MAP - Mycobacterium avium paratuberculosis bacteria
by Lydia D.
This is in response to Peter Bray's post from 22nd March under the thread "Crohn's Disease - Under the knife"
Peter, I have done a fair amount of research in this area and it is clear that MAP infection is not found in the entire Crohn's population. There have been numerous clinical studies done on MAP and Crohn's, but the medical fraternity in general is not convinced that MAP has a key role.
One would expect the prevalence of Crohn's to be higher in the countryside, but it is not. MAP can survive for a relatively long time in animal slurry, the ground, run-off water, etc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC404446/
Crohn's disease is also not higher in countries that have a tradition of eating or drinking unpasteurised dairy products, such as France and Italy. It is, however, higher in Scandinavian countries and in certain other populations. For example, Ashkanazi Jews and smokers.
Passive smoking also significantly increases the risk for Crohn's. Alcohol and street drugs (as toxins) may also play a part in exacerbating Crohn's disease in certain patients. http://health.msn.com/health-topics/digestive-health/ibd-and-crohns/gene-mutations-linked-to-crohns-disease-in-ashkenazi-jews
There are, however, some who are convinced that MAP does have a main role in Crohn's patients with proven MAP infection. As you are aware, Prof. John Hermon-Taylor is a key UK opinion leader in this area. http://www.crohns.org/council/hermon-taylor.htm
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2803%2900724-2/abstract
However, it is clear that one size does not fit all and the triple antibiotic therapy does not work in all patients.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654961/?tool=pmcentrez
http://www.crohns.net/Miva/education/articles/Microbial_Factors.shtml
From my reading, genetic susceptibility, epigenetics and lifestyle would appear to be major factors in the triggering of Crohn's disease. You might like to watch the following videos on epigenetics:
https://www.youtube.com/watch?v=kp1bZEUgqVI
https://www.youtube.com/watch?v=toRIkRa1fYU
I read about your sad loss. Unfortunately, your daughter had severe, refractory illness and was very sensitive to the medication. It is a very nasty illness in its severe form. I really admire the fact that you are continuing to help Crohn's patients and giving us the benefit of your year-long experience in this area as a care-giver and father of Cathy; a young Crohn's patient who, sadly, is not longer with us. It is really commendable and I, for one, thank you very much.