However, it is the vaccine which may be responsible for the massive rise is cases of IBD in children, says Andrew Wakefield, director of the Royal Free study group. Mr Wakefield said studies in Scotland had discovered that over the last 20 years cases in children had risen by more than seven times, from four per million to 29 per million. During that time, although cases of live measles dropped drastically, the measles vaccine was introduced and widely used.
Medicine usually first attempts to treat each illness with mesalazine (mesalamine in the States), an antiinflammatory, or sulphasalazine (sulfasazaline), a drug with two halves containing mesalazine and a sulphur drug chemically akin to aspirin. As the latter is the more dangerous drug, which can lead to acute intolerance syndrome, causing bloody diarrhea, cramping and great pain, some doctors prefer preparations with only the mesalazine portion left in.
As we described in WDDTY vol 5 no 6 (Drug of the Month), mesalazine has a number of its own problems. These include a surprising number of gastrointestinal problems in a drug supposed to be used for that purpose: nausea, abdominal pain, diarrhea, and even causing a worsening of the colitis. It has also been known to cause hepatitis, lowered blood cell count, pancreatitis and kidney failure. This is particularly worrisome for those patients on long term "maintenance" therapy.
For more severe cases, doctors often turn to today's catch all therapy for all inflammation: steroids. Although prednisone or prednisolone are the usual drugs of choice, medicine has been tinkering with a new type of steroid called budesonide. Although it has potent topical anti inflammatory activity (that is, at the site where the drug actually makes contact with your body), it supposedly doesn't much effect the rest of your body because it is largely inactivated once it hits your liver. In order to deliver budesonide straight to the intestine, medicine has developed a controlled release preparation, which supposedly doesn't start working until it reaches your gut.
One study found that patients taking the highest doses of budesonide had higher remission rates than patients taking a placebo over eight weeks. Although budesonide didn't cause the usual significant side effects associated with steroids moon face, thinning skin, osteoporosis, permanent adrenal disease, eye damage, such as glaucoma it was shown to suppress your body's own natural supply of steroids in the blood. Furthermore, in another study comparing budesonide against prednisolone, the older drug worked better (66 per cent remission rate against 53 per cent at four weeks), but had worse side effects (N Engl J Med, 29 Sept 1994).
Once again medicine appears to be blind to the suggestion that food allergy or intolerance may cause or exacerbate the condition. According to several Birmingham and Scottish doctors, at least two controlled trials demonstrated that avoiding foods found not to be tolerated significantly prolonged the time before the disease returned. Numerous patients expected to undergo colectomies managed to avoid the operations by having their allergies fully investigated and keeping away from the offending foods. "Patients remained well for years unless they inadvertently ate one of the foods that they could not tolerate," the group said in a letter to the British Medical Journal (22 October 1994). Besides avoidance, in some cases the patients underwent enzyme potentiated desensitization (EPD), a method of desensitizing patients to the offending allergen by finding a "neutralizing dose", which switches off symptoms, and giving it to them periodically by injection or under the tongue.