Crohn’s Disease is a condition characterized by a chronic inflammation of the lower bowel which results in widespread inflammation and scaring of the mucosa, obstruction, fistulae, and chronic pain and diarrhea. The disease affects roughly 16/100,000 people worldwide, with a relatively undetermined pathogenicity.
The traditional view of the the cause of Crohn’s Disease is an auto-immune disorder which targets intestinal epithelium. However, much research (like my capstone project) indicates that an infectious mechanism may be at play.
Enter Mycobacterium avium spp. paratuberculosis (MAP) the causative agent of Johne’s Disease, a chronic inflammatory disease of the lower bowel which affects cattle and other ruminants, costs US farmers 1.5 billion dollars in herd loss annually, and has been an accepted pathology brought about by infection with MAP for years. Johne’s disease demonstrates many identical signs to Crohn’s disease, with the main difference being the infected animal’s status as either livestock or as a human, respectively. There is actually a rapid MAP antigen test to determine if your herd has been affected. The bacteria spread through, and can be found in stool and secretions (like milk) from affected animals.
MAP is an acid-fast organism which is strikingly difficult to culture, is nearly impossible to detect, can exist in a paucibacillary form (with less than 10,000 organisms per infected animal), can exist without a cell wall, and is disturbingly present in food we buy at the grocery stores given its possible causative role in a relatively debilitating chronic disease. It has been found in 11.8% of pasteurized cow’s milk. Also, it’s not killed by standard pasteurization technique.
It has been widely speculated by some physicians (and my capstone project) that Johne’s disease and Crohn’s Disease are one in the same disease, and treating Crohn’s Disease like an auto-immune disorder overlooks the actual causative agent of the disease. The bacteria has been detected in many resected tissue specimens from patients with Crohn’s Disease, and in the blood of the severely affected. While research and studies are limited still, cases of long-term complete remission from severe Crohn’s disease have been achieved by treatment with powerful antibiotics aimed at eradicating the underlying infection.
This hypothesis, like many new ideas, meets a lot of resistance in the medical community, though, and it will be years before any changes to procedure are made even if research supports this idea. Admittedly, again, research is still limited and researchers sill aren’t completely sure what the pathologic mechanism behind the disease is, but an association is clear, and we are no strangers to chronic inflammatory diseases of the lower bowel with an infectious origin which people don’t believe in. Dr. Barry Marshall had to DRINK A CULTURE OF HELICOBACTER PYLORI to prove to the medical community that it wasn’t stress that caused stomach ulcers.
If anyone has questions or wants sources or additional information on the topic, I’m relatively informed on the issue and I would be glad to provide any info. After all, this was my capstone; I may not have mentioned that.