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Crohn's Disease Forum » Books, Multimedia, Research & News » Inflammatory Bowel Disease in Asia: A Second Chance at Uncovering Environmental Factors


03-29-2016, 05:20 PM   #1
wildbill_52280
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Inflammatory Bowel Disease in Asia: A Second Chance at Uncovering Environmental Factors

Inflammatory Bowel Disease in Asia: A Second Chance at Uncovering Environmental Factors
http://ehp.niehs.nih.gov/124-a49/
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Last edited by wildbill_52280; 03-29-2016 at 11:03 PM.
03-29-2016, 07:37 PM   #2
xeridea
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Here's an NIH link since Medscape one isn't working.

It'd be interesting if they find the environmental link, and if they can find the same gene mutations in the European/Western populations and the Asian populations that they're looking at.

What I found most interesting though, is that they say CD incidence rate in West is stabilizing, whereas it's rising in Asia. If environmental factors, you'd think rates would be on same increase trajectory.
03-29-2016, 11:22 PM   #3
wildbill_52280
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Here's an NIH link since Medscape one isn't working.

It'd be interesting if they find the environmental link, and if they can find the same gene mutations in the European/Western populations and the Asian populations that they're looking at.

What I found most interesting though, is that they say CD incidence rate in West is stabilizing, whereas it's rising in Asia. If environmental factors, you'd think rates would be on same increase trajectory.
Thanks for finding a working link! I fixed it in my original post.
If environmental factors are not changing much, then neither should the rate be changing. So then if Asian environment is becoming more westernized/Industrialized, then one might expect you would see the incidence rate changing.

This part was kind of interesting to me.
Croitoru leads the GEM (Genetics, Environmental, Microbial) Project, a prospective cohort of more than 4,000 healthy individuals across Canada, the United States, the United Kingdom, and Israel, which aims to identify factors that contribute to Crohn’s disease.20 The study participants all have a sibling or parent with Crohn’s disease, which puts them at higher risk for developing the disease than the general population. Croitoru and colleagues have conducted gut permeability testing to assess the integrity of the intestinal barrier and collected detailed questionnaires on diet and environmental risk factors. Blood samples were used to genotype participants for IBD susceptibility genes, and stool samples enabled the researchers to characterize the composition and diversity of each participant’s gut microbiome.

Since the study started in 2008, 44 study participants have developed Crohn’s disease. Croitoru says the research team will need a total of about 70–75 new diagnoses before they can begin to find any meaningful signals in the data.
03-30-2016, 09:19 AM   #4
Madhu
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This is exactly what my husband's GI told us. Nobody in his family has IBD. Yet he got it. Dr said he has a gene that is susceptible to IBD. It was dormant all along, and the change in environment when he moved from India to the US must have triggered it

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03-30-2016, 09:37 AM   #5
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I read the article. I find no answer to one question: have they controlled for lack of diagnostic facilities in underdeveloped areas? The children of immigrants have spent more time in the West, with more chances of detection, and hence are not comparable.

My mother developed "intestinal TB" in 2000, and was "cured" through anti-TB drugs. Before her passing away in 2014, she suffered from IBS, but no bowel obstruction or the like. I have a belief that it was Crohn's, and that disease runs in the family. One of her uncles, a senior bank officer, had a mass taken out by surgery way back in 1980s from his intestines. No physicians explained that. Hardly anyone knew about Crohn's.

Coupled with the lack of transparency in many families on such matters in my country, for whatever reasons, many cases are remaining undiagnosed is what I believe.
03-30-2016, 12:17 PM   #6
wildbill_52280
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This is exactly what my husband's GI told us. Nobody in his family has IBD. Yet he got it. Dr said he has a gene that is susceptible to IBD. It was dormant all along, and the change in environment when he moved from India to the US must have triggered it
Doctors don't really know the absolute causes of IBD. This was merely his own theory. To his credit though it does sound based in science and could be a good theory, its possible this is how it happened but not for certain at all.

There are many things that could cause IBD, I believe the best evidence we have right now is a few patients that seem cured by Fecal Microbiota transplants, so many things could contribute to damage to the microbiome such as: antibiotics from doctors for surgeries/infections, antibiotics in the food supply, preservatives in food that inhibit bacterial growth, Vitamin d deficiency(most IBD patients live in canada), pro-inflammatory dietary omega 6 fats(like corn oil its in many processed foods), artifical sweeteners have been shown to alter the microbiome like sucralose and sacharin, carageenan can cause intestinal inflammation which could in turn damage the microbiome, polysorbate 80 can feed bad bacteria, Low fiber diets starve out good bacteria causing extinction, high sugar diets feed bad bacteria which outcompete good bacteria. Combine any 2-3 or all these variables together and you have your environmental cause of IBD.
03-31-2016, 01:08 PM   #7
Madhu
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Doctors don't really know the absolute causes of IBD. This was merely his own theory. To his credit though it does sound based in science and could be a good theory, its possible this is how it happened but not for certain at all.

There are many things that could cause IBD, I believe the best evidence we have right now is a few patients that seem cured by Fecal Microbiota transplants, so many things could contribute to damage to the microbiome such as: antibiotics from doctors for surgeries/infections, antibiotics in the food supply, preservatives in food that inhibit bacterial growth, Vitamin d deficiency(most IBD patients live in canada), pro-inflammatory dietary omega 6 fats(like corn oil its in many processed foods), artifical sweeteners have been shown to alter the microbiome like sucralose and sacharin, carageenan can cause intestinal inflammation which could in turn damage the microbiome, polysorbate 80 can feed bad bacteria, Low fiber diets starve out good bacteria causing extinction, high sugar diets feed bad bacteria which outcompete good bacteria. Combine any 2-3 or all these variables together and you have your environmental cause of IBD.
I completely agree. His GI also said that could be a possible cause, nobody can ever confirm the theory.
03-31-2016, 01:45 PM   #8
my little penguin
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Thing to keep in mind
No family history of Ibd
Does not mean that you don't have
Family genes for Ibd

No family history of Ibd on either side for us
But when we had Ds participate in the 23&me study

Lots of genes for Ibd /arthritis and crohns showed up

So unless you had your entire genome mapped
Can't say no "family history " -genetic history since that are pretty similar
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03-31-2016, 01:54 PM   #9
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Thing to keep in mind
No family history of Ibd
Does not mean that you don't have
Family genes for Ibd

No family history of Ibd on either side for us
But when we had Ds participate in the 23&me study

Lots of genes for Ibd /arthritis and crohns showed up

So unless you had your entire genome mapped
Can't say no "family history " -genetic history since that are pretty similar
It would be interesting to know what fraction of the human race shares any/more of these genes. If the number is disproportionately high, then environmental factors as moderator variables are more important is what I would think.
03-31-2016, 02:09 PM   #10
Eridon2002
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It would be interesting to know what fraction of the human race shares any/more of these genes. If the number is disproportionately high, then environmental factors as moderator variables are more important is what I would think.
I think environmental factors are more important. Human's genes take a multitude of generations to change. Genetically we are not much different than our ancestors thousands of years ago and certainly not different than 50 years ago. But what has changed drastically is our diet/antibiotic and pesticide usage. We are likely diagnosing the milder cases more than in the past, however, since severe and even moderate Crohn's/UC is so life altering there is no way it would have not been diagnosed. If our society continue in this trajectory I would think the Crohn's genes will be naturally selected out(at least those that cause severe enough pains and at young enough age to not procreate. I won't be passing any of my genes along since low body weight + Crohn's put me into early menopause at 37.
03-31-2016, 02:20 PM   #11
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It would be a fascinating study to investigate the effects of environmental factors on Crohn's genetics. However, it would be difficult to operationalize it. To control for environmental factors one has to go to "underdeveloped" areas and these are the areas that lack diagnostic facilities.
05-03-2016, 10:17 PM   #12
irishgal
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I'm guessing the rise of dairy consumption coincides with IBD in Asia. They mentioned this at the Chicago symposium as well.
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05-04-2016, 01:55 PM   #13
wildbill_52280
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I'm guessing the rise of dairy consumption coincides with IBD in Asia. They mentioned this at the Chicago symposium as well.
As confusing as science can be, I just read a study that suggests dairy was somewhat protective.
05-04-2016, 08:04 PM   #14
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Wow wildbill - interesting. Haven't seen that one. Send it on over. I would love to read it!
05-05-2016, 04:33 PM   #15
wildbill_52280
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Wow wildbill - interesting. Haven't seen that one. Send it on over. I would love to read it!
here it is- https://www.ecco-ibd.eu/index.php/pu...stigation.html

Although once someone develops IBD, lactose seems to exacerbate symptoms.
05-05-2016, 07:42 PM   #16
Eridon2002
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here it is- https://www.ecco-ibd.eu/index.php/pu...stigation.html

Although once someone develops IBD, lactose seems to exacerbate symptoms.
I wonder if that doesn't have to do where the disease is located. For example, if Crohn's is in small intestines than the cells that make lactase to digest lactose are damage. Those who have the disease in their colon may not be as sensitive to dairy. My disease is in my colon and I eat a lot of dairy with no problems. Although I also produce the lactase gene (23&me) and am Northwestern European descent so less likely to genetically be predisposed with lactose intolerance.
05-05-2016, 09:20 PM   #17
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I wonder if that doesn't have to do where the disease is located. For example, if Crohn's is in small intestines than the cells that make lactase to digest lactose are damage. Those who have the disease in their colon may not be as sensitive to dairy. My disease is in my colon and I eat a lot of dairy with no problems. Although I also produce the lactase gene (23&me) and am Northwestern European descent so less likely to genetically be predisposed with lactose intolerance.
My crohns is in my small bowel but when I got tested to see if I was lactose intolerant the result was negative.
05-05-2016, 10:00 PM   #18
wildbill_52280
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I'm not so sure that the connection between lactose and ibd symptoms has anything to do with lactase enzyme production, it may be related to e.coli bacteria in our guts, and possibly other pathogens, that have the lac operon gene which allows them to use lactose to grow and create more symptoms like inflammation and diarhea. Lactose and sucrose and other simple sugars increases my symptoms, so this is one theory as to why it seems to do so. I have crohns and it affects my small intestine and colon.
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