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General Information:
Crohn's Disease is an inflammatory bowel disease that can cause chronic diarrhea, malnutrition, weight loss, fatigue and in some cases death.

There are over 500,000 diagnosed Crohn's patients in the U.S. Some estimate that there are another 500,000 people that have not been diagnosed, but still suffer from Crohn's Disease.

Crohn's Disease is prevalent in developed countries, and where milk is consumed, except for India where milk is boiled before being consumed. Crohn's Disease is also more prevalent in families where one or more relatives have IBD.

Possible Causes:
For many years Crohn's Disease was thought to be an autoimmune disease where the body rejects it's self.

A growing number of researchers believe that some Crohn's Disease is not a purely autoimmune disease but may have a pathogenic cause or trigger. The most likely candidate is mycobacterium avium ss. paratuberculosis (MAP), a bacteria that causes a Crohn's like disease (Johne's) in most species of animals. Dr. Shafran has coined the term Mycobacterium Induced Regional Enteritis (MIRE) to describe this form of Crohn's Disease.

MAP has been isolated in the tissue of some Crohn's disease patients. As well as antibodies to MAP in the blood stream. 

Possible Sources of MAP:
MAP infects up to 20% of the dairy herds in the U.S. MAP is shed in the milk and pasteurization may not kill all of it. A study of the milk supply in the U.K. showed 25% of the retail milk tested was positive for MAP. Dairy cows that are MAP positive are routinely slaughtered for hamburger meat. Safe cooking temperature and time to eliminate the MAP threat from infected meat are not know at this time. Vegetables fertilized with MAP infected cow manure can also carry the bacteria.

The Crohn's Disease, MAP Link:
Dr. Burrill B. Crohn suggested a infectious cause, of the disease that bears his name, in the early 1930's. A lack of technology prevented him and others from making this link provable. Research to find an infectious cause stopped for all practical purposes until the 1980's.

Early attempts to control this infection with antibiotics for tuberculosis failed. It was not until the mid 1980's, when macrolide antibiotics were invented, that there was an effective treatment for MAP.

MAP is a difficult bacteria to work with. It is slow growing and becomes "wall-less". MAP also survives very well in macrophages (white blood cells) making it difficult to eliminate. With effort and patience MAP can be detected.

Resistance and Research:
Do to the past failure to isolate and control MAP with the technology of the time, many researchers and Gastroenterologist are reluctant to accept this form of Crohn's Disease. This is similar to the reluctance to prescribe antibiotics for H. Pylori, the cause of 80% of ulcers.

This reluctant mindset has severely limited the resources and funding available to study and treat this form of Crohn's Disease. 

Hope:
Researchers and physicians such as Dr. Shafran have been pursuing this research, often times paying out of their own pockets. This dedication has brought forth a treatment for the MIRE form of Crohn's Disease called RMAT (Rifabutin and macrolide antibiotic therapy). A recent trial of RMAT showed a 77.1% remission rate (Remission = CDAI score of 150 or less) with endoscopic healing. A small trial showed RMAT to be effective in healing fistulas, a problem that plagues many Crohn's Disease suffers.

Currently Dr. Shafran has 200 patients in an open trial with RMAT. While still early in the treatment the results to date are very promising. Many of these patients have stated that RMAT has given their lives back to them.


The information contained in this site is intended for information purposes only and is not intended as a means of diagnosing or treating disease. Please consult your doctor before starting any treatment.