Interesting article about possible new treatments on the horizon

[kimmidwife]

http://www.nature.com/mi/journal/v7/n1/full/mi201373a.html

 

[Clash]

Thanks.

 

[Optimistic]

Ty for sharing! I came across someone recently who works as a researcher for a European pharma company in a gi/nutrition division. I told her my son had crohns and her face lit up, saying in a year to a few years there are some great things coming down pike. We were separated then but I will see her again in a few months and I am going to be ALL OVER HER!!

I'm just starting This paper and have a question from intro.

"Although there is still no general consensus on the definition of the term mucosal healing, mucosal healing on endoscopy usually refers to resolution of ulcers in CD and erosions and ulcers in UC"

I'm focusing on use of term ulcers. I think you can have microscopic inflammation without ulcers. If there are no ulcers does that mean remission?

 

[Maya142]

Now researchers say histologic remission is the goal - no inflammation on the biopsies either.

 

[crohnsinct]

Depends who you ask. Some big gun gi's came out with a position statement (I posted it here and a couple of them big name ped gi's) that resolution of ulcers was goal. Normal biomarkers and histology were considered adjunctive goals.

Hmpf!

This is why every patient needs to come to a consensus with their doc as to treatment goals.

 

[Optimistic]

I've been told numerous times the goal is zero imflammatiom which I guess is histologcal.

Let's just assume goal is no ulcers and no symptoms. Do we know what the risk is of walking around with inflammation? What portion of people who think they are fine, never thought of ibd, would show microscopic inflammation?


Going up me up all night reading.,,

 

[Clash]

We came to a consensus with C's GI, the CD just refuses to cooperate.

Just from personal experience with C's disease I think mucosal healing (healing of ulcers) along with histological remission (at the cellular level) leads to a more stable remission. Six months ago C's bowels looked pristine, GI raved, then biopsies came back with active disease/inflammation at the cellular level. A scope Dec. 18th showed visual inflammation in small bowel, throughout colon and to the rectum. Maybe had we been able to address the cellular level of inflammation C would've had a better shot a long, stable remission.

 

[crohnsinct]

i was also under the impression we were to shoot for histologic remission.

Here is that reference
http://www.ncbi.nlm.nih.gov/m/pubmed/26303131/

They do t even shoot for normal biomarkers! Makes my blood boil everytime I read it.

O had scopes early March. Visually pristine. In June gi asks for fc because biopsies showed inflammation. Took him 3 months to mention it. Fc returns at 150. No action. September possible symptoms poppi g up. Repeat fc is 450. Small increase in mtx. Gi says symptoms not crohns. Getting another fc soon.

I agree with clash. At least as far as kids are concerned. Maybe with adults you can ease up a bit. I have heard of a few people dx'd with their colon cancer screening test so I guess it is possible to be walking around with crohns and not know it.

 

[Farmwife]

We Grace had been mostly microscopic inflammation and her GI said she's not in remission until that's all gone.

 

[kimmidwife]

Our GI also wants healing on biopsies not just the ulcers. I really agree with the others that should be the goal.
CIC,
I would be really upset about that it took him three months to mention that.

 

[Tesscorm]

Kim, when you have a chance, can you reload the link? It worked for me a couple of days ago but isn't working now??

Thanks

 

[my little penguin]

Gi wants healing /clean biopsies and very little symptoms especially EIM
Ds has had clean scopes no ulcers or inflammation on biopsies the last 2-3 scopes