• Posted November 13, 2023

Subtle Changes Could Predict Inflammatory Bowel Disease Years Before Symptoms Hit

MONDAY, Nov. 13, 2023 (Healthday News) -- Inflammatory bowel disease starts to develop years before patients come down with symptoms, a new study suggests.

Gut changes can be detected in blood tests up to eight years before a diagnosis of Crohn's disease and up to three years prior to a diagnosis of ulcerative colitis, according to findings recently published in the journal Cell Reports Medicine.

This could provide doctors an opportunity to take preventive action before symptoms begin or prescribe medicine when it will be most effective, the investigators said.

"Our research shows that the bowel damage we're seeing at the point of diagnosis is just the tip of the iceberg. So many changes are subtly taking place in the body before the disease takes hold, "researcher James Lee said in a Francis Crick Institute news release. Lee is group leader of its Genetic Mechanisms of Disease Laboratory in London.

"This has huge implications for prevention, as it highlights that there's a window of opportunity for treatment,"he added. "We don't yet know whether preventative measures like changing diet or stopping smoking would stop someone getting these diseases, but this opens the door to that possibility."

Crohn's disease and ulcerative colitis involve excessive inflammation in the gut, leading to symptoms like abdominal pain and diarrhea.

"These incurable diseases affect young individuals and are twice as common as type 1 diabetes. Understanding the exact mechanisms behind their development is essential to ultimately prevent the diseases from occurring,"said Tine Jess, director of the Center for Molecular Prediction of Inflammatory Bowel Disease at Aalborg University in Denmark.

For this study, researchers evaluated the electronic health records of patients in Denmark, comparing 20,000 people with IBD against 4.6 million without IBD. They looked at 10 years of test results prior to patients' IBD diagnosis, to see if they had any early changes in common.

They discovered changes in certain minerals, blood cells and inflammatory markers that occurred in IBD patients years before they developed symptoms and were diagnosed.

Most of the changes observed were subtle and would have appeared within a normal range for standard blood tests, researchers said. They wouldn't have been flagged as a cause for concern by doctors.

Researchers will next investigate if these findings could be used to predict who will get IBD, as well as whether treatment and prevention could help people avoid or minimize an oncoming case of IBD.

"So many young people are affected by IBD. Their lives, hopes and aspirations for the future are turned upside down by a diagnosis and trying to live with a chronic disease,"said lead researcher Marie Vestergaard, an Aalborg University doctoral student.

"As a young person myself, it gets me," she added. "I am happy that our research might help predicting who could potentially suffer from IBD and thus start treatment earlier, which would greatly improve their quality of life."

More information

The U.S. Centers for Disease Control and Prevention has more about inflammatory bowel disease.

SOURCE: Francis Crick Institute, news release, Nov. 7, 2023