Crohn's research takes off

A University of Otago researcher says her move to Dunedin has rapidly advanced her study into the link between swollen lips and mouth problems among children and teenagers and their chances of developing the often debilitating bowel disorder Crohn's disease.

Associate Prof Anita Nolan, a doctor who retrained as a dentist, said it had long been suspected that severely swollen lips, rough skin inside the mouth, mouth ulcers and sore gums could be an early indicator of Crohn's, but the link had not yet been confirmed.

She began her study while working in the United Kingdom, but her work had taken off since her move to Dunedin in February last year.

"I've found huge enthusiasm here from patients and my university colleagues. My colleagues are coming to me and asking what they can do to help."

She now has 70 study participants ranging in age from 4 to the early 70s and has added many Otago and Canterbury sufferers to those already signed up in London and Newcastle, UK. More than 30 people had joined the study in the past month alone.

"It was a bit slow to begin with, but it has taken off as the word has spread."

Eventually, she hopes to have 300 participants.

"The bigger the number, the better the accuracy."

Prof Nolan said she had also had interest from a potential research collaboration partner in Canada.

The main symptom of Crohn's, chronic bowel pain, was the result of damage to the intestine.

By the time adults were identifying pain problems, some damage to the bowel had already occurred. The presence of mouth ulcers and other problems could precede bowel symptoms by up to 10 years, she said.

If a link could be confirmed between mouth problems in young people and their future chances of developing Crohn's, it might be possible to influence patients' diagnoses, diets, lifestyles and treatment options. That, in turn, could help prevent some of the worst outcomes of the debilitating, often embarrassing, condition, she said.

"We would never say to the parents of a child their child is going to get Crohn's, but we might be able to start looking for more evidence and refer that child for diagnosis ... through blood tests, faecal tests or an endoscopy.

"Dealing with Crohn's is about being prepared. The earlier you start treatment, the better it is for the patient."

She hoped to have an initial report on her research findings completed by the end of this year.

Crohn's disease
• Types of inflammatory bowel disease which can occur in any part of the digestive system, from the mouth to the rectum.
• A modern disease of the Western world thought to be caused by a combination of genetic, environmental and immunological factors.
• Mainly affects people aged 15-35.
• Cannot be cured but can be managed with medication; surgery sometimes an option. Some people affected so severely they cannot study or work.
• Main symptoms include abdominal cramps and pain, frequent diarrhoea, severe urgency to have a bowel motion, fever, loss of appetite, weight loss, anxiety, fatigue, anaemia.
• May also lead to ulcers, abscesses, bowel obstructions, joint pain, rheumatism, skin conditions, eye inflammations, liver disorders and osteoporosis.
• New Zealand and Canada have the highest number of sufferers in the world.
• Affects an estimated 15,000 New Zealanders.
Source: Crohn's and Colitis New Zealand.

- allison.rudd@odt.co.nz