We all need support every once in awhile

Well I have been trying to navigate this information highway when it comes to IBS/IBD. The information out there is mind boggling.

I was on the WebMD site today and found this great IBS support group. I know not everyone likes support groups or web groups. But from a personal experience I have found them to be a wealth of information.

The ability to speak to others about your symptoms. What they have tried, what has worked or not worked. One of the things I have found it that there just doesn't seem to be any really clear answer about the diet.

For example some doctors and practitioners are adamant that those who suffer from IBD should stay away from dairy products. Then you can go and read articles that tell you that you can eat dairy within moderation. Again very confusing and sometimes can be contradictory.

Then we get onto the the debate about Soluble and Insoluble fibres which ones you should eat or not eat. Or how one should never eat on Insoluble fibre on an empty stomach and should always eat them with a Soluble fibre. Oh my goodness.

Now what about Fat....Fat is bad...but we need a certain amount in our diet. Some literature says that Fat should be 20 -25% of our total caloric intake. That the fats we chose should be Monounsaturated and contain essential fatty acids....fats such as olive oil, canola oil, avocados, finely ground nuts, fatty fish and flax oil. Now I know we have all heard of the benefits of these fats not only for the GI(gastrointestinal)tract but for mental and cardiac health as well.

This is where the support groups can come in handy the can help you navigate this sometimes very confusing topic. You read an article and you are not sure about it's content or just want to get other's opinions on the topic.

Here is the link to the WebMD IBS Support Group . This link will also help you navigate through the WebMD site which is a wealth of information. One of their current articles Irritable Bowel Syndrome: What Kind of Fiber, What Kind of Oils? I found this to be a very informative article and made me think that I needed to go out and get me some Peppermint tea.

So in a nutshell, I think we all need support every once in awhile. It's nice to know there are places that you can go to get this kind of support.

Our Immune system....

Well I saw my GP again. My gut has been acting up. My stools have more mucous and bloody again. So I am back on the enemas instead of the suppositories. When I spoke with my GP she said that even though it is Proctitis it is still colitis and can spread. Why thanks doc! She told me that the surgeon had written to her and although I was not scheduled to see him until the New Year, he said if I had any flare ups that I had to go see him right away. Urgh! So I am trying to be diligent with my use of the enemas and increased my yogurt intake and I have been taking Probiotic tablets up to three times a day.

My pain is intermittent, but it likes to remind me that it is there. In doing some more reading and research it would appear I fall into this category.....

Proctosigmoiditis: Colitis affecting the rectum and the sigmoid colon (the lower segment of colon located right above the rectum). Symptoms include bloody diarrhea, cramps, and tenesmus. Moderate pain on the lower left side of the abdomen may occur in active disease.
(I found this information from the Crohn's and Colitis Foundation of America site.)

When I was reading information on this site it talked about Chron's and Colitis being an immune system problem. Where the body attacks itself. I found this section very interesting.....

Both illnesses do have one strong feature in common. They are marked by an abnormal response by the body's immune system. The immune system is composed of various cells and proteins. Normally, these protect the body from infection. In people with IBD, however, the immune system reacts inappropriately. Mistaking food, bacteria, and other materials in the intestine for foreign or invading substances, it launches an attack. In the process, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation. These cells then generate harmful products that ultimately lead to ulcerations and bowel injury. When this happens, the patient experiences the symptoms of IBD.(taken from Crohn's & Colitis Foundation of America site)

This really helped me understand why sometimes I feel like I have arthritic hands. Certain times the joints in my hands really ache. My sister who has Crohn's tells me that when she gets flare ups her hip and sciatica bothers her. She suffers from arthritis and inflammatory disease. She has had Crohn's for over 35 years.

There is so much to learn about this disease. I continue to research what I can in order to help keep me healthy and to slow and maybe one day stop the progression of the disease.

My Visit to the GP

I have found health care a little different here on the island. What I mean by that is, we don't have specialists for everything like you do in the city. Your GP is truly a General practitioner and your surgeon if he isn't orthopedic is a General surgeon in the truest sense of the word. Case in point. We do not have a Gastroenterologist on the Island North of the capital city. So when I have any issues with my colitis I see the general surgeon.

It has now been brought to my attention that although I have ulcerative colitis it is not as ominous as other forms of colitis. I have been told mine is Ulcerative Proctitis which only effects the lower portion of the colon to the rectum. Now with that being said I still have to take my salofalk suppositories twice a day and when I have flare ups with my IBS I take a Librac(apo cholrax) which although is a benzodiazipine it works on the smooth muscles of the bowel helping to relax them. When they work they work....more times than not they don't really give me much relief.

When I was at the doctors the other day we briefly talked about my colitis and she said that she wanted to talk with me a length at another appointment. This is all so very new to me...it's only been a year since I was diagnosed and I have already been in hospital once for a bad flare up.

What I have read and been told is that Proctitis presents differently than general colitis. With Proctitis you have more issues with keeping your bowels regular. You go from times of loose stool to constipation. The important thing with Proctitis is to try and regulate the bowel movements and to prevent constipation. Probiotics are great....you can find these in many yogurts or you can take the tablets. A bulk forming agent which is suppose to be good is Metamucil. I on the other hand hate metamucil because of it's bulk forming properties it just hurts my stomach and makes me feel bloated. As if I don't have enough problems. So I opt to increase my intact of yogurt. Not all yogurts are created equal so check the labels. I like Activia it works for me. Here is a great link on a report by CTV.ca on a study that was done in Alberta showing the benefits of Probiotic in the treatment of Ulcerartive ColitisHealth. Definetly an interesting and informative read. And here is another article supporting the above research Probiotic Solution for Colitis

Why Fibre is so Important in our diet

Fibre:

Fibre keeps the lining of the digestive tract healthy. Fibre is found in cereals, fruits and vegetables, legumes(dried beans, peas and lentils,),nuts and seeds and whole grain breads. During times of flare ups one might want to avoid or minimize their intake of legumes, nuts, seeds and whole grain breads. Minimizing the intake of during times of flare up might help minimize the gas and bloating people with IBD experience.

There are two kinds of fibre Water-soluble and Insoluble Fibre.

Water-soluble Fibre: helps lower blood cholesterol and maitains healthy blood sugar. Some types of water-soluble fibre control diarrhea by giving more formation to stool. Water-soluble fibre is derived from fruit such as apples, grapefruit,oranges, and plums; vegetables and legumes such as carrots,lentils, potatoes, soybeans, split peas, and from grains sucha as barley,oat bran,oatmeal and psyllium seed.

Insoluble fibre, or roughage, stimulates bowel movements and makes a bigger bulkier stool. Insoluble fibre comes from cereals including bran cereals,unprocessed bran,whole-grain bread or whole-grain cereal;brown rice, baked poatoes(including the skin)and fruits such as apples(with skin), blueberries , raisins, raspberries and strawberries. A diet low in fibre maybe the cause of further complications such as diverticulosis.

Nutrition Part Two

In my last post I mentioned I would talk about the nutrients you need and how a poor diet can affect the body.

Nutrients You Need: Carbohydrates, Proteins and Fat

Carbohydrates should supply half of the day's energy. Their are two forms of carbohydrates Complex carbohydrates and Simple sugars. Complex carbohydrates come from whole-grain breads, cereals, pasta, rice, legumes(dried beans, peas, lentils),fruits and vegetables. Simple sugars come from sugar, honey, syrup, jam or jelly , candies soft drinks pastries,and the natural sugars in milk and fruit or fruit juices.

Simple sugar can pose a problem for those with IBD. Too much simple sugar can cause (or increase) diarrhea. That's because simple sugars cause more fluid to be drawn into the intestine, so food passes through quickly. Diarrhea can be somewhat controlled by limiting the consumption of concentrated sweets and desserts, soft drinks and undiluted fruit juices and dried fruits or high-sugar fruits such as grapes, pineapple and watermelon.

Proteins build and repair every cell in the body, and are especially important to growing children and to people who are ill or recovering from surgery. Proteins help wounds heal faster, repair the lining of the digestive tract, and help the tract product the enzymes that digest food and absorb nutrients. Foods that supply proteins include, meat, poultry, fish, eggs, milk legumes(dried beans, peas, lentils) and tofu.

Fat, the most concentrated source of energy, insulates the body and protects vital organs. Fish( in particular, cold-water fish, such as tuna, salmon, bluefish, mackerel and shellfish),is high in both fat and protein, and is easy to digest. Fats can be obtain in butter, margarine, vegetable oils, dairy, sauces and baked and fried food. Fat can be problematic for some people and should be monitored. More on fats in future posts.

Note: People with IBD are prone to losing protein from severe diarrhea. Signs and symptoms of protein deficiency include fatigue,brittle nails and dull, dry hair.

How a Poor Diet Affects the Body

There are many things that can happen to the body when it is deprived of appropriate nutritional intact...below is a list of things that could happened and how it could be caused by the lack of nutrients.....

• Anemia - can be caused by lack of Iron, Vitamin B12 or folic acid
• Bleeding & bruising - Vitamin K
• Bloating, diarrhea, gas - Maldigestion of carbohydrates and fat
• Bone fractures and pain - Protein, Vit. D, Calcium deficiency
• Delayed growth - lack of calories, malabsorbed proteins, fats or carbohydrate
• Lip and mouth sores - Iron, or B-Vitamin deficiency
• Muscle spasms - Electrolytes deficiency or imbalance
• Muscle wasting - Decrease caloric intact and malabsorption of proteins, fats, and carbohydrates.

It's not okay to just stop eating. People with IBD sometimes think they need to change their diet. They may feel too sick to eat, or are interested in trying a special diet plan. For whatever the reason for changing eating habits it's important to consult members of your health-care team. They will be able to help you design a diet specific to your needs.

In my next post I would like to talk about Fibre in the Diet, Medications and it's affect on nutrition and some of the common problems.

I hope you find this post informative and helpful...and if you know someone who might benefit from this post..please pass it along.

Good Health to you all!!

Nutrition Part One - Overview

There is so much to learn about Inflmmatory Bowel Disease and one area is that of Nutrition and Diet.

A lot of the information I am going to provide here is from the Crohn's and Colitis Foundations of Canada site. If you would like to find out more you can go to their web site....http://www.ccfc.ca/English/index.html

When I first started doing research on this topic I wanted some graphics to help demonstrate the effects IBD has on a person both pyhsically and the effects it has on self image. I came across the cover of this book....which I think illistrates very well how people with IBD can be effected.

I know that is exactly how I felt. It gets way to personal and at times very humbling....but it is necessary in order to get to the bottom of things(no pun intended). Acutally maybe there was...humour can be good and healthy. I digress.

NURTITION:

While good nutrition is universally important, it's even more so for people with IBD. That's because the better-nourished they are , the better their bodies will respond to the treatment of IBD.

People with IBD tend to eat less during periods of pain. Additionally when IBD is active, the digestive process is interrupted and nutrients are not absorbed effectively. Malnutrition may result.

People with IBD must be on guard for malnutrition which can happen very easily. People who are malnourished lose weight, lack energy, can become deficient in proteins,and essential vitamins and minerals and are more susuceptible to other illnesses.

Malnutrition can also be caused by malabsorption; the digestive tract's reduced ability to absorb all the nutrients offer to it.

Malabsorption may happen in IBD when:

• nutrients are lost through bleeding and diarrhea


• medications taken for IBD interact adversely with nutrients


• part of the intestine is surgically removed(that is, there is less absorptive tissue to process the nutrients in food).

A healthy diet is key component in the treatment of IBD. It's important that people with IBD consult their health-care team(doctor,dietitian, gastroenterologist and others)about the treatment that is most appropriate for their circumstances.

When symptoms are mild, a normal healthy diet and regular visits to your health professional may be advised. When symptoms are moderate,the person may be advised to change their diet slightly, and eat certain foods while avoiding others. Nutritional supplements may be recommended to reduce symptoms or compensate for weight loss.

Tomorrow I will post about the nutrients you need and how a poor diet affects the body.

Good Health to you all!

Understanding Crohn's & Ulcerative Colitis

The two forms of inflammatory bowel disease (IBD) -- Crohn's disease (CD) and ulcerative colitis (UC) -- have several signs and symptoms in common, but they are very different conditions. One of the main differences between CD and UC is the location of the disease. CD can affect the digestive tract anywhere between the mouth and the anus, while UC only affects the large intestine (or colon). A second important difference is that CD inflammation involves all layers of the intestinal wall and UC affects only the inner lining.

Another key difference between CD and UC is the presence of co-morbid (or associated) conditions. Strictures, fistulas, and fissures tend to be more common in CD, while toxic megacolon is more common in UC. Distinguishing between the two forms of IBD can be difficult at times, but knowing the difference between the two is extremely important for treatment.

IBD is not the same as IBS although often they are confused and people think they are the same. IBD is a disease and IBS is a syndrome.

The annual incidence of Ulcerative colitis(UC) and Crohn's disease ranges from 1 to 10 per 100,000 people annually. The peak age-specific incidenc occurs near the age of 20, and a second smaller peak occurs near the age of 50. The prevalence of UC and Crhon's diseae ranges from 10 to 70 per 100,000 people, but recent studies have shown prevalence as high as 200 per 100,000 people. In the United States, males and females are equally affected, but both whites and people of Jewish decent are at much higher risk of developing inflammatory bowel disease.

The Facts on Ulcerative Colitis

Ulcerative colitis a type of inflammatory bowel disease (IBD) that causes inflammation and sores in the lining of the rectum and large intestine (colon). It's a chronic condition although symptoms can disappear for months at a time, only to flare up again unexpectedly. It typically first appears in men or women between the ages of 15 and 40, but occasionally this condition first occurs in people in their 60s.

Causes of Ulcerative Colitis

Researchers believe ulcerative colitis happens when the immune system overreacts in defending the body against a virus, bacteria, or dietary or environmental substance in the intestinal wall. It's still not clear what the exact trigger might be, but it's thought to vary from person to person.

Ulcerative colitis is an autoimmune disease that tends to occur in people with a family history of the condition. It is related to other autoimmune conditions, in which the immune system mistakenly attacks the body's own tissues instead of only fighting infections. Ulcerative colitis occurs most commonly in Caucasians, and particularly in people of Jewish heritage.

Certain environmental triggers can also lead to colitis. For example, people who live in cities are more at risk of developing the disease than those in rural areas.

Symptoms and Complications of Ulcerative Colitis

Bloody diarrhea is the main symptom of ulcerative colitis, caused by the inflammation in the bowel. People with colitis can have anywhere from three to 20 bowel movements daily, even losing control of their bowels and having diarrhea during sleep, in severe cases.

Other signs and symptoms of ulcerative colitis include:

• lower abdominal pain and cramps (especially during defecation)
• rectal bleeding
• anemia (iron deficiency) due to blood loss in diarrhea
• urgency to defecate (urgent bowel movements) or incontinence (loss of bowel control)
• weight loss or other signs of malnutrition (e.g., tiredness or malaise)
• fever over 37.5ºC, especially when disease symptoms are severe

Some people with colitis develop arthritis, skin rashes, or inflammation of the eye, and about 4% get liver disease. In children, ulcerative colitis can lead to limited growth. There are also acute complications like bleeding and potentially severe inflammation of the intestinal wall (toxic megacolon).

A few people with ulcerative colitis will eventually develop colon cancer. Only people with severe inflammation extending to the upper colon - about one in three cases - have a much higher risk of developing colon cancer. The risk of colon cancer also increases over time, but regular examination by your doctor can help to reduce the risk.

(The above information on UC was obtained from CHealth)