The procedure for processing milk in the UK should be changed to ensure bacteria associated with Crohn鈥檚 disease are killed, says the Food Standards Agency. In the meantime, people at risk of the disease should avoid either boil pasteurised milk or drink alternatives such as soy or UHT milk, says a leading bowel specialist.
However, many scientists are sceptical that a bacterium is to blame for the debilitating gut disorder.
Crohn鈥檚 disease is common throughout the developed world, with an estimated incidence of at least one in 1,600 in the UK. There has been a sevenfold increase in the number of cases in British children over the past 10 years.
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Research conducted by John Hermon-Taylor, professor of surgery at St George鈥檚 Hopsital, London, and others has implicated a bacterium called Mycobacterium avium paratuberculosis (MAP) in the development of Crohn鈥檚.
In Europe, milk must heated to 70C for 15 seconds. But this is not long enough to kill MAP. The FSA now recommends that the treatment time should be increased to 25 seconds. But there will be no final decision until a period of further consultation finishes in March 2002.
In the US, pasteurisation involves heating milk to 70C for 42.5 seconds.
Antibiotic-resistant
Hermon-Taylor鈥檚 study of Crohn鈥檚 patients found that the 鈥渙verwhelming majority鈥� were also infected with the MAP bacterium, while the bacterium was found in very few healthy people.
MAP is highly resistant to antibiotics. Hermon-Taylor鈥檚 team is working on specialised antibiotics designed to target MAP, and treatment with these antibiotics has had some success, he says. 鈥淚f you kill the bacteria, people with Crohn鈥檚 get better.鈥�
However, Chris Hughan, chief executive of the UK鈥檚 Crohn鈥檚 in Childhood Research Association (CCRA), says: 鈥淭here is absolutely no proof that MAP is linked to Crohn鈥檚 disease and at this point nobody has even managed to replicate Hermon-Taylor鈥檚 results. We don鈥檛 know the causes of Crohn鈥檚 disease, although a defective gene has been identified that accounts for about 30 per cent of cases.
Calcium deficient
鈥淚 would urge children not to stop drinking milk,鈥� he adds. 鈥淐hildren with Crohn鈥檚 disease have enough major problems with growth due to the effects of the disease and their steroid treatment, without also being calcium deficient.鈥�
A report published by the EU last year on MAP and Crohn鈥檚 disease concluded: 鈥淭he currently available evidence is insufficient to confirm of disprove that MAP is a causative agent of at least some cases of Crohn鈥檚 disease in man.鈥� But it called for urgent research in the area.
Hermon-Taylor insists critics 鈥渄on鈥檛 understand the science.鈥�
Denmark and the Netherlands, which are large consumers of dairy products are also looking into new ways of treating milk to the incidence of Crohn鈥檚 disease.