Dairy and Crohn’s disease: Is there a link?

Imagine not being able to live more than five feet away from the bathroom because you have chronic diarrhea and terrible abdominal cramps and pain. Imagine living with constant fatigue as a consequence of extreme weight loss. These symptoms are a reality for Crohn’s disease patients. UCLA student Laura Thompson, 21, had never heard of the disease until she was diagnosed at 17.

“I was always feeling cramps, and I kept losing weight, so my mom took me to the doctor,” Thompson says. “We were shocked when we heard there was not a cure for what I had.”

Thompson says that she had to change her lifestyle, and learn to manage her busy school schedule around her disease.

“It has not been easy to live with this condition; I need constant checking, I have to take medication every day, and I need to follow a very strict diet,” Thompson says. “Sometimes I have to miss classes because I need to go to the doctor. Sometimes I have to miss school because the symptoms are back.”

Thompson, who was ashamed of her symptoms when they started, says she has been more open about her health condition since she joined a support group for patients with Crohn’s disease.

“It is an embarrassing disease,” Thompson says. “It is always awkward when you are with friends and you have to run to the bathroom.”

Crohn’s disease is a “chronic inflammation of the gastrointestinal tract,” according to the U.S. National Library of Medicine.

The causes of Crohn’s disease are unknown, but there is a controversial debate among researchers about the possible connection between Crohn’s and Mycobacterium avium paratuberculosis, or MAP bacteria.

MAP bacteria are the causative agents of Johne’s disease, a condition that affects a variety of mammals, including cattle.

Johne’s disease produces similar symptoms in animals as Crohn’s disease does in humans. It is argued by some that MAP bacteria can be transmitted from cows to humans through meat or dairy products. However, this theory has yet to be proven.

One of the advocates of this theory is Dr. Lester Friedlander, doctor of veterinary medicine, and former U.S. Department of Agriculture chief inspector of the largest cow slaughter plant in the United States.

Friedlander has been warning Americans about the presence of MAP bacteria in milk and meat for more than a decade. According to Friedlander, around 70 percent of the dairy herds in the U.S. are infected with Johne’s disease, creating a menace for consumers, because the bacteria can survive pasteurization.

Friedlander also states that cows infected with Johne’s disease are being slaughtered for human consumption, and that the USDA allows it even if it is against their regulation.

“As a USDA inspector, I had to make sure that the animals for human consumption were healthy and disease free,” Friedlander says. “But these cows came with a veterinarian service form, VS-127, and were infected with Johne’s.”

Friedlander claims he saw thousands of Johne’s cows going into his plant for human consumption.

“When I told my supervisor in the USDA that they should condemn these cows because they were a direct way to Crohn’s disease in humans, they told me that they could not do it, because the research was still being conducted,” Friedlander says.

In 1995, after talking about the issue on radio and television appearances, Friedlander’s superior asked him to resign from his position working for the USDA. However, Friedlander assures he has a copy of a USDA research paper that states that Johne’s disease in dairy cows is linked to Crohn’s disease in humans.

According to Friedlander, people should consume meat and dairy with caution because of these associated risks.

“For a better lifestyle, people should follow a vegan or vegetarian diet because it is safer; you don’t get diseases in carrots or squash, and there are so many diseases in animals,” Friedlander says.

Dr. Michael Payne, a veterinarian with the University of California’s School of Veterinary Medicine claims that there are many inaccuracies in Friedlander’s statements.

“If someone can figure what is the exact connection between MAP and Crohn’s, that person will win a Nobel Prize in medicine,” Payne says. “Among researchers, there is a robust discussion about what role MAP plays in the occurrence or exacerbation of symptoms in people diagnosed with Crohn’s disease.”

Payne does not discard the MAP theory, but for him, the exact cause of Crohn’s disease remains unanswered.

“Based on pathological, culture and immunological studies in Crohn’s patients, the most commonly accepted theory probably is that MAP—and potentially other bacteria—may trigger an overly aggressive immune response in the GI tracts of small groups of genetically susceptible populations.”

However, Payne believes that more research in the area is required.

“It is unknown how many exposures are needed, and how many MAP may be required to initiate infection in a human, or even whether all humans are susceptible to infection,” Payne says. “Therefore, it is difficult to predict the importance of these potential routes of exposure.”

Regarding the safety of dairy products, Payne assures that pasteurization has been shown to decrease or even eliminate MAP bacteria at levels which would expected to be found in raw milk.

“This, perhaps, explains the results of a case-control study in the United Kingdom where no association was found between consumption of either drinking water or dairy products and the development of Crohn’s disease,” Payne says.

Payne also assures that the number of herds infected with Johne’s disease in the U.S., according to the National Animal Health Monitoring System, is around 23 percent, not 70 percent as Friedlander says.

“No matter what environmental samples or cultures from individual cows show, at least in California cows, clinical Johne’s Disease—as opposed to detection of exposure by a blood sample—is a rare condition,” Payne says. “If the association between MAP and Crohn’s were so simple and straightforward, then there would be a whole lot of people with Crohn’s disease, and that is not the case.”

According to Friedlander, the reason why the number of Crohn’s disease patients is not bigger can be attributed to genetics.

“Most people have an immune system that can fight Crohn’s disease, but there are others who have a predisposition to the disease,” Friedlander says. “When people go to the doctor and they get diagnosed with Crohn’s disease, the first recommendation the doctor makes is to stay away from dairy products, and they say it because they know there is a connection between dairies and the disease.”

Despite arguments against his claims, Friedlander will continue his efforts to prove the connection between Johne’s and Crohn’s diseases. He believes the next step would be for the Centers for Disease Control and Prevention to declare Johne’s disease a zoonotic disease, an animal disease that can be transmitted to humans.

“Once the CDC gives that statement, these cows will not be used for human consumption,” Friedlander says. “The CDC does not want to make that statement because it represents huge economic losses.”

Friedlander says he contacted CDC veterinarian Dr. Carol S. Rubin over six weeks ago about the issue.

“I discussed with her about the direct link between Johne’s disease in dairy cows and Crohn’s disease in humans,” Friedlander says. “They told me they will look into it, but they haven’t gotten back to me yet.”

Santa Monica College student Karin Hauenstein, a horse welfare and health advocate, has changed her eating habits after hearing all the dangers related to meat and milk consumption asserted by Friedlander.

“Even though I am not vegan or vegetarian, I almost have to live like one,” Hauenstein says. “I stopped drinking milk and only eat meat when I know where it comes from. Even kosher is not safe anymore.”

Amira Schultz, walk manager of the Crohn’s & Colitis Foundation of America in Greater Los Angeles,   stresses the importance of keeping in mind how difficult it is to live with the disease.

“We might not know what causes the disease, but we do know what triggers the symptoms,” Schultz says.

The CCFA works to find a cure for Crohn’s disease and ulcerative colitis. The organization also refers patients to support groups, and seeks to improve their quality of life for those affected by these diseases.

According to Schultz, there are different ways to treat Crohn’s disease, and the CCFA tries to match each patient with the best type of treatment for each specific case. However, the different drugs and procedures treat the symptoms, not the disease.

For Laura Thompson, the debate of whether or not MAP bacteria cause the disease is not as relevant as the research for finding a cure.

“It is not easy to live with Crohn’s disease,” Thompson says. “Sometimes I feel good, but the discomfort and the threat of getting worse is always there. For now, I take care of my diet and take my medication, but I still want a normal life.”