Gut 57:1182-1183 doi:10.1136/gut.2008.152355
  • Letter
    • PostScript

Helminths as governors of inflammatory bowel disease

  1. D Ludwig1
  1. 1Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Lübeck, Germany
  2. 2Institute of Anatomy, University of Lübeck, Lübeck, Germany
  3. 3Institute of Pathology, University Hospital of Schleswig-Holstein, Lübeck, Germany
  4. 4Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
  5. 5Department of Pediatrics and Neonatology, University Hospital of Schleswig-Holstein, Kiel, Germany
  1. Dr J Büning, Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck/Germany; juergen.buening{at}
  • Published Online First 27 March 2008

The incidence of the inflammatory bowel diseases (IBDs), ulcerative colitis and Crohn’s disease has markedly increased in industrialised countries during the past few decades. In contrast to these countries, where helminthosis is rare, IBD is still uncommon in global areas where most people carry worms.1 2 Thus lack of exposure to parasites may critically contribute to the risk of IBD. In an article in Gut, Summers et al3 demonstrated efficacy of treatment with Trichuris suis in active Crohn’s disease (Gut 2005;54:87–90). T suis was additionally shown to be effective in ulcerative colitis in a randomised trial carried out by the same group.4 However, neither study addressed the mechanisms of action. Here we present a real-life scenario, which supports the impact of helminths in the prevention of IBD, and provide a rationale for the mechanisms of action.

A 12-year-old girl was admitted to our hospital with pasty and sporadically bloody stools. Outpatient rectal treatment with mesalazine …

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