Guess I’ll eat some worms

By Richard P. Holm, M.D.

This month, a scientific journal reported the remarkable case of a 35-year-old man who took an unusual treatment for ulcerative colitis. His colon was so inflamed and sore that he had been advised by doctors to have it surgically removed. After researching experimental therapy for ulcerative colitis, he decided to travel to Thailand where a doctor gave him 1,500 roundworm eggs to swallow.

The idea that worms might have something to do with ulcerative colitis and Crohn’s disease came from the observation that colitis is common in developed countries like America, where worm or parasitic infections are rare. In contrast, colitis is rare in countries where virtually the entire population has worms living inside of them.

This is similar to scientist David Strachan’s “hygiene hypothesis,” that was presented in the British Medical Journal in 1989. He showed data that hay fever and eczema were more common in families with one child than in larger families, and he speculated that the difference was because of an earlier and broader exposure to infections in the larger families. He suggested that more exposure to the dirty world results in less allergies.

Strachan’s idea has expanded and the “hygiene hypothesis” proposes that in developed countries, as a result of a “too-clean” environment, there is an increase in the diseases of the immune system such as inflammatory bowel disease, multiple sclerosis, asthma, and even childhood-onset diabetes mellitus type 1. Remember, however, the “hygiene hypothesis” is still just theory.

Let’s get back to our patient with colitis that traveled to Thailand. To everyone’s delight, after eating worm eggs, the gentleman quickly became symptom free. About three years later, after a relapse, he took more eggs and got better again. Over the six years that scientists studied the patient, they found his immune system was changed by worm therapy and noted that his colon had increased mucous production.

We are not talking night crawlers here, and some worm infections can be very harmful in humans, so people should not eat worms without scientific direction. Studies are now underway using pig whipworms, which are a less-aggressive worm, in treating not only inflammatory bowel disease, but also multiple sclerosis.

“Nobody loves me, everybody hates me, guess I’ll eat some worms.” Maybe some day we’ll be eating worms for colitis, too.