Is Your Crohn's Disease Caused by Your MilkJanuary 30, 2022
Is Your Crohn's disease from Your Milk?
There is something rotten about Crohn's Disease. Its prevalence has been steadily increasing in the USA and Great Britain. Since the year 1999, the prevalence has increased from 0.9 % to today at 1.3%. That's close to a 50% increase. That was close to the same increase we saw in 1999 over the prior decades. We keep doing this. That speaks to an environmental cause for the disease. That's Fact #1.
Fact #2. Crohn's is basically a disease of "granulomas", little oval-shaped structures in the wall of the small bowel. Now, that pathological structure is only shared with two other diseases. Tuberculosis. And sarcoidosis. We know tuberculosis in its classical form is an infectious disease caused by Mycobacterium tuberculosis. Could the same thought be applied to Crohn's? Could Crohn's disease in humans be the same as Johne's in dairy? Is it just in dairy? Is there more news about it?
What is Johne's disease? It is the infection of cows with atypical tuberculosis that gradually saps their milk production. It is present in some 1%+ of Wisconsin cows. Its control is still voluntary, though most farmers now know about it. What is reality now is that we collect milk into giant trucks that mix the milk from hundreds of cows, if not several dairies making the infection potentially much more widely dissipated. You don't buy your milk from one farmer, and one cow. Every glass of milk has the product of 200 cows in it. Hmmm.
There is more news. We now know it is not just in cows. Small mammals get it too. Goats and sheep are vulnerable. The University of Wisconsin now has a full-fledged Johne's information center with faculty dedicated to studying it and assisting the dairy industry. The technology of genetic analysis has leaped forward and it is now possible to find the DNA of the mycobacteria avium paratuberculosis (MAP) in manure, just like we are tracking COVID in human sewage systems. That's huge and presents an enormous tool for control and eradication.
This column has covered this topic before, but it has been over 10 years since we reviewed it. I wanted to see if the world of science had come to any conclusions that are more helpful or definitive. There continues to be smoke, and there continues to be speculation, but proof is very elusive. A review article in the World Jr of Gastroenterology details the problems. The waxy wall around the MAP bacteria makes it able to survive pasteurization and many community water purification systems. It is an extremely slow-growing bacteria. That means culturing it is no mean feat and requires a prolonged observation time: on the order of months rather than the two days to find streptococcus.
One might ask the question, can you detect the MAP DNA in human stool? And the answer is YES! It has been studied and guess what the findings show? A stunning 68% of Crohn's patients have the MAP DNA in their stool. 65% of ulcerative colitis patients were positive. Sounds like a slam dunk. Except that 48% of controls were positive. But small numbers (20 and 30 cases in each group). The MAP DNA is certainly there.
Apparently, the MAP bacteria needs iron and can't import it from the outside world. To do so requires making "mycobactin", which is a complex molecule that binds the iron. The MAP bacteria can't do that and depends on passively getting it from elsewhere. That may be the key to its extremely slow growth making its culture growth almost impossible.
But all this news represents a gradual tilt from faint possibility of MAP causing Crohn's to being at the point of almost recognizing it as the cause in at least 50%, and calling for all patients to be assessed for their presence of MAP DNA in their stools. If positive, long-term, low-grade antibiotic treatment may be in order.
That takeaway message for you should be that almost 48% of the population has MAP DNA in their stool. Does that represent 48% of people being affected by the MAP bacteria, just not having Crohn's or UC yet, or does it reflect the incredible sensitivity of DNA technology to find the MAP DNA that came from milk ingestion of contaminated dairy?
Johne's is hard to detect in dairy cows. With diligence, it is possible to find it, but its persistence speaks to the fact that it is still there, and despite a well-known program to address it, it remains there.
www.What will Work for me? I think it's time to test our milk with DNA for the presence of MAP DNA. It's time to make control of MAP mandatory for anyone who supplies dairy for public consumption. Plain and simple. Our dairy otherwise could be considered an existential threat to our safety and wellbeing. Anyone with Crohn's would agree. We can't keep increasing at 50% every 20 years and soon not all have it. And in my book, I now believe we have to consider Crohn's an infectious disease and be open to long-term treatment with antibiotics. Call your representative or senator and ask them to get on board. Send them this email. They know someone with Crohn's. I won't buy animal milk products until I'm assured of their safety.
1. What is Johne's disease? Answer: An infectious disease in animals (cows, sheep, goats....) caused by the atypical mycobacterium avium paratuberculosis. (MAP)
2. Is the MAP bacteria cleared with pasteurizing? Answer: No one can tell you "absolutely".
3. What percent of Crohn's from Italy have MAP DNA in their stool? Answer: about 2/3rds. But asymptomatic folks have a 48% prevalence rate.
4. What has been happening to the prevalence of Crohn's in America? Answer: On the order of doubling every 40 years. Some horrible number.
5. What is the impact of Crohn's on those who have it? Answer: Just awful. You don't want this disease.
The column was written by John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI.