In Canada, one in every 150 people has inflammatory bowel disease (IBD). There are more than 10,000 new diagnoses of IBD each year, and the number of Canadian children diagnosed with Crohn鈥檚 disease has almost doubled in the last 20 years.
The Maritimes have the highest rates of IBD in the world, and it鈥檚 not clear why.
鈥淲e know genetics play a role, and likely there鈥檚 some environmental factor that we haven鈥檛 identified,鈥� says Dr. Tony Otley, professor of pediatrics in the Division of Gastroenterology & Nutrition at AV俱乐部 Medical School.
IBD can cause stomach pain, diarrhea, nausea and vomiting, anxiety, depression, and other heath problems.
Irritable bowel syndrome (IBS) is another chronic bowel condition. And while it isn鈥檛 caused by inflammation like IBD, it can trigger similar symptoms in the one in five Canadians who have it.
Investigating the microbiome
Over the next five years, $36 million will be invested into a pan-Canadian gastrointestinal research network that will connect 70 researchers from across the country with patients and policy-makers.
鈥淗umans are made up of more bacterial cells than we are human cells. There鈥檚 promising evidence to show that by altering the balance of bacteria in our guts 鈥� our microbiome 鈥� we can decrease IBD-related inflammation,鈥� says Dr. Otley, principal investigator for the pediatric component of the study. 鈥淭his funding will increase our research capacity at AV俱乐部. Collaborations are already happening, but this will super-charge what we鈥檙e able to do.鈥�
By understanding gastrointestinal bacteria better, it鈥檚 hoped doctors will eventually be able to manipulate people鈥檚 microbiomes through food, medications, or fecal transplantation.
鈥淲ithin 24 hours of changing your diet, you make changes to your microbiome,鈥� says Dr. Otley, a gastroenterologist at the IWK Health Centre, where he and his colleagues follow about 300 children and teenagers with IBD. 鈥淲e鈥檙e trying to understand if there鈥檚 a way to tweak the microbiome so that we can create a healthier one.鈥�
Improving the treatment plan
Currently, many IBD symptoms are treated with drugs. But the drugs can have negative side effects when used long-term.
鈥淎s a pediatric gastroenterologist, IBD is a lifelong condition for my patients. So when you鈥檝e got a child or a teen diagnosed, parents worry about the impact medications might have on their kids when used over many years.鈥�
鈥淲ith IBD, for example, you want to dampen down inflammation, which means dampening down the immune response. But we know that when the immune system is dampened, people are more prone to certain infections. Also, our immune systems are an important surveillance for cancer. Immune suppressant drugs are a real concern for families.鈥�
If a person鈥檚 microbiome can be changed safely and effectively, it鈥檚 possible future IBD treatments will be personalized.
鈥淩ather than telling someone they have IBD and then providing them with a list of treatments, we hope that we鈥檒l be able to tailor treatment plans based on what an individual鈥檚 microbiome looks like,鈥� says Dr. Otley. 鈥淚deally, we鈥檒l be able to fine-tune diet and other approaches to optimize patient outcomes.鈥�
While one of the main goals of the gastroenterology network is to find better ways to treat IBD and IBS, researchers will also be looking at the mental health implications associated with these chronic conditions.
鈥淎nxiety and depression are common in people living with IBD and IBS. And I think often we operate in silos, where we have the gastroenterologists doing their research and our psychiatry colleagues doing their research 鈥� each in isolation from each other. But with this Canadian network, we鈥檙e really going to gain from everybody working together.鈥�
The research network is funded by the Canadian Institutes of Health Research, with partnership funding from AV俱乐部 Medical Research Foundation, AV俱乐部, IWK Health Centre, Ascenta Skin, and the Department of Pediatrics.