What causes Crohns disease?
Published on 3 May 2017
Research Training Fellowship*: Dr James Ashton
At least 115,000 people have Crohn's disease in the UK.1 Up to one third are young – less than 21 years old – when their condition is diagnosed.1 Children with Crohn’s disease can experience symptoms, such as diarrhoea, abdominal pain and tiredness, which result from inflammation in the gut, but it’s unclear what triggers this inflammation. Dr James Ashton, of the University of Southampton, aims to improve understanding of what causes Crohn’s disease. His work may one day lead to better treatments and improved quality of life for children and young people with this debilitating condition.
How are children’s lives affected now?
More and more children are being diagnosed with Crohn’s disease, an incurable condition that primarily affects the gut.2-4
The condition is unpredictable. Children have periods of time with very mild symptoms or no symptoms, followed by times when their symptoms flare up and become particularly bad.
“Children with Crohn’s disease tend to have more severe symptoms than adults,” says Dr Ashton. “The condition can have a significant impact on children’s lives – for example, their growth, schooling and psychological wellbeing can all be affected.” Symptoms can affect children’s self-esteem, relationships and social lives.
Medication and nutritional therapy can help, but many children with Crohn’s disease have to undergo surgery within 10 years of diagnosis to remove damaged parts of the bowel.5
“A lack of understanding of what causes Crohn’s disease is hindering efforts to develop better treatments and use the treatments we have effectively,” says Dr Ashton. “More research is needed urgently.”
How could this research help?
“We are investigating what triggers Crohn’s disease, and its flare ups, in children,” says Dr Ashton. No-one knows exactly what causes the condition, but it’s thought that a combination of genetic and environmental factors are involved.
Dr Ashton is studying the role the microbiome plays in triggering disease. The microbiome is the community of bacteria that live in the gut. He is also assessing how this community of bacteria might interact with two other factors to cause disease. One is the children’s genetic susceptibility to developing Crohn’s disease (which depends on which genes they have). The other is the activity of the children’s immune system (which can change if genes are turned on or turned off).
“We hope that our findings will help in the development of better ways to predict disease severity, as well as new and improved treatments, with the ultimate goal of improving children’s lives,” says Dr Ashton.
1. National Institute for Health and Clinical Excellence (NICE). Crohn’s disease: management. Last updated May 2016. https://www.nice.org.uk/guidance/cg152/chapter/Context Website accessed 21 March 2017.
2. Ashton JJ et al. Rising incidence of paediatric inflammatory bowel disease (PIBD) in Wessex, Southern England. Arch Dis Child 2014; 99: 659-664.
3. Hope B et al. Rapid rise in incidence of Irish paediatric inflammatory bowel disease. Arch Dis Child 2012; 97: 590-594.
4. Henderson P et al. Rising incidence of pediatric inflammatory bowel disease in Scotland. Inflamm Bowel Dis 2012; 18: 999-1005.
5. The Inflammatory Bowel Disease (IBD) Standards Group. Standards for the Healthcare of People who have Inflammatory Bowel Disease (IBD). IBD Standards 2013 Update. http://s3-eu-west-1.amazonaws.com/files.crohnsandcolitis.org.uk/Publicat... Website accessed 3 April 2017.
|Project Leader||Dr James J Ashton BMedSci BMBS MRCPCH|
|Location||Human Development and Health, University of Southampton|
|Grant awarded||14 February 2017|
|Start date||6 September 2017|
|End date||5 September 2020|
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* Research Training Fellowships:
Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research.