Friday, October 10, 2008

Pediatric Gastroenterology - Probiotics Fight Irritable Bowel Syndrome

Several studies presented at a recent meeting of the American College of Gastroenterology highlight the safety and efficacy of probiotics in improving symptoms and normalizing bowel movement frequency in patients suffering from Irritable Bowel Syndrome (IBS).

A systematic review of the efficacy of probiotics in IBS that included 19 randomized controlled trials found that "probiotics are effective in IBS,” although there was not enough information to be sure whether one probiotic is particularly effective or whether combinations of probiotics are required.

In a separate study conducted at seven pediatric GI centers in the United States, Italy, and India, researchers found that probiotics were safe and significantly more effective than the placebo in alleviating IBS-related symptoms in children and teenagers.

Read more!

How to treat Type 2 Diabetes?

The medications for type 2 diabetes are designed to:

1. Increase the insulin output by the pancreas.

2. Decrease the amount of glucose released from the liver.

3. Increase the sensitivity (response) of cells to insulin.

4. Decrease the absorption of carbohydrates from the intestine.

5. Slow emptying of the stomach to delay the presentation of carbohydrates for digestion and absorption in the small intestine.

When selecting therapy for type 2 diabetes, consideration should be given to:

1. The magnitude of change in blood sugar control that each medication will provide.

2. Other coexisting medical conditions (high blood pressure, high cholesterol, etc.)

3. Adverse effects of the therapy

4. Contraindications to therapy

5. Issues that may affect compliance (timing of medication, frequency of dosing)

6. Cost to the patient and the healthcare system

It's important to remember that if a drug can provide more than one benefit (lower blood sugar and have a beneficial effect on cholesterol, for example), it should be preferred. It's also important to bear in mind that the cost of drug therapy is relatively small compared to the cost of managing the long-term complications associated with poorly controlled diabetes.

Varying combinations of medications also are used to correct abnormally elevated levels of blood glucose in diabetes. As the list of medications continues to expand, treatment options for type 2 diabetes can be better tailored to meet an individuals needs. Not every patient with type 2 diabetes will benefit from every drug, and not every drug is suitable for each patient. Patients with type 2 diabetes should work closely with their physicians to achieve an approach that provides the greatest benefits while minimizing risks.

Patients with diabetes should never forget the importance of diet and exercise. The control of diabetes starts with a healthy lifestyle regardless of what medications are being used.

WARNING: All the information below applies to patients who are not pregnant or breastfeeding. At present the only recommended way of controlling diabetes in women who are pregnant or breastfeeding is by diet, exercise and insulin therapy. You should speak with your doctor if you are taking these medications and are considering becoming pregnant or if you have become pregnant while taking these medications. Read more!

What is Haemodialysis?

Hemodialysis is the most common method used to treat advanced and permanent kidney failure. Since the 1960s, when hemodialysis first became a practical treatment for kidney failure, we’ve learned much about how to make hemodialysis treatments more effective and minimize side effects. In recent years, more compact and simpler dialysis machines have made home dialysis increasingly attractive. But even with better procedures and equipment, hemodialysis is still a complicated and inconvenient therapy that requires a coordinated effort from your whole health care team, including your nephrologist, dialysis nurse, dialysis technician, dietitian, and social worker. The most important members of your health care team are you and your family. By learning about your treatment, you can work with your health care team to give yourself the best possible results, and you can lead a full, active life.

In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special filter that removes wastes and extra fluids. The clean blood is then returned to your body. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals like potassium and sodium in your body.

One of the biggest adjustments you must make when you start hemodialysis treatments is following a strict schedule. Most patients go to a clinic—a dialysis center—three times a week for 3 to 5 or more hours each visit. For example, you may be on a Monday-Wednesday-Friday schedule or a Tuesday-Thursday-Saturday schedule. You may be asked to choose a morning, afternoon, or evening shift, depending on availability and capacity at the dialysis unit. Your dialysis center will explain your options for scheduling regular treatments.

Researchers are exploring whether shorter daily sessions, or longer sessions performed overnight while the patient sleeps, are more effective in removing wastes. Newer dialysis machines make these alternatives more practical with home dialysis. But the Federal Government has not yet established a policy to pay for more than three hemodialysis sessions a week.

About once a month, your dialysis care team will test your blood by using one of two formulas—URR or Kt/V—to see whether your treatments are removing enough wastes. Both tests look at one specific waste product, called blood urea nitrogen (BUN), as an indicator for the overall level of waste products in your system. For more information about these measurements, see the NIDDK fact sheet Hemodialysis Dose and Adequacy.Several centers around the country teach people how to perform their own hemodialysis treatments at home. A family member or friend who will be your helper must also take the training, which usually takes at least 4 to 6 weeks. Home dialysis gives you more flexibility in your dialysis schedule. With home hemodialysis, the time for each session and the number of sessions per week may vary, but you must maintain a regular schedule by giving yourself dialysis treatments as often as you would receive them in a dialysis unit. Read more!