CD & colitis

[kickingfrog]

CD & ulcerative colitis.
J R Soc Med. 1986 April; 79(4): 204–205. PMCID: PMC1290274


Familial association between coeliac disease and ulcerative colitis: preliminary communication.

J F Mayberry, H L Smart, and P J Toghill

Abstract
One hundred and twenty patients who were members of the Nottinghamshire Coeliac Group completed a questionnaire about the occurrence of coeliac disease, ulcerative colitis and Crohn's disease amongst first-degree relatives. Siblings were at a 20-fold risk of developing coeliac disease and a 15-fold risk of developing ulcerative colitis, and significantly increased risks for these two conditions were also seen in other family members. The relatives of patients with coeliac disease are at increased risk not only of developing coeliac disease but also ulcerative colitis. This provides further support for a possible role of a dietary allergen in the development of ulcerative colitis.

www.ncbi.nlm.nih.gov/pmc/articles/PMC1290274/
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[kickingfrog]

A Case of Sequential Development of Celiac Disease and Ulcerative Colitis:

Discussion of Diagnosis

William Dickey

...Initially, the case patient's celiac disease responded well to gluten exclusion, as shown by the resolution of her symptoms, the recovery of her hemoglobin level and the disappearance of EmA and TTGA from her serum; in addition, subsequent follow-up confirmed the absence of histologic abnormalities in duodenal biopsy samples.
Enteroscopy and CT scanning did not detect evidence of lymphoma on diagnosis of celiac disease. Subsequent wireless capsule endoscopy, which is a valuable imaging technique for the diagnosis of small-bowel tumors, also did not detect evidence of lymphoma....
There was no evidence of collagenous or lymphocytic colitis in the patient's colon histology, and her response to active treatment of ulcerative colitis and maintenance of gluten exclusion avoided the need to carry out investigations for pancreatic insufficiency, lactose intolerance and bacterial overgrowth.

Colon Pathology in Patients With Celiac Disease
The association between celiac disease and microscopic colitis (either collagenous or lymphocytic) is well recognized.
In addition, Yang et al....reported that the prevalence of ulcerative colitis and Crohn's disease was significantly higher among patients with celiac disease than in the general population (prevalence rate ratios of 3.6 and 8.5, respectively).
In 5 out of 10 patients with both celiac disease and IBD the diagnosis of celiac disease preceded that of IBD (by 7 months to 12 years); in addition, the symptoms of 4 of these 5 patients were improved by a gluten-free diet, which suggests that gluten is not the trigger for IBD in patients with celiac disease.
Similarly, the case patient had excellent clinical, serological and histologic improvement of celiac disease before the onset of her ulcerative colitis symptoms.
....
www.medscape.com/viewarticle/560764_3

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Nat Clin Pract Gastroenterol Hepatol. 2007 Aug;4(8):463-7.

A case of sequential development of celiac disease and ulcerative colitis.

Dickey W.

Source
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, UK. [e-mail]

Abstract
BACKGROUND:
A 65-year-old white female who presented with flatulence and weight loss was investigated by celiac antibody testing, esophagogastroduodenoscopy, duodenal biopsy and colonoscopy. There were no positive findings, except for diverticulosis. Almost 5 years later repeat investigations performed in response to the patient's anemia confirmed the development of celiac disease. After 18 months of symptom improvement as a result of gluten exclusion the patient developed diarrhea, and colonoscopy revealed ulcerative colitis.

INVESTIGATIONS:
Physical examination; analysis of full blood count; measurement of serum ferritin, vitamin B(12), folate and C-reactive protein levels; thyroid and autoantibody profiling (including analysis of endomysial and tissue transglutaminase antibodies); CT scanning of the chest, abdomen and pelvis; and performance of esophagogastroduodenoscopy, push enteroscopy, colonoscopy and wireless capsule endoscopy.

DIAGNOSIS:
Celiac disease and ulcerative colitis.

MANAGEMENT:
Gluten-free diet, mesalazine and prednisolone.

www.ncbi.nlm.nih.gov/pubmed/17667995

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[kickingfrog]

Coeliac disease and collagenous colitis

Abstract


Postgrad Med J. 1990 Mar;66(773):238-41.

Coeliac disease and collagenous colitis.

O'Mahony S, Nawroz IM, Ferguson A.

SourceGastro-intestinal Unit, Western General Hospital, Edinburgh, Scotland, UK.

Abstract
We describe a case of collagenous colitis in a young man with coeliac disease who had responded clinically and histologically to a gluten-free diet three years previously.
The collagenous colitis responded initially to oral corticosteroid therapy and he is now asymptomatic (and with normal rectal mucosa) on oral mesalazine.
Collagenous colitis should be considered in the coeliac patient with diarrhoea despite adherence to a gluten-free diet.

PMID:2362896[PubMed - indexed for MEDLINE] PMCID:PMC2429479

[kickingfrog]

'Worm Therapy' Stimulates Gut Mucus


Stephanie Pappas

Date: 01 December 2010 .

..Ulcerative colitis, a type of inflammatory bowel disease, is marked by constant abdominal pain and frequent bloody diarrhea.
The disease, which leaves the intestinal lining inflamed and ulcerated, isn't well understood.
Some patients improve with immune-suppressing drugs, but these treatments can have major side effects.
When all else fails, patients require surgery to remove part, or all, of the colon.
Frustrated by these options, some patients have turned to a treatment not for the squeamish-at-heart: Swallowing the eggs of parasitic worms.
These worms, or helminthes, are able to modulate their host's immune system to stay alive.
Several studies (along with anecdotal reports) have shown that as a side effect, inflammatory bowel symptoms decrease.
In the new study, published today (Dec. 1) in the journal Science Translational Medicine, researchers followed a man who deliberately infected himself with Trichuris trichiura, the human whipworm. It's an approach not recommended by doctors:
The only worm that's been approved for clinical testing in the United States is Trichuris suis, a pig whipworm that survives in humans only temporarily. For this patient, however, the worms seemed to ease the ulcerative colitis symptoms, perhaps by stimulating immune cells to produce proteins that promote healing instead of inflammation. ...

...Whipworm treatment
The patient, a 35-year-old man, was diagnosed with ulcerative colitis in 2003. In 2004, rather than take immune-suppressing steroids, the patient swallowed 500 whipworm eggs he had obtained from Thailand. Three months later, he downed an additional 1,000 eggs.
After taking the eggs and seeing his symptoms improve to the point that he didn't need treatment ⎯ the man contacted P'ng Loke, now a professor of medical parasitology at New York University's Langone Medical Center.
Then a researcher at the University of California, San Francisco, Loke agreed to track the patient's progress and analyze just what was going on in the man's gut.

"When he had colonoscopies for different reasons, we basically tried to characterize biopsies that were taken from his gut," Loke told LiveScience. "We tried to look at these biopsies and see what kinds of immune cells were activated… what kind of genes were activated. We were trying to put together a picture of what was going on in the gut at different times."
In 2005, Loke and his colleagues observed a symptom-free patient with a large intestine full of worms.
In worm-infested areas, the intestinal lining looked healthy and mucus-rich.
In 2008, the man's ulcerative colitis symptoms returned. The flare-up coincided with a drop in the number of worm eggs in the man's stool, from 15,000 eggs per gram to less than 7,000, the researchers observed.
The patient dosed himself with another 2,000 whipworm eggs. His symptoms retreated....

www.livescience.com/9036-worm-therapy-stimulates-gut-mucus.html