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If this is the case, it would be interesting to see the effect of (a) fasting, (b) non-EN fluid / liquid diet (e.g. bone broth/juice), compare to EEN. Also PEN doesn’t work that well as EEN, guess the fecal stream has to be reduced to a level such that it contacts minimally with our bowel wall?

@kiny, thank you for posting as always. You may not know but the insight you bring here is the silver lining to many of us. I have tried EEN myself and it’s definitely legit - more than one time saved me from surgery and complications. When it comes to the management of ileal CD, EN has efficacy...

I see. But what makes macrophages compromised in the first place? Is it an inborn defect (primary ID)? Or is our innate immune depleted by the environmental factors (secondary ID)? If it's inborn, then why aren't genetic variants commonly shared in most disease population? So what you mean...

This looks interesting. Just a thought though, could it be that the wide use of immune-directed drugs e.g. biologics / thiopurines that pulls up a dampened effectiveness of this kind of immune stimulating therapies: M-CSF, GM-CSF, site-specific immunomodulator etc.? They can hardly find...

If Crohn’s is in nature immunodeficiency, do you think it is primary or secondary? In other words, is the impaired immune response inherited or acquired? If it’s acquired, how is it acquired? Like you said, genetic susceptibility alone has no causal effect towards development of CD. So there...

finally someone is pointing this out……:)(y) It's Time to Change Tack in IBD Treatment Marcel A. Behr, MD, MSc, Ildiko Mehes, JD, Charles N. Bernstein To appear in: Gastroenterology Accepted Date: 11 June 2024 Introduction Contemporary reviews on the pathogenesis of IBDs (most commonly...

If compromised innate immune response and xenophagility is a key factor of CD pathogenesis, do you think resetting them by means of something like vaccines or reprogrammed immune cells can help eliminate the entrenched pathogens (e.g. AIEC) that were able to evade xenophagy? Somewhat like Car-T...

I joined a clinical trial before and they did an AIEC antigen test (ELISA) for me by blood draw. Result was a few times more than the reference range, indicating that my guts are very likely being colonised by AIEC. Just wonder how reliable is this kind of biomarkers or non-invasive test? as...

https://www.biospace.com/article/releases/agomab-receives-fda-fast-track-designation-for-agmb-129-in-fibrostenosing-crohn-s-disease-and-starts-stenova-phase-2a-clinical-trial/ Sounds like exciting news. What are your thoughts on this?

How to differentiate whether I am just metabolising fast or the drug is actually failing? My trough drug level is higher than range but with undetectable antibodies. GI said the biologic is not working well on me.

I live in Hong Kong (a more westernised part of China I presume?). IBD prevalence here has up 6-fold since 1990s. Doctors here also follow the latest treatment protocols and use biologics / immunosuppressants heavily in a top-down manner. I was unfortunately misdiagnosed by my first GI (an old...