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Tuesday, 10 November 2015

Crohn's Disease is caused by common pharmaceutical drugs?

Crohn's disease is an inflammatory bowel disease (IBD), a long-term condition that causes inflammation and ulcers in the lining of the digestive system. Inflammation can affect any part of the digestive system but most commonly occurs in either the small or large intestines.

Abdominal pain and diarrhoea are the most common symptoms, but it can also cause include rectal bleeding, weight loss, arthritis, skin problems, inflammation of the eyes, and fever. Severe cases can be extremely painful and distressing.

What is the cause of Crohn’s disease?
NHS Causes does not know “the exact causes” Crohn’s disease, but they say that the factors contributing to it are thought to be genetics, the immune system, smoking, previous infection, and environmental factors. They also say that there is “no treatment” for the disease. Several drugs are are used in treatment, however, including anti-inflammatory drugs, steroids, cortisone, immune system suppressors, Remicade, antibiotics, and anti-diarrheal drugs.

It is also suggested that Crohn`s disease is an auto-immune disease where the body`s immune system attacks the tissues of the digestive system.

History and facts about Crohn’s disease
Although there is literature purported to describe Crohn’s disease dating back to the 18th and 19th century, even to Hippocrates, the disease was not ‘discovered’ or described until 1932 by Dr Burrill Crohn.

Crohn's disease is now becoming more common. It can be found in both men and women, usually but not exclusively in teenagers and younger people. In 2011 the St Mark’s Foundation estimated that there are about 90,000 people living with Crohn’s disease in Britain, but that this figure is rising with more that 8,000 being diagnosed each year. In North America it now affects about 400,000 to 600,000 people, about 1 in 1000. About 1 in 20 people with the disease go on to develop bowel cancer within 10 years of diagnosis.

Another estimate, in 2014, said that in England, Crohn’s disease had increased by 300% between 2003 and 2012, for young people aged between 16 and 29.

The rise of Irritable Bowel disease, which includes Crohn’s and Ulcerative Colitis is discussed on this Family Practice News website. It describes a literature review that found 260 studies on the incidence and prevalence of both diseases throughout the world. The findings suggested “that the global prevalence of IBD will continue to increase substantially”.

Pharmaceutical drugs that can cause Crohn’s disease
Various food additives have been implicated as the cause of Crohn’s. But it is known that the disease can be caused by some of the most common pharmaceutical drugs.

Dr Ryan Ungaro Icahn School of Medicine, New York, conducted a meta-analysis of eleven observational and case control studies, involving over 7,000 cases, and discovered that exposure to antibiotics was associated with Crohn’s disease.

"Exposure to antibiotics may somehow contribute to alterations in the microbiome and result in dysbiosis, which is known to be part of the pathogenesis that leads to IBD”.

Antibiotics are usually taken by mouth, and are known to upset the microbial balance of the gut, so a connection with Crohn’s disease is perhaps not surprising.

This common painkiller is also linked to Crohn’s disease. This is perhaps unsurprising as aspirin has been notorious for its harmful impact on the gastrointestinal system. The Science Today website published an article, “Regular use of aspirin increases risk of Crohn's disease by 5 times, study finds” in 2010. Dr Hart, of the University of East Anglia, who conducted the research said.

"This is early work but our findings do suggest that the regular use of aspirin could be one of many factors which influences the development of this distressing disease in some patients”.

This drug was used for the treatment of acne but has been linked to Crohn’s disease. The drug was introduced in 1982, but was withdrawn in 2009 because of the number of lawsuits taken against the manufacturer, Roche. The drug was also associated with birth defects and suicide. However, the dangers have not passed! Generic forms of Accutane are still available! The background is outlined on the Drugwatch website.

“Researchers analyzed all adverse drug reaction reports submitted to the Food and Drug Administration between 1997 and 2002 and found 85 cases of Inflammatory Bowel Disease, including cases of Crohn’s disease, associated with isotretinoin (Accutane) use. Of those 85 cases, researchers found that, Isotretinoin use was highly probable as the cause in four cases, probably the cause in 58 cases, and possibly the cause in 23 cases.”

Other drugs

This is not an exhaustive list of the pharmaceutical drugs known to cause Crohn’s disease, but it is hopefully sufficient for anyone taking, or planning to take any pharmaceutical drug to undertake a thorough web search for any possible associations.