Gut instinct: Dr. Ed de Zoeten’s journey to promote digestive health

Caregivers / Researcher

Dr DeZoeten

Tucked into a corner of Dr. Ed de Zoeten’s office is a folding two-wheel scooter, the kind kids propel down neighborhood sidewalks, kicking rhythmically.

The scooter is Dr. de Zoeten’s vehicle for “commuting” between Children’s Hospital Colorado and his University of Colorado research lab, a 10-minute walk away. The scooter saves him five minutes each direction, he reckons: an hour a week; a week a year. The scooter also, clearly, ups the fun factor.

For Dr. de Zoeten—who is racing to understand and cure digestive diseases—urgency might be the driver, but fun rides shotgun.

The urgency dates to the 1990s, during his M.D.-Ph.D. studies. Dr. de Zoeten’s mother was dying from cancer complications related to ulcerative colitis, which causes bleeding sores in the colon. Tragically, she died before he finished school, but her death catalyzed his interest in inflammatory bowel disease (IBD), a group of chronic autoimmune disorders that wreak havoc on the digestive tract, including ulcerative colitis and Crohn’s disease. Studies show that as many as 80,000 children in the United States suffer from IBD.

His mother wasn’t the only influence on Dr. de Zoeten’s career. The other was a passion for helping kids.

“I always knew I wanted to work with kids,” he says. “They’re so resilient and positive. Kids go through really unpleasant procedures, and they come out ready to play.” He shrugs. “They’re just … better than adults.”

They’re also still growing, or at least should be; Dr. de Zoeten looks for solutions to help promote growth when things go wrong.

“I had an 11-year-old patient who wasn’t gaining weight,” he recounts. “He was always tired, and he’d stopped growing.”

The child’s primary care doctor sent him to an adult gastroenterologist, who could tell his gut was very inflamed but couldn’t find where. That’s when the patient was referred to Dr. de Zoeten’s team.

“We did a capsule endoscopy, sending a camera—the size of a big horse pill—through his digestive tract,” says Dr. de Zoeten. “It showed us a very inflamed area in his small intestine.”

Once the problem was isolated, Dr. de Zoeten diagnosed Crohn’s disease and discussed treatment options with the child and his parents. They agreed on nutritional therapy: a removable nasogastric (NG) feeding tube, threaded through a nostril and into the stomach each night to deliver anti-inflammatory nutrients. Three months of treatment put the boy’s IBD into full remission.

“He’s off the NG tube; he’s growing; and he’s playing baseball again,” says Dr. de Zoeten. “I love how quickly we got him in, diagnosed, and back to being an active, happy kid again.”

Hope in new research

Patient care is only 40 percent of Dr. de Zoeten’s work; the other 60 percent is research aimed at better understanding IBD’s causes, treatments and potential cures. Recently, Dr. de Zoeten’s team has been seeking ways to harness the body’s own immune system to decrease inflammation in the gut through something called cell stress pathways. 

“Our cells have the ability to protect themselves in response to stress,” explains Dr. de Zoeten. “We’re finding that by inducing these stress pathways – for example, through a fever – we can activate the immune system in a way that decreases inflammation.”

It’s a groundbreaking approach. Many current therapies designed to wipe out a disease inadvertently wipe out the body’s immune system in the process. But Dr. de Zoeten’s research seeks to work with the way the body functions normally to reduce inflammation and restore balance to the intestines.

The research could have far-reaching impacts, not only for those fighting IBD, but also for conditions like rheumatoid arthritis.

Other promising avenues include nutritional anti-inflammatories. Dr. de Zoeten is currently working with a company to develop a protein found in breast milk, lactoferrin, as a possible IBD treatment.   

“We’re finding that this protein can activate the immune system in a way that decreases inflammation,” says Dr. de Zoeten. “Now we’re ready to start clinical trials in patients.”

One of the greatest benefits of lactoferrin is that it’s a nutritional therapy, not a drug.

“There are some very effective IBD medications, but when you’re changing the way the body functions, there’s always the risk of side effects,” said Dr. de Zoeten. “If this protein can decrease inflammation in the small intestine, then we can treat the disease with far fewer risks.”

Dr. de Zoeten says that philanthropic support is key to advancing new IBD treatments. Research funding is scarce, and without the funds to establish baseline data, it’s nearly impossible to apply for large, highly-competitive grants from the National Institute of Health (NIH), the federal government’s largest research funding agency.  

“The NIH funding rate for some programs is as low as 7 percent,” says Dr. de Zoeten. “Philanthropy funding is critical to keeping our research moving forward.”

And that research could make all the difference for Dr. de Zoeten’s young patients.

“I now have patients who are graduating from college,” says Dr. de Zoeten fondly. “I’ve been treating some of them for 10 years. It’s pretty incredible to watch them succeed and not let this disease take over their lives.” He pauses and smiles. “These kids are amazing.”

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