Crohn's Disease/Syndrone
(may also apply to other bowel problems)
I won’t go into any medical descriptions of the condition since you probably wouldn’t be reading this if you didn’t already have a diagnosis.
Also, some doctors are now recognizing this treatment option but I know that not all are aware of it or are willing to try it. While they dither, you suffer.

Traditionally
Severe cases were treated by surgery which results in considerable problems even when 100% successful, or immunosuppressive agents.
Milder cases are treated with a change of diet and steroids (which cause many problems.)
These treatments are based on the theory that the inflammation (which is the actual problem patients face) is caused by the person’s body rejecting parts of itself.
There are autoimmune diseases, and, in perhaps 30% of the cases, Crohn’s Disease (used to be called Crohn’s Syndrone – a sure indication that little is actually known about it) may well be an autoimmune condition.

New Research
Recent research shows that it is extremely likely, almost to the point of scientific certainty, that in about 70% of Crohn’s cases the inflammation is caused by an infection in much the same way that stomach ulcers are now known to mostly be caused by an infection.
`Everyone has the bacteria which causes these problems but not everyone experiences the problem for various reasons, probably mostly due to genetic variations.
What’s my evidence?
Simple, many cases of Crohn’s can quickly be put in remission by a simple course of antibiotics.
Also, traces of the particular infections agent (bacteria) are found in large amounts in many Crohn’s patients but not in the general population.
So, if you have a diagnosis of Crohn’s, you can either opt for surgery and dangerous immunosuppressive drugs or surgery/diet and steroids, or try to talk your doctor into letting you try a relatively safe antibiotic for 30 days to see if that puts you in complete remission.
I consider it a no-brainer since you can always go back to the traditional therapies later if the antibiotics fail.

Brief Details
Researchers gave proven Crohn’s patients with an active disease process, Cipro and Metranidazol for 30-60 days and about 70% of them quickly went into remission.
Later research showed that the more dangerous Metranidazol wasn’t necessary.
Cipro isn’t inexpensive or a pleasant drug to take, but it is a lot better than having active Crohn’s and, if it works, you only take it occasionally for limited periods, this isn’t an ongoing treatment.
I have also found evidence of an actual cure for Crohn’s but it is very expensive, not available in the U.S., and the results aren’t conclusive so I am not reporting on that YET.
The suspected infection is Mycobacterium avium paratuberculosis (MAP).

Treatment
You definitely need to do this under a doctor’s supervision, but the basic treatment is to take Cipro 500 mg twice daily for up to 6 months. (It may only take about 30 days for significant results to be seen.)

IMPORTANT NOTE: Cipro and metronidazole cannot be given to children because they can cause cartilage and liver damage. Research shows that clarithromycin can control Crohn's disease in children.

If your condition makes it inadvisable to take Cipro, the full antibiotic treatment options are:

Treatment options 6 months duration

Rifabutin 150 mg twice daily
Clarithromycin (Biaxin) 500 mg twice daily

Or

Cipro 500 mg twice daily
Metronidazole 250 mg four times daily on alternate weeks
Check liver function monthly if taking Metronidazole.



Brief Evidence
Prantera C, Berto E, Scribano ML, Falasco G.

Division of Gastroenterology, Nuovo Regina Margherita Hospital, Rome, Italy, published the results of a study of 233 patients in Ital J Gastroenterol Hepatol. 1998 Dec;30(6):593-8.
The patients all had active Crohn's disease and were treated with metronidazole and/or ciprofloxacin (cipro) (1 g daily each) during the period of 1984-1996.
Success was considered achieved if there was total or partial remission of the active Crohn’s.
Similar rates of remission occurred in the three test groups. 70.6% for those who got both antibiotics, 72.8% with metronidazole, 69.0% with ciprofloxacin (cipro) alone.
In about 60% pain, diarrhea, fever, and abscesses were reduced.
Remission lasted on average of about one year.
Their conclusion was that “these results strongly support the important role of faecal flora in causing Crohn's disease symptoms.”
That is pretty compelling evidence which is supported by other studies. The differences between the combination treatment and the treatment with Cipro alone are statistically insignificant and Cipro is the safer drug.


Two-year outcomes analysis of Crohn's Disease treated with rifabutin and macrolide antibiotics.
G.P.H. Gui, P.R.S.Thomas, M.L.V.Tizard, J.Lake, J.D.Sanderson and J.Hermon-Taylor.   University Department of Surgery, St Georges Hospital Medical School, Cranmer Terrace, London SW17 0RE, U.K.
Source: J Antimicrob Chemother 1997 Mar;39(3):393-400
Abstract.
Fifty-two patients with severe Crohn's disease were enrolled in this study. Six (11.5%) were intolerant of the medication and had to be excluded. The remaining 46 patients were treated with rifabutin in combination with a macrolide antibiotic(clarithromycin or azithromycin). Patients were treated for a mean of 18.7 (range 6-35) months and followed up for 25.1 (range 7-41) months. Of the 19 patients who were steroid dependent at the start of this study, only two continued to require steroids when treatment was established. A reduction in the Harvey-Bradshaw Crohn's disease activity index occurred after 6 months treatment (P = 0.004, paired Wilcoxon test) and was maintained at 24 months (P < 0.001). An improvement in inflammatory parameters was observed as measured by a reduction in erythrocyte sedimentation rate (P = 0.009) and C-reactive protein (P = 0.03) at 18 months compared with pretreatment levels, and an increase in serum albumin at 12 months (P = 0.04). When subsets of the study population were analyzed, patients with pan-intestinal disease achieved better remission at 2 years than did those with less extensive involvement (P = 0.04, Mann-Whitney U-test). No difference in treatment response by age, disease duration, the presence of granulomas on histology, or the occurrence of drug-induced side-effects was observed. These data suggest that treatment with rifabutin and clarithromycin may result in a substantial clinical improvement in Crohn's disease and justify the conduct of a randomized controlled trial.


Another study published in Gastroenterology 118(4): A4182 (2000) (not available online at this time) showed a 77% remission rate when treating Crohn's patients as if they actually had a MAP infection.



Additional  Important Information

Here are the Medline (National Institutes of Health) notes on taking
Clarithromycin
For prevention or treatment of Mycobacterium avium complex (MAC) infection:
Adults and teenagers--500 mg two times a day.
Children 6 months of age and older--7.5 mg per kg (3.4 mg per pound) of body weight, up to 500 mg, two times a day.
Infants up to 6 months of age--Use and dose must be determined by your doctor.
This is also used to treat stomach ulcers caused by Helicobacter pylori but that is a common treatment so I’m not doing a report on ulcers.

Again from MedlineThings to watch for when taking Cipro:

Fluoroquinolones (Cipro)

Precautions
Avoid sunlight
Avoid antacids
Watch for skin rash, dizziness, etc.
Tendonitis
Slow heart rate

That’s the basics. I have extensive references based on serious clinical trials which have been conducted in Canada, Italy, Australia, and England but the results all agree.

If you find a doctor who is resistant to trying Cipro therapy (I think it is the safest and most effective antibiotic for this treatment), contact me and I can provide extensive research notes. 

I am NOT providing medical advice or selling information, simply compiling and publishing research from published and moderated professional journals.



Copyright, 2005, John A. McCormick, Inc.
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This page was last updated: March 26, 2010