Researchers have highlighted how people with Crohn’s disease can achieve “profound remission” for between 3 and 23 years using personalized combinations of antibiotics and poop transplants.
The battle against Crohn’s is far from won, but this extremely small case series shows there is hope for the millions of people suffering from this nasty disease.
Crohn’s disease is a chronic condition that causes inflammation of the digestive tract, leading to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. The condition is defined by ulceration and inflammation of the digestive system, in which the body's immune system attacks the gastrointestinal tract. While the precise cause of Crohn's disease is not clear, it is known to be associated with a number of environmental, immune, and bacterial factors in genetically susceptible people. Although there is no “cure” as such, drugs and surgery can give long periods of relief from symptoms.
One especially interesting avenue of treatment involves our microscopic pals, bacteria. There are hundreds of naturally occurring bacteria living our guts: mostly harmless, many good, and some bad. Since the late 1980s, an increasing amount of research has shown that these gut-dwelling bacteria play a key role in Crohn’s disease. For example, it's thought that certain gut bacteria may secrete proteins that interact with the cell layer lining the colon, causing the inflammation associated with the development of Crohn’s.
So the theory goes, if you can control the gut microbiome, you can control the disease. In this new study, reported in the journal Gut Pathogens, researchers assessed how 10 people with Crohn’s disease had responded to previous treatments involving bacteria.
"It has been shown that there is an imbalance present in the gut microbiome in Crohn’s disease with a possible infective aetiology – Mycobacterium avium subsp. paratuberculosis being the most proposed. Antibacterial therapy and Faecal Microbiota Transplantation are emerging treatments which can result in clinical and endoscopic remission, if employed correctly. The objective of this study was to report on the treatment and clinical outcomes of patients with Crohn’s disease in prolonged remission," the study authors write.
Scientists at the Centre for Digestive Disease in Sydney documented the progress of 10 Australian patients with Crohn’s disease who had previously received individualized treatments using different combinations of antibiotics and/or a so-called "crapsule," an oral capsule of freeze-dried donor fecal microbiota designed to colonize the patient’s damaged gut ecosystem with new bacteria.
Within this small group, the researchers found the 10 treated patients had experienced prolonged remission for 3 to 23 years – meaning they were clinically asymptomatic and did not require further treatment – with a median remission length of 8.5 years.
Crohn’s is generally associated with periods of “flare-ups” followed by periods of remission where symptoms are negligible. The key to treatment, whether it's drugs or surgery, is simply to maintain remission. So, while the remission of Crohn’s disease through treatment is nothing new, this new research highlights that prolonged remission is achievable through treatment.