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In This Issue
Two research studies evaluating dietary changes and complementary medicine for the treatment of inflammatory bowel diseases (IBD) have been launched at Rush University Medical Center. They have been funded by the National Institute of Health. One study will look at the impact of mind/body medicine on patients suffering from ulcerative colitis (UC) and the other will assess how diet impacts patients with Crohn's Disease.
"Both Crohn's disease and ulcerative colitis are due to an autoimmune response to the bacteria or bacterial antigens inside the intestines, said Dr. Ali Keshavarzian, director of digestive diseases and nutrition at Rush and principal investigator and co-investigator on the studies. Basically, the immune system is having an abnormally aggressive reaction to the bacteria."
"We want to control flare-ups of the diseases," said Keshavarzian. "Unfortunately, the treatments for IBD can be toxic and risky. There are increased risks of cancer, infection and even death as a result of IBD treatment. That's why we're looking at how diet as well as stress relate to the flare-ups. It may be that if we can lower stress and get the right diet, we may be able to control these illnesses."
One study is looking for participants suffering from Ulcerative Colitis in order to find out if complementary and alternative medicine techniques may help reduce the effects when conventional medicine has not been successful.
"We're looking at the relationship between stress and ulcerative colitis flare-ups, said Dr. Sharon Jedel, clinical psychologist in the section of gastroenterology at Rush and the study's co-investigator. "The trial includes education about stress and training individuals in certain stress reduction techniques using alternative therapies."
"Approximately 40 percent of patients with IBD use complementary and alternative medicine; however, there is a lack of scientific evidence of the efficacy," said Keshavarzian. "Complementary treatments and services are a large, yet hidden section of our health care system."
Rush is looking to enroll 100 subjects suffering from moderately severe UC who have experienced a flare-up in the last six months. Participants will be assigned randomly to one of two possible eight-week courses on mind/body medicine.
The second study which is a dietary trial is looking for 90 participants with Crohn's disease to see if diet adjustments as well as dietary food supplements promoting the growth of good bacteria might help control flare ups.
"We're trying to get improve the mix of bacteria in the intestines of patients with IBD. Imagine making a picture with different colors," said Dr. Ece A. Mutlu, gastroenterologist at Rush and principal investigator on the study. "It could be terrible or harmonious depending on the composition and quantity of certain colors. We're trying to create a harmonious environment in the intestines with the right types of bacteria."
"One of the many advantages of coming to Rush is that we're looking for alternatives to IBD treatment that may have less side effects," says Mutlu. "Our hope is to find a number of solutions to control these debilitating diseases."
The American College of Gastroenterology Annual Meeting presented several studies emphasizing the effectiveness and safety of probiotics in treating gastrointestinal problems related to Irritable Bowel Syndrome (IBS). IBS is a disorder of the gastrointestinal system that causes abdominal pain and altered bowel habits (diarrhea and/or constipation).
A review of 19 randomized controlled trials involving over 1600 patients found that probiotics were helpful in controlling and improving bowel movements in those suffering from diarrhea and constipation due to IBS.
Lead researcher Dr. Paul Moayyedi says that probiotics are effective in IBS, but that we do not have enough information to be sure whether there is one probiotic that is particularly effective or whether combinations of probiotics are required.
Another review studied IBS patients who suffered from diarrhea. They were given a multi-strain probiotic for 28 days. The number of episodes of diarrhea decreased significantly in the patients taking probiotics when compared to the placebo group.
An additional study found that probiotics were significantly more effective than placebo in reducing IBS-related symptoms in children and teenagers as well.
A fatty acid found in olive oil, nuts and avocados wards off hunger pangs, according to a new research.
Pharmacologists at UC Irvine showed that these fats trigger production of a compound in the small intestine that curbs hunger pangs. The discovery points toward new approaches to treating obesity and other eating disorders.
Daniele Piomelli, the Louise Turner Arnold Chair in Neurosciences, and his colleagues have studied how a fat-derived compound called oleoylethanolamide regulates hunger and body weight.
The analysis revealed that an unsaturated fatty acid called oleic acid stimulates production of OEA, which in turn decreases appetite.
Oleic acid is transformed into OEA by cells in the upper region of the small intestine. OEA then finds its way to nerve endings that carry the hunger-curbing message to the brain. There, it activates a brain circuit that increases feelings of fullness.
Piomelli believes OEA could be used in a variety of drugs because it is a key to the way the body naturally handles fatty foods and regulates eating and body weight.
"We are excited to find that OEA activates cell receptors that already have been the focus of successful drug development," he said.
"This gives us hope for a new class of anti-obesity drugs based on the savvy use of natural appetite-controlling mechanisms," the expert added.
In previous studies, Piomelli found that increasing OEA levels can reduce
appetite, produce weight loss and lower blood cholesterol and triglyceride levels.
The next time American soldiers dig into the candy, cookies and cakes they get as rations, they will be taking a healthy bite - what with the treats containing probiotics, the beneficial bacteria already found in the human gut.
The move to add probiotics to their snacks comes as the incidences of soldiers serving in Iraq and Afghanistan coming down with diarrhea increases.
Most of the products are still in development, but the U.S. military hopes to soon begin human trials. If they pass, they will be sent to soldiers in the field.
Kenneth Racicot is food technologist for the U.S. Army Research Development Engineering Command (REDCOM) a military research and development center in Natick, Massachusetts. He says that the incidence of intestinal illness is above average. They are trying to come up with nutritional strategies to help alleviate that.
Washington, July 2008.
In Good Health.
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