IBS Treatment

May 6th, 2010

IBS treatment-Dietary Therapy

About 50% of people with IBS report that their symptoms arise after eating a meal, giving rise to the theory that food hypersensitivity, or intolerance may be the cause.  Foods in the diet can be the source of all of the symptoms of IBS, including pain, bloating, abdominal discomfort, and alterations in bowel habit. Some of the primary foods that are most likely to cause IBS symptoms are dairy products, eggs, and wheat.  Other potential food triggers include high fatty foods, caffeinated drinks, and raw fruits and vegetables.  Foods like beans, onions, bagels, bananas, and carrots have been associated with increased gas.  These foods can initiate a low-grade immunity reaction.  In the general population, the threshold is much higher, but for some patients with IBS, a cascade effect takes place.  It results in more and more immunity cells being activated. 

Randomized controlled trials in England have focused on identifying and eliminating food triggers.  The results of these trials were positive.  The study showed that 54% of the patients who followed the diet improved their symptoms compared to 15% who were on a fake diet.  The study also showed that when the regular diet was resumed, the patients again began to experience the symptoms of IBS.

For more than 20 years, dietary restrictions have been the first line of treatment for IBS.  Since dietary restrictions of a large group of suspected foods are not practical, physicians use elimination-challenge diets to pinpoint the food triggers.  Prior to initiating dietary restrictions, the person will be asked to write a journal of the symptoms experienced and for which foods.  This journal should occur over a 1 to 2 week span and include descriptions of symptoms and the times they occur.  The symptoms can be varied, covering GI complaints, skin changes, mood changes, fatigue, and concentration difficulties.  Foods identified as triggers are reviewed and then eliminated from the diet, using either a low-intensity or high-intensity elimination, or a high-intensity or “few foods” diet.  A low -intensity elimination, or a “food-specific” diet removes one food or food group from the diet.  A high-intensity elimination diet removes more than one food or food group from the diet. 

It is preferred most by physicians, because many times, a person may be intolerant to a combination of foods, and not just one food in the diet.  A few-food diet is restricted to the intake of only certain foods that do not trigger symptoms.  This diet has to be highly monitored to ensure compliance.  If symptoms decrease during the avoidance phase, it is highly likely that the foods that were eliminated were causing the symptoms.  To ensure this is the case, the food is gradually reintroduced to determine if symptoms recur.  If more than one food is eliminated, the foods are reintroduced one at a time every 3 to 4 days, to provide enough time for symptoms to appear.  If there is a recurrence of symptoms after a certain food is reintroduced, the triggering food is identified and a long term dietary plan is made. 

Dietary therapy with the elimination of triggering foods has been successful in relieving the GI symptoms for both adults and children, especially those with diarrhea-predominant IBS.  It has been proven to be effective when used alone or with traditional medications. 

References:
Hanaway PJ, ed. Irritable Bowel Syndrome. Second ed. Philadelphia: Saunders Elsevier; 2007. Rakel D, ed. Integrative Medicine.
Rindfleisch JA, ed. Adverse Food Reactions and the Elimination Diet. Second ed. Philadelphia: Saunders Elsevier; 2007. Rakel D, ed. Integrative Medicine.

Posted in IBS Irritable Bowel Syndrome | 3 Comments »

Vitamin D might fight Crohn’s disease

May 4th, 2010
Vitamin D, touted as the “sunshine cure,” might also prevent and fight Crohn’s disease, suggests a new study by Montreal researchers.

The discovery has yet to be confirmed by clinical trials, but it raises hopes for the estimated 170,000 Canadians with either Crohn’s disease or ulcerative colitis.

Canada has one of the highest reported rates in the world for Crohn’s disease, a chronic inflammatory bowel disorder that usually affects the lower small intestine.”Our data suggests for the first time that Vitamin D deficiency can contribute to Crohn’s disease,” said John White, an endocrinologist at the Research Institute of the McGill University Health Centre.

White noted that people who live in northern climates — which receive less sunshine that is essential for the fabrication of Vitamin D by the human body — are especially vulnerable to Crohn’s disease.

White and his colleagues treated cancer cells in the lab with Vitamin D, and then carried out a micro-array or genetic analysis of those cells. They found that Vitamin D switched on two genes that are important in preventing or fighting Crohn’s disease.

“It’s reasonable to think that Vitamin D deficiency can contribute to the frequency of the disease,” White said. “Siblings of patients with Crohn’s disease that haven’t yet developed the disease might be well advised to make sure they’re Vitamin D sufficient.”

As for whether taking Vitamin D could be an effective treatment for Crohn’s, White was cautious, saying that would have to be demonstrated in a clinical trial.

The White study was published in the Journal of Biological Chemistry.

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More IBD Genes Identified

March 24th, 2010

According to a study published online in the journal Nature Genetics, researchers have identified 13 more genes that are associated with ulcerative colitis. The study looked at the genes of 2,009 people with ulcerative colitis and 1,580 controls in order to determine which genes affected ulcerative colitis. Researchers then place the number of genes now known to be associated with ulcerative colitis at 30, and about half of those are also associated with Crohn’s disease.

While this new information may seem esoteric, it does help further the understanding of the causes of inflammatory bowel disease (IBD). It could be years before this data is able to be applied in any meaningful way for people who have IBD, but every new piece of data brings the medical community one step closer to prevention and effective treatment of IBD.

Sources:

McGovern DP, Gardet A, Törkvist L, et al. “Genome-wide association identifies multiple ulcerative colitis susceptibility loci.” Nat Genet 2010 Mar 14 [Epub ahead of print]. 23 Mar 2010.

This article is a reprint of  http://ibdcrohns.about.com/b/2010/03/24/more-ibd-genes-identified.htm

The time or date displayed reflects when an article was added to Google News March 24. 2010

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Cannabis Hope for Inflammatory Bowel Disease

February 18th, 2010

Chemicals found in cannabis could prove an effective treatment for the inflammatory bowel diseases Ulcerative Colitis Disease and Crohn’s Disease, say scientists.

Laboratory tests have shown that two compounds found in the cannabis plant — the cannabinoids THC and cannabidiol — interact with the body’s system that controls gut function.

Crohn’s Disease and Ulcerative Colitis, which affect about one in every 250 people in Northern Europe, are caused by both genetic and environmental factors. The researchers believe that a genetic susceptibility coupled with other triggers, such as diet, stress or bacterial imbalance, leads to a defective immune response.

Dr Karen Wright, Peel Trust Lecturer in Biomedicine at Lancaster University, presented her soon-to-be published work at The British Pharmacological Society’s Winter Meeting in London.

She said: “The lining of the intestines provides a barrier against the contents of the gut but in people with Crohn’s Disease this barrier leaks and bacteria can escape into the intestinal tissue leading to an inappropriate immune response.

“If we could find a way to restore barrier integrity in patients we may be able to curb the inflammatory immune response that causes these chronic conditions.”

Dr Wright, working with colleagues at the School of Graduate Entry Medicine and Health in Derby, has shown that cells that react to cannabinoid compounds play an important role in normal gut function as well as the immune system’s inflammatory response.

“The body produces its own cannabinoid molecules, called endocannabinoids, which we have shown increase the permeability of the epithelium during inflammation, implying that overproduction may be detrimental,” said Dr Wright.

“However, we were able to reverse this process using plant-derived cannabinoids, which appeared to allow the epithelial cells to form tighter bonds with each other and restore the membrane barrier.”

The research was carried out using cell cultures in a dish but, interestingly, when the team attempted to mimic the conditions of the gut by reducing the amount of oxygen in the cells’ environment, much lower concentrations of cannabinoid were needed to produce the same effect.

Dr Wright added: “What is also encouraging is that while THC has psychoactive properties and is responsible for the ‘high’ people experience when using cannabis, cannabidiol, which has also proved effective in restoring membrane integrity, does not possess such properties.”

Source:http://www.sciencedaily.com/releases/2009/12/091220175502.htm
The time or date displayed reflects when an article was added to Google News Dec.20, 2009

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Posted in colitis, crohn's, crohn's disease, ulcerative colitis | 1 Comment »

Fatty acids affect ulcerative colitis risk

February 10th, 2010

People who eat lots of red meat, cook with certain types of oil, and use some kinds of polyunsaturated fatty acid (PUFA)-heavy margarines may be increasing their risk of a painful inflammatory bowel disease.

These foods are high in linoleic acid and people who are the heaviest consumers of this omega-6 PUFA are more than twice as likely to develop ulcerative colitis as those who consume the least.

Researchers have found that eating more eicosapentaenoic acid, an omega-3 fatty acid found in fish and fish oils, is associated with a lower risk of the disease. While people need a certain amount of linoleic acid to survive, excess amounts are taken up into the lining of the colon, and if they’re released, they can promote inflammation. Omega-3 fatty acid does the opposite. It basically dampens down inflammation.

To investigate the role of fatty acids and ulcerative colitis, a life-long disease characterised by inflammation of the lining of the large intestine, researchers looked at data from the European Prospective Investigation into Cancer and Nutrition (EPIC) trial, which included over half a million people from 10 European countries. Their analysis included 203,193 men and women 30 to 74 years old. During follow-up, which ranged from about 2 to 11 years, 126 people developed ulcerative colitis.

It was found that people in the top quartile of linoleic acid intake (they were consuming around 13 to 38 grams a day) were 2.5 times more likely to have developed the disease than people who consumed the least, about 2 to 8 grams daily.

There’s currently no proven dietary treatment for ulcerative colitis but the current findings raise the possibility that eating a diet low in linoleic acid could be helpful. While a Western-style, red-meat-heavy diet is high in this fatty acid and low in omega-3s, a more Mediterranean style eating pattern – with plenty of fruits and vegetables, fish, and nut oils – would be low in linoleic acid and high in omega-3. If omega-3s do help prevent ulcerative colitis, eating a couple of servings of fish a week would probably be protective, the researchers concluded.

Source:
http://doctor.ndtv.com/storypage/ndtv/id/4118/Fatty_acids_affect_ulcerative_colitis_risk.html
The time or date displayed reflects when an article was added to Google News Dec.4, 2009

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The Benefits of Probiotics

January 23rd, 2010

Probiotic

The human body is made up of an estimated 100 trillion bacterial cells from at least 500 species, not including viruses and fungi. These bacterias (probiotics) are referred to as “friendly” bacteria and are responsible for several important biological functions. Some of these functions include assisting with digestion, keeping other harmful bacteria at bay and stimulating the immune system.

Researchers found that probiotics hold the answer to the growing number of cases of antibiotic resistance and abuse. This has caused consumers to search for other natural alternatives to treating various health conditions.

Certain studies have proven the many health benefits of probiotics such as the prevention or control of:

Food and skin allergies in children
Bacterial vagniosis
Premature labor in pregnant women
Inflammatory bowel disease
Recurrent ear and bladder infections
Chronic diarrhea

Probiotics are defined as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.”

Probiotic bacteria, which are living microorganisms that have beneficial effects on human health, have mostly been studied as treatments for different gastrointestinal diseases and allergies. However, not much is known about what kind of effects they have on the immune system in healthy adults.

A new study shows that probiotics can modulate immune responses via your gut‘s mucosal immune system.

It was found that probiotics have an anti-inflammatory potential. They caused a decrease in serum CRP levels, and a reduction in the bacteria-induced production of proinflammatory cytokines.

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Arthritis may be a warning symptom of IBD

January 7th, 2010

Often, arthritis can appear before the symptoms of IBD, especially in children with Crohn’s disease. If your child develops arthritis, Crohn’s should be considered, even if your child isn’t yet experiencing any intestinal symptoms and occult stool tests are negative.

Another form of arthritis called “spinal arthritis” – or spondylitis – can occur years before the onset of more common IBD symptoms, such as bloody diarrhea and abdominal pain. Spondylitis produces pain and stiffness in the lower spine and sacroiliac joints. A more sinister and rare form of spinal arthritis called “ankylosing spondylitis” can lead to inflammation of the eyes, lungs and heart valves. Both forms of spondylitis are serious illnesses that can severely limit your quality of life and lead to serious complications. It’s important to seek timely treatment or better yet, try to prevent the onset of arthritis if you’re at risk because you suffer from IBD.

Prevention is key for IBD sufferers.

If you suffer from IBD – be it either ulcerative colitis or Crohn’s disease - it’s important to talk to a doctor about preventative measures you can take to avoid arthritis. As the saying goes – and it’s particularly true in this case – the best offense is defense.

Clearly, people suffering from colitis and arthritis need to address both diseases. Otherwise, you’ll be simply relieving symptoms rather than treating the underlying cause. For example, NSAIDs (non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen) along with steroid injections are often used to treat arthritis and lessen pain associated with it. But if you’re an IBD sufferer – beware! NSAIDs can irritate your intestinal lining and lead to more inflammation. It’s important that your treatment plan considers all aspects of both conditions.

If you’re overweight, try to lose weight. Your diet should be modified according to your body neeeds, avoiding specific triggers that lead to your symptoms. Although you need to follow a special diet (i.e. gluten-free in celiac disease or meat-free in gout and other arthitic pain), it is important to keep all the essential nutrients, especially protein, in balance with proper quantity and quality of minerals and vitamins. Controlling your nutrition will be the most important tool on your road to wellness.

For more information about arthritis treatment

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Acid Reflux

January 6th, 2010

Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up or refluxes) into the esophagus. The liquid can inflame and damage the lining (cause, cause esophagitis) of the esophagus although visible signs of inflammation occur in a minority of patients. The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum. (The duodenum is the first part of the small intestine that attaches to the stomach.) Acid is believed to be the most injurious component of the refluxed liquid. Pepsin and bile also may injure the esophagus, but their role in the production of esophageal inflammation and damage is not as clear as the role of acid.

GERD is a chronic condition. Once it begins, it usually is life-long. If there is injury to the lining of the esophagus (esophagitis), this also is a chronic condition. Moreover, after the esophagus has healed with treatment and treatment is stopped, the injury will return in most patients within a few months. Once treatment for GERD is begun, therefore, it usually will need to be continued indefinitely although it is argued that in some patients with intermittent symptoms and no esophagitis, treatment can be intermittent and done only during symptomatic periods.

In fact, the reflux of the stomach’s liquid contents into the esophagus occurs in most normal individuals. One study found that reflux occurs as frequently in normal individuals as in patients with GERD. In patients with GERD, however, the refluxed liquid contains acid more often, and the acid remains in the esophagus longer. It has also been found that liquid refluxes to a higher level in the esophagus in patients with GERD than normal individuals.

As is often the case, the body has ways (mechanisms) to protect itself from the harmful effects of reflux and acid. For example, most reflux occurs during the day when individuals are upright. In the upright position, the refluxed liquid is more likely to flow back down into the stomach due to the effect of gravity. In addition, while individuals are awake, they repeatedly swallow, whether or not there is reflux. Each swallow carries any refluxed liquid back into the stomach. Finally, the salivary glands in the mouth produce saliva, which contains bicarbonate. With each swallow, bicarbonate-containing saliva travels down the esophagus. The bicarbonate neutralizes the small amount of acid that remains in the esophagus after gravity and swallowing have removed most of the liquid.

Gravity, swallowing, and saliva are important protective mechanisms for the esophagus, but they are effective only when individuals are in the upright position. At night during sleep, gravity is not in effect, swallowing stops, and the secretion of saliva is reduced. Therefore, reflux that occurs at night is more likely to result in acid remaining in the esophagus longer and causing greater damage to the esophagus.

Certain conditions make a person susceptible to GERD. For example, GERD can be a serious problem during pregnancy. The elevated hormone levels of pregnancy probably cause reflux by lowering the pressure in the lower esophageal sphincter (see below). At the same time, the growing fetus increases the pressure in the abdomen. Both of these effects would be expected to increase reflux. Also, patients with diseases that weaken the esophageal muscles, such as sclerodema or mixed connective tissue diseases, are more prone to develop GERD.

Learn more about Acid reflux diet

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What are the complications of Crohn’s disease?

December 30th, 2009

Intestinal blockage can occur in people with Crohn’s disease. Blockage occurs because the intestinal wall thickens or swells from inflammation and scar tissue. Ulcers can also cause tunnels to form through the inflamed areas of the intestine or even the healthy parts. These tunnels are called fistulas. Sometimes pockets of infection, called abscesses, can form in and around the fistulas. Fistulas can be treated with medicine, but sometimes surgery is needed.

People with Crohn’s disease often don’t get the nutrients they need. If you have Crohn’s disease, you may not get enough protein, vitamins, or calories in your diet. If you aren’t getting nutrients, it may be because you

-have an upset stomach that keeps you from eating enough
-may be losing protein in the intestine
-may not be able to absorb nutrients from your food

 
Other problems that some people with Crohn’s disease suffer from are arthritis, skin problems, swelling in the eyes or mouth, kidney stones, and gallstones.

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Diverticulosis

December 19th, 2009

Diverticulitis occurs when small, bulging pockets – or diverticula – occur within the colon and become infected. In most cases a slight or micro-perforation occurs.

Diverticulosis, the presence of the pocket without infection, is very common as we grow older. Nearly half of Americans over 50 will have diverticulosis, and many will have no symptoms at all. They often will be diagnosed at the time of their screening colonoscopy.

The longer a person has the pouches, the greater the chance of getting them infected and hence, being diagnosed with diverticulitis. Some cases are attributed to low-fiber diet and/or constipation. Diets rich in fiber and prompt medical evaluations are recommended mainstays for prevention and treatment, respectively.

The mere presence of diverticulosis usually will not cause significant symptoms. However, when an infection does occur severe abdominal pain is common, usually in the left lower abdomen. Fever, tenderness and altered bowel habits are common with diverticulitis.

During the acute infection, a low-fiber diet is best to limit the amount of food intake that might remain in the intestinal tract undigested.

Complications of diverticulitis can greatly increase the mortality of the disease. When perforation is not contained, peritonitis will occur and emergency surgery is necessary. The mortality rate soars above 35 percent in this scenario. Abscesses, septic shock, multisystem failure and bowel obstruction can also complicate the condition. Fistulous tracts can arise between intestines or other organs including the bladder, vagina and skin. Bleeding from diverticulosis can cause massive blood losses.

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