6 ms·

Is it well-established that IBD is caused by E Colli? Is it like a sensitivity to E Colli?

voxl 1y ago
We don't know. It's probably a combo of genetic factors and bacteria. It's at the very least complicated and multifaceted, because you can't just take a culture or biopsy of inflamed skin and say "A ha! This is clearly different!" All the most effective treatments try to turn off parts of the immune system, and even though have minor success with some patients going through multiple different immunosuppressants to find the right one, or even cocktail, that adequately manages the disease.
- smeej 1y ago
  It's also the case that there is a bewildering variety of things that get sort of lumped together as "IBD." Crohn's and ulcerative colitis are two of them, but there's no particular reason to assume inflammatory bowel diseases all have the same set of causes. Pretty much all of them are made worse by an e. coli infection, though, so a drug that can target just those bacteria is helpful! During my own IBD journey, I've managed to stump the heck out of two different teams of GIs. I had been diagnosed with UC by biopsy during colonoscopy, and then at my last colonoscopy, despite not having been on medication for more than two years, they determined not only that I don't have it now, but that I never did. They told me "remission" would look different from "this bowel has never had IBD." But they also insisted I had not been misdiagnosed. And yet they told me with a straight face that it is incurable. I had it in the past, confirmed by pathology. I don't have it now. And it's incurable. I give up. In the end, I don't care enough to fight them about the contradiction, because the part I most care about is the "I don't have it now" part, and we're all in agreement on that. (Note for any who are interested: I stopped medication after successfully reducing my inflammation markers within normal limits by eating the exact same thing for every single meal for 20 months with no cheating of any kind. They told me that shouldn't have been possible either, but it worked. And yes, it was as miserable as it sounds, but less miserable than living with UC.)
  - jgord 1y ago
    Any hypothesis for why eating only one thing would solve IBD ? Would that select for a particular biota / micro-fauna environment ? or cause less mechanical / chemical inflammation ? glad it worked in your case.
    - marginalia_nu 1y ago
      Not the person you're replying to, but my own IBD went away completely after I did keto for an extended period. This was a decade ago and it hasn't come back even as my diet returned to normal. In my n=1 experience, it seems maybe significant dietary changes can perturb the gut ecosystem out of whatever state corresponds to IBD.
      - Llamamoe 1y ago
        They sometimes can, but most properly gut-adapted microbes only have their relative prevalence reduced by diet changes, by and large people unfortunately tend to snap back once diet is discontinued. Ideally, you'd combine that with doing a stool transplant first, since it's the main thing (other than just antibiotics) that causes permanent compositional changes.
      - jinnko 1y ago
        I had a similar experience, i.e. strict keto for 9 months and fully came off meds with no signs of UC or asthma. UC came back after around 2 years and I don't remember how long before I had to start asthma meds again. I can no longer do keto though, each time I try I get palpitations now after around a week.
        marginalia_nu 1y ago
        Yeah my asthma went into remission as well, though this was also a period of my life when I was very physically active and in the best shape of my life, so it's hard to say what was the cause there.
    - smeej 1y ago
- ajuc 1y ago
  I have UC and it's obviously related to stress.
Herodotus38 1y ago
Not directly since we all have it. It’s a bit confusing from the article but basically they discovered an antibiotic which can target a narrower spectrum than before which will minimize messing up your natural flora and allow drug resistant enterobacter (e coli is a main species, but not the only one) to be over represented. There is an association with ibd and. microbiomes that have e coli over-represented. And there are some subtypes of e coli that appear to be associated, see: https://pubmed.ncbi.nlm.nih.gov/29141957/ https://pubmed.ncbi.nlm.nih.gov/29141957/
pazimzadeh 1y ago
not exactly but E. coli and other Enterobacteriaceae can actually use the inflammation to their advantage Inflammation release nitrates, which Enterobacteriaceae can use as a replacement for oxygen as a terminal electron acceptor They can also encroach more easily on the protective mucus layers, which are thinner and more porous during inflammatory conditions (which itself may be a result of a messed up microbiota, which is why broad-spectrum antibiotics are not a solution) These Enterobacteriaceae blooms in turn can cause inflammation, makes remission harder There has been some success in reducing inflammation levels in IBD by blocking some of the binding factors that E. coli uses to attach to the epithelium/mucus

voxl 1y ago

We don't know. It's probably a combo of genetic factors and bacteria. It's at the very least complicated and multifaceted, because you can't just take a culture or biopsy of inflamed skin and say "A ha! This is clearly different!" All the most effective treatments try to turn off parts of the immune system, and even though have minor success with some patients going through multiple different immunosuppressants to find the right one, or even cocktail, that adequately manages the disease.

smeej 1y ago
It's also the case that there is a bewildering variety of things that get sort of lumped together as "IBD." Crohn's and ulcerative colitis are two of them, but there's no particular reason to assume inflammatory bowel diseases all have the same set of causes. Pretty much all of them are made worse by an e. coli infection, though, so a drug that can target just those bacteria is helpful! During my own IBD journey, I've managed to stump the heck out of two different teams of GIs. I had been diagnosed with UC by biopsy during colonoscopy, and then at my last colonoscopy, despite not having been on medication for more than two years, they determined not only that I don't have it now, but that I never did. They told me "remission" would look different from "this bowel has never had IBD." But they also insisted I had not been misdiagnosed. And yet they told me with a straight face that it is incurable. I had it in the past, confirmed by pathology. I don't have it now. And it's incurable. I give up. In the end, I don't care enough to fight them about the contradiction, because the part I most care about is the "I don't have it now" part, and we're all in agreement on that. (Note for any who are interested: I stopped medication after successfully reducing my inflammation markers within normal limits by eating the exact same thing for every single meal for 20 months with no cheating of any kind. They told me that shouldn't have been possible either, but it worked. And yes, it was as miserable as it sounds, but less miserable than living with UC.)
- jgord 1y ago
  Any hypothesis for why eating only one thing would solve IBD ? Would that select for a particular biota / micro-fauna environment ? or cause less mechanical / chemical inflammation ? glad it worked in your case.
  - marginalia_nu 1y ago
    Not the person you're replying to, but my own IBD went away completely after I did keto for an extended period. This was a decade ago and it hasn't come back even as my diet returned to normal. In my n=1 experience, it seems maybe significant dietary changes can perturb the gut ecosystem out of whatever state corresponds to IBD.
    - Llamamoe 1y ago
      They sometimes can, but most properly gut-adapted microbes only have their relative prevalence reduced by diet changes, by and large people unfortunately tend to snap back once diet is discontinued. Ideally, you'd combine that with doing a stool transplant first, since it's the main thing (other than just antibiotics) that causes permanent compositional changes.
    - jinnko 1y ago
      I had a similar experience, i.e. strict keto for 9 months and fully came off meds with no signs of UC or asthma. UC came back after around 2 years and I don't remember how long before I had to start asthma meds again. I can no longer do keto though, each time I try I get palpitations now after around a week.
      - marginalia_nu 1y ago
        Yeah my asthma went into remission as well, though this was also a period of my life when I was very physically active and in the best shape of my life, so it's hard to say what was the cause there.
  - smeej 1y ago
ajuc 1y ago
I have UC and it's obviously related to stress.

Herodotus38 1y ago

Not directly since we all have it. It’s a bit confusing from the article but basically they discovered an antibiotic which can target a narrower spectrum than before which will minimize messing up your natural flora and allow drug resistant enterobacter (e coli is a main species, but not the only one) to be over represented. There is an association with ibd and. microbiomes that have e coli over-represented. And there are some subtypes of e coli that appear to be associated, see: https://pubmed.ncbi.nlm.nih.gov/29141957/ https://pubmed.ncbi.nlm.nih.gov/29141957/

pazimzadeh 1y ago

not exactly but E. coli and other Enterobacteriaceae can actually use the inflammation to their advantage Inflammation release nitrates, which Enterobacteriaceae can use as a replacement for oxygen as a terminal electron acceptor They can also encroach more easily on the protective mucus layers, which are thinner and more porous during inflammatory conditions (which itself may be a result of a messed up microbiota, which is why broad-spectrum antibiotics are not a solution) These Enterobacteriaceae blooms in turn can cause inflammation, makes remission harder There has been some success in reducing inflammation levels in IBD by blocking some of the binding factors that E. coli uses to attach to the epithelium/mucus