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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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