Fighting intestinal disease from within
In Canada, more than 200,000 lives are seriously affected by diseases of the bowel and colon. Unfortunately, we don't know what causes many of these debilitating and chronic diseases—let alone how to cure them.
Complaints related to the stomach and intestines feature among the top three reasons people go to see a doctor. Attempts to address those gastrointestinal problems account for up to 15% of total direct healthcare spending in Canada—which is more than we spend on either cardiovascular or mental-health problems. So, given that over eight million Canadians suffer from gastrointestinal problems, finding out just how our intestines work could make a big difference to the healthcare system and our efforts to prevent disease.
AHFMR support helped bring Dr. Derek McKay to Alberta from McMaster University in 2006. Now a member of the Gastrointestinal Research Group at the University of Calgary, Dr. McKay heads a team of researchers working to understand the physiology of the small and large intestines (which include our bowels and colon).
In the fight against intestinal disease, their research concentrates on a trio of diseases affecting the lower abdomen that are not only painful, but often painfully embarrassing. Symptoms include abdominal pain, bloating, diarrhea, and constipation. Inflammatory bowel disease, a condition that severely reduces quality of life for about 200,000 people in Canada, actually comprises two different intestinal diseases: Crohn's disease and ulcerative colitis. Completing the trio is irritable bowel syndrome, the most common gastrointestinal diagnosis worldwide. In Canada it affects 13% to 20% of the population.
These numbers add up to a lot of suffering caused by a kind of disease that most patients don't want to talk about. In our intestine-shy culture it seems that the less said about bowel disease, the better. However, bowel disease is increasing in world populations. Dr. McKay notes, "It's vitally important to increase public awareness on the issue of bowel disease. There is so much unnecessary stigma attached to anything that goes wrong below the waist."
A parasitologist by training, Dr. McKay says that one of his favourite projects is the study of tapeworm parasites and their role in intestinal immune responses. Though using an actual tapeworm as a treatment may seem unpalatable to some and impractical to others, Dr. McKay hopes this research can help him find a way to mimic the desired immune responses that tapeworms can initiate—which block or reduce the severity of such intestinal disorders as irritable bowel disease.
Another exciting research project under Dr. McKay's guidance aims to determine how our intestines "know" when to let nutrients into the bloodstream, while keeping bacteria and toxins out. Considering that a person's gut is essentially one long tube that has been divided into different structures—mouth, esophagus, stomach, and bowels—this barrier function must be extremely sophisticated. Dr. McKay's research in this field is specifically focused on the function of the mucous cells lining the internal surface of the intestine.
As a recognized leader in gastrointestinal research, Dr. McKay has ample knowledge to share with the world. He is the recipient of a prestigious 2007 Masters Award in Gastroenterology and holds a Canada Research Chair in Intestinal Immunophysiology in Health and Disease. Though only mid-career, Dr. McKay has already supervised 38 research trainees studying at undergraduate, master's, doctoral, and post-doctoral levels. His work includes an emphasis on working with student researchers for several reasons. "It's more fun having students around. Young people help keep labs vibrant," he admits. Moreover, students provide a crucial element of continuity in research. That continuity could be a key factor in eventually finding cures or even preventing diseases altogether.