Crohn’s Disease Surgeries Make Steady Advances

New Procedures, Some Pioneered by NewYork-Presbyterian/Weill Cornell Surgeons, Subject of Recent Review

Thousands of Americans suffering from the chronic inflammatory bowel condition known as Crohn’s disease are leading longer, healthier lives due to innovative new surgeries, according to experts at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

“Four out of five Crohn’s patients will require some kind of surgery at some point during their lives, but these advanced, often minimally invasive techniques are sparing precious bowel tissue while improving quality of life,” says senior author Dr. Fabrizio Michelassi, Lewis Atterbury Stimson Professor and chairman of the Department of Surgery at Weill Cornell Medical College and surgeon-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

He and co-author Dr. Sharon L. Stein, assistant professor of surgery at Weill Cornell Medical College and colorectal surgeon at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, wrote a “state of the science” review in a recent issue of the journal Practical Gastroenterology.

As many as 500,000 people in the U.S. suffer from Crohn’s disease, which triggers inflammation along the gastrointestinal tract, most typically in the lower bowel. Certain drugs can help ease symptoms, but there is no cure for this chronic illness. Some of the more severe complications of Crohn’s disease include strictures (narrowing of the bowel), abscesses, perforations, fistulas (abnormal, obstructive connections between tissues), hemorrhage and even cancers. These types of complications often require surgical intervention.

“In the past, this was limited to complex, invasive surgeries that required the removal of whole sections of the affected bowel. But over the past two decades, advances in surgery have changed that paradigm,” Dr. Stein notes.

Some of the innovations outlined in the review include:

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Can rectal vitamin E induce remission in patients with mild to moderate ulcerative colitis?

It is believed that the generation of an exaggerated intestinal immune response to otherwise innocuous stimuli along with generation of oxygen free radicals plays a key role in the pathophysiology of UC. However, no disease-specific treatment for UC has yet emerged. Vitamin E is a major lipophilic antioxidant in cellular membranes with excellent antioxidant activities which protects membrane lipids from peroxidation by scavenging not only chain carrying peroxyl radicals but also singlet oxygen and superoxide anion radicals. This is especially interesting in case of UC, considering the pivotal role of oxygen free radicals in the genesis of mucosal damage. Given the recent evidence suggesting anti-inflammatory properties for Vitamin E, one may ask whether d-alpha tocopherol, as the dominant vitamin E isomer in plasma with the highest biopotency, can be expected to reduce the development of tissue injury in UC.

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Vitamin D deficiency common in patients with IBD, chronic liver disease

Vitamin D replacement may be necessary to reverse deficiency-related bone loss

New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Two separate studies highlight the importance of regular Vitamin D checkups in the evaluation of patients with certain digestive diseases.

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Biodegradable polymers show promise for improving treatment of acute inflammatory diseases

A family of biodegradable polymers called polyketals and their derivatives may improve treatment for such inflammatory illnesses as acute lung injury, acute liver failure and inflammatory bowel disease by delivering drugs, proteins and snips of ribonucleic acid to disease locations in the body.

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Experts continue to cite Bifantis as promising probiotic treatment for Irritable Bowel Syndrome

Studies show inflammatory biomarkers return to normal levels, reduction in IBS symptoms after treatment with Bifantis

Two new review articles that cover therapeutic approaches to irritable bowel syndrome (IBS) in the July issue of Nutrition in Clinical Practice, cite growing evidence that probiotics, and specifically Bifidobacterium infantis 35624 (Bifantis), are effective in helping manage IBS. Both articles point to data that suggest Bifantis (available in the U.S. only in supplement form, marketed as Align) has anti-inflammatory properties that help normalize gut function at a cellular level.

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Stem Cells Heal Chronic Inflammation in the Gut

News About Inflammatory Bowel Disease, Crohn’s Disease:

May Help Restore Immune System to Normal Function for Crohn’s Disease

Stem cells are being studied at NewYork-Presbyterian/Weill Cornell to heal the gut in subjects suffering from Crohn’s disease. Physician-scientists believe that these cells might help to restore the ability of the immune system to control inflammation by secreting anti-inflammatory proteins into the digestive tract, allowing for regeneration of tissue and prevention of scar tissue. It is believed that Crohn’s disease results from a malfunctioned immune response, leading to uncontrolled inflammation in the tissues of the intestine. Diarrhea, painful cramping, blood in stool, ulcers and other wounds in the digestive tract are all possible symptoms of the disease.

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A New Approach to Treating Autoimmune Disease

In autoimmune diseases, the immune system turns against the bodys own tissues and organs, wreaking havoc and destruction for no apparent reason. Partly because the origins of these diseases are so obscure, no effective treatment exists, and the suffering they inflict is enormous. Now Weizmann Institute scientists have developed a method that in the future may make it possible to treat autoimmune diseases effectively without necessarily knowing their exact cause. Their approach is equivalent to sending a police force to suppress a riot without seeking out the individuals who instigated the unrest.

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Novel toxin receptor discovered for ulcer-causing stomach pathogen

Helicobacter pylori is one tough bug. It can survive in the human stomach, a zone with a pH somewhere between that of lemon juice and battery acid. Now researchers have discovered how an H. pylori toxin gets into cells, a feat that helps the bacterium live in one of the most inhospitable environments in the body.

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Virtual biopsy can tell whether colon polyp is benign without removal

A probe so sensitive that it can tell whether or not a cell living within the human body is veering towards cancer development may revolutionize how future colonoscopies are done, say researchers from the Mayo Clinic in Jacksonville, Fla.

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What else may probiotics do in adults?

Probiotic bacteria, defined as living microorganisms that have beneficial effects on human health, have mostly been studied in the prevention and treatment of different gastrointestinal diseases and allergies. Probiotic products, however, are usually consumed by the general, healthy population but not much is known what kind of effects they have on the immune system in healthy adults. It is not clear how probiotics exert their health effects, but one of the most probable action mechanisms is the modulation of immune responses via the gut’s mucosal immune system.

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