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Crohn’s Disease

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Definition:-
Crohn’s disease is an inflammatory bowel disease (IBD). It causes inflammation of the lining of your digestive tract, which can lead to abdominal pain, severe diarrhea and even malnutrition.

The inflammation caused by Crohn’s disease often spreads deep into the layers of affected bowel tissue. Like ulcerative colitis, another common IBD, Crohn’s disease can be both painful and debilitating and sometimes may lead to life-threatening complications.
click & see the pictures
It  may affect any part of the gastrointestinal tract from anus to mouth, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea (which may be bloody), vomiting, or weight loss, but may also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis and inflammation of the eye.

Crohn’s disease is an autoimmune disease, in which the body’s immune system attacks the gastrointestinal tract, causing inflammation; it is classified as a type of inflammatory bowel disease. There has been evidence of a genetic link to Crohn’s disease, putting individuals with siblings afflicted with the disease at higher risk. It is understood to have a large environmental component as evidenced by the higher number of cases in western industrialized nations. Males and females are equally affected. Smokers are three times more likely to develop Crohn’s disease. Crohn’s disease affects between 400,000 and 600,000 people in North America. Prevalence estimates for Northern Europe have ranged from 27–48 per 100,000. Crohn’s disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age.

While there’s no known medical cure for Crohn’s disease, therapies can greatly reduce the signs and symptoms of Crohn’s disease and even bring about long-term remission. With these therapies, many people with Crohn’s disease are able to function well.

Symptoms :-
Many people with Crohn’s disease have symptoms for years prior to the diagnosis. The usual onset is between 15 and 30 years of age but can occur at any age. Because of the ‘patchy’ nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more vague than with ulcerative colitis. People with Crohn’s disease will go through periods of flare-ups and remission.

Crohn’s disease can range from mild to severe and may develop gradually or come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission). When the disease is active, signs and symptoms may include:

#Diarrhea. The inflammation that occurs in Crohn’s disease causes cells in the affected areas of your intestine to secrete large amounts of water and salt. Because the colon can’t completely absorb this excess fluid, you develop diarrhea. Intensified intestinal cramping also can contribute to loose stools. Diarrhea is the most common problem for people with Crohn’s.

#Abdominal pain and cramping. Inflammation and ulceration may cause the walls of portions of your bowel to swell and eventually thicken with scar tissue. This affects the normal movement of contents through your digestive tract and may lead to pain and cramping. Mild Crohn’s disease usually causes slight to moderate intestinal discomfort, but in more-serious cases, the pain may be severe and include nausea and vomiting.

#Blood in your stool. Food moving through your digestive tract may cause inflamed tissue to bleed, or your bowel may also bleed on its own. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. You can also have bleeding you don’t see (occult blood)…..click & see

Endoscopy image of colon showing serpiginous ulcer

#Ulcers. Crohn’s disease can cause small sores on the surface of the intestine that eventually become large ulcers that penetrate deep into — and sometimes through — the intestinal walls. You may also have ulcers in your mouth similar to canker sores.

#Reduced appetite and weight loss. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
Erythema nodosum due to CD….…click & see

Other signs and symptoms :-
People with severe Crohn’s disease may also experience:

#Fever
#Fatigue
#Arthritis
#Eye inflammation
#Skin disorders
#Inflammation of the liver or bile ducts
#Delayed growth or sexual development, in children

When to see a doctor :-
See your doctor if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn’s disease, such as:

#Abdominal pain
#Blood in your stool
#Ongoing bouts of diarrhea that don’t respond to over-the-counter (OTC) medications
#Unexplained fever lasting more than a day or two.

Cause:-
Although the exact cause of Crohn’s disease is still unknown.  Previously, diet and stress were suspect, but now doctors know that although these factors may aggravate existing Crohn’s disease, they don’t cause it. A combination of environmental factors and genetic predisposition seems cause the disease. The genetic risk factors have now more or less been comprehensively elucidated, making Crohn’s disease the first genetically complex disease of which the genetic background has been resolved. The relative risks of contracting the disease when one has a mutation in one of the risk genes, however, are actually very low (approximately 1:200). Broadly speaking, the genetic data indicate that innate immune systems in patients with Crohn’s disease malfunction, and direct assessment of patient immunity confirms this notion. This had led to the notion that Crohn’s disease should be viewed as innate immune deficiency, chronic inflammation being caused by adaptive immunity trying to compensate for the reduced function of the innate immune system.Now, researchers believe that a number of factors, such as heredity and a malfunctioning immune system, play a role in the development of Crohn’s disease.

#Immune system. It’s possible that a virus or bacterium may cause Crohn’s disease. When your immune system tries to fight off the invading microorganism, the digestive tract becomes inflamed. Currently, many investigators believe that some people with the disease develop it because of an abnormal immune response to bacteria that normally live in the intestine.

#Heredity. Mutations in a gene called NOD2 tend to occur frequently in people with Crohn’s disease and seem to be associated with a higher likelihood of needing surgery for the disease. Scientists continue to search for other genetic mutations that might play a role in Crohn’s.

Complications:
Crohn’s disease can lead to several mechanical complications within the intestines, including obstruction, fistulae, and abscesses. Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents. Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. Abscesses are walled off collections of infection, which can occur in the abdomen or in the perianal area in Crohn’s disease sufferers.

Crohn’s disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohn’s disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn’s colitis have a relative risk of 5.6 for developing colon cancer.[26] Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn’s colitis for at least eight years. Some studies suggest that there is a role for chemoprotection in the prevention of colorectal cancer in Crohn’s involving the colon; two agents have been suggested, folate and mesalamine preparations.

Individuals with Crohn’s disease are at risk of malnutrition for many reasons, including decreased food intake and malabsorption. The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohn’s disease are referred to a dietitian for assistance in nutrition.

Crohn’s disease can cause significant complications including bowel obstruction, abscesses, free perforation and hemorrhage.

Crohn’s disease can be problematic during pregnancy, and some medications can cause adverse outcomes for the fetus or mother. Consultation with an obstetrician and gastroenterologist about Crohn’s disease and all medications allows preventative measures to be taken. In some cases, remission can occur during pregnancy. Certain medications can also impact sperm count or may otherwise adversely affect a man’s ability to conceive.

Risk factors:-
Risk factors for Crohn’s disease may include:

#Age. Crohn’s disease can occur at any age, but you’re likely to develop the condition when you’re young. Most people are diagnosed with Crohn’s between the ages of 20 and 30.

#Ethnicity. Although whites have the highest risk of the disease, it can affect any ethnic group. If you’re of Ashkenazi Jewish descent, your risk is even higher.

#Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn’s disease has a family member with the disease.

#Cigarette smoking. Cigarette smoking is the most important controllable risk factor for developing Crohn’s disease. Smoking also leads to more severe disease and a greater risk of surgery. If you smoke, stop. Discuss this with your doctor and get help. There are many smoking-cessation programs available if you are unable to quit on your own.

#Where you live. If you live in an urban area or in an industrialized country, you’re more likely to develop Crohn’s disease. Because Crohn’s disease occurs more often among people living in cities and industrial nations, it may be that environmental factors, including a diet high in fat or refined foods, play a role in Crohn’s disease. People living in northern climates also seem to have a greater risk of the disease.

#Isotretinoin (Accutane) use. Isotretinoin (Accutane) is a powerful medication sometimes used to treat scarring cystic acne or acne that doesn’t respond to other treatments. Although cause and effect hasn’t been proved, studies have reported the development of inflammatory bowel disease with isotretinoin use.

#Nonsteroidal anti-inflammatory drugs (NSAIDs). Although these medications — ibuprofen (Advil, Motrin, others), naproxen (Aleve), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and others — haven’t been shown to cause Crohn’s disease, they can cause similar signs and symptoms. Additionally, theses medications can make existing Crohn’s disease worse.

Diagnosis:-
The diagnosis of Crohn’s disease can sometimes be challenging, and a number of tests are often required to assist the physician in making the diagnosis. Even with a full battery of tests it may not be possible to diagnose Crohn’s with complete certainty; a colonoscopy is approximately 70% effective in diagnosing the disease with further tests being less effective. Disease in the small bowel is particularly difficult to diagnose as a traditional colonoscopy only allows access to the colon and lower portions of the small intestines; introduction of the capsule endoscopy aids in endoscopic .

Your doctor will likely diagnose Crohn’s disease only after ruling out other possible causes for your signs and symptoms, including irritable bowel syndrome (IBS), diverticulitis and colon cancer. To help confirm a diagnosis of Crohn’s disease, you may have one or more of the following tests and procedures:

#Blood tests. Your doctor may suggest blood tests to check for anemia — a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection. Two tests that look for the presence of certain antibodies can sometimes help diagnose which type of inflammatory bowel disease you have, but not everyone with Crohn’s disease or ulcerative colitis has these antibodies. While your doctor may order these tests, a positive finding doesn’t mean you have Crohn’s disease and a negative finding doesn’t mean that you’re free of the disease.

#Fecal occult blood test (FOBT). You may need to provide a stool sample so that your doctor can test for blood in your stool.

#Colonoscopy. This test allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis, which may help confirm a diagnosis. Some people have clusters of inflammatory cells called granulomas, which help confirm the diagnosis of Crohn’s disease because granulomas don’t occur with ulcerative colitis. In the majority of people with Crohn’s, granulomas aren’t present and diagnosis is made through biopsy and the location of the disease. Risks of colonoscopy include perforation of the colon wall and bleeding.

#Flexible sigmoidoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the sigmoid, the last section of your colon.

#Barium enema. This diagnostic test allows your doctor to evaluate your large intestine with an X-ray. Before the test, your receive an enema with a contrast dye containing barium. Sometimes, air also is added. The barium dye coats the lining of the bowel, creating a silhouette of your rectum, colon and a portion of your small intestine that’s visible on an X-ray.

#Small bowel imaging. This test looks at the part of the small bowel that can’t be seen by colonoscopy. After you drink a solution containing barium, X-ray, CT or MRI images are taken of your small intestine. The test can help locate areas of narrowing or inflammation in the small bowel that are seen in Crohn’s disease. The test can also help your doctor determine which type of inflammatory bowel disease you have.

#Computerized tomography (CT). Sometimes you may have a CT scan, a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel that can’t be seen with other tests. Your doctor may order this scan to better understand the location and extent of your disease or to check for complications such as a partial blockages, abscesses or fistulas. Although not invasive, a CT scan exposes you to more radiation than a conventional X-ray does.

#Capsule endoscopy.
If you have signs and symptoms that suggest Crohn’s disease but other diagnostic tests are negative, your doctor may perform capsule endoscopy. For this test you swallow a capsule that has a camera in it. The camera takes pictures, which are transmitted to a computer that you wear on your belt. The images are then downloaded, displayed on a monitor and checked for signs of Crohn’s disease. Once it’s made the trip through your digestive system, the camera exits your body painlessly in your stool. Capsule endoscopy is generally very safe, but if you have a partial blockage in the bowel, there’s a slight chance the capsule may become lodged in your intestine.

Treatments:-

Modern Treatment:-
The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohn’s disease usually involves drug therapy or, in certain cases, surgery.

Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you. In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.

Medication:-
Acute treatment uses medications to treat any infection (normally antibiotics) and to reduce inflammation (normally aminosalicylate anti-inflammatory drugs and corticosteroids). When symptoms are in remission, treatment enters maintenance with a goal of avoiding the recurrence of symptoms. Prolonged use of corticosteroids has significant side-effects; as a result they are generally not used for long-term treatment. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs.

Medications used to treat the symptoms of Crohn’s disease include 5-aminosalicylic acid (5-ASA) formulations, prednisone, immunomodulators such as azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab[15], certolizumab  and natalizumab. Hydrocortisone should be used in severe attacks of Crohn’s disease.

Low doses of the opiate receptor antagonist Naltrexone (also Low dose naltrexone) have been found to be effective in inducing remission in 67% of patients with Crohn’s disease in a small study conducted at Pennsylvania State University. Dr. Jill Smith, Professor of Gastroenterology at Pennsylvania State University’s College of Medicine concluded that “LDN therapy appears effective and safe in subjects with active Crohn’s disease.”  Smith and her colleagues have since received a NIH grant and are proceeding with a definitive Phase II placebo-controlled clinical trial.

Lifestyle changes:-
Certain lifestyle changes can reduce symptoms, including dietary adjustments, proper hydration and smoking cessation. Eating small meals frequently instead of big meals may also help with a low appetite. To manage symptoms have a balanced diet with proper portion control. Fatigue can be helped with regular exercise, a healthy diet and enough sleep. A food diary may help with identifying foods that trigger symptoms. Some patients should follow a low dietary fiber diet to control symptoms especially if fiberous foods cause symptoms.

Surgery:
Crohn’s cannot be cured by surgery, though it is used when partial or a full blockage of the intestine occurs. Surgery may also be required for complications such as obstructions, fistulas and/or abscesses, or if the disease does not respond to drugs. After the first surgery, Crohn’s usually shows up at the site of the resection though it can appear in other locations. After a resection, scar tissue builds up which can cause strictures. A stricture is when the intestines become too small to allow excrement to pass through easily which can lead to a blockage. After the first resection, another resection may be necessary within five years.  For patients with an obstruction due to a stricture, two options for treatment are strictureplasty and resection of that portion of bowel. There is no statistical significance between strictureplasty alone versus strictureplasty and resection in cases of duodenal involvement. In these cases, re-operation rates were 31% and 27%, respectively, indicating that strictureplasty is a safe and effective treatment for selected patients with duodenal involvement

Short bowel syndrome (SBS, also short gut syndrome or simply short gut) can be caused by the surgical removal of the small intestines. It usually develops if a person has had half or more of their small intestines removed.  Diarrhea is the main symptom of short bowel syndrome though other symptoms may include cramping, bloating and heartburn. Short bowel syndrome is treated with changes in diet, intravenous feeding, vitamin and mineral supplements and treatment with medications. Another complication following surgery for Crohn’s disease where the terminal ileum has been removed is the development of excessive watery diarrhea. This is due to an inability to reabsorb bile acids after resection of the terminal ileum.

In some cases of SBS, intestinal transplant surgery may be considered; though the number of transplant centres offering this procedure is quite small and it comes with a high risk due to the chance of infection and rejection of the transplanted intestine

Prospective treatments:
Researchers at University College London have questioned the wisdom of suppressing the immune system in Crohn’s, as the problem may be an under-active rather than an over-active immune system: their study found that Crohn’s patients showed an abnormally low response to an introduced infection, marked by a poor flow of blood to the wound, and the response improved when the patients were given sildenafil citrate.

Recent studies using helminthic therapy or hookworms to treat Crohn’s Disease and other (non-viral) auto-immune diseases seem to yield promising results.

Complementary and alternative medicine:-
More than half of Crohn’s disease sufferers have tried complementary or alternative therapy. These include diets, probiotics, fish oil and other herbal and nutritional supplements. The benefit of these medications is uncertain.

#Acupuncture is used to treat inflammatory bowel disease in China, and is being used more frequently in Western society. However, there is no evidence that acupuncture has benefits beyond the placebo effect.

#Methotrexate is a folate anti-metabolite drug which is also used for chemotherapy. It is useful in maintenance of remission for those no longer taking corticosteroids.

#Metronidazole and ciprofloxacin are antibiotics which are used to treat Crohn’s that have colonic or perianal involvement, although, in the United States, this use has not been approved by the Food and Drug Administration. They are also used for treatment of complications, including abscesses and other infections accompanying Crohn’s disease.

#Thalidomide has shown response in reversing endoscopic evidence of disease.

#Cannabis-derived drugs may be used to treat Crohn’s Disease with its anti-inflammatory properties. Cannabis-derived drugs may also help to heal the gut lining.

#Soluble Fiber has been used by some to treat symptoms.^ a b c Tungland BC, Meyer D, Nondigestible oligo- and polysaccharides (dietary fiber): their physiology and role in human health and food, Comp Rev Food Sci Food Safety, 3:73-92, 2002 (Table 3)

#Probiotics include Sacchromyces boulardii   and E. coli Nissle 1917.

#Boswellia is an ayurvedic (Indian traditional medicine) herb, used as a natural alternative to drugs. One study has found that the effectiveness of H-15 extract is not inferior to mesalazinesimilar, and suggests it that its safety makes it superior in benefit-risk evaluations.

Lifestyle and home remedies:-
Sometimes you may feel helpless when facing Crohn’s disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

Diet
There’s no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up in your condition. If you think there are foods that make your condition worse, try keeping a food diary to keep track of what you’re eating as well as how you feel. If you discover certain foods are causing your symptoms to flare, it’s a good idea to try eliminating those foods. Here are some suggestions that may help:

#Limit dairy products. Like many people with inflammatory bowel disease, you may find that problems, such as diarrhea, abdominal pain and gas, improve when you limit or eliminate dairy products. You may be lactose intolerant — that is, your body can’t digest the milk sugar (lactose) in dairy foods. If so, limiting dairy or using an enzyme product, such as Lactaid, will help break down lactose.

#Try low-fat foods. If you have Crohn’s disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Foods that may be especially troublesome include butter, margarine, cream sauces and fried foods.

#Experiment with fiber. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. You may also find that you can tolerate some fruits and vegetables, but not others. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and nuts, seeds, corn and popcorn. Consult your doctor prior to starting a high-fiber diet.

#Avoid problem foods. Eliminate any other foods that seem to make your signs and symptoms worse. These may include “gassy” foods such as beans, cabbage and broccoli, raw fruit juices and fruits — especially citrus fruits, spicy food, popcorn, alcohol, and foods and drinks that contain caffeine, such as chocolate and soda.

#Eat small meals. You may find you feel better eating five or six small meals a day rather than two or three larger ones.

#Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.

#Consider multivitamins. Because Crohn’s disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful. Check with your doctor before taking any vitamins or supplements.

#Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Stress :-
Although stress doesn’t cause Crohn’s disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one.

When you’re stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acid. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.

Although it’s not always possible to avoid stress, you can learn ways to help manage it. Some of these include:

#Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that’s right for you.

#Biofeedback. This stress-reduction technique may help you reduce muscle tension and slow your heart rate with the help of a feedback machine. You’re then taught how to produce these changes without feedback from the machine. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.

#Regular relaxation and breathing exercises. One way to cope with stress is to regularly relax. You can take classes in yoga and meditation or use books, CDs or DVDs at home.

You may click to see this article :-Banana Plantain and Broccoli Fibers for Crohn’s Disease Treatment

Prognosis:
Crohn’s disease is a chronic condition for which there is currently no cure. It is characterised by periods of improvement followed by episodes when symptoms flare up. With treatment, most people achieve a healthy height and weight, and the mortality rate for the disease is relatively low. However, Crohn’s disease is associated with an increased risk of small bowel and colorectal carcinoma, including bowel cancer.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Crohn’s_disease
http://www.mayoclinic.com/health/crohns-disease/DS00104

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Vitamin D may Help Fight Crohn’s Disease

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A new study has discovered that nutritional supplements with vitamin D could help fight Crohn’s disease,  which is a chronic form of inflammatory bowel disease.

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Researchers from McGill University found a link that ties vitamin D to Crohn’s disease, according to a report published in the Journal of Biological Chemistry.

It was noted that people who live in northern countries where they receive less sunlight are more prone to developing Crohn’s disease. Initial research was conducted to determine the nutritional supplement’s affect on cancer, however, when scientists determined the results kept pointing the immune system, they decided to look at other options.

The researchers were quick to point out that siblings of victims of Crohn’s disease that haven’t noticed symptoms yet should consider looking at their vitamin D levels as it may be a way to treat the ailment before it starts.

“This discovery is exciting, since it shows how an over-the-counter supplement such as Vitamin D could help people defend themselves against Crohn’s disease,” said researcher Marc J. Servan. “We have identified a new treatment avenue for people with Crohn’s disease or other inflammatory bowel diseases.”

Source:Better Health Research:Jan.27.2010

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Turmeric Can Sooth Bowel

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Do you have bowel problem? Try out turmeric, for a new study says that the spice relieves symptoms in many cases.

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An international team has carried out the study and found that curcumin, the major yellow constituent of turmeric, helps in reducing inflammation in many people suffering from bowel disease, the ‘British Journal of Nutrition‘ reported.

Crohn’s disease, a form of inflammatory bowel, can be aggravated or relieved by the sufferer‘s diet. Only by linking particular components to effects on the specific genotype can we get true understanding of the disease and how to treat it.

“This finding means that some people with Crohn’s disease may benefit from eating turmeric, but this is entirely dependent on their genetic makeup. Others may not get any benefit, or may even have a severe reaction,” lead researcher Christine Butts of Plant & Food Research said. And, according to the researchers, the discovery may assist in the development of diet-based treatments for people suffering from the equivalent genetic form of the disease.

“We are one step closer to understanding this disease and how to best control it with diet,” Butts said.

Added co-researcher Kieran Elborough: “In diseases with complex genetics, such as Crohn’s disease, understanding which genetic variants are affected by which food compounds is important in knowing what to avoid in the diet.

“Using this knowledge, we can develop dietary supplements with added benefits which can help bowel disease sufferers based on their personal genotype.”

Sources: The Times Of India

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Suppliments our body needs

Bromelain

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Bromelain is a mixture of enzymes found naturally in the juice and stems of pineapples. Called a proteolytic enzyme, bromelain is believed to help with the digestion of protein.

Some bromelain appears to be absorbed by the body intact, so it’s also thought to have effects outside the digestive tract. In fact, bromelain is often marketed as a natural anti-inflammatory for conditions such as arthritis. It’s one of the most popular supplements in Germany, where it is approved by the Commission E for the treatment of inflammation and swelling of the nose and sinuses due to surgery or injury.

Bromelain is typically extracted from pineapples and made into capsule or tablet form. Because it’s able to digest protein, bromelain is available in some grocery stores as a meat tenderizer. A topical form of bromelain is also being explored experimentally for burns.

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When used for as a digestive aid, bromelain is usually taken with meals. When used for inflammatory conditions, practitioners typically recommend taking bromelain between meals on an empty stomach to maximize absorption.

History:
Bromelain is one of a group of proteolytic enzymes that are capable of digesting protein and is found in the stem and fruit of the pineapple plant. It is extracted from the pineapple by filtration or by chemical processing, and both are safe and effective. The German Commission E (the equivalent of the USFDA) recommends the use of Bromelain as a digestive aid, a treatment for traumatic injuries and joint inflammation and a treatment for bronchitis and sinusitis. There is a great deal of new research currently being conducted into its use as an antibacterial, an antiviral (including HIV) and an immune system enhancer.

Beneficial Uses:
Bromelain is considered an aid to good digestion, because it intensifies the digestive process by breaking down protein, and facilitates the passing of food to the intestine. The ability to speed protein digestion makes it useful in treating Crohn’s disease, and the protein digesting enzymes found in it may help to heal gastric ulcers and relieve symptoms of heartburn and stomach and gastrointestinal upset. It is believed to promote and maintain overall proper digestion and may be used as a digestive enzyme for pancreatic insufficiency. Interesting note: It is so effective in digesting protein that the food industry employs Bromelain to tenderize meat.

In the matter of diabetes management,
Bromelain’s ability to facilitate the passing of food to the intestine helps to counteract gastroparesis, a condition caused by long-term diabetic nerve damage, in which the stomach is unable to pass food along properly. Controlling gastroparesis is of considerable importance in diabetes management, since delays in passing flood through the digestive tract makes the timing of insulin medications and injections difficult, and the use of Bromelain may help diabetics time the need for their insulin and other medications. Moreover, Bromelain has also been used as a digestive enzyme for pancreatic insufficiency.

Bromelain has been called a fine anti-inflammatory and is widely used after traumatic injuries and surgery. It is said to “release” inflammation by breaking down proteins in swollen tissues and is thought to reduce swelling in virtually all kinds of inflammatory reactions. Bromelain apparently inhibits formation of prostaglandin E-2, a chemical that causes inflammation, and it also helps to stimulate the production of prostaglandin E-1, an anti-inflammatory chemical. Bromelain supplements may be as effective as some commonly used nonsteroidal, anti-inflammatory medications (ibuprofen, etc.) for reducing the pain of carpal tunnel sydrome, osteoarthritis and rheumatoid arthritis. It has also been said to ease pain and bruising, bursitis, cuts, lymphedema, sore muscles, tendonitis and speeds up the healing of joint and tendon injuries.

For the relief of bronchitis and sinusitis, Bromelain is said to suppress cough, reduce nasal mucus that is associated with sinusitis and relieve the swelling and inflammation caused by hay fever and allergies. Although not all experts agree, The Complete German Commission E Monograph recommends Bromelain for sinus inflammation. Bromelain supplements are believed to enhance the efficacy of antibiotics by keeping them in the system longer and helping them to treat infection. Bromelain may also stop sinusitis from progressing to bronchitis and is also thought to decrease bronchial secretions, increasing lung function, and inhibit upper respiration infections. There have been reports that the same actions that reduce blood platelet stickiness (see heart health below) also reduce the thickness of mucus in patients with chronic bronchitis or asthma. Bromelain is also approved by the Commission for treatment of sinus and nasal swelling, following ear, nose and throat surgery or trauma, which supports its anti-inflammatory properties.

Bromelain may support good heart health and lower blood pressure. It is said to stop blood clot formation by inhibiting the platelet-activating factor (PAF), a chemical that signals blood platelets to form clots. Inhibiting PAF short-circuits the entire clotting process and leads to lower blood pressure and reductions in angina pain. This anti-clotting action might help to prevent ischemic stroke and heart attack. Moreover, it is also believed that Bromelain breaks down arteriosclerotic plaques once they have formed. This blood thinning action has been said to help in cases of thrombophlebitis.

Women may find relief from premenstrual syndrome (PMS) with the use of Bromelain supplements. It is believed to balance the body’s production of prostaglandins, a class of regulatory hormones, including a number of substances that cause smooth muscles to contract. As a smooth muscle relaxant, Bromelain is thought to decrease spasms of the cervix that accompany PMS.

Bromelain is believed to have strong antiviral properties and may be very helpful in stimulating the immune system. Scientists at Sloan Kettering Cancer Hospital in New York City have observed that Bromelain dissolves cellular adhesion molecules that allow HIV to attach to surfaces of uninfected

T- cells and increases production of compounds called integrins that are depleted when HIV attacks cells in the central nervous system. It also inhibits protease, an enzyme the human immunodeficiency virus HIV needs to replicate itself. Its antiviral qualities appear to provide enzymes that dissolve warts and activate immune system against the viruses that cause them.

As an antiseptic, Bromelain shows great promise in copious current lab research. Some research has shown evidence that the supplement can fight against infectious agents, such as bacteria and viruses (see above), and may prove to be a useful addition to conventional treatment of bronchitis, pneumonia and urinary tract infections. Its antibacterial effects may also help to control diarrhea caused by bacteria. Bromelain is believed to increase the actions of antibiotics and chemotherapy, apparently by keeping them in the system longer.

Recommended Dosage:
Take one (1) capsule, one (1) time each day with water at mealtimes.

You may click to see:-->The Benefits of Bromelain to improve quality of life

>Bromelain The Natural Treatment For Rheumatoid Arthritis

Side Effects and Safety Concerns:

Some of the more common side effects of bromelain include indigestion, nausea and diarrhea. Other side effects may include vomiting, increased heart rate, drowsiness and abnormal uterine bleeding or heavy menstruation.

Bromelain has resulted in allergic reactions and asthma symptoms, including breathing problems, tightness in the throat, skin hives, rash or itchy skin. People with allergies to pineapples should avoid bromelain. Allergic reactions may also occur in people with allergies to latex, carrot, celery, fennel, rye, wheat, papain, bee venom or grass, birch or cypress pollens.

People with peptic ulcers should not use bromelain. People with other digestive disorders should consult a qualified healthcare professional before using bromelain.

Theoretically, bromelain may increase the risk of bleeding, so people with bleeding disorders and those taking medication that can increase the risk of bleeding should only use bromelain under the supervision of their physician. It should not be taken two weeks before or after dental procedures or surgery.

The safety of bromelain in pregnant or nursing women, children or people with liver or kidney disease isn’t known.

Possible Drug and Herb Interactions:-
People taking “blood-thinners” (anticoagulant or anti-platelet medication), such as aspirin, warfarin (Coumadin), heparin, clopidogrel (Plavix), non-steroidal anti-inflammatory medications such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve) should only use bromelain under a physician’s supervision. It should also be used with caution by people taking herbs and supplements that are thought to increase the risk of bleeding, such as ginkgo biloba and garlic.

Studies suggest bromelain may also increase the absorption of other medications, such as:

amoxicillin, tetracycline and other antibiotics

chemotherapy drugs such as 5-fluorouracil and vincristine

“ACE inhibitor” blood pressure medications such as captopril (Capoten) and lisinopril (Zestril)

medications that cause drowsiness, such as benzodiazepines lorazepam (Ativan) or diazepam (Valium), some antidepressants, narcotics such as codeine, and barbituates such as phenobarbitol.

Resources:
http://altmedicine.about.com/cs/herbsvitaminsa1/a/Bromelain.htm
http://www.herbalextractsplus.com/bromelain.cfm

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Conditions that may increase the risk for problems after a mouth or dental injury:
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Many conditions, lifestyle choices, medicines, and diseases interfere with one’s ability to heal or fight infection. The person may be at risk for a more serious problem from his or her symptoms if he or she have any of the following. Be sure to tell the health professional in detail.

THE CONDITIONS:-

*Heart valve disease:

*Heart valve replacement

*Previous dental injuries

*Previous dental or gum surgery

*Radiation therapy to the mouth, face, or neck (now or in the past)

*Surgery to remove the spleen

Lifestyle choices:

*Alcohol abuse or withdrawal

*Drug abuse or withdrawal

*Smoking or other tobacco use

Medicines:

*Antiseizure medicines, such as phenytoin

*Birth control pills (oral contraceptives)

*Blood-thinning medicines, such as warfarin, heparin, and aspirin

*Calcium channel blockers, which are used to control high blood pressure or for people with heart problems

*Corticosteroids, such as prednisone

*Medicines that contain gold

*Medicines to prevent organ transplant rejection

*Medicines used to treat cancer (chemotherapy)

*Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen

Diseases:

*Cancer

*Crohn’s disease

*Dental disease, such as tooth decay or gum disease

*Diabetes

*Eating disorders, such as anorexia nervosa or bulimia nervosa

*Gastroesophageal reflux disease

*Hemophilia

*Idiopathic thrombocytopenic purpura (ITP)

*Infection of the muscles and valves of the heart (endocarditis)

*Iron deficiency anemia

*Malabsorption syndromes

*Scleroderma

*Sickle cell disease

*Sjögren’s syndrome

*Vitamin deficiencies, such as too little folate, niacin, pyridoxine, riboflavin, vitamin C, and vitamin K
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Sources:MSN Health & Fitness

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