Eight years ago, New Yorker Herbert Smith did the unthinkable -- he swallowed thousands of pig whipworm eggs in a desperate bid to quell his advancing Crohn's disease.
The microscopic eggs, invisible to the naked eye, were suspended in a liquid solution.
"There was nothing to it," said the 33-year old financial analyst, who uses a pseudonym to talk about his worm-drinking ways. "It was drinking half a cup of salty water."
At that moment, he said, "I felt excitement and definitely hope."
For Smith, something incredible happened. After swallowing 2,500 worm eggs every two weeks for three months, most of his Crohn's symptoms vanished.
"I was definitely ecstatic," he said. "The symptom reduction was pretty drastic."
"I did have blood tests before and after," he said, and "the markers of inflammation went down significantly."
As for his physician's reaction, Smith said "he was cautiously optimistic."
Smith has been battling Crohn's disease since he was diagnosed as a teenager.
"The worst day of your life is to find out there's no known cure," he said. "It affects your quality of life in a significant way, and most treatments are subpar."
As many as 1.4 million Americans live with Crohn's disease or its cousin, ulcerative colitis, according to the U.S. Centers for Disease Control and Prevention. In Crohn's disease, the body's immune system mistakenly attacks the lining of the intestine, causing diarrhea, abdominal pain, fatigue, bleeding and infections. For Smith, the disease has been difficult to control.
Despite undergoing multiple operations to remove part of his gut, his symptoms always returned, he said. He calculated that at his current rate of required surgeries, he would eventually run out of small intestine. If this occurred, he would require liquid feedings through an intravenous line, with potentially fatal consequences.
"That realization was pretty hard to take in," said Smith. "I had to do my own research."
Worms as Medicine
Smith started studying the medical literature on how parasites might be useful in the treatment of inflammatory bowel disorders such as Crohn's disease. He also learned that one could order a three-month supply of pig whipworm eggs from Europe for 3,500 euros.
But he was realistic about his treatment goals.
"I knew that the most I could hope for was a remission for Crohn's, not a cure," he said.
Despite his promising response to pig whipworms in 2004, Smith had to stop because "it was very expensive and hard to get," he said.
Today, researchers are eagerly studying the experimental therapy. After finding that pig whipworm treatment was effective and safe in a small number of Crohn's patients, scientists are now conducting multicenter studies across the United States and Europe. The goal is to determine if this treatment will relieve symptoms and be tolerated across a larger group of patients.
Dr. Joel V. Weinstock, a parasitologist and chief of the Division of Gastroenterology/Hepatology at Tufts Medical Center in Boston, said there was a scientific basis behind drinking pig whipworms to help reduce symptoms in autoimmune disorders, such as Crohn's.
"Parasites are known to dampen the immune systems of their hosts," Weinstock explained. More specifically, drawing from animal studies from his laboratory, pig whipworms appear to activate cells that regulate the immune system so that it doesn't overreact.