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Evaluation of Lower Functional Gut Disorders. Canadian Journal of Gastroenterology. 22(7): 614-616. July 2008.
This article reviews the current thinking regarding the endoscopic evaluation of lower functional gut disorders, including irritable bowel syndrome (IBS). The authors note that the key to diagnosing functional disorders is knowing how much investigation is needed before making the diagnosis. They review recommended patient approaches for IBS, for alternating or mixed bowel pattern IBS, for diarrhea-predominant IBS, and for constipation-predominant IBS. One section briefly considers some additional testing that might be indicated, including that for lactose intolerance or small intestinal bacterial overgrowth (SIBO). The author concludes that although the diagnostic accuracy of IBS is excellent, shifts in IBS symptomatology are common. Typical symptoms without alarm features generally do not require exhaustive evaluation before the initiation of therapy. In patients with alarm features or diarrhea-predominant symptoms, or in patients who fail initial supportive management, further directed investigations may be warranted. 24 references.
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Ice Cream For All? Lactagen And Lactose Intolerance. Today’s Dietitian. 10(4): 24-26. April 2008.
This article describes the use of Lactagen, a natural dietary supplement, for people who have lactose intolerance, which is defined as the inability to digest significant amounts of lactose, the primary sugar in milk and milk products. The author briefly describes the problems that people with lactose intolerance encounter. The author introduces Andrew Ritter, president and developer of Lactagen. Lactagen is synthesized from lactose, Lactobacillus acidophilus, tricalcium phosphate, fructo-oligosaccharides (FOS), cellulose gum, and silica. Lactagen is a powder that is dissolved in 4 to 6 ounces of water and is taken with meals for 38 days. After the 38-day program, many people can enjoy dairy products again without their previous problems of lactose intolerance symptoms. The author considers the history of this supplement, and reports from a placebo-controlled study that confirmed a significant decrease in severity of lactose intolerance symptoms after the 38-day program. A final section considers the place of Lactagen in an overall program of managing lactose intolerance. Most of the professionals interviewed support the idea that consuming healthful bacteria, like those found in the Lactagen product, can revitalize the intestines and reduce lactose intolerance. 3 references.
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Lactose Intolerance: Definition, Symptoms And Treatment. Digestive Health Matters. 16(1): 16-18. Spring 2008.
This article outlines the definition, symptoms, and treatment of lactose intolerance, a term that refers to the development of gastrointestinal (GI) symptoms following the ingestion of milk or dairy products. Lactose intolerance is caused by a shortage of a digestive enzyme called lactase, which is produced within the lining of the small intestine. The authors review the populations in whom lactose intolerance is most prevalent and detail the symptoms of this condition. The remainder of the article explores the diagnostic tests that may be used to confirm the presence of lactose intolerance, treatment strategies, and recent studies and ongoing research in this area. The initial treatment for lactose intolerance is complete elimination of all lactose-containing products from the diet. This should include yogurt, frozen yogurt, and cheese. Many of these foods can eventually be reintroduced slowly as tolerated. Over-the-counter lactase preparations are available that may help improve the digestion of lactose. These products are taken just before eating a lactose-containing meal.
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Nutrition and the Gluten-Free Diet. Regina, Saskatchewan: Case Nutrition Consulting. 2008. pp 73-140.
This chapter about nutrition is from a book designed to provide practical information, in an easy-to-access format, about celiac disease and the gluten-free diet that is used to manage the disease. The author notes that many people with celiac disease focus on the important issue of eating only gluten-free foods but may lack information and inclusion of vital nutritional concerns in their dietary plans. This chapter covers specific dietary concerns, how to use nutritious gluten-free alternatives, guidelines for healthy eating, and the nutritional composition of a variety of gluten-free ingredients and foods. Specific nutritional concerns discussed include anemia, iron, folate, vitamin B12, bone disease, calcium, vitamin D, lactose intolerance, and dietary fiber. The author reviews nutritious gluten-free alternative grains, including amaranth, buckwheat, flax, mesquite, millet, Montina (Indian ricegrass), quinoa, sorghum, teff, and wild rice. For each, the chapter notes handling and preparation, nutritional contents, and references for additional information. The final section considers dietary guidelines for healthy eating on a gluten-free diet, including the nutrient composition of gluten-free grains, flours, starches, legumes, nuts, and seeds. References are included in each of section of the chapter. 43 tables.
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Problems Digesting Dairy Products? Rockville, MD: Food and Drug Administration. 2008. 2 p.
This fact sheet explains the problem of lactose intolerance, an inability to digest lactose, which is the natural sugar found in milk and other dairy products. People who cannot digest lactose have a shortage, or deficiency, of an enzyme called lactase, which is produced in the small intestine. The fact sheet reviews the difference between allergy and intolerance, lists the symptoms of lactose intolerance, discusses the groups in which lactose intolerance is most common, outlines some ways to cope with lactose intolerance without jeopardizing nutrition, describes how to determine from food labels whether milk products are present in a particular item, and briefly mentions diagnostic tests that may be conducted to determine whether lactose intolerance is present. People have different levels of tolerance to lactose and some may be able to consume a lactose-containing product in smaller amounts. Dietary supplements with lactase enzyme are available to help people digest foods that contain lactose. A final section offers practical suggestions for consumers who are lactose intolerant. Readers are referred to two government websites for more information. One sidebar discusses the problems associated with drinking raw, or unpasteurized, milk and the myths that surround its use. 1 figure.
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Role of Food and Dietary Intervention in the Irritable Bowel Syndrome. Practical Gastroenterology. 32(7): 33-42. July 2008.
This article explores the role of food and dietary intervention in irritable bowel syndrome (IBS). IBS is described as a constellation of symptoms, and its diagnosis is often one of exclusion after considering other causes for the patient’s symptoms. IBS is characterized by alterations in bowel habits, constipation, diarrhea, abdominal pain, and chronicity. The authors stress that the role of diet and its effect on patients with IBS is often underestimated. They describe the common provocative dietary agents and potential mechanisms that induce symptoms of IBS, including abnormal intestinal gas. Topics include milk and lactose intolerance, nondairy milk alternatives, dietary fiber, foods that may aggravate symptoms, well-tolerated foods and beverages in IBS patients, and the role of probiotics in IBS. The article concludes with a brief review of data on alternative therapy for IBS, including herbal medicines. The authors stress that a food diary kept by IBS patients can be very useful to establish possible food triggers that exacerbate symptoms in individual patients. Dietary changes require motivation and are often time consuming, but the potential result of symptom relief can be worth the effort. 6 tables. 33 references.
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Carbohydrate Intolerance and Celiac Disease. Lifeline. 27(4): 5-8. 2007.
This article, from a patient education newsletter, reviews the interplay of carbohydrate intolerance and celiac disease, which is characterized by gluten intolerance. The author notes that the most common carbohydrate intolerance in celiac disease is lactose, but more and more celiacs are being diagnosed with fructose intolerance. The author describes the chemical structure of these carbohydrates and how they are absorbed, where they are typically found in the diet, the symptoms of secondary lactose intolerance in patients whose intestines have been damaged by gluten ingestion, children with transient lactose intolerance, symptoms of lactose malabsorption, the use of oral lactase to improve lactose absorption, the differences between hereditary and acquired fructose intolerance, the sources of fructose including high fructose corn syrup, the difficulties in determining fructose and sucrose content in foods and beverages, and problems with sugar substitutes, also called artificial sweeteners. Readers are encouraged to consider other sources of their symptoms if they continue to experience gastrointestinal difficulties after 2 to 12 months on a gluten-free diet. Two sidebars list examples of hidden lactose sources and examples of dietary sources of fructose and sucrose. 5 tables. 7 references.
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Clinical Ramifications of Malabsorption of Fructose and Other Short-Chain Carbohydrates. Practical Gastroenterology. 31(8): 51-62, 65. August 2007.
This article considers the clinical ramifications of the intestinal malabsorption of fructose and other short-chain carbohydrates, including fermental oligosaccharides, disaccharides, and polyols, collectively known as FODMAPs. Some of these are fructose, lactose, polyols, and galactans. The authors note that symptoms of pain, flatulence, bloating, constipation, and/or diarrhea commonly present in various gastrointestinal disorders and may be attributed to the malabsorption of FODMAPs. FODMAPs are theoretically attractive targets for dietary change due to their high osmotic activity and rapid fermentability, leading to luminal distention and the potential for subsequent symptom induction in those patients with less adaptable bowels or visceral sensitivity. The authors note there is little in the conventional medical literature dealing with this issue. They propose a global approach to the reduction of dietary FODMAPs and review the current evidence that supports this approach’s effectiveness in relieving symptoms in the majority of people with functional gut disorders. A final section answers commonly asked questions that may be prompted by the low-FODMAP-diet approach. 1 figure. 8 tables. 33 references.
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Gourmet Colon Prep. Practical Gastroenterology. 31(11): 41-42, 47-57. November 2007.
This article reviews the current diet regimens used during bowel preparation for colonoscopy and offers suggestions for dietary measures that may make the bowel preparation more tolerable and thus ultimately more successful. The authors summarize selected commercially available colonoscopy preparations and their accompanying manufacturer diet and liquid recommendations. The authors review clinical trials addressing some alternative regimens for bowel preparation. Specific topics include the clear liquid diet, the use of lactose-free, fiber-free nutritional supplements, low-residue diet options, sample menus, preparations for patients who have an ileostomy or jejunostomy, and tips for improving acceptability. The authors conclude that liberalizing the preprocedure diet may not only decrease hunger during the preparation period but can also decrease the patient’s dread of such a long period without food. Emphasizing the importance of adequate fluid intake to prevent dehydration is valuable, and providing a variety of options for the liquid diet may be helpful. 11 tables. 13 references.
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Holistic Healing for Dairy Discomfort. Today's Dietitian. 9(11): 12-13. November 2007.
This article reminds dietitians of the problems associated with lactose intolerance, a sensitivity to milk and milk products that can result in diarrhea, nausea, abdominal cramps, bloating, and gas. The author discusses the increased incidence of lactose intolerance in specific ethnic groups, geographic factors, how to promote and manage overall gut health in people with lactose intolerance, desensitizing the gut to lactose through regular intake, the connections between celiac disease—gluten intolerance—and lactose intolerance, temporary episodes of lactose intolerance, complications of inadequate calcium consumption, osteoporosis and its prevention, and utilizing dairy sources that are easier to digest than milk. The author stresses that increased knowledge about the background and management of lactose intolerance allows professional dietitians to better educate their clients, help them comprehend their condition, and incorporate management strategies beyond eliminating milk and dairy products.
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Lactose Intolerance: Testing and Challenges. Today's Dietitian. 9(7): 24, 26. July 2007.
Older adults generally have decreased levels of lactase, which can result in increased frequency of suspected lactose intolerance among long-term care (LTC) residents. In addition, there are some differences in prevalence in different groups: lactose intolerance affects 80 percent of African Americans, 80 to 100 percent of American Indians, and 90 to 100 percent of Asians. This article reviews the diagnostic and screening tests that may be used to diagnose lactose intolerance. Lactose intolerance is often characterized by bloating, flatulence, abdominal pain, and diarrhea. The tests reviewed include the hydrogen breath test, the lactose tolerance test, and the stool acidity test. A final section considers the interplay between osteoporosis and lactose intolerance, focusing on the need for a diet that is adequate in calcium and vitamin D without including milk and dairy products. One sidebar lists recommended steps to the successful control of lactose intolerance. 3 references.
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Lactose Intolerance: What You Need to Know. Intolerancia a La Lactosa : Lo Que Usted Debe Saber. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 4 p.
This fact sheet familiarizes readers with lactose intolerance, defined as an inability to digest foods with lactose in them. Lactose is the sugar found in milk and foods made with milk. Written in a question-and-answer format, the fact sheet describes the symptoms of lactose intolerance, dietary strategies to use to cope with lactose intolerance, the importance of reading food labels, and the use of lactase enzyme drops or tablets. A final section explains how to contact the National Digestive Diseases Information Clearinghouse (NIDDK) for more information. This fact sheet is from the NIDDK Awareness and Prevention Series. The fact sheet is presented in English and Spanish (2 pages each).
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Meal Replacement Products for People With Diabetes. Today’s Dietitian. 9(10): 35-38, 40. October 2007.
This article describes the use of meal replacement products (MRPs) in diabetes meal planning, particularly for those people with diabetes who are working to lose weight. The author notes that MRPs can be used by most people with diabetes, not only for safe and effective weight loss, but also for a quick balanced meal or to add extra nutrients during times of special need. MRPs come in many different forms: multiflavored shakes, bars, puddings, and powders. Most are lactose-free and gluten-free and have different types of artificial sweeteners. The author cautions that not all MRPs are suitable for people with diabetes and not all are designed for weight loss. One table summarizes the guidelines for selecting MRPs that will be appropriate for diabetes and weight loss. Another table offers both a 1,200-calorie sample meal plan and a 1,500-calorie sample meal plan that incorporate MRPs. The author concludes by reminding readers that successful, long-term weight management requires a lifelong commitment to a healthful lifestyle, behaviors emphasizing sustainable and enjoyable eating practices, and daily physical activity. 4 tables.
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Dietary Nutritional Recommendations for Patients with Dumping Syndrome (Rapid Gastric Emptying). Digestive Health Matters. 15(02): 15 p. Summer 2006.
This article presents dietary and nutritional recommendations for patients who are coping with dumping syndrome, or rapid gastric emptying. Dumping syndrome is a collection of symptoms that occur when food is emptied too quickly from the stomach, filling the small intestine with undigested food that is not adequately prepared to permit efficient absorption of nutrients in the small intestine. Dumping syndrome is most common in patients who have undergone gastrectomy, the surgical removal of part or all of the stomach. The author reviews the symptoms and diagnosis of the condition and notes that dietary therapy is usually the initial line of treatment. Guidelines include eating smaller, more frequent meals; choosing foods that are already less solid, such as hamburger rather than steak; limiting fluid consumption during meals; avoiding nutrient-rich drinks; eating fewer simple sugars; eating more complex carbohydrates and foods high in soluble fiber; increasing the amount of dietary fats and protein; and trying lactose-free milk. The author emphasizes that most patients have relatively mild symptoms and respond well to dietary changes. A brief final section reviews some of the medications that may also be recommended for patients with rapid gastric emptying.
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Dietary Treatment of Gastrointestinal Diseases. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 63-76.
This chapter about the dietary treatment of gastrointestinal (GI) diseases is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the GI tract. The author defines medical nutrition therapy (MNT) as diet modification, nutrient supplementation, nutrition support, and nutrition counseling as modes of therapy for disease. The chapter focuses on dietary modifications that are used to treat hospitalized or ambulatory patients with diseases of the mouth, esophagus, stomach, intestine, liver, and pancreas. The chapter covers modifications in consistency, including the clear liquid diet, the soft low-residue diet, mechanically altered diets, and the liquid diet following oral surgery; a diet for gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD); a diet following gastrectomy, including dietary modifications for dumping syndrome, and those for gastric bypass or gastric stapling for obesity; a diet for lactose intolerance or hypolactasia; a gluten-restricted diet for celiac disease; MNT for inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, and the role of foods or dietary patterns in the etiology of IBD; a diet for ileostomy and colostomy; a diet for short bowel syndrome; a diet for acute and chronic pancreatitis; a diet to control diarrhea; a diet for constipation and diverticulosis; and sodium and protein restricted diets for liver disease, including concerns about ascites and sodium intake, and the use of protein restriction and branched chain amino acid formulas in patients with chronic liver disease and hepatic encephalopathy. The author concludes by cautioning that these diets should be used with moderation, particularly when they do not provide all nutrients. They may exacerbate existing nutrition problems and malabsorption, altered metabolism, and increased secretory losses of nutrients. 4 tables. 95 references.
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Food Allergies. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 97-108.
This chapter about food allergies is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The authors describe the problem when food proteins, although indispensable for life, become harmful when recognized by the immune system as foreign antigens. When this happens, food proteins trigger an abnormal immune response and subsequently an inflammatory reaction, which can vary in extent and duration. Allergic reactions to food frequently occur in early childhood and disappear spontaneously within the first 4 to 6 years of life. The authors define adverse reactions to food (ARF), noting that they are caused by a variety of mechanisms, with only about a third of the reactions in children and 10 percent of those in adults being due to an abnormal immunological reaction to food. The chapter reviews the cellular and molecular mechanisms of food allergy; the biochemistry of food allergens; the clinical classification of food allergy, notably non-GI manifestations, GI manifestations, latex-food allergy syndrome, food protein enteropathy and food protein enterocolitis or proctitis, and eosinophilic esophagitis and gastroesophageal reflux disease (GERD); nonimmune ARF, including pseudoallergic and pharmacologic reactions, lactose intolerance, psychological intolerance, and physiological food intolerance; and diagnosis and treatment strategies. The authors conclude with a brief discussion of a new understanding of the role of innate defense systems and the gut microflora, which have opened exciting new therapeutic options such as the use of probiotic bacteria for treatment and prevention of food allergy. 3 tables. 95 references.
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Guidelines for a Gluten-Free Lifestyle. 4th ed. Studio City, CA: Celiac Disease Foundation. 2006. 58 p.
This booklet provides guidelines for people following a gluten-free diet, which is usually used to treat celiac disease (CD), a condition characterized by gluten intolerance. The introductory material outlines the goals and activities of the Celiac Disease Foundation, a nonprofit, public benefit corporation dedicated to providing services and support regarding CD and dermatitis herpetiformis (DH) through programs of awareness, education, advocacy, and research. The author discusses the basics of CD and describes what happens when gluten is ingested, related conditions or complications that can result from untreated CD, the clinical features of CD, the symptoms of DH, diagnostic approaches including blood tests and genetic testing, the relationship between CD and diabetes mellitus, how to locate a health care provider who is knowledgeable about CD, the physiology of intestinal gluten sensitivity, the need for a lifelong gluten-free diet, allowed and disallowed foods on a gluten-free diet, concerns about oats and cross-contamination, the role of medications and how to find out if they are gluten-free, the differences between allergy and intolerance, wheat intolerance versus gluten intolerance, the link between CD and lactose intolerance, how to begin a gluten-free diet, shopping hints, preparing the pantry, reading food labels, and avoiding food contamination. The bulk of the booklet consists of lists and charts of foods and food items and practical guidance on how to live well on a gluten-free diet, including sample menus. The booklet concludes with a list of references; a list of additional resources, including website addresses; a glossary of terms; and an appendix that lists allowable gluten-free ingredients alphabetically. 3 figures. 2 tables. 31 references.
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How to Get the Nutrients You Need. IN: Thompson, T. Celiac Disease Nutrition Guide: Gluten-Free Survival Skills. Chicago, IL: American Dietetic Association. 2006. pp 19-24.
A gluten-free diet should be based on whole grain or enriched grain foods, as well as fresh, frozen, unprocessed, or lightly processed vegetables, fruits, milk products (or nondairy equivalents), and protein foods. This chapter on getting proper nutrients on a gluten-free diet is from a booklet designed to be a resource for people with newly-diagnosed celiac disease who are undertaking a gluten-free diet for the treatment of their disease. Celiac disease is a genetically inherited autoimmune disease characterized by sensitivity to proteins found in the grains wheat, rye, and barley. When these grains are eaten by a person with celiac disease, they trigger an immune response that damages the lining of the small intestine. In this chapter, the author first considers the use of MyPyramid, developed by the U.S. Department of Agriculture, to help choose foods that provide appropriate daily nutrients. Readers are referred to the government website for more information (www.mypyramid.gov). The rest of the chapter considers specific nutrients and how a gluten-free diet may impact each. Topics include foods that are rich in B vitamins, iron, and fiber; the use of enriched gluten-free whole grain foods and where to obtain them; the differences in nutrient content between enriched and unenriched foods; and calcium and lactose intolerance, including secondary lactose intolerance that may resolve after the use of a gluten-free diet. Readers are encouraged to access the National Digestive Diseases Information Center Clearinghouse website for more information about lactose intolerance (www.niddk.nih.gov/health/digest/pubs/lactose/lactose.htm).
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Lactose Intolerance. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2006. 8 p.
Lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk. This condition affects between 30 and 50 million Americans. It results from a shortage of the enzyme lactase, which breaks down milk sugar into simpler forms that can be absorbed into the bloodstream. This fact sheet describes the symptoms, diagnosis, and treatment of lactose intolerance. Other issues addressed include calcium needs and hidden lactose. The fact sheet includes a chart of the calcium and lactose content in common foods, a diagram of the digestive system, and a brief list of resource organizations for readers needing additional information. The fact sheet concludes with a brief description of the National Digestive Diseases Information Clearinghouse. 2 figures. 2 tables.
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Lactose Intolerance: What You Should Know. Leawood, KS: American Academy of Family Physicians. 2006. 2 p.
This patient education fact sheet reviews the basics of lactose intolerance, a condition that results in problems digesting milk, cheese, and other dairy products. This condition is most common in people of Asian, American Indian, Hispanic/Latino, South American, or African American heritage. The fact sheet reviews the causes of lactose intolerance, the symptoms of lactose intolerance, treatment options, and where to get additional information—contact information for the National Digestive Diseases Information Clearinghouse is provided. The main problems caused by lactose intolerance in adults are gas, stomach cramps and bloating, and diarrhea. Some people with lactose intolerance can safely eat and drink small amounts of dairy products, others cannot have any at all without experiencing symptoms. Treatment entails making changes in one’ s diet to help digest milk or getting one’ s calcium needs from other foods besides dairy products. The fact sheet includes a blank section for readers to make notes or for health care providers to provide individualized information.
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Nutrition and the Gluten-Free Diet. IN: Gluten-Free Diet: A Comprehensive Resource Guide. Expanded Edition. Regina, Saskatchewan: Case Nutrition Consulting. 2006. pp. 73-126.
This chapter on nutrition is from a book designed to provide practical information, in an easy-to-access format, about celiac disease and the gluten-free diet that is used to manage the disease. The author notes that many people with celiac disease focus on the important issue of eating only gluten-free foods, but may lack information and inclusion of nutritional concerns, which are also vital. This chapter covers specific dietary concerns, how to use nutritious gluten-free alternatives, guidelines for healthy eating, as well as the nutritional composition of a variety of gluten-free ingredients and foods. Specific nutritional concerns discussed include anemia, iron, folate, vitamin B12, bone disease, calcium, vitamin D, lactose intolerance, and dietary fiber. The author reviews nutritious gluten-free alternative grains, including amaranth, buckwheat, flax, mesquite, millet, Montina (Indian ricegrass), quinoa, sorghum, teff, and wild rice. For each, the chapter notes handling and preparation, nutritional contents, and references for additional information. The final section considers dietary guidelines for healthy eating on a gluten-free diet. References are included in each of the sections of the chapter. 43 tables.
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Small and Large Intestines. IN: Digestive Disorders 2005. Palm Coast, FL: Medletter Associated. pp 24-29. 2005.
This lengthy section on the small and large intestines is from a White Paper on digestive disorders, including conditions that affect the esophagus, stomach, gallbladder, bile ducts, small intestine, and large intestine. This chapter covers normal anatomy of the small and large intestines; the examination of the colon and rectum, including barium enema, sigmoidoscopy, colonoscopy, virtual colonoscopy, and capsule endoscopy; and the causes, symptoms, diagnosis, and treatment of constipation, diverticulosis and diverticulitis, diarrhea, celiac disease (gluten intolerance), Crohn's disease, ulcerative colitis, irritable bowel syndrome, hemorrhoids, anal fissure, and colorectal cancer. Numerous sidebars cover some topics in greater detail: research on the clinical utility of virtual colonoscopy, specific foods and a suggested menu for people on a clear liquid diet, strategies for living with lactose intolerance, understanding changes in color of the feces (stool), the interrelationship between appendectomy and the risk of ulcerative colitis, the grains that are safe for people on a gluten-free diet (for celiac disease), a drug used in Crohn's disease that may reverse or delay the formation of fistulas, travel tips for people with inflammatory bowel disease (IBD), the risks associated with eating red meat and drinking alcohol for people with colitis, the impact of depression on IBD flare-ups, quality of life issues in irritable bowel syndrome (IBS), coping with pruritus ani (anal itching), the risks of colorectal cancer associated with a high-glycemic diet (one that includes a lot of simple and complex sugars), how high doses of aspirin may fight colon polyps, a new anticancer drug (Avastin, bevacizumab) used for metastatic colorectal cancer, laparoscopic surgery for colon cancer, and how colon cancer is staged. One illustration outlines the parts of the lower digestive system and the diseases or conditions that can affect each part. One chart summarizes the drugs used for IBD.
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Specific Carbohydrate Diet: Does it Work?. Take Charge. p 12-19. Summer 2005.
This article reviews the available facts on the specific carbohydrate diet (SCD) and offers a variety of perspectives to help readers navigate its complexities and form their own opinions as to its value for treating inflammatory bowel disease (IBD, including ulcerative colitis and Crohn's disease). The author first discusses the physiological theory behind the SCD, and defines the SCD as a grain-free, lactose-free, and sucrose-free meal plan that is several degrees more restrictive than the gluten-free diet. The author then lists exactly what foods would be permitted, with some critique from a gastroenterologist who points out inconsistencies in the food plan. The article goes on to elaborate on the concerns about SCD: the diet is hard to follow and there is little scientific evidence to show whether it is truly effective or which patient population it helps. The author addressed the need for additional research in this area, commenting on the lack of funding for this particular type of research. Other topics discussed include concerns for potential harm caused by the SCD, particularly in children who may be underweight or malnourished, and the psychological stresses brought on by such a restrictive diet. The author concludes that the decision to go on the SCD should be discussed between the patient, the physician, and the nutritionist on the team.
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Yogurt and Yogurt Drinks. Diabetes Self-Management. 22(4): 52-58. July-August 2005.
Yogurt is a nutrient-dense food that contains good amounts of protein, calcium, magnesium, phosphorus, riboflavin, and vitamins B6 and B12. Yogurt also contains live bacteria cultures. This article describes yogurt and yogurt drinks and their possible role in a healthy diet plan for people with diabetes. The author stresses that yogurt is a nutritious food choice, but some varieties are high in added sugars and saturated fat. The author defines yogurt, discusses serving sizes and styles, the different varieties available, the nutrients in yogurt, carbohydrate in yogurt (lactose), and special ingredients that are added to some yogurts, including dietary fiber and phytosterols. The article concludes with a lengthy, detailed chart of many brand names of yogurts, with their serving size, calories, fat, calories from fat, saturated fat, sodium, carbohydrate, fiber, and protein levels noted.
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Guidelines for a Gluten-Free Lifestyle. Studio City, CA: Celiac Disease Foundation. 2004. 57 p.
This booklet provides guidelines for people following a gluten-free diet (often due to celiac disease, which is characterized by gluten intolerance). The introductory material outlines the goals and activities of the Celiac Disease Foundation, a nonprofit, public benefit corporation dedicated to providing services and support regarding celiac disease (CD) and dermatitis herpetiformis (DH), through programs of awareness, education, advocacy, and research. The remainder of the book, written in question and answer format, reviews the basics of CD and describes what happens when gluten is ingested, related conditions or complications that can result from untreated CD, the clinical features of CD, the symptoms of DH, diagnostic approaches, the interrelationship between CD and diabetes mellitus, how to locate a health care provider who is knowledgeable about CD, the need for a lifelong gluten-free diet, allowed and disallowed foods on a gluten-free diet, the role of medications (and how to find out if they are gluten-free), the differences between allergy and intolerance, wheat intolerance versus gluten intolerance, the link between CD and lactose intolerance, shopping hints, preparing the pantry, avoiding food contamination, tips for dealing with CD in an infant or young child, and how to deduct gluten-free foods as a medical expense on taxes. The bulk of the booklet consists of lists and charts of foods and food items and practical guidance on how to live well on a gluten-free diet, including sample menus. The booklet concludes with a list of references, a list of additional resources (including web site addresses), a glossary of terms, and an appendix that lists allowable gluten-free ingredients alphabetically. 2 figures. 2 tables. 30 references.
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Lactose Intolerance and Your Child. Chicago, IL: American Academy of Pediatrics. 2004. 4 p.
Lactose is the sugar found in milk and other dairy products. Lactase is a natural enzyme made in the intestinal tract that digests lactose. When there is not enough lactase in the body, lactose that is eaten is not digested and stays in the intestine, causing gas, bloating, stomach cramps, and diarrhea. This brochure helps parents understand lactose intolerance in children. The author emphasizes that lactose intolerance is completely different from milk allergy, which involves the immune system. The brochure discusses the symptoms of lactose intolerance, who tends to get this condition, temporary lactose intolerance in infants, diet therapy to diagnose lactose intolerance (removal of dairy foods from the child's diet), other foods that may contain lactose, diagnostic tests that may be used to confirm lactose intolerance, and strategies for coping with lactose intolerance (including the addition of over-the-counter lactase). One side bar lists other good dietary sources of calcium. The brochure concludes with a brief section of information about the American Academy of Pediatrics (AAP). 1 table.
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