Twenty-five percent of people with IBD develop a chronic peripheral or spinal form of arthritis, known as spondylitis (SpA) of IBD, which typically begins affecting people in their teens to young adult years and can last a lifetime. For more information, refer to the “About SpA of IBD” section of the Spondylitis Association of America web site.

Who Gets IBD
IBD is almost nonexistent in approximately one-third of the world, mostly in underdeveloped countries with harsh sanitary conditions. Some in the medical field believe that the existence of parasitic worms living in the intestines of humans and animals actually protect those people against IBD.

“It turns out that countries where IBD is common are those industrialized, developed nations like the U.S., where there are no intestinal helminths. Conversely, where helminths are prevalent, the incidence of IBD is very low,” stated Robert W. Summers, MD, a gastroenterologist at the University of Iowa College of Medicine. Summers goes on to explain that IBD emerged in the U.S. during the 1920’s and 1930’s when the nation began shifting to improved plumbing and sanitation, and people no longer fertilized soil with human and animal waste. “Until then, parasites were very common. And we didn’t have much IBD.”

Although the exact cause is unknown, IBD may result from an overactive immune system in which cells that normally attack invading disease and infection end up targeting healthy tissue. People with IBD are often treated with medications that suppress immune response. Worm eggs also decrease the overactive immune response, possibly by secreting a substance.

Study Layout
Summers and colleagues gave seven IBD patients a solution containing thousands of “whipworm” eggs commonly found in pig intestines. Each dose contained 2,500 live eggs that were harvested at an USDA laboratory.

In the beginning, all patients showed evidence or improving (as tabulated by scores in a quality of life questionnaire and as a drop in a symptoms score), but their symptoms recurred. They continued with additional doses every two weeks. Some have continued the doses for years now and are doing well. They have yet to detect side effects in any of the patients.

The Iowa researchers tested three other types of worms in studies of mice with colitis, all of which have been effective.

What it May Mean for the Future
These worms have been around for over three million years, so approximately one-third of the world’s population do well with them in their GI tracts and apparently have no problems. Unlike other parasites that cause infection, the human body does not recognize the pig whipworm as a foreign invader so it does not cause problems.

The same researchers are currently conducting two studies involving 100 patients in which half get the worm egg solution and the other half get a placebo mixture.

For more information, refer to http://my.webmd.com/content/Article/74/89187.htm