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Blood Tests for Colitis and Crohn’s Disease: an Introduction
Blood tests for ulcerative colitis and Crohn’s disease are relatively new and exciting developments that have greatly added to the screening, diagnosis and management of ulcerative colitis and Crohn’s disease. Differentiating the two can improve predictions of responses to medical treatments, decisions about surgical options and risks of various complications. It is resistant to various proteins including Baker’s or Brewer’s yeast (saccharomyces cerevisiae) and bacteria such as Escherichia. coli (E. coli) is in the blood of many people with Crohn’s disease but rarely in normal people. In most people with Crohn’s disease, colitis is similar to Crohn’s disease, which is difficult for normal people.
Antibody tests and serologic tests are blood tests that look for signs of disease. Serologic markers and antibody tests for ulcerative colitis and Crohn’s disease include pANCA and ASCA, OmpC, and CBir1 Flagelin. The last three blood tests for Crohn’s are available through one laboratory, Prometheus Laboratories, Inc.
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) of unknown cause that usually involves the colon. Affecting the lower part of the colon and the intestine can cause blockage and perforation (rupture) but usually result in bloody diarrhea, blood in the stool, weight loss, abdominal pain, including joint pain and arthritis, skin rash, eye pain and sometimes severe liver disease known as primary sclerosing cholangitis that can lead to cirrhosis and liver cancer. It can be cured by removing the entire colon but not Crohn’s disease.
Crohn’s disease can also cause colitis but it usually affects the lower end of the small intestine called the ileum (ileitis or regional enteritis). When Crohn’s affects only the colon it can be difficult to distinguish from ulcerative colitis although Crohn’s disease can affect the colon in an unrelenting manner but ulcerative colitis continues. Crohn’s disease can affect the intestinal tract from the mouth to the anus and cannot be treated by removing the colon. It is often associated with intestinal constrictions that can lead to the need for surgery. A fistula may involve abnormal connections of the intestine with other organs and the skin, resulting in an abscess or cavity that may require surgery. different types of problems occur.
In the past, the diagnosis of ulcerative colitis and Crohn’s disease was most accurate due to the appearance of the colon on the colon or x-rays that confirmed the presence or absence of the colon. of other parts of the intestinal tract. The diagnosis is confirmed by the typical pattern of inflammation of the intestinal lining that can be seen under a microscope on a biopsy obtained during a colonoscopy. However, before blood tests were available about 10% of people with IBD were diagnosed with indeterminate colitis because biopsies could not distinguish between ulcerative colitis and Crohn’s disease. .
Blood tests currently available include pNCA, anti-ASCA, anti-OmpC, and anti-CBir1 flagelin antibodies. pANCA is the anti-nuclear antibody. A negative antibody against the nuclear protein of cells is highly sensitive and specific for ulcerative colitis. The pANCA antibody is subdivided into subtypes by Prometheus Laboratories Inc. Neutrophil-specific pANCA ELISA (NSNA) is positive in most people with ulcerative colitis (UC) and in a small proportion of people with Crohn’s disease who have a similar disease. UC. The immunofluorescent cell staining of neutrophils (NSNA IFA) and the Dnase enzyme test (NSNA DNase sensitivity) are also performed as part of Prometheus IBD Serology 7. The last test when there are high levels of especially related to the development of inflammation of the rectal bag ( pouchitis) created when a person has his entire colon removed for ulcerative colitis that does not respond to medical treatment.
ASCA is an anti-saccharomyces cerevisiae antibody. Saccharomyces cerevisiae is Brewer’s yeast or Baker’s yeast. Crohn’s patients have a high number of different antibodies against this yeast. Some have suggested that another yeast, Candida albicans, may play a role in this negative response. Some people with celiac disease have this antibody in their blood without the symptoms of Crohn’s disease. OmpC stands for an antibody that develops in many Crohn’s patients against the outer membrane porin of E. coli bacteria even though that bacteria is not considered the cause of Crohn’s disease. Prometheus Laboratories recently added an antibody test for a specific protein on bacteria that forms a ring or hair on some bacteria that allows the bacteria to move and attach in the intestine called CBir1 flagelin.
Future blood tests will include antibodies to certain sugar residues (mannose) in the cell wall of the yeast saccharomyces cerevisiae. Anti-laminaribioside and anti-chitobioside antibodies have recently been reported to be present in Crohn’s patients who are anti-ASCA negative and may be more effective in distinguishing them from people with ulcerative colitis. This is also interesting because of the suspicion and public interest in the role of sugar, glycans and yeast in IBD. Especially the reports in the lay literature about the success of a specific carbohydrate diet in IBD.
If you have ulcerative colitis or Crohn’s disease these blood tests can be very helpful in your treatment. If you have abdominal pain, diarrhea or blood in your stools then consider these tests. If you have irritable bowel syndrome, these tests will rule out ulcerative colitis and Crohn’s disease. Since 10% of people with ulcerative colitis and Crohn’s disease also have celiac disease, celiac blood tests should also be considered. Lactose intolerance is common in IBD, IBS and celiac disease.
Future helpful information on colitis, Crohn’s disease, celiac disease, food allergies, food intolerances, food sensitivities, eosinophilic esophagitis and irritable bowel syndrome will be available to Dr. Scot Lewey, dietitian and dietitian at http://www. .thefooddoc.com. Information about colitis and Crohn’s disease can also be obtained from the Crohn’s and Colitis Foundation of America (CCFA, http://www.ccfa.org). Dr. Scot Lewey is a member of the medical advisory board for the Rocky Mountain Chapter of CCFA. For more information on Prometheus Laboratories Inc. visit http://www.prometheuslabs.com. Further explanation of blood tests can be found in a separate article by the nutrition doc and references below.
Abreu MT et.al. Serologic Test Use in Crohn’s Disease. Clinical Gastroenterology and Hepatology. Volume 4, Number 3. 2001
Dotan me et.al. Antibodies to Laminaribioside and Chitiobioside Are Novel Serologic Markers in Crohn’s Disease. Gastroenterology. Vol.131, No. 2. 2006
May, L et al. Familial Expression of Anti-Escherichia coli Outer Membrane Porin C in Correlates of Patients with Crohn’s Disease. Gastroenterology. Vol. 130, No. 4 2006
Stadaert-Vitse et.al. Candida albicans is an Immunogen for Anti-Saccharomyces cerevisiae Clinical Symptoms for Crohn’s Disease. Gastroenterology. Vol 130, No 6. 2006
Targan, SR et al. Antibodies to Cbir1 Flagelin Determine a Unique Response Associated with Crohn’s Disease. Gastroenterology. Vol.128, No.7. 2005
Copyright The Food Doc, LLC, 2006. All rights reserved. http://www.thefooddoc.com
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