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Powerful Nutrient Cocktail Can Put Kids with Crohn's into Remission
June 17, 2009Treating children with inflammatory bowel disease (IBD) usually involves the same steroids-based medication prescribed to adults. But such treatments can have negative side effects for kids and teens dealing with IBD.
Dr. Raanan Shamir of Tel Aviv University's Sackler School of Medicine and Schneider Children's Medical Centre shows that there is another path to treating IBD in children: a nutritional formula that was first developed for astronauts. This supplement puts 60-70% of children with Crohn's disease, a common IBD disorder, into remission - a success rate similar to that of traditional steroid-based drugs, but without side effects like malnutrition and growth retardation.
Dr. Shamir recently reported his research in the Journal of Pediatric Gastroenterology and Nutrition.
Eating Like an Astronaut
Dr. Shamir's research was inspired by the problem of malnutrition and growth retardation in children battling IBD. Steroids and other biological agents, the most common treatment for IBD, were having an adverse affect on the children's growth, despite their effectiveness in adult patients.
It was a problem first tackled by NASA: How could astronauts most efficiently get their daily nutrients? The answer was a specially-designed powder that contains all the daily nutrients a person needs. Aboard spacecrafts, astronauts dine on this nutritional powder mixed with water. Since then, these powders have become a common item on the pharmacy shelf.
A similar concept works wonders for children suffering from IBD. "Prepared powder, with liquids, gives you all the nutritional requirements you need for the day," Dr. Shamir explains. "We don't know why these formulas work, and nobody has shown that any one formula is preferable to another. People have to be committed and eat nothing else during the period of time they are on nutrition therapy, and it is difficult to do - but if they do it, they go into remission."
To induce remission, children need to be on nutrition therapy for 6-8 weeks. And in order to maintain remission, 25-50% of their caloric intake must be supplied by nutrition therapy, sometimes for years. This is why children experiencing the treatment need the support of physicians, dieticians, psychologists, and of course their families.
Dr. Shamir's quest to educate the international medical community about the benefits of nutrition therapy has been an uphill battle. "The acceptance of this is difficult," he says. "You have to persuade the family. Not all physicians know it works, and it's much easier to give someone a prescription than try to work with the child."
A Replacement for Steroids
"In adults, studies have shown that steroids are more effective in the battle against IBD than nutrition-based therapies. I think it is easier to get compliance from children, especially when it involves their growth. For adults, growth is not a concern - they just want to feel better," explains Dr. Shamir.
Dr. Shamir and his team of researchers have worked to show the international medical community that nutrition was equal to steroids in the treatment of children with IBD. "We published the most recent meta-analysis to show that nutrition is as good as steroids as a first-line therapy for Crohn's disease," he says.
The next step in his research, says Dr. Shamir, is to "define exactly the role of nutrition in inducing remission in these patients, and the role of nutrition in maintaining remission.
American Friends of Tel Aviv University
Eating Like an Astronaut
Dr. Shamir's research was inspired by the problem of malnutrition and growth retardation in children battling IBD. Steroids and other biological agents, the most common treatment for IBD, were having an adverse affect on the children's growth, despite their effectiveness in adult patients.
It was a problem first tackled by NASA: How could astronauts most efficiently get their daily nutrients? The answer was a specially-designed powder that contains all the daily nutrients a person needs. Aboard spacecrafts, astronauts dine on this nutritional powder mixed with water. Since then, these powders have become a common item on the pharmacy shelf.
A similar concept works wonders for children suffering from IBD. "Prepared powder, with liquids, gives you all the nutritional requirements you need for the day," Dr. Shamir explains. "We don't know why these formulas work, and nobody has shown that any one formula is preferable to another. People have to be committed and eat nothing else during the period of time they are on nutrition therapy, and it is difficult to do - but if they do it, they go into remission."
To induce remission, children need to be on nutrition therapy for 6-8 weeks. And in order to maintain remission, 25-50% of their caloric intake must be supplied by nutrition therapy, sometimes for years. This is why children experiencing the treatment need the support of physicians, dieticians, psychologists, and of course their families.
Dr. Shamir's quest to educate the international medical community about the benefits of nutrition therapy has been an uphill battle. "The acceptance of this is difficult," he says. "You have to persuade the family. Not all physicians know it works, and it's much easier to give someone a prescription than try to work with the child."
A Replacement for Steroids
"In adults, studies have shown that steroids are more effective in the battle against IBD than nutrition-based therapies. I think it is easier to get compliance from children, especially when it involves their growth. For adults, growth is not a concern - they just want to feel better," explains Dr. Shamir.
Dr. Shamir and his team of researchers have worked to show the international medical community that nutrition was equal to steroids in the treatment of children with IBD. "We published the most recent meta-analysis to show that nutrition is as good as steroids as a first-line therapy for Crohn's disease," he says.
The next step in his research, says Dr. Shamir, is to "define exactly the role of nutrition in inducing remission in these patients, and the role of nutrition in maintaining remission.
American Friends of Tel Aviv University
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Probiotic Found to Be Effective Treatment for Colitis In Mice
The probiotic, Bacillus polyfermenticus, can help mice recover from colitis, a new study has found.
The bowels of infection
Current research suggests that latent cytomegalovirus (CMV) infection may exacerbate inflammatory bowel disease (IBD). The related report by Onyeagocha et al, "Latent cytomegalovirus infection exacerbates experimental colitis," appears in the November 2009 issue of The American Journal of Pathology.
Discovery of genetic defect may lead to better treatments for common gut diseases
New findings related to an uncommon genetic disorder may impact the diagnosis and treatment of inflammatory bowel disease (IBD), the most common chronic gastrointestinal illness in children and teens. Two million Americans have IBD which involves inflammation of the gastrointestinal tract.
Pitt researchers net $5 million from NIH to explore better ways to grow cells for regenerative medicine
Regenerative medicine researchers at the University of Pittsburgh received two grants totaling more than $5 million from the National Institutes of Health (NIH) to explore new methods for cultivating replacement cells from existing tissues and organs.
Visionary concept earns La Jolla Institute scientist prestigious NIH Pioneer Award
A scientist at the La Jolla Institute for Allergy & Immunology has received one of the National Institutes of Health (NIH)'s top awards -- the 2009 NIH Director's Pioneer Award.
Promising new target emerges for autoimmune diseases
University of Michigan scientists say they have uncovered a fundamentally new mechanism that holds in check aggressive immune cells that can attack the body's own cells.
Antimicrobial antibodies in celiac disease: Trick or treat?
Anti-microbial antibody formation has been reported in celiac disease.
Budesonide is not beneficial for the treatment of diarrhea in metastatic melanoma patients
Patients with stage III or IV melanoma taking ipilimumab and the oral steroid budesonide to reduce side effects did not have less diarrhea, a known side effect of ipilimumab.
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