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Body Changes Detected Up To Eight Years Before Inflammatory Bowel Disease Diagnosis
Researchers at the Francis Crick Institute and Aalborg University in Copenhagen have shown that changes can be detected in blood tests up to eight years before a diagnosis of Crohn's disease and up to three years before a diagnosis of ulcerative colitis.
This means the beginnings of inflammatory bowel diseases start a long time before symptoms occur, and in the future may provide an opportunity for doctors to take preventative action before symptoms begin, or prescribe medication when it will be most effective.
Crohn's disease and ulcerative colitis are collectively known as inflammatory bowel diseases (IBD). They are incurable conditions which involve excessive inflammation in the gut, leading to symptoms like abdominal pain and diarrhea. Early diagnosis and treatment are key to improving outcomes, but nearly a quarter of the 25,000 people diagnosed each year in the UK wait over a year.
In their study published in Cell Reports Medicine, the team used electronic health records from people in Denmark, comparing 20,000 people with an IBD diagnosis with controls from 4.6 million people without IBD.
It was previously thought that most people have symptoms for about a year before diagnosis, but significant bowel damage is often seen, suggesting that changes have been taking place for a lot longer.
The researchers confirmed this by looking at 10 years of test results before diagnosis. They observed changes in a series of minerals, cells in the blood and markers of inflammation, such as fecal calprotectin, a molecule released into the gut during inflammation and currently used to determine which people with bowel symptoms need further investigations. These changes were observed up to eight years before diagnosis in Crohn's disease and three years in ulcerative colitis.
Importantly, most of the changes observed were subtle and would have appeared within a normal range for standard blood tests, so wouldn't have been flagged as a cause for concern. It required a huge dataset to be able to detect these changes across many different markers.
The researchers' next steps are to investigate if treatment or prevention has an impact before people get symptoms, and whether the findings from this research could be developed further to predict who will develop IBD in the future.
First author, Marie Vestergaard, Ph.D. Student at the Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, at Aalborg University, said, "So many young people are affected by IBD. Their lives, hopes and aspirations for the future are turned upside down by a diagnosis and trying to live with a chronic disease. As a young person myself, it gets me. I am happy that our research might help predicting who could potentially suffer from IBD and thus start treatment earlier which would greatly improve their quality of life."
James Lee, Group Leader of the Genetic Mechanisms of Disease Laboratory at the Crick, said, "Our research shows that the bowel damage we're seeing at the point of diagnosis is just the tip of the iceberg. So many changes are subtly taking place in the body before the disease takes hold.
"This has huge implications for prevention as it highlights that there's a window of opportunity for treatment. We don't yet know whether preventative measures like changing diet or stopping smoking would stop someone getting these diseases, but this opens the door to that possibility. It also underscores the importance of early diagnosis and treatment, as many of the changes in the gut are likely to have been happening long before people become ill."
Tine Jess, Director at the Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, at Aalborg University, said, "Our findings are novel and go hand-in-hand with emerging evidence that chronic inflammatory bowel diseases likely have their onset years prior to diagnosis."
"These incurable diseases affect young individuals and are twice as common as type 1 diabetes. Understanding the exact mechanisms behind their development is essential to ultimately prevent the diseases from occurring. Our unique Danish data resources combined with cross-disciplinary and international collaboration help answering yet unanswered questions critical for patients worldwide."
Sarah Sleet, CEO of Crohn's & Colitis UK, said, "There are over 500,000 people in the UK with Crohn's and Colitis. We know that earlier diagnosis leads to better outcomes for everyone, but waiting lists for diagnostic tests can be long. Not only that, many people put off going to the GP to get their symptoms checked out—either because they don't realize how serious they could be, or through fear or embarrassment. Anything that could potentially speed up the process of getting an accurate diagnosis is a hugely positive step in the right direction."
More information: Vestergaard, M. Et al, Characterising the pre-clinical phase of inflammatory bowel disease, Cell Reports Medicine (2023). DOI: 10.1016/j.Xcrm.2023.101263. Www.Cell.Com/cell-reports-medi … 2666-3791(23)00440-8
Citation: Body changes detected up to eight years before inflammatory bowel disease diagnosis (2023, November 7) retrieved 29 November 2023 from https://medicalxpress.Com/news/2023-11-body-years-inflammatory-bowel-disease.Html
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Everything You Need To Know About Inflammation
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Inflammation is a key aspect of the body's immune defenses. It can be acute or chronic. Symptoms can include swelling, heat, pain, and more. Treatments can depend on the underlying cause.
The body may send cells to defend against a foreign body, such as a thorn, an irritant, or a pathogen. Pathogens include bacteria, viruses, and other organisms, which cause infections.
Sometimes, the body mistakenly perceives its own cells or tissues as harmful. This reaction can lead to autoimmune diseases, such as type 1 diabetes.
Experts believe inflammation may contribute to a wide range of chronic diseases. Examples of these are metabolic syndrome, which includes type 2 diabetes, heart disease, and obesity.
People with these conditions often have higher levels of inflammatory markers in their bodies.
In this article, find out more about why inflammation happens, its symptoms, and ways to resolve it.
There are two main types of inflammation: acute and chronic.
Acute inflammationAn injury or illness can involve acute, or short-term, inflammation.
There are five key signs of acute inflammation:
These signs are not always present. Sometimes inflammation is "silent," without symptoms. A person may also feel tired, generally unwell, and have a fever.
Symptoms of acute inflammation last a few days. Subacute inflammation lasts 2–6 weeks.
Chronic inflammation can continue for months or years. It either has or may have links to various diseases, such as:
The symptoms will depend on the disease, but they may include pain and fatigue.
Measuring inflammationWhen inflammation is present in the body, there will be higher levels of substances known as biomarkers.
An example of a biomarker is C-reactive protein (CRP). If a doctor wants to test for inflammation, they may assess CRP levels.
CRP levels tend to be higher in older people and those with conditions such as cancer and obesity. Even diet and exercise may make a difference.
Inflammation happens when a physical factor triggers an immune reaction. Inflammation does not necessarily mean that there is an infection, but an infection can cause inflammation.
Acute inflammationAcute inflammation can result from:
When the body detects damage or pathogens, the immune system triggers a number of reactions:
Signs of acute inflammation can appear within hours or days, depending on the cause. In some cases, they can rapidly become severe. How they develop and how long they last will depend on the cause, which part of the body they affect, and individual factors.
Some factors and infections that can lead to acute inflammation include:
Chronic inflammationChronic inflammation can develop if a person has:
Sensitivity: Inflammation happens when the body senses something that should not be there. Hypersensitivity to an external trigger can result in an allergy.
Exposure: Sometimes, long-term, low-level exposure to an irritant, such as an industrial chemical, can result in chronic inflammation.
Autoimmune disorders: The immune system mistakenly attacks normal healthy tissue, as in psoriasis.
Autoinflammatory diseases: A genetic factor affects the way the immune system works, as in Behçet's disease.
Persistent acute inflammation: In some cases, a person may not fully recover from acute inflammation. Sometimes, this can lead to chronic inflammation.
Factors that may increase the risk of chronic inflammation include:
Long-term diseases that doctors associate with inflammation include:
Inflammation plays a vital role in healing, but chronic inflammation may increase the risk of various diseases, including some cancers, rheumatoid arthritis, atherosclerosis, periodontitis, and hay fever.
The following table summarizes some key differences between acute and chronic inflammation.
It is essential to identify and manage inflammation and related diseases to prevent further complications.
Acute inflammation can cause pain of varying types and severity. Pain may be constant and steady, throbbing and pulsating, stabbing, or pinching.
Pain results when the buildup of fluid leads to swelling, and the swollen tissues push against sensitive nerve endings.
Other biochemical processes also occur during inflammation. They affect how nerves behave, and this can contribute to pain.
Treatment of inflammation will depend on the cause and severity. Often, there is no need for treatment.
Sometimes, however, not treating inflammation can result in life threatening symptoms.
During an allergic reaction, for example, inflammation can cause severe swelling that may close the airways, making it impossible to breathe. It is essential to have treatment if this reaction occurs.
Without treatment, some infections can enter the blood, resulting in sepsis. This is another life threatening condition that needs urgent medical treatment.
Acute inflammationA doctor may prescribe treatment to remove the cause of inflammation, manage symptoms, or both.
For a bacterial or fungal infection, for example, they may prescribe antibiotics or antifungal treatment.
Here are some treatments specifically for treating inflammation:
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) will not remove the cause of inflammation, but they can help relieve pain, swelling, fever, and other symptoms. They do this by countering an enzyme that contributes to inflammation.
Examples of NSAIDs include naproxen, ibuprofen, and aspirin. These are available to purchase online or over the counter. People should check first with a doctor or pharmacist to ensure they make the right choice.
People should only use NSAIDs long term if a doctor recommends them, as they can have adverse effects. Aspirin is not suitable for children.
Pain relief: Acetaminophen, including paracetamol or Tylenol, can relieve pain but does not reduce inflammation. These drugs allow the inflammation to continue its role in healing.
Corticosteroids
Corticosteroids, such as cortisol, are a type of steroid hormone. They affect various mechanisms involved in inflammation.
Corticosteroids can help manage a range of conditions, including:
They are available as pills, injections, in an inhaler, or as creams or ointments.
Long-term use of corticosteroids can be harmful. A doctor can advise on their risks and benefits.
Treatment for diseases that involve long-term inflammation will depend on the condition.
Some drugs act to repress the body's immune reactions. These can help relieve symptoms of rheumatoid arthritis, psoriasis, and other similar autoimmune reactions. However, they can also leave a person's body less able to fight an infection if it occurs.
People who have undergone transplant surgery also need to take immunosuppressant drugs to prevent their bodies from rejecting the new organ. They, too, need to take extra care to avoid exposure to infections.
Various herbal supplements may help manage inflammation.
Harpagophytum procumbens: Also known as devil's claw, wood spider, or grapple plant, this herb comes from South Africa and is related to sesame plants. Some older research from 2011 has shown it may have anti-inflammatory properties. Various brands are available to purchase online.
Hyssop: People can mix this plant with other herbs, such as licorice, for the treatment of some lung conditions, including airway inflammation. However, the hyssop essential oil has led to life threatening convulsions in laboratory animals, so caution is necessary.
Ginger: People have long used ginger to treat dyspepsia, constipation, colic, and other gastrointestinal problems, as well as rheumatoid arthritis pain. Ginger is available fresh in groceries or online in supplement form.
Turmeric: Curcumin, the main ingredient in turmeric, may have benefits for arthritis, Alzheimer's disease, and some other inflammatory conditions. Supplements with turmeric and curcumin are available online.
Cannabis: A cannabinoid called cannabichromene may have anti-inflammatory properties. People should check first if cannabis-related products are legal where they live.
Learn more here about anti-inflammatory supplements.
These herbs are not approved by the Food and Drug Administration (FDA) for medicinal use. Always talk to a doctor before using any herbal or other supplements.
Some foods contain nutrients that may help reduce inflammation.
They include:
Studies have suggested that people with high levels of CRP may be less likely to follow a diet that is rich in fresh products and healthy oils, such as the Mediterranean diet.
The following may aggravate inflammation:
Diet alone will not control inflammation, but making suitable choices may help prevent it from getting worse.
Learn more here about the anti-inflammatory diet.
Below are some frequently asked questions about inflammation.
What are the five signs of inflammation?The five signs of acute inflammation are:
Three potential causes of acute inflammation are:
Treatment for inflammation may depend on the cause. However, people can also take steps such as eating an anti-inflammatory diet and taking herbal supplements, such as ginger or turmeric.
What is the fastest way to flush inflammation?Over-the-counter NSAIDs, such as naproxen (Aleve), ibuprofen (Advil), and aspirin can help to quickly relieve the symptoms of inflammation, such as pain and swelling. However, this treatment will not remove the cause of inflammation.
Inflammation is part of the process by which the immune system defends the body from harmful agents, such as bacteria and viruses. In the short term, it can provide a useful service, although it may also cause discomfort.
Long-term or chronic inflammation, however, can both lead to and result from some severe and possibly life threatening conditions.
People with tumors, rheumatoid arthritis, inflammatory bowel disease, drug reactions, and other health issues may have high levels of CRP, which is a sign of an inflammatory immune response.
As scientists learn more about the role of inflammation in disease, their findings could lead to more effective treatments for various illnesses that do not yet have a cure, such as type 1 diabetes.
What Does A Chigger Bite Look Like And How To Treat It
Chiggers, also known as red bugs, can bite humans, causing itchiness, inflammation, and skin discoloration. Symptoms typically resolve independently. Several treatments can help reduce irritation.
Read on to learn about chiggers, what their bite looks like, and how to treat the bites.
Chiggers are small mites from the Trombiculid family that inhabit woodland and grassy environments. When they're in larval form, they can latch onto human skin and cause irritation through their bites. Despite what you may have heard, they do not actually burrow into the skin.
As adults, chiggers are not parasitic. They are only a problem for humans when they're still in larval form.
Chigger larvae are very small, averaging between 1/120 and 1/150 inches in diameter, according to the American Osteopathic College of Dermatology (ACOD), which makes them hard to see.
They're most likely to attack exposed skin folds of the body or areas covered with tight clothing that they can penetrate.
These creatures feed on bits of skin, secreting a digestive enzyme, which causes intense itching and irritation. This condition is called trombiculiasis.
Where do chiggers bite?Chiggers will usually attach to clothing and migrate their way to the skin. They often show up on the:
Bites from chigger mites can cause:
You will not feel it when a chigger latches on, and you probably will not feel anything when it bites. However, most people report symptoms within hours of the bite.
The most problematic symptom of chigger bites is the intense itching and formation of bumps that may look like welts, blisters, pimples, or hives.
Chigger bites are most common in places where clothing fits tightly. Most chigger bites occur around the ankles, waist, armpits, crotch, or behind the knees.
ComplicationsDisease transmission via chigger bites is an understudied area. However, chigger bites can transmit scrub typhus in rare cases. Scrub typhus can result in multiple organ failure and can be potentially fatal without treatment.
The transmission of other diseases is possible, but evidence in this area is lacking.
Chigger bites are largely seasonal in the Northern Hemisphere. The larval mites mature between June and September, making trombiculiasis most common in the summer and fall. In more tropical regions around the world, chigger mites feed year-round.
Common areas where you may be subject to chigger bites include overgrown grassy areas, forests, or moist ground near bodies of water.
Chigger bites can be distinguished from other common arthropod bites in certain ways.
Bed bug bites tend to occur in a clustered or zigzag formation in raised red bumps, while chigger bites are more grouped around areas where tight clothing meets the skin and may show up as either flat or raised.
Flea bites and chigger bites occur in similar patterns and may resemble each other. The main difference is that chigger bites tend to be hard and scabby in the center.
Mosquito bites tend to be larger bumps that show up individually rather than in clusters.
Treatment focuses on symptom management, such as reducing itching and swelling.
The following remedies may help reduce inflammation and itching.
In more complicated situations, a professional may prescribe:
It can take up to 2 weeks for chigger bites to heal.
If you suspect you have chigger bites, immediately wash your skin with soap and water and clean any clothes you wear. This will get rid of any remaining chiggers on your body.
In the meantime, try to avoid scratching the area, as further breaks to the skin barrier can increase the risk of further infection. Apply an antiseptic to any welts.
Chiggers are often too small to be visible in grassland or woodland environments. As a result, preventive measures are typically general ones.
Avoid common chigger habitatsSpring, summer, and fall are prime times for chigger bites. When you're in wooded areas that may be chigger-infested, try not to brush up against vegetation. When hiking, walk in the center of the trails rather than along the sides.
Chiggers live in tall weeds and grass, berry patches, and wooded areas. They may be in your backyard, by the lake, and clustered along your favorite hiking trail. They are most active in spring, summer, and fall afternoons when temperatures are warm.
ClothingWear long sleeves and long pants that can be tucked into your socks or shoes. Use insect or tick repellent, especially around the tops of your shoes, shirt neck, cuffs, and waistband. Shower as soon as you go indoors. Wash your clothes in hot water.
It's important to see a doctor if your chigger bites do not subside in 2 weeks, if inflammation increases, or if you experience any symptoms of scrub typhus, such as:
Chigger bites can cause itchy, inflamed bumps on the skin. These larval mites are common in grassy and woodland environments and are often too small for you to notice them.
Symptoms of chigger bites typically resolve independently. Antihistamines, cold compresses, and anti-itch lotions can help manage symptoms.
If your symptoms do not resolve within 2 weeks, it's recommended that you schedule an appointment with a healthcare professional.
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