Happy New Years to all. It's been a while and by some miracle my health has been pretty good. Hopefully I don't ruin it by celebrating too much tonight. Swedish meatballs, beer, 7-layer dip, Patron, Hypnotiq and Red Bull, Sausages....ugh. Recipe for Crohn's Disease Disaster anyone?
Anyhow, happy new year to you all. I am greatful for all of the support from the Crohn's Community and am glad to be able to provide information, experiences, and a good poop story now and then!
Monday, December 31, 2007
Wednesday, December 19, 2007
6 Tips for Managing Your Crohn's Disease Through the Holidays
1. Keep to Your Routines - Continue to take your medication on time and get regular rest. Crohn’s Disease Flare Ups are bound to happen when you don't follow the routine that works for you.
2. Beat the Holiday Blues - If you feel the holiday blues coming on, don't be afraid to talk to your healthcare provider. The sooner you get help, the better you will feel throughout the season. As I have said many times, I always have Crohn’s Disease flare ups during the holidays. So far so good this year!
3. Don't Party Too Hard - Decide which social functions you can realistically attend without stress overload. Running yourself ragged to make every holiday party can leave you too tired to enjoy any of them. Be sensible about holiday drinking. Some people with IBD find that alcohol can contribute to symptoms such as diarrhea or gas. I suck at this one!!
4. Less is more - Keep your entertaining simple, and save yourself energy and frustration. I suck at this one too…come to my holiday party!
5. Take a Break! - Take a time out for yourself if you need it. Some quiet time to de-stress is important.
6. Travel Well – Keep your diet…get your rest. Manage your Crohn’s Disease, don’t let it manage you.
2. Beat the Holiday Blues - If you feel the holiday blues coming on, don't be afraid to talk to your healthcare provider. The sooner you get help, the better you will feel throughout the season. As I have said many times, I always have Crohn’s Disease flare ups during the holidays. So far so good this year!
3. Don't Party Too Hard - Decide which social functions you can realistically attend without stress overload. Running yourself ragged to make every holiday party can leave you too tired to enjoy any of them. Be sensible about holiday drinking. Some people with IBD find that alcohol can contribute to symptoms such as diarrhea or gas. I suck at this one!!
4. Less is more - Keep your entertaining simple, and save yourself energy and frustration. I suck at this one too…come to my holiday party!
5. Take a Break! - Take a time out for yourself if you need it. Some quiet time to de-stress is important.
6. Travel Well – Keep your diet…get your rest. Manage your Crohn’s Disease, don’t let it manage you.
Monday, December 17, 2007
The Brits Announce Bacteria in Cows Milk Likely Cause of Crohn's Disease
Scientists at the University of Liverpool, United Kingdom, have discovered a certain type of bacteria in cattle as a likely cause for Crohn's disease in human beings. The bacteria, called Mycobacterium paratuberculosis, are known to cause the debilitating Johne's disease in cattle. It is believed the bacteria are transferred from cows to humans via milk and dairy product consumption. The British scientists have been able to observe reactions caused by the bacteria in the human body that could tap it as a cause for Crohn's disease. This could open up new ways for finding more effective treatment options for Crohn's.
Crohn's disease is a chronic inflammation of the intestines. Patients suffering from Crohn's disease experience pain, bleeding, and diarrhea. If medical treatment options are not successful, relieve can often only be found through the removal of the effected part of the intestines. Similarly, Johne's disease in cattle causes severe diarrhea. As a result of the disease cattle usually slowly perishes. While the cause of Johne's disease has been known, until now there had been no known cause for Crohn's disease. It has been most recently theorized that Crohn's (not Chrones, chrons, or chron's) disease is genetically linked. The British Scientists now seem to be able to explain how the presence of Mycobacterium paratuberculosis in a patient's body can cause Crohn's disease.
It has long been known that patients suffering from Crohn's disease have a higher than usual level of E.coli bacteria in their body. Similarly, Mycobacterium paratuberculosis has been known to be present in Crohn's disease tissue. But until now, nobody has been able to explain the bacteria's presence and connection to the disease. Now the British scientists have been able to observe that the bacteria, Mycobacterium paratuberculosis, inhibit the body's immune system response to E.coli bacteria.
Mycobacterium paratuberculosis discharges a mannose-containing molecule. Mannose is a type of sugar. This molecule stops macrophages, a type of white blood cells, from destroying E.coli bacteria in the patient's body. The increased level of E.coli bacteria weakens the immune systems response to other intestinal bacteria, including Mycobacterium paratuberculosis.
The scientists also determined that the bacteria could cause an increase in a circulating antibody protein (ASCA). Two-thirds of Crohn's disease patients have this type of protein indicating a likely infection with Mycobacterium paratuberculosis.
Clinical trials are planned to seek out treatment options through an antibiotic combination, which is aimed at eliminating Mycobacterium paratuberculosis in a Crohn's disease patient's body. If the scientists' assumption is correct, the disease should subside with the elimination of the bacteria.
Crohn's disease is a chronic inflammation of the intestines. Patients suffering from Crohn's disease experience pain, bleeding, and diarrhea. If medical treatment options are not successful, relieve can often only be found through the removal of the effected part of the intestines. Similarly, Johne's disease in cattle causes severe diarrhea. As a result of the disease cattle usually slowly perishes. While the cause of Johne's disease has been known, until now there had been no known cause for Crohn's disease. It has been most recently theorized that Crohn's (not Chrones, chrons, or chron's) disease is genetically linked. The British Scientists now seem to be able to explain how the presence of Mycobacterium paratuberculosis in a patient's body can cause Crohn's disease.
It has long been known that patients suffering from Crohn's disease have a higher than usual level of E.coli bacteria in their body. Similarly, Mycobacterium paratuberculosis has been known to be present in Crohn's disease tissue. But until now, nobody has been able to explain the bacteria's presence and connection to the disease. Now the British scientists have been able to observe that the bacteria, Mycobacterium paratuberculosis, inhibit the body's immune system response to E.coli bacteria.
Mycobacterium paratuberculosis discharges a mannose-containing molecule. Mannose is a type of sugar. This molecule stops macrophages, a type of white blood cells, from destroying E.coli bacteria in the patient's body. The increased level of E.coli bacteria weakens the immune systems response to other intestinal bacteria, including Mycobacterium paratuberculosis.
The scientists also determined that the bacteria could cause an increase in a circulating antibody protein (ASCA). Two-thirds of Crohn's disease patients have this type of protein indicating a likely infection with Mycobacterium paratuberculosis.
Clinical trials are planned to seek out treatment options through an antibiotic combination, which is aimed at eliminating Mycobacterium paratuberculosis in a Crohn's disease patient's body. If the scientists' assumption is correct, the disease should subside with the elimination of the bacteria.
Thursday, December 13, 2007
Crohn's Disease and Stress - Exploring the Link Between Crohn's and Stress
Although stress doesn't cause Crohn's disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one. Every flare-up and even my initial diagnosis can be directly related to stress. Almost every Chron's Disease patient I talk to or hear about supports a simple fact. There is a link between Crohn's and Stress.
It is basic science (and common sense). When you're stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself. For someone with Crohn's this stress often leads to falre ups
Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:
Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers. For me....soccer, running and lifting weights all reduce my stress. They also give me incentive to eat better. Less stress and better diet = Healthier Living = Crohn's Flare Up Control. If you are having a flare up, I feel that these things can also bring you out of it.
Regular relaxation and breathing exercises. An effective way to cope with stress from Crohn's disease is to regularly relax and exercise. You can take classes in yoga and meditation or practice at home using books or tapes.
You can also practice progressive relaxation exercises. These help relax the muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all the tension go. Next, tighten and relax your calves. Continue until muscles in your body, including those in your eyes and scalp, are completely relaxed.
Deep breathing also can help you relax. Most adults breathe from their chests. But you become calmer when you breathe from your diaphragm — the muscle that separates your chest from your abdomen. When you inhale, allow your belly to expand with air; when you exhale, your abdomen naturally contracts. Deep breathing can also help relax your abdominal muscles, which may lead to more normal bowel activity.
Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you as you imagine your intestinal muscles becoming smooth and calm.
Other techniques. Set aside at least 20 minutes a day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.
Bottom Line: Whatever you can do to reduce stress in your life will have a positive impact on your Crohn's.
Take care, be healthy and live a better life.
It is basic science (and common sense). When you're stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself. For someone with Crohn's this stress often leads to falre ups
Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:
Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers. For me....soccer, running and lifting weights all reduce my stress. They also give me incentive to eat better. Less stress and better diet = Healthier Living = Crohn's Flare Up Control. If you are having a flare up, I feel that these things can also bring you out of it.
Regular relaxation and breathing exercises. An effective way to cope with stress from Crohn's disease is to regularly relax and exercise. You can take classes in yoga and meditation or practice at home using books or tapes.
You can also practice progressive relaxation exercises. These help relax the muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all the tension go. Next, tighten and relax your calves. Continue until muscles in your body, including those in your eyes and scalp, are completely relaxed.
Deep breathing also can help you relax. Most adults breathe from their chests. But you become calmer when you breathe from your diaphragm — the muscle that separates your chest from your abdomen. When you inhale, allow your belly to expand with air; when you exhale, your abdomen naturally contracts. Deep breathing can also help relax your abdominal muscles, which may lead to more normal bowel activity.
Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you as you imagine your intestinal muscles becoming smooth and calm.
Other techniques. Set aside at least 20 minutes a day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.
Bottom Line: Whatever you can do to reduce stress in your life will have a positive impact on your Crohn's.
Take care, be healthy and live a better life.
Friday, December 7, 2007
Crohn's Disease Tattoo- And Crohn's Disease Travel Tips
Hey guys, go my Humira shot Wednesday night. Nothing much new to report other than I have been waking up with pretty bad cramps. Doc Shafran usually says thats not a great sign. We'll see, makes me nervous as my Crohn's invaraible acts up during the holidays. Got my leg tattoo worked on yesterday. My wife is getting a Crohn's Disease ribbon tattoo (very small) on her foot to show her support for all of us Crohnies.
Also, below is a great article on travelling and Crohn's. I thought it was appropriate given the holiday travel many of us will be planning to do. Article is from Sara Jenkins, Sarah is an acclaimed writer on medical matters, and has written extensively on the subjects of Attention Deficit Disorder, Bird Flu and Cohn’s Disease.
Although Crohn’s Disease is a difficult disorder, you should not keep yourself from living the best life possible because you suffer from this disorder. You should continue in your life as you would without Crohn’s, although a few more precautions may be necessary. When traveling, this will ensure a smooth and enjoyable trip. The first thing you should do, whether you are traveling abroad or close to home, is locate a doctor in the area you will be visiting. There are several organizations available to utilize in your search or you can simply ask your doctor for referrals.
If you are taking prescription medication, you should be sure to take plenty for the duration of your trip. You should also keep it with you when you travel on the plane to avoid it being lost in the heaps of luggage. Always keep your medication in its original container and a typed statement from your doctor regarding what medications you are taking and what they are for.
You will also need to get copies of all of your prescriptions, including foreign names, in case you have to refill them abroad. However, you should avoid this by carrying enough medication with you, as filling prescriptions in other counties can sometimes be difficult. A common ailment among travelers to less developed countries is known as "traveler’s diarrhea". This can be especially dangerous for sufferers of Chron's Disease and special care should be taken to avoid it from occurring. Basically, traveler’s diarrhea occurs from the ingestion of water or food that is not as stringently processed as in the United States. Steps that should be taken include being very careful about what you eat or drink; do not drink water unless you boil it; avoid drinks made from tap water, like tea or juices that may have been mixed from concentrate; use bottled water to drink and to brush your teeth with; avoid ice, ice cream, and uncooked fruits, vegetables, and meat; avoid diary products as they may not be pasteurized; and do not eat any questionable food.
If you become affected with traveler’s diarrhea, take an over the counter medication and be sure to intake plenty of fluids to avoid dehydration. Also watch for signs of a medical emergency, such as high fever or chills, which may be a sign of infection; profuse rectal bleeding; extreme abdominal pain; dizziness; or dehydration. If any of these occur, seek medical attention immediately.
-Scott
Also, below is a great article on travelling and Crohn's. I thought it was appropriate given the holiday travel many of us will be planning to do. Article is from Sara Jenkins, Sarah is an acclaimed writer on medical matters, and has written extensively on the subjects of Attention Deficit Disorder, Bird Flu and Cohn’s Disease.
Although Crohn’s Disease is a difficult disorder, you should not keep yourself from living the best life possible because you suffer from this disorder. You should continue in your life as you would without Crohn’s, although a few more precautions may be necessary. When traveling, this will ensure a smooth and enjoyable trip. The first thing you should do, whether you are traveling abroad or close to home, is locate a doctor in the area you will be visiting. There are several organizations available to utilize in your search or you can simply ask your doctor for referrals.
If you are taking prescription medication, you should be sure to take plenty for the duration of your trip. You should also keep it with you when you travel on the plane to avoid it being lost in the heaps of luggage. Always keep your medication in its original container and a typed statement from your doctor regarding what medications you are taking and what they are for.
You will also need to get copies of all of your prescriptions, including foreign names, in case you have to refill them abroad. However, you should avoid this by carrying enough medication with you, as filling prescriptions in other counties can sometimes be difficult. A common ailment among travelers to less developed countries is known as "traveler’s diarrhea". This can be especially dangerous for sufferers of Chron's Disease and special care should be taken to avoid it from occurring. Basically, traveler’s diarrhea occurs from the ingestion of water or food that is not as stringently processed as in the United States. Steps that should be taken include being very careful about what you eat or drink; do not drink water unless you boil it; avoid drinks made from tap water, like tea or juices that may have been mixed from concentrate; use bottled water to drink and to brush your teeth with; avoid ice, ice cream, and uncooked fruits, vegetables, and meat; avoid diary products as they may not be pasteurized; and do not eat any questionable food.
If you become affected with traveler’s diarrhea, take an over the counter medication and be sure to intake plenty of fluids to avoid dehydration. Also watch for signs of a medical emergency, such as high fever or chills, which may be a sign of infection; profuse rectal bleeding; extreme abdominal pain; dizziness; or dehydration. If any of these occur, seek medical attention immediately.
-Scott
Monday, December 3, 2007
Embarassing Crohn's and Work Story - Unbelievable
So this morning I get to work about an hour early as normal. I fold up the sports section of the Orlando Sentinel and put it my back pocket. I then begin my casual stroll to the bathroom. "Nothing to see here folks, not going poop..just minding my own business..."
So I read about all of the NFL news, wash my hands, check my face out in the mirror for any leftover toothpaste or zit cream, and walk back into the office. I stroll through the hall of our accouting department and give a half-hearted, monday morning hello to the ladies. I see our COO walking down the hall and she is looking at me funny.
From about 20 ft away, I see this look...then she asks me what is that....At this point I notice that I have toilet paper (from lining the seat) stuck in my pants. And n0t 5 sheets. I double it up on the seat, so I had a good 15-20 sheets trailing down my pant leg like a tail. It was so long that about 2 sheets are touching the floor!!!
She starts cracking up and says, "OH, this is going to be a good one Scott." As I snatched it out of my pants, I calmly replied that I was throwing myself a ticker-tape parade to start the beginning of the week!
Wow, what a Monday. I love Crohn's disease and poop stories. Unfortunately this one is VERY true!
So I read about all of the NFL news, wash my hands, check my face out in the mirror for any leftover toothpaste or zit cream, and walk back into the office. I stroll through the hall of our accouting department and give a half-hearted, monday morning hello to the ladies. I see our COO walking down the hall and she is looking at me funny.
From about 20 ft away, I see this look...then she asks me what is that....At this point I notice that I have toilet paper (from lining the seat) stuck in my pants. And n0t 5 sheets. I double it up on the seat, so I had a good 15-20 sheets trailing down my pant leg like a tail. It was so long that about 2 sheets are touching the floor!!!
She starts cracking up and says, "OH, this is going to be a good one Scott." As I snatched it out of my pants, I calmly replied that I was throwing myself a ticker-tape parade to start the beginning of the week!
Wow, what a Monday. I love Crohn's disease and poop stories. Unfortunately this one is VERY true!
Sunday, December 2, 2007
Scott Roy in the Orlando Sentinel - Crohn's Article with Dr. Shafran
Link to the article is here - http://www.orlandosentinel.com/community/news/deltona/orl-crohns0207dec02,0,4333743.story
Dr. Shafran (Winter Park, FL) was featured in the Orlando Sentinel today for an article highlighting his Crohn's Disease Research. He just published a paper on a new antibiotic used to treat Crohn's, and the relation to bacteria and Crohn's Disease. Yours truly, Mr Scott Roy, is featured in the lead photo. I love the way Dr. Shafran and his staff take care of me!! He is an awesome doctor. I encourage you all to check out the article, and if you are in Florida, you will not find a better Gastroenterologist.
Dr. Shafran (Winter Park, FL) was featured in the Orlando Sentinel today for an article highlighting his Crohn's Disease Research. He just published a paper on a new antibiotic used to treat Crohn's, and the relation to bacteria and Crohn's Disease. Yours truly, Mr Scott Roy, is featured in the lead photo. I love the way Dr. Shafran and his staff take care of me!! He is an awesome doctor. I encourage you all to check out the article, and if you are in Florida, you will not find a better Gastroenterologist.
Here is the article:
Dr. Ira Shafran sees Crohn's disease patient Scott Roy at his Winter Park office. Shafran is a gastroenterologist who is treating some Crohn's disease patients with antibiotics. (ROBERTO GONZALEZ, ORLANDO SENTINEL / November 21, 2007)
Doctors are trying a new strategy to treat Crohn's disease, an often-debilitating digestive condition that typically strikes in the teens or 20s and causes lifelong problems.
About 700,000 Americans suffer from the incurable illness, which can lead to inflammation, scarring and intestinal blockages that require surgery. Patients often take powerful steroids and immune-suppressing drugs to control symptoms.
But some doctors are experimenting with antibiotics as the main therapy. Their goal is to attack a bacterial infection that they think could be causing the disease.
Arianne Percy believes in the strategy.
The 26-year-old Deltona woman has been taking an antibiotic for six months. After dealing with abdominal pain since the age of 12, Percy said she is now symptom-free 90 percent of the time.
"I feel better than I have in years," Percy said. "I just hope it keeps working."
Her physician, Dr. Ira Shafran of Winter Park, has been studying potential bacterial causes of Crohn's for years. He thinks one culprit is a cousin to tuberculosis -- Mycobacterium avium paratuberculosis or MAP.
Shafran said an early, aggressive course of antibiotics could help many patients get better control of their symptoms. He has been testing antibiotic treatments in his own patients since the late 1990s, with varying success.
"While specific bacteria have never been identified as the only cause for Crohn's, we have enough scientific evidence . . . that bacteria are pivotal in the origin and persistence of this disease," Shafran said.
Inflames bowels
Crohn's disease -- named in 1932 after Dr. Burrill B. Crohn -- is a form of inflammatory bowel disease or IBD. Historically, doctors had thought of the illness as an autoimmune disorder.
Such conditions occur when the immune system attacks its own tissues -- in this case, the digestive tract. But many doctors now think Crohn's is not the body's attack on itself but a mistaken assault on bacteria that naturally live in the intestines. Numbering in the billions, these bacteria aid in food digestion and typically pose no harm.
For Crohn's patients, doctors speculate that the visitors provoke a chronic immune response that wreaks havoc on the body.
Sufferers can face abdominal cramping, diarrhea and the urgent need to use the bathroom. The condition can flare up periodically throughout a sufferer's lifetime.
"It's a disease of young people, [striking] at a time when they want to go to school, get married and start their careers," said Dr. Daniel Present, a Crohn's expert at the Mount Sinai School of Medicine in New York. "It can be very serious."
Some patients need to take potent immune-suppressant medication. Many also take antibiotics, though usually for short periods and in combination with other medicines.
Dr. Jonathan Braun from the University of California at Los Angeles said it's too early to know whether the drugs could play a bigger role in controlling the illness. Though many suspect Crohn's is linked to bacteria, he said there is no consensus on which specific types are to blame, which antibiotics are effective and how long a patient should take them.
"There's a lot of research that's left to be done on bacteria in the gut, and I think that as we understand those better, there will be new treatments," said Braun, chairman of the National Scientific Advisory Committee for the Crohn's & Colitis Foundation of America. "But for now, it's important to realize that while antibiotics may help some patients, none have shown to work on the majority of patients."
More research needed
In his Winter Park practice, Shafran estimates that about 100 of his patients are on long-term antibiotic therapy for Crohn's. They may remain on the drugs for years, with Shafran monitoring their progress and reducing the dosage as their symptoms subside.
He acknowledges the approach doesn't always work.
Another of his patients, Kira Banks, 25, of College Park has been through a course of antibiotics without success. She now takes an immune-suppressing drug that she credits with bringing her relief.
"This can be a very devastating disease," Banks said.
Shafran and his like-minded colleagues say more research is needed into the possible bacterial origins of Crohn's. For now, many have focused on Mycobacterium because the organism is known to cause a digestive disorder in cattle called Johne's disease.
But Shafran said MAP is not the sole answer to Crohn's, which is influenced by genetics and many as-yet unknown environmental triggers. He worries that drug companies, which typically don't make as much money on antibiotics, will not be interested in investigating their wider use in Crohn's sufferers.
And doctors are entrenched in their habits, turning to immune suppressants and other, more-potent drugs to attack the illness.
"A lot of people think, 'Why should I use a small-caliber weapon when I've got all these .44 Magnums lying around?' " Shafran said.
Dr. William Chamberlin from Texas also treats many of his Crohn's patients with antibiotics, often using generic versions that he says offer a low-cost treatment with fewer side effects.
"I cannot say it's a cure for patients, though some do remarkably well," said Chamberlin, an associate professor at Texas Tech University. "Others don't really do well at all."
Robyn Shelton can be reached at rshelton@orlandosentinel.com or 407-420-5487.
Dr. Ira Shafran sees Crohn's disease patient Scott Roy at his Winter Park office. Shafran is a gastroenterologist who is treating some Crohn's disease patients with antibiotics. (ROBERTO GONZALEZ, ORLANDO SENTINEL / November 21, 2007)
Doctors are trying a new strategy to treat Crohn's disease, an often-debilitating digestive condition that typically strikes in the teens or 20s and causes lifelong problems.
About 700,000 Americans suffer from the incurable illness, which can lead to inflammation, scarring and intestinal blockages that require surgery. Patients often take powerful steroids and immune-suppressing drugs to control symptoms.
But some doctors are experimenting with antibiotics as the main therapy. Their goal is to attack a bacterial infection that they think could be causing the disease.
Arianne Percy believes in the strategy.
The 26-year-old Deltona woman has been taking an antibiotic for six months. After dealing with abdominal pain since the age of 12, Percy said she is now symptom-free 90 percent of the time.
"I feel better than I have in years," Percy said. "I just hope it keeps working."
Her physician, Dr. Ira Shafran of Winter Park, has been studying potential bacterial causes of Crohn's for years. He thinks one culprit is a cousin to tuberculosis -- Mycobacterium avium paratuberculosis or MAP.
Shafran said an early, aggressive course of antibiotics could help many patients get better control of their symptoms. He has been testing antibiotic treatments in his own patients since the late 1990s, with varying success.
"While specific bacteria have never been identified as the only cause for Crohn's, we have enough scientific evidence . . . that bacteria are pivotal in the origin and persistence of this disease," Shafran said.
Inflames bowels
Crohn's disease -- named in 1932 after Dr. Burrill B. Crohn -- is a form of inflammatory bowel disease or IBD. Historically, doctors had thought of the illness as an autoimmune disorder.
Such conditions occur when the immune system attacks its own tissues -- in this case, the digestive tract. But many doctors now think Crohn's is not the body's attack on itself but a mistaken assault on bacteria that naturally live in the intestines. Numbering in the billions, these bacteria aid in food digestion and typically pose no harm.
For Crohn's patients, doctors speculate that the visitors provoke a chronic immune response that wreaks havoc on the body.
Sufferers can face abdominal cramping, diarrhea and the urgent need to use the bathroom. The condition can flare up periodically throughout a sufferer's lifetime.
"It's a disease of young people, [striking] at a time when they want to go to school, get married and start their careers," said Dr. Daniel Present, a Crohn's expert at the Mount Sinai School of Medicine in New York. "It can be very serious."
Some patients need to take potent immune-suppressant medication. Many also take antibiotics, though usually for short periods and in combination with other medicines.
Dr. Jonathan Braun from the University of California at Los Angeles said it's too early to know whether the drugs could play a bigger role in controlling the illness. Though many suspect Crohn's is linked to bacteria, he said there is no consensus on which specific types are to blame, which antibiotics are effective and how long a patient should take them.
"There's a lot of research that's left to be done on bacteria in the gut, and I think that as we understand those better, there will be new treatments," said Braun, chairman of the National Scientific Advisory Committee for the Crohn's & Colitis Foundation of America. "But for now, it's important to realize that while antibiotics may help some patients, none have shown to work on the majority of patients."
More research needed
In his Winter Park practice, Shafran estimates that about 100 of his patients are on long-term antibiotic therapy for Crohn's. They may remain on the drugs for years, with Shafran monitoring their progress and reducing the dosage as their symptoms subside.
He acknowledges the approach doesn't always work.
Another of his patients, Kira Banks, 25, of College Park has been through a course of antibiotics without success. She now takes an immune-suppressing drug that she credits with bringing her relief.
"This can be a very devastating disease," Banks said.
Shafran and his like-minded colleagues say more research is needed into the possible bacterial origins of Crohn's. For now, many have focused on Mycobacterium because the organism is known to cause a digestive disorder in cattle called Johne's disease.
But Shafran said MAP is not the sole answer to Crohn's, which is influenced by genetics and many as-yet unknown environmental triggers. He worries that drug companies, which typically don't make as much money on antibiotics, will not be interested in investigating their wider use in Crohn's sufferers.
And doctors are entrenched in their habits, turning to immune suppressants and other, more-potent drugs to attack the illness.
"A lot of people think, 'Why should I use a small-caliber weapon when I've got all these .44 Magnums lying around?' " Shafran said.
Dr. William Chamberlin from Texas also treats many of his Crohn's patients with antibiotics, often using generic versions that he says offer a low-cost treatment with fewer side effects.
"I cannot say it's a cure for patients, though some do remarkably well," said Chamberlin, an associate professor at Texas Tech University. "Others don't really do well at all."
Robyn Shelton can be reached at rshelton@orlandosentinel.com or 407-420-5487.
Record Day for this Crohn's Disease Blog - Due to David Garrard Crohn's Mention on NBC
Watching the Jaguars Colts NFL game today and they mentioned David Garrard's Battle with Crohn's Disease and also some stuff on his wife Mary. As a result I have had over 250 visitors so far today (average about 125 a day) from people doing Google searches for terms such as David Garrard Crohn's. Garrard Crohn's, David Garrard wife Mary, David Garrard Crohn's Treatment, Jaguar crohn's, mary garrard and many more.
For those of you looking, my David Garrard 2 of my Garard related posts are here, and here.
For those of you looking, my David Garrard 2 of my Garard related posts are here, and here.
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