Inflammatory Bowel Disease

Discussing the latest advances in Crohn’s disease and ulcerative colitis

May 11th, 2016 · 3 Comments

CCFA to Study Impact of Specific Diets on Crohn's Disease

By Kanaaz Pereira kanaazpe

One of the first questions that people diagnosed with inflammatory bowel disease (IBD) have is, "What can I eat, and will changing my diet help with the symptoms or even cure my disease?"  The Crohn’s & Colitis Foundation of America (CCFA) has been given $2.5 million to investigate the value of a carbohydrate-rich diet and a Mediterranean-style diet in preventing relapse in Crohn’s patients who are currently in remission. People enrolled will be randomized to one of the two diets, and free meals will be provided for six weeks through a meal-delivery service. Patients can continue purchasing meals afterwards. There will be multiple sites across the country, and Mayo Clinic in Rochester, Minnesota is one of them.

Dr. Sunanda Kane M.D., outlines more details about the study, known as the Food and Crohn’s Exacerbation Study (FACES).

You can learn more about the study online here.

For more information about IBD, visit mayoclinic.org/IBD

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: dietary changes, IBD, Sunanda Kane

May 6th, 2016 · Leave a Comment

FDA Approves of Biosimilar to Infliximab

By Kanaaz Pereira kanaazpe

The FDA recently approved of a biosimilar (CT-P13) to infliximab, which is used for treating IBD patients, as well as patients suffering from rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. The new drug would be the first biosimilar monoclonal antibody approved in the United States. Dr. Edward Loftus, M.D., explains how biosimilars work, and discusses some of the issues surrounding this medication, and its potential benefits and drawbacks.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: biosimilar, CT-P13, Edward Loftus, FDA, IBD, infliximab, rheumatoid arthritis

May 6th, 2016 · Leave a Comment

Can Oral Contraceptives Worsen Crohn's Disease?

By Kanaaz Pereira kanaazpe

A new study, published in Gastroenterology, suggests that long-term use of combination oral contraceptives may increase the risk for surgery among women with established Crohn’s disease. The research team evaluated the association between oral contraceptives and risk for Crohn’s disease complications, including need for surgery and steroid use. They found that steroid use did not appear to increase with past or current use of oral contraceptives, and that the increased risk for surgery was only associated with combination oral contraceptives. Dr. Sunanda Kane, M.D., explains why this may not be a definitive study and puts the results into perspective.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: Crohn's Disease, Gastroenterology, IBD, oral contraceptives, Sunanda Kane, surgery

May 3rd, 2016 · Leave a Comment

Vedolizumab Safe for Inflammatory Bowel Disease

By Kanaaz Pereira kanaazpe

Vedolizumab (proposed trade name Entyvio), was developed as a treatment for patients with moderate to severe ulcerative colitis (UC) or Crohn's disease (CD), who have failed at least one conventional therapy, including tumor necrosis factor (TNF) antagonists. Dr. Edward Loftus, M.D., reviews a recent study published in the journal Gut, in which researchers reported on the safety profile of vedolizumab.

What is already known on this subject?

  • Vedolizumab is a monoclonal antibody that selectively prevents the infiltration of leucocytes into the gastrointestinal submucosa.
  • The efficacy and safety of vedolizumab in adults with IBD have been demonstrated in several clinical trials with follow-up to 1 year.

What are the new findings?

  • Treatment with vedolizumab for up to 5 years in a population of over 2800 patients demonstrated a favourable safety profile.
  • Vedolizumab is not associated with an increased risk of serious or opportunistic infections, and the rate of malignancy (0.1/100 person-years) is consistent with that observed in patients with IBD normally.

Although a favourable benefit-risk profile makes vedolizumab a useful option for the long-term treatment of IBD, researchers still need to better understand and observe how its safety profile evolves over time.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: Crohn's Disease, Edward Loftus, Entyvio, GUT, IBD, monoclonal antibody, ulcerative colitis, Vedolizumab

April 19th, 2016 · 2 Comments

IBD or IBS - That is the Question

By Kanaaz Pereira kanaazpe

Many people are confused between two distinct gastrointestinal disorders: inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS). Dr. Jean Fox, M.D., gives us a primer on the key differences, and similarities, between IBD and IBS.

For more information about IBD and, visit mayoclinic.org/IBD.

Dr. Fox is a gastroenterologist at Mayo Clinic.

Tags: gastrointestinal disorders, IBD, IBS, Jean Fox

April 6th, 2016 · Leave a Comment

Can You Teach a Teen New Tricks?

By Kanaaz Pereira kanaazpe

These days, everyone seems to have a coach. Here, Dr. Jeanne Tung, M.D., talks about problem solving coaching by telephone for teenagers with inflammatory bowel disease (IBD).

We know that successfully taking medications for IBD is critical in inducing and maintaining remission. However, studies have shown that many teenagers may not be following through with their doctors’ instructions. Based on a recent study published in Inflammatory Bowel Diseases, Dr. Tung discusses how structured coaching by telephone, for older teenagers and their families may be helpful in improving adherence.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Tung is a pediatric gastroenterologist at Mayo Clinic.

 

Tags: coaching, IBD, Inflammatory Bowel Diseases, Jeanne Tung, medication adherence, phone counseling, teenagers

March 26th, 2016 · Leave a Comment

Biologic Drugs – Are They Safe to Use During Pregnancy?

By Kanaaz Pereira kanaazpe

One of the major medical therapies used to treat chronic inflammatory conditions such as Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or psoriasis are anti-tumor necrosis factor (anti-TNF) agents. These include, but are not limited to drugs like Remicade, Simponi, Humira and Cimzia. Women who are pregnant, and taking these medications are always concerned about the potential for birth defects.

A study published in the February issue of Clinical Gastroenterology and Hepatology, compared the risk of any major birth defect for infants born to women with chronic inflammatory disease, with and without anti-TNF treatment. Dr. Sunanda Kane explains the results of the study, and reassures us that birth defects are not significantly more prevalent among women receiving anti-TNF agents during pregnancy.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: Anti-TNF agents, Cimzia, Clinical Gastroenterology and Hepatology, Crohn's Disease, Humira, IBD, pregnancy, psoriasis, Remicade, rheumatoid arthritis, Simponi, Sunanda Kane, ulcerative colitis

March 24th, 2016 · Leave a Comment

The New Birth Trend That’s All About Bacteria

By Kanaaz Pereira kanaazpe

It may sound strange, but some women who give birth by caesarean section (C-section) are covering their newborn in fluid swabbed from their vagina! A baby born vaginally is exposed to a plethora of different bacteria as it comes down the birth canal; these bacteria set up the child’s microbiome, (bacteria in human skin, guts, and mouths), which is what enables their body to defend against all kinds of diseases. Babies delivered by C-section acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders.

Based on a pilot study published in the journal Nature Medicine, Dr. Sunanda Kane discusses how babies born by C-section may receive benefits from being swabbed by their mother’s birth fluid, thus restoring the balance of the immune system. The procedure involves taking a swab from the mother's vagina and wiping it over the baby's mouth, eyes, face and skin from head to toe, shortly after birth by C-section. The hope is that by exposing a C-section baby to its mother’s vaginal fluid, the child’s microbiome and immune system will become more similar to that of a child born vaginally, and their risk of disease will reduce.

Although the work is promising, more research is needed to confirm the findings. According to Dr. Maria Dominguez-Bello, who led the research: "The current study represents proof of a principle in a small cohort, and shows that our method is worthy of further development as we seek to determine the health impact of microbial differences.”

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: bacteria, C-section, cesarean section, IBD, immune system, microbiome, Nature Medicine, Sunanda Kane

March 5th, 2016 · Leave a Comment

Lifestyle and Diet in Inflammatory Bowel Disease

By Kanaaz Pereira kanaazpe

Note: This post was originally published on Mayo Clinic News Network 

Inflammatory bowel disease (IBD), which consists of Crohn’s disease and ulcerative colitis, can be a frustrating diagnosis to deal with. In general, there is no clear evidence that one trigger alone causes problems. Therefore, there is no particular food, diet or lifestyle that causes, prevents or cures IBD.

"Some patients are more fortunate and can control their IBD through medication. Other patients experience flare-ups, meaning the lining of the intestine is inflamed and the absorption of nutrients in the body is disturbed. Identifying the cause of this disturbance takes time, patience and some homework," says Sebastian Strobel, M.D., Mayo Clinic Health System gastroenterologist.

Keeping a food diary is a great way to manage flare-ups. Start with a low-fiber or liquid diet until the situation is resolved, and realize certain foods may make symptoms worse.

In general, IBD patients should follow a healthy diet while keeping these tips in mind:

  • Eat smaller, more frequent meals.
  • Enjoy food in a relaxed atmosphere.
  • Avoid identified trigger foods.
  • Limit foods such as seeds, nuts, beans, fruit and bran.
  • Drink plenty of good fluids, such as water, low-sugar sports drinks and diluted fruit juice.
  • Stay away from caffeine and energy drinks.
  • Use the choosemyplate.gov website as a guideline.

Be careful with vitamins and mineral supplements. Remember that most of our needed vitamins are obtained just by eating a balanced diet. Some over-the-counter supplements can contain lactose, starch and other ingredients that can worsen your symptoms. Look for the USP (United States Pharmacopeia) symbol on the bottle.

Besides eating a recommended diet, there may still be some supplements suggested for patients with IBD. Talk to your health care provider about assistance from calcium, vitamin D, folic acid, vitamin B12, iron, zinc and probiotics. Live-culture yogurts are recommended for all IBD patients.

As with any health condition, healthy lifestyle practices make it easier to manage your diagnosis.

  • Don’t smoke, or quit to reduce symptoms.
  • Get regular physical activity to build up bone mass.
  • Eat a sensible diet.
  • Maintain a body mass index of less than 25.

By tuning in to your body, making healthy choices and working closely with your provider, you can enhance your quality of life living with IBD.

To learn more about IBD, visit mayoclinic.org/ibd.

 

Tags: Crohn's Disease, diet, IBD, Mayo Clinic Health System, Sebastian Strobel, ulcerative colitis

February 29th, 2016 · Leave a Comment

Another Reason for Teens to Eat Their Vegetables

By Kanaaz Pereira kanaazpe

Both Crohn’s disease (CD) and ulcerative colitis (UC) present day-to-day as well as long-term challenges for the adolescent patient. Based upon a study, published in the journal Inflammatory Bowel Diseases, Dr. Laura Raffals offers insights into the association between teenagers’ diet and the risk of developing IBD.

Researchers categorized the diet into two groups:

  1. Prudent Diet: Characterized by high intake of vegetables, fruit, better quality grains, fish, and poultry.
  2. Western Diet: Characterized by high intake of desserts, sweets, snacks, red and processed meat, refined grains, and fries.

They observed a 53% lower risk of Crohn's disease among those with a high prudent dietary pattern; at the same time they found no significant association between Western diet and risk of CD.

Findings from the study suggest that diet may have some influence on the development of IBD, particularly Crohn's disease, and Dr. Raffals advises all her patients with IBD to encourage their children to eat a healthy diet.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Raffals is a gastroenterologist at Mayo Clinic.

Tags: Crohn's Disease, diet, IBD, Inflammatory Bowel Diseases, Laura Raffals, teenagers, ulcerative colitis

February 5th, 2016 · Leave a Comment

Are Fecal Transplants Effective in Children with IBD?

By Kanaaz Pereira kanaazpe

Clostridium difficile infection (CDI) is the leading cause of nosocomial diarrhea and is increasing in prevalence both in adult and paediatric populations. Moreover, those with inflammatory bowel disease (IBD) are at increased risk of CDI. Fecal microbiota transplantation (FMT) is an effective treatment for recurrent CDI, but little data is available regarding the effectiveness and associated microbiome changes of fecal microbiota transplantation (FMT) for Clostridium difficile infection in children.

In a recent study, researchers investigated C. difficile eradication and microbiome changes with FMT in children with and without IBD. Dr. Mark Bartlett discusses the results, and also provides insight into why IBD patients are susceptible to recurrent CDI. The study is published in Alimentary Pharmacology and Therapeutics.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Bartlett is a gastroenterologist at Mayo Clinic.

Tags: Alimentary Pharmacology Therapeutics, Clostridium difficile infection CDI, fecal microbiome, Fecal Transplant, IBD, Mark Bartlett

January 27th, 2016 · Leave a Comment

Higher Risk for Pneumococcal Disease in IBD Patients

By Kanaaz Pereira kanaazpe

Mayo Clinic gastroenterologist, Dr. William Tremaine discusses a recent study published in The American Journal of Gastroenterology, that aimed to determine the risk of pneumococcal disease in patients with inflammatory bowel disease (IBD), compared with the general population, and how IBD medications may affect this risk, or whether the risk varies before or after IBD diagnosis.

Researchers from Copenhagen, Denmark found that IBD patients had a significantly higher risk for pneumococcal disease compared with controls overall. Dr. Tremaine highlights the importance of this study, especially in terms of disease prevention, and recommendations on routine pneumococcal vaccination.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Tremaine is a gastroenterologist at Mayo Clinic.

Tags: American Journal of Gastroenterology, IBD, pneumococcal disease, Vaccinations, William Tremaine

December 29th, 2015 · Leave a Comment

Specific Carbohydrate Diet for Pediatric IBD

By Kanaaz Pereira kanaazpe

Dietary intervention such as the specific carbohydrate diet (SCD), initially used to treat celiac disease, has been effective in patients with inflammatory bowel disease (IBD) as well. Dr. Jeanne Tung, M.D., discusses a study, published in the journal Nutrition, where pediatric gastroenterologists at Seattle Children's Hospital looked back at their patients who had tried the specific carbohydrate diet.

In general, the SCD tries to avoid the following foods:

  • Grains, chickpeas
  • Refined sugars or sugar substitutes, molasses, corn syrup, maple syrup
  • Chocolate
  • Processed foods, processed meats and fish
  • Soy products
  • Canned fruits and vegetables
  • Root vegetables
  • Milk, cream, commercial yogurt
  • Nut milk, rice milk, hemp milk

What is allowed?

  • Fresh or frozen vegetables and fruits
  • Most nuts, peas, beans
  • Fresh or frozen meats, turkey, chicken, fish, eggs
  • Some hard cheese, homemade yogurt
  • Honey
  • Juice that is not concentrated

Although the mechanism of action for the SCD is not known, it is hypothesized that the diet decreases intestinal inflammation by changing the fecal microbiome from a proinflammatory state to noninflammatory state.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Tung is a pediatric gastroenterologist at Mayo Clinic.

 

Tags: diet, fecal microbiome, IBD, Jeanne Tung, Nutrition, specific carbohydrate diet

December 20th, 2015 · 1 Comment

Pregnancy Concerns in Women With IBD

By Kanaaz Pereira kanaazpe

Women with inflammatory bowel disease (IBD) are at increased risk for adverse birth outcomes such as preterm delivery and small for gestational age (SGA) infants, and most recognized cases have underlying placental causes. Dr. Sunanda Kane, M.D., discusses a study, published in Annals of Gastroenterology that examined whether women with IBD have a higher rate of placental inflammation than non-IBD controls.

Researchers compared placental tissue of 26 women who had Crohn's disease or ulcerative colitis, and had delivered healthy children, with the placental tissue of 26 women who gave birth around the same time but didn't have IBD. They found that despite having an autoimmune inflammatory condition, the placenta did not appear to be at any increased risk of inflammation in the group of women who suffered from IBD.

While this is reassuring data, Dr. Kane explains that it does not change the recommendation for continuing anti-inflammatory drugs during pregnancy in women with IBD. Understanding what affects poor birth outcomes in IBD women is crucial to develop efficient and targeted therapeutics to improve births.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: Annals of Gastroenterology, Crohn's Disease, IBD, placental inflammation, pregnancy, Sunanda Kane, ulcerative colitis

December 13th, 2015 · Leave a Comment

New Gene Variants May Contribute to Very Early Onset IBD

By Kanaaz Pereira kanaazpe

Major advances in understanding the genetic contribution to the development of inflammatory bowel diseases (IBD) have been achieved in the last decade. However, these studies were performed primarily in adults and in children 10 years of age and older, and did not include children with very early-onset IBD (VEO-IBD), diagnosed at younger than 5 years of age. Dr. Konstantino Papadakis, M.D., discusses a study published in Gastroenterology, which investigated whether patients with VEO-IBD carry rare or new variants in genes that might contribute to disease development.

This study is critical as it provides a method to identify some of the underlying genetic defects as well as the pathways that contribute to the disease process in VEO-IBD patients. Moreover, these findings highlight the fact that clinicians can begin to individualize treatment to the specific patient, and may allow for targeted therapy in these children.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Papadakis is a gastroenterologist at Mayo Clinic.

Tags: Gastroenterology, genome-wide association studies, IBD, Konstantinos Papdakis, VEO-IBD

December 4th, 2015 · Leave a Comment

Faecal Testing and IBD

By Kanaaz Pereira kanaazpe

Inflammatory bowel disease (IBD), mainly consisting of Crohn’s disease and ulcerative colitis, are lifelong intestinal disorders, and disease flares are often unpredictable and significantly affect the patient’s quality of life. Sunanda Kane, M.D., discusses stool tests for pediatric and adult patients with inflammatory bowel disease, focusing  on two proteins that may help identify active inflammation.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: IBD, protein, stool testing, Sunanda Kane

December 3rd, 2015 · Leave a Comment

Symptoms and Diagnosis of IBD

By Kanaaz Pereira kanaazpe

How is inflammatory bowel disease (IBD) diagnosed? What are the symptoms? William Faubion, M.D., discusses these questions.

 

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Faubion is a gastroenterologist at Mayo Clinic specializing in pediatric and adult inflammatory bowel disease (IBD).

Tags: diagnosis, IBD, symptoms, William Faubion

December 1st, 2015 · Leave a Comment

CCFA Awareness Week: Dec.1-7, 2015

By Kanaaz Pereira kanaazpe

Living with inflammatory bowel disease (IBD) can be difficult, but the right resources and support can make day to day living much easier. The Crohn's & Colitis Foundation of America (CCFA) is a non-profit, volunteer-driven organization dedicated to finding the cures for Crohn's Disease and ulcerative colitis.

In an effort to raise awareness and support for patients and families battling Crohn's Disease and ulcerative colitis, Dr. Jeanne Tung, M.D., highlights some of the research and activities, and invites you to join the conversation during CCFA's Awareness week.

The week of December 1-7, 2015 is reserved to encourage all Americans to help find cures for inflammatory bowel diseases and raise support for the now 1.6 million Americans battling Crohn’s and ulcerative colitis through awareness and advocacy.

To learn more about Crohn's & Colitis Foundation of America, visit ccfa.org

For more information about IBD, visit mayoclinic.org/IBD.

Dr. Tung is a pediatric gastroenterologist at Mayo Clinic.

Tags: Crohn's Disease, IBD, Jeanne Tung, ulcerative colitis

November 21st, 2015 · Leave a Comment

Interval Colorectal Cancer Low with Surveillance Colonoscopy

By Kanaaz Pereira kanaazpe

Surveillance is recommended for patients with chronic inflammatory bowel disease (IBD), as they have an increased risk of colorectal cancer (CRC). According to recent study data, published in Clinical Gastroenterology and Hepatology, the incidence of interval colorectal cancers, (cancers occurring between scheduled surveillance colonoscopies), is low in patients undergoing regular surveillance colonoscopy. Dr. John Kisiel, M.D., explains how current surveillance guidelines may impact interval CRC.

Dr. Kisiel underscores two important facts:

  • Surveillance guidelines practiced in the United States are appropriate, and, "although they are conservative, we are catching more cancers."
  • The authors of the study found that 20% of the patients had low grade dysplasia, which are low grade pre-cancers. These are cancers that doctors want to find on surveillance exams, so that they can be treated in a timely manner and prevent the development of cancer.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Kisiel is a gastroenterologist at Mayo Clinic.

 

 

Tags: Clinical Gastroenterology and Hepatology, dysplasia, IBD, interval colorectal cancer, John Kisiel, surveillance colonoscopy

November 20th, 2015 · 1 Comment

Insight into Endoscopic Balloon Dilatation for Crohn's Disease

By Kanaaz Pereira kanaazpe

Endoscopic balloon dilatation (EBD) is a recognized treatment for symptomatic Crohn's strictures. Dr. Kenneth Schroeder M.D., talks about a recent study, published in Alimentary Pharmacology and Therapeutics, that examines the efficacy, as well as complication rates for EBD.

The role of EBD in the management of Crohn's strictures may need to be redefined, and future studies are needed to determine whether endoscopic balloon dilatation has significant long-term benefits.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Schroeder is a gastroenterologist at Mayo Clinic.

Tags: Crohn's Disease, endoscopic balloon dilatation, Kenneth Schroeder, strictures

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