Comments on: Crohn's Disease: Which came first, dysbiosis or inflamation?

By: Raymond Dee

Raymond Dee — Fri, 02 May 2014 00:56:49 +0000

There’s a lot of confusion inside and outside the IBD community on the difference of Crohn’s disease, ulcerative colitis and colitis. Can you please enlighten us?

By: jane

jane — Mon, 17 Mar 2014 18:03:05 +0000

Dr. Death – Did either Adelady or I confine our comments to milk allergy? There are also multiple studies reporting substantial increases in childhood hay fever and possibly asthma, with the number harmed being enormously more than 0.09%. A plausible causative mechanism has been proposed. It will be impossible to prove that or any other mechanism, no matter how many studies showing the same association pile up, until a large prospective clinical trial of vaginal swabbing vs. non-swabbing is done. In fact, in America such a method would not be recommended by most doctors until many such trials had been done, taking many years. In the meantime, people who know that there probably are harms associated with C-sections cannot be blamed for considering harmless ways of avoiding needless harm.

As for the safety of the proposed method: The normal means of childbirth for us, as for all mammals, involves pushing the baby’s face through, horrors!, an icky moist mucous-membrane-lined non-sterilized woman’s vagina. We can therefore conclude that contact between pure little face and icky vagina is not lethal, or we would still be oviparous today. Taking a little swab and quickly wiping it across the baby’s lower face would be a much briefer and less intense exposure to the same icky (though often biologically necessary) germs. In most cases, that should not pose any safety risk whatsoever.

By: Dr.Death

Dr.Death — Mon, 17 Mar 2014 15:45:34 +0000

Interesting article, although it should be noted that a acute bout of gastroenteritis itself is also a known risk factor for IBD: (Porter CK, Gastroenterology. 2008;135(3):781)

Greg, small correction, there is no such thing as Irritable Bowl Disease. This is a mix-up of Inflammatory Bowel Disease (IBD), that includes Crohn, and Irritable Bowel syndrome (IBS)

Jane:
Although most studies agree that having a C-section is associated with a higher rate of (food) allergy, no causative mechanism has been proven. There is no evidence that swabbing kids with vaginal flora would be effective, let alone safe. The risk increase of a C-section is small. Accepting an absolute risk of milk allergy of 0.50%, having a C-section would increase this absolute risk to 0.59%. (Metsala et al. 2010) Not that scary of a number, meaning that any intervention needs to be very safe.

By: jane

jane — Sun, 16 Mar 2014 22:36:04 +0000

There’s considerable reason to suspect that could reduce the risk of allergies associated with C-sections, and it’s hard to prohibit. Most American mothers are too biophobic to dare do it, though.

By: adelady

adelady — Sun, 16 Mar 2014 09:39:50 +0000

I once heard a lecturer saying, among other things, that the increase in such problems might be a consequence not of hospital birth, but of C section birth. His recommendation was that immediately after birth an attendant, or the mother herself, could take a swab of her vaginal flora and swish it around the infant’s mouth to imitate the normal transfer of flora during vaginal birth.

It’s an idea. Can’t possibly suggest an estimate of its worth. It wouldn’t explain the increase in inflammatory bowel conditions in people whose birth was not C section.

By: Greg Laden

Greg Laden — Sat, 15 Mar 2014 19:55:55 +0000

Joseph, I’m going to guess not. The whole process of developing gut flora is slower and the real business probably starts later, so what happens in the first few days, and thus the difference between home and hospital, is probably not a factor. One could do a preliminary study to see if there is anything at all there, but I doubt it. But, I’m just guessing here.

By: Sue

Sue — Sat, 15 Mar 2014 19:31:10 +0000

Interesting! My husband was diagnosed with Crohn’s at the same time they found his small intestine and colon cancer. He was on antibiotics all through chemo, and now the Chron’s is acting up again.

By: Joseph Yaroch

Joseph Yaroch — Sat, 15 Mar 2014 17:44:31 +0000

I have an idle curiosity, as to whether there is a difference, between home birth and hospital birth, in the subsequent intestinal biome and the incidence of inflammatory bowel disease.