Crohns and gut bacteria colonization

[Lewie1980]

Ok, so I am new to this forum but have suffered from Crohn's for 19 years now (currently 34 y/o). After a recent flare I decided to finally start taking things into my own hands rather than relying on a GI (they all run the same play book anyway).

I am going to throw some ideas out there and I wanted to get some feedback on whether they have merit. Apologies if my scientific knowledge is limited and my language is rudimentary.

Here's what I have been thinking about:

- all of us are born "sterile" and our gut microbiome is initially passed to us from our mothers through breast feeding
- those that are breast fed less than 6 months have a higher likelihood of developing Crohn's disease
- many people on this forum link the onset of Crohn's to an event that impacted the balance of their intestinal microbiome (for instance, a course of broad spectrum antibiotics). In my case, my family and I believe that accidentally drinking chlorinated pool water as a youngster (I used to swallow water when my brother and I wrestled in the pool) might have triggered the onset of the disease.
- some Crohn's sufferers have used Faecal Microbiota Transplants to positive effect in treating Crohn's, although this treatment has not been as effective with Crohn's patients as with colitis.
- FMT's are considered extremely effective at treating c.diff which gives merit to the line of thinking that a loss of bacteria diversity in our guts can cause disease but the introduction of new bacteria can bring the gut back to symbiosis
- veterinarians treat animals with intestinal problems with FMT and it is believed that the reason that dogs sniff and eat other dogs faeces is to maintain gut flora diversity
- soldiers exposed to dysentery have a lower instance of Crohn's disease
- 2 years ago I went on a very strict dysbiosis diet which alleviated ALL of my Crohn's symptoms (without medication) and got rid of my candida, which I'd had all my adult life, in a single week. Unfortunately, the diet was so restrictive (no sugar, starches, grains, fruits, dairy - pretty much just meat and veg) that I would get head spins if I exercised and my wife said it was like living with a zombie. As soon as I stopped the diet (after 1 month) I started to go backward.

Alright, so that's the background info. This is what I want people's thoughts on:
- i believe that Crohn's is brought on (not caused, but "switched on") by the absence of bacteria, rather than the presence of bad bacteria. THis is why (I believe) stopping breast feeding within 6 months increases the chance of developing Crohn's disease later
- the reason my symptoms returned slowly after stopping the dysbiosis diet was due to the fact that I had reduced the size of the offending colonies of bacteria but as I hadn't introduced any new bacteria I could not achieve long term symbiosis and the bad bacteria flourished once more
- FMT may not be effective for Crohn's disease as the affected area can be far greater than with UC and it is hard to get the newly introduced bacteria to the required areas
- if none of us start life suffering from CD, and there is an environmental trigger, could returning our guts to their initial state bring us into permanent remission (pending any subsequent "events" that would trigger the emergence of the disease again, considering we are susceptible to it)?

So, I am going to do an experiment with myself as the guinea pig (the best kind, right?). In 3 days my wife is due to give birth to our second child. She is going to pump extra breast milk which I will drink on a daily basis. I will put myself on a very strict diet for a period of 1 month, in order to reduce the colonies of harmful bacteria from my gut and therefore improve the environment for the new bacteria being introduced from the breast milk.

So there it is, my crazy "grade 3 science" approach to trying to understand Crohn's and find a cure. Now feel free to tear this idea to shreds...

 

[xeridea]

It is somewhat empowering to try to gain an upper hand on the disease and feel you have some control over it. The things you are suggesting may very well help manage the symptoms of your CD. I think it is accepted that you can modify the composition of gut flora by controlling the type of nutrients you provide them by what you eat. You've already seen some benefits so you have some tools that can help you in your case.

For the sake of your baby though, be sure that he gets all of the first week's worth of nursing output. The "breast milk" production at this early stage is mostly colostrum and contains the very important immunoglobulins that provide passive immunity (temporary bridging immunity) for your baby as she transitions from a sterile gut and begins developing his own immune system. I don't know of any evidence that suggests you as an adult can get any curative benefit from the colostrum or breast milk. Your body has already developed it's own immune responses and immune fingerprint and you can't simply erase the 34 years of immunity programming and start from scratch like a baby does.

Crohn's is believed to be a dysfunction of the innate immune system with evidence that suggests a genetic predisposition for acquiring the disease by way of a likely environmental trigger. I am of the school of thought that CD is an immunodeficiency, not an auto-immune disease. To this day there is no known "cure" for it. Many therapeutic strategies, perhaps even diet, may put the disease into remission, but there is as yet nothing that can guarantee against a reactivation/flair.

I encourage you to learn as much as you can about the disease, and stay vigilant in maintaining an upper hand. Even though there is no known cure, hundreds of millions of dollars are being poured into research each year for finding the cause and coming up with newer, more effective therapies. Do what you can to maintain remission, including taking medication prescribed by your doctor. Remember with this disease, you can have no outward symptoms but persistent (micro-) inflammation can still be wreaking havoc on the inside, and then one day, BAM! Your best strategy is maintaining remission and preventing permanent damage.

Lots of inroads are being made, and a cure, or at least a very effective long-term therapy, may become available in the next few years.

Cheers!

 

[wild_one353]

excellent!!!

if you are willing to do that, why don't you just try a fecal transplant? see the link below in my signature.

the issues with fecal transplants are that these bacteria die within minutes of being exposed to oxygen, and they aren't administered frequently enough for a long enough time to both fight the bad bacteria and re establish and dominate the intestines again. This is why the evidence of current studies seems to show lack of effectiveness for fecal transplants in IBD.
It's the protocol of FMT that needs to be perfected, and that takes time. Oral fecal transplant will likely be superior to enemas, we some evidence now that this is the case, see the thread link below. Since this is only the beginning of FMT, people untrained in science will be watching these studies and come to false conclusions from the large learning curve and the up and downs of this learning process, dont let that be you!!

 

[Lewie1980]

Hi Xeridea. Thanks for your response. I can confirm that I will not be touching the first weeks milk (colostrum etc). It will take a while for my wife's production of breast milk to reach a level that she could produce surplus so I will wait a few weeks and then see how she is going.

Wild Bill - I am also looking into FMT and as I live in Australia am trying to get an appointment to see Dr Thomas Borody who is a pioneer in the field. I also came to the conclusion that the more FMT could be repeated the more effective it would be, however, using an enema to get the stool sample into the ileum could not be consistent. Having oral FMT would make it difficult to administer frequently due to requirement for gastric tubes to pass into the duodenum. I understand that oral FMT is dangerous due to risk of gagging or vomiting the material and getting it in the wind pipe etc.

For that reason I theorized that breast milk, which contains some 700 different bacteria species, might achieve the same outcome but in a much "friendlier" form of administration. Also, there are milk banks that could be used to regularly acquire new microbiota and maintain remission (if it works) - although I suspect the of freezing of the milk would kill many of the bacteria.

One last thing: I wonder if there is a study of a typical Crohn's disease microbiome vs that found in breast milk (or a healthy fecal sample) to determine what bacteria species are actually missing. Does anyone know if this has ever occurred? It would make sense if it differed for all of us, as this might correlate to the difference presentation of our symptoms and severity. Perhaps this will one day become a standard test for Crohn's but since I was diagnosed I have not had to provide a stool sample for testing and I certainly never got told what was missing / merely that my sample "confirmed" Crohn's disease.

 

[mf15]

Might as well give it a shot, 700 different species.
Will be interested to see if you get any improvement.
By the way the baby also gets flora when passing through the birth canal.

Old Mike
http://www.sciencedaily.com/release...+Science+News)&utm_content=Google+Feedfetcher

 

[Catherine]

Have you seen the Catalyst program, this episode may interest you.

http://www.crohnsforum.com/showthread.php?t=66444

 

[DJW]

Hi Lewie.

I hope you are successful. Please keep us posted.