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Book “Sophie’s Story” To Give Honest Impression of Irritable Bowel Syndrome

by Gabriel on November 13, 2011

The owner of IBS Tales, Sophie Lee, has written a new book called “Sophie’s Story” which chronicles her life dealing with Irritable Bowel Syndrome.

I want to tell the absolute truth about IBS, because the reality of this disorder is so often clouded by embarrassment and myths. Perhaps the most pervasive myth is that IBS means mild diarrhea and nothing more. Many people with no experience of IBS wonder why we have such difficulty in coping with our condition. This book shows why. - Sophie Lee, “Sophie’s Story”

It would appear that “Sophie’s Story” is aiming to be an accurate & detailed account of what life with Irritable Bowel Syndrome is like, even if the truth about IBS isn’t pretty. Her story will probably resonate with many who have had similar frustrating & painful experiences while dealing with Irritable Bowel Syndrome.

Sophie has been kind enough to provide me with a review copy that I will read & then review at a later date. You can purchase the book right now on Amazon, Amazon UK. For international orders it’s best to check the IBS Tales website for further details.

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Mustard, Broccoli & Other Veggies Key To Intestinal Health

by Gabriel on October 14, 2011

Research done at Babraham Institute in the UK has shown that diets low or void of certain vegetables leads to a weakening of the protective microbial layer of the intestinal tract causing higher chances of inflammation while reducing healing capacity.

Mustard, Broccoli & Other Veggies Key To Intestinal Health The researchers focused on intra-epithelial lymphocytes(IELs) which reside just below the epithelial cell layer that makes up the walls of the intestinal tract. IELs play an important role in the immune response to foreign invaders, they are essentially the first line of defense against bacteria trying to setup shop in the intestinal tract or penetrate the intestinal lining. Mice involved in the study were given a specific diet that was devoid of “cruciferous vegetables”. Those given this diet showed a reduction in the number of IELs residing in their gut. They also looked at mice that were genetically modified to not have IELs. Both mice groups showed similar problems with regards to being able to control the microbial flora in their digestive tract as well as showing a slowed ability to heal from damage to the intestinal tract.

It appears that cruciferous vegetables contain compounds which bind to “aryl hydrocarbon receptors”(AhRs) which the IELs express. When these compounds bind with AhRs it promotes the continued growth of IELs. Cruciferous vegetables are largely made up of green leafy vegetables as well as mustards.

Widely available cruciferous vegetables are:

Broccoli
Cauliflower
Cabbage
Brussel Sprouts
Collard Greens
Kale
Bok Choy
Rutabagas
Radish
Mustard Seed
Wasabi

Some people with digestive issues have trouble with fibrous plants & care should be taken when adding these plants to a diet that previously did not contain many or any of them. People who cannot tolerate them raw may look to incorporate them into gently cooked dishes.

One thing to note is that the detection of high levels of IELs has often been a hallmark of inflammation. While this doesn’t mean that promoting IELs by eating more vegetables will lead to more inflammation, it would suggest that IELs are not the root cause of Inflammatory Bowel Diseases.

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Two New Social Networking Sites Look To Help Crohn’s & Colitis Patients Connect

by Gabriel on October 13, 2011

While Facebook may be the dominate social media platform, many niche social networks are popping up, including those for Crohn’s Disease & Ulcerative Colitis patients.

Crohnology Social Networking Site

Crohnology is the creation of Sean Ahrens, a twelve-year veteran of Crohn’s Disease & a software developer who works in the San Francisco Bay Area in California. The look of the site is pretty well polished with features that allow you communicate with & find others who have Inflammatory Bowel Diseases. Of particular note is the ability to list treatments you’ve tried & then rate how well those treatments worked for you. The site is currently in private beta mode, but you can request an invitation by going to the website & entering your e-mail address.

IntenseIntestines Social Network

IntenseIntestines was initially a blog site but has recently switched over to a social networking platform. It appears to be more of a community oriented site allowing users to create a custom profile, join groups, post on forums as well as upload pictures & videos. While it may lack the polished look & perhaps more advanced features of Crohnology, it still looks as though it could be a valuable resource down the road as more members join.

As more patients turn from just being “patients” and instead into “patient advocates” tools such as these social network sites will become a valuable resource for patients to help themselves without having to rely so much on the medical community which often times has a cold & distant bed manner. Often patients are in the dark all too often when it comes down to what to expect from certain treatments & all too often the medical community gives them vague or even inaccurate information. Additionally by connecting patients with other patients, new & alternative methods of treatments may spread more quickly thanks to sites such as these.

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Remicade Can Improve Outcomes For Ulcerative Colitis But There Are Risks

by Gabriel on October 12, 2011

Remicade, which is the brand name for the drug Infliximab, was recently approved for use in children by the FDA & a recent study shows positive outcomes can come from it’s use. However trustworthiness, warnings & lawsuits suggests that there are serious risks.

A recent study published in Gastroengology came to the conclusion that those taking Remicade treatments showed better outcomes & had less chances of needing surgery later, than those taking placebo. While this appears to be good news the trustworthiness of the study might come into question because many of researchers involved disclosed ties to pharmaceutical companies, including the manufacturer of Remicade which was also involved in funding the study.

The FDA also recently announced the approval of Remicade in children ages 6 & older. The approval does come with the stipulation that it be used in children with moderate to severe Ulcerative Colitis who are not responding to other treatment methods. The FDA has given Remicade & similar drugs like Humira “black box warnings” because of the risk of things like cancer, neurological damage & severe infection.

Remicade & Humira are considered Tumor Necrosis Factor(TNF) blockers, specifically TNF-alpha blockers. TNF is a signaling protein that is responsible for part of the immune system & inflammatory process. TNF blockers are derived antibodies, turning these drugs into almost mini-immune systems that seek out a specific target. While blocking TNF can help with inflammatory diseases, the side effects from blocking TNF obviously show that it’s not perfect. The immune system is very complex with many different signaling proteins working together. Future drugs will probably look at targeting different proteins or multiple proteins as well as trying to have a “gentler” overall touch. Due to the complexities involved with generating the antibodies for TNF blocking drugs, the drugs are very expensive costing tens of thousands of dollars per dose.

For many Remicade & Humira have been helpful, but some have been bitten by the serious side effects that they can cause. A woman in Montana sued the manufacturer of Humira over neurological damage to her feet. Recently a Tennessee man claimed Humira caused him to become susceptible to a severe fungal infection. The Crohn’s & Colitis Foundation of America also has a page with information on the cancer risks of TNF blocking drugs.

Those looking into TNF blocker drugs for themselves or someone else such as a child, should read up on the possible side effects & warnings before moving forward with treatment.

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RedHill Biopharma’s RHB-104 MAP Treatment for Crohn’s Disease

by Gabriel on October 10, 2011

RedHill Biopharma is looking to start FDA & European drug trials soon for their RHB-104 MAP bacterium treatment for those with Crohn’s Disease.

The Phase II/III FDA drug trials in the US will be lead by Professor David Y. Graham from Baylor College of Medicine located in Houston, Texas. Professor Graham worked for NASA as a physician during the Apollo program, has written over 800 medical articles & is considered to be one of the “Top 50 Most Influential Gastroenterology Professionals of the 20th Century” as rated by Gastroenterology.com.

“Phase II/III” trials differ from more typical separate Phase II & Phase III trials in that the study is more randomized than a typical Phase II trial, as well as there being more participants involved. This allows data from a Phase II/III trial to be used going forward in a Phase III trial. However, Phase II/III trials require more infrastructure & patients, raising costs. Phase II/III trials could be looked at as though they are Phase III trials with stronger stop parameters than a typical Phrase III trial. Given that the drugs used within RHB-104 have gone through Phase III trials in Australia, this is probably why RedHill Biopharma is confident in moving forward with the Phase II/III style of trial.

RHB-104 is a triple antibiotic formula that is used to treat MAP bacterium. MAP is a shorter way of saying “Mycobacterium avium subspecies paratuberculosis” bacterium. The inception of RHB-104 dates back to the late 1990s with development being started by Dr. Thomas Borody of the Centre for Digestive Diseases. The three components of RHB-104 are Rifabutin, Clarithromycin and Clofazimine which are all rather common antibiotics, the difference is in using all three, dosage level & duration of treatment.

Dr. Borody has also helped in the development of different triple antibiotic treatments for H. Pylori infections, which is a leading cause of peptic ulcers. One of these treatments was also purchased by RedHill Biopharma which has labeled it RHB-105. I’ve also mentioned Dr. Borody’s work on fecal transplantation / bacteriotherapy which is another treatment Dr. Borody uses for Crohn’s Disease.

What is now known as RHB-104 in the US has been a hot potato throughout the biotech world for over the last decade. The drug formula was initially licensed to a company called Pharmacia, but upon their merger with Pfizer(who did not wish to continue development of the drug), ownership fell back to the Dr. Borody founded company Giaconda under the name “Myoconda”. Finally in August of 2010, RedHill Biopharma purchased the rights to Myoconda for US & European distribution.

RedHill Biopharma does appear to be serious about bringing RHB-104 to market what with the recent exclusive acquisition of a DNA based MAP bacterium infection test that was developed by Dr. Saleh Naser of the biomedical division at the University of Central Florida.

MAP infection appears to be present in about 40 – 50% of those with Crohn’s Disease. MAP bacterium are known to cause Johne’s disease in animals such as cattle. Johne’s disease is an inflammation of the small intestine & can be fatal in some cases. Currently there is no definitive proof that MAP infection is the cause of Crohn’s Disease, the fact alone that not all patients with Crohn’s Disease have MAP infections should highlight that MAP is probably not the sole cause for all patients. It could be the sole cause or at least a contributing factor for some though. The main link between MAP & Crohn’s Disease is from studies showing that MAP infection is more prevalent in those with Crohn’s Disease than in those who have Ulcerative Colitis.

What with concerns over antibiotics causing Crohn’s Disease, some may have worries about this treatment essentially being 3 different antibiotics. I would not be too concerned if someone has already been given a diagnosis of Crohn’s Disease as you cannot change your diagnosis & if you test positive for MAP infection perhaps MAP was more the cause of the disease than antibiotic usage. Of course some could argue that antibiotic usage might lead to more susceptibility of MAP infection. Neither theories are proven though. Perhaps a combination of RHB-104 along with Dr. Borody’s bacteriotherapy could be a likely treatment avenue for those concerned about their digestive bacterial flora’s health post-treatment.

RedHill Biopharma has not released a date for when the trials are too begin, but assigning Professor Graham as the leader of the study appears to be a step in the right direction.

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“The Man Who Couldn’t Eat” Chronicles Relationship With Food & Disease

by Gabriel on October 9, 2011

Jon Reiner’s recently released book about his battles with Crohn’s Disease discusses the impacts of disease on a person as well as society’s relationship with food.

The Man Who Couldn't Eat

Food is not just sustenance. It is memories, a lobster roll on the beach in Maine; heritage, hot pastrami club with a half-sour pickle; guilty pleasures, a chocolate rum-soaked Bundt cake; identity, vegetarian or carnivore. Food is the sensuality of a ripe strawberry or a pork chop sizzling on the grill. But what if the very thing that keeps you alive, that bonds us together and marks occasions in our lives, became a toxic substance, an inflammatory invader? In this beautifully written memoir, both gut-wrenching and inspiring, award-winning writer Jon Reiner explores our complex and often contradictory relationship with food as he tells the story of his agonizing battle with Crohn’s disease—and the extraordinary places his hunger and obsession with food took him.

I have not personally read this book yet & I am not sure that I will in the immediate future due to the bad memories I have from my stint of serious Gastroparesis back in 2006. From the description, reviews & the first few pages I’ve read it sounds as though his experience was somewhat similar to mine. The concept of food being poisonous or causing harm is such an alien concept to most. Our society literally runs on food. You really do not notice how many food commercials there are or how there are one or more restaurants or food stores practically every block, until you’ve been robbed of the ability to eat. When eating makes you ill, it turns your life into a paradox, you must eat to live but eating almost seems to be killing you. It doesn’t just take a toll on you but on those around you who are unable to change your predicament.

I am not sure I’d recommend the book to those currently suffering through a bad digestive illness, although it might provide an avenue of sympathy, someone who has been there, who understands. To those who are in the good graces of the digestive gods it might do them good to read the book & count their digestive blessings even if the subject matter causes some indigestion.

You can pick the book up at your local bookstore or on Amazon. You can also read the first couple of pages on Amazon.com as well.

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Study Suggests Cannabis Helpful In Treating Inflammatory Bowel Disease

by Gabriel on October 8, 2011

A small scale observational study published in the Journal of the Israeli Medical Association looked at the effects of cannabis usage among patients who had Crohn’s Disease.

The study found 30 patients through an Israeli medical marijuana organization. They asked these patients about their disease & wellbeing before & after cannabis usage. When possible, they referenced the answers given with the patients medical records. Most all of the patients had been on conventional treatments such as anti-inflammatories, corticosteriods & some where also using anti-tumor necrosis factor antibodies. About half had also experienced the need to have surgery at some point. These patients opted to use marijuana due to the fact that they were not responding well to conventional treatments. The average amount of THC(tetrahydrocannabinol) intake from marijuana per day was about 0.5mg – 1.5mg.

The results of the study suggested marijuana greatly improved the condition of most of the study participants. Not only did the patients report a lessening of symptoms but there was physical evidence as well. The mean bowel movements per day reduced from 8 to 5, there appeared to be a reduction in the number of patients requiring surgery & many of the patients were able to reduce or stop taking some of the conventional medications.

Israel is rather restrictive in it’s marijuana laws but is opening up, even the Israeli Defense Force is looking to use marijuana as an aid for Post Traumatic Stress Disorder.

Marijuana contains over 60 different cannabinoids. The main cannabinoids of interest are THC(tetrahydrocannabinol) & CBD(cannabidiol). Cannabinoids have an anti-inflammatory effect & also appear to help with pain & nausea. They could be of great use for other digestive problems like Irritable Bowel Syndrome or Gastroparesis.

Hopefully studies like these help to change the minds of those who are against the benefits of the medical marijuana.

Source: Treatment of Crohn’s Disease with Cannabis: An Observational Study

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Tranzyme’s TZP-102 Gastroparesis Treatment Starts Phase IIb Trials

by Gabriel on October 7, 2011

Tranzyme’s TZP-102 is a Ghrelin receptor agonist designed for treatment of Gastroparesis in diabetic patients. Phase IIb trials are currently underway to further test it’s efficacy.

Ghrelin is a hormone that is generated within the walls of the stomach. It’s mainly responsible for the feeling of hunger along with helping to gear up the digestive system for food intake. Leptin is another digestive hormone that is almost the opposite of Ghrelin in that it promotes feelings of satiety & lowers appetite. Those with Gastroparesis often have problems with loss of appetite & early feelings of fullness along with nausea & vomiting. While it’s known that usually a loss of digestive motility is the reason for these symptoms, it is not often known where the loss of motility came from. In some cases motility is not an issue, yet symptoms remain. It is possible that those suffering from Gastroparesis may be dealing with an underproduction of Ghrelin or an overproduction of Leptin. It is also possible that these hormone levels are fine but some other issue exists like nerve or muscle damage. Regardless of the cause, increasing production of Ghrelin may be beneficial to those dealing with Gastroparesis as it may allow the digestive system to regain some lost motility while improving appetite & reducing feelings of fullness.

Tranzyme’s TZP-102 is a Ghrelin receptor agonist. It’s goal is to coax the body to produce more of the Ghrelin hormone. It is currently listed as being designed for the treatment of diabetes related Gastroparesis. I personally think this labeling of the drug might have been a tactic to receive fast track status from the FDA. I would not be surprised if doctors later prescribe it “off label” for those who do not have diabetes, if TZB-102 makes it to market.

The Phase IIb trials of TZP-102 will be looking to test efficacy of 10mg, 20mg & placebo dosages. In September 2011 Tranzyme released information from a study done at Aarhus University Hospital in Denmark which suggested promising early results.

Oral administration of TZP-102 for 28 days significantly improved gastroparesis symptoms;
The observed effects were similar in type 1 and type 2 diabetic patients;
TZP-102 was well tolerated with no impact on body weight or glucose control parameters; and
Overall, TZP-102 represents a promising pharmacological option to address an unmet medical need for patients whose day-to-day life is impaired by gastroparesis.

Tranzyme is not alone in their attempts to use Ghrelin to treat Gastroparesis, although they appear to be the furthest along. Rhythm Pharmaceuticals is working on RM-131, another Ghrelin agonist. Meanwhile GalaxoSmithKline is working on GSK962040 which is a Motilin agonist. Motilin is another digestive hormone, similar to Ghrelin.

Sources: Tranzyme Press Releases 611224 & 604457

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David Archuleta & Casey Abrams Talk Crohn’s & Ulcerative Colitis

by Gabriel on October 7, 2011

American Idol fan favorites David Archuleta & Casey Abrams raising awareness of Crohn’s Disease & Ulcerative Colitis in recent videos.

David Archuleta was a fan favorite & the runner-up to the seventh season of American Idol. He’s spent his time since American Idol traveling around the country & the world performing on tours & for different events. He recently updated his Youtube channel to discuss what he’s currently been up to. One of the topics he discusses in the video is the recent diagnosis of his older sister’s Crohn’s Disease. He thanked many of the fans who wrote to him regarding the condition as well as the CCFA. It sounds as though his sister is doing better, but as those dealing with Crohn’s Disease know, there is no easy fix & David states he is still trying to learn more about the disease & how he can best help his sister.

Casey Abrams was another fan favorite during the tenth season of American Idol. I’ve previously discussed Casey Abram’s struggles with Ulcerative Colitis while performing on American Idol as well as his IBD Idols project. He was recently featured on CNN’s “Human Factor” series which profiles people overcoming challenges in their life. The video & article discuss Casey Abrams life & the challenges he faced with Ulcerative Colitis. The video also includes some interview footage of him discussing the disease as well.

It’s great to see these two in the public eye bringing more attention to serious digestive diseases like Crohn’s Disease & Ulcerative colitis.

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