Archive for December, 2008

 

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John Libonati

New IBS Guidelines Include Screening for Celiac Disease

December 20th, 2008 by John Libonati


New guidelines for the treatment of IBS published by the American College of Gastroenterology include screening for celiac disease...

New IBS Guidelines Offer Treatment Ideas

American College of Gastroenterology Updates Recommendations for Irritable Bowel Syndrome By Bill Hendrick

WebMD Health NewsReviewed by Louise Chang, MDDec. 19, 2008 -- New guidelines have been issued by the nation's gastroenterologists that are aimed at easing the abdominal pain, diarrhea, and other symptoms of irritable bowel syndrome (IBS), which afflicts millions of Americans.

The guidelines, issued by the American College of Gastroenterology, also offer hope to patients who've struggled with the condition and found satisfactory treatments lacking.

IBS is diagnosed in people whose symptoms include abdominal pain, bloating, gas, diarrhea, and constipation, or a combination of these symptoms. Though sometimes confused with inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, IBS is a separate condition.

IBS care uses up more than $20 billion a year in direct and indirect expenditures, according to William Chey, MD, professor of medicine and director of the Gastrointestinal Physiology Laboratory at the University of Michigan Health System. He developed the guidelines in conjunction with Philip Schoenfeld, MD.

"The last time the American College of Gastroenterology published guidelines for the management of IBS was in 2002, and the College recognized that in the span of five to six years there has been a remarkable explosion in knowledge that's become available that's helped us to understand the cause and management of IBS," Chey says in a news release.

Tests and Treatments for IBS According to the new guidelines:

Patients with symptoms typical for IBS -- and without alarm features like rectal bleeding, low blood count due to iron deficiency, weight loss, or a family history of colon cancer, IBD, or celiac disease -- do not need extensive testing before being diagnosed.

IBS patients with diarrhea, or a combination of constipation and diarrhea, should be screened with blood tests for celiac disease, a disorder in which patients can't tolerate the gluten protein found in wheat or other grains.

When IBS patients have alarm features or are over 50 years old, they should have further tests (such as colonoscopy) to rule out other bowel disease such as IBD and colon cancer. IBS patients and their doctors should consider treatments involving antidepressants, which have been shown to offer relief.

The drug Amitiza helps with women who have IBS with constipation; the non-absorbable antibiotic rifaximin can ease IBS and bloating as a short-term treatment. And Lotronex, a drug that affects serotonin receptors, can be considered for patients with severe IBS with diarrhea.

Certain anti-spasm treatments may offer short-term help with abdominal pain from IBS. These include hyoscine, cimetropium, and peppermint oil.

A probiotic called Bifidobacteria may help some IBS patients.

According to the guidelines, women are twice as likely as men to suffer from IBS, which often begins in young adulthood. Gastroenterologists have found that dietary changes have proved helpful, including the addition of dietary fiber supplements such as psyllium.

Chey says IBS can be managed in most patients with counseling, dietary and lifestyle interventions, and use of both over-the-counter and prescription medications.

The guidelines suggest many treatments might be tried, though the authors concede no single magical answer has yet been found to eliminate symptoms in IBS patients. But the guidelines offer hope for people with IBS that their doctors can try a number of methods to reduce discomfort, and that some of the steps that can be taken seem to work.

ARTICLE SOURCE: http://www.webmd.com:80/ibs/news/20081219/new-ibs-guidelines-offer-treatment-ideas


John Libonati

Shared Genes in Type 1 Diabetes and Celiac Disease

December 16th, 2008 by John Libonati

A 2008 study provides more evidence that there is a link between celiac disease and gluten. This article in Scientific American reviews the study.

Diabetes and celiac disease: A Genetic Connection Patients with type 1 diabetes have been known to be more prone to another autoimmune disorder, celiac disease, in which gluten in wheat, rye and barley triggers an immune response that damages the small intestine or gut. Now there’s evidence that the two diseases have a genetic link: they share at least seven chromosome regions.

The discovery, published in this week's New England Journal of Medicine, indicates that both diseases may be triggered by similar genetic and environmental mechanisms, such as certain foods, that cause patients' immune systems to become overactive and destroy healthy instead of infected tissue. Previous research has found that celiac disease is five to 10 times more common in people with type 1 diabetes than in the general population, an editorial accompanying the study notes.

"These findings suggest common mechanisms causing both celiac and type 1 diabetes – we did not expect to see this very high degree of shared genetic risk factors," said study co-author David van Heel, a gastrointestinal geneticist at Barts and the London School of Medicine and Dentistry.

Van Heel and his colleagues studied genetic material or DNA from about 20,000 people, half of them healthy, nearly half with type 1 diabetes, and 2,000 with celiac disease. The overlapping genetic variants occurred on regions of chromosomes (parts of cells that carry genetic code) that are believed to regulate the gut’s immune system, the BBC notes.

Type 1 diabetes occurs when a person’s immune system mistakenly attacks healthy beta cells in the pancreas that produce the hormone insulin, which is needed to convert glucose into energy. In celiac disease, a similar attack occurs on the small intestine when sufferers eat gluten-rich grains, causing inflammation in the gut that can lead to bloating, abdominal pain, nausea, constipation, diarrhea, fatigue, anemia, headaches, weight loss and failure to thrive in children. Whereas diabetes 1 patients must inject insulin daily to make up for their deficiency, people with celiac disease can avoid damage and symptoms by sticking to a gluten-free diet.

"The finding raises the question of whether eating cereal and other gluten products might trigger type 1 diabetes by altering the function of the gut and its interaction with the pancreas, the authors write. But Robert Goldstein, chief scientific officer of the Juvenile Diabetes Research Foundation, which helped fund the study, says it would be premature to assume from this study that gluten is also a diabetes trigger.

“I fear the newspaper headlines in the popular press will read like, ‘Eating wheat will cause type 1 diabetes,’” Goldstein tells us. “The presence or absence of these associations has to be linked to some biological consequence” for a person's health.

Article Source: http://www.sciam.com/blog/60-second-science/post.cfm?id=diabetes-and-celiac-disease-a-genet-2008-12-11

*UK Study Source: Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease, New England Journal of Medicine. http://content.nejm.org/cgi/content/full/NEJMoa0807917

John Libonati

Gluten Free Restaurants – Philadelphia

December 16th, 2008 by John Libonati

Celiac disease - Gluten Free friendly restaurants in Philadelphia (listed alphabetically)

Applebee’s Restaurant

http://www.applebees.com/

Applebee Dietary Inquiries 888-592-7753 You can call this number and someone will provide information on gluten free menu items. I have spoken with them while seated in the restaurant – though you could certainly call ahead of time.

Arpeggio

http://www.arpeggiobyob.com

542 Springhouse Village Center Springhouse, PA 19477 {GPS} 1101 BETHLEHEM PIKE OR SPRINGHOUSE VILLAGE CENTER 215-646-5055 Mediterranean BYOB. Per my GI doc, the owner is very in tune to the needs of celiac patients.

Boston Style Pizza 447 N Sumneytown Pike North Wales, PA (215) 699-3977 Has gluten-free pizza as well as a recently expanded gluten-free menu.

Carrabba's Italian Grill

http://carrabas.com/index.aspx

2575 Maryland Road Willow Grove, PA 19090 (215) 659-3950 Has a gluten-free menu

Charlie Brown’s Steakhouse 324 W. Swedesford Road Berwyn, PA 19312 (610)240-0997 www.charliebrowns.com/ Has a gluten free menu and location information online.

Chipotle www.chipoltle.com Plymouth Meeting Mall location Website has a gluten-free listing. Staff and management were very receptive to requests as well as the food being delicious and healthy.

Five Guys Burgers and Fries www.fiveguys.com Check website for local sites – coming soon to K of P mall. Great burgers and fries! Locations I visited were very gluten-friendly.

JB Dawson’s

http://jbdawsons.com/index.html

Has a gluten free menu available online as well as upon request at each location. This is a local chain with five outlets –one near Plymouth Meeting Mall. The corporate Director of Kitchen's is very Celiac aware as he has family member with Celiac.

Jules Thin Crust Pizza

http://www.julesthincrust.com/

Offers great gluten –free pizza and crusts to make your own. Locations in Doylestown and Newtown.

Legal Seafoods

http://www.legalseafoods.com/

King of Prussia Mall. Great food and great attention to gluten-free concerns. Gluten-free menu is available.

Morton’s Restaurant

http://www.mortons.com/

King of Prussia Mall location is actually working on an allergy menu for customers, though other locations have been very responsive to gluten-free requests. My waitress, Gina, was very well versed and great at offering gluten-free alternatives.

Outback Steakhouse

http://www.outbacksteakhouse.com/

Has a gluten free menu available online as well as upon request at each location.

Pasta Pomodoro

http://www.pastapomodoronj.com

Won 2007 NFCA Gluten-free cooking competition Voorhees NJ

PF Chang’s China Bistro

http://www.pfchangs.com/

Great Chinese food. They have a gluten-free menu available and are very responsive to concerns. Plymouth Meeting Mall location is now open.

Redstone American Grill www.redstonegrill.com Plymouth Meeting Mall Have spoken with Director of Culinary Operations from corp office. Gave me local chef’s name and email as well as a listing of gluten-free menu items.

John Libonati

Erewhon Organic Corn Flakes 11 oz. – Product Reviews

December 4th, 2008 by John Libonati

These light and crispy flakes are made with simple pure ingredients - organically grown corn and sea salt. And, Erewhon Corn Flakes are 100% natural, low in sodium, and low fat. Great taste and great nutrition! Allergy Alert: contains corn. Kosher.

Ingredients: Organic corn flour, sea salt.

Product does not contain: Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Peanuts

Nutrition Facts: Serving Size 1 1/4 cup Serving per container: 6

Amount per Serving: Calories 210, Total Fat 2.5g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 100mg, Total Carbohydrates 26g, Dietary Fiber 3g, Sugars 3g, Protein 2g, vitamin A 10%, vitamin C 2%, calcium 0%, iron 15%

Delicious organic cereal made from the actual whole grain of organic brown rice. After the rice has been carefully toasted, it is glazed with a subtle blend of honey and brown rice syrup that sparkles with sweetness. Then a delicious medley of strawberries, raspberries and blue berries is added. Kosher.

Ingredients: Organic whole grain brown rice, organic brown rice syrup, honey, freeze dried blueberries, freeze dried raspberries, freeze dried strawberries, sea salt, and natural flavor.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts: Serving Size 1 cup Serving per container: 9 Amount per Serving: Calories 120, Total Fat 0.5g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 100mg, Total Carbohydrates 27g, Dietary Fiber 1g, Sugars 6g, Protein 2g, vitamin A 0%, vitamin C 4%, calcium 0%, iron 2%

This chewy pizza crust is easy to make! Mix requires addition of oil, egg, cheese (optional) and liquid (milk or milk substitute) to make pizza dough, calzones, cracker bread, and more. Yeast free and made in a gluten-free environment.

Ingredients: Manoic (tapioca) flour, modified manoic starch (100% manoic), salt, minced herbs (basil, garlic, onioin, oregano, thyme).

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts Serving Size 0.75 oz. Serving per container 10 Amount per Serving: Calories 70 Total Fat 0g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 190g, Total Carbohydrates 17g, Dietary Fiber 0g, Sugars 0g, Protein 0g, Vitamin A 0%, Vitamin C 0%, Calcium 0%, Iron 0%

John Libonati

Erewhon Rice Twice 10 oz. – Product Review

December 3rd, 2008 by John Libonati

Delicate crisps and tender puffs of organic brown rice gives you two distinct textures in this exceptional cereal. Rice is glazed with a blend of honey and brown rice syrup that sparkles with sweetness. Besides having great taste, Rice Twice is a fat free, low sodium food you can eat out-of-hand...just bag it for snacks at school, work, or on the road! "Only the purest, finest natural ingredients from the people who coined the term "natural foods."

Ingredients: Organic brown rice, brown rice syrup, honey, sea salt.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts: Serving Size 3/4 cup Serving per container: 9 Amount per Serving: Calories 120, Total Fat 0g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 60mg, Total Carbohydrates 26g, Dietary Fiber 0g, Sugars 8g, Protein 2g, vitamin A 0%, vitamin C 0%, calcium 0%, iron 0%

One of a family of snacks. 100% organic chewy fruit and nut natural energy bar with creamy lemon, crunchy cashews, and anti-oxident goji berries. Deliciously satisfying. No added sugar. Not genetically engineered.

Allergy Alert: contains nuts. May contain trace amounts of dairy, peanuts, and soy.

Ingredients: Organic dates, organic roasted cashews, organic goji berries, organic lemon juice concentrate, organic vanilla.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Corn,

Nutrition Facts: Serving Size 1 bar (45g) Serving per container 1 Amount per Serving: Calories 160 Total Fat 6g, Saturated Fat 1g, Trans Fat 0g, Cholesterol 0mg, Sodium 5mg, Potassium 310mg, Total Carbohydrates 27g, Dietary Fiber 6g, Insoluble fiber 5g, Sugars 17g, Protein 4g, vitamin A 2%, vitamin C 0%, calcium 2%, iron 8% , selenium 4%, vitamin E 2%

The chewy texture and flavor of this product prove that wheat is not necessary to make good bread. Requires the addition of oil, eggs, and liquid (milk or milk substitute or water). Yeast free and made in a gluten free environment.

Ingredients: Manoic (tapioca) flour, modified manoic starch (100% manoic), iodine-free salt, cream of tartar, sodium bicarbonate.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts Serving Size 70 Serving per container 10 Amount per Serving: Calories 70 Total Fat 0g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 0g, Total Carbohydrates 17g, Dietary Fiber 0g, Sugars 0g, Protein 0g, Vitamin A 0%, Vitamin C 0%, Calcium 0%, Iron 0%

by John Libonati

Here are six important facts about celiac disease in the United States:

1. Doctors do not understand celiac disease. 97% of celiacs are not diagnosed. Diagnosis takes over 10 years on average and follow up treatment is poor.

2. Doctors do not understand nutrition. Medical schools do not teach it, so doctors generally do not look for nutrient deficiencies unless you are emaciated.

3. Most of the 300 health problems stemming from celiac disease are due to nutrient deficiencies.

4. Comparing symptoms with one another does not work in celiac disease because symptoms change over time and everyone absorbs or malabsorbs nutrients differently. You may absorb everything but vitamin B12. Another person will not absorb calcium or vitamin D. Even siblings sometimes have totally different symptoms.

5. Symptoms from nutrient deficiencies show up before intestinal damage occurs, but also after starting the gluten-free diet depending on the degree of damage and quality of diet.

6. Most celiacs do not realize how sick they really are. They think, "This is me. I've always been this way." They end up spending thousands of dollars on lotions, salves, medications and surgeries when the root of their problem has been a missing nutrient or nutrients all along.

You need to understand gluten and how celiac disease affects your body if you want to be healthy.

You must be able to identify health problems and the nutritional deficiencies that cause them so you can add the missing nutrients to your diet and inform your doctor to help him treat you.

You need the book, Recognizing Celiac Disease.

Recognizing Celiac Disease teaches you everything about gluten, celiac disease, the health problems it causes and what you need to fix them.

Thousands of celiacs around the world are using Recognizing Celiac Disease…because it works.

"Having been dx with CD for one year, I reached saturation - almost overload point a few months ago. Then I read the summary of "Recognizing Celiac Disease" and felt it might encompass everything I had referenced across numerous articles and books - and more. I love being able to look in the index and go to detailed information in my struggle to ensure my nutritional requirements and deficiencies are being met and addressed." - Reta McCallum, TX

Read how this one of a kind book is helping others at www.recognizingceliacdisease.com.

Order your copy of Recognizing Celiac Disease today. Review it and bring it with you to your next doctor visit. This way you can work with your doctor to make sure you get the best treatment possible.

Visit www.recognizingceliacdisease.com for more information and to see what others are saying.

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