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UC=caused by infection? Sick gut flora is key component.

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Posted 4/26/2012 10:25 PM (GMT 0)
Good point on the empirical observations, DBwithUC. :)

In other words...things are complicated! :D
Posted 4/26/2012 10:33 PM (GMT 0)
Fruitgirl: Did you read the T-bet article,basically even in T-Bet sufficient mice they got colitis from the bacteria,which to me is quite scary. The research article is still on the net, may post it,if I start a new thread on T-Bet,which was also posted years ago. Seems you can regulate T-Bet by regulating PPAR alpha which can be regulated by fatty acids inn the diet, the question is which way.
Old Mike
Posted 4/26/2012 11:32 PM (GMT 0)
Let's assume that the gut flora imbalance may be the trigger for inflammation whether it's an infection or not. So why not change the gut flora regardless of what caused it? That's the reasoning behind Dr Borody's treatments.
If it is in fact an infection that changes the gut flora for the worse, then it is quite possible that this same infection can be passed onto family members through human contact. Hence the data that suggests it may run in families. A round of abx, for example, or other environmental impacts can then tip the scales of the relatives gut flora allowing the infection to take over.
Posted 4/27/2012 12:50 AM (GMT 0)
For me obviously gut flora is a huge part of it. My U.C. started when I took Biaxin, a broad spectrum antibiotic that kills good bacteria, but not all the bad ones, and my UC was "cured" (well sort of) when I took the triple ABX combo that kills virtually everything including the really pathogenic ones.
Posted 4/27/2012 1:55 AM (GMT 0)
@ Trojen: i completely agree that it is most likely an infection. I, too, believe that our immune systems are created smart and hence i don't believe that immune cells can starts attacking the colon for 'no reason'.
Evidence that it is an infection:
1- Antibiotics work for some people to get them out of flares, for me they completely stopped the unbearable cramps but not the diarrhoea unfortunately

2- ONLY 20% of those with UC actually have it in their families: so the MAJORITY of UCers do NOT have a relative with IBD which in turn means that the majority of UC is NOT caused by genes!!! im sick of hearing about the 'Genetics' theory.

3- Probiotics help in alleviating the symptoms in some/many cases

4- The main anti-inflammatory drug used in the 'maintenance' of remission is 5-ASA: which (guess what folks?) besides the fact that science still does NOT know the exact mechanisms by which it works to keep UC in remission; is actually an ANTIBACTERIAL!!! which IMO is the reason why many UCers are at higher risk of C Diff because they are kind of like people who take long term antibiotics.

5- Other 'natural' anti inflammatories that work such as Garlic, Boswellia, Curcumin, Licorice actually (besides the fact they are anti inflammatory) possess POTENT ANTIBACTERIAL/ANTIVIRAL/ANTIPARASITIC/ANTIFUNGAL activity (google it if you don't believe me).
Clay and Bee pollen who some swear by also have the ANTIBACTERIAL/VIRAL etc activties.
http://www.jonbarron.org/immunity/barron-report-natural-health-remedies-infection

6- Steroids work: YES THIS MEANS IT IS LIEKLY AN INFECTION IF STEROIDS HELP CONTROL IT!!!! HOW?
BEcause of the little known fact that Steroids, suppress cellular immunity (Th1) but INCREASE HUMORAL IMMUNTIY (Th2) ? that's right!!! Now how many of you already knew that? very few im guessing bc all we hear is "steroids suppress immunity and hence this proves that UC is autoimmune" blah blah blah. But they don't tell you that steroids don't suppress all immunity; they actually stimulate some subtypes.
Here are the articles to prove the effect of Cortisol (which is what steroids mimic) on immunity subtypes for the skeptics:
https://www.thieme-connect.com/ejournals/abstract/hmr/doi/10.1055/s-2007-981462

http://onlinelibrary.wiley.com/doi/10.1196/annals.1321.009/abstract;jsessionid=57D803760720FC82BE6F8A279CFB64ED.d03t03?userIsAuthenticated=false&deniedAccessCustomisedMessage=


7- Fish oil works only for a few people and recent METANALALYSIS found that it is actually of NOT BENEFIT for UC (unlike Crohn's). This is because fish oil is only anti-inflammatory WITHOUT the antibacterial/antiviral effects.


@DBwithUC: while your explanation is quite scientific and plausable: i actually disgaree because many of us actually go into remission (meaning our body BOUNCES BACK TO NORMAL if you like the spring theory) and we may be in remission for a long time until we get a flareup again: in my opinion because the underlying infection (whether viral or bacterial) gets the right circumstances for it to resurface; a bit like the Herpex Simplex virus.
Posted 4/27/2012 2:24 AM (GMT 0)
Some great points Conquer UC. I too believe it is most likely an underlying infection caused by unknown bacteria. Maybe the reason antibiotics works for some and not others is that the abx does enough to shift the scale back in favour of the good bacteria thus controlling the bad bacteria and infection. A person may however flare again if circumstances result in the flora changing again eg. a round of abx for an unrelated infection or the bad bacteria simply overpowers the good bacteria over time. However if the flora is not replaced with new bacteria then the viscous cycle will continue. Again this is the theory behind Dr Borody's treatment using fecal transplant.

 

Posted 4/27/2012 2:30 AM (GMT 0)
The data reports that it can run in families to the extream where nearly every family memeber has an IBD wouldn't prove that it's contagious, otherwise everyone would have it...2 parts to IBD are hereditary factor and trigger factor....as I've mentioned before my mom got her UC AFTER I got my CD, I'm the youngest of 6 kids and so far the only one that has an IBD, doesn't mean my other siblings won't at some point, it's likely more of a matter of theirs being triggered.

On the flip side of what I stated in the above paragraph, it may only be me that's destined to have an IBD because it's just how I genetically developed as a result of being my parents offspring (since technically I'm an only child) but my mom (who had UC) still had 5 other children with 2 different men (2 with first husband and 3 with second common-law, then just me). I have a malfunctioning immune system just as my mom did, none of my other siblings have any types of autoimmune diseases (except for one other half sister that was my Dad's daughter, not my moms, but that sister doesn't have any bowel issues, just things like fibro and psorasis...so her and I share the same Dad, my mom's other kids (all my half sisters and one brother) don't have any immune disorders/diseases.
Posted 4/27/2012 11:01 AM (GMT 0)
Great points, great discussion...this was what I was hoping for. My goal is to add focus on the cause within our treatment protocol. If in fact this discussion can open some eyes to the gut flora/infection UC cause theory, then maybe more will pursue this path for treatment and towards remission or cure? My point of this post was to simply get people thinking about fixing the problem...not excepting it. Suppression is needed in a UCers treatment protocol, but it should not be the end fix. We need to stop the underlying problem or it will forever linger. Sure, surgical removal is always an option. I look at colectomy as I do an amputation. If a person gets an uncontrolled infection in a limb, you have the option of amputation and fixing the problem. However, wouldn't it be great if you could some how stop the infection and save the limb first? I'm not against surgery, as this is a necessary approach within the protocol. However, the problem I have, is that surgery is the ONLY "cure" option within our current protocol. Otherwise, its simply acceptance and suppression? The medical industry creates billions $$$ residual income with this focus...I'm just sayin.

It seems like we have a strong concensus within this thread for the gut flora and/or infection UC theory to be quite plausible. IMO: To except UC as an incurable disease and chalk it up to a malfunctioning immune system is simply lazy and irresponsible. Of course there is a cause and cure....we just have to find it. This is VERY different than being born with a dissability of some sort. This was contracted via the environment. Sure, we are all genetically wired (predisposed) for many things, I'm sure UC is no different. Look at the pro football (USA)Manning family....father and two sons all played or playing professional football at the highest level. So again, genes are passed down to our children...good and bad ones. There is a reason why we're asked about family medical history when meeting with doctors or applying for life insurance. If heart disease runs in the family, you have increased odds of getting heart disease (and higher premiums). This does NOT mean your going to get heart disease. Point being, lets not use gene predisposition to disprove or diminish any focus on a cause or cure. I think its safe to say, no one here was born with UC, so why not focus on the cause as a path to a cure.

Not to be repetitive, but I think the FACT that the majority of our gut flora is unknown is key, and the problem lies within it. IMO: Focusing on killing any unknown pathogens and rebalancing the guts flora seems to be the best non-surgical cure option out there.
Posted 4/27/2012 11:29 AM (GMT 0)
I am the only one I know of in my family/extended family with UC but my mum and I have a gene called HLAB27. My UC appeared after I quit smoking.
Posted 4/27/2012 6:01 PM (GMT 0)
Agreed that most don't realize how complex this disease really is....

Here's some insight based on research done by another Canadian IBD lead researcher;

Dr. Kathy Siminovitch and her research team discovered a gene located on chromosome 5 specific to CDers, that normally produces a protein that sits on the cell surface and controls movement of specific substances in and out of the cell. When altered (scratched) the gene produces a protien that functions improperly, allowing toxins increased entry into the cell. This particular gene is noted as being identified as one of the genes that predisposes the development of crohn's disease.

With this discovery, researchers can now use an assay (laboratory test to find and measure the amount of a specific substance) of this gene to distinguish between crohn's disease and ulcerative colitis so that this disease can be diagnosed and treated most accurately. Of course this will still take some time.

This research was noted in 2004.
Posted 4/27/2012 6:18 PM (GMT 0)

ssarow said...
There are medical professionals researching this disease every single day and if it was truly an infection, wouldn't you think they would adamantly state its indeed an infection?

Don't you remember the resistance in the medical community to the theory that ulcers were caused by a pathogenic bacteria? Those that originally proposed the idea were laughed at an ostracized.

The way our bodies react to infectious agents is greatly influenced by our genetics, so genetics always play a part in infectious diseases.

I agree though that there are likely several different causes for U.C., just as there are with stomach ulcers. I think around 20% ulcers are not cause by H Pylori.
Posted 4/27/2012 6:27 PM (GMT 0)
Not even the doctors/researchers who believe MAP is implicated in CD believe that all CD is caused by MAP. They also say that the antibiotics we have might not be strong enough to tackle the infection which they believe causes CD. So, just because abx aren't working, doesn't mean there isn't an infection.
As for genetics, it is very complicated but my daughter's GI (who specializes in genetic research and IBD) has told us that there are about 120 known genes which are implicated in various degrees with CD. Over half the white population of Northern Europe carries one or more of these mutations. Perhaps it makes them more susceptible to infection or dysbiosis or makes it more difficult for their bodies to regulate themselves. Even though she specializes in genetics, this same GI feels that correcting the gut flora through abx/probiotics (and yes FT) is a key to treating IBD. She's clear that it's very early days and no one knows which abx to use, which bacteria are involved and potentially which infection (she does believe MAP is a cause in certain cases of CD btw). This is why she prefers to experiment with abx before immunosuppressants and has told me that is what she would do if it were her chid.
Posted 4/28/2012 7:51 PM (GMT 0)
As far as immune dysfunction goes, perhaps many of us are in the same boat due to diet. The fats we eat have control over our gene expression, being inflammatory or not.

http://www.jbc.org/content/284/23/15400.full.pdf+html

One reason perhaps that antibiotics dont work on everyone is bacterial biofilms where the antibiotic cannot

penetrate.
Old Mike

Posted 4/29/2012 12:40 AM (GMT 0)
A big question I've always had is what makes the disease accelerate full-time at any given age? Before 21, I feel like I've always had some sort of IBS.
Posted 4/29/2012 1:26 AM (GMT 0)

DBwithUC said...
I think you are incorrect to say the odds are stacked in favor of an unknown infection theory. IMO, you are praying it is, that it can be found and killed. You want to believe this. Maybe it will prove true (like with stomach ulcers) but maybe you are simplifying things too much and ignoring facts that don't fit.

I think the more productive discussion should be on the ways gut-flora interacts with the immune system, and on the ways the balance of gut flora can be regulated. I don't see the value in insisting that disturbance of gut flora has to start with infection.

Dehydration ( mild ) and fake sugars all seem to upset my flora by altering my GI PH. Downing large glasses of water halts the gas.

The flora 'signature' is altered for sure in A-IBD ( Active UC or CD ) I have seen a document that graphically depicts the difference between, normal, UC, CD.

This is along that same line of thinking - Bacterial Diversity distinctions betweeen all 3.

Linked Story... said...
The global composition of the intestinal bacterial microflora
rather than the presence of single pathogens appears to be
relevant for IBD pathogenesis and aetiology.

gut.bmj.com/content/53/5/685.full.pdf

Checkout the pdf, I will look for the primary document I am thinking of.


Came across this on page 176

books.google.com/books?id=W_a7plftTUMC&pg=PA176&lpg=PA176&dq=Bacterial+Diversity+cd+uc&source=bl&ots=88hwsJlQ_k&sig=UAxAe-mbKisNPz5e8BcoL_Xz7SA&hl=en&sa=X&ei=JZmcT7mFKaGQ2gWS39z_Dg&ved=0CF8Q6AEwBg#v=onepage&q=Bacterial%20Diversity%20cd%20uc&f=false

f. prausnitzii is an anti-inflammatory bacteria that is low in UC and CD but not in normal people.

Is he crowded about by a hostile bacteria ? Is the PH change all that is needed for this one to die off ? Do we just need to repopulate and therefore have come all the way back to FT ?

Post Edited (aguywithuc) : 4/28/2012 7:35:11 PM (GMT-6)

Posted 4/29/2012 3:52 AM (GMT 0)

stereofidelic89 said...
A big question I've always had is what makes the disease accelerate full-time at any given age? Before 21, I feel like I've always had some sort of IBS.

This is a good point. When I was diagnosed, the doctor told me UC is often called "a disease of the young." Most people get the disease between ages 15-30. Why?
Posted 4/29/2012 4:57 AM (GMT 0)

Sara14 said...

stereofidelic89 said...
A big question I've always had is what makes the disease accelerate full-time at any given age? Before 21, I feel like I've always had some sort of IBS.

This is a good point. When I was diagnosed, the doctor told me UC is often called "a disease of the young." Most people get the disease between ages 15-30. Why?

I was 42.
Posted 4/29/2012 12:38 PM (GMT 0)
aguywithuc, Interesting articles....I'm not surprised.

This thread has produced some awesome info and a great debate. I feel now more than ever, the problem lies within the gut flora. Autoimmune simply suggests we have a malfunctioning immune system....regardless, why is this? Again, we weren't born this way? Something caused this. IMO: The proof is in the pudding....in this case, the gut flora.

Suppressing the immune system or inflammation is useful with active disease, but does NOTHING for the root cause/problem. You still need to focus on the problem if you want to fix the problem.

The major challenge with the gut flora, is science does't know the majority of its "DNA". How do you fix what you don't know? Well, at this point of the discussion, I would think FT is a good start. ONLY because, it appears as though it will fight off pathogens and restore, to provide a abx/pbx treatment affect, thus hopes of a healthier flora and more manageable disease. My big hang up with FT, is why do some donors work and others don't? That's another discussion I guess.

Lastly, I want to point out that this discussion is not to talk smack, but is a way for us to work collectively to fix the problem. Science is focused and funded on what will make money. HW is the best outlet I've found to talk UC, so I'm hoping the people talking here may make some sense of this and possibly contribute to science....who knows.
Posted 4/29/2012 1:01 PM (GMT 0)
@ Trojen: Amen to that!!

As a side note: i have always wondered what would happened if we gave someone with active UC an immune STIMULANT, you know like high doses of echinacea or astragalus or other ways to boost Th2 (humoral) immunity (kinda like the steroids but more specific without the systemic side effects)...Ever wondered what would come out of an experiment like this?
I guess it would be UNETHICAL though to conduct such as experiment so we'll never really know.
Posted 4/29/2012 1:23 PM (GMT 0)
Conquer UC
They've been doing trial stimulating the immune systems of CD patients in the UK in recent years with good results. Google search will provide the info if you're interested. Here's an overview of the theory and a synopsis of this discussion

http://news.bbc.co.uk/2/hi/health/4740632.stm
Posted 4/29/2012 3:45 PM (GMT 0)
I agree some type of infection is the cause in many cases, although genetic weakness makes a difference as well.
Stress can contribute as it does to many health problems.
Some form of bacteria and/or parasite is acting pathogenic. Both of these causes often will not show up on stool tests, especially parasites. It may show up finally when it is so bad you are in the hospital.

I myself had bad case of parasites and bacteria which almost killed me, using both natural and western medicine got it under control in the hospital. I believe I still have that pathogenic bacteria (Enterococcus faecium) inside of me to some extent because it is one of those "super bugs" that adapt quickly to antibiotics and survive. One last antibiotic I have left to try and destroy it completely is very expensive, Linezolid, is recommended for it, so I am holding off on using it if my body can destroy what's left by itself. Flagyl did help against it, and so did Levaquin more so, to initially knock it down.

My natural doctor gave me Zymex II for the parasites, which I know I had because they came out in my stools for some time until they were gone finally.

Although my bowels are not 100% normal, they do fairly well and I don't use any anti-inflamatory drugs like I did in the past, which didn't seem to help anyways.

Just telling my experience so far. So for me anyways, the cause is/was bacteria and parasite related along with inherit genetics from my mother for bowel problems.

Forgot to add, for some reason after this experience I devolved an intolerance to chicken, including eggs to some extent, they will can irritation in my bowels. Strange I know, but I have to avoid eating chicken. Even some yogurts can cause irritation for whatever reason.

Post Edited (Zippy123) : 4/29/2012 9:54:48 AM (GMT-6)

Posted 4/29/2012 4:04 PM (GMT 0)
The worm therapy and probiotic therapy are two forms of stimulating the immune system in the colon. There was a study (if I remember correctly) that gave CD patients inactive probiotics, and they acted as a stimulant as well.


q
Posted 4/29/2012 4:50 PM (GMT 0)
Hi Guys: On the subjuect of immune stimulation.
Possibly before you can stimulate the immune sys easily, you have to stop suppressing it. Linoleic acid both supresses and makes inflammatory cytokines, elongates to archindonic acid which has its own set of inflammatory cytokines. Eating too much archindonic acid is not good either.
Fish oil also acts to suppress,but has a better cytokine profile.
Linoleic acid also shifts the gut bacterial balance towards gram negative.
Read my thread on T-BET.
CLA breaks this pathway and up regulates T cells against viral and bacterial pathogens.
What is interesting about this approach is that, depending on the type of fat you can up regulate genes,just goes to show you are what you eat.
Explained well here.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947030/?tool=pubmed
Here is an oldi but goodie.

http://gut.bmj.com/content/25/12/1399.full.pdf+html?sid=bd1f7c3d-b9e5-4923-afe8-f607b67f1176

Mike

Post Edited (Old Mike) : 4/29/2012 10:57:37 AM (GMT-6)

Posted 4/29/2012 5:04 PM (GMT 0)
RE; immune system, researchers cannot agree if ours is over or under active so they've basically settled on "malfunctioning".
Posted 4/29/2012 11:10 PM (GMT 0)
One of the big brick walls we are up against is that drug companies can make billions off of immune system suppressants (like biologics) but can't make a dime off of antibiotics or other products that alter gut flora (like probiotics). There is therefore a huge financial disincentive for researchers to spend time looking at infectious causes. A few governments, like the government of Japan, have funded studies into infectious causes, so not all hope is lost. I think CCFA should be leading the way in regards to this in the United States, but it seems like they are not. Perhaps they are on the immune suppression band wagon because they accept big donations from big pharma and don't wish to bite the hand that feeds them. No conspiracy theories here, just basic observations of how money issues affect research into U.C..
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