Vit D and IBD

Tuesday, 30 June 2015 by

3.coverA research paper published in the United European Gastroenterology Journal showed that if you are experiencing a period of remission with Cohn’s disease that Vitamin D confers additional benefit in restoring/maintaining appropriate gut permeability.[1]

In this small study – some 27 people were involved, all of whom were determined to be in remission at the time of the oral supplementation with either 2000 iu of vitamin D or a placebo for 90 days. They found, that patients treated with the supplementation were more likely to maintain their intestinal permeability, whereas this deteriorated in the placebo group. Increased intestinal permeability is considered a measure of gut leakiness, which is shown to predict and precede clinical relapse in CD. In addition, patients with the highest blood levels of vitamin D had signs of reduced inflammation (measured by C-reactive protein and antimicrobial peptides), and these patients also reported better quality of life.

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ajg_cimageA paper in the American Journal of Gastroenterology looks at various markers to see if it is possible to use them to differentiate between IBS and IBD.[1]


Irritable bowel syndrome (IBS) is viewed as a diagnosis of exclusion by most providers. The aim of our study was to perform a systematic review and meta-analysis to evaluate the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), faecal calprotectin, and faecal lactoferrin to distinguish between patients with IBS and inflammatory bowel disease (IBD) and healthy controls (HCs).

IBD and C Difficile Infection

Thursday, 12 February 2015 by

XLargeThumb.00054725-201502000-00000.CVMany patients with diarrhoea diagnosed with inflammatory bowel disease (IBD) are not routinely checked for Clostridium difficile infection (CDI), researchers have found.[1]

This organism is well understood to have a correlative risk for increasing symptoms and reducing therapeutic intervention effectiveness and 5% of IBD patients are found with CDI.

A recent article in Medscape (Expert Rev Clin Immunol. 2013;9(8):735-747.) looked at the role of foods in the management of IBD. The author Lynette Ferguson summarised some of the key areas, and this summary is a synopsis of her paper.

Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease, which are both inflammatory disorders of the gastrointestinal tract. Both types of inflammatory bowel disease have a complex aetiology, resulting from a genetically determined susceptibility interacting with environmental factors, including the diet and gut microbiota. Genome Wide Association Studies have implicated more than 160 single-nucleotide polymorphisms in disease susceptibility. Consideration of the different pathways suggested to be involved implies that specific dietary interventions are likely to be appropriate, dependent upon the nature of the genes involved. Epigenetics and the gut microbiota are also responsive to dietary interventions. Nutrigenetics may lead to personalized nutrition for disease prevention and treatment, while nutrigenomics may help to understand the nature of the disease and individual response to nutrients.

In numerous earlier posts I have explored the emerging evidence as well as the historical experiences for the use of faecal microbial transplantation (FMT) and the management of complex dysbiotic gastrointestinal tracts: this is also sometimes called faecal transplant therapy (FTT)

Whilst the greatest amount of data on this therapy is available with reference to the successful (>92%) treatment of clostridium difficile infection, others have been exploring its potential treatment in regard to other complaints related to dysbiosis of the gastrointestinal flora.

Autoimmunity and the Worm

Saturday, 17 November 2012 by

An immunologist, Dr Joel Weinstock provoked mixed reactions from the scientific community when he suggested that in line with Strachan’s hygiene theory[1] and Rook’s ‘old friend’s theory,[2] that the removal from the western world of helminths, had provided the opportunity for inflammatory diseases of the bowel and elsewhere to increase in frequency.[3] 20 years on from Strachan’s first proposals and Weinstock’s hypothesis have been examined in human trials and found to be effective, and the human microbiome project has uncovered other interesting relationship’s.[4]

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Faecal Transplant (FT) and IBD

Tuesday, 25 September 2012 by | Comments: 2

I have explored the role of appropriate transplantation in the resolution of MRSA infection that fails to resolve with antibiotic therapy, and have intimated that other conditions of the bowel and linked tissues may also benefit. The model is: that loss of mucosal tolerance underlies the pathology of inflammatory bowel disease and is also linked to irritable bowel syndrome. These altered states of function reflect a combination of environmental, genetic and emotional events that coalesce into a wide range of conditions.

It is a global phenomenon – the increase in gastrointestinal inflammatory disease over the last 50 years, so fast is this occurring that genetic drift is very unlikely to be attributable as causal; but it is likely that changes in diet and lifestyle amongst the genetically susceptible act as triggering agents to induce aberrant immune responses that lead to inflammatory bowel disease and other systemic inflammatory illnesses.

In a fascinating study published in Nature on the 13th June in their letters section a group of researchers show how the inclusion of fats derived from milk, change the bacterial composition in the gastrointestinal tracts of mice promoting the development of colitis.[1]

Apples Can Suppress IBD

Monday, 12 December 2011 by

Here’s another reason why “an apple a day keeps the doctor away”—according to new research findings published in the Journal of Leukocyte Biology (, oral ingestion of apple polyphenols (antioxidants found in apple peels) can suppress T cell activation to prevent colitis in mice.[1] This study is the first to show a role for T cells in polyphenol-mediated protection against an autoimmune disease and could lead to new therapies and treatments for people with disorders related to bowel inflammation, such as ulcerative colitis, Crohn’s disease and colitis-associated colorectal cancer.

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Antibiotics and IBD in Childhood

Wednesday, 09 March 2011 by

Inflammatory Bowel Disease such as Ulcerative Colitis and Crohn’s blight people’s lives and restrict their functionality. The formative years of our lives represents the time when microbiological partnerships are being formed to provide lifelong co-dependence on each other. The role of the microbiota in immune tolerance in the gut and elsewhere is increasingly understood but is still an area rich for investigation.

In this study of Danish children a nationwide cohort study was conducted of all Danish singleton children born from 1995 to 2003 (N=577,627) with individual-level information on filled antibiotic prescriptions, IBD and potential confounding variables.[1] Using Poisson regression, rate ratios (RRs) of IBD were calculated according to antibiotic use. Antibiotic use was classified according to time since use, type, number of courses used and age at use.

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