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- A check at a recent dinner party showed that no
one knew anything about Crohn's Disease - an inflammatory disease
of the guts which attacks any part of the digestive tract, from mouth
to anus, but has a predilection for the large and small intestines.
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- It causes deeper ulceration than ulcerative colitis,
attacking the structures in the sub-mucosal regions under the intestinal
lining. Initially associated with diarrhoea and bleeding, it later
causes obstruction, adhesions, fistulae vand abscesses. The gut may
perforate. Crohn's was rarely reported before 1900 and was only described
by Dr Burrill Crohn in detail in the 1930s. Since the 1950s its incidence
has increased at least threefold, but Professor John Hermon-Taylor
of St. George's Hospital in London suggests that it is still under-reported.
It is probable that it affects at least 80,000 people in the United
Kingdom.
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- The professor has tried for years to explain the
similarity between Crohn's in humans and Johne's Disease in cattle
and other animals. Johne's results from infection with mycobacterium
paratuberculosis.
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- Professor Hermon-Taylor and others tried to prove
that mycobacterium paratuberculosis is also responsible for Crohn's.
Now DNA testing has shown the organism is present in Crohn's sufferers.
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- Worryingly the organism can be cultured in 3 per
cent of standard milk bottle samples, and in a high percentage of
dairy cows. A possible source of human infection is therefore milk.
Epidemiological studies show a higher incidence of Crohn's in communities
downwind of water flowing through grazed pastures. This suggests that
the organism is whipped up from the water's surface, then inhaled
by locals.
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- Professor Hermon-Taylor suspects that the increase
of Crohn's Disease is coincident with the increase in modern farming
techniques.
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- Not surprisingly there has been a reluctance to
accept an association between Crohn's and Johne's Disease which would
suggest a major public health problem. Opponents of the thesis question
the lack of response of Crohn's Disease to anti-microbial therapy.
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- However, a recent study at the South Cleveland Hospital
has shown that when appropriate antibiotic therapy was given a good
response was obtained.
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- Professor Hermon-Taylor has had similarly successful
results. He found that 70 per cent went into remission after antibiotics
and 50 per cent stayed in lasting remission.
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