ORLANDO, Fla. – Doctors are trying a new strategy to treat Crohn’s disease, an often-debilitating digestive condition that typically strikes in the teens or 20s and causes lifelong problems.

About 700,000 Americans suffer from the incurable illness, which can lead to inflammation, scarring and intestinal blockages that require surgery. Patients often take powerful steroids and immune-suppressing drugs to control symptoms.

But some doctors are experimenting with antibiotics as the main therapy. Their goal is to attack a bacterial infection that they think could be causing the disease.

Arianne Percy believes in the strategy.

Percy, 26, has been taking an antibiotic for six months. After dealing with abdominal pain since the age of 12, Percy said she is now symptom-free 90 percent of the time.

“I feel better than I have in years,” Percy said. “I just hope it keeps working.”

Her physician, Dr. Ira Shafran, has been studying potential bacterial causes of Crohn’s for years. He thinks one culprit is a cousin to tuberculosis – Mycobacterium avium paratuberculosis or MAP.

Shafran said an early, aggressive course of antibiotics could help many patients get better control of their symptoms. He has been testing antibiotic treatments in his own patients since the late 1990s, with varying success.

Crohn’s disease – named in 1932 after Dr. Burrill B. Crohn – is a form of inflammatory bowel disease or IBD. Historically, doctors had thought of the illness as an autoimmune disorder.

Such conditions occur when the immune system attacks its own tissues – in this case, the digestive tract. But many doctors now think Crohn’s is not the body’s attack on itself but a mistaken assault on bacteria that naturally live in the intestines. Numbering in the billions, these bacteria aid in food digestion and typically pose no harm.

For Crohn’s patients, doctors speculate that the visitors provoke a chronic immune response that wreaks havoc on the body.

Sufferers can face abdominal cramping, diarrhea and the urgent need to use the bathroom.

The condition can flare up periodically throughout a sufferer’s lifetime.

“It’s a disease of young people, (striking) at a time when they want to go to school, get married and start their careers,” said Dr. Daniel Present, a Crohn’s expert at the Mount Sinai School of Medicine in New York. “It can be very serious.”

Some patients need to take potent immune-suppressant medication. Many also take antibiotics, though usually for short periods and in combination with other medicines.

Dr. Jonathan Braun from the University of California at Los Angeles said it’s too early to know whether the drugs could play a bigger role in controlling the illness. Though many suspect Crohn’s is linked to bacteria, he said there is no consensus on which specific types are to blame, which antibiotics are effective and how long a patient should take them.

“There’s a lot of research that’s left to be done on bacteria in the gut, and I think that as we understand those better, there will be new treatments,” said Braun, chairman of the National Scientific Advisory Committee for the Crohn’s & Colitis Foundation of America. “But for now, it’s important to realize that while antibiotics may help some patients, none have shown to work on the majority of patients.”

In his practice, Shafran estimates that about 100 of his patients are on long-term antibiotic therapy for Crohn’s. They may remain on the drugs for years, with Shafran monitoring their progress and reducing the dosage as their symptoms subside.

He acknowledges the approach doesn’t always work.

Another of his patients, Kira Banks, 25, has been through a course of antibiotics without success. She now takes an immune-suppressing drug that she credits with bringing her relief.

“This can be a very devastating disease,” Banks said.

Shafran and his like-minded colleagues say more research is needed into the possible bacterial origins of Crohn’s. For now, many have focused on Mycobacterium because the organism is known to cause a digestive disorder in cattle called Johne’s disease.

But Shafran said MAP is not the sole answer to Crohn’s, which is influenced by genetics and many as-yet unknown environmental triggers. He worries that drug companies, which typically don’t make as much money on antibiotics, will not be interested in investigating their wider use in Crohn’s sufferers.

And doctors are entrenched in their habits, turning to immune suppressants and other, more-potent drugs to attack the illness.

“A lot of people think, “Why should I use a small-caliber weapon when I’ve got all these .44 Magnums lying around?”‘ Shafran said.

Dr. William Chamberlin from Texas also treats many of his Crohn’s patients with antibiotics, often using generic versions that he says offer a low-cost treatment with fewer side effects.

“I cannot say it’s a cure for patients, though some do remarkably well,” said Chamberlin, an associate professor at Texas Tech University. “Others don’t really do well at all.”

(c) 2007, The Orlando Sentinel (Fla.).

Visit the Sentinel on the World Wide Web at http://www.orlandosentinel.com/.

Distributed by McClatchy-Tribune Information Services.


PHOTO (from MCT Photo Service, 202-383-6099): MED-CHRONSDISEASE

AP-NY-12-07-07 0611EST

Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.