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  • The Dietitian Clinic at Karolinska has vast experience in patients with inflammatory bowel disease,

    Therese Liljebo, clinical dietician, has since 2000 worked at the Dietitian Clinic, Karolinska University Hospital in Solna. She is a member of the Dietitians’ National Association Reference Group in gastroenterology.Therese Liljebo will in the coming days begin at the Karolinska Institute’s Graduate School of Medicine with the goal of doctoral studies in the area of Irritable Bowel Syndrome (IBS) and nutrition.

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    The Dietitian Clinic at Karolinska has vast experience in patients with inflammatory bowel disease, IBD.

    The treatment goal of physicians is to reduce inflammatory activity and induce complete remission. There is no cure for IBD; the disease is chronic and will relapse, says Therese Liljebo.

    – Most of the patients are in need for continuous medical treatment. Therapy repertoire includes pharmaceuticals and nutritional therapy. Patients especially with Crohn’s disease often lose weight due to diarrhea, loss of appetite, pain due to narrowing or other problems that affect the eating negatively.

    – Nutritional treatment is aimed at improving patients’ nutritional status during relapses, before surgery and partly for maintaining remission and increasing patients’ quality of life.

    – As a part of therapeutic arsenal we also count Antisecretory factor (AF) in the form of Salovum egg powder or SPC Flakes, despite the fact that AF is not a drug but a medical food, incidentally the first product in Europe classified as a medical food. In the Stockholm County, Salovum can be prescribed via the ordering portal since a few years back which has facilitated its use.

    – We dieticians never give patients Salovum, without first consulting the physician, emphasizes Therese Liljebo.

    Antisecretory factor

    AF, antisecretory factor, is a protein that regulates the water- and iontransport across the cell membrane and has an anti-inflammatory effect and is a fundamental part of the fluid balance of the body. AF is available as flakes (SPC Flakes) and egg powder (Salovum). The powder is prepared and freeze-dried by the yolks from hens fed with specially processed grain. The difference is that while the flakes stimulate the body’s own production of AF, the egg powder contains preformed AF.

    – Salovum, which can be prescribed via the Order Portal of the Stockholm County Council, is always in consultation with the doctor. The dose varies from three (loading dose) to twelve bags per day. A major advantage is the absence of side effects.

    – In patients with large areas of Morbus Crohn inflammation of the colon, we have in approximately half of the patients seen tendencies for beneficial effects of Salovum. For example, we have seen cases where the body weight increased from 42 kg to 46 kg in less than a year with a simultaneous reduction of calprotectin from 4000 to 30 where the number of bowel movements during the same period went from 10-12 down to 2 per day.

    – It is however important to point out that we have not done any scientific assessment of the effect of Salovum.

    Think outside the box

    It is good to not only think about drugs in inflammatory bowel diseases. Being able to reassure the patient that Salovum is free of side-effects, is a great advantage, she concludes.

     

    COB

    Quote Box:

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    “Approximately 0.5-1 percent of the Swedish population today has inflammatory bowel disease; a disease which is chronic and affects all ages.

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    The fact that the diseases are chronic, sometimes with serious disease progression, affecting all ages means that inflammatory bowel disease meets criteria for being a new widespread disease”

    Source: Annika Brinkenberg Lapidus, MD, PhD, Gastrointestinal Centre Ersta Hospital, Stockholm, Läkartidningen No 45/2009 volume 106

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    Facts on IBD

    Inflammatory bowel disease, IBD, involves a chronic inflammation of the intestinal lining (mucosa). The cause of the disease is unknown, but both genetic factors and environment matters. The inflammatory bowel diseases include:

    • Ulcerative colitis

    • Crohn’s disease

    • Unclassified colitis, “Inflammatory bowel disease unclassified”, IBD-U.

    Even microscopic colitis and lymphocytic colitis are sometimes counted as IBD.

     

    IDB is a lifelong disease, often debuting at 15-40 years of age. It usually comes in spells with longer periods of little or no disease activity.

    Studies show that approximately 20 percent of patients with Crohn’s disease develop chronic continuous disease activity. In ulcerative colitis, the figure is much lower.

     

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