Treatment of Crohn's disease
Until the cure is found there are steps that someone can take to minimize the disease's impact on his or her life, A combination of treatment options can help you stay in control of your disease and help you to lead a full and rewarding life remember that there is no standard treatment that will work for all patients each patient’s situation is different and treatment must be followed for each circumstance
Treatment for Crohn’s and other IBD varieties can include the use of medication alterations in diet and nutrition and sometimes surgical procedures to repair or remove affected portions of your GI tract, While Crohn’s Disease may not be the result of bad reactions to specific foods paying special attention to your diet may help reduce symptoms, replace lost nutrients, and promote healing, For people diagnosed with Crohn’s disease it is essential to maintain good nutrition because Crohn’s often reduces your appetite while increasing your body’s energy needs additionally common Crohn’s symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals, Many people who experience Crohn's disease flare ups find that soft bland foods cause less discomfort than spicy or high-fiber food's, While your diet can remain flexible and should include a variety of foods from all food groups your doctor will likely recommend restricting your intake of dairy if you are found to be lactose-intolerant.
- About 70% of people with Crohn’s disease eventually require surgery.
- Different types of procedures may be performed depending on the reason, severity of illness, and location of the disease.
- Approximately 30% of patients who have surgery for Crohn’s disease experience recurrence of their symptoms within three years and up to 60% will have recurrence within ten years.
There are Several groups of drugs to treat Crohn’s disease today:
•Aminosalicylates (5-ASA) These include medications that contain 5-aminosalicylate acid (5-ASA).Examples are sulfasalazine, mesalamine,olsalazine, and balsalazide.These drugs are not specially approved by the Food and Drug Administration (FDA) for use in Crohn’s. However, they can work at the level of the lining of the GI tract to decrease inflammation they are thought to be effective in treating mild to moderate episodes of Crohn’s disease and useful as a maintenance treatment in preventing relapses of the disease they work best in the colon and are not particularly effective if the disease is limited to the small intestine.
•Corticosteroids Prednisone and methylprednisolone are available orally and rectally, Corticosteroids nonspecifically suppress the immune system and are used to treat moderate to severely active Crohn's disease By "non specifically," we mean that these drugs do not target specific parts of the immune system that play a role in inflammation but rather that they suppress the entire immune response these drugs have significant short and long-term side effects and should not be used as a maintenance medication, If you cannot come off steroids without suffering a relapse of your symptoms your doctor may need to add some other medications to help manage your disease.
•Immunomodulators This class of medications modulates or suppresses the body’s immune system response so it cannot cause ongoing inflammation, Immunomodulators generally are used in people for whom aminosalicylates and corticosteroids haven’t been effective or have been only partially effective they may be useful in reducing or eliminating the need for corticosteroids, They also may be effective in maintaining remission in people who haven’t responded to other medications given for this purpose, Immunomodulators may take several months to begin working.
•Antibiotics may be used when infections such as abscesses occur in Crohn’s disease, They can also be helpful with fistulas around the anal canal and vagina, Antibiotics used to treat bacterial infection in the GI tract include metronidazole, ampicillin, ciprofloxacin, others.
•Biologic Therapies, These medications represent the latest class of therapy used for people with Crohn's disease who have not responded well to conventional therapy, These medications are antibodies grown in the laboratory that stop certain proteins in the body from causing inflammation.
•Our gut is home to over a trillion bacteria, without which we would not be able to digest our food and convert it into protein, vitamins, minerals, and other essential nutrients our cells need.
At the same time, our immune system has the complex job of protecting us against pathogens - foreign organisms that cause harm - a task made even more challenging by the presence of our friendly gut flora.
Immune system relies on receptors to distinguish friendly from unfriendly bacteria To help distinguish friendly from unfriendly microbes, the immune system relies on a complex array of receptors or specialized proteins that can sense patterns that are unique to bacteria, such as small pieces of their cell wall. The receptors bind to the fragments and send a signal to other parts of the immune system to come and collect and eliminate the corresponding pathogen, or if the fragment belongs to a friendly microbe then to come and help control its growth.
More than 58 variants of NOD2 have been linked to various diseases - 80% of them to Crohn's disease. But things go wrong when one or more of these specialized bacteria-sensing proteins starts malfunctioning or mutates. For instance, it can send the wrong signal, or fail to send a signal at all, or not bind properly, causing the immune system to attack friendly bacteria. There is speculation that such breakdowns in the immune system are what leads to chronic inflammatory diseases like Crohn's.
One of the bacteria-sensing receptors, the protein NOD2 - short for nucleotide-binding oligomerization domain containing protein 2 - is already known to researchers. More than 58 variants of NOD2 have been linked to various diseases - 80% of them to Crohn's disease.
It was while they were investigating NOD2's signaling mechanism and how it breaks down, that the team came across another protein, HSP70 - heat shock protein 70 - a chaperone protein that helps proteins fold themselves into correct three-dimensional shapes.
Increasing expression of the bodyguard protein keeps bacteria-sensing protein stable Prof. Grimes says they found if they increased the expression of HSP70, mutant versions of NOD2 found in Crohn's disease were able to sense bacterial cell wall fragments and send the right signals to the immune system. They had essentially found a fix for mutant NOD2, now they just needed to work out how the fix was working.
Further experiments showed that HSP70 acts as a bodyguard to the receptor protein and stabilizes it. The chaperone molecule "enhances NOD2's activity and increases its half-life," they note.
"Basically, HSP70 keeps the protein around - it kind of watches over and protects NOD2, and keeps it from going in the cellular trash can," Prof. Grimes explains.
So far the team has only run tests using human cell lines. They are now planning to study human tissue through a collaboration with Nemours/A.I. duPont Hospital for Children to find out if levels of NOD2 can be controlled by varying expression of HSP70.
They also want to find out if mutated NOD2 leads to increased inflammation, and how the underlying signaling works.
Rates of Crohn's disease are increasing worldwide. In the US there are around 700,000 people with Crohn's, according to the Crohn's and Colitis Foundation of America. The disease affects men and women equally, and while it can occur at any age, it is more prevalent among young people between the ages of 15 and 35.
The researchers say that identifying proteins that interact with and help to stabilize NOD2 is an important first step to finding new treatments for Crohn's.
A grant from the National Institutes of Health helped to finance the study.
Meanwhile, Medical News Today recently learned how another group of researchers found how changes in gut bacteria may predict infection and inflammation before symptoms emerge. They believe their findings will help doctors better understand how foreign bacteria disrupt gut microbes, and from that find better treatments for gastrointestinal conditions.
At the same time, our immune system has the complex job of protecting us against pathogens - foreign organisms that cause harm - a task made even more challenging by the presence of our friendly gut flora.
Immune system relies on receptors to distinguish friendly from unfriendly bacteria To help distinguish friendly from unfriendly microbes, the immune system relies on a complex array of receptors or specialized proteins that can sense patterns that are unique to bacteria, such as small pieces of their cell wall. The receptors bind to the fragments and send a signal to other parts of the immune system to come and collect and eliminate the corresponding pathogen, or if the fragment belongs to a friendly microbe then to come and help control its growth.
More than 58 variants of NOD2 have been linked to various diseases - 80% of them to Crohn's disease. But things go wrong when one or more of these specialized bacteria-sensing proteins starts malfunctioning or mutates. For instance, it can send the wrong signal, or fail to send a signal at all, or not bind properly, causing the immune system to attack friendly bacteria. There is speculation that such breakdowns in the immune system are what leads to chronic inflammatory diseases like Crohn's.
One of the bacteria-sensing receptors, the protein NOD2 - short for nucleotide-binding oligomerization domain containing protein 2 - is already known to researchers. More than 58 variants of NOD2 have been linked to various diseases - 80% of them to Crohn's disease.
It was while they were investigating NOD2's signaling mechanism and how it breaks down, that the team came across another protein, HSP70 - heat shock protein 70 - a chaperone protein that helps proteins fold themselves into correct three-dimensional shapes.
Increasing expression of the bodyguard protein keeps bacteria-sensing protein stable Prof. Grimes says they found if they increased the expression of HSP70, mutant versions of NOD2 found in Crohn's disease were able to sense bacterial cell wall fragments and send the right signals to the immune system. They had essentially found a fix for mutant NOD2, now they just needed to work out how the fix was working.
Further experiments showed that HSP70 acts as a bodyguard to the receptor protein and stabilizes it. The chaperone molecule "enhances NOD2's activity and increases its half-life," they note.
"Basically, HSP70 keeps the protein around - it kind of watches over and protects NOD2, and keeps it from going in the cellular trash can," Prof. Grimes explains.
So far the team has only run tests using human cell lines. They are now planning to study human tissue through a collaboration with Nemours/A.I. duPont Hospital for Children to find out if levels of NOD2 can be controlled by varying expression of HSP70.
They also want to find out if mutated NOD2 leads to increased inflammation, and how the underlying signaling works.
Rates of Crohn's disease are increasing worldwide. In the US there are around 700,000 people with Crohn's, according to the Crohn's and Colitis Foundation of America. The disease affects men and women equally, and while it can occur at any age, it is more prevalent among young people between the ages of 15 and 35.
The researchers say that identifying proteins that interact with and help to stabilize NOD2 is an important first step to finding new treatments for Crohn's.
A grant from the National Institutes of Health helped to finance the study.
Meanwhile, Medical News Today recently learned how another group of researchers found how changes in gut bacteria may predict infection and inflammation before symptoms emerge. They believe their findings will help doctors better understand how foreign bacteria disrupt gut microbes, and from that find better treatments for gastrointestinal conditions.