There is very little known about the natural cause of Crohn’s disease because all patients either undergo standard medical care or seek alternative therapy. There is one exception however and that is patients in clinical trials assigned to placebo groups. (1-3) Be that as it may, even these patients do not represent the natural course of the disease since they are seen by doctors and other healthcare providers. In order to properly evaluate therapies for Crohn’s disease we must better understand its natural history.
Alternative healthcare providers commonly believe that standard medical practice is counterproductive to the body’s natural, normal attempts to restore itself to health. Even tough, these standard medical practices have their place and should be used when required. A study of 77 patients diagnosed with active Crohn’s with a CDAI (Crohn’s Disease Activity Index) of 150 or above, receiving placebo therapy during Part 1 of the 17 week trial, showed the following: (1, 3)
1. None of the patients died;
2. Only seven participants (9%, nine percent) showed a major worsening of the disease;
3. 25 patients (32% thirty-two percent) showed a lesser worsening (increase to CDAI of above 450, presence of a fever of 100F for two weeks)
4. 25 Patients (32% thirty-two percent) were considered failures due the fact that their CDAI stayed above 150.
5. 20 patients (26% twenty-six percent)achieved clinical remission.
6. On at least one point during the seventeen week trial, 49% (forty-nine percent) of participants had a CDAI of below 150.
Patients who responded favorably to the placebo continued to be observed during part 1 phase 2 of the trial. None of the patients’ x-rays showed a worsened condition during phase 1 or phase 2. 18% (eighteen percent) showed improvement on intestinal x-rays. The majority (70% seventy percent) of patients reacting favorable to the placebo, remained in remission at one year. 45% (forty-five percent) remained in remission at two years. These results show that about 20% (twenty percent) of patients will undergo spontaneous remission at one year and 12% (twelve percent) at two years. If one includes another factor, the placebo therapy’s success increases dramatically. 41% (forty-one percent) of patients with no history of steroid therapy showed remission after 17 weeks , 23% (twenty-three percent) of these patients continued in remission after two years. This compares to only 4% (four percent) of patients with prior steroid use.
The European Cooperative Crohn’s Disease Study (ECCDS) had similar results. (1- 3) 110 patients were in the placebo group. (68 patients with prior treatment and 42 patients without prior treatment). 55% (fifty-five) percent of the placebo group was in remission by 100 days, 34% (thirty-four percent) remained in remission at 300 days. 21% (twenty-one percent) remained in remission at 700 days. This shows that no prior therapy increases the likelihood of remission.
These results indicate that one should strive for remission in the disease. Once remission is achieved, it can be maintained by non-drug therapy better than by the currently used highly toxic, limited effective drugs. (1)
Next: Prostaglandin Metabolism, Mucin Defects, Intestinal Micro-flora
1. Meyers S., Janowitz H.D. Natural History of Crohn’s Disease: An Analytical Review of the Placebo Lesson. Gastroenterol 87 (1984):1189-92
2. Mekhjian H.S., et al. Clinical Features and Natural History of Crohn’s Disease. Gastroenterol 77 (1979):898-906
3. Malchow H., et al. European Cooperative Crohn’s Disease Study (ECCDS): Results of Drug Treatment. Gastroenterol 86 (1984):249-66