Australian doc says infection is at root of Crohn's disease -- Newsday.com

In the tradition of an Australian Nobel-Prize winner who bucked the establishment, another doctor from down under insists Crohn's disease, an inflammatory bowel disorder, is caused by renegade microbes.

Two decades ago, Dr. Barry Marshall proved bacteria cause stomach ulcers by drinking a vial of Helicobacter pylori, developing ulcers - then curing himself with antibiotic therapy, forever ending what had prevailed as medical wisdom that stress causes ulcers.

Now, fellow Aussie Dr. Thomas Borody, who recently was awarded the Marshall Prize in Australia for innovative scientific research and who will lecture next week on Long Island, has proposed that Crohn's disease, is caused by Mycobacterium avium paratuberculosis (or MAP for short). The microbe is a distant relative of the tuberculosis and leprosy bacteria.

Borody, director of the Centre for Digestive Diseases in Sydney, believes patients can achieve relief with a triple drug regimen he has devised and routinely prescribes.

"What we're dealing with is the Helicobacter phenomenon all over again," Borody said in a telephone interview. "The medical community believes that Crohn's is caused by an overreactive immune system. But they're stuck in their ways, just as they were with the idea that stress caused ulcers. This is another one of those things that is so obvious. What we're saying is that Crohn's disease is most likely caused by an infection."

Over the past 20 years he has conducted a series of studies showing not only the presence of bacteria in Crohn's patients, but that all tend to respond to these three antibiotics: rifabutin, clarythromycin and clofazimine. He will report on data from 213 of his patients at an unusual venue for a medical presentation: the Suffolk Y Jewish Community Center in Commack at 7 p.m. Monday.

Borody is expected to report that as many as 95 percent of his patients have responded to treatment. He was invited to speak at the Y by the organization's director of community affairs, Kelly Alpert Vest, herself a Crohn's patient for 20 years.

After her own exhaustive research, Vest said when she sought Borody's triple-drug therapy she was turned down by doctors on Long Island and in Manhattan. She ultimately sought treatment in Texas and says she has improved dramatically.

"I invited him to speak because there is a dearth of information out there about MAP and I discovered a lot of resistance to even considering the treatment when I approached the established medical community," Vest said. The Crohn's and Colitis Foundation of American defines Crohn's as chronic inflammation of the gastrointestinal tract that can involve any area from the mouth to the anus.

The disease can lead to ongoing bouts of abdominal pain, diarrhea and tears in the intestinal lining that often bleed. American Jews of European descent are four to five times more likely to develop Crohn's and other inflammatory bowel disorders than the general population. And while all inflammatory bowel conditions have long been thought of as conditions largely affecting whites, there has been a steady increase among blacks.

But conventional medical wisdom holds that an immune system out of whack bombards the gastrointestinal tract. Borody, on the other hand, said the notion of a bacterial cause was first postulated as early as 1913. It has taken until now to prove that antibiotics work.

Dr. Ramona Rajapakse, an assistant professor at Stony Brook University Hospital and a specialist in inflammatory bowel disorders, said there were tests in the past involving antibiotics, which proved negative. She added that ciprofloxacin, the antibiotic used to treat anthrax, is often prescribed for Crohn's because it is a powerful anti-inflammatory agent.

"Patients have actually brought information to me about [Borody]," Rajapakse said, "especially patients in the Jewish community. I explain to them that it's a theory, it's not proven and it's a theory that has been in existence for a long time." Current treatments include anti-inflammatory drugs and others that control the immune system.