Antibiotics For Long-Term Crohn's Treatment :shock:

[tex]

Hi All,

This study compared and analyzed data from 13 different antibiotic treatment regimens which have been tried for Crohn's patients. They found a couple of antibiotics to be effective:

Three trials of nitroimidazoles (206 patients) showed a significant benefit (odds ratio, 3.54), the researchers note, as did 4 trials of clofazimine (322 patients; OR, 2.86).

Their conclusions:

"We believe that further research is justified to better define the role of antibacterial agents and combination regimens in Crohn's disease," the investigators say. "Future studies should focus on clofazimine, alone or in combination with a macrolide and a rifamycin, as well as in combination with a nitroimidazole, and perhaps ciprofloxacin."

OK, look at what they found to be effective:

nitroimidazoles - this class of antibiotics has been found to be especially effective against the three most medically important anaerobic protozoan parasites, Giardia, Trichomonas, and Entamoeba.

clofazimine - this is a fat-soluble riminophenazine dye, used in combination with rifampicin and dapsone, as multidrug therapy (MDT) for the treatment of leprosy. It has been used investigationally in combination with other antimycobacterial drugs to treat Mycobacterium avium infections in AIDS patients and Mycobacterium avium paratuberculosis infection in Crohn's disease patients. Clofazimine also has a marked anti-inflammatory effect and is given to control the leprosy reaction, erythema nodosum leprosum (ENL).

Note that certain macrolide antibiotics have been shown to be effective against mycobacteria, and ciprofloxacin is a broad-spectrum antibiotic that we on this board have found to be consistently effective for bringing temporary remission from the diarrhea associated with MC.

So, there seems to be some interest in pursuing the treatment of Crohn's disease, from the aspect of possible MAP involvement. How about that?

http://www.medscape.com/viewarticle/716394

Tex

[Polly]

Hi Tex,

This is REALLY interesting. It validates some of our own experiences and theories, doesn't it? Now if we could get more infectious disease and GI docs researching together, we might be on to something.

It strikes me that the kind of infectious agents we have been discussing lately are parasites (MAP, protozoa - like what Cristi has been dealing with). These bugs seem not to ever be fully eradicated like the "usual" type of bacterial infections like strep, staph, etc. It seems the antibiotics quiet them down for a while, but it's only a matter of time before something triggers them to rear their ugly heads again.

Thanks for sharing.

Love,

Polly

[tex]

It strikes me that the kind of infectious agents we have been discussing lately are parasites (MAP, protozoa - like what Cristi has been dealing with). These bugs seem not to ever be fully eradicated like the "usual" type of bacterial infections like strep, staph, etc. It seems the antibiotics quiet them down for a while, but it's only a matter of time before something triggers them to rear their ugly heads again.

Before effective antibiotics were developed, nothing could cure leprosy. People who suffered from the disease were isolated and developed severe disfigurements. Today, doctors prescribe antibiotics to cure leprosy and kill Mycobacterium leprae (the bacteria that cause the disease). The three most commonly used antibiotics are rifampin, dapsone, and clofazimine. Because Mycobacterium leprae can be resistant to these medications individually, a combination is often used.

http://diseases.emedtv.com/leprosy/cure-leprosy.html

Apparently, a 99.9% cure rate is now a reality for leprosy, though treatment must be continued for one to two full years, in order to accomplish that. Imagine what something like that would mean for all the Crohn's sufferers in the world - a complete cure. Presumably, that would apply to the other IBDs as well.

Love,
Tex

[ant]

Wow, this is fascinating!

It certainly fits with the way I reacted positively to antibiotics to stop D for a few years before my chronic D and Dx MC. And since then the temporary relief from D when on antibiotics once or twice.

One thought is that if I have a MAP in my system all the antibiotics I have had over the years has now made it a "Super" MAP?

Thanks, Love Ant

[Gabes-Apg]

Super Map?
or mother in law map (gets worse every time it comes to visit!!!)
or or mouse map (hides out really well and when you find it, huge mess and difficult to get rid of)

[Polly]

Ant,

Super MAP is a real possibility, I'd guess, knowing how resistance works.

Gabes, you are so funny!

This whole issue is a double-edged sword, isn't it? The classic thinking is that colitis results because of the imbalance between the "good" and "bad" bacteria in the colon. Something (like certain antibiotics) destroys the good, allowing the bad to predominant and cause all of that inflammation and distress we experience. So maybe "regular" antibiotics, the usual penicillin, sulfa, etc., kill off good bacteria and allow the bad (think MAP) to overgrow. But maybe if we use the appropriate antibiotics (the ones Tex cited in that article) and just tackled the MAP, that's the answer. It's hard to imagine taking antibiotics over many years, though, isn't it?

And here's another thought. If I remember correctly, when I took Cipro (longterm for sinus problems) I could eat my intolerances without any problem. Of course I didn't try gluten, but eggs and other things were suddenly OK. Now why would this be??? (Dr. Fine says that MC and gluten intolerance are on the same gene, and the former "turns on" the latter. How would Cipro change this???)

We definitely need a new paradigm for understanding MC, don't we?

Love,

Polly

[tex]

And here's another thought. If I remember correctly, when I took Cipro (longterm for sinus problems) I could eat my intolerances without any problem. Of course I didn't try gluten, but eggs and other things were suddenly OK. Now why would this be???

Hmmmmm. I never devoted any thought to that before, but by golly, you're right. Back when I took Cipro, (a couple of two-week regimens), I knew nothing about food intolerances, and so I was still eating gluten, and anything else that struck my fancy. Almost immediately, though, once I started taking the Cipro, my reaction stopped, and didn't return until a few days after the Cipro treatments ended, even though I was eating gluten, dairy, etc. Thinking back, though, I vividly remember that my BMs were very unique. They were sort of bright yellow, (kinda like baby poop), and full of small gas bubbles. They were formed, and yet not rigid - IOW, they seemed sort of "fluffy". Is that typical of "Cipro poop"?



Love,
Tex

[Gabes-Apg]

wouldnt the cipro be more like a bandaid rather than a cure.

it just stops or minimises the body reactions. the original issue is still there under the band aid

[tex]

Yes, because you have to continue taking it, in order to stay in remission. (just like any other med). However, as long as you continue to take it, you will be in remission from symptoms. It works much faster than Entocort, or most of the other meds, too, but the reason why it is not a practical treatment option, is because it creates a high risk of tendonitis, or even a torn ligament, (often the Achilles tendon), especially if it's taken long-term.

Tex

[Polly]

Good morning, good buddies!

OK, after I made that comment above about my concern about taking longterm antibiotics, I did a little research to see if there were any natural compounds known to kill MAP.

And I found an article titled "Antibacterial Activities of Naturally-Occuring Compounds against MAP".

Check out www.ncbi.nlm.nih.gov/pmc/articles/PMC2565950/

It appears that cinnamon in 2 different forms (trans-cinnaldehyde and cinnamon oil) was the most effective against mycobacteria avium paratuberculosis (MAP). I think cinnamon oil is readily available, as of course, is the powdered cinnamon spice. Of course, the compounds in this study were tested "in vitro" (in a test tube outside the body) and that does not necessarily mean that they would be effective "in vivo" (inside the body) but it is certainly possible.

So what do you think? I would not want to officially recommend that anyone try this as an MC treatment, and of course, we have no idea about what amount (dose) might be effective in the body, but I think I might want to look for opportunities to add more cinnamon to my diet.

Love,

Polly

[ant]

Well cinnamon tests good too. It is great spice for all sorts of uses.


love ant

[Rosie]

Polly, did you look hard to see if chocolate also kills MAP? I'd like an excuse to up my intake.............

Polly wrote:

and of course, we have no idea about what amount (dose) might be effective in the body

Cinnamon looks like the "wonder spice". Here is something I found, and that also gives a place to start with amount to take: 1/2 teaspoon cinnamon powder mixed with 1 tablespoon honey once a day.

10 Health Benefits of Cinnamon

Studies have shown that just 1/2 teaspoon of cinnamon per day can lower LDL cholesterol.

Several studies suggest that cinnamon may have a regulatory effect on blood sugar, making it especially beneficial for people with Type 2 diabetes.

In some studies, cinnamon has shown an amazing ability to stop medication-resistant yeast infections.

In a study published by researchers at the U.S. Department of Agriculture in Maryland, cinnamon reduced the proliferation of leukemia and lymphoma cancer cells.

It has an anti-clotting effect on the blood.

In a study at Copenhagen University, patients given half a teaspoon of cinnamon powder combined with one tablespoon of honey every morning before breakfast had significant relief in arthritis pain after one week and could walk without pain within one month.

When added to food, it inhibits bacterial growth and food spoilage, making it a natural food preservative.

One study found that smelling cinnamon boosts cognitive function and memory.

Researchers at Kansas State University found that cinnamon fights the E. coli bacteria in unpasteurized juices.

10. It is a great source of manganese, fiber, iron, and calcium.

Should be interesting to try....under the category of "can't hurt, might help".

Rosie

[tex]

Polly,

Needless to say, that was a great find. Thanks for sharing that information.

I believe we've discussed some of cinnamon's therapeutic qualities before, but never with regard to MAP.

Here's a pretty good overview from the Memorial Sloan-Kettering Cancer Center, which provides some guidelines on the use of cinnamon, including indications, warnings, side effects, contraindications, and supporting research, and it also mentions some of the benefits that Rosie listed, along with a few details, and references:

http://www.mskcc.org/mskcc/html/84132.cfm

Apparently the essential oil of cinnamon bark, (that you referred to), is about 90% cinnamaldehyde. There are some interesting links there, such as this one, showing how cinnamaldehyde can be used to "overcome" the resistance of C. diff to the antibiotic clindamycin. Of course, this is another "in vivo" study, but still, the results are very interesting.

http://www.ncbi.nlm.nih.gov/pubmed/1799 ... t=Citation

It also has been shown to inhibit lymphocyte proliferation, and modulate T-cell differentiation:

http://www.ncbi.nlm.nih.gov/pubmed/9848 ... t=Citation

And, here's some interesting "trivia", from Wikipedia:

Cinnamaldehyde is an effective insecticide, and its scent is also known to repel animals like cats and dogs.[5] Cinnamaldehyde has recently been recognized as a very effective insecticide for mosquito larvae.[6] As little as 29 ppm (parts per million) of cinnamaldehyde kills half of Aedes aegypti mosquito larvae in 24 hours.[7][8]

29 ppm is a pretty low dose, so that's a pretty impressive potency.

Love,
Tex

[cludwig]

Hi Friends,

I started the herbal parasite medication yesterday and am already noticing less bloating and cramping. The herbs are as follows....artemesia annua, oil of oregano, garlic powder, black walnut, grapefruit seed extract, pumpkin seed, bromelain and papain. Way, way too soon to say...but a good start anyway. I am not ruling out antibiotics if I can't get them under control...cross that bridge when I get to it. I feel confident that I could tolerate a smaller maintenance dose...I took two pills yesterday but have to get up to 6 per day.

Polly...the DNA stool test that I took also measure the beneficial gut bacteria like bifido and lactobacillus and these really took a hit after my antibiotic use...especially the bifido. The only probiotic I seem to be able to tolerate is the VSL. It comes in a pouch and recommends using the whole pouch. I take a quarter teaspoon with every meal and seem to be able to tolerate the teeny doses although I can't say I notice any benefit...just no adverse effects. I often wonder for the bifido if probiotics in suppository form wouldn't be more effective and wouldn't have to mess with the stomach and small intestine. Probably most people would not want to go this route.

Tex...I didn't realize anyone else had noticed small gas bubbles in their poop. I have had this since I got sick in 2005. Some people thought this was from yeast but I always test negative for yeast. Also babies will have bubbles in their poop when they have not developed the pancreatic enzyme necessary to digest carbohydrates. Do you know of any other explanations for bubbles in feces?

We've been talking about the role of stress and cortisol and their effect on the immune system. When discussing alternatives to long term antibiotics to treat parasites....balancing and getting one's immune system functioning correctly may prove to help as the rest of the population has been exposed to these same parasites but are functioning better than we are. I am in the middle of reading an amazing book called Why Do I Still Have Thyroid Symptoms by Datis Kharrazian. It is only partially about the thyroid...his biggest advise is to eliminate gluten...but the main point of the book is about understanding the TH1 and TH2 sides of the immune system and very clear explanations of how one side can come to dominate and interesting clues for you to see which side is the over stimulated side for you.

I remember you, Tex saying that you thought that sugar consumption may have been a contributing factor for you. This book discusses how minor glucose problems can really escalate cortisol levels which directly affects the immune system. He advocates using herbs and vitamins to get the immune system functioning in a more balanced way. I used to be a person who thought we should all get our vitamins and minerals from eating the correct foods...but I am now thinking that may be okay for young people but that us with our compromised digestive systems simply are not able to digest and absorb properly. Every test that I have had finds nutritional deficiencies even though I eat well. I think it just escalates as we get older.

He also advocates for vitamin D saying that it is good for the immune system regardless of whether you are Th1 or Th2 dominant.


Sorry to go on and on....but I really love this book.

Love,
Cristi

[Gabes-Apg]

will the cinnamon work for mother in laws as well????