Solving the Mystery of What Causes Crohn’s Disease and Ulcerative Colitis. Clues Abound, But the Case Is Far From Closed.

Second of five parts

There’s no question that Crohn’s disease and ulcerative colitis are characterized by chronic inflammation affecting the digestive tract that can wreak health-altering havoc in its sake.

“The big question has always been, why is that it there?” says Alan Moss, M.D., the newly appointed chief scientific officer of the Crohn’s & Colitis Foundation and director of the Crohn’s and Colitis Program at Boston Medical Center.

In a recent interview with Managed Healthcare Executive, Moss discussed the evolving understanding of the source of inflammatory bowel disease, an umbrella term for Crohn’s disease and ulcerative colitis. Researchers have ventured beyond inflammation to consideration and study of the possible role of that the microbiota, the vast numbers of microorganisms that live in the gut. Researchers have also explored diet and nutrition; Moss has conducted studies looked at the relationship of vitamin D to inflammatory bowel disease.

But how do these possible causal factors all fit together? Moss told MHE that is still a huge unknown.

“There are clearly so many parts here,” Moss said, referring to the cause of inflammatory bowel disease. “Diet is clearly part of it, microbiota is part of it, fungi are part of it, your genetic response is part of it, how you regulate (epithelial) cells is part of it. They are all in there. No one has figured out the sequence.”