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Crohn’s disease and ulcerative colitis: how do the foods children eat affect their disease?

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What did the project achieve?

“Our study has boosted our understanding of how certain dietary nutrients can impact on a child’s gut health, which we hope will pave the way to more effective nutritional therapies for children with inflammatory bowel conditions,” says Dr Harween Dogra of Queen Mary University, London.

Up to one in four cases of inflammatory bowel disease (IBD) – including Crohn’s disease and ulcerative colitis – are diagnosed in children and teenagers.1 Young people with these conditions will experience a range of debilitating symptoms such as diarrhoea, abdominal pain and weight loss – as well as unique emotional and social challenges.

As problems with the immune system in the lining of the digestive tract are known to contribute to the development of IBD, Dr Dogra was investigating the immune-modulating effects of various dietary nutrients on gut samples collected from adults and children with IBD.

“In our laboratory experiments, we found that certain nutrients – specifically milk proteins and a type of fat found in coconut oil – can dampen immune responses in the digestive tract,” says Dr Dogra. “However, milk proteins had an effect only on gut samples with an intact intestinal lining – whereas coconut oil fats showed an effect even when this lining was damaged and removed, as may happen in inflammatory bowel diseases.”

The team is now carrying out further work to understand the biological mechanisms by which these nutrients change the responses of immune cells within the gut.

“Understanding how these nutrients interact with the immune system could lead to the development of better anti-inflammatory nutrient therapies for IBD that are safer than existing medications with fewer side-effects,” says Dr Dogra.

References:

  1. Ruel J et al. IBD across the age spectrum: is it the same disease? Nature Reviews Gastroenterology & Hepatology 2014; 11(2): 88-98.

This research was completed on

Research Training Fellowship*: Dr Harween Dogra

Estimates suggest more than 115,000 people have Crohn’s disease in the UK and around 146,000 have ulcerative colitis.1,2 Around one in four of the people who are diagnosed with these two conditions are children or adolescents.3 Young people with either condition can experience debilitating symptoms – such as diarrhoea, abdominal pain and tiredness – which result from inflammation within the gut. Dr Harween Dogra, of Queen Mary University, London, is investigating how the foods children eat affect their disease. She hopes her work will one day lead to better ways to control Crohn’s disease and ulcerative colitis through diet.

How are children’s lives affected now?

“Children with Crohn’s disease and ulcerative colitis are often unable to enjoy food because it causes tummy pain and diarrhoea,” says Dr Dogra. “These symptoms bring with them the stigma of having to go to the toilet all the time, spending a long time in the toilet and sometimes needing to use suppository medicines.”

“Some children lose their appetite completely,” continues Dr Dogra. “Inadequate nutrition can lead to anaemia, meaning children feel tired and lethargic. They miss school days and cannot take part in activities they enjoy. Children’s growth can also slow down. The most severely affected children require bowel surgery and a stoma – an opening from the bowel to the surface of the tummy to collect stools in a bag.”

Medication for Crohn’s disease and ulcerative colitis often helps reduce symptoms, but can have significant side effects. The more potent medicines require children to have frequent blood tests. Better treatments are urgently needed.

How could this research help?

“I aim to improve understanding of the disease processes involved in Crohn’s disease and ulcerative colitis by studying how the immune system in the gut responds to nutrients in food,” says Dr Dogra. “At the moment, we cannot properly explain why children develop Crohn’s disease, or ulcerative colitis, or how the foods they eat may influence their symptoms. Children and their families commonly ask about these things, but we cannot answer their questions very well, which is very frustrating.”

“My work could give children and their families a better explanation of how diet impacts Crohn’s disease and ulcerative colitis, which would be fantastic in itself,” continues Dr Dogra. “It may also lead to the development of better nutritional therapies, as an add-on or an alternative to medication. Nutritional therapies that are safer than existing medicines, with fewer side effects, and that control the disease without the need for frequent blood tests, could improve the quality of life of children with Crohn’s disease and ulcerative colitis considerably.”

References

1. National Institute for Health and Care Excellence (NICE). Crohn's disease: Management in adults, children and young people. NICE guideline [CG152]. October 2012. http://www.nice.org.uk/guidance/cg152/chapter/introduction Website accessed 19 March 2015.

2. National Institute for Health and Care Excellence (NICE). Ulcerative colitis: Management in adults, children and young people. NICE guideline [CG166]. June 2013. https://www.nice.org.uk/guidance/cg166/chapter/Introduction Website accessed 1 June 2015.

3. Crohn’s and colitis UK. IBD in children: a parent’s guide. http://www.crohnsandcolitis.org.uk/Resources/CrohnsAndColitisUK/Document... Website accessed 1 June 1015.

 

* Research Training Fellowships:
Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research

 

Project Leader Dr Harween Dogra BMedSci MBBS MRCPCH
Project Team Professor Ian R Sanderson MBBS FRCPCH PhDProfessor L Ashley Blackshaw BSc PhDDr Andy Stagg BSC (Hons) PhD
Project Location Centre for Digestive Diseases, Blizard Institute, Barts and the London School of Medicine and Dentistry
Project Location Other Digestive Diseases Neurogastroenterology Group, Wingate Institute, Barts and the London School of Medicine and DentistryCentre for Immunology and Infectious Diseases, Blizard Institute, Barts and the London School of Medicine and Dentistry
Project duration 2 years
Date awarded 9 February 2015
Project start date 1 March 2015
Project end date 28 February 2017
Grant amount £156,471
Grant code GN2348

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