Digestive WellnessMarch 2010 how to reevaluate and regain control of your digestive health

CAN BACTERIA BE GOOD FOR YOU?

At the University of Chicago Medical Center, we ask questions like this every day.Questions that have the potential to forever change the way gastrointestinal disorders are treated.

DISCOVER FOR YOURSELF.discover.uchospitals.edu | 888-UCH-0200

digestive wellness

CONTENTS 2 EatingRight

3 TreatingGastrointestinalCancers

4 DigestiveEnzymes

5 GoingOrganic

5 ProbioticsAnd

PreventiveNutrition

6 StartingEarly

6 ShouldIGoGluten-Free

7 DigestiveWellnessAnd

NaturalAlternatives

7 KnowTheFacts

8 PanelOfExperts

DIGESTIvEWEllNESSA special supplement produced by Mediaplanet and distributed by the Chicago Tribune.

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Digestive issues are more

common than most people

think —approximately one

in 25 people suffers from a food al-

lergy and many more suffer from food

intolerances. Celiac disease affects an

estimated one percent of Americans.

And one in five experience symptoms

of irritable bowel syndrome, which

affects twice as many women as

men. If you have a chronic digestive

condition, a carefully planned diet

can make a difference. With certain

diseases, what you eat may reduce

symptoms. In other cases, diet can be

the primary treatment leading to im-

proved health.

For those who are in need of help,

who is the best expert? A recent sur-

vey by the American Dietetic Associa-

tion and the University of Tennessee

Graduate School of Medicine showed

96 percent of primary care physicians

believe the nation’s healthcare sys-

tem should place more emphasis on

nutrition to treat and manage chronic

disease. However, only 12 percent be-

lieve physicians currently pay enough

attention to nutrition when treating

these diseases.

Whether you are trying to treat dis-

ease, lose weight or just make health-

ier choices, it may be hard to figure

out whom to listen to for advice. Hear-

ing someone is a “nutritionist” often

makes the person sound like they’re

educated and trained in nutrition

science and health issues. But in many

states, titles like “nutritionist” and “diet

counselor” are not regulated, so terms

like these can be used by people who

are not qualified to give accurate nu-

trition advice. While some nutritionists

may have an educational background

in nutrition science, others may have

little if any actual nutrition training or

just mail-order credentials. Even if a

person holds degrees from accredited

institutions, nutrition may not be his

or her specialty.

Who is the qualified nutrition

expert? When you need trusted, accu-

rate, timely and practical advice, seek

the advice of a registered dietitian.

With our education and experience,

RDs have the skills and knowledge

to translate nutrition science into

practical meal planning. A registered

dietitian can help you navigate food

allergies; work with your healthcare

team by helping you change your eat-

ing plan pre- or post-surgery; and help

you find ways to work with health

problems such as IBS .

The next time you hear nutrition

advice on television or see a diet book

that looks like it might help you lose

those last 10 pounds, take a closer

look to make sure the information is

coming from the qualified expert in

food and nutrition science: a regis-

tered dietitian.

Visit the American Dietetic Asso-

ciation at www.eatright.org to locate

a registered dietitian near you.

The American Dietetic Association

is the world’s largest organization of

food and nutrition professionals. ADA

is committed to improving the na-

tion’s health and advancing the pro-

fession of dietetics through research,

education and advocacy.

The content in this special advertis-

ing section was not developed by the

American Dietetic Association. The

American Dietetic Association does

not endorse any of the advertisers ap-

pearing within this special advertising

section or the companies mentioned in

the advertorial sections.

Eating Right: Optimizing Your Digestive Health

At every stage of life, from infancy through our senior years, nutrition is essential to keeping our bodies running at their best. As we age, our nutrient needs change with our bodies. But for those with digestive issues, proper food choices not only help them lead a healthier life, but often a more comfortable life.

By: JESSIE M. PAVlInAC, MS, RD, CSR, lD, PRESIDEnT, AMERICAn DIETETIC ASSoCIATIon

Jessie M. Pavlinac

a very special thanks to...

the next time you hear nutrition advice on television or see a diet book that looks like it might help you lose those last 10 pounds, take a closer look to make sure the information is coming from the qualified expert in

food and nutrition science: a registered dietitian.

digestive wellness

IT DID FOR MARY CARLENE SHEDD.Imagine being told you have cancer. It’s scary. Terrifying even. Now imagine

your doctor taking the time to teach you all about your disease and

treatment, going so far as to sketch a diagram of your surgery. That is

exactly what Mary found at the University of Chicago Medical Center after

her diagnosis of colon cancer. And not only did she receive the latest

treatments combined with the skill of a team of expert surgeons, but she

found the confi dence and comfort only knowledge can provide. At the

University of Chicago Medical Center, we think educating patients is an

essential part of treating them.

DISCOVER FOR YOURSELF.

discover.uchospitals.edu

888-UCH-0200

CAN A SIMPLE DRAWING MAKE ALL THE DIFFERENCE IN CANCER SURGERY?

And though there is no com-

mon thread running through

all GI cancers, there is a stan-

dard approach to diagnosis that is

critical to prescribing the best course

of treatment.

“First, we must determine where

the cancer comes from—what is the

cell of origin,” says Hedy Kindler, MD,

medical director of gastrointestinal

oncology at the University of Chicago

Medical Center. “That information

determines how the cancer behaves

and helps us understand how it might

respond to treatment. Then we ascer-

tain whether the cancer is localized

and removable with surgery, or if it has

metastasized and traveled to another

site.”

There are some commonalities

among treatment regimens for GI can-

cers, but different cancers will require

different treatments depending on the

cell of origin and the degree of spread.

Treatments may include surgery, radia-

tion, chemotherapy, or novel targeted

therapies. For most GI cancers surgery

is considered the only curative treat-

ment, so it is critical for patients to

select a treatment facility with the right

expertise.

“It is very clear that both short- and

long-term surgical outcomes are

better in institutions where surgeries

are done more often by highly-

experienced surgeons,” says Mitchell

Posner, MD, chief of surgical oncology

at the University of Chicago Medical

Center and president of the Society of

Surgical oncology. “not only is there

less patient mortality, but cancer recur-

rence is less likely.”

Though finding a high quality treat-

ment team is important to surviving

and living with GI cancer, finding

the cancer early is equally critical

because cancer treatments are most

successful in the earliest stages of

disease. As a result, researchers and

oncologists are continually looking

for ways to diagnose earlier and

more accurately.

“If we can better image tumors

and use molecular markers to detect

cancers earlier, we have a better

chance of helping patients,” says

Posner. “We have already made great

strides in the area of colon cancer,

and though we know there is a

sequence of events that occurs in

pancreatic cancer it is still much harder

to detect.”

In fact, survival rates for colorectal

cancer have increased significantly in

the past 10 years alone, and 90 percent

of those diagnosed with stage one

disease can now expect to live five

years or longer. That success is partially

attributable to improved diagnostic

tools that allow disease to be found

earlier, as well as improved treatments.

“Though we have made only incre-

mental progress in treating some dis-

eases, the impressive strides in others

help us understand the multiple ways

cancer evades treatment, and may one

day help us treat all cancers more ef-

fectively.”

of course, the great hope of all

cancer patients is a cure. But Kindler

says that though we may not be

able to cure every cancer, there is

reason to be hopeful. At present, while

some patients can be cured, other

patients can live with their cancer

for many years, in the same way

that patients live with other chronic

diseases such as diabetes and high

blood pressure.

“oncologists are eternal optimists,”

Kindler continues. “We never know

where the next great discovery will

come from, and we cannot predict a

timeline. However, as we continue to

learn more about the underlying biol-

ogy of each cancer, and as we go from

the laboratory to clinical trials of novel

treatments, there is definitely hope for

the future.”

Treating Gastrointestinal Cancers Gastrointestinal (GI) cancers vary widely depending on which part of the digestive system is affected. From the esophagus to the anus, each disease site has its own unique traits and each cancer its own risk factors, treatment options and particular challenges.

Mitchell Posner, MD and Irving Waxman, MD discuss a patient’s course of treat-ment. Collaboration among physicians provides patients with comprehensive treatment plans.

Eating Right: Optimizing Your Digestive Health

digestive wellness

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You wrote a short booked called Why Diets Don’t Work. In a sentence or two, why do you think that?Most diets fail long term because they require too much effort and often consist of changes in behav-ior that are unrealistic and in many ways, unhealthy. They simply “ask too much of us!” People don’t want to give up their favorite foods forever or live with guilt and shame when they have a home cooked meal. Most diets are a recipe for burning out.

What are some tips you recom-mend to people who don’t need surgery but need to lose weight?Everyone is unique so the key is be-ing honest with yourself, mindful of your relationship with food, and find-ing good practical tools to help you gain more control over your eating habits. one powerful tip I give is to eat before you eat. It sounds strange but a good dose of fiber, some pro-tein and a glass of water 30 minutes before your biggest meals can work wonders for stretching the parts of your stomach that lead to satiety. When dinner time comes, tools like that help you be full and eat less (a mantra of ours).

What other tips do you often give?Drink plenty of water, try to minimize the white stuff (processed sugars, starch), make protein 50 percent to 75 percent of each meal (to leave you feeling full longer and give your body what it actually wants), eat five to six small meals per day (to help avoid binge eating at night), and watch out for sugary drinks, fancy coffees, and saturated fats.

So it is possible to lose weight and eat what you want?yes, absolutely. Moderation is the key. The biggest problems are over-eating and mindless grazing. Eating food that makes you feel good and taking time to enjoy each bite can go a long way.

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“Enzymes play a crucial role

in proper digestion by

breaking down proteins,

fats and carbohydrates into their

simplest component,” says Jason

Barker, nD, a naturopathic physician

and spokesperson for Enzymedica.

“once this process is complete,

the body is prepared to absorb

and utilize the nutrients that have

been eaten.“

But what happens when the body

fails to produce enzymes in sufficient

quantities? Many people don’t learn

that lesson until they experience it for

themselves.

“Two of the biggest reasons for

poor digestion are our body’s inability

to produce enough enzymes and the

lack of digestive enzymes in the foods

we eat,” says Jason Barker. “lactose

intolerance is one easily-recognized

example of an enzyme deficiency.”

lactose intolerance occurs when

the body fails to produce enough

lactase, the enzyme that breaks down

the lactose in dairy products. Affecting

up to 50 million Americans, symptoms

of this condition include bloating,

abdominal pain and diarrhea. It can

be combated by gradually introduc-

ing dairy into the diet, or by taking a

lactase supplement.

And while the patient and their phy-

sician should determine the course of

treatment, some experts advocate for

a conservative initial approach.

“In most cases I advocate for taking

a conventional route first—examine

behaviors, consider stress level and

look at the diet to see if you can get

what you need from the food you eat,”

says Jennifer Ventrelle, MS, RD, lDn,

CPT, a nutrition consultant with Rush

nutrition and Wellness Center at Rush

University Medical Center.

Dr. Barker recommends a combina-

tion approach.

“By eating (raw) foods with en-

zymes intact and supplementing

with enzymes when eating cooked or

processed foods, we can increase our

body’s enzyme efficiency.”

Digestive EnzymesMost people learn in fifth grade science class that enzymes are involved in digestion, but many people don’t understand the critical role they play.

two of the biggest reasons for poor digestion are our body’s inability to produce enough

enzymes and the lack of digestive enzymes in the foods we eat.

digestive wellness

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After all, if you can reduce your

risk for allergies and heart

disease by consuming bee

pollen and fish oil, maybe health in-

surance will be less critical down

the road.

Many people are certainly inter-

ested in maintaining their digestive

health, and probiotics are fast be-

coming the preventive “it” product

of the day. These healthy bacteria

that enter the body through supple-

ments or probiotic-rich foods are not

new, but there is a steadily growing

consumer interest.

“I have noticed a growing aware-

ness of and interest in probiotics,“

says Jennifer Ventrelle, MS, RD, lDn,

CPT, a nutrition consultant with

Rush nutrition and Wellness Center

at Rush University Medical Center.

“That may be attributed to the fact

that we are learning more about

probiotics and their health benefits,

and also because people are seeing

products as Kefir and yogurt being

advertised with health claims about

containing probiotics.”

A growing body of evidence sup-

ports those health claims, and it ap-

pears that probiotics can be beneficial

in both treating and preventing diges-

tive issues.

“Probiotics can be particularly ben-

eficial for people with conditions such

as Irritable Bowel Syndrome or Crohn’s

Disease that may disrupt their gut

microbial flora by enhancing their im-

mune systems and supporting other

digestive system functions,” says

Ventrelle. “In addition, these bacteria

can help individuals who don’t have

gastrointestinal disorders maintain

the balance of beneficial and harmful

bacteria in the intestine.”

As it is with most nutritional supple-

ments, however, Ventrelle says it is

important to use moderation when

bringing probiotics into your diet.

“If added to the diet too quickly,

probiotics can cause diarrhea. How-

ever, when added slowly, most people

can eat many products and foods

containing probiotics as part of an

overall well-balanced diet without

adverse consequences.”

Probiotics And Preventive Nutrition With health care in a state of flux, it is no surprise that preventive nutrition is one of the fastest growing food trends in America today.

Going Organic: The Why And How

While researchers are still

investigating exactly how

much safer and nutritious

organic food is, advocates say there

are numerous health benefits of eat-

ing organically, including improved

digestion.

“one of the real advantages of

eating organic foods is they do not

contain preservative chemicals and do

contain a richer diversity of microor-

ganisms that help the digestive system

extract nutrients in food,” says Dr.

Charles Benbrook, chief scientist with

The organic Center.

In addition, Benbrook says current

research in support of organic food

strongly suggests that decreased ex-

posure to pesticides in food and water

is beneficial to all people, and infants

and children in particular.

“The evidence is very clear that

pesticides in beverages and foods

contribute to a suite of developmental

problems in kids including allergies,

ADHD, autism, asthma, and predis-

poses them to metabolic syndrome

later in life.”

In addition to being largely

chemical-free, Benbrook says the

benefits of organic food are twofold: 1)

on average, they are 25 percent more

nutrient-dense and 2) they do not

contain the long list of food additives,

preservatives, colors and flavor en-

hancers contained in non-organic food.

So —should you go organic? There

are many factors consumers consider

when making that decision, including

nutrition, environmental concerns and

cost. If you do choose to go organic,

Benbrook says there are a number of

ways to move incrementally into your

new lifestyle.

“When local fruits and vegetables

are in season, visit your local farmer’s

market, area farms or co-op and try

to eat more local organic food that is

picked when it is really ripe and con-

tains by far the most nutrients. In the

winter, look for high-quality frozen or

canned fruits and vegetables that have

been preserved.”

Making the right food choices has a proven affect on digestion, but does choosing organic food make a difference?

digestive wellness

For many, it would be skeptical

at best. And while an explana-

tion that they are consuming

“friendly bacteria” probably won’t

help, early research does show that,

like bushy broccoli and crunchy car-

rots, probiotics can provide important

health benefits to children.

“Probiotics may help children have

fewer colds, need fewer antibiotics and

miss fewer days of school,” says

Dawn Jackson Blatner, RD, lDn,

American Dietetic Asso-

ciation spokesperson

and author of

The Flexitarian

Diet. “In addi-

tion, they may

also help reduce

diarrhea and an-

tibiotic-induced

diarrhea.”

For children

and adults

alike, probiotic

s u p p l e m e n t s

essentially work

by replacing

bad bacteria with good, creating a

more balanced intestinal environment.

And while probiotics appear to benefit

most people, Blatner says there may be

added benefits for the young.

“Because a child’s immune system is

still in development, probiotics may be

even more helpful in childhood than

in adulthood to help kids better fight

off sickness.”

So—how do you entice the picky

eater into consuming a daily dose of

bacteria? There is a growing number

of products on the grocery shelf, in-

cluding yogurt, probiotic-rich cheeses

(packaging may state “live culture”),

and nondairy foods such as sauer-

kraut and tempeh. one of the most

probiotic-rich foods, however, is kefir. A

cultured and fermented milk product

similar to yogurt, kefir contains 10

healthy bacteria compared with one or

two in yogurt.

Blatner says, “Kefir can be a good

source of probiotics for children be-

cause it tastes good—meaning kids

will actually drink it! In addition to the

probiotics, it contains protein, fiber and

vitamins and minerals children need

such as calcium and Vitamin D.”

Who knows, maybe one day soon

children will start requesting probiotics

for dessert.

There’s a good reason for it—it’s

called Celiac Disease and at

least three million Americans

are affected by it.

A genetic autoimmune disorder

triggered by the consumption of

gluten proteins, Celiac Disease causes

the immune system to attack the

small intestine, inhibiting absorption

of nutrients and potentially causing

osteoporosis, infertility and neurologi-

cal conditions.

According to Dr. Stefano Guandalini,

founder and director of The University

of Chicago Celiac Disease Center,

the disease has long been under

diagnosed.

“Until recently, physicians in this

country thought Celiac Disease was

very rare. In fact, at least one percent of

the population has Celiac, but because

it presents with many different symp-

toms it is often overlooked.”

Though many people with Celiac

Disease report no symptoms, there are

literally hundreds of signs that may ap-

pear during childhood or adulthood,

including: recurring abdominal bloat-

ing, chronic diarrhea or constipation,

fatigue, delayed puberty and failure

to thrive.

Dr. Guandalini says people should

speak with their doctors if there is

family history of the disease, or if they

experience any symptoms. Patients

should adhere to their normal diet

prior to testing but, upon diagnosis, he

says there is really only one treatment:

lifelong adherence to a gluten-free diet.

“A strict gluten-free diet is manda-

tory for those with Celiac Disease

because as little as a crumb of bread

can activate the disease.”

And while other conditions such as

gluten intolerance and wheat allergy

might benefit from a gluten-free diet,

there is no evidence that it is healthier

for the unaffected person. For more in-

formation, visit www.celiacdisease.net.

Starting Early: Probiotics And Kids

Should I Go Gluten-Free: Celiac Disease

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digestive wellness

There’s a reason burp cloths are

a popular baby shower gift—

new parents spend a lot of time

cleaning when babies spit-up! But some

newborns spit up more frequently than

others, experiencing unusual discom-

fort that may be symptomatic of acid

reflux disease.

More than half of all newborns suffer

from infant acid reflux, and Beth

Jackson-Gagne, MS, oTR/l, founder of

Baby Stay Asleep, says it’s important for

parents to observe closely to determine

whether their child may be affected.

“If new parents suspect their baby

suffers from acid reflux, they should

monitor the child’s spit up behavior,

especially after meals or snacks and

during bedtime hours.”

Symptoms for infant acid reflux

include irritable behavior, difficulty

falling or staying asleep, bad breath,

blood in stool, wet burp sounds and

refusing feedings. And while only a

trained professional can make a diag-

nosis, Jackson-Gagne says if reflux is

confirmed, there are numerous ways to

treat the symptoms.

“Positioning is key. During and after

feeding, keep babies as upright as pos-

sible in order to keep food from coming

back up. During sleep, raise the head

of the crib to let gravity help keep the

infant’s food down.”

As long as they are doctor-recom-

mended, Jackson-Gagne says some

infants may find relief with medications

such as antacids or proton pump inhibi-

tors, which reduce stomach acid.

But what can parents do to prevent

infant acid reflux in the first place?

Jackson-Gagne says while there are no

surefire remedies, good feeding and

bedtime routines can go a long way.

“An ounce of prevention is worth

a pound of cure. But once a child is

diagnosed, parents must act quickly in

order to avoid potential complications

such as failure to thrive and long-term

food aversions that may lead to refusal

to eat.”

Know The Facts: Infant Acid RefluxEosinophilic Esophagitis (EoE) is on the rise. Possibly related to food or environmental allergies, the most common symptom of EoE is difficulty swallowing food.

Some experts say these prob-

lems, combined with readily

available processed foods, can

negatively affect the digestive system

and, ultimately, our overall well being.

“Many of the foods we consume

are impure, contaminated with heavy

metals and other environmental toxins

which our bodies are not designed to

process,“ says Dr. Isaac Eliaz, MD, MS,

lAc and founder of Econugenics. “The

digestive system is constantly chal

lenged to ensure we are nourished,

protect the body and play a critical role

in supporting the immune system.”

In an effort to combat the ill effects

of environmental issues outside of

their control, some Americans are inte-

grating natural alternatives into their

diets. Dr. Eliaz says if there is one bodily

system where natural alternatives are

the leading treatment choice, it is the

digestive system. In fact, he says people

are turning to a combination of West-

ern and Eastern philosophies to treat a

number of ailments including irritable

bowel syndrome and GERD.

“one category of alternative treat-

ments functions to support normal di-

gestive processes. This type of support

can provide ‘digestive heat’ that trans-

lates into normal, well-synchronized

peristaltic movement that restore and

support the digestive system in a way

that helps normalize the secretion of

digestive enzymes and balances the

healthy bacteria in the gut.”

Dr. Eliaz says the key to using natural

alternatives is to introduce different

herbs, compounds and minerals that

support the digestive system and

promote total well being without over-

stimulating the body.

Digestive Wellness And Natural AlternativesAccording to a 2007 United nations report, more than 81 percent of Americans live in urban areas. And while city life offers numerous health benefits including availability of high-quality foods and access to high-quality medical care, there are also a number of potential disadvantages including lowered physical activity, poor water quality and air pollution.

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digestive wellness

Q: What is an overlooked natural remedy for a

common digestive complaint—constipation?

A: What makes us constipated? lack of fiber? yes,

sometimes. But there’s a complementary reason

that we often miss. Magnesium, also known as

Mother nature’s muscle relaxant, helps encour-

age our body’s natural muscle movement (in-

cluding the digestive tract)—motility—to pro-

mote regular bowel movements. Magnesium is

a mineral, it is not a laxative.

Getting your period, have a headache, prone

to muscle aches, flying or traveling by car or sit-

ting at a desk all day? Any of these situations can

exacerbate constipation by slowing or stopping

motility. Thus, increasing magnesium intake can

address the problem at the core (as can add-

ing daily activity such as chair twists or other

stretches.) Also, magnesium works in opposition

to calcium (which helps our muscles contract).

So if you’re taking a calcium supplement—make

sure it contains absorbable magnesium too.

Foods rich in magnesium include whole grains

(the actual grain, not the flour as much), beans,

and chocolate (portion control and good qual-

ity). For supplementation, I recommend magne-

sium citrate. For more information on recipes,

foods, and supplement recommendations, visit

www.ashleykoffapproved.com or get Recipes for

IBS by Ashley Koff, RD where books are sold.

Panel Of Experts

DAVID T. RUBIn, MD Co-Director, University of Chicago Inflammatory Bowel Disease CenterAssociate Professor of MedicineUniversity of Chicago Medical Center

Q: What are probiotics and why are they

important?

A: The term probiotic literally translates to “for

life,” and that couldn’t be more true. your diges-

tive tract is filled with trillions of bacteria, some

promote health (probiotics), and some can harm

your health. Probiotics are healthy bacteria that

keep the harmful bacteria in check and help you

create and maintain a healthy internal balance.

Probiotics promote efficient digestion and

absorption of nutrients and promote an overall

healthy digestive tract. numerous studies sup-

port the idea that regular consumption of pro-

biotics can help with many intestinal conditions

and can even help lower the risk of colon cancer.

What’s more, the positive effects of probiotics

might not be limited to just the digestive tract.

For instance, research suggests that probiotics

help maintain healthier blood cholesterol and

blood pressure levels, support our immune

system and potentially aid with weight control.

you can add probiotics to your diet with

supplements, or an effective (and enjoyable)

way to get them is from yogurt or from foods

and drinks made with yogurt. Plus you get many

added benefits: yogurt is naturally rich in es-

sential vitamins and nutrients including protein,

calcium, riboflavin, Vitamin B6 and Vitamin B12.

There’s a reason they’re called PRobiotics and

they need to be part of your diet. It’s a small

change you can make that can have big effects

on your health.

lInDSEy DUnCAn, nD, CnGenesis Today

Q: I’m lactose intolerant. Are there any dairy prod-

ucts I can still enjoy?

A: Absolutely —just because you’ve been diag-

nosed with lactose intolerance does not mean

you need to abstain from the entire dairy food

group, nor should you, as it provides the bulk of

your bone-building calcium needs.

Between 30 and 50 million Americans suffer

from lactose intolerance, meaning they don’t

produce enough of an enzyme called lactase,

normally manufactured by cells that line the small

intestine, which breaks down lactose into a more

easily absorbable unit. The result: Discomfort

ranging from mild-to-intense nausea to cramps,

bloating, gas, and diarrhea. An array of lactose-

free products can be found at many mainstream

grocery stores, as well as calcium-fortified orange

juice. There’s also kefir, a tangy, yogurt-like drink

that’s been a staple in Russia for centuries and is

gaining traction as a hot superfood in the US. A

recent Journal of the American Dietetic Associa-

tion study found that kefir can actually improve

lactose digestion; the live and active bacteria

cultures help break down milk’s sugars. Kefir also

helps colonize the intestines, further protecting

them from disease-causing bacteria. In addition,

one cup of kefir supplies 30 percent of your daily

calcium needs, is low in fat and contains a healthy

dose of fiber, too.

lESlIE GolDMAn, MPH Health and medical writerspokesperson for lifeway Kefir

ASHlEy KoFF, RD Ashely Koff Approved

Q: What advances in treatment have become

available for inflammatory bowel disease?

A: Inflammatory bowel disease (IBD) is a chronic

intestinal condition that includes two primary

types, Crohn’s disease and ulcerative colitis. Al-

though the causes of these conditions remain un-

known, scientists here and elsewhere have made

significant discoveries of the genetic associations

and have new information that will someday

lead to individualized therapies. In the meantime,

however, there have been tremendous advances

in available treatments. our new treatment strat-

egies now include successful ways to maintain

remission long-term, improve a patient’s quality

of life, avoid hospitalizations, and prevent surgery.

In 2010, there are multiple versions of the

aminosalicylate therapies to treat ulcerative

colitis, offering different delivery systems and

the convenience of fewer pills taken fewer times

per day. In Crohn’s disease, we have a steroid de-

signed to provide significantly fewer side effects

than traditional steroids. When it is needed, sur-

gery remains an important treatment, and new

laparoscopic approaches have resulted in shorter

recoveries and better outcomes. The greatest ad-

vance in treating IBD has been the development

of biologic therapies, antibodies engineered to

target specific proteins related to inflammation.

We have learned that they work much better

when they are used earlier in the disease course

and are much safer than ineffective therapy and

the ravages of active disease.

A lifetime of disability or steroid treatments is

no longer acceptable in IBD. Patients suffering

from IBD in the current era should ask for and

expect expert advice, access to leading-edge

therapies, and a team approach to management

that helps them to achieve control over the dis-

ease until a cure is found.