Source: http://www.sciam.com/article.cfm?alias=excess-bacteria-dont-infl&chanID=sa003&modsrc=reuters
NEW YORK (Reuters Health) - An abnormally high number of bacteria in the small intestine does not appear to be a major factor affecting the symptoms of irritable bowel syndrome, Swedish researchers report in the medical journal Gut.
Irritable bowel syndrome (IBS), or spastic colon, is a common disorder characterized by abdominal pain, diarrhea, cramping, and constipation. The syndrome is thought to arise from overactivity of the nerves in the intestine that control movement.
"The data do not support an important role for small intestinal bacterial overgrowth, according to commonly used clinical definitions, in IBS," senior investigator Dr. Magnus Simren told Reuters Health.
Simren and colleagues at Sahlgrenska University Hospital, Gothenburg, note that a high rate of bacterial overgrowth has been reported in patients with IBS, but these observations were based on tests that only indirectly measured bacteria levels.
They therefore assessed small intestinal bacterial overgrowth by a direct test -- bacterial culture of small-bowel test samples -- among 162 patients with IBS and 26 healthy subjects. Cultures revealed the exact same rate of intestinal bacterial overgrowth in both groups, 4 percent.
Signs of intestinal movement abnormalities were seen in 86 percent of patients with overgrowth and in 39 percent of patients without overgrowth. The investigators also observed that movement abnormalities did not reliably predict altered small-bowel bacterial levels.
Monday, June 4, 2007
PET/CT Should Be 'First-step' Test For Patients With Crohn's Disease
Source: http://www.sciencedaily.com/releases/2007/06/070604155841.htm
PET/CT Should Be 'First-step' Test For Patients With Crohn's Disease
Science Daily — The molecular imaging power of PET/CT is invaluable in noninvasively monitoring Crohn's disease--a chronic inflammatory disease of the gastrointestinal tract that mainly affects young people, according to a study released by Belgian scientists at the 54th Annual Meeting of SNM, the world's largest society for molecular imaging and nuclear medicine professionals.
"Our study is the first one demonstrating the value of PET/CT in Crohn's disease," said Roland Hustinx, head of the nuclear medicine division at the University Hospital of Liège and professor of nuclear medicine at the University of Liège. "PET/CT (positron emission tomography/computed tomography) imaging--with the radiotracer fluorodeoxyglucose or FDG--could be used as a first-step test in patients with clinical or biological signs suggesting active disease," he noted. "PET/CT can answer the major question: What is the activity of the disease"" explained Hustinx.
Crohn's disease, an inflammatory bowel disease (IBD) that can affect the digestive system, has no medical cure, and its causes are unknown, explained Hustinx. Once the disease begins, it can fluctuate between periods of inactivity (remission) and activity (relapse). During relapses, symptoms--varying in nature, frequency and intensity--include abdominal pain, diarrhea and worsening general physical condition. Estimates indicate that up to 2 million people in this country could be affected by Crohn's and related diseases. IBD most commonly begins during adolescence and early adulthood.
"The clinical course of the disease is characterized by a succession of periods of clinical relapses and remissions," said Hustinx. "Its diagnosis relies on clinical and biological signs (markers of inflammation in the blood) as well as direct examination of the bowel using ileocolonoscopy, an endoscopic examination of the large bowel, where the last part of the small bowel (ileum) is also examined," added Hustinx, who indicated that prevalence of the disease is increasing.
"Endoscopic evaluation--a diagnostic medical procedure in which a small, flexible tube with a light and lens is inserted into the body to assess the interior surfaces of an organ--is the gold standard to answer, 'What is the activity of this disease"'" said Hustinx. The answer to this question will decide whether the clinician prescribes a treatment that is likely to be effective but also very costly and associated with side effects. "Ileocolonoscopy is invasive, unpleasant for the patient, sometimes incomplete due to unreachable segments and can only assess mucosal lesions, while the disease may sometimes affect deeper parts of the bowel wall," he indicated.
"The big advantage of PET/CT is that it is noninvasive, simple, fast and without any side effects. There was no preparation for the patients, except that they fasted for six hours. Each study took less than 20 minutes," said Hustinx. "If the PET/CT is positive, the doctor should confirm the results using endoscopy. If the PET/CT is negative, there would be no need for the endoscopy--given the high negative predictive value of the technique," he added.
"In our study, all bowel areas that showed severe endoscopic lesions were correctly identified by PET/CT. There was not a single case in which the ileocolonoscopy showed severe lesions and PET/CT showed a normal metabolic activity," said Hustinx. "Conversely, this means that when the PET/CT is negative--no matter how important the clinical symptoms are--the disease is not active," he added. "PET/CT has, therefore, the potential to deeply modify the exploration algorithm of patients with Crohn's, reducing the number of endoscopic examinations and allowing a better, noninvasive monitoring of the disease's activity," he indicated.
PET/CT molecular imaging--with radioactive drugs such as FDG--enables the collection of both biological and anatomical information during a single exam, with PET picking up metabolic signals of body cells and tissues and CT offering a detailed map of internal anatomy.
"Our results must be confirmed by other investigators on a larger scale," said Hustinx, indicating that his team is currently conducting a study evaluating the capacity of PET/CT to assess early on the response of the disease to "biological treatments." Treatment has been significantly improved over the past few years with the development of biological treatments, which have shown potential for obtaining mucosal healing in Crohn's disease, noted Hustinx. "This mucosal healing has been associated with higher sustained quality of life, lower rate of hospitalization and lower need for surgery. A sustained clinical remission--and a control of intestinal lesion--has become the target of new treatment strategies," he said.
PET/CT Should Be 'First-step' Test For Patients With Crohn's Disease
Science Daily — The molecular imaging power of PET/CT is invaluable in noninvasively monitoring Crohn's disease--a chronic inflammatory disease of the gastrointestinal tract that mainly affects young people, according to a study released by Belgian scientists at the 54th Annual Meeting of SNM, the world's largest society for molecular imaging and nuclear medicine professionals.
"Our study is the first one demonstrating the value of PET/CT in Crohn's disease," said Roland Hustinx, head of the nuclear medicine division at the University Hospital of Liège and professor of nuclear medicine at the University of Liège. "PET/CT (positron emission tomography/computed tomography) imaging--with the radiotracer fluorodeoxyglucose or FDG--could be used as a first-step test in patients with clinical or biological signs suggesting active disease," he noted. "PET/CT can answer the major question: What is the activity of the disease"" explained Hustinx.
Crohn's disease, an inflammatory bowel disease (IBD) that can affect the digestive system, has no medical cure, and its causes are unknown, explained Hustinx. Once the disease begins, it can fluctuate between periods of inactivity (remission) and activity (relapse). During relapses, symptoms--varying in nature, frequency and intensity--include abdominal pain, diarrhea and worsening general physical condition. Estimates indicate that up to 2 million people in this country could be affected by Crohn's and related diseases. IBD most commonly begins during adolescence and early adulthood.
"The clinical course of the disease is characterized by a succession of periods of clinical relapses and remissions," said Hustinx. "Its diagnosis relies on clinical and biological signs (markers of inflammation in the blood) as well as direct examination of the bowel using ileocolonoscopy, an endoscopic examination of the large bowel, where the last part of the small bowel (ileum) is also examined," added Hustinx, who indicated that prevalence of the disease is increasing.
"Endoscopic evaluation--a diagnostic medical procedure in which a small, flexible tube with a light and lens is inserted into the body to assess the interior surfaces of an organ--is the gold standard to answer, 'What is the activity of this disease"'" said Hustinx. The answer to this question will decide whether the clinician prescribes a treatment that is likely to be effective but also very costly and associated with side effects. "Ileocolonoscopy is invasive, unpleasant for the patient, sometimes incomplete due to unreachable segments and can only assess mucosal lesions, while the disease may sometimes affect deeper parts of the bowel wall," he indicated.
"The big advantage of PET/CT is that it is noninvasive, simple, fast and without any side effects. There was no preparation for the patients, except that they fasted for six hours. Each study took less than 20 minutes," said Hustinx. "If the PET/CT is positive, the doctor should confirm the results using endoscopy. If the PET/CT is negative, there would be no need for the endoscopy--given the high negative predictive value of the technique," he added.
"In our study, all bowel areas that showed severe endoscopic lesions were correctly identified by PET/CT. There was not a single case in which the ileocolonoscopy showed severe lesions and PET/CT showed a normal metabolic activity," said Hustinx. "Conversely, this means that when the PET/CT is negative--no matter how important the clinical symptoms are--the disease is not active," he added. "PET/CT has, therefore, the potential to deeply modify the exploration algorithm of patients with Crohn's, reducing the number of endoscopic examinations and allowing a better, noninvasive monitoring of the disease's activity," he indicated.
PET/CT molecular imaging--with radioactive drugs such as FDG--enables the collection of both biological and anatomical information during a single exam, with PET picking up metabolic signals of body cells and tissues and CT offering a detailed map of internal anatomy.
"Our results must be confirmed by other investigators on a larger scale," said Hustinx, indicating that his team is currently conducting a study evaluating the capacity of PET/CT to assess early on the response of the disease to "biological treatments." Treatment has been significantly improved over the past few years with the development of biological treatments, which have shown potential for obtaining mucosal healing in Crohn's disease, noted Hustinx. "This mucosal healing has been associated with higher sustained quality of life, lower rate of hospitalization and lower need for surgery. A sustained clinical remission--and a control of intestinal lesion--has become the target of new treatment strategies," he said.
Clinically Proven Probiotic for IBS Symptoms
Source: http://www.healthnewsdigest.com/news/Family_Health_210/Clinically_Proven_Probiotic_for_IBS_Symptoms.shtml
(HealthNewsDigest.com)- CLEVELAND, OH --- For the nearly 60 million Americans* who suffer from Irritable Bowel Syndrome (IBS), everyday life can present many challenges. IBS is a common digestive disorder in which the gastro-intestinal system does not function properly, with symptoms ranging from mild to severe abdominal pain, cramping, bloating, gas, constipation and diarrhea. It’s estimated that 70-80% of all IBS sufferers are women. A probiotic treatment such as Digestive Advantage Irritable Bowel Syndrome, the only once-daily, over-the-counter product for IBS, has been proven effective in providing relief for IBS sufferers.
The recurring symptoms of IBS can affect all aspects of a person’s quality of life; personally, professionally, socially and financially. “As my symptoms continued to get worse, it was difficult to work, be social, travel and go about my daily activities because I had to be chained to a bathroom,” said 55 year-old Linda Hicks of Huntington Beach, California. “Often times it didn’t even matter what I ate, it seemed like it triggered my symptoms.”
Hicks has lived with IBS for the past two years and in that course of time sought out many treatment options to help relieve her abdominal pain and bloating. She tried numerous products and while they provided some relief, Hicks says she’s been able to live a more normal and active life since she began taking Digestive Advantage Irritable Bowel Syndrome, a once-daily, over-the-counter treatment for IBS that has proven to be extremely effective for numerous people in managing their IBS symptoms. “Digestive Advantage Irritable Bowel Syndrome gave me my life back,” said Hicks. “I now have the freedom to go out in public and live normally without worrying about my IBS.”
In an IBS double blind, placebo controlled study using Rome II criteria, the Ganeden Cultures™, or probiotic strain of bacteria, in Digestive Advantage Irritable Bowel Syndrome were proven to help reduce abdominal pain and bloating. Probiotics are beneficial or friendly bacteria that live in the digestive tract and help promote digestive health and strengthen the immune system.
Jeffrey D. Roberts, MSEd, BSc, President & Founder of the IBS Association/IBS Self Help and Support Group, has lived with IBS for more than 25 years and knows all too well what IBS sufferers live through.
“It’s extremely important that people seek out knowledge and gain a better understanding of their condition,” Roberts said. “Always seek advice from a doctor and manage your stress, along with changes in diet and lifestyle is wise advice for anyone, especially for the millions who experience IBS symptoms or have been diagnosed with Irritable Bowel Syndrome.” And while there is no cure for IBS, Roberts also touts the beneficial effects of probiotic supplements such as Digestive Advantage Irritable Bowel Syndrome in helping people feel significant relief.
(HealthNewsDigest.com)- CLEVELAND, OH --- For the nearly 60 million Americans* who suffer from Irritable Bowel Syndrome (IBS), everyday life can present many challenges. IBS is a common digestive disorder in which the gastro-intestinal system does not function properly, with symptoms ranging from mild to severe abdominal pain, cramping, bloating, gas, constipation and diarrhea. It’s estimated that 70-80% of all IBS sufferers are women. A probiotic treatment such as Digestive Advantage Irritable Bowel Syndrome, the only once-daily, over-the-counter product for IBS, has been proven effective in providing relief for IBS sufferers.
The recurring symptoms of IBS can affect all aspects of a person’s quality of life; personally, professionally, socially and financially. “As my symptoms continued to get worse, it was difficult to work, be social, travel and go about my daily activities because I had to be chained to a bathroom,” said 55 year-old Linda Hicks of Huntington Beach, California. “Often times it didn’t even matter what I ate, it seemed like it triggered my symptoms.”
Hicks has lived with IBS for the past two years and in that course of time sought out many treatment options to help relieve her abdominal pain and bloating. She tried numerous products and while they provided some relief, Hicks says she’s been able to live a more normal and active life since she began taking Digestive Advantage Irritable Bowel Syndrome, a once-daily, over-the-counter treatment for IBS that has proven to be extremely effective for numerous people in managing their IBS symptoms. “Digestive Advantage Irritable Bowel Syndrome gave me my life back,” said Hicks. “I now have the freedom to go out in public and live normally without worrying about my IBS.”
In an IBS double blind, placebo controlled study using Rome II criteria, the Ganeden Cultures™, or probiotic strain of bacteria, in Digestive Advantage Irritable Bowel Syndrome were proven to help reduce abdominal pain and bloating. Probiotics are beneficial or friendly bacteria that live in the digestive tract and help promote digestive health and strengthen the immune system.
Jeffrey D. Roberts, MSEd, BSc, President & Founder of the IBS Association/IBS Self Help and Support Group, has lived with IBS for more than 25 years and knows all too well what IBS sufferers live through.
“It’s extremely important that people seek out knowledge and gain a better understanding of their condition,” Roberts said. “Always seek advice from a doctor and manage your stress, along with changes in diet and lifestyle is wise advice for anyone, especially for the millions who experience IBS symptoms or have been diagnosed with Irritable Bowel Syndrome.” And while there is no cure for IBS, Roberts also touts the beneficial effects of probiotic supplements such as Digestive Advantage Irritable Bowel Syndrome in helping people feel significant relief.
Friday, June 1, 2007
Crohn's disease patients fight to get drug on PBS
Source: http://www.abc.net.au/news/newsitems/200706/s1940562.htm
People living with Crohn's disease say the Federal Government is ignoring their plight as they fight to get a drug vital to their treatment on the Pharmaceutical Benefits Scheme (PBS).
Sarah Hird, 22, will eventually have her bowel removed if she cannot keep up with the $18,000 a year she needs for the drug Infliximab to keep her illness under control.
"There's got to be something the Government can do for us," she said.
"It has to be done."
The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended the drug for the PBS, but sufferers are worried that it will not be listed.
Health Minister Tony Abbott says it is not the Government's fault.
"We are happy to go forward with this PBAC recommendations, for some reason the company won't," he said.
"The company is denying this drug to people with Crohn's disease."
But the company says the recommendation is too restrictive and would deny the drug to the majority of patients.
People living with Crohn's disease say the Federal Government is ignoring their plight as they fight to get a drug vital to their treatment on the Pharmaceutical Benefits Scheme (PBS).
Sarah Hird, 22, will eventually have her bowel removed if she cannot keep up with the $18,000 a year she needs for the drug Infliximab to keep her illness under control.
"There's got to be something the Government can do for us," she said.
"It has to be done."
The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended the drug for the PBS, but sufferers are worried that it will not be listed.
Health Minister Tony Abbott says it is not the Government's fault.
"We are happy to go forward with this PBAC recommendations, for some reason the company won't," he said.
"The company is denying this drug to people with Crohn's disease."
But the company says the recommendation is too restrictive and would deny the drug to the majority of patients.
Drug firm's movie gets mixed reviews
Source: http://www.twincities.com/allheadlines/ci_6033025?nclick_check=1
Depending on whom you ask, the movie "Innerstate" is either a touching documentary about people overcoming autoimmune diseases, or a sly tactic in "Big Pharma" advertising.
Either way, it's coming soon to a theater in Brooklyn Center.
"Innerstate" chronicles a race car driver with Crohn's disease, a countrywestern singer with rheumatoid arthritis and a restaurant manager with psoriasis. All three have comeback stories despite their incurable diseases.
"The movie was meant to inspire people and give people hope," said Janie Feliz, 20, the singer, whose condition hasn't slowed her drive toward a career in Nashville.
The controversy comes from the fine print. The hourlong movie is funded and produced by Centocor Inc., the maker of Remicade, the top-selling drug for autoimmune conditions, which result when the immune system mistakenly attacks healthy cells. All three people in the movie take Remicade, and while the brand name isn't mentioned in the film, some critics believe it is an advertisement masquerading as a documentary.
"Innerstate" reflects a blending of advertising and art taking place in much of American culture. The movie's indirect approach also reflects a softer edge from a drug industry that usually hammers home brand names and catchphrases such as the Purple Pill. The idea of such "patient education" or "disease awareness" is to inform people about diseases so they are motivated to learn about treatments on their own.
"It's a means to create marketing buzz about these diseases," said Jon Schommer, a drug-marketing expert with the University of Minnesota College of Pharmacy.
"Innerstate" has appeared in 10 cities since February, and concern has been building. A labor union in Philadelphia complained last week that, although the drug name isn't mentioned in the movie, it is featured prominently in materials distributed after the show. The union represents custodians who clean Centocor's offices.
Centocor created the movie to inform the public about diseases that are poorly understood and can cause pain and humiliation for patients, said Michael Parks, Centocor's vice president of communications.
Remicade is a biologic drug, meaning it is made from human cell cultures, and it disrupts how the immune system attacks the body. There are several competing drugs for autoimmune diseases, but Remicade is the market leader, producing $3 billion in sales last year for Centocor and its parent company, Johnson Johnson.
Doctors have reported remarkable turnarounds for patients with autoimmune diseases since these drugs were developed. Previously, there was little to stop rheumatoid arthritis, for example, which deforms joints and causes severe pain and swelling.
Crohn's inflames the digestive tract, raising the risk of colon cancer and causing pain and chronic diarrhea. Psoriasis causes flaky, scaly skin that is not only uncomfortable but also can embarrass sufferers.
"Innerstate" opens with Jason Knott, 33, who grew up with psoriasis and skin lesions covering as much as 80 percent of his body. He recalls in the film how parents pulled their children out of the water as he dipped into a neighborhood pool.
Centocor's Parks selected the three patients for the film, focusing on young, active patients to break down myths about the diseases.
"It is, in our mind, unconscionable that psoriasis patients are still treated like lepers," Parks said. "It's not a communicable disease."
Public stigma over autoimmune diseases came up during this session of the Minnesota Legislature, when lawmakers took ridicule for voting to guarantee that people with Crohn's disease or ulcerative colitis could use restrooms in private buildings or retail stores.
Ray Ciccarelli, who is profiled in the movie, has Crohn's disease. The 36-year-old now races in a NASCAR junior league, but prior to treatment, he rarely left his house for fear of not getting to a bathroom in time.
Regardless of whether "Innerstate" is intended as marketing, analysts believe it will help Centocor. As the market leader, it benefits from anything promoting the diseases its drugs can treat.
The key question is whether the film crosses the line from information to persuasion, said Schommer, the U expert, who has not seen the film.
Centocor appears to be using a marketing strategy common in Europe, where drug companies are banned from advertising directly to consumers, Schommer said. The strategy is to heighten public awareness about a disease and then arm physicians with drug information and samples they can offer when patients come to them with questions.
"The successful ones have it orchestrated beautifully," Schommer said.
Dr. Carolyn Bowles believes it is marketing, and that drug companies are poor sources for patient education. The Edina rheumatologist nonetheless accepted Centocor's invitation to speak after the June 9 screening in Brooklyn Center.
She said some patients don't need Remicade, which has such powerful effects on the immune system that it can increase the risks of infections such as tuberculosis.
Others need it earlier but are forced to wait because of insurance restrictions, she said. Remicade is given by infusion and costs each patient $12,000 to $20,000 per year.
Depending on whom you ask, the movie "Innerstate" is either a touching documentary about people overcoming autoimmune diseases, or a sly tactic in "Big Pharma" advertising.
Either way, it's coming soon to a theater in Brooklyn Center.
"Innerstate" chronicles a race car driver with Crohn's disease, a countrywestern singer with rheumatoid arthritis and a restaurant manager with psoriasis. All three have comeback stories despite their incurable diseases.
"The movie was meant to inspire people and give people hope," said Janie Feliz, 20, the singer, whose condition hasn't slowed her drive toward a career in Nashville.
The controversy comes from the fine print. The hourlong movie is funded and produced by Centocor Inc., the maker of Remicade, the top-selling drug for autoimmune conditions, which result when the immune system mistakenly attacks healthy cells. All three people in the movie take Remicade, and while the brand name isn't mentioned in the film, some critics believe it is an advertisement masquerading as a documentary.
"Innerstate" reflects a blending of advertising and art taking place in much of American culture. The movie's indirect approach also reflects a softer edge from a drug industry that usually hammers home brand names and catchphrases such as the Purple Pill. The idea of such "patient education" or "disease awareness" is to inform people about diseases so they are motivated to learn about treatments on their own.
"It's a means to create marketing buzz about these diseases," said Jon Schommer, a drug-marketing expert with the University of Minnesota College of Pharmacy.
"Innerstate" has appeared in 10 cities since February, and concern has been building. A labor union in Philadelphia complained last week that, although the drug name isn't mentioned in the movie, it is featured prominently in materials distributed after the show. The union represents custodians who clean Centocor's offices.
Centocor created the movie to inform the public about diseases that are poorly understood and can cause pain and humiliation for patients, said Michael Parks, Centocor's vice president of communications.
Remicade is a biologic drug, meaning it is made from human cell cultures, and it disrupts how the immune system attacks the body. There are several competing drugs for autoimmune diseases, but Remicade is the market leader, producing $3 billion in sales last year for Centocor and its parent company, Johnson Johnson.
Doctors have reported remarkable turnarounds for patients with autoimmune diseases since these drugs were developed. Previously, there was little to stop rheumatoid arthritis, for example, which deforms joints and causes severe pain and swelling.
Crohn's inflames the digestive tract, raising the risk of colon cancer and causing pain and chronic diarrhea. Psoriasis causes flaky, scaly skin that is not only uncomfortable but also can embarrass sufferers.
"Innerstate" opens with Jason Knott, 33, who grew up with psoriasis and skin lesions covering as much as 80 percent of his body. He recalls in the film how parents pulled their children out of the water as he dipped into a neighborhood pool.
Centocor's Parks selected the three patients for the film, focusing on young, active patients to break down myths about the diseases.
"It is, in our mind, unconscionable that psoriasis patients are still treated like lepers," Parks said. "It's not a communicable disease."
Public stigma over autoimmune diseases came up during this session of the Minnesota Legislature, when lawmakers took ridicule for voting to guarantee that people with Crohn's disease or ulcerative colitis could use restrooms in private buildings or retail stores.
Ray Ciccarelli, who is profiled in the movie, has Crohn's disease. The 36-year-old now races in a NASCAR junior league, but prior to treatment, he rarely left his house for fear of not getting to a bathroom in time.
Regardless of whether "Innerstate" is intended as marketing, analysts believe it will help Centocor. As the market leader, it benefits from anything promoting the diseases its drugs can treat.
The key question is whether the film crosses the line from information to persuasion, said Schommer, the U expert, who has not seen the film.
Centocor appears to be using a marketing strategy common in Europe, where drug companies are banned from advertising directly to consumers, Schommer said. The strategy is to heighten public awareness about a disease and then arm physicians with drug information and samples they can offer when patients come to them with questions.
"The successful ones have it orchestrated beautifully," Schommer said.
Dr. Carolyn Bowles believes it is marketing, and that drug companies are poor sources for patient education. The Edina rheumatologist nonetheless accepted Centocor's invitation to speak after the June 9 screening in Brooklyn Center.
She said some patients don't need Remicade, which has such powerful effects on the immune system that it can increase the risks of infections such as tuberculosis.
Others need it earlier but are forced to wait because of insurance restrictions, she said. Remicade is given by infusion and costs each patient $12,000 to $20,000 per year.
Living with Crohn's
Source: http://www.newsobserver.com/105/story/587470.html
Missy Baxter, Correspondent
As a marathon runner and fitness specialist, Darren Pangle appears to be the picture of perfect health. His daily workouts include an hour of cardio training and at least 30 minutes of weight training. The results are evident. Standing 6 feet 2 inches and weighing 260 pounds, Pangle has 30-inch quads, 20-inch biceps and only about 10 percent body fat.
"A lot of people think I'm a bodybuilder when they first meet me," said the 42-year-old Chapel Hill resident.
So people are often shocked when they learn that Pangle has a chronic disease that almost cost him his life when he was a teen and continues to cause health problems.
"When I tell people about my life, they usually can't believe that I have any medical problems at all -- unless I show them the huge scar on my stomach," he explained.
Pangle is among hundreds of Triangle residents who have Crohn's disease, an illness that causes extreme intestinal problems and can lead to severe complications, such as an obstructed bowel, persistent diarrhea and rectal bleeding.
Pangle's medical problems began at age 19, when he flipped a riding lawn mower while cutting grass on a steep embankment. At first, the injury didn't seem too severe. There weren't any bruises, just a stiff back the next morning. Within a few days, though, the pain began to intensify.
"On the third day after the accident, I woke up sweating and I couldn't move at all," he recalled. "I called my brother, and ... he literally had to carry me to the hospital."
Physicians conducted a multitude of tests and determined that Pangle was suffering from peritonitis, an inflammation of the thin membrane that lines the abdominal wall. Doctors told him the problem could have been brewing before the accident or it could have been prompted by it. Either way, a life-threatening infection was rapidly spreading throughout his body.
"The doctors told me I had less than eight hours to live, so they needed to do emergency exploratory surgery and that's when they found out I had Crohn's disease," he recalled. "After surgery, I wound up in a coma for three days and I lost 72 pounds in six days."
How many have it
Named after Dr. Burrill B. Crohn, who documented the disease's symptoms in a 1932 research paper, Crohn's disease is similar to ulcerative colitis, which also causes extreme gastric problems. Crohn's and colitis are the two main categories of a larger group of illnesses known as inflammatory bowel diseases.
An estimated 1.3 million Americans have Crohn's or colitis, according to Kelli King, development director of the Carolinas Chapter of the Crohn's and Colitis Foundation of America.
"Each year, about 30,000 more people are diagnosed with Crohn's and colitis, of which about 10 percent are under age 18," King said.
For decades, many patients with Crohn's suffered quietly and the disease often went undiagnosed, King said. The nature of the disease sometimes prompts people to keep their condition secret from others.
"It's such a personal subject that many people don't discuss their symptoms and don't go to the doctor, but thankfully that seems to be changing," King said.
The number of patients diagnosed with Crohn's seems to be increasing, she said, because the public and doctors are becoming more aware of the symptoms.
To raise money for research on Crohn's, as well as educational and support programs, the Carolinas Chapter of CCFA has organized an annual event, known as the Guts & Glory Walk/Run, for almost three decades. More than 400 people are expected to participate in the 26th Annual Guts & Glory Run/Walk on Saturday at the GlaxoSmithKline campus in Research Triangle Park.
continue...
Missy Baxter, Correspondent
As a marathon runner and fitness specialist, Darren Pangle appears to be the picture of perfect health. His daily workouts include an hour of cardio training and at least 30 minutes of weight training. The results are evident. Standing 6 feet 2 inches and weighing 260 pounds, Pangle has 30-inch quads, 20-inch biceps and only about 10 percent body fat.
"A lot of people think I'm a bodybuilder when they first meet me," said the 42-year-old Chapel Hill resident.
So people are often shocked when they learn that Pangle has a chronic disease that almost cost him his life when he was a teen and continues to cause health problems.
"When I tell people about my life, they usually can't believe that I have any medical problems at all -- unless I show them the huge scar on my stomach," he explained.
Pangle is among hundreds of Triangle residents who have Crohn's disease, an illness that causes extreme intestinal problems and can lead to severe complications, such as an obstructed bowel, persistent diarrhea and rectal bleeding.
Pangle's medical problems began at age 19, when he flipped a riding lawn mower while cutting grass on a steep embankment. At first, the injury didn't seem too severe. There weren't any bruises, just a stiff back the next morning. Within a few days, though, the pain began to intensify.
"On the third day after the accident, I woke up sweating and I couldn't move at all," he recalled. "I called my brother, and ... he literally had to carry me to the hospital."
Physicians conducted a multitude of tests and determined that Pangle was suffering from peritonitis, an inflammation of the thin membrane that lines the abdominal wall. Doctors told him the problem could have been brewing before the accident or it could have been prompted by it. Either way, a life-threatening infection was rapidly spreading throughout his body.
"The doctors told me I had less than eight hours to live, so they needed to do emergency exploratory surgery and that's when they found out I had Crohn's disease," he recalled. "After surgery, I wound up in a coma for three days and I lost 72 pounds in six days."
How many have it
Named after Dr. Burrill B. Crohn, who documented the disease's symptoms in a 1932 research paper, Crohn's disease is similar to ulcerative colitis, which also causes extreme gastric problems. Crohn's and colitis are the two main categories of a larger group of illnesses known as inflammatory bowel diseases.
An estimated 1.3 million Americans have Crohn's or colitis, according to Kelli King, development director of the Carolinas Chapter of the Crohn's and Colitis Foundation of America.
"Each year, about 30,000 more people are diagnosed with Crohn's and colitis, of which about 10 percent are under age 18," King said.
For decades, many patients with Crohn's suffered quietly and the disease often went undiagnosed, King said. The nature of the disease sometimes prompts people to keep their condition secret from others.
"It's such a personal subject that many people don't discuss their symptoms and don't go to the doctor, but thankfully that seems to be changing," King said.
The number of patients diagnosed with Crohn's seems to be increasing, she said, because the public and doctors are becoming more aware of the symptoms.
To raise money for research on Crohn's, as well as educational and support programs, the Carolinas Chapter of CCFA has organized an annual event, known as the Guts & Glory Walk/Run, for almost three decades. More than 400 people are expected to participate in the 26th Annual Guts & Glory Run/Walk on Saturday at the GlaxoSmithKline campus in Research Triangle Park.
continue...
Thursday, May 31, 2007
Swiss regulator asks Novartis to withdraw IBS drug
Source: http://www.iht.com/articles/ap/2007/05/31/business/EU-FIN-COM-Switzerland-Novartis.php
ZURICH, Switzerland: The Swiss pharmaceuticals regulator said Thursday it ordered the withdrawal of Novartis AG's Zelmac for irritable bowel syndrome, saying the risks of the treatment are greater than the benefit.
Swissmedic, the regulatory agency, said a new analysis of the data from clinical studies revealed an increased risk of cardiovascular issues, such as angina and heart attack, with the medicine when compared to a placebo.
Novartis agreed in March to stop selling Zelnorm in the United States, the name under which it was sold there, at the request of the Food and Drug Administration after it was linked to a higher chance of heart attack, stroke and worsening chest pain that can become a heart attack.
Novartis reacted to the Swissmedic decision with "surprise and disappointment," according to a statement.
The company said it would comply with the request, but is still convinced that Zelmac offers important benefits to patients. Novartis said Swissmedic had rejected a compromise to partially allow the restricted and controlled sale of the medicine.
ZURICH, Switzerland: The Swiss pharmaceuticals regulator said Thursday it ordered the withdrawal of Novartis AG's Zelmac for irritable bowel syndrome, saying the risks of the treatment are greater than the benefit.
Swissmedic, the regulatory agency, said a new analysis of the data from clinical studies revealed an increased risk of cardiovascular issues, such as angina and heart attack, with the medicine when compared to a placebo.
Novartis agreed in March to stop selling Zelnorm in the United States, the name under which it was sold there, at the request of the Food and Drug Administration after it was linked to a higher chance of heart attack, stroke and worsening chest pain that can become a heart attack.
Novartis reacted to the Swissmedic decision with "surprise and disappointment," according to a statement.
The company said it would comply with the request, but is still convinced that Zelmac offers important benefits to patients. Novartis said Swissmedic had rejected a compromise to partially allow the restricted and controlled sale of the medicine.
Walkers taking steps for Crohn's
Source: http://www.timminspress.com/webapp/sitepages/content.asp?contentid=548819&catname=Local+News
A local teenager diagnosed with Crohn's disease is asking Timmins residents to join him at Gillies Lake on Sunday for the ninth-annual Heel 'n' Wheel-a-thon.
Aaron Cividino, 15, is this year's honorary chairman of the event, which each year raises funds for Crohn's and Colitis research.
Cividino, a Grade 9 student at Roland Michener Secondary School, was diagnosed with Crohn's about a year and a half ago, but he said his doctors believe he has been living with the disease for at least five years.
It's his experience with the inflammatory bowel disease that prompted him to accept an invitation to be this year's honorary chairperson.
"Crohn's is a chronic disease but it is seldom fatal," Aaron said. "It can affect almost any part of the digestive tract and restricts the body from being able to absorb proper amounts of nutrients. In most cases, it creates a lot of pain in the lower abdomen."
After being diagnosed with Crohn's, Aaron and his family turned to the Crohn's and Colitis Foundation. He began attending monthly meetings and said he was surprised to learn how many others are going through the same situation.
As the honorary chairman, Aaron said he is looking to bring in more participants to the walk than ever before.
"So far, I am able to live a fairly normal life and do the things other teens do, but I know that this could change at any time," he said. "I live day-to-day hoping that I will stay healthy and that a cure will be found in my lifetime."
Crohn's and Colitis Foundation Timmins affiliate president Diane Belanger said Aaron was a natural selection to help promote this year's event. Being so young, Aaron is proof that Crohn's and Colitis can affect anyone.
"We get maybe 100 participants each year but we'd like to see more," she said. "This year, we've added a family theme and we'll have a barbecue, a DJ and lots of games for children. We are also once again going to have a classic car show. Anyone with a vintage car they wish to show off is welcome to join in."
The foundation has set a fundraising goal of $14,000 - a realistic goal, Belanger said, since last year's event raised about $13,000. Prizes will be awarded to various participants and to top-pledge earners. Registration takes place at 11 a.m. and the walk gets underway at 1 p.m.
A local teenager diagnosed with Crohn's disease is asking Timmins residents to join him at Gillies Lake on Sunday for the ninth-annual Heel 'n' Wheel-a-thon.
Aaron Cividino, 15, is this year's honorary chairman of the event, which each year raises funds for Crohn's and Colitis research.
Cividino, a Grade 9 student at Roland Michener Secondary School, was diagnosed with Crohn's about a year and a half ago, but he said his doctors believe he has been living with the disease for at least five years.
It's his experience with the inflammatory bowel disease that prompted him to accept an invitation to be this year's honorary chairperson.
"Crohn's is a chronic disease but it is seldom fatal," Aaron said. "It can affect almost any part of the digestive tract and restricts the body from being able to absorb proper amounts of nutrients. In most cases, it creates a lot of pain in the lower abdomen."
After being diagnosed with Crohn's, Aaron and his family turned to the Crohn's and Colitis Foundation. He began attending monthly meetings and said he was surprised to learn how many others are going through the same situation.
As the honorary chairman, Aaron said he is looking to bring in more participants to the walk than ever before.
"So far, I am able to live a fairly normal life and do the things other teens do, but I know that this could change at any time," he said. "I live day-to-day hoping that I will stay healthy and that a cure will be found in my lifetime."
Crohn's and Colitis Foundation Timmins affiliate president Diane Belanger said Aaron was a natural selection to help promote this year's event. Being so young, Aaron is proof that Crohn's and Colitis can affect anyone.
"We get maybe 100 participants each year but we'd like to see more," she said. "This year, we've added a family theme and we'll have a barbecue, a DJ and lots of games for children. We are also once again going to have a classic car show. Anyone with a vintage car they wish to show off is welcome to join in."
The foundation has set a fundraising goal of $14,000 - a realistic goal, Belanger said, since last year's event raised about $13,000. Prizes will be awarded to various participants and to top-pledge earners. Registration takes place at 11 a.m. and the walk gets underway at 1 p.m.
Wednesday, May 30, 2007
A Psychological Approach To The Management Of Irritable Bowel Syndrome
Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=72095
Antidepressants and psychological treatments such as hypnotherapy have the potential to help patients with severe irritable bowel syndrome (IBS), say researchers in this week's BMJ.
IBS is a very common disorder, but conventional 'physical' treatments often do not work very well and patients can feel that their symptoms are being ignored, downplayed or misunderstood.
Patients with IBS are more likely to suffer from depression and have 'abnormal' behaviour patterns including anxiety and somatisation (conversion of an emotional, mental, or psychosocial problem to a physical complaint). This has led to the idea that IBS has a psychological as well as a biological basis and a growing body of evidence supports the use of antidepressants for IBS, write the authors.
However, many doctors are reluctant to prescribe such agents to patients who are clearly not depressed.
Other 'psychological' therapies exist that patients with IBS should be made aware of, they say. For example, 'talking therapy' (known as cognitive behavioural therapy) is as effective as antidepressant treatment and its benefits last longer.
Hypnotherapy has also been reported to be an effective intervention for IBS in small trials, although a recent review of hypnotherapy trials found insufficient evidence to recommend its widespread use and suggested that this treatment option should be restricted to specialist centres dealing with more severe cases of the syndrome.
Nevertheless, hypnotherapy has the potential to help those patients whose IBS is severe, say the authors.
The choice of treatment will depend on the individual patient and, inevitably, will be limited by local availability, they add. However, IBS is undeniably very common and many patients are probably denied help by lack of access to therapists with the appropriate psychological skills.
They believe that increasing provision of primary care services for patients with IBS will provide an avenue for effective and early psychological treatment for a condition in which real improvement can be achieved.
Antidepressants and psychological treatments such as hypnotherapy have the potential to help patients with severe irritable bowel syndrome (IBS), say researchers in this week's BMJ.
IBS is a very common disorder, but conventional 'physical' treatments often do not work very well and patients can feel that their symptoms are being ignored, downplayed or misunderstood.
Patients with IBS are more likely to suffer from depression and have 'abnormal' behaviour patterns including anxiety and somatisation (conversion of an emotional, mental, or psychosocial problem to a physical complaint). This has led to the idea that IBS has a psychological as well as a biological basis and a growing body of evidence supports the use of antidepressants for IBS, write the authors.
However, many doctors are reluctant to prescribe such agents to patients who are clearly not depressed.
Other 'psychological' therapies exist that patients with IBS should be made aware of, they say. For example, 'talking therapy' (known as cognitive behavioural therapy) is as effective as antidepressant treatment and its benefits last longer.
Hypnotherapy has also been reported to be an effective intervention for IBS in small trials, although a recent review of hypnotherapy trials found insufficient evidence to recommend its widespread use and suggested that this treatment option should be restricted to specialist centres dealing with more severe cases of the syndrome.
Nevertheless, hypnotherapy has the potential to help those patients whose IBS is severe, say the authors.
The choice of treatment will depend on the individual patient and, inevitably, will be limited by local availability, they add. However, IBS is undeniably very common and many patients are probably denied help by lack of access to therapists with the appropriate psychological skills.
They believe that increasing provision of primary care services for patients with IBS will provide an avenue for effective and early psychological treatment for a condition in which real improvement can be achieved.
ECP May Be Effective In Treating Crohn's Disease
Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=72328
Results from an international multi-center Phase II clinical trial suggest that extracorporeal photopheresis (ECP) may be effective in treating patients with clinically active (OR symptomatic) Crohn's disease who cannot tolerate or are refractory to immunosuppressants and/or anti-TNF agents. A 50% response rate after 3 months of ECP treatment was noted in the study, using standard disease activity criteria, as presented this afternoon at a scientific research session of Digestive Disease Week (DDW). The majority of patients who responded to ECP therapy had a notable improvement in their disease symptoms and signs after only six weeks of treatment.
"We show in this pilot study that ECP is effective in patients with Crohn's disease (CD) that have previously failed the strongest therapies we currently have," explains Maria Abreu, MD, Associate Professor in The Henry D. Janowitz Division of Gastroenterology and in the Center for Immunobiology at The Mount Sinai Medical Center. ECP is believed to bolster tolerance in the immune system, which may be important in immune-mediated diseases such as Crohn's. In contrast, most patients with inflammatory bowel disease are currently treated with medicines that suppress the immune system. Unlike ECP, those medications can have many serious side effects.
The 28 patient trial studied the safety and efficacy of ECP in patients with a Crohn's Disease Activity Index (CDAI) of at least 220 and less than 450 indicating that at least moderately active symptomatic CD was present. Clinical response was defined as a CDAI decrease of 100 or greater from baseline and/or a CDAI of less than 150 at week 12. Patients received two treatments of ECP weekly from weeks 0-4 and two treatments every other week from weeks 6-12 with no infectious complications reported.
"The findings of our study suggest that Crohn's disease patients who have not responded to other therapies may benefit from ECP," concludes Dr. Abreu.
Results from an international multi-center Phase II clinical trial suggest that extracorporeal photopheresis (ECP) may be effective in treating patients with clinically active (OR symptomatic) Crohn's disease who cannot tolerate or are refractory to immunosuppressants and/or anti-TNF agents. A 50% response rate after 3 months of ECP treatment was noted in the study, using standard disease activity criteria, as presented this afternoon at a scientific research session of Digestive Disease Week (DDW). The majority of patients who responded to ECP therapy had a notable improvement in their disease symptoms and signs after only six weeks of treatment.
"We show in this pilot study that ECP is effective in patients with Crohn's disease (CD) that have previously failed the strongest therapies we currently have," explains Maria Abreu, MD, Associate Professor in The Henry D. Janowitz Division of Gastroenterology and in the Center for Immunobiology at The Mount Sinai Medical Center. ECP is believed to bolster tolerance in the immune system, which may be important in immune-mediated diseases such as Crohn's. In contrast, most patients with inflammatory bowel disease are currently treated with medicines that suppress the immune system. Unlike ECP, those medications can have many serious side effects.
The 28 patient trial studied the safety and efficacy of ECP in patients with a Crohn's Disease Activity Index (CDAI) of at least 220 and less than 450 indicating that at least moderately active symptomatic CD was present. Clinical response was defined as a CDAI decrease of 100 or greater from baseline and/or a CDAI of less than 150 at week 12. Patients received two treatments of ECP weekly from weeks 0-4 and two treatments every other week from weeks 6-12 with no infectious complications reported.
"The findings of our study suggest that Crohn's disease patients who have not responded to other therapies may benefit from ECP," concludes Dr. Abreu.
Tuesday, May 29, 2007
FDA to Weigh Tysabri for Crohn's Disease
Source: http://www.ibtimes.com/articles/20070529/elan-biogen-tysabri.htm
Elan Corp. PLC and Biogen Idec Inc., the makers of Tysabri, announced Tuesday that U.S. regulators would soon review the drug for its possible use by sufferers of the gastrointestinal ailment Crohn's disease.
Both companies said two review committees of the U.S. Food and Drug Administration would jointly consider on July 31 whether to permit sale of Tysabri to treat Crohn's, which causes chronic but nonfatal inflammation of the intestines and afflicts 1 million people worldwide.
Clinical trials of Tysabri - which last year was approved for use in the United States and European Union to combat the most advanced cases of multiple sclerosis - have indicated that the drug is effective in preventing inflammatory immune cells from penetrating the wall of the intestine, limiting the damage they can cause.
Both MS and Crohn's are diseases that cause the immune system to attack the body's soft tissues, including those that line the intestines and nerves.
Tysabri's use for MS patients has been heavily restricted because of its link to a rare, usually fatal disease of the central nervous system called progressive multifocal leukoencephalopathy, or PML. Both companies temporarily withdrew the drug from sale in February 2005 after three patients in clinical trials contracted PML; two, including a Crohn's sufferer, died.
Elan of Dublin, Ireland, and Biogen Idec of Cambridge, Mass., applied in December for FDA approval of Tysabri for Crohn's sufferers.
The disease most commonly develops in people in their teens and 20s and has no cure. It can cause diarrhea, abdominal cramps, fever and bowel obstructions, leading to lost appetite and decreased weight.
The leading current treatment for Crohn's is Remicade, manufactured by Johnson & Johnson. Analysts say, if given FDA approval, Tysabri probably would be prescribed only to those Crohn's sufferers who were not responding to treatment from longer-established, lower-risk drugs.
Elan shares fell 0.03 euros ($0.04) to 14.15 euros ($19.09) on the Irish Stock Exchange.
Elan Corp. PLC and Biogen Idec Inc., the makers of Tysabri, announced Tuesday that U.S. regulators would soon review the drug for its possible use by sufferers of the gastrointestinal ailment Crohn's disease.
Both companies said two review committees of the U.S. Food and Drug Administration would jointly consider on July 31 whether to permit sale of Tysabri to treat Crohn's, which causes chronic but nonfatal inflammation of the intestines and afflicts 1 million people worldwide.
Clinical trials of Tysabri - which last year was approved for use in the United States and European Union to combat the most advanced cases of multiple sclerosis - have indicated that the drug is effective in preventing inflammatory immune cells from penetrating the wall of the intestine, limiting the damage they can cause.
Both MS and Crohn's are diseases that cause the immune system to attack the body's soft tissues, including those that line the intestines and nerves.
Tysabri's use for MS patients has been heavily restricted because of its link to a rare, usually fatal disease of the central nervous system called progressive multifocal leukoencephalopathy, or PML. Both companies temporarily withdrew the drug from sale in February 2005 after three patients in clinical trials contracted PML; two, including a Crohn's sufferer, died.
Elan of Dublin, Ireland, and Biogen Idec of Cambridge, Mass., applied in December for FDA approval of Tysabri for Crohn's sufferers.
The disease most commonly develops in people in their teens and 20s and has no cure. It can cause diarrhea, abdominal cramps, fever and bowel obstructions, leading to lost appetite and decreased weight.
The leading current treatment for Crohn's is Remicade, manufactured by Johnson & Johnson. Analysts say, if given FDA approval, Tysabri probably would be prescribed only to those Crohn's sufferers who were not responding to treatment from longer-established, lower-risk drugs.
Elan shares fell 0.03 euros ($0.04) to 14.15 euros ($19.09) on the Irish Stock Exchange.
Monday, May 28, 2007
Facts and Fallacies About Digestive Diseases
Source: http://www.healingwell.com/library/ibd/info6.asp
Introduction Researchers have only recently begun to understand the many, often complex, diseases that affect the digestive system. Accordingly, people are gradually replacing folklore, old wives' tales, and rumors about the causes and treatments of digestive diseases with accurate, up-to-date information. But misunderstandings still exist, and, while some folklore is harmless, some can be dangerous if it keeps a person from correctly preventing or treating an illness. Listed below are some common misconceptions (fallacies), about digestive diseases, followed by the facts as professionals understand them today.
Ulcers: Spicy food and stress cause stomach ulcers.
False.
The truth is, almost all stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal anti-inflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Spicy food and stress may aggravate ulcer symptoms in some people, but they do not cause ulcers.
Heartburn: Smoking a cigarette helps relieve heartburn.
False.
Actually, cigarette smoking contributes to heartburn. Heartburn occurs when the lower esophageal sphincter (LES)—a muscle between the esophagus and stomach—relaxes, allowing the acidic contents of the stomach to splash back into the esophagus. Cigarette smoking causes the LES to relax.
Celiac Disease: Celiac disease is a rare childhood disease.
False.
Celiac disease affects children and adults. At least 1 in 1,000 people and, in some populations, 1 in 200 people have celiac disease. Most often, celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating, diarrhea, abdominal pain, skin rash, anemia, and thinning of the bones (osteoporosis). Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.
People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, barley, and possibly oats, regardless of whether or not they have symptoms. In these people, gluten destroys part of the lining of the small intestine, which interferes with the absorption of nutrients. The damage can occur from even a small amount of gluten, and not everyone has symptoms of damage.
Bowel Regularity: Bowel regularity means a bowel movement every day.
False.
The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and perfectly healthy people may fall outside both ends of this range.
Constipation: Habitual use of enemas to treat constipation is harmless.
False.
The truth is, habitual use of enemas is not harmless. Over time, enemas can impair the natural muscle action of the intestines, leaving them unable to function normally. An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.
Irritable Bowel Syndrome: Irritable bowel syndrome is a disease.
False.
Irritable bowel syndrome is not a disease. It is a functional disorder, which means that there is a problem in how the muscles in the intestines work. Irritable bowel syndrome is characterized by gas, abdominal pain, and diarrhea or constipation, or both. Although the syndrome can cause considerable pain and discomfort, it does not damage the digestive tract as diseases do. Also, irritable bowel syndrome does not lead to more serious digestive diseases later.
Diverticulosis: Diverticulosis is an uncommon and serious problem.
False.
Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs—or out-pouchings—called diverticula, develop in the wall of the colon. These tend to appear and increase in number with age. Most people do not have symptoms and would not know that they had diverticula unless x-ray or intestinal examination were done. Less than 10 percent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.
Inflammatory Bowel Disease: Inflammatory bowel disease is caused by psychological problems.
False.
Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may be a virus or bacteria interacting with the body's immune system. There is no evidence to support the theory that inflammatory bowel disease is caused by tension, anxiety, or other psychological factors or disorders.
Cirrhosis: Cirrhosis is only caused by alcoholism.
False.
Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from other diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage disease, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals like iron or copper in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver.
Ostomy Surgery: After ostomy surgery, men become impotent and women have impaired sexual function and are unable to become pregnant.
False.
Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not experience impotence, or, if they do, it is temporary. If impotence does occur, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution. In women, ostomy surgery does not damage sexual or reproductive organs, so it does not directly cause sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create some temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.
Introduction Researchers have only recently begun to understand the many, often complex, diseases that affect the digestive system. Accordingly, people are gradually replacing folklore, old wives' tales, and rumors about the causes and treatments of digestive diseases with accurate, up-to-date information. But misunderstandings still exist, and, while some folklore is harmless, some can be dangerous if it keeps a person from correctly preventing or treating an illness. Listed below are some common misconceptions (fallacies), about digestive diseases, followed by the facts as professionals understand them today.
Ulcers: Spicy food and stress cause stomach ulcers.
False.
The truth is, almost all stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal anti-inflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Spicy food and stress may aggravate ulcer symptoms in some people, but they do not cause ulcers.
Heartburn: Smoking a cigarette helps relieve heartburn.
False.
Actually, cigarette smoking contributes to heartburn. Heartburn occurs when the lower esophageal sphincter (LES)—a muscle between the esophagus and stomach—relaxes, allowing the acidic contents of the stomach to splash back into the esophagus. Cigarette smoking causes the LES to relax.
Celiac Disease: Celiac disease is a rare childhood disease.
False.
Celiac disease affects children and adults. At least 1 in 1,000 people and, in some populations, 1 in 200 people have celiac disease. Most often, celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating, diarrhea, abdominal pain, skin rash, anemia, and thinning of the bones (osteoporosis). Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.
People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, barley, and possibly oats, regardless of whether or not they have symptoms. In these people, gluten destroys part of the lining of the small intestine, which interferes with the absorption of nutrients. The damage can occur from even a small amount of gluten, and not everyone has symptoms of damage.
Bowel Regularity: Bowel regularity means a bowel movement every day.
False.
The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and perfectly healthy people may fall outside both ends of this range.
Constipation: Habitual use of enemas to treat constipation is harmless.
False.
The truth is, habitual use of enemas is not harmless. Over time, enemas can impair the natural muscle action of the intestines, leaving them unable to function normally. An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.
Irritable Bowel Syndrome: Irritable bowel syndrome is a disease.
False.
Irritable bowel syndrome is not a disease. It is a functional disorder, which means that there is a problem in how the muscles in the intestines work. Irritable bowel syndrome is characterized by gas, abdominal pain, and diarrhea or constipation, or both. Although the syndrome can cause considerable pain and discomfort, it does not damage the digestive tract as diseases do. Also, irritable bowel syndrome does not lead to more serious digestive diseases later.
Diverticulosis: Diverticulosis is an uncommon and serious problem.
False.
Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs—or out-pouchings—called diverticula, develop in the wall of the colon. These tend to appear and increase in number with age. Most people do not have symptoms and would not know that they had diverticula unless x-ray or intestinal examination were done. Less than 10 percent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.
Inflammatory Bowel Disease: Inflammatory bowel disease is caused by psychological problems.
False.
Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may be a virus or bacteria interacting with the body's immune system. There is no evidence to support the theory that inflammatory bowel disease is caused by tension, anxiety, or other psychological factors or disorders.
Cirrhosis: Cirrhosis is only caused by alcoholism.
False.
Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from other diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage disease, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals like iron or copper in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver.
Ostomy Surgery: After ostomy surgery, men become impotent and women have impaired sexual function and are unable to become pregnant.
False.
Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not experience impotence, or, if they do, it is temporary. If impotence does occur, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution. In women, ostomy surgery does not damage sexual or reproductive organs, so it does not directly cause sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create some temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.
Pearl Jam Guitarist Talks About Making Music and Living with Crohn's Disease on BigButtRadio.com
Source: http://www.prweb.com/releases/2007/5/prweb524485.htm
Crohn's disease and ulcerative colitis, also collectively known as inflammatory bowel disease (IBD) is estimated to affect as many as 1 million Americans. Persistent diarrhea (loose, watery, or frequent bowel movements), abdominal pain, fever, and, at times, rectal bleeding are the distinguishing symptoms of Crohn's disease. And though the disease can vary in severity among those afflicted, all those identified as having it would agree it's a life altering diagnosis.
So when Andy Savage, host of the internet radio show BigButtRadio.com, asked Pearl Jam guitarist, Mike McCready, if he ever needed to leave the stage in the middle of show to go to the bathroom, he wasn't quite ready for the candidness of the answer. "Sometimes, I didn't quite make it off the stage", laughed the rock star. "But, I never let the disease stop me from doing what I love and that's the message I want to send to kids who are dealing with it also."
"Man, I have to commend you," said Savage. "I don't know how you stay so positive. I was doing research about the disease last night and it's just a terrible condition to have to go through life with." "Yes, but research by people like those from the Crohn's and Colitis Foundation of America (CCFA) are making great strides in reducing the severity of the symptoms of the disease. I went public with my condition to show people that despite the disease you can still have a life and career," McCready said.
Patrick the Trainer, fitness expert to the show wanted to know if nutrition was an important consideration, since IBD targets primarily the digestive tract. "Yeah, it's important to make adjustments to your diet," agreed McCready. "Eliminating milk from my diet was helpful to me, but because the disease behaves so differently in individuals, other foods might be identified as being problematic for someone else." Does the musician feel that his "coming out" with the status of his health made a difference to young people with the disease? "I think so. I've met kids who have told me thanks that I've made it a little easier for them. And that's really satisfying, but don't get me wrong, I'm no hero. I just want to help whoever I can and I'm glad for the opportunity," he said.
"And now you have a child of your own, Congratulations!" said Savage. "Yeah, my wife gave birth to our beautiful daughter fifteen days ago. So if I sound a little tired…" replied McCready, clearly overjoyed with fatherhood. "Tired? What, are you kidding? There's probably like four nannies working around the clock caring for your newborn. You're a rock star!" countered show host Savage. But McCready was quick to respond, "No, no. I'm the kind of guy who wants to be involved in everything concerning our new baby. I don't want to miss a thing." Are you concerned about your daughter suffering with Crohn's also, Patrick the Trainer wanted to know. "After all, there's some evidence to indicate that the disease is hereditary." The guitarist took a moment to answer. "My wife and I thought about it. This wasn't a decision we took lightly, but the improvements in treating the disease are increasing every day and though the chance of our child having Crohn's is slight, we feel the support is there if she needs it."
So what's next for the new father and social activist? "Well, the band has a tour of Europe scheduled to start soon and I'm looking forward to that." The musician takes a beat, and then continues, "You know, some people might think I've had it rough with the Crohn's affecting my life the way it has, but I couldn't be more blessed. To be able to make a living doing what I love is truly a gift and I'm thankful for that everyday."
Crohn's disease and ulcerative colitis, also collectively known as inflammatory bowel disease (IBD) is estimated to affect as many as 1 million Americans. Persistent diarrhea (loose, watery, or frequent bowel movements), abdominal pain, fever, and, at times, rectal bleeding are the distinguishing symptoms of Crohn's disease. And though the disease can vary in severity among those afflicted, all those identified as having it would agree it's a life altering diagnosis.
So when Andy Savage, host of the internet radio show BigButtRadio.com, asked Pearl Jam guitarist, Mike McCready, if he ever needed to leave the stage in the middle of show to go to the bathroom, he wasn't quite ready for the candidness of the answer. "Sometimes, I didn't quite make it off the stage", laughed the rock star. "But, I never let the disease stop me from doing what I love and that's the message I want to send to kids who are dealing with it also."
"Man, I have to commend you," said Savage. "I don't know how you stay so positive. I was doing research about the disease last night and it's just a terrible condition to have to go through life with." "Yes, but research by people like those from the Crohn's and Colitis Foundation of America (CCFA) are making great strides in reducing the severity of the symptoms of the disease. I went public with my condition to show people that despite the disease you can still have a life and career," McCready said.
Patrick the Trainer, fitness expert to the show wanted to know if nutrition was an important consideration, since IBD targets primarily the digestive tract. "Yeah, it's important to make adjustments to your diet," agreed McCready. "Eliminating milk from my diet was helpful to me, but because the disease behaves so differently in individuals, other foods might be identified as being problematic for someone else." Does the musician feel that his "coming out" with the status of his health made a difference to young people with the disease? "I think so. I've met kids who have told me thanks that I've made it a little easier for them. And that's really satisfying, but don't get me wrong, I'm no hero. I just want to help whoever I can and I'm glad for the opportunity," he said.
"And now you have a child of your own, Congratulations!" said Savage. "Yeah, my wife gave birth to our beautiful daughter fifteen days ago. So if I sound a little tired…" replied McCready, clearly overjoyed with fatherhood. "Tired? What, are you kidding? There's probably like four nannies working around the clock caring for your newborn. You're a rock star!" countered show host Savage. But McCready was quick to respond, "No, no. I'm the kind of guy who wants to be involved in everything concerning our new baby. I don't want to miss a thing." Are you concerned about your daughter suffering with Crohn's also, Patrick the Trainer wanted to know. "After all, there's some evidence to indicate that the disease is hereditary." The guitarist took a moment to answer. "My wife and I thought about it. This wasn't a decision we took lightly, but the improvements in treating the disease are increasing every day and though the chance of our child having Crohn's is slight, we feel the support is there if she needs it."
So what's next for the new father and social activist? "Well, the band has a tour of Europe scheduled to start soon and I'm looking forward to that." The musician takes a beat, and then continues, "You know, some people might think I've had it rough with the Crohn's affecting my life the way it has, but I couldn't be more blessed. To be able to make a living doing what I love is truly a gift and I'm thankful for that everyday."
Extracorporeal photopheresis effective in treating Crohn's disease
Source: http://www.huliq.com/22723/extracorporeal-photopheresis-effective-in-treating-crohns-disease
Results from an international multi-center Phase II clinical trial suggest that extracorporeal photopheresis (ECP) may be effective in treating patients with clinically active (OR symptomatic) Crohn’s disease who cannot tolerate or are refractory to immunosuppressants and/or anti-TNF agents.
A 50% response rate after 3 months of ECP treatment was noted in the study, using standard disease activity criteria, as presented this afternoon at a scientific research session of Digestive Disease Week (DDW). The majority of patients who responded to ECP therapy had a notable improvement in their disease symptoms and signs after only six weeks of treatment.
"We show in this pilot study that ECP is effective in patients with Crohn's disease (CD) that have previously failed the strongest therapies we currently have," explains Maria Abreu, MD, Associate Professor in The Henry D. Janowitz Division of Gastroenterology and in the Center for Immunobiology at The Mount Sinai Medical Center. ECP is believed to bolster tolerance in the immune system, which may be important in immune-mediated diseases such as Crohn’s. In contrast, most patients with inflammatory bowel disease are currently treated with medicines that suppress the immune system. Unlike ECP, those medications can have many serious side effects.
The 28 patient trial studied the safety and efficacy of ECP in patients with a Crohn’s Disease Activity Index (CDAI) of at least 220 and less than 450 indicating that at least moderately active symptomatic CD was present. Clinical response was defined as a CDAI decrease of 100 or greater from baseline and/or a CDAI of less than 150 at week 12. Patients received two treatments of ECP weekly from weeks 0-4 and two treatments every other week from weeks 6-12 with no infectious complications reported.
"The findings of our study suggest that Crohn’s disease patients who have not responded to other therapies may benefit from ECP," concludes Dr. Abreu.-The Mount Sinai Hospital / Mount Sinai School of Medicine
Results from an international multi-center Phase II clinical trial suggest that extracorporeal photopheresis (ECP) may be effective in treating patients with clinically active (OR symptomatic) Crohn’s disease who cannot tolerate or are refractory to immunosuppressants and/or anti-TNF agents.
A 50% response rate after 3 months of ECP treatment was noted in the study, using standard disease activity criteria, as presented this afternoon at a scientific research session of Digestive Disease Week (DDW). The majority of patients who responded to ECP therapy had a notable improvement in their disease symptoms and signs after only six weeks of treatment.
"We show in this pilot study that ECP is effective in patients with Crohn's disease (CD) that have previously failed the strongest therapies we currently have," explains Maria Abreu, MD, Associate Professor in The Henry D. Janowitz Division of Gastroenterology and in the Center for Immunobiology at The Mount Sinai Medical Center. ECP is believed to bolster tolerance in the immune system, which may be important in immune-mediated diseases such as Crohn’s. In contrast, most patients with inflammatory bowel disease are currently treated with medicines that suppress the immune system. Unlike ECP, those medications can have many serious side effects.
The 28 patient trial studied the safety and efficacy of ECP in patients with a Crohn’s Disease Activity Index (CDAI) of at least 220 and less than 450 indicating that at least moderately active symptomatic CD was present. Clinical response was defined as a CDAI decrease of 100 or greater from baseline and/or a CDAI of less than 150 at week 12. Patients received two treatments of ECP weekly from weeks 0-4 and two treatments every other week from weeks 6-12 with no infectious complications reported.
"The findings of our study suggest that Crohn’s disease patients who have not responded to other therapies may benefit from ECP," concludes Dr. Abreu.-The Mount Sinai Hospital / Mount Sinai School of Medicine
Treating mind eases IBS
Source: http://www.health24.com/news/Gastrointestinal/1-914,40453.asp
Created: Monday, May 28, 2007
Hypnotherapy, antidepressants and other mind-centred treatments could help people battling severe irritable bowel syndrome, a British survey of the literature finds.
Such treatments are effective because "people who have irritable bowel syndrome (IBS) don't necessarily have a clinical disorder in terms of psychology but have certain behaviour patterns that make them vulnerable to symptoms," explained Bu'Hussain Hayee, a clinical research fellow at University College Hospital in London.
He and Dr Ian Forgacs, a consulting gastroenterologist at Kings College Hospital, compiled the survey, published in the May 26 British Medical Journal, as a working guide for physicians.
"In part, the symptoms of irritable bowel syndrome are similar to those you find in depression, so things that work for depression work for it," Hayee said. Patients with IBS "are not depressed," he said, "but the treatments work."
Symptoms of the condition can include cramping, bloating, constipation and diarrhoea. The condition is surprisingly common. The US National Institute of Diabetes and Digestive and Kidney Disease estimates that as many as 1 in 5 adult Americans will suffer one or more symptoms of IBS at some time in their lives. Most people can control symptoms with diet, medications and stress management.
One common stress-management technique successfully used in IBS is cognitive behavioural therapy, Hayee said. That's a general term for a set of psychotherapies based on the belief that changing the way a person thinks about a condition can bring about improvement, even if the condition does not change.
"It has proven to be effective," Hayee said. "It focuses on the patient's perception of symptoms rather than on the symptoms themselves." Studies have shown that cognitive behaviour therapy is as effective in IBS as antidepressant medication, and that its effects last longer, he said.
Hypnotherapy has also proven effective in small trials, although a recent review found insufficient evidence to recommend its widespread use, Hayee said.
In a condition with such a wide range of symptoms, treatment must be tailored to the individual patient, he said. "In general, people who are more open to the idea of therapy will do better," Hayee said.
IBS is a case of "brain-gut interaction," added Dr Sita Chokhavatia, a professor of medicine in the gastroenterology department of Mount Sinai Medical Centre in New York City, who specializes in treating the condition.
"There is a 'big brain' in the skull and a 'little brain' in the enteric [intestinal] tract," she said. "Either you have too much information going up or too much information going down."
Treatment requires doctor-patient discussion in a psychiatric setting, Chokhavatia said. "You discuss it with patients - not so much as a psychological disease per se but as a brain-gut reaction, so the patient can sense less pain."
The focus must be on the symptoms felt by a specific patient, she said. "Cognitive behavioural therapy has been used more in patients with constipation, where it has been shown to be successful in some studies," Chokhavatia said.
Talks between doctor and patient are used to establish levels of anxiety and stress felt by individuals, she said. If stress levels are high, hypnotherapy might be offered, "like people trying to stop smoking," Chokhavatia said.
The official government one-in-five estimate for IBS incidence might be low, she added, "Lots of people don't complain," Chokhavatia said. "They feel symptoms but don't come to the doctor."
Those who do seek help have a reasonable chance of getting it under control, in terms of gaining a better quality of life, she said. � (HealthDayNews)
Created: Monday, May 28, 2007
Hypnotherapy, antidepressants and other mind-centred treatments could help people battling severe irritable bowel syndrome, a British survey of the literature finds.
Such treatments are effective because "people who have irritable bowel syndrome (IBS) don't necessarily have a clinical disorder in terms of psychology but have certain behaviour patterns that make them vulnerable to symptoms," explained Bu'Hussain Hayee, a clinical research fellow at University College Hospital in London.
He and Dr Ian Forgacs, a consulting gastroenterologist at Kings College Hospital, compiled the survey, published in the May 26 British Medical Journal, as a working guide for physicians.
"In part, the symptoms of irritable bowel syndrome are similar to those you find in depression, so things that work for depression work for it," Hayee said. Patients with IBS "are not depressed," he said, "but the treatments work."
Symptoms of the condition can include cramping, bloating, constipation and diarrhoea. The condition is surprisingly common. The US National Institute of Diabetes and Digestive and Kidney Disease estimates that as many as 1 in 5 adult Americans will suffer one or more symptoms of IBS at some time in their lives. Most people can control symptoms with diet, medications and stress management.
One common stress-management technique successfully used in IBS is cognitive behavioural therapy, Hayee said. That's a general term for a set of psychotherapies based on the belief that changing the way a person thinks about a condition can bring about improvement, even if the condition does not change.
"It has proven to be effective," Hayee said. "It focuses on the patient's perception of symptoms rather than on the symptoms themselves." Studies have shown that cognitive behaviour therapy is as effective in IBS as antidepressant medication, and that its effects last longer, he said.
Hypnotherapy has also proven effective in small trials, although a recent review found insufficient evidence to recommend its widespread use, Hayee said.
In a condition with such a wide range of symptoms, treatment must be tailored to the individual patient, he said. "In general, people who are more open to the idea of therapy will do better," Hayee said.
IBS is a case of "brain-gut interaction," added Dr Sita Chokhavatia, a professor of medicine in the gastroenterology department of Mount Sinai Medical Centre in New York City, who specializes in treating the condition.
"There is a 'big brain' in the skull and a 'little brain' in the enteric [intestinal] tract," she said. "Either you have too much information going up or too much information going down."
Treatment requires doctor-patient discussion in a psychiatric setting, Chokhavatia said. "You discuss it with patients - not so much as a psychological disease per se but as a brain-gut reaction, so the patient can sense less pain."
The focus must be on the symptoms felt by a specific patient, she said. "Cognitive behavioural therapy has been used more in patients with constipation, where it has been shown to be successful in some studies," Chokhavatia said.
Talks between doctor and patient are used to establish levels of anxiety and stress felt by individuals, she said. If stress levels are high, hypnotherapy might be offered, "like people trying to stop smoking," Chokhavatia said.
The official government one-in-five estimate for IBS incidence might be low, she added, "Lots of people don't complain," Chokhavatia said. "They feel symptoms but don't come to the doctor."
Those who do seek help have a reasonable chance of getting it under control, in terms of gaining a better quality of life, she said. � (HealthDayNews)
Diet in Inflammatory Bowel Disease
Source: http://www.crohns.org.uk/
Diet in Inflammatory Bowel Disease
Diet in Inflammatory Bowel Disease
Background
Over the years there have been a number of different approaches to diet in IBD, ranging from complete bowel rest and dietary exclusion to high energy, high protein diets, and from low fibre diets to high fibre diets. Even now advice may vary from one treatment centre to another. Understandably, many people are confused as to which diet they should be following.
To some extent advice will vary depending on whether you have Crohn's disease or ulcerative colitis, the site of the disease and past and current treatments. However, it is generally agreed that in most cases of IBD, the normal guidelines for a healthy balanced diet should be followed.
What is a balanced diet?
The basic dietary principles in IBD are no different to those for the general population. Starchy foods (potato, rice, bread, pasta, breakfast cereals) should form the basis of all meals. Fruit and vegetables should also form a large part of the diet, unless otherwise indicated, with at least five portions per day. Dairy foods, which provide calcium and protein, should be taken three times a day. Protein foods, (meat, fish, eggs, pulses, nuts, etc.) are essential for growth and repair and also provide iron - these should be taken twice daily. Other foods ( spreads, oils, fatty and sugary foods, alcohol, etc.) provide few nutrients other than energy but add variety to the diet – these should be enjoyed in moderation only.
However, having an illness of the digestive tract will have an effect on the way in which your body handles food. For some people this may mean they have difficulty in eating such a wide variety of foods or that they have increased requirements for certain foods.
How does inflammation affect dietary requirements?
When your gut becomes inflamed you may experience pain, discomfort or nausea. These can cause your appetite to be poor which, after a while, will lead to weight loss.
You may also find you are losing weight because your digestive tract is not absorbing food as efficiently as a normal gut. In Crohn's disease, damage to the lining of the small intestine may reduce its capacity to absorb nutrients. This can cause the body to become short of energy or deficient in certain minerals and vitamins, which may make you feel tired. If you have a fever this will increase the body's need for energy. The increased energy requirement is to some extent offset by a reduction in the amount of physical activity taken so it is best to take it easy when suffering with active disease.
Food residue that is not absorbed in the small intestine will enter the large intestine (or colon). An inflamed large intestine may not be able to reabsorb sufficient water or salt from the residue which will result in the passing of a large volume of diarrhoea or semi-solid stool. You may also lose some protein from leakage of the damaged intestinal lining. If this lining bleeds there is a risk of becoming deficient in iron which can lead to anaemia.
When a relapse has been treated you should then begin to feel much better with a return of your appetite. A nutritious diet, high in calories and protein, is then needed to replace lost energy and nutrients.
If your appetite remains poor for a while, you may find small, frequent meals and snacks easier to manage than a few large ones. Extra energy can be obtained from simple carbohydrates or sugars such as sweet drinks, biscuits and sugary desserts, but try to have these in addition to other foods rather than instead of them, as they supply little if any extra vitamins or minerals. Special high energy and nutritious drinks can be obtained on prescription from your doctor. Medical advice should be sought if you are losing weight or struggling to regain it.
Fluids need to be replaced during bouts of diarrhoea and vomiting to prevent dehydration. Usually this can be achieved by drinking more liquid but in severe cases, a solution of salt and glucose in water may be prescribed to improve absorption. In hospital, fluid losses are sometimes replaced by giving fluids into a vein.
Should the inflamed gut be rested?
When the gut becomes inflamed, eating frequently provokes pain because the lining of the intestine is irritated by food passing through. However, it is unwise to stop eating and drinking altogether as this will make the body very weak.
In certain circumstances, for example if the gut has become completely obstructed, it may be necessary to stop eating and receive nutrition via a vein into the blood. This is known as Total Parenteral Nutrition (TPN). In Crohn’s disease TPN 'dampens' down inflammation in most cases and is sometimes used as a treatment or as preparation for surgery. This is not the case in ulcerative colitis although TPN is still used sometimes to provide nutrition when the gut is not working. Special artificial diets known as 'enteral diets' are also effective in Crohn's disease at reducing inflammation, but they are not helpful in ulcerative colitis.
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