I have twins who were both diagnosed with Crohn's about a year ago as young adults. In both cases, it is limited to their colons. They have no abcesses. My one son got quite sick a year ago - he was rapidly losing weight and just lay around the house (very unusual for him). While we were waiting to see a gastroenterologist and feeling quite desperate, his PCP prescribed a round of Metronidazole. The PCP had already performed a number of tests and was pretty clear the only problem was IBD. Before my son was even finished with the course of antibiotics, he was feeling great, and he was back to eating and all of his usual activities. Bottom line - the only dramatic improvement in either of my sons came with this antibiotic; biologics don't seem to be having enough affect (at least the ones we've tried so far). When my sons were first diagnosed, we spoke with literally five top IBD specialists around the country (I know some of you will think that was going overboard, but it was helpful to us, and during the pandemic, it was possible to have lots of virtual appointments). When we mentioned to any of these specialists how well the Metronidazole worked, they all just seemed to scratch their heads about it, shrug, and then launch into a discussion about biologics. So I'm wondering, has anyone else out there with IBD had this kind of experience with antibiotics?
Antibiotics for Crohn's?
- Thread starter momsa
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It may be worth looking into triple antibiotic therapy AKA antimap therapy see human para website or Crohn’s map vaccine website for details. There is a theory that Crohn’s is/ can be caused by a bacteria found in milk and red meat called map. Some people have had great success going into remission by taking a cocktail of these antibiotics. In London they are currently trialling a vaccine designed to kill the map bacteria. Before you get too excited, the antibiotic treatment does not work for everyone. Redhill biopharma did a study a couple of years ago if you are interested.
When I spoke to my GI about antibiotic therapy he wanted me to try all biologic options first so I haven’t tried it yet. He thought that his colleagues have found in practice only some people respond well. Also it means staying on antibiotics for a long while e.g. two years or more.
There is some discussion about which antibiotics are best and this is partly based on patient tolerance- some cause nausea etc. Some kill the bugs but you can’t stay on them because risk of side effects (tendon damage I think). There is also the issue that antibiotics can kill all bugs good and bad so when you stop the bad bugs bounce back harder with less competition and the beginning of treatment resistance. So there’s a lot to weigh up.
It might be worth a discussion with an anti map treatment experienced GI, in the UK that would be Dr Sanderson’s team at St Guys hospital in London,not sure about the US.
The other things to keep an eye on might be: qu biologics in Canada (developing a treatment to stimulate immune system to kill bugs based on E. coli), diets like SCD or IBD-AID (trying to improve microbiome to make it harder for bad bugs to get a grip) and phage therapy (mount sinai in New York, I think, trying to find a bug killing phage rather than antibiotic to kill the bad bugs without hurting good bugs).
The trouble is that during covid a lot of the research got parked while the focus went to covid treatment research and/ or lockdown prevented trials and lab work. So progress has been slower than hoped.
When I spoke to my GI about antibiotic therapy he wanted me to try all biologic options first so I haven’t tried it yet. He thought that his colleagues have found in practice only some people respond well. Also it means staying on antibiotics for a long while e.g. two years or more.
There is some discussion about which antibiotics are best and this is partly based on patient tolerance- some cause nausea etc. Some kill the bugs but you can’t stay on them because risk of side effects (tendon damage I think). There is also the issue that antibiotics can kill all bugs good and bad so when you stop the bad bugs bounce back harder with less competition and the beginning of treatment resistance. So there’s a lot to weigh up.
It might be worth a discussion with an anti map treatment experienced GI, in the UK that would be Dr Sanderson’s team at St Guys hospital in London,not sure about the US.
The other things to keep an eye on might be: qu biologics in Canada (developing a treatment to stimulate immune system to kill bugs based on E. coli), diets like SCD or IBD-AID (trying to improve microbiome to make it harder for bad bugs to get a grip) and phage therapy (mount sinai in New York, I think, trying to find a bug killing phage rather than antibiotic to kill the bad bugs without hurting good bugs).
The trouble is that during covid a lot of the research got parked while the focus went to covid treatment research and/ or lockdown prevented trials and lab work. So progress has been slower than hoped.
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Metronidazole was very effective along with EEN when my son was diagnosed. Metronidazole isn't a great medicine to stay on for very long, though, and when we tried it again at a later date it didn't seem to do much.
I think amoxicillin has also helped my son's Crohn’s at times, although the effects weren't dramatic.
The most common anti-MAP treatment consists of 3 antibiotics, and when used long-term it apparently has some decent results.
I think there's a role for antibiotics, but they're not as reliable as biologics.
I think amoxicillin has also helped my son's Crohn’s at times, although the effects weren't dramatic.
The most common anti-MAP treatment consists of 3 antibiotics, and when used long-term it apparently has some decent results.
I think there's a role for antibiotics, but they're not as reliable as biologics.
Thanks for your responses. I can understand some long term problems with staying on antibiotics, I'm just worried, because we aren't having great success with biologics. They all seem to only work for about half of the population. I was hoping that some new treatments would be coming down the pike a bit faster, but the explanation by Delta_Hippo that things have been slowed by the pandemic was heartening - I hope that means that research will now speed up.
