Microbial causation of the chronic idiopathic inflammatory bowel diseases.

SUMMARY: : The inability to find microbial causes for the idiopathic inflammatory bowel diseases has caused investigators and physicians to conclude that these IBDs are not infectious diseases. However, given the complexity of the intestinal flora and fauna and our very limited understanding of its microbiology, it is quite possible that one or more etiologic agents for the IBDs exist, but have not been detected. Consideration of a number of models for how persistent microbes could cause disease, as well as an analysis of the specific relationship of Helicobacter pylori to human disease, facilitates new paradigms for analysis of the IBDs. If the IBDs are due to microbial agents, then the numerous immunological abnormalities observed are thus secondary phenomena. The development of a more comprehensive knowledge base of the microbiology of the human intestine in general, and of IBD patients in particular, is most needed for advances to be made toward cure.