Inflammatory bowel disease – Treatment breakthrough

Irish scientists have made a breakthrough which could lead to new drug treatments for the condition.

IBD refers to the conditions Crohn’s disease and ulcerative colitis. There is no known cause or cure and some 20,000 Irish people, including hundreds of children, are affected.

The conditions have similar symptoms, including abdominal pain, diarrhoea, fever, loss of appetite and weight loss. Left uncontrolled, symptoms may ‘flare up’, causing severe abdominal pain and frequent visits to the bathroom. If parts of the colon become too inflamed, patients may need surgery and a life-long colostomy bag.

However, new research from the National Children’s Research Centre (NCRC), which is based in Our Lady’s Hospital for Sick Children in Crumlin, offers hope to those affected.

The researchers found that a protein called IL-36 is found in higher levels at the time of diagnosis in children attending the national paediatric IBD service in Crumlin.

According to lead researcher, Dr Patrick Walsh of Trinity College Dublin, this is ‘good news’ for those affected by IBD ‘as it means it is now possible for someone to develop a drug to treat the condition’.

Inflammatory bowel disease
Inflammatory bowel disease

“If such a drug can be found to reduce IBD levels in children, this might turn off the disease or reduce the symptoms,” he explained.

The research was also carried out by consultant paediatric gastroenterologist, Dr Seamus Hussey, and he pointed out that Ireland’s rate of IBD is on the increase, but the reasons for this are unclear.

“In the past decade the number of new cases of IBD in children attending Crumlin has increased by over 90% and numbers continue to rise.

“There are in the region of 20,000 children and adults in Ireland affected by IBD in one form or another. There is no cure for IBD and while we as doctors try to manage the disease over time, many people with it still end up requiring surgery,” he said.

Dr Walsh added that the only way to find out why the numbers are increasing is to continue researching the disease.

“It is only through these investigations that we can hope to find a reason for the increase, and ultimately to find a better way to treat the condition.”

Details of the findings in relation to IL-36 are published in the journal, Muscosal Immunology.

Blood tests to diagnose irritable bowel syndrome

In what is thought to be a world first, scientists have developed a new set of blood tests to diagnose irritable bowel syndrome.

The diagnostic tool can quickly and accurately diagnose the painful condition, offering hope to millions afflicted across the world.

There are currently no specific tests routinely used by doctors to identify IBS.

As a result, millions of patients undergo invasive investigations to rule out other, more serious conditions including bowel cancer and Crohn’s disease, before specialists can arrive at a diagnosis.

Gastroenterologist Dr Mark Pimentel, at Cedars-Sinai Medical Center in LA, believes his new method could help secure an early diagnosis for patients, avoiding the need for years of medical appointments.

He said the tests confirm when an individual has developed IBS as a result of food poisoning, a major cause of the disorder.

Toxins produced by bacteria, such as salmonella, can severely harm the digestive system by damaging nerves critical to healthy gut function.

The new blood tests identify the presence and amount of specific antibodies reacting to the toxins.

Dr Pimentel said: ‘Having an early diagnosis means patients can avoid years of invasive tests and visits to specialists that often leave them with more questions than answers.

‘With these new blood tests many patients will now be able to proceed right to therapy for their condition.’

IBS is the most common gastroenterological disorder plaguing patients in the US, affecting nearly 40 million people.

Irritable Bowel Syndrome
Irritable Bowel Syndrome

In the UK, one in five people suffers the condition, while an estimated 10 per cent of the world’s population are affected.

Dr Pimentel said the disorder has been ‘nearly impossible to diagnose until now’.

It is characterised by a cluster of confounding symptoms, including chronic bloating, abdominal pain, gas, and bouts of relentless diarrhoea, constipation or both.

Fatigue and the stress patients suffer as a result of trying to plan their lives around visits to the bathroom, can prove debilitating.

Dr Pimentel and his team of researchers studied nearly 3,000 people, comparing IBS patients to those diagnosed with inflammatory bowel disease, coeliac disease and those with no gastrointestinal disease.

The blood tests identified the two antibodies associated with IBS – anti Cdtb and anti-vinculin – with greater than 90 per cent certainty, they found.

‘Most IBS patients have been told at one time or another that the disease was psychological, all in their head,’ said Dr Pimentel.

‘The fact that we can now confirm the disease through their blood, not their head, is going to end a lot of the emotional suffering I have seen these patients endure.’

The study, validating the accuracy of the blood tests, was published in the journal PLOS ONE.

Dr Pimental also presented his research on Sunday at Digestive Disease Week 2015 in Washington D.C.