Amy C. Brown

Existing dietary guidelines for Crohn’s disease and ulcerative colitis

Patients with inflammatory bowel disease (IBD) often question their doctors about diet. The objectives of this article are to provide clinicians with existing dietary advice by presenting the dietary information proposed by medical societies in the form of clinical practice guidelines as it relates to IBD; listing dietary guidelines from patient-centered IBD-related organizations; and creating a new ‘global practice guideline’ that attempts to consolidate the existing information regarding diet and IBD. The dietary suggestions derived from sources found in this article include nutritional deficiency screening, avoiding foods that worsen symptoms, eating smaller meals at more frequent intervals, drinking adequate fluids, avoiding caffeine and alcohol, taking vitamin/mineral supplementation, eliminating dairy if lactose intolerant, limiting excess fat, reducing carbohydrates and reducing high-fiber foods during flares. Mixed advice exists regarding probiotics. Enteral nutrition is recommended for Crohn’s disease patients in Japan, which differs from practices in the USA.

Ginger's (Zingiber officinale Roscoe) inhibition of rat colonic adenocarcinoma cells proliferation and angiogenesis in vitro.

Gingers (Zingiber officinale Roscoe) natural bioactives, specifically ginger extract and 6‐gingerol, were measured for their in vitro inhibition of two key aspects of colon cancer biology – cancer cell proliferation and angiogenic potential of endothelial cell tubule formation. Ginger extract was obtained via column distillation, while the 6‐gingerol was purchased from Calbiochem. Antiproliferation activity was assessed through tritiated thymidine ([3H]Tdr) incorporation studies of YYT colon cancer cells; the anti‐angiogenic ability of gingerol was assessed by a Matrigel assays using MS1 endothelial cells. These selected ginger bioactives had: 1) a direct effect on YYT rat cancer cell proliferation (6–1.5% ginger extract; 100–4 µM 6‐gingerol); 2) an indirect effect on MS1 endothelial cell function either at the level of endothelial cell proliferation or through inhibition of MS1 endothelial cell tube formation (100–0.8 µM). Compound 6‐gingerol was most effective at lower doses in inhibiting endothelial cell tube formation. These in vitro studies show that 6‐gingerol has two types of antitumor effects: 1) direct colon cancer cell growth suppression, and 2) inhibition of the blood supply of the tumor via angiogenesis. Further research is warranted to test 6‐gingerol in animal studies as a potential anticancer plant bioactive in the complementary treatment of cancer. Copyright

Anticancer Activity of Morinda citrifolia (Noni) Fruit: A Review

This review investigated the relationship of noni juice, or its extract (fruit, leaves or root), to anticancer and/or immunostimulant properties. A Medline search was conducted using the key search words ‘Morinda citrifolia’ and ‘Morinda citrifolia and cancer’ (1964 to October, 2011) along with cross‐referencing. Botanical and chemical indexes were not included. A total of 304 and 29 (10%) articles, respectively, were found under these key terms. Of the 19 studies actually related to cancer, seven publications were in vitro cancer studies, nine were in vivo animal cancer studies, and three were in vivo human cancer studies. Among the in vitro studies, a ‘concentrated component’ in noni juice and not pure noni juice may (1) stimulate the immune system to ‘possibly’ assist the body fight the cancer, and (2) kill a small percentage (0–36%) of cancer cells depending on the type. The nine animal studies suggest that a concentrated component in noni juice may stimulate the immune system; but only slightly increases the number (about 1/3; 25–45%) of surviving mice. Other than two case studies, only two human clinical studies existed. The first consisted of testing freeze‐dried noni fruit, which reduced pain perception, but did not reverse advanced cancer. The second was on smokers ingesting an unknown concentration of noni juice who experienced decreased aromatic DNA adducts, and decreased levels of plasma superoxide anion radicals and lipid hydroperoxide.

Traditional kava beverage consumption and liver function tests in a predominantly Tongan population in Hawaii

Purpose. To determine the effects of traditionally prepared kava beverages on the liver function tests of regular kava beverage consumers in a population of Tongan and non-Tongan residents of Hawaii (Oahu). Methods. The liver function tests of 31 healthy adult kava drinkers were compared against a control group of 31 healthy adult non-kava drinkers. Subjects were recruited from the general population, a kava bar, and Tongan kava drinking circles. The liver function profile included AST, ALT, ALP, GGT, and bilirubin (total and direct). Other tests included total protein, albumin, and screens for viral hepatitis and hemochromatosis when indicated. Results. Chronic kava beverage consumption was associated with elevation of GGT in 65% of the kava drinkers versus 26% in the controls (P = .005). ALP was elevated in 23% of kava drinkers versus 3% in the controls (P  = .053). Conclusion. Heavy kava beverage consumption was associated with significantly elevated GGT levels.

Does evidence exist to include dietary therapy in the treatment of Crohn’s disease?

Prescription drugs and surgery are two common medical therapies for Crohn’s disease (CD), an inflammatory bowel disease that affects the GI tract. Unfortunately, certain drugs can cause serious side effects, and surgeries must often be repeated. No diet has been established to alleviate the pain and suffering of CD patients. This is curious given the fact that a higher prevalence of food sensitivities exist in this population of patients, and enteral nutrition is not only the first-line of therapy in Japan, but a known research method used to place the majority of CD patients into remission. Although not all patients respond equally to diet, many simply remove symptom-provoking foods, such as dairy, wheat, corn and certain fruits and vegetables. We suggest assisting these patients in their self-assessment of irritating and symptom-provoking foods by educating them in the use of a food–symptom diary followed by a customized elimination diet trialed for 2–4 weeks to determine if there is any benefit to the individual patient.

Gluten sensitivity: problems of an emerging condition separate from celiac disease

Gluten sensitivity appears to be emerging as a separate condition from celiac disease, yet no clear definition or diagnosis exists. As a result, patients with gluten sensitivity experience delayed diagnosis and continuing symptoms if they consume gluten. This emerging medical problem may involve human genetics, plant genetic modifications, gluten as a food additive, environmental toxins, hormonal influences, intestinal infections and autoimmune diseases. The treatment is similar to that for celiac disease – a gluten-free diet. The use of a gluten-free diet or an elimination diet is encouraged in assisting people to determine whether or not they are gluten sensitive. It is time to not only recognize, but to treat and further research gluten sensitivity, as unconfirmed environmental factors continue to spread this problem further into the general population.

Autoimmune and gastrointestinal dysfunctions: does a subset of children with autism reveal a broader connection?

A large number of autoimmune disorders have a gastrointestinal (GI) dysfunction component that may interplay with genetic, hormonal, environmental and/or stress factors. This narrarive review investigates possible links between autism, immune system abnormalities and GI symptoms in a subgroup of children with autism. A literature search on Medline (1950 to September 2010) was conducted to identify relevant articles by using the keywords ‘autism and gastrointestinal’ (71 publications) and ‘autism and immune’ (237 publications), cross-referencing and general searching to evaluate the available literature on the immunological and GI aspects of autism. Sufficient evidence exists to support that a subgroup of children with autism may suffer from concomitant immune-related GI symptoms.

Effectiveness of kukui nut oil as a topical treatment for psoriasis

Background  No cure for psoriasis exists for the 1–3% of the American population who suffer from it; however, anecdotal reports from patients with psoriasis visiting Hawaii who purchased kukui nut oil, claim it helped reduce the severity of their lesions.

Ulcerative colitis, Crohn's disease and irritable bowel syndrome patients need fecal transplant research and treatment

Dear Sir, Dr. Barry Marshall, the Nobel Prize winning Australian physician, showed that the Helicobacter pylori bacterium was causing most peptic ulcers, reversing decades of medical doctrine. A thorough review of the literature suggests that inflammatory bowel disease (IBD; ulcerative colitis and Crohns disease) is related to bacterial dysbiosis (infection via microorganism, injury, and or imbalance), the cause of which may be multifactorial. If not, then why are antibiotics sometimes used to treat IBD? Spouses of Crohns disease patients are at an increased risk for the disease.1 Bacteria can cause ulcers …

Heart Toxicity Related to Herbs and Dietary Supplements: Online Table of Case Reports. Part 4 of 5.

ABSTRACT Background: The purpose of this review was to create an online research summary table of heart toxicity case reports related to dietary supplements (DS; includes herbs). Methods: Documented PubMed case reports of DS appearing to contribute to heart-related problems were used to create a “Toxic Table” that summarized the research (1966 to April, 2016, and cross-referencing). Keywords included “herb,” “dietary supplement,” and cardiac terms. Case reports were excluded if they were herb combinations (some exceptions), Chinese herb mixtures, teas of mixed herb contents, mushrooms, poisonous plants, self-harm (e.g. suicide), excess dose (except vitamins/minerals), drugs or illegal drugs, drug-herbal interactions, and confounders of drugs or diseases. The spectrum of heart toxicities included hypertension, hypotension, hypokalemia, bradycardia, tachycardia, arrhythmia, ventricular fibrillation, heart attack, cardiac arrest, heart failure, and death. Results: Heart related problems were associated with approximately seven herbs: Four traditional Chinese medicine herbs – Don quai (Angelica sinensis), Jin bu huan (Lycopodium serratum), Thundergod vine or lei gong teng (Tripterygium wilfordii Hook F), and Ting kung teng (Erycibe henryi prain); one an Ayruvedic herb – Aswagandha, (Withania somnifera); and two North American herbs – blue cohosh (Caulophyllum thalictroides), and Yohimbe (Pausinystalia johimbe). Aconitum and Ephedra species are no longer sold in the United States. The DS included, but are not limited to five DS – bitter orange, caffeine, certain energy drinks, nitric oxide products, and a calming product. Six additional DS are no longer sold. Licorice was the food related to heart problems. Conclusion: The online “Toxic Table” forewarns clinicians, consumers and the DS industry by listing DS with case reports related to heart toxicity. It may also contribute to Phase IV post marketing surveillance to diminish adverse events that Government officials use to regulate DS.