Treating Crohn’s Disease

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This study comes from National Institutes of Health.

BACKGROUND/AIMS:
This study was designed to assess the role of foods with raised IgG antibodies and additives on the symptoms and inflammation of Crohn’s disease.

METHODS:
Eight patients with Crohn’s disease in remission were studied. They followed a strict diet during phase I. Then, provocations with two, three-day periods (phases II and III) followed: in phase II, pure forms of foods with high IgG antibodies and in phase III, off-the-shelf forms of those foods were added. Stool samples were collected for fecal calprotectin assay. Blood samples were taken on the 11th and 17th days for highly sensitive C-reactive protein, ferritin, erythrocyte sedimentation rate, white blood cells, and platelets. Patients kept a diet-symptom diary.

RESULTS:
Increased Crohn’s disease activity index scores were found statistically significant (p=0.012) between pre- and during the provocation weeks. There were significant increases according to Harvey-Bradshaw Index when the highest values during the phases I, II (p=0.027) and I, III (p=0.027) were compared. The increases in highly sensitive C-reactive protein (p=0.025) and white blood cells (p= 0.036) were found statistically significant. Fecal calprotectin levels showed day-to-day variability. When compared, the levels of fecal calprotectin increased in all patients on the last day of the restriction (10th day) and the first day of the provocation (11th day) with the exception of one patient.

CONCLUSIONS:
Foods with raised IgG antibody levels and food additives can provoke the symptoms and may stimulate the inflammation in patients with Crohn’s disease. Addition of a proper diet with restriction of those foods may be beneficial in the medical treatment.

Uzunısmaıl H, Cengız M, Uzun H, Ozbakir F, Göksel S, Demırdağ F, Can G, Balci H.
Source
Department of Gastroenterology, İstanbul University Cerrahpaşa Medical School İstanbul/Turkey. hulyauzunismail@gmail.com

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This is great to see! I believe it’s the first study connecting IgG food reactions to Crohn’s disease.  But before you take a look at the study, here’s a quick overview of IgG and IgE antibodies.

What does IgG and IgE mean?

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for the two different kinds of antibodies produced by the immune system in allergic reactions to food.  Conventional allergy testing looks for IgE reactions only. These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea. These are the reactions that people usually think of when they hear the word allergy.

The problem with this type of testing is that most food allergies are not IgE reactions, but are rather IgG reactions, which usually show up hours or even days after ingestion of the allergen. They are generally not nearly as dramatic as the more severe IgE reactions, and usually result in “mere” constipation, diarrhea, bloating, gas and abdominal pain. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

Study from National Institutes of Health:

The effects of provocation by foods with raised IgG antibodies and additives on the course of Crohn’s disease: a pilot study.

BACKGROUND/AIMS:
This study was designed to assess the role of foods with raised IgG antibodies and additives on the symptoms and inflammation of Crohn’s disease.

METHODS:
Eight patients with Crohn’s disease in remission were studied. They followed a strict diet during phase I. Then, provocations with two, three-day periods (phases II and III) followed: in phase II, pure forms of foods with high IgG antibodies and in phase III, off-the-shelf forms of those foods were added. Stool samples were collected for fecal calprotectin assay. Blood samples were taken on the 11th and 17th days for highly sensitive C-reactive protein, ferritin, erythrocyte sedimentation rate, white blood cells, and platelets. Patients kept a diet-symptom diary.
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