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There is a very interesting article in the November 9 Science News,
"Gastrointestinal Blues:  Research finds bugs that inflame the human gut."
In the last two years, it says, a rheumatologist and gastroenterologist
have been looking into the role of two bacteria--Bacterioides and
Mycobacterium paratuberculosis--in Crohn's disease and ulcerative colitis.
(They do not mention celiac disease.)  The gastroenterologist is R. Balfour
Sartor.

Their experiments showed that even rats with an inserted human gene that
causes ulcerative colitis didn't get colitis if they had been raised in a
germ-free environment and were still germ-free.  But if they were
inoculated with Bacterioides they did.  Their small intestine showed
inflammatory cells, which meant colitis was an autoimmune disease, brought
on by infection with Bacterioides.  (That human gene inserted into the
rats' DNA was HLA-B27, which causes certain autoimmune diseases).  Giving
the rats an antibiotic effective against Bacterioides calmed the irritation
of the colon.  Sartor is thinking of giving the same antibiotic to humans
with ulcerative colitis, to kill off the Bacterioides, then filling the
ecological niche the Bacterioides used to occupy with Lactobacillus (the
same bacillus used in yoghurt cultures), which will fight off the
Bacterioides if it tries to move back in.

Enter Robert J. Greenstein, a medical researcher in NYC, whose postdoc
student Dina Mishina found another bacteria in Crohn's disease and
ulcerative patients but not in colon cancer patients:  Mycobacterium
paratuberculosis.  It too causes an inflammatory response.  Greenstein
hypothesized that if the imune system succeeds in fighting it off, the
inflammation will subside, leaving only a scarred gut.  If the infection is
not suppressed, the patient will end up with pockets or holes in his gut
and be very sick.  Other doctors are not convinced about the role of M.
paratuberculosis in Crohn's disease.  Greenstein reminds them that the link
between peptic ulcers and Helicobactor pylori was established recently and
is now accepted despite initial skepticism.  (But I predict that it will
take over 100 years for the general public to stop blaming stomach ulcers
on stress.)

Now I would like to give my own theory of the etiology and many forms of
CD.  I never had any medical education, so this is pure speculation.  One
or more microorganisms can invade and set up a low level inflammation at
any time from infancy on.  The inflammation, of course, is not directly
caused by the microorganism but by our own immune bodies that try to fight
it off.  If the inflammation is severe enough, it can destroy cells and
interfere with the function of the villi.  (A photo in that Science News
article shows a section of infected gut, from a person with ulcerative
colitis.  The villi that are so swelled up that there is no space between
them.  It is hard to see how they could absorb enough nutrients to keep a
person going.)

If a young and growing person is infected, their development would be
affected by the infection's interference with absorption of essential
nutrients.  Even if they start a gluten-free diet later on, they will not
be able to make up for lost developmental opportunities.  The brain and
nervous system, teeth, and even the digestive system itself, are formed
early in life and their owner will not be able to make very large changes
in them later on.  Prenatal infections are a possibility--i.e., a person
could be born with CD.

I think people's symptoms vary so widely because 1) they get infected at
different stages of life, 2) some peoples'genes may predispose them to CD
(we know it runs in families), 3) some people may be eating a more
nourishing diet, and have better health habits.

I think the reason an infection hasn't been suspected as a cause of CD is
that the infection may not cause obvious symptoms like a fever that can be
measured with a thermometer.

Why can't some enterprising medical researcher look for an infecting
organism in DC and DH?  Why is diet still seen as the only way to treat
them?  In my opinion, the medical community has paid little attention to CD
partly because for most of them it looks like like several unknown diseases
that occur in various combinations, perhaps along with hypochondria--like
Gulf War Syndrome: undiagnosable because it doesn't fit an existing
pattern, therefore nonexistent.  But maybe it's time to look at a new
pattern.

There is some evidence that Alzheimer's disease, by the way, is caused by
inflammation of certain cells in the brain--which then die off.  This has
not been established yet, though.

My explanation for the success of the diet, by the way, is that it
systematically deprives the microorganisms of the only kind of food they
can eat.  (While we're hypothesizing, let's hypothesize that these
microorganisms are not the kind that kill off their host, but are parasites
whose intention is to keep them alive.  So they live off what we eat,
instead of vital body tissues.)  We have to starve them to death, while
making sure we are nourished.  When we kill them off this way, we get well.
By the way, for all we know, they could be fungi, or yeasts, or bacteria.

There--I've stuck my neck out.  I'm ready for your comments.

Ellen McCrady

7105 Geneva Dr.
Austin, TX 78723
512-929-3992
fax: 929-3995
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