Infliximab helps with weight gain in Chrones Disease patients

Research carried out at the University of North Carolina in the US, people treated with infliximab who also have chrones disease experience weight gain which so far can not be explained.

It was reported that some crohn's disease patients put on as much as 75 pounds, which is far more than any weight gain that had been witnessed in patients with rheumatoid arthritis and treated with infliximab.

A clinical research fellow at the Universit, Cristal Brown said that chrones patients were often malnourished and that this could help if the fight against the disease. The difficult question to ask is that what if they were to push chrones disease sufferers into obesity and all the associated problems that come with that?

Chrones patients who used Infliximab gained almost five times as much weight as patients with arthritis (4.97 kg versus 1.1 kg) and some people with Crohn's gained as much as 20 to 30 kg. There was no difference in weight gain between patients with luminal versus fistulous disease or by steroid use, baseline body mass index, smoking status, or chrons disease activity. These findings were based on the records on 92 people with Chrons disease and 51 rheumatoid arthritis patients. All of whom were at least 18 years old and who had received three or more infusions of infliximab.

It is thought that many patients with the disease would probably benefit from a small weight gain as the disease often led to some degree of undernourishment, but there is a need for a larger study to determine the cause of this weight gain and the role of leptin in the weight gain.

Chrones Disease & Stress

I have often felt that how I feel in general can affect my Crohn's and like others I wonder if stress has an effect and even make the symptoms of Chrones disease worse?

As far as I have been able to ascertain there no hard evidence that stress can cause chrones disease in the fist place. However it is true to say that people who suffer with chrones do often experience the increased stress in their lives when compare to people without the disease. But this is mainly due to having to cope with a chronic illness.

I have seem some reports that suggest that people with Crohn’s disease have flare ups more often when they are going through a particularly stressful situation in their lives.

Based on this the best advice is that if you feel that there is a connection between your stress levels and a worsening of your chrones disease symptoms, try researching relaxation techniques like slow breathing exercises and possibly even meditation.

Also as always, make sure you eat well and correctly, get enough sleep and contact your doctor.

Nicotine, Smoking & Chrones Disease

The effects of Nicotine and Smoking on Chrones Disease

The general thought is that smoking cigarettes actually has a detrimental effect on Crohn's disease. The statistics show that people who smoke, or who have smoked in the past, have a bigger chance of developing Chrones than non-smokers. If you already have Crohn's disease and you smoke, you are more likely to have an increased number of relapses, repeat surgeries, and may require aggressive immunosuppressive treatment.

Most people with People Chrones disease are strongly encouraged by their doctors to stop smoking in order to prevent flare-ups of the disease.

Location of Chrones
A study conducted a few years ago and then published in The American Journal of Gastroenterology, has shown that there is a link between smoking and Chrones Disease.

What the study seemed to show is that smoking may actually decide which part of your intestinal tract is affected in people who have Crohn's Disease.

The Importance of the Findings
The importance of these findings cannot be underestimated as where chrones disease is located in your body often determines if you will need surgical treatment or not.

The results suggested that crohn's disease seems to appear more often in the small intestine and not the colon in smokers. Chrones disease located in the small intestine is often more penetrating and thus causes more damage and as a result has to be treated with surgery more often.

More Information
Amazon.com have a number of articles related related to Smoking and Chrones available for download, including an article from Internal Medicine News by Bruce Jancin on how if you stop Smoking it helps to Cut Crohn's Surgery Repeats:
Smoking & Crohn's Disease

Ulcerative Colitis likely caused by Immune deficiency

At the Harvard School of Public Health in the US, Experiments being carried out on mice have identified an immune deficiency as the most likely cause of ulcerative colitis. Ulcerative colitis is a severe inflammatory disease of the colon and is similar to Chrones Disease. For the differences between Chrones Disease and Ulcerative colitis, take a look at my post on Chrones Disease and Ulcerative Colitis are they different?

This research also demonstrated that once mice had Ulcerative colitis, it could then be passed from mother to their offspring and even between adult animals. They also linked ulcerative colitis in mice to a deficiency of a molecule in the immune system, which would normally prevent harmful bacteria in the large intestine from breaking the bowel's protective lining and thus allow the damaging inflammation. A shortage of a protein called T-bet which usually regulates the harmful bacteria. This then allows the bacterial attack on the intestinal wall. This then causes the inflammation we know as ulcerative colitis that's identified by the open sores throughout the colon.

It is hoped that better understanding of Ulcerative Colitis will also lead to a better understanding of Chrones Disease and one day a possible cure.

The details of this study is posted on-line in the journal Cell. www.cell.com

Cancer Drugs used to treat Chrones Disease

New cancer drugs could help regulate body's immune system and thus help fight Chrones disease according to some researchers in the US. Known as histone deacetylases inhibitors, or HDACs, the new cancer drugs might work extremely well in blocking the over active immune systems in people who have autoimmune diseases including chrones disease.

Wayne Hancock of Children’s Hospital of Philadelphia says that this treatment for Crohn's disease would improve the immune systems ability to actually regulate itself and in the one study carried out on mice, the drug helped reverse and even prevent inflammatory bowel disease as well as prevented the rejection of heart transplants in other mice.

Up till now, the drug has mostly been used in studying cancer, but that could change and more tests could soon be done for diseases like Chrones disease.

Chrones Disease and Perianal Fistulas

So what is a Fistula?

Fistulas are pretty common in people who have Chrones Disease and the basic definition is that they are abnormal connections or passageways between organs or vessels that should not normally connect to each other.

What Are Perianal Fistulas?

A perianal fistula is a abnormal connection between the anus and rectum with another organ or vessel such as the skin or the vagina.

According to research about 12 percent of people with chrones disease have Perianal fistulas, this is a huge amount as there are said to be at least half a million people with Crohn's disease in the US alone. Anal fistulas can lead to a big drop in the quality of life for anyone who has them as they can cause anal incontinence and infections.

How are Fistulas treated?

Surgery
Surgery is currently the main form of treatment, which is invasive as well as having a fairly poor success rate.

Anti TNF-alpha and drugs like Remicade (Infliximab) are also now used. The success rate of this treatment varies from patient to patient.

Cx401 (Still in development)
Cx401 is an non-embryonic (autologous) stem cell product developed by Cellerix from human adipose tissue. This autologous source offers clear advantages over other alternatives such as bone-marrow, including easier access to the stem cells and higher yield (100 to 1,000 times). Using a minimal amount of fat drawn from the patient, it is possible to obtain stem cells that have an extraordinary capacity to facilitate the healing process of fistulas.

How will the CX401 treatment work?
The treatment consists of the extraction, expansion and re-administration of the patient's own cells into the area that has fistulas. The natural healing of the fistula tract is achieved through the anti-inflammatory properties of Cx401.

So far there have been excellent clinical results obtained to date with the product. In a study to evaluate feasibility and safety of Cx401, it was confirmed that it has the potential to treat fistulas in Chrones Disease patients and showed a 75% response rate only 8 weeks after the initial treatment.

Chrones Disease and Pregnancy

Because chrones disease often affects women of child-bearing age, I thought I would take a look at what the complications are of having Chrones disease whilst pregnant:

Risk of an early Birth
There have been some recent studies carried out at the Aarhus University Hospital in Denmark by Dr. Bente Norgard and what they have shown that having an active chrones disease (a flare-up) during your pregnancy raises the risk of having a pre-term birth. This risk was shown to be three times higher in women with active chrones disease.

The researchers looked at the impact of chrones disease in 86 women with inactive Chrones disease during pregnancy (chrones in remission) and 71 women who had low to moderately high active chrones disease during their pregnancy.


What they also found is that women with the active chrones disease during their pregnancy, were shown the risks of giving birth to a child of low birth weight and congenital abnormalities were not increased, compared to the women with inactive chrones disease.

Overall the best advice is if you have crohn's disease and you are wanting to have a baby is to first get the disease under control and in remission. It is also important to work closely with your doctors who will be able to advise you and to point out the medications that you can and cannot take during the pregnancy.

SOURCE: American Journal of Gastroenterology, September 2007.