CROHN'S DISEASE
ORAL CONTRACEPTIVE USE AND SMOKING ARE RISK FACTORS FOR
RELAPSE IN CROHN'S DISEASE
Since lifestyle factors have been shown to influence prognosis
in Crohn's disease, a study was undertaken to prospectively
assess the effects of smoking and oral contraceptive use
on clinical relapse rates. The influence of smoking and
the use of oral contraceptives on relapse risk was measured
using life-table analysis (log rank tests) and Cox proportional
hazards modelling. Out of 152 patients, 61 (40%) had a relapse.
Univariate analysis showed unfavourable outcomes for women,
current smokers, and use of oral contraceptives. The Cox
model retained current smoking vs. never smoking (hazard
ratio, 2.1), oral contraceptive use (hazard ratio, 3.0),
as predictors of relapse. Ex-smokers did not have an increased
risk and sex, age, time in remission, disease location,
and disease duration were not significant predictors.
Timmer, A. et al
GASTROENTEROL. 1998, 114 (6) 1143-50
EFFECT OF A LOW-IMPACT EXERCISE PROGRAM ON BONE MINERAL
DENSITY IN CROHN'S DISEASE
Osteoporosis is a common complication of inflammatory bowel
disease, and people with Crohn's disease are at particular
risk. Since physical exercise increases bone mineral density
(BMD) in healthy young adults and slows the rate of bone
loss in later life, a randomised controlled trial was carried
out to investigate the effect of exercise on BMD in patients
with Crohn's'disease. Participants in the trial were randomised
to a control group or a low-impact exercise program of increasing
intensity. BMD was measured at baseline and 12 months at
the hip and spine.
Nonsignificant gains in BMD occurred at the hip and spine
in the exercise group compared with controls, but in fully
compliant patients BMD increased by 3.54% at the femoral
neck, 2.97% at the spine, 4.1% at Ward's triangle, and 7.77%
at the greater trochanter. Increases in BMD were significantly
related to the number of exercise sessions completed. Thus,
progressive low-impact exercise is a potentially effective
method of increasing BMD in Crohn's disease and, if sustained,
the increases may reduce the risk of osteoporotic fracture.
Robinson, RJ. et al
GASTROENTEROL. 1998, 115 (1) 36-41
CROHN’S DISEASE AND SUGAR
A review of the association between Crohn’s disease
and consumption of sugars found no relationship between
national sugar consumption data and the incidence or mortality
relating to Crohn’s disease. Low sugar diets did not
appear to be of benefit for the disease.
EUROP. J. CLIN. NUT. 1998, 52, 229-238
QUALITY OF UK MILK TO BE STUDIED
Britain’s Ministry of Agriculture, Fisheries and
Food has announced a £200 000 study into the microbiological
quality of raw and pasteurised cow’s milk. Concerns
about links between Crohn’s disease and Mycobacterium
paratuberculosis have prompted the inclusion of the organism
in the study, although MAFF says that no evidence exists
of a public health risk. In a previous MAFF survey of milk
in Northern Ireland, six out of the 31 samples tested positive
for the micro-organism.
Crohn’s disease is increasingly common, and many
factors have been suggested as causative agents. The commonly
found M. paratuberculosis occasionally causes the similar
Johne’s disease in cattle. However, studies have suggested
that larger numbers of cows are subclinically infected and
that the organism gets into the milk supply. Although most
of the organisms are killed by pasteurisation, at peak times
of year up to 25% of retail milk has traces of M. paratuberculosis.
M paratuberculosis has been anecdotally linked to Crohn’s
disease for many years. Researchers agree that the disease
is due to several factors, including genetic susceptibility
and stress, but remain divided about the role of the micro-organism.
BMJ no. 7157 p491
ORAL CONTRACEPTIVE USE AND SMOKING ARE RISK FACTORS FOR
RELAPSE IN CROHN'S DISEASE
Since lifestyle factors have been shown to influence prognosis
in Crohn's disease, a study was undertaken to prospectively
assess the effects of smoking and oral contraceptive use
on clinical relapse rates. The influence of smoking and
the use of oral contraceptives on relapse risk was measured
using life-table analysis (log rank tests) and Cox proportional
hazards modelling. Out of 152 patients, 61 (40%) had a relapse.
Univariate analysis showed unfavourable outcomes for women,
current smokers, and use of oral contraceptives. The Cox
model retained current smoking vs. never smoking (hazard
ratio, 2.1), oral contraceptive use (hazard ratio, 3.0),
as predictors of relapse. Ex-smokers did not have an increased
risk and sex, age, time in remission, disease location,
and disease duration were not significant predictors.
Timmer, A. et al
GASTROENTEROL. 1998, 114 (6) 1143-50
EFFECT OF A LOW-IMPACT EXERCISE PROGRAM ON BONE MINERAL
DENSITY IN CROHN'S DISEASE
Osteoporosis is a common complication of inflammatory bowel
disease, and people with Crohn's disease are at particular
risk. Since physical exercise increases bone mineral density
(BMD) in healthy young adults and slows the rate of bone
loss in later life, a randomised controlled trial was carried
out to investigate the effect of exercise on BMD in patients
with Crohn's'disease. Participants in the trial were randomised
to a control group or a low-impact exercise program of increasing
intensity. BMD was measured at baseline and 12 months at
the hip and spine.
Nonsignificant gains in BMD occurred at the hip and spine
in the exercise group compared with controls, but in fully
compliant patients BMD increased by 3.54% at the femoral
neck, 2.97% at the spine, 4.1% at Ward's triangle, and 7.77%
at the greater trochanter. Increases in BMD were significantly
related to the number of exercise sessions completed. Thus,
progressive low-impact exercise is a potentially effective
method of increasing BMD in Crohn's disease and, if sustained,
the increases may reduce the risk of osteoporotic fracture.
Robinson, RJ. et al
GASTROENTEROL. 1998, 115 (1) 36-41
