New treatments help Michael Morley thrive following ordeal with Crohn's disease

It was a Morley family tradition for the six kids to measure themselves at the end of each summer, marking their respective heights on an open stud of the cottage wall in East Bay, Cape Breton.

But, in the summer of 2010, at the age of 10, Michael Morley realized he hadn’t grown a single inch since the summer before. Curious, he weighed himself on the bathroom scale, and was surprised to see that he hadn’t gained any weight either.

By the middle of September his parents, Theresa and Allan, were genuinely concerned. Michael was pale and noticeably thinner; he said he felt “full,” yet he was barely eating a thing. Theresa, a registered nurse at the VG Hospital in Halifax, started to think it might be Crohn’s disease. This suspicion was soon confirmed with a barium swallow test at the IWK Health Centre. Michael was started on a liquid diet, to be fed through a nasogastric tube.

The kids at school certainly stared at Michael when he arrived at school with a tube in his nose, carrying a backpack containing his liquid food and the pump that pushed it through the tube and into his stomach. “Some of the kids were a bit scared by it,” Michael recalls. “But my mom came and gave a presentation to the class, and I had to answer a bunch of questions—once they knew what it was all about, they got used to it and no one gave me a hard time.”

After several months of tube-feeding 20 hours a day, Michael gained 20 pounds. He only took a break from the feeds when he’d go on the ice for hockey practice (he didn’t have the energy to play many games), and for an hour before and after his twice-daily antibiotic dose. But after about six months of exclusive tube-feeding, he went from feeling quite a bit better to not-so-good anymore.

“The feeds were making him nauseated and he had developed canker sores in his mouth, little red dots on his arms and legs, and larger, red tender patches on his legs,” says Theresa. “Endoscopic investigations showed his digestive tract was a mess.”

Dr. G. Mahdi, Michael’s gastroenterologist at the IWK, started him on immune-suppressing biologics. When the first treatment brought little relief, Dr. Mahdi switched Michael to another biologic agent, which he had to learn to inject into himself. While this treatment brought considerable relief, Michael was still ill.

In the midst of these treatments, Dr. Mahdi retired and Michael came under the care of a new gastroenterologist, Dr. Johan Van Limbergen, recruited to expand Dalhousie Medical School’s research effort in the area of inflammatory bowel disease (IBD). When Michael developed pain and swelling in his belly following a scoping procedure that found a stricture in his bowel, Dr. Van Limbergen recommended surgery to remove the damaged portion of the bowel.

“I feel 100 per cent better after the surgery,” says Michael. “I have to stay away from high-sugar and greasy junk foods, and my friends help me with that, but overall I feel great.”

Michael continues to inject himself with the biologic weekly, to keep inflammation at bay, but after years of low appetite and energy, he now has energy to burn. He spent his summer hiking, swimming, boating and looking after his uncle’s hobby farm in Big Pond, Cape Breton.

Michael and his family are keen to support Dalhousie Medical Research Foundation’s 2016-17 Molly Appeal, which is raising funds for inflammation, infection and immunity research. This includes funds to improve Dr. Van Limbergen’s ability to analyze the populations of bacteria—known as the microbiome—in the guts of his Crohn’s and colitis patients. Dr. Van Limbergen wants to develop more sophisticated ways to understand the role each patient’s intestinal microbiome plays in the severity of their IBD and likelihood of responding well to various treatments. “We are aiming for more personalized medicine,” Dr. Van Limbergen explains, “so that patients receive the most effective possible treatment as early as possible in the course of their disease.”