2023-11-23 23:00:00
IBD, which affects more than 212,000 people in France, is often detected between the ages of 20 and 30, generally during a painful flare-up. Women, in particular, are diagnosed later than men. Gold, plus un diagnostic for IBD is late, the higher the risks of complications and recourse to surgery.
Good news: researchers from the London Francis Crick Institute and Aalborg University in Copenhagen have just established four indices linked to blood markers which may soon make it possible to detect and treat earlier these inflammatory bowel diseases.
As these diseases still have no curative treatments, these new data are extremely promising and bring hope to better prevent and control the painful symptoms of IBD.
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Crohn’s, ulcerative colitis: family history is one of the main identifiable risk factors
Generally, only 2 to 14% of IBD patients have one or more family members also affected. If several genetic factors are suspected in their occurrence (such as the Nod2 gene in Crohn’s disease), However, IBD is not considered hereditary disease.. However, a positive family history of IBD remains the strongest identifiable risk factor for these diseases. Indeed, several studies have shown that if you have an affected first-degree relative, your risk of developing IBD is 10 to 15 times higher than that of the general population. A 2001 study of French and Belgian couples also showed that if you have two parents with IBD, you have a 33% chance of also having it by the age of 28.
So, you can pay attention to the different blood markers set out in this article, without being afraid and thinking that you will one day necessarily trigger one of these pathologies.
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Subtle changes in leukocytes, neutrophils and platelets up to eight years before
This British-Danish study published at the beginning of last November in Cell Reports Medicine compared the electronic medical data of 20,000 Danes with a diagnosis of IBD with those of 4.6 million other people without IBD. Here’s what the researchers found.
Crohn’s disease :
- Eight years ago the diagnosis, the levels of leukocytes, neutrophils and platelets are higher.
- Seven years agoCRP levels are higher and hemoglobin levels lower.
- Five years agomonocyte levels are higher and iron, albumin and bilirubin levels lower.
Ulcerative colitis :
- Three years ago At diagnosis, levels of CRP, leukocytes, neutrophils, eosinophils and platelets are higher.
Ces changes in blood parameters are subtle and light. As they remain located within the normal ranges of standard analyses, if you take a blood test, they will not be flagged as a cause for concern. On the other hand, in association with unexplained and lasting intestinal symptoms, they can indicate IBD in gestation..
One of the authors of the study sums it up as follows: “ Many subtle changes take place in the body before disease takes hold. Our research shows that the intestinal damage we see at diagnosis is just the tip of the iceberg. »
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Blood markers useful for managing the disease at an early stage?
Can these blood markers be used now to manage the disease earlier? As the first author of the study, Marie Vestergaard (PhD student at the Center for Molecular Prediction of Inflammatory Bowel Diseases, PREDICT, at Aalborg University), explains: “ Our research can help predict who could potentially suffer from IBD, leaving themopportunity to start treatment earlier et would significantly improve their quality of life. »
So, in case of strong family history (read box above) or experiencing several early symptoms (read box below “Early symptoms to recognize”), it may be possible, very soon, to ask your doctor or specialist for a blood test aimed at looking for these early signals of IBD.
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Crohn’s, ulcerative colitis: early symptoms to recognize
Concerning Crohn’s disease, the first symptoms include:
- a loss of appetite ;
- of the abdominal pain ;
- fever ;
- exhaustion;
- of the joint pain ;
- nausea ;
- pain and redness in the eyes;
- red, swollen, painful bumps on the skin, often on the legs below the knees.
Concerning ulcerative colitis, the first signs include:
- loss of appetite;
- abdominal pain;
- a sudden urgent need to defecate;
- loose or watery stools;
- bloody stools.
To know : Taken in isolation, these symptoms may seem unrelated, but if you experience more than one, it may be a sign of IBD. Generally, these first signs will be mild and short-lived and their severity increases as the attacks accompany the progression of the disease.
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Food, tobacco, microbiota: what are the best measures to reduce symptoms?
Conventional medicine offers few preventive measures for IBD. However, much research shows that because a large part of the immune system is located in the digestive tract, there is a strong link between nutrition and immunity. We know that an unbalanced diet affects our microbiota and our immune system and can influence the onset of autoimmune and allergic diseases. Furthermore, IBD develops mainly in Westernized countries, which suggests a fundamental role of Western dietary habits (ultraprocessed foods, food additives, etc.) and dysbiosis in their development.
Although no definitive association between dietary factors and autoimmune diseases has so far been firmly established, a large proportion of IBD patients consider certain diets or dietary supplements (targeting the gut or autoimmunity for example) as useful complementary measures. Indeed, insufficient consumption of “healthy foods” negatively affects the production of bacterial metabolites, compounds that have beneficial effects on immunity.
Regarding Crohn’s disease, stopping smoking and avoiding anti-inflammatory medications (which can cause attacks) are the first measures to take to limit symptoms. Concerning diet, clinical practice shows that avoiding food (gluten or milk for example) does not have the same effects from one patient to another, which calls for an individualized approach. Also, generally speaking, a classic Mediterranean type dietrich in fruits and vegetables and omega-3 seems to be the most suitable to everyone and the least risky, in comparison with less proven diets or which may promote deficiencies and imbalances.
Other patients obtain some improvement in their symptoms with Seignalet type diets (a must against autoimmunity) or the no-carb diet FODMAP. The ideal is therefore to establish an individualized diet, the results of which can be observed on a case-by-case basis. There are also diets specifically developed to support IBDcomme l’IBD-AID (Inflammatory Bowel Disease – Anti-Inflammatory Diet or anti-inflammatory diet dedicated to inflammatory bowel disease) recommended by the Crohn’s & Colitis Foundation, which avoids certain carbohydrates and adds more prebiotic and probiotic foods to restore the balance between helpful and harmful bacteria.
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Irritable bowels: should you go on a FODMAP-free diet?
Patients suffering from ulcerative colitis will benefit from avoid spicy foods, coffee, alcohol and certain vegetables such as certain cruciferous vegetables and legumes (beans, cabbage, broccoli, etc.) and limit dairy products and fiber which can worsen intestinal symptoms. It will also be important to hydrate properly and favor small meals throughout the day rather than two or three larger meals.
Either way, as James Lee, head of the Francis Crick Institute’s Genetic Mechanisms of Disease Laboratory who carried out the study, concludes: ” We don’t yet know if preventative measures such as changing diet or quitting smoking would stop a person from getting these diseases, but this opens the door to this possibility. It also highlights the importance of early diagnosis and treatment, as many changes in the gut likely occurred long before people became ill. »
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