It was reported this week in the journal Nature that UK and Dutch scientists believe they may have found a way to make it easier to target and prevent bowel cancer

When genetic damage was inflicted on stem cells from the intestines of mice, the result was a speedy transformation into fast-growing tumours.

Cancer Research UK said it was a "leap forward" in understanding bowel cancer.

Patients with ulcerative colitis need to be regularly monitored for bowel cancer, but it can often feel like one is waiting for bad news.

The research indicates that the inflammatory processes of Ulcerative Colitis could be causing gentetic damage to stem cells in the intestines.  Further research is needed to prove whether this mechansim indeed takes place in humans. 

Scientists want to know what event causes a normal, healthy bowel cell to turn cancerous and start to form tumours.

First of all, however, they have to identify which cells within the intestine are vulnerable to cancerous changes.

All cell types in the colon arise from stem cells - so-called "master cells" - which can form a variety of different tissue types.

When a stem cell divides in two, one half becomes another stem cell, while the other "daughter" cell has begun the transformation into the cell needed to form another tissue type.

A key question is whether cancer starts back at the stem cell change, or later on, in one of the cell types it produces.

The research by the Beatson Institute in Glasgow, Cardiff University, and the Hubrecht Institute in the Netherlands, isolated intestinal stem cells in mice, then "knocked out" a specific gene called APC from them.

The APC gene is described as a "tumour suppressor gene" and plays a role in regulating the way a cell divides.

'Seek and destroy'

Within days, the stem cell populations had started to form tumours. When the same technique was applied to non-stem cell "daughter" cells, far fewer tumours were formed.

This points the finger clearly at stem cells as a primary source of bowel cancer changes.

Professor Hans Clevers, from the Hubrecht Institute, said: "We are very excited by these findings but we need to establish whether the stem cells will behave the same way in human cancers as they do in mice."

Dr Owen Sansom, from the Beatson Institute, added: "We are now looking to understand how we can use these results to seek out and destroy stem cells that are lacking the APC gene."

Dr Lesley Walker, from Cancer Research UK, said: "As in most cancers, the cell that the cancer originates from has remained elusive in bowel cancer.

"So this work is a big leap forward in our understanding of the origins of the disease."

Results released today by pharmaceutical firm Novartis on the development of an oral pill for multiple sclerosis (MS) show that the drug can significantly reduce the number of relapses people experience compared to interferon beta-1a.

FTY720 (or Fingolimod) is an oral therapy that is currently being tested in a series of clinical trials as a potential treatment for relapsing-remitting MS.

The trial involved two doses of FTY720 - 0.5mg and 1.25mg. Those on the 0.5mg dose experienced on average 52 per cent fewer relapses than those on interferon beta-1a, and those on the 1.25mg dose experienced 38 per cent fewer.

The results released today were interim results from the TRANSFORMS study, a phase III or late stage clinical trial for people with relapsing remitting MS.

The pill is taken once a day and works by suppressing lymphocytes - a particular part of the immune system which is thought to be involved in causing damage to the central nervous system in people with multiple sclerosis.

MS Society Research Manager, Doug Brown, said: "An alternative to regular injections will be welcome relief for people living with MS.

"These results are very positive, and we look forward to the day when an effective and safe oral pill is available."

Final results from this trial and two other phase III trials also looking at FTY720 are expected during 2009.

Read more about Fingolimod on the MS Society's Research News Pages

Sourced from MS Society news

Scientists have uncovered vital clues about how to treat serious bowel disorders by studying the behaviour of cells in the colon.

Researchers at the University of Edinburgh believe a chemical messenger that is essential for developing a baby's gut in the womb could hold the key to new treatments for inflammatory bowel disease (IBD), a condition which affects 1 in 250 people in the UK.

The team studied a chain of chemical reactions inside colon cells, called the Hedgehog signalling pathway, which controls the way it behaves and communicates with other cells.

The researchers found that some patients with IBD inherit a defective copy of one of the important links in this chain, a gene called GLI1. This defective GLI1 is only half as active as normal. Additionally, the Hedgehog pathway itself signals at lower levels than normal when the large bowel is inflamed.

The results suggest that the GLI1 protein may calm inflammation within the healthy colon, and that this process appears to go wrong in IBD patients, causing their gut to become inflamed.

The researchers now hope to test whether strengthening this weakened protein will help to prevent or treat inflammatory bowel diseases like Crohn's disease and ulcerative colitis.

Dr Charlie Lees from the University's Institute of Genetics and Molecular Medicine, who led the study, said: "Everybody has billions of bacteria in the gut, the vast majority of which do us no harm. Our body's natural immune responses identify and eliminate harmful bacteria, whilst living in harmony with the healthy bacteria. But in people with inflammatory bowel disease, that response goes wrong and an over-active immune response against these healthy bacteria leads to chronic inflammation in the gut.

"It now seems that the Hedgehog signalling pathway, and specifically the GLI1 protein, is crucial to that response. We think it provides an important signal to certain types of immune cells in the gut wall, instructing them to adopt an anti-inflammatory state. If we can find ways to bolster these responses in people with IBD, we may be able to help prevent the painful attacks which are so devastating to patients."

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Article adapted by Medical News Today from original press release.

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The research was carried out in collaboration with the Universities of Michigan (USA), Cambridge, and the Karolinska University Hospital and is published in the Journal of the Public Library of Science (PLoS) Medicine. Click here to view.

Source: Ronnie Kerr

University of Edinburgh

Article URL: http://www.medicalnewstoday.com/articles/132319.php

Harmony Cuisine advocates the charter presented by Colitis UK to assist people with Ulcerative Colitis.

This charter consists of practical changes to minor legislation that would make a huge difference to the lives of people with Ulercative Colitis.

Colitis UK have drawn up a petition at No.10 Downing Street online.  You can find details of the chater and the petition itself at http://petitions.number10.gov.uk/ColitisCharter/. 

Please visit this site and feel free to put your own name to the petition.

A recent Microsoft report supports Harmony Cuisine's assertion that health related websites should only contain clinically evidenced information that is fully referenced and peer reviewed.  Furthermore, the report highlights how important it is for health websites to present information in a contextually accurate way.

Fear seems to be used by many sites as a sales tool.  Specifically, they tap into the users concerns to try to sell them something they most likely do not need.  Harmony Cuisine abhors this type of approach and is committed to providing information and knowledge in a supportive and positve way.

The report is detailed below and was sourced from the British Society of Gastroenterology.

A team at Microsoft studied health-related Web searches on popular search engines and surveyed 515 employees about their healthrelated searching. They found that health information online is breeding a generation of  cyberchondriacs" - people who needlessly fear the worst diagnosis after surfing the net. Microsoft conducted the study to improve its own search engine.

Roughly 2% of all the Web queries were health-related, and about 250,000 users, or a quarter of the sample, engaged in a least one medical search during the study.

The researchers found Web searches for common symptoms such as headache and chest pain were just as likely or more likely to lead people to pages describing serious conditions as benign ones, even though the serious illnesses are much more rare.

Searching for "chest pain" or "muscle twitches" returned terrifying results with the same frequency as less serious ailments, even though the chances of having a heart attack or a fatal neurodegenerative condition is far lower than having simple indigestion or muscle strain, for example.

New Graded Recommendations Clarify the Clinical Options for Physicians and Patients

Taken from http://www.acg.gi.org//

Irritable Bowel Syndrome (IBS) is one of the most common disorders managed by gastroenterologists. There have been numerous changes in the clinical landscape in recent years and new evidence has emerged on the benefits and risks of drugs used for IBS. The American College of Gastroenterology today published a new evidence-based systematic review on the management of Irritable Bowel Syndrome as a supplement to the January 2009 issue of The American Journal of Gastroenterology.

The College's evidence-based position statement on IBS offers new graded recommendations on testing and treatment of this chronic, recurrent functional disorder of the gastrointestinal tract that affects all aspects of daily life for its sufferers. In order to critically evaluate the rapidly expanding research about IBS and to assess the evidence of efficacy of new IBS drugs, the ACG IBS Task Force performed a comprehensive meta-analysis of the evidence on therapies for IBS.

The College's new recommendations include expert assessments of traditional therapies for IBS, as well as a range of new treatments, including evidence on probiotics; the non-absorbable antibiotic rifaximin; antidepressants; antispasmodics and peppermint oil; fiber, bulking agents and laxatives; antidiarrheals, including loperamide; the 5-HT3 receptor antagonist alosetron; the 5-HT4 (serotonin) receptor agonist tegaserod; the chloride channel activator lubiprostone; psychologic therapies; herbal preparations and acupuncture. The evidence-based review also includes new recommendations about the routine use of diagnostic tests for patients who present with IBS symptoms, as well as food allergy testing and diet in IBS.

"For the gastroenterologist seeing patients with IBS, the new ACG recommendations specify whether or not the range of potential therapies are better than placebo for resolving IBS symptoms," said Lawrence J. Brandt, M.D., MACG, Chair of the ACG IBS Task Force.

"The College's graded recommendations on IBS take into account the quality of the evidence, such as the strength of study design, and the magnitude of benefit of different treatments. The benefits of treatment must be balanced against any potential risks," explained Dr. Brandt.

"This new meta-analysis of the literature on the diagnosis and therapy of IBS offers physicians the opportunity to make clinical decisions about IBS based on a thorough assessment of the evidence," explained ACG President Dr. Eamonn M.M. Quigley, one of the contributors to the position statement.

The ACG Evidence-Based Systematic Review on IBS can be accessed at http://www.acg.gi.org/media/releases/ajg_ibs_supp_0109.pdf

Highlights of ACG's New Recommendations on IBS Therapies

In general, treatments for IBS are directed towards the patient's predominant symptoms. There are a wide variety of available therapies, many of which improve individual IBS symptoms. Only a small number of therapies has been shown to be of benefit for global symptoms of IBS.

• Trials suggest psyllium, fiber, certain antispasmodics, and peppermint oil are effective in IBS patients although the quality of the evidence is poor.
• Evidence suggests that some probiotics may be effective in reducing overall IBS symptoms but more data are needed.
• Anti-diarrheals reduce the frequency of stools but do not affect the overall symptoms of IBS.
• 5HT 3 antagonists are efficacious in IBS patients with diarrhea and the quality of evidence is good. Patients need to be carefully selected, however, because potentially serious side effects include constipation and colon ischemia. Current use of alosetron is regulated by a prescribing program set forth by the FDA.
• 5HT 4 agonists are modestly effective in IBS patients with constipation and the quality of evidence is good although the possible risk of cardiovascular events associated with these agents may limit their utility. Currently, there are no 5-HT 4 receptor agonists available for use in North America.
• Tricyclic anti-depressants and selective serotonin reuptake inhibitors have been shown to be effective in IBS patients of all subtypes. The trials generally are of good quality but the limited number of patients included in trials implies that further evidence could change the confidence in the estimate of effect and therefore the quality of evidence was graded as moderate.
• Non-absorbable antibiotics are effective, particularly in diarrhea-predominant IBS.
• The selective C-2 chloride channel activator, lubiprostone, is efficacious in constipation-predominant IBS with a moderate quality of evidence.
• Psychological therapies also may provide benefit to IBS patients although the quality of evidence is poor.
• While available trials of unique Chinese herbal mixtures appeared to show a benefit in IBS, it is not possible to combine these studies into a meaningful meta-analysis. Overall, any benefit of Chinese herbal therapy in IBS continues to be potentially confounded by the variable components used and their purity. Also, there are significant concerns about toxicity, especially liver failure, with use of any Chinese herbal mixture.
• A systematic review of trials of acupuncture for IBS was inconclusive. Further work is needed before any recommendations on acupuncture can be made.
• Patients often believe that certain foods exacerbate their IBS symptoms. There is, however, insufficient evidence that food allergy testing or exclusion diets are efficacious in IBS and their routine use outside a clinical trial is not recommended

New Recommendations on Diagnostic Testing in IBS

Because of the low likelihood of uncovering organic diseases, routine diagnostic testing with complete blood count, serum chemistries, thyroid function studies, stool for ova and parasites, and abdominal imaging should not be routinely performed in patients with typical IBS symptoms and no alarm features. Routine serologic screening for celiac sprue should be pursued in patients with diarrhea predominant IBS and the mixed type of IBS. Lactose breath testing can be considered when lactose maldigestion remains a concern despite dietary modification.

Currently, there are insufficient data to recommend breath testing for small intestinal bacterial overgrowth in IBS patients. Because of the low pre-test probability of Crohn's disease, ulcerative colitis, and colonic neoplasia, routine colonic imaging is not recommended in patients under the age of 50 years with typical IBS symptoms and no alarm features. Colonoscopic imaging should be performed in IBS patients with alarm features to rule out organic diseases and in those over the age of 50 years for the purpose of colorectal cancer screening. The College recommends that African-Americans begin colorectal cancer screening at age 45. When colonoscopy is performed in patients with IBS-D, obtaining random biopsies can be considered to rule out microscopic colitis.

About IBS

For the clinical gastroenterologist, IBS is one of the most commonly seen problems. IBS is characterized by abdominal discomfort associated with altered bowel function; structural and biochemical abnormalities are absent. The pathophysiology of IBS is multi-factorial. Individual symptoms have limited accuracy for diagnosing IBS and the disorder is considered as a symptom complex.

IBS Prevalence and Burden of Illness

• IBS is a prevalent and expensive condition that can significantly impair health related quality of life (HRQOL) and reduce work productivity.
• Epidemiologic studies suggest that 7-10% of people in the general population have IBS worldwide. Community-based studies indicate that IBS-D and IBS-M subtypes are more prevalent than IBS-C, and that switching among subtype groups may occur over time.
• IBS is 1.5 times more common in women than in men.
• IBS is more common in lower socioeconomic groups and more commonly diagnosed in patients younger than 50 years.
• IBS patients make more visits to their physicians, undergo more diagnostic tests, are prescribed more medications, miss more workdays, have lower work productivity, are hospitalized more frequently, and account for greater overall direct costs than patients without IBS.
• Resource utilization is highest in patients with severe symptoms, and poorer HRQOL.

ACG IBS Expert Task Force

• Chair, Lawrence J. Brandt, M.D., MACG, Montefiore Medical Center
• William D. Chey, M.D., FACG, University of Michigan Medical Center
• Amy E. Foxx-Orenstein, D.O., FACG, Mayo Clinic, Division of Gastroenterology
• Eamonn M.M. Quigley, M.D., FRCP, FACG, Cork University Hospital, National University of Ireland at Cork
• Lawrence R. Schiller, M.D., FACG, Baylor University Medical Center
• Philip S. Schoenfeld, M.D., M.Ed., M.Sc., FACG, Veterans Affairs Ann Arbor Healthcare System
• Nicholas J. Talley, M.D., Ph.D., FACG, Mayo Clinic Jacksonville, Department of Internal Medicine
• Brennan M. R. Spiegel, M.D. MSHS, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA
• Statistician-Epidemiologist, Paul Moayyedi, B.Sc., M.B., Ch.B., Ph.D., M.P.H., FRCP (London), FRCPC, FACG, McMaster University Medical Centre, Division of Gastroenterology

Website: http://www.acg.gi.org//

Publication of a Canadian study on colonoscopy's impact on reducing colon cancer deaths suggests a lower impact on mortality than previously reported. Physician experts from the American College of Gastroenterology urge patients and the public to recognize that even if the assumptions and design of this case-control study have produced accurate data, colonoscopy remains the best available option for detection of precancerous colon polyps and the only test with the potential to prevent colorectal cancer by removing these growths.

Taken from www.acg.gi.org

"While colonoscopy is not perfect, the physicians at the American College of Gastroenterology are committed to making a good test even better and patients can take steps to maximize the colonoscopy's potential," said Dr. Eamonn Quigley, ACG President.

"The position of the College is that the training and experience of the endoscopist are critical to a quality colonoscopy," he continued. The College advises patients to seek a well-trained endoscopist who performs many of these tests and has a record of performing a complete examination of the colon.

Gastroenterologists receive special training in colonoscopy and perform more colonoscopies by far than any other specialty. Their training emphasizes attention to detail and incorporates comprehensive knowledge of the entire GI tract to provide the highest quality endoscopy and consultative services. Many GI physicians participate in rating and improvement programs such as the one being piloted by the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy. Such a quality benchmarking program permits gastroenterologists to measure their performance on issues such as reaching the cecum, an anatomical landmark in the colon that represents a thorough exam.

"Beyond the training of the endoscopist, the most important take-away for patients from this study is the essential message of following the instructions on bowel cleansing - the cleanest colon results in the best exam," added Dr. Quigley.

Following doctor's instructions when preparing for the exam is critical. Before a colonoscopy, the colon must be completely clean for the test results to be accurate. The ACG will soon publish a new guideline on colorectal cancer screening that will call for "split preps"-

a regimen for taking the laxatives in two doses that provides the cleanest colon at the time of the exam.

"The College sees significant strengths in the proven benefits of visualizing pre-cancerous growths and removing them in a single examination during colonoscopy," commented Dr. Quigley. "Because of its excellent sensitivity in detecting polyps and its potential for removing them and breaking the sequence of polyp to cancer in a single diagnostic and therapeutic intervention, colonoscopy is one of the most powerful preventive tools in clinical medicine."

Web User, the UK's best selling internet magazine marked the launch of its annual Advent Calendar today with Harmony Cuisine. Harmony Cuisine opens the Christmas celebrations with Web User's online advent calendar. Harmony Cuisine is the first surprise treat behind the 1st of December door with a fantastic 20% discount offer. ‘Web User' are also doing a feature on Harmony Cuisine's website in their December 19th magazine issue.

In October a health report revealed that the credit crunch is actually leading to less people taking time off work due to sickness.  83 per cent of workers reported that the credit crunch was impacting them and 42 per cent reported that they would be less likely to take time off work during an economic slowdown.  The research suggests that this is largely due to people being afraid of losing their jobs.

The credit crunch also seems to have impacted on employers' responses to sick staff.  Research conducted during August by HSA suggested that a third of employers are putting unnecessary pressure on staff to work during their time off sick.

It is clear to Harmony Cuisine that these statistics demonstrate a requirement for both employees and employers' needs to be met.  If employees work while they are sick they will generally underperform, make mistakes (creating rework for others) and quite possibly pass any contagions to other employees, thus creating a vicious circle that ultimately results in a financial cost to both parties.

Employees with long-term conditions can often be more susceptible to opportunistic infections.  Harmony Cuisine's system can support employees to maintain a good health status by providing them with the practical knowledge and tools needed to eat appropriate nutrition.

Employees are given the opportunity to take control of their condition rather than having it control them.  This is inspiring and motivating and creates a positive experience that enables employees to be productive.

If you'd like to find out more please feel free to contact us. 

Harmony Cuisine and GlaxoSmithKline will be working together to demonstrate the value of providing a 'locus of control' to employees.  This will help enable employees to take control of their conditions rather than having their conditions control them.

Harmony Cuisine will be incorporating depression, stress and anxiety into its knowledge base and recipe system as part of the project.  This will expand on the flexibility and scope of our Unique to You system and add to the benefits it contributes to an organisation.  The system already incorporates Crohns, Ulcerative Colitis, Coeliac Disease, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and Multiple Sclerosis.

Employees with long-term conditions or caring for those with long-term conditions are put under immesne pressures to operate effectively at work whilst maintaining good health.  This puts pressures on an organisation's absenteeism, presenteeism, employee engagement and morale.

GSK have recognised that the Harmony Cuisine system could help to address these in a unqiue and innovative way whilst also supporting its ongoing accomplishments as an employer of choice.

Harmony Cuisine is thrilled that an organisation such as GSK has acknowledged the innovation and potential of our unique service.

We'll keep you informed as the project progresses.....