Health Research Report 19 AUG 2013 – Video

 

Topics:

Sugar is Toxic, Doubles the Death rates in mammals * Aug 13 Journal of Nature Communications

6 Months of Fish Oil Reverses liver disease in Children * Online Journal of Parenteral and Enteral Nutrition — The Fish Oil report took extra time primarily because of two factors 1. The Soybean oil they give children causes Intestinal failure and liver disease

2. Insurance Companies will not cover Fish Oil because it is considered to expensive and experimental

3. Plus a few other reasons to they let children suffer and die because of bureaucracy.

 

Linked the Full Study as is…Please Read

 

Contact: Amy Albin aalbin@mednet.ucla.edu 310-794-8672 University of California – Los Angeles Health Sciences

6 months of fish oil reverses liver disease in children with intestinal failure, study shows

Children who suffer from intestinal failure, most often caused by a shortened or dysfunctional bowel, are unable to consume food orally. Instead, a nutritional cocktail of sugar, protein and fat made from soybean oil is injected through a small tube in their vein.

For these children, the intravenous nutrition serves as a bridge to bowel adaptation, a process by which the intestine recovers and improves its capacity to absorb nutrition. But the soybean oil, which provides essential fatty acids and calories, has been associated with a potentially lethal complication known as intestinal failure–associated liver disease, which may require a liver and/or intestinal transplant. Such a transplant can prevent death, but the five-year post-transplant survival rate is only 50 percent.

Previous studies have shown that replacing soybean oil with fish oil in intravenous nutrition can reverse intestinal failure–associated liver disease. However, the necessary duration of fish oil treatment had not been established in medical studies.

Now, a clinical trial conducted at the Children’s Discovery and Innovation Institute at Mattel Children’s Hospital UCLA has found that, compared with soybean oil, a limited duration (24 weeks) of fish oil is safe and effective in reversing liver disease in children with intestinal failure who require intravenous nutrition. The researchers believe that fish oil may also decrease the need for liver and/or intestinal transplants — and mortality — associated with this disease.

The researchers’ study, “Six Months of Intravenous Fish Oil Reverses Pediatric Intestinal Failure Associated Liver Disease,” is published online in the Journal of Parenteral and Enteral Nutrition.

“With this particular study, we set out to determine if a finite period of six months of intravenous fish oil could safely reverse liver damage in these children, and we have had some promising results,” said lead author Dr. Kara Calkins, an assistant professor in the department of pediatrics in the division of neonatology and developmental biology at UCLA. “But because intravenous fish oil is not yet approved by the Food and Drug Administration and is much more costly than soybean oil, it is typically not covered by insurance. As a result, this oil is considered experimental and is currently available only under special protocols. If it proves safe and effective for patients, we hope it would eventually be available for wider use.”

For the study, intravenous soybean oil was replaced with intravenous fish oil in 10 patients between the ages of 2 weeks and 18 years who had advanced intestinal failure–associated liver disease and who were at high risk for death and/or transplant. The researchers compared these subjects with 20 historical controls who had received soybean oil.

Results showed that the children receiving fish oil had a much higher rate of reversal of liver disease than those who received the standard soybean oil. In fact, after 17 weeks of fish oil, nearly 80 percent of patients experienced a reversal of their liver disease, while only 5 percent of the soybean patients saw a reversal.

The next phase of research will involve following children for up to five years after they stop fish oil to determine if their liver disease returns and if transplant rates are truly decreased, the study authors said.

“We are also trying to better understand how fish oil reverses this disease by investigating changes in proteins and genes in the blood and liver,” Calkins said. “These studies will provide the scientific and medical community with a better understanding of this disease and how intravenous fish oil works.”

For Isabella Piscione, who was one of the first patients at UCLA to receive the fish oil treatment under compassionate use, her outcome with the treatment paved the way for researchers to establish the six-month protocol. Because of multiple surgeries due to an obstruction in her intestines, Isabella was left with only 10 centimeters of intestine. She depended on intravenous nutrition for survival, which unfortunately resulted in liver damage.

When Isabella started the fish oil treatment, she was just over 6 months old and was listed for a liver and bowel transplant. Within a month of starting the treatment, her condition started to improve. By six months, her liver had healed, and she no longer needed a transplant.

“We cried tears of joy each week that we saw her getting better and better,” said her father, Laureano Piscione. “She is a success story.”

###

Study co-authors from UCLA included Dr. James Dunn; Dr. Stephen Shew; Laurie Reyen, R.N.; Dr. Douglas Farmer; Dr. Sherin Devaskar; and Dr. Robert Venick.

The study was funded by a grant from a National Institutes of Health (NIH/NCRR M01-RR00865). Calkins has received funding from NIH K12HD00140 and T32G075776. Calkins and Venick have received funding from the Today’s and Tomorrow’s Children Fund.

Intravenous fish oil was purchased with funds from the UCLA Department of Pediatric Surgery, the Women’s Auxiliary Club at UCLA and Dr. James Yoo of the UCLA Department of Surgery.

 

 

For more information on Mattel Children’s Hospital UCLA, visit http://www.uclahealth.org/mattel.

 

6 Months of Fish Oil Reverses Liver Disease

Caption: Isabella was born with short bowel syndrome which meant she could not eat food normally. She was given nutrition intravenously through a food substitute called total parenteral nutrition (TPN). But then, she developed liver damage probably caused by the soybean oil in the TPN. Her condition worsened and she was listed for a liver and bowel transplant. However, the doctors at Mattel Children’s Hospital UCLA offered an experimental treatment under compassionate use that replaced the soybean oil with fish oil. After six months, her liver had healed and she no longer needed a transplant. This photo shows Isabella in October 2009 after her treatment.

Credit: The Piscione family

 

Dr. Kara Calkins, University of California — Los Angeles Health Sciences

Caption: UCLA’s Dr. Kara Calkins and colleagues found that six months of fish oil treatment can reverse liver disease in children with intestinal failure.

Credit: UCLA

6 months of fish oil reverses liver disease in children with intestinal failure, study shows

Contact: Amy Albin aalbin@mednet.ucla.edu 310-794-8672 University of California – Los Angeles Health Sciences

Children who suffer from intestinal failure, most often caused by a shortened or dysfunctional bowel, are unable to consume food orally. Instead, a nutritional cocktail of sugar, protein and fat made from soybean oil is injected through a small tube in their vein.

For these children, the intravenous nutrition serves as a bridge to bowel adaptation, a process by which the intestine recovers and improves its capacity to absorb nutrition. But the soybean oil, which provides essential fatty acids and calories, has been associated with a potentially lethal complication known as intestinal failure–associated liver disease, which may require a liver and/or intestinal transplant. Such a transplant can prevent death, but the five-year post-transplant survival rate is only 50 percent.

Previous studies have shown that replacing soybean oil with fish oil in intravenous nutrition can reverse intestinal failure–associated liver disease. However, the necessary duration of fish oil treatment had not been established in medical studies.

Now, a clinical trial conducted at the Children’s Discovery and Innovation Institute at Mattel Children’s Hospital UCLA has found that, compared with soybean oil, a limited duration (24 weeks) of fish oil is safe and effective in reversing liver disease in children with intestinal failure who require intravenous nutrition. The researchers believe that fish oil may also decrease the need for liver and/or intestinal transplants — and mortality — associated with this disease.

The researchers’ study, “Six Months of Intravenous Fish Oil Reverses Pediatric Intestinal Failure Associated Liver Disease,” is published online in the Journal of Parenteral and Enteral Nutrition.

“With this particular study, we set out to determine if a finite period of six months of intravenous fish oil could safely reverse liver damage in these children, and we have had some promising results,” said lead author Dr. Kara Calkins, an assistant professor in the department of pediatrics in the division of neonatology and developmental biology at UCLA. “But because intravenous fish oil is not yet approved by the Food and Drug Administration and is much more costly than soybean oil, it is typically not covered by insurance. As a result, this oil is considered experimental and is currently available only under special protocols. If it proves safe and effective for patients, we hope it would eventually be available for wider use.”

For the study, intravenous soybean oil was replaced with intravenous fish oil in 10 patients between the ages of 2 weeks and 18 years who had advanced intestinal failure–associated liver disease and who were at high risk for death and/or transplant. The researchers compared these subjects with 20 historical controls who had received soybean oil.

Results showed that the children receiving fish oil had a much higher rate of reversal of liver disease than those who received the standard soybean oil. In fact, after 17 weeks of fish oil, nearly 80 percent of patients experienced a reversal of their liver disease, while only 5 percent of the soybean patients saw a reversal.

The next phase of research will involve following children for up to five years after they stop fish oil to determine if their liver disease returns and if transplant rates are truly decreased, the study authors said.

“We are also trying to better understand how fish oil reverses this disease by investigating changes in proteins and genes in the blood and liver,” Calkins said. “These studies will provide the scientific and medical community with a better understanding of this disease and how intravenous fish oil works.”

For Isabella Piscione, who was one of the first patients at UCLA to receive the fish oil treatment under compassionate use, her outcome with the treatment paved the way for researchers to establish the six-month protocol. Because of multiple surgeries due to an obstruction in her intestines, Isabella was left with only 10 centimeters of intestine. She depended on intravenous nutrition for survival, which unfortunately resulted in liver damage.

When Isabella started the fish oil treatment, she was just over 6 months old and was listed for a liver and bowel transplant. Within a month of starting the treatment, her condition started to improve. By six months, her liver had healed, and she no longer needed a transplant.

“We cried tears of joy each week that we saw her getting better and better,” said her father, Laureano Piscione. “She is a success story.”

###

Study co-authors from UCLA included Dr. James Dunn; Dr. Stephen Shew; Laurie Reyen, R.N.; Dr. Douglas Farmer; Dr. Sherin Devaskar; and Dr. Robert Venick.

The study was funded by a grant from a National Institutes of Health (NIH/NCRR M01-RR00865). Calkins has received funding from NIH K12HD00140 and T32G075776. Calkins and Venick have received funding from the Today’s and Tomorrow’s Children Fund.

Intravenous fish oil was purchased with funds from the UCLA Department of Pediatric Surgery, the Women’s Auxiliary Club at UCLA and Dr. James Yoo of the UCLA Department of Surgery.

For more information on Mattel Children’s Hospital UCLA, visit http://www.uclahealth.org/mattel.

Digest This: Cure for Cancer May Live in Our Intestines / People will not die from cancer, if our prediction is true

The discovery of Robo1 protein in the intestinal stem cells (depicted in yellow) leads to tolerance of higher doses of chemoradiation for cancer patients. (Credit: Dr. Wei-Jie Zhou)

July 31, 2013 — Treating a cancerous tumor is like watering a houseplant with a fire hose — too much water kills the plant, just as too much chemotherapy and radiation kills the patient before it kills the tumor.

However, if the patient’s gastrointestinal tract remains healthy and functioning, the patient’s chances of survival increase exponentially, said Jian-Guo Geng, associate professor at the University of Michigan School of Dentistry. Recently, Geng’s lab discovered a biological mechanism that preserves the gastrointestinal tracts in mice who were delivered lethal doses of chemotherapy.

The findings, which will appear in the journal Nature, could revolutionize cancer therapy, Geng said.

“It’s our belief that this could eventually cure later-staged metastasized cancer. People will not die from cancer, if our prediction is true,” said Geng, who emphasized that the findings had not yet been proven in humans. “All tumors from different tissues and organs can be killed by high doses of chemotherapy and radiation, but the current challenge for treating the later-staged metastasized cancer is that you actually kill the patient before you kill the tumor.

“Now you have a way to make a patient tolerate to lethal doses of chemotherapy and radiotherapy. In this way, the later-staged, metastasized cancer can be eradicated by increased doses of chemotherapy and radiation.”

Geng’s lab found that when certain proteins bind with a specific molecule on intestinal stem cells, it revs intestinal stem cells into overdrive for intestinal regeneration and repair. Stem cells naturally heal damaged organs and tissues, but so-called “normal” amounts of stem cells in the intestine simply cannot keep up with the wreckage left behind by the lethal doses of chemotherapy and radiation required to successfully treat late-stage tumors.

However, the phalanx of extra stem cells protect the intestine and gastrointestinal tract, which means the patient can ingest nutrients, the body can perform other critical functions and the bacterial toxins in the intestine are prevented from entering the blood circulation, Geng said.

These factors could give the patient just enough of an extra edge to survive the stronger doses of chemotherapy and radiation, until the tumor or tumors are eradicated.

In the study, 50-to-75 percent of the mice treated with the molecule survived otherwise lethal doses of chemotherapy. All of the mice that did not receive the molecule died, Geng said.

“If you can keep the gut going, you can keep the patient going longer,” Geng said. “Now we have found a way to protect the intestine. The next step is to aim for a 100-percent survival rate in mice who are injected with the molecules and receive lethal doses of chemotherapy and radiation.”

Geng’s lab has worked with these molecules, called R-spondin1 and Slit2, for more than a decade. These molecules repair tissue in combination with intestinal stem cells residing in the adult intestine.

Could probiotics help HIV patients?

Contact: Jillian Hurst press_releases@the-jci.org Journal of Clinical Investigation

Antiretroviral (ARV) drugs are the first line therapy for patients with HIV; however, ARV-treated, HIV-infected individuals still have a higher mortality rate than uninfected individuals. During the course of infection, HIV patients develop inflammation that damages the walls of the intestines, known as the gut mucosa, allowing intestinal microbes to escape and enter the blood stream to cause a life-threatening systemic infection. The health of the gut mucosa is significantly influenced by the complement of bacteria in the gut and there is mounting evidence that probiotic supplements benefit patients intestinal disorders, such as irritable bowel syndrome, C. difficile infection, and inflammatory bowel disease.

In this issue of the Journal of Clinical Investigation, researchers led by Jason Brenchley at the National Institute of Allergy and Infectious Disease, demonstrated that probiotic supplementation may also be beneficial for ARV-treated HIV patients. Brenchley and colleagues treated SIV-infected macaques (a model of human HIV-infection) with either ARV alone or ARV in combination with a mixture of probiotics. Macaques treated with probiotics had enhanced gastrointestinal immune function and decreased inflammation compared to macaques treated with ARV alone. In a companion article, Judith Aberg and colleagues at New York University School of Medicine discuss how these findings could benefit HIV patients.

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TITLE: Probiotic/prebiotic supplementation of antiretrovirals improves gastrointestinal immunity in SIV-infected macaques

AUTHOR CONTACT: Jason M. Brenchley NIAID NIH, Bethesda, MD, USA Phone: 301-496-1498; E-mail: jbrenchl@mail.nih.gov

View this article at: http://www.jci.org/articles/view/66227?key=1cff041937d9040dfed7

ACCOMPANYING THE ATTENDING PHYSICIAN

TITLE: Clash of the microbes: let’s bring back the good guys

AUTHOR CONTACT: Judith Aberg New York University School of Medicine, New York, NY, USA Phone: 2122637300; Fax: ; E-mail: judith.aberg@nyumc.org

View this article at: http://www.jci.org/articles/view/66736?key=64b158b04e2a168811a3

Prebiotic may help patients with intestinal failure grow new and better gut

Contact: Phyllis Picklesimer
p-pickle@illinois.edu
217-244-2827
University of Illinois College of Agricultural, Consumer and Environmental Sciences

URBANA – Adding the right prebiotic to the diets of pediatric patients with intestinal failure could replace intravenous feeding, says a new University of Illinois study.

“When we fed the carbohydrate fructooligosacharide (FOS) as a prebiotic, the gut grew and increased in function,” said Kelly A. Tappenden, a U of I professor of nutrition and gastrointestinal physiology. “The study showed that using the correct pre- and probiotic in combination could enhance these results even more.”

When FOS enters the intestines, bacteria convert it into butyrate, a short-chain fatty acid that increases the size of the gut and its ability to digest and absorb nutrients, she said.

But today’s IV solutions don’t contain butyrate and adding it would entail drug development trials and regulatory red tape. She wanted to see if adding this carbohydrate to the diet while continuing to provide most nutrients intravenously would cause the gut to start producing butyrate on its own. It worked.

According to Tappenden, at least 10,000 U.S. patients are totally reliant on intravenous feeding because their intestines have been surgically shortened.

Many of these patients are premature infants who develop necrotizing enterocolitis, a kind of gangrene of the intestine. In the U.S., one in eight infants is a preemie, and removing necrotized, or dead, intestine is the most common surgical emergency in these babies.

“Surgery saves their lives, but with so much intestine removed, they’re unable to digest or absorb nutrients. These babies are also at risk for long-term complications, such as bone demineralization and liver failure. Our goal is to take kids who’ve had this resection and cause their gut to grow and adapt,” she said.

She tested her hypothesis about butyrate using newborn piglets, an excellent model for the human infant in metabolism and physiology. Piglets with intestinal failure were assigned to one of four groups: a control group; a group whose diet contained FOS, a carbohydrate given as a prebiotic to stimulate the production of butyrate by beneficial bacteria; a probiotic, or actual live bacteria; and a combination of pre- and probiotics.

“We believed that bacteria in the gut would use the prebiotic to make butyrate and support intestinal growth. But we thought that might only happen in the group that received both pre- and probiotics because we didn’t know if the newborn gut would have enough bacteria to make this important short-chain fatty acid.”

Actually, the neonatal piglets did have enough bacteria in their guts, and the prebiotic alone was effective in increasing intestinal function and structure, she said.

“In fact, the probiotic that we used in one of the groups eliminated the beneficial effect of the prebiotic. That shows us that we need to be exceptionally careful in selecting the probiotic we use, matching it to the specific disease,” she noted. Many consumers believe all probiotics are equal, but the effect of specific bacterial strains is different, she said.

“At this point, we can only recommend consumption of the FOS prebiotic alone,” she added.

The article appears in the September 2012 issue of the Journal of Parenteral and Enteral Nutrition and is available online at http://pen.sagepub.com/content/current. Jennifer L. Barnes of the U of I and Bolette Hartmann and Jens J. Holst of the University of Copenhagen, Copenhagen, Denmark, are co-authors of the study, which was funded by grants from the National Institutes of Health.

 

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Whole milk is effective and cost-effective as oral contrast agent

2008 Re-post for filing

Contact: Necoya Tyson
necoya@arrs.org
703-858-4304
American College of Radiology

An item commonly found in many homes – whole milk – is just as effective, costs less and is easier on the patient than a diluted (0.1%) barium suspension that is also commonly used as an oral contrast agent in conjunction with CT to examine the gastrointestinal tract, a new study finds.

The study included 215 patients undergoing abdominal and pelvic CT, said Chi Wan Koo, MD, lead author of the study. All patients were given an IV contrast media; 115 were also given whole milk as an oral contrast agent; 100 received a 0.1% barium suspension. Two radiologists reviewed all the images and scored them based on degree of bowel distension and bowel wall visibility. Adequate bowel distension is necessary to optimize resolution of the bowel wall and contents, said Dr. Koo.

The study found that the images taken of patients who were given whole milk were just as useful as the images that were taken of patients given the diluted barium, she said.

In addition, patients were given a questionnaire, asking them how well they tolerated the oral contrast agents, and a cost comparison was done. “We found that milk was less expensive, it had better patient acceptance and fewer adverse symptoms,” Dr. Koo said.

Whole milk and 0.1% barium suspension are valuable in the diagnosis of small bowel disorders, such as ischemia, neoplasm and Crohn’s disease, said Dr. Koo. They are also useful in evaluating pancreatic and biliary abnormalities.

 

###

 

The study appears in the May issue of the American Journal of Roentgenology, published by the American Roentgen Ray Society

My doctor’s orders? Crisps, doughnuts and strictly no veg

*If we have a contest for worst medical advice EVER!!! I think we have a pretty good contender here – Engineering Evil

By Jo Waters

PUBLISHED:20:07 EST, 27  August 2012| UPDATED:20:07 EST, 27 August 2012

When Justin Hansen was told his gut condition  meant he’d have to follow a severely restricted diet for the rest of his life,  he was devastated.

But then he learned exactly how it would be  restricted.

‘Apparently, burgers, chips, chocolate,  full-fat milk, cakes, biscuits and sausage rolls are all ideal foods for me,’ says Justin.

Crohn's disease: Only half of the nutrients will be absorbed, so generally a patient needs to eat 50 per cent more food to make it upCrohn’s disease: Only half of the nutrients will be  absorbed, so generally a patient needs to eat 50 per cent more food to make it  up

‘The dietitian recommended I boost my calorie  intake with snacks such as sugary doughnuts, crisps and treacle  pudding.

‘I could hardly believe it. I’d have to eat  almost exclusively junk food to stay alive.’

Justin, a 51-year-old former IT consultant  who lives with his girlfriend in  Brighton, has Crohn’s disease, an inflammatory  bowel condition affecting 60,000 Britons.

Crohn’s  causes symptoms including pain,  diarrhoea, vomiting, weight loss and  fatigue, but in some cases, such as  Justin’s, it leads to a complication known as intestinal failure.

Here, the inflammation destroys the tissue of  the bowel so badly that surgeons must cut out sections of the intestine.

Patients can live without a complete bowel,  says Dr Simon Gabe, a consultant gastroenterologist at St Mark’s Hospital in  Harrow, London, who treats 300 intestinal failure patients a year.

‘The average gut varies in length between 3.5  and eight metres and the critical amount you need to stay alive is one metre,’ he says.

The problem is that when the intestine is  shortened, food passes through so quickly that its calories, nutrients, fluids  and electrolytes (salts) are not absorbed into the body.

Only half of the nutrients will be absorbed,  so generally a patient needs to eat 50 per cent more food to make it up. If the  bowel is very short, as Justin’s is, they must eat more.

What’s more, going against all received  wisdom about nutrition and health, patients must avoid high-fibre foods, which  pass through the gut quickly, and stick to carbohydrates, fat and sugar.

‘We recommend eating a high-calorie, but  low-volume diet,’ says Dr Gabe.

‘Fatty, high salt, refined carbohydrate foods  such as white bread and cakes are best because they are calorie dense and low in  fibre.

‘Patients can eat as much as they can manage,  and they certainly won’t develop a weight problem.

‘If they can’t consume enough calories, they  will lose dramatic amounts of weight and waste away, so they are also given  daily intravenous nutrition into a vein through a central line in their chest to  ensure that they are getting adequate calories.

‘The liquid food passes directly into their  bloodstream. Patients are taught to administer this and most do it overnight for  eight hours, sometimes every night.’

Going against all received wisdom about nutrition and health, patients must avoid high-fibre foods, which pass through the gut quicklyGoing against all received wisdom about nutrition and  health, patients must avoid high-fibre foods, which pass through the gut  quickly

Every year 4,000 people in Britain are put on  this diet as a result of a short bowel.

As well as Crohn’s, intestinal failure can be  caused by mesenteric infarction, where a blood clot blocks the gut and the colon  has to be removed by surgery.

Another cause is intestinal dismotility,  where the gut loses the ability to propel food and becomes blocked, sometimes as  a result of a stomach virus, or a complication of diabetes or stomach surgery.

Justin’s symptoms started in October 2001.

Over the following months he developed  swollen joints, mouth ulcers and infected nail beds.

‘I’d always been fit and healthy, but  suddenly it felt as if my body was packing up on me — I was struggling to walk a  short distance,’ he says.

‘At first, the symptoms were so random, no  one could work out why — I visited my GP umpteen times.

‘It wasn’t until 2003, when I had diarrhoea  and was vomiting, that anyone took it seriously.’

Justin’s sister Lou, a nurse, sent him to  A&E. An X-ray of his bowel showed his colon was in danger of  rupturing.

Further investigations revealed Justin had  Crohn’s disease.

He had an emergency operation to remove part  of his large intestine, and then an ileostomy to remove his bowel before being  fitted with a colostomy bag.

‘That was hard enough to deal with, but then  a week after surgery complications developed,’ says Justin.

‘My bowel became ulcerated — I was  desperately ill and spent nine months in hospital. I didn’t eat for five months — my bowel was falling apart.

‘At one stage my weight dropped from 11½st to  6st (I’m 5ft 11in). A few times I closed my eyes and hoped I’d never wake up.’

Doctors stabilised Justin’s condition and  after five months he began to eat and drink again.

It was then he was told about the diet he’d  have to follow for the rest of his life, with doctors advising he needed 4,000  to 5,000 calories a day.

‘It was funny that I had packets of crisps on  prescription,’ he says. ‘But at first I struggled to eat even one  bag.

‘Gradually, though, I began to eat more. I  always had one eye on the calorific content — I remember being so desperate to  top up my calories I’d mix milk with powdered milkshake and ice  cream.

‘Ironically, I don’t like junk food or  chocolate much. The foods I craved were things such as apples and salads, which  are bad for me.’

A typical breakfast would be cereal with  sugar, white toast with butter and jam and a full English of sausage, bacon,  eggs and hash browns.

Recommended snacks for mid-morning include  sugary doughnuts, crisps or a cream cake.

Lunch can be sausage rolls, pasties or a  sandwich with butter and/or mayonnaise.

In the evening, patients are encouraged to  eat meat, fish or chicken with potatoes, rice or pasta, lots of salt, few  vegetables and a creamy rice pudding, treacle pudding or tapioca with jam and  cream.

Patients are also given supplements to ensure  they get all the vitamins and minerals they need.

However, Justin struggled to maintain the  calorie intake and after more complications and surgery had a permanent  intravenous nutrition line fitted.

He is studying for an MSc in occupational  therapy and says his health has stabilised.

Alison Culkin, a specialist dietitian at St  Mark’s Hospital who advises Justin, says: ‘These patients can find it very  difficult to consume so many calories because they often have bowel problems,  feel nauseous, have a fluctuating appetite or a colostomy bag.’

Researchers at St Mark’s are developing a  grow-your-own bowel technique, which will potentially cure patients like Justin.

Scientists aim to be able to take tissue from  a patient’s bowel and use stem cells to grow new bowel tissue in laboratories — avoiding the problem of rejection.

Justin and a team of friends recently  completed a kayak trip from Manchester to London to raise money for  the hospital.

‘I want to highlight the problems intestinal  failure patients face and give hope to newly diagnosed patients that you can  lead a normal life.

‘I’m living proof you can do extraordinary  things. I just wish my GP had diagnosed Crohn’s disease earlier.

‘Maybe I might never have had to go through  this

Read more: http://www.dailymail.co.uk/health/article-2194464/My-doctors-orders-Crisps-doughnuts-strictly-veg.html#ixzz24zPaEtLc