Hidden GEM

Danette Dooley
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A new study hopes to find environmental triggers to inflammatory bowel disease as medical professionals continue their fight against Crohns'

Dr. Jerry McGrath is a gasterenterologist at Memorials faculty of medicine who works out of the Health Sciences Centre, and Jackie Stokes is research co-ordinator, paediatrics, at the Janeway hospital. Both are recruiting participants for a national study

A research project that could change life for over 100,000 Canadians is about to begin at several universities throughout the country, and Memorial University is one of them.
The objective of the genetic, environmental and microbial (GEM) project is to recruit and follow the several years siblings of people diagnosed with Crohn's disease, says Dr. Jerry McGrath, a gastroenterologist at Memorial's faculty of medicine.
"The feeling is that family members are at a higher risk of developing Crohn's disease than people who don't have family members with it. So, we want to see if there are certain things - like environmental exposure - that brothers and sisters may have been exposed to when they were growing up, to put them at higher risk," McGrath says.
An inflammatory bowel disease (IBD) that causes inflammation in the gastrointestinal tract, Crohn's disease is as embarrassing as it is painful.
Those inflicted with the disease are usually diagnosed between the ages of 15 and 25 and the Crohn's and Colitis Foundation of Canada (CCFC) estimates that 112,000 Canadians live with Crohn's disease.
It is hoped the GEM project will help identify the cause or trigger of Crohn's disease, McGrath says, and explain why some individuals develop Crohn's and others do not.
During the course of the study, researchers will measure several factor before and after a diagnosis of Crohn's disease is made.
"We'll be looking to see if there are any changes in GI (gastrointestinal) symptoms," McGrath says.
Such symptoms include diarrhea, weight loss, fevers, chills or abdominal pain, he says.
If these individuals have any of these symptoms, he says, they'll be checked further to see if they have developed Crohn's disease.
The researchers are also studying genetic factors that put individuals at higher risk of developing the disease, he says.

Smoke linked to disease
The strongest environmental link, McGrath says, is cigarette smoke.
About 70 per cent of people who suffer from Crohn's disease smoke, he says.
"That's much, much higher than you'd see in the general population and smoking seems to affect the severity of the disease and the ability of some of our medications to successfully treat the disease."
McGrath says investigators are hoping to recruit 5,000 healthy individuals to participate in the $5.5-million, six-year study.
Newfoundland has one of the highest rates of Crohn's disease in the country, McGrath says. He encourages anyone affected by the disease to become involved.
"And Canada actually has one of the highest rates of Crohn's disease in the world," McGrath adds.
The study is open to individuals diagnosed with Crohn's disease and their siblings. All study participants must be between the ages of 6 and 35.
Jackie Stokes, research co-ordinator, paediatrics at the Janeway hospital, says the study is the only one of its kind in North America.
It provides a unique opportunity for family members to help in the detection and management of Crohn's disease, Stokes says.
"Even younger siblings are eager to become involved, even if it means having a blood test and giving other not so fun samples as well. They want to do their part to help their brother or sister deal with this disease," Stokes adds.

Treatment improving
While there is no cure for Crohn's disease, McGrath says strides have been made over the years in treating those who suffer from the IBD.
"There are lots of patients who now manage to avoid surgery because of some of the newer and stronger medications … that we didn't have just 10 years ago." McGrath says.
Those medications include experimental drugs that are available to physicians like McGrath at the Health Sciences Centre.
Although treatments have improved the quality of life of those who live with Crohn's, there is still much stigma attached to the disease, McGrath says.
"No one wants to talk about how they're having bloody bowel movements or how they're waking up at night with abdominal pain. So, it's a disease that's still not socially acceptable in the general population. Which is sad, because so many people suffer in silence," he says.
November is Crohn's and Colitis Awareness Month throughout the country.
McGrath will be a speaker at an education symposium which takes place at the Fairmont hotel Nov. 29.
Sponsored by the CCFC, symposium speakers will address, among other things, the latest trends in IBD.
Over 80 per cent of CCFC fundraising proceeds go directly towards research and education initiatives like the GEM project.
"If we get out there and inform more people about it, hopefully we'll be able to increase the amount of research revenue that we have and that will increase our ability to find a cure," McGrath says.
For more information on Crohn's disease or on the symposium e-mail CCFC regional director Julie Bowering at jbowering@ccfc.ca.
To register for the GEM project, call Jackie Stokes at 777-4972, e-mail jstokes@mun.ca or visit ccfc.ca.

danette@nl.rogers.com

Organizations: Colitis Foundation of Canada, Janeway hospital, Health Sciences Centre Fairmont hotel

Geographic location: Newfoundland, Canada, North America

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