Exciting Developments Provide Patients with a Better Lifestyle

he debilitating and sometimes painful symptoms associated with many digestive disorders are the focus of two new studies at Winthrop-University Hospital, offering patients new hope for what ails them. Investigators and physicians in Winthrop's Institute for Digestive Disorders are optimistic that new medications will help those suffering from digestive disorders such as Crohn's Disease and Irritable Bowel Syndrome. In addition, excitement is stirring over plans for a new and expanded Endoscopy Suite that will provide a larger, more comfortable and family-oriented facility for those seeking important screenings for a variety of gastrointestinal diseases, including colon cancer and gastroesophageal reflux disease (GERD).

Dr. James Grendell (left) talks to a patient about the clinical trial for Crohn's Disease and the options available to her for treatment, as Lois Bonetti, RN, Clinical Research Coordinator checks her vitals.

New studies - Crohn's Disease and Irritable Bowel Syndrome

A new study now underway at Winthrop on Crohn's Disease could dramatically change the standard treatment for the chronic condition. In fact, the study is based upon a drug that has been on the market for quite some time. Leukine, which is currently used to help boost the immune systems of patients on chemotherapy, is now in study to see how its immune boosting effects help alleviate symptoms of Crohn's Disease.

Crohn's Disease, an inflammatory bowel disorder that causes inflammation in the small intestine, is thought to be caused by an overactive immune response to antigens such as bacteria. But, with the success of treatment with Leukine, a new school of thought is now being considered.

The new theory is that in Crohn's Disease, a person's immune system may not have been active enough to suppress the inflammatory response that leads to debilitating symptoms. Leukine stimulates the immune system to get rid of the antigens in the small intestine that cause the inflammation.

The disease is typically treated with strong steroids such as prednisone or immunosuppressants, which depress the immune system and can leave a patient vulnerable to other infections. According to James Grendell, MD, Chief, Department of Gastroenterology, Hepatology and Nutrition at Winthrop, this new drug has the ability to control the disease without the adverse side effects of commonly used medications.

"Preliminary studies already demonstrate that Leukine stimulates the body's immune system and alleviates many of the debilitating symptoms of the disease," said Dr. Grendell. "This is the first approach that not only helps the patient living with Crohn's disease, but also doesn't harm the immune response and lead to other infections."

Unlike other popular treatments that are given by a transfusion in a doctor's office, Leukine is administered by injection once a day for eight weeks. Patients are taught to give themselves the injection at their own convenience.

"Leukine has been on the market for quite some time, so we are familiar with its efficacy," added Dr. Grendell. "We have seen some dramatic, positive results in past studies as far as its ability to reduce symptoms of Crohn's Disease and are excited about the potential this new treatment possesses for patients looking for relief."

New Medication to Treat IBS in Study

A second investigation is also underway to study the effects of a new medication on people experiencing diarrhea associated with Irritable Bowel Syndrome or IBS. IBS is a disorder of the intestines that leads to crampy abdominal pain, gas, bloating, and changes in bowel habits including diarrhea and constipation. The medication in study will work to block diarrhea.

According to Kavita Kongara, MD, Director of the Women's Motility Center in the Institute for Digestive Disorders at Winthrop, "Currently, we treat patients with fiber treatments, antispasmodic agents to relax the colon, and antidepressants which have demonstrated some ability to control IBS symptoms."

She added, "Unfortunately, there are few options available to treat all of the symptoms of IBS. That is why we are very optimistic that this new medication will be even more effective than treatments available now."

The study is appropriate for women and men with diarrhea associated with IBS who will be given either a placebo pill or the actual medication three times a day to chronicle the alleviation of symptoms.

For more information on the Crohn's Disease or IBS studies taking place at Winthrop, call the Clinical Trials Center at (516) 663-9582.

Living with Digestive Disorders - Nutrition Tips to Last a Lifetime

For many patients living with an inflammatory bowel disorder, proper diet can play a major role in controlling some of the symptoms. While no diet has the ability to cure these diseases, nutritionists often help patients identify foods to avoid and offer dietary tips for everyday living.

Arlene Stein, MS, RD, CNSD, a certified nutrition support dietitian in the Institute for Digestive Disorders stated that, "Proper diet for a patient suffering from an inflammatory bowel disease is very individualized according to the disease and its severity."

"Regulating a patient's diet is often trial and error," Ms. Stein added. "We usually start with a very basic diet and slowly introduce one new food at a time in small amounts to see how well the patient can tolerate it."

People diagnosed with a digestive disorder are often encouraged to keep a food diary and document which types of foods are more easily tolerated than others. In addition, many patients will take a lactose tolerance test, since dairy products can often exacerbate digestive disorders in those who are lactose intolerant.

"We often find that fatty, fried foods and gas-producing foods are the least tolerable for people with digestive diseases," said Ms. Stein, who recommends eating more tolerable, fiber-rich foods such as oatmeal, canned fruit and brown rice. Additionally, patients should avoid caffeine and alcohol and should drink plenty of water.

Because one of the issues with diseases such as IBS or Crohn's is malabsorption or poor absorption of nutrients by the intestines, it is also important to maintain the proper caloric intake for energy.

"Crohn's Disease or IBS can be a very difficult diagnosis to live with," explained Donna Norkaitis-Gerrity, MS, RD, CDN, certified dietitian. "It is important for the patient to maintain energy in the form of protein, since so much protein is lost in the intestine. Frequent, smaller meals is one of the best ways to maintain proper energy levels."

External factors such as stress also play a role in aggravating a digestive condition. Dietitians and physicians alike recommend looking for ways to avoid or decrease stress levels, from relaxing with a mug of peppermint tea to yoga and meditation.

For more information on the Institute for Digestive Disorders, call 1-866-2-DIGEST.