Crohn’s disease and ulcerative colitis are known as inflammatory bowel diseases (IBD). These conditions are chronic, causing excessive inflammation in the intestinal tract, manifesting in symptoms such as abdominal pain and diarrhea. Identifying and treating them in the early stages is vital to improving the prognosis.
Researchers from the Francis Crick Institute in London, UK, and Aalborg University in Copenhagen, Denmark, have shown that the changes can be detected in blood tests up to eight years before Crohn’s disease is diagnosed and up to three years before of the diagnosis of ulcerative colitis.
These findings suggest that inflammatory bowel diseases begin to develop long before symptoms appear and, in the future, could give doctors the opportunity to intervene preventively or prescribe more effective treatments.
In a study published in the journal Cell Reports Medicine, the team analyzed the electronic health records of 20,000 people diagnosed with BII and compared them with 4.6 million people without the condition.
Until now, most patients were thought to start showing symptoms about a year before diagnosis, but significant intestinal damage is often seen, indicating that the changes occurred much longer.
Analyzing the results of tests carried out 10 years before the diagnosis, the researchers confirmed this theory. They observed changes in the levels of some minerals, blood cells and markers of inflammation, such as fecal calprotectin, a molecule released in the gut during inflammation, currently used to identify people with gut symptoms who need further investigation.
These changes were observed up to eight years before the diagnosis of Crohn’s disease and three years before the diagnosis of ulcerative colitis. Despite the subtleness of these changes, which remained within the normal range of standard blood tests, they would not have been considered cause for concern.
The researchers now aim to investigate whether treatment or preventive measures can have an impact before patients show symptoms, and whether these results can be used to predict who will develop BII in the future.
“A large number of young people face BII. Diagnoses and attempts to live with a chronic disease affect their lives, hopes and aspirations for the future,” said Marie Vestergaard, PhD student at the Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, at Aalborg University.
This research could help identify those at potential risk of BID, thus allowing treatment to start earlier and, implicitly, greatly improving their quality of life.
The recent findings have significant implications for prevention, highlighting a window of opportunity for therapeutic interventions, the study authors noted.
However, it remains to be seen whether preventive measures, such as dietary adjustment or smoking cessation, could prevent these diseases. The study also highlights the importance of early diagnosis and treatment, as many of the changes in the gut may have occurred long before symptoms appear.
These new findings support the idea that chronic inflammatory bowel disease can have its onset years before it is diagnosed. As incurable conditions that mainly affect young people, they are twice as common as type 1 diabetes.
The exact understanding of the mechanisms underlying the development of these diseases is crucial for preventing their occurrence.
The estimated number of people affected by Crohn’s and colitis in the UK exceeds 500,000, and early diagnosis could lead to better outcomes for these patients. Many people put off going to the doctor to check their symptoms, either due to a lack of awareness of their severity, or out of fear or shame, experts point out.
Any improvement in the process of obtaining an accurate diagnosis is considered a positive step in the right direction, commented Sarah Sleet, CEO of Crohn’s & Colitis UK, referring to the results of this study.
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