A MAJOR new study into Crohn's and ulcerative colitis is seeking to pinpoint what triggers devastating flare-ups of the bowel disorders, amid "epidemic" rates in Scotland.
Scientists in Edinburgh are recruiting 1500 patients from across the UK for the two-year project.
Participants will have their own DNA mapped from saliva samples and the genetic make-up of their gut bacteria analysed from regular stool samples. They will also be asked to complete monthly online questionnaires about their eating, sleeping and exercise habits, feelings of stress and anxiety, and symptoms.
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Experts will then compare data from those who suffer flare-ups to those who do not in a bid to identify the triggers.
Chief investigator, Dr Charlie Lees, a consultant gastroenterologist, said: “We're trying to work out why some people have flare-ups and others don't.
"Patients want to know what they should eat, how they should exercise, what they can and can't do, so primarily with PREdiCCt we're trying to find out how environmental factors including diet and lifestyle affect flare-ups, but we're also going to try and work out how the gut microbiota and genetics affect disease flare-ups."
The PREdiCCt study is the first study of its kind worldwide to gather detailed genetic and lifestyle factors simultaneously and on such a large-scale.
It is open to anyone who considers their symptoms to be "in remission" will be led by Edinburgh University and NHS Lothian in collaboration with the Rowett Institute in Aberdeen and the Wellcome Trust Sanger Institute near Cambridge.
Funding is being provided by Glasgow-based charity Cure Crohn’s Colitis, the Scottish Government’s Chief Scientist Office, and Crohn’s and Colitis in Childhood.
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Crohn’s disease and ulcerative colitis, collectively known as inflammatory bowel disease, are caused when the immune system mistakenly attacks the digestive tract, triggering excruciating abdominal cramps, diarrhoea, nausea and tiredness. While some patients can successfully suppress symptoms with drugs, in many cases patients have to resort to surgery to remove a section of their bowel only to suffer a relapse. There is no cure.
The condition typically emerges in adolescence or when a patient is in their 20s and Scotland has one of the highest rates in the world - around one in 200 people.
In the past 45 years, the number of under-16s diagnosed with Crohn's disease in Scotland has ballooned by 750 per cent, although the reason for the surge remains a mystery.
A number of theories have been suggested, including antibiotic over-prescribing, processed food and a lack of vitamin D, with studies in North America indicating that incidence increases in sunlight-deprived northern latitudes.
Studies have also pointed to correlations between an increase in caesarean sections coupled with a decline in breastfeeding for the trend since both reduce infants' early exposure to maternal bacteria which has been shown to protect against other problems such as asthma, food allergies, hay fever and obesity in later life.
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Human trials have also launched this month to test a potential Crohn's vaccine, developed at King's College London, which has already shown success in animal studies. It follows evidence that Crohn's may be caused by a pasteurisation-resistant bug found in milk - mycobacterium avian subspecies paratuberculosus (MAP) - which enters humans through beef and dairy products and has also been found in high quantities in infant milk formula. MAP has been found in around 92 per cent of Crohn's patients, but it has also been detected in gut samples from healthy people.
Anyone interested in taking part can contact study organisers on predicct@ed.ac.uk.
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