Research examines new methods for managing digestive health
David Cohen, M.D.·Published 20 May 2013·9 min read
Key points
Research presented at Digestive Disease Week® (DDW) explores new methods for managing digestive health through diet and lifestyle.
Building on growing knowledge about the human microbiome, research from the University of Illinois, Urbana-Champaign; University of Pittsburgh, PA; Wageningen University, the Netherlands; and the University of KwaZulu-Natal, South Africa, features new data on microbiota and colorectal cancer risk.
A study from Texas Tech University, El Paso, and the University of Mississippi, Oxford, holds promising results for diabetic patients suffering from indigestion symptoms like nausea, vomiting, bloating and heartburn.
Individuals suffering from Crohn's disease are often plagued by reduced muscle strength, fatigue and poor quality of life.
Research presented at Digestive Disease Week® (DDW) explores new methods for managing digestive health through diet and lifestyle.
Individuals suffering from Crohn's disease are often plagued by reduced muscle strength, fatigue and poor quality of life. These symptoms can remain even when patients are in remission. A randomized, double blind, placebo-controlled study found for the first time that vitamin D supplementation corresponded to significant relief of these symptoms.
"Our findings may have significant implications for these patients," said Tara Raftery, research dietician and PhD candidate at Trinity College Dublin, Ireland. "These findings, to our knowledge, are the first to suggest potential benefits of vitamin D supplementation on muscle strength with corresponding benefits for fatigue and quality of life in Crohn's disease. These findings, however, need to be confirmed in larger studies."
The study found that after three months of taking 2000 IU of vitamin D per day, patients' muscle strength, measured by hand-grip, was significantly higher in both dominant and non-dominant hands compared to those taking placebo. Patients also reported significantly less general, physical and mental fatigue and a higher quality of life when levels of vitamin D were 75 nano mole per liter or more.
Diet swap provides clue to level of colorectal cancer risk
Building on growing knowledge about the human microbiome, research from the University of Illinois, Urbana-Champaign; University of Pittsburgh, PA; Wageningen University, the Netherlands; and the University of KwaZulu-Natal, South Africa, features new data on microbiota and colorectal cancer risk. Researchers found a dramatic and rapid shift in gut microbiota after switching the diet in healthy subjects from a traditional Western diet to a Zulu African diet and vice-versa. Funded by a grant from the National Institutes of Health, the study's results show changes in gut microbiota that might explain levels of colorectal cancer risk.
"African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the U.S. The reasons for this are not yet understood," said Franck Carbonero, postdoctoral research associate at University of Illinois at Urbana-Champaign. "Our findings offer insight into this disparity and pave the way for new research."
Women’s gastrointestinal (GI) systems are different than that of men’s. Not only are women physically dissimilar, some organs also operate differently, and then there are the hormones!
"There are two major differences between male and female GI tracts," explains Shakti Singh, M.D. opens new window, gastroenterologist and hepatologist at Sutter Gould Medical Foundation in Modesto. "One involves the fact that women have a uterus and ovaries and the colon has to go around them, hypothetically making the colon’s route more convoluted. The second difference is hormones and their effect on the female GI tract."
Written and revised by
David Cohen, M.D.
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Hormones and a GI system that’s more sensitive to irritants may explain the propensity of women to be six times more likely to have irritable bowel syndrome - their most common GI complaint - compared to men.
Some more differences:
Women have more sensitive bitter and sweet tastebuds. Certain organs in a woman's GI tract - the esophagus, small intestine, colon or large intestine and rectum - are more sensitive. This can make women experience heartburn more strongly than men. Because aspirin and aspirin-like compounds known as non-steroidal anti-inflammatory drugs (NSAIDs) can increase a woman’s risk of developing stomach ulcers, gastritis or inflammation of the stomach, and bleeding from the stomach, a woman should work with her doctor to create a plan to protect her stomach if she takes NSAIDs. A woman’s muscles that prevent the backflow of food and stomach acid into the esophagus and windpipe are stronger and more efficient. Although this can increase the sensation of having a "lump in your throat," these strong muscles may also increase a woman’s protection against esophageal damage caused by heartburn and acid reflux. A woman secretes less stomach acid than a man, reducing her risk of developing acid-related ulcers. A woman’s stomach empties food more slowly than a man’s, increasing the incidence of nausea and bloating. Until old age (when the difference disappears), a woman’s large intestine empties more slowly than a man’s, increasing her risk of constipation. Anatomical differences in the rectum and anal canal make a woman less able to handle an episode of diarrhea. The hormones progesterone and estrogen can make a woman’s gallbladder empty more slowly and increase the cholesterol in her gallbladder, doubling her risk of developing gallstones. A woman has a different enzyme system that breaks down medications in the small intestine and liver, so she tolerates various medications differently. Hormones produced during pregnancy can affect a woman who has been diagnosed with inflammatory bowel disease such as Crohn’s Disease or ulcerative colitis, making the problem get better, get worse or remain unchanged. Hormones can also increase a pregnant woman’s experiences of nausea, gallstones and heartburn. For women, colon cancer (the third most frequent type of cancer for American women) may be associated with breast cancer, never giving birth to children, and cancer on the right side of the colon.
During the study, researchers fed 20 Zulu Africans 600 grams of meat per day for two weeks and fed 20 African Americans in Pittsburgh a traditional Zulu diet comprised primarily of a corn-based porridge called putu. Comparing stool samples before and after the diet exchange in each case, researchers found dramatic changes in colonic microbiota.
"Our results show that the human colonic microbiota is shaped by diet in a very dynamic manner," said Rex Gaskins, PhD, professor of Immunobiology at University of Illinois at Urbana-Champaign. "Not only that, we observed alterations in the balance of beneficial and detrimental microbial groups, which may explain, in part, the increase in colorectal cancer risk that is conferred by a Western diet."
What Is Crohn's Disease? Crohn's disease is an ongoing condition that causes inflammation of the digestive tract, or the GI (gastrointestinal) tract (the gut). Crohn's disease may also be called ileitis or enteritis. Crohn's disease can affect any part of the gut, from the mouth all the way down to the anus. In the majority of cases the lower part of the small intestine - the ileum - is affected. Patients with Crohn's disease can feel pain; the condition makes the intestines empty frequently, resulting in diarrhea.
In the UK about 1 in 1,500 people have Crohn's disease, according to the National Health Service (NHS), (another study says 1 in 800). It is slightly more prevalent among women than men according to UK sources (NHS), while US sources state that it affects both sexes equally (NIH). Although Crohn's disease typically starts between the ages of 15 to 40, it can start at any age.
New needleless acupuncture therapy decreases symptoms of indigestion
A study from Texas Tech University, El Paso, and the University of Mississippi, Oxford, holds promising results for diabetic patients suffering from indigestion symptoms like nausea, vomiting, bloating and heartburn. The study tested a new method of therapy using a custom-made wireless device to stimulate acupuncture points with electrical waves on the surface of the skin rather than needles.
"Treatment options for this patient group are severely limited," said Richard McCallum, MD, professor and founding chair of the division of gastroenterology, department of medicine, Texas Tech University Health Sciences Center. "This is a novel approach to symptom relief that overcomes the shortcomings of other therapies."
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Because of the limited pharmacological treatment options available, many patients build up a tolerance to prescribed medicine. Additionally, traditional acupuncture requires patients to make repeat appointments and a fear of needles may make it undesirable for many patients. The wireless, needleless device tested in the study was designed by Jiande Chen, PhD, professor at the University of Texas' Medical Branch at Galveston, and allows clinicians to tailor the frequency and amplitude of the electrical waves used to stimulate acupuncture points.
Funded by grants from the National Institutes of Health, patients were instructed to spend 240 minutes each day using the device on designated spots on the body. They kept a detailed diary tracking specific gastroparesis symptoms and the number of heartburn episodes per day.
Dr. McCallum worked with fellow Texas Tech professor Irene Sarosiek, MD, senior author of this project, to analyze results of a four-week period of use of the device. Compared to the placebo group, the device significantly improved five out of nine gastroparesis symptoms - vomiting was reduced by 39 percent, nausea by 30 percent and bloating by 21 percent. The number of heartburn episodes decreased significantly when patients utilized active stimulation.
Increasingly, children are developing digestive problems that were once reserved for adults. Digestive problems such as bloating, gas, diarrhea, constipation, and even inflammatory bowel diseases can result from a multitude of factors, but the underlying cause is often inappropriate eating habits.
The role of good nutrition in health is unfortunately still underemphasized in North America. Although we recognize a relationship between food and the body's functionioning, there is still a tendency to assume that the mechanics of the body are malfunctioning due to other reasons.
We need to realize that if digestion is impaired, that means the food we eat is not being broken down and absorbed properly. Digestion is how your body takes food and makes it usable in the form of energy and nutrients. In many healing modalities, it is believed that problems with digestion are at the heart of all other health conditions.
To help improve your child’s digestion and their body’s access to nutrients, it is best to implement some of the strategies listed below. Oftentimes, even modifying some of the harmful habits that overwhelm children's systems can be enough to bring about change.
"These exciting initial results have great potential for patients," Dr. McCallum said. "With the customizable features of the device, we can explore fine-tuning the therapy to directly target specific symptoms."
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Ms. Raftery will present data from the study "Vitamin D supplementation improves muscle strength, fatigue and quality of life in patients with Crohn's disease in remission," abstract Sa1198, on Saturday, May 18, at 8 a.m. in West Hall 1A of the Orange County Convention Center.
Dr. Carbonero will present data from the study "Short-term reciprocal diet exchanges impact colonic fermentation and hydrogenotrophic microbiota for native Africans consuming a typical Western diet and African Americans consuming a traditional African diet" abstract Sa1965, on Saturday, May 18, at 8 a.m. in West Hall 1A of the Orange County Convention Center.
Dr. McCallum will present data from the study "Self-Administered Needleless Acupuncture Therapy to Control Dyspepsia and GERD Symptoms in Patients Diagnosed with Diabetic Gastroparesis," abstract 749, on Monday, May 20, at 3 p.m. in room 102AB of the Orange County Convention Center.
Digestive Disease Week® (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 18 to 21, 2013, at the Orange County Convention Center, Orlando, FL. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.
