Study to tackle rare gut illness

Local | Carain Yeung 26 Apr 2017

The number of cases of a rare bowel illness - Crohn's disease - increased sevenfold in the past two decades in Hong Kong but the cause is still unknown and no medication can bring a complete cure.

With HK$14 million provided by a private New York fund, researchers at the Chinese University of Hong Kong can now collaborate with two Australian universities and four mainland hospitals in tackling the disease. Crohn's disease is a major subtype of inflammatory bowel disease, which affects mainly young adults but can bring lifelong symptoms, such as inflammation and ulceration at the digestive tract as well as joint and skin problems.

Surgery is required for serious cases as intestinal obstruction can result from frequent inflammation and the presence of leakage and abscesses along the intestine can also lead to the formation of an abnormal channel linking nearby organs.

Australia has the highest incidence rate of Crohn's disease in the Asia- Pacific region, with 14 cases per 100,000 people, according to vice chancellor Joseph Sung Jao-yiu, a gastroenterologist. Hong Kong ranks second but the figure increased sevenfold between 1995 and 2014 - from 0.1 per 100,000 to 1.5.

Although the cause is unknown, professor Siew Ng said certain risk factors have been identified, including processed food with food additives and exposure to antibiotics.

Those who were breastfed or kept pets during childhood are less likely to suffer from the illness when they grow up, Ng said. Imbalance of the microbial ecology in the intestine may also be a cause.

About 70 percent of patients are adults aged between 20 and 30, Ng said, adding that she has also seen a patient as young as six years old. Crohn's disease patients have to undergo 1.5 surgeries on average.

A Mr Chan said he had surgery to remove his rectum in 2006 but symptoms, including ulceration at the skin of his legs and inflammation at his arm joints, remained. He now relies on biologic medication to control the symptoms.

"Currently, patients with inflammatory bowel disease are prescribed with antiobiotics and drugs that inhibit inflammation, such as steroids," Sung said.

"These may not be the best solution as you are not targeting the root cause but simply changing or inhibiting the microbes in the intestines."

Researchers from CUHK and University of Melbourne are leading a three-year project together with the University of Queens and four partner laboratories in the mainland with a grant from The Leona M & Harry B Helmsley Charitable Trust.

"The ENIGMA Studies - Eastern Inflammatory Bowel Disease Gut Microbiota" aims to find out the association between the disease, especially Crohn's disease, and the patients' gut microbiota and dietary habits.

CUHK is recruiting 100 patients and 100 healthy persons locally for the study.

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