD and explains the importance of eliminating certain carbohydrates in order to alleviate digestive ailments such as IBD, IBS, and celiac disease.

For those suffering from gastrointestinal illnesses, the Specific Carbohydrate Diet (SCD) offers a method for easing symptoms and pain, and ultimately regaining health. Recipes for the Specific Carbohydrate Diet™ offers a diverse and delicious collection of 150 SCD-friendly recipes. The easy-to-make and culturally diverse recipes featured in the book, include breakfast dishes, appetizers, main dishes, and desserts such as — Hazelnut-Vanilla Pancakes, Olive Sandwich Bread, Chicken Satay, Roasted Bass with Parsley Butter, Thin Crust Pizza, Gretel’s Gingerbread Cookies, Mango Ice Cream, among others. It is accompanied by 40 full-color photos that will inspire you to get cooking again

Crohns Disease Prognosis

12.09.09

Crohn’s disease is a life-long illness. The severity of the disease can vary, and a patient can experience periods of time when the disease is not active and he or she is symptom free. However, the complications and risks of Crohn’s disease tend to increase over time. Well over 60% of all patients with Crohn’s disease will require surgery, and about half of these patients will require more than one operation over time. About 5-10% of all Crohn’s patients will die of their disease, primarily due to massive infection.

Endoscope
A medical instrument that can be passed into an area of the body (the bladder or intestine, for example) to allow examination of that area. The endoscope usually has a fiber-optic camera that allows a greatly magnified image to be shown on a television screen viewed by the operator. Many endoscopes also allow the operator to retrieve a small sample (biopsy) of the area being examined, to more closely view the tissue under a microscope.

Fistule
An abnormal channel that creates an open passageway between two structures that do not normally connect.

Gastrointestinal tract
The entire length of the digestive system, running from the stomach, through the small intestine, large intestine, and out the rectum and anus.

Immune system
The body system responsible for producing various cells and chemicals that fight infection by viruses, bacteria, fungi, and other foreign invaders. In autoimmune disease, these cells and chemicals turn against the body itself.

Inflammation
The result of the body’s attempts to fight off and wall off an area that is infected. Inflammation results in the classic signs of redness, heat, swelling, and loss of function.

Obstruction
A blockage.

Ulceration
A pitted area or break in the continuity of a surface such as skin or mucous membrane.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.)

People with Crohn’s disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohn’s disease are able to hold jobs, raise families, and function successfully at home and in society

Crohns Disease Probiotics

11.30.09

Probiotics in the Treatment of Crohn’s Disease
Alterations in the bacterial milieu of the gut are common in Crohns disease. The use of various probiotic bacteria to promote a balance of appropriate intestinal flora has yielded mixed results. Mechanisms associated with the beneficial effects of probiotic therapy in Crohn’s Disease include:

(1) inhibition of pathogenic bacteria via growth suppression or epithelial binding
(2)  improved epithelial and mucosal barrier function; and
(3) altered immuno-regulation via stimulation of secretory IgA or reduction in TNF-alpha.

Saccharomyces boulardii
Plein et al demonstrated the efficacy of Saccharomyces boulardii (Sb) in a randomized, double-blind, placebo-controlled study of 20 Crohn’s Disease patients. Patients were given 250 mg Sb three times daily for 10 weeks and evaluated via bowel movement frequency and the CDAI index. Patients receiving Sb experienced a significant reduction in frequency of bowel movements (from 5.0 to 3.3 per day) and CDAI index (193 to 107) by week 10 of treatment.

Another study utilizing Saccharomyces boulardii therapy in 32 Crohn’s Disease patients demonstrated a significant benefit of a combination of Saccharomyces boulardii and mesalamine compared to mesalamine alone. Relapse in the mesalamine-only group was 37.5 percent at six months compared to only 6.25 percent in the mesalamine-plus Saccharomyces boulardii group.

E. coli (Nissle strain)
Pathogenic E. coli that adhere to and invade intestinal epithelial cells (IEC) have been isolated from ileal lesions of Crohns patients. Boudeau et al demonstrated the in vitro ability of a non-pathogenic E. coli strain (Nissle 1917) to prevent pathogenic E. coli strains from adhering to and invading IEC. When IEC were co-infected with probiotic Nissle strain and pathogenic E. coli, the Nissle strain exhibited a dose- and time-dependent adhesion to IEC, which prevented adhesion of various pathogenic E. coli strains by 78.0- 99.9 percent.

When IEC were pre-incubated with Nissle strain E. coli and pathogenic strains were added later, adhesion and invasion of pathogenic strains was inhibited by 97.2-99.9 percent. Malchow et al conducted a double-blind, randomized, placebo-controlled trial investigating the efficacy of E. coli Nissle strain 1917 for inducing and maintaining remission in 28 patients with colonic Crohns disease.

Patients were randomized to either 60 mg prednisolone daily (with a standard tapering schedule) plus twice daily doses of 2.5 x1010 probiotic Nissle strain E. coli (treatment group) or identical prednisolone therapy plus placebo (placebo group). The rate at which remission was achieved was comparable in both groups (85.7% for treatment patients versus 91.7% for placebo patients), but only 33.3 percent of patients in the E. coli treatment group relapsed at one year, compared to 63.6 percent in the placebo group.

Lactobacillus GG
Malin et al investigated the effect of oral Lactobacillus GG on the intestinal immunological barrier in a small study of 14 children with CD and seven control patients (hospitalized for investigation of abdominal pain but with no evidence of intestinal disease). Lactobacillus GG was administered to patients and controls at 1010 colony forming units mixed in liquid twice daily. Lactobacillus GG therapy significantly increased the IgA immune response in Crohns patients compared to controls, resulting in an improved mucosal barrier.

Another study of Lactobacillus GG demonstrated that administration in children with mildto- moderate stable Crohn’s Disease improved gut barrier function and clinical status after six months of therapy.228 However, a randomized, double-blind, placebo-controlled trial of 45 post-surgery Crohns patients given Lactobacillus GG for one year did not show it to be more effective than placebo in preventing disease recurrence.229

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