Understanding IBD and Ulcerative Colitis

Uncomfortable symptoms such as abdominal cramps, gassiness and frequent bathroom visits may just seem like annoyances that decrease your quality of life. However, if these symptoms increase or persist, or you also have diarrhea, pain, fatigue and weight loss, you should be examined for inflammatory bowel disease (IBD). Not to be confused with irritable bowel syndrome (IBS), which includes some disturbance in bowel function but is not a disease, IBD can produce destructive inflammation, which can lead to permanent intestinal damage. Depending on the extent of the damage and the length of time you have IBD, it could also put you at a higher risk for colorectal cancer.

Ulcerative colitis (UC) is a common type of IBD that may be affecting as many as 700,000 American men and women. It creates long-lasting ulcers (sores) in the digestive tract and causes inflammation in the colon and rectum. Symptoms include painful cramps, loss of appetite and loose, bloody and/or urgent bowels. Researchers aren't quite sure what causes UC and other inflammatory bowel diseases: most likely a complex interaction of genetic and environmental factors, with a possible link to the immune system. Though not seen as direct causes of UC or IBD, stress, smoking, and fatty and processed foods can aggravate the diseases' symptoms and should be avoided.

There is no known cure for IBD; it's a lifelong disease that has alternating periods of remission and flare-up. However, there is treatment available in the form of medication, combination therapy and surgery, if necessary. Your doctor may also be able to help you adjust your diet to avoid discomfort, possibly by avoiding spicy and high-fiber foods or by restricting your dairy intake.

March is Colorectal Cancer Awareness Month, so if you think you may be suffering from colon inflammation, especially if you have a family history of colorectal diseases, make an appointment with your primary care physician at www.mygbmcdoctor.com or see a GBMC gastrointestinal specialist by visiting www.gbmc.org/gi.

4 Tips for Healthy Grocery Shopping

Making healthy choices begins in the grocery store. You won't be able to prepare nutritious meals if you don't start out with the proper ingredients. March is National Nutrition Month, so here are some tips from Katie Perry, a registered dietitian at GBMC, to help you stick to your plan.

1. Plan
Planning your meals in advance will help you stay on track and only buy the items you need. Bring a list to the store that will help you keep track of what you're running low on and what ingredients you'll need for the week ahead. Having a plan and committing to it can help prevent impulse buys. Bringing home unhealthy food means you will eat it, so stock your pantry and refrigerator with nutritious options that will be there when you need them.

2. Shop the perimeter.
The outer aisles of the store are where the more natural, whole foods are located, such as produce, deli and dairy. (We do want to avoid the bakery though!) The goal is to buy and eat food in its most natural state because this is how it provides the most nutrition. Most foods found in the inner aisles of the stores are highly processed, containing large amounts of fat, sugar, salt and other additives. Steer clear of aisles full of cereal, chips, crackers, cookies, granola bars, candy and soda. However, there are some aisles worth venturing down. Head down the canned food aisle for canned tuna in water and for beans, which add a healthy dose of protein. The frozen aisle is another to explore: frozen fruit and veggies are great in a pinch and are often flash-frozen to preserve freshness.

3. Don't shop when hungry.
Shopping on an empty stomach can lead you to indulge your cravings and make less nutritious choices. When you're hungry, everything looks good, especially tempting junk food. To prevent impulse buys, be sure to eat a healthy snack containing protein and/or fiber before going to the grocery store. Some examples include veggie sticks and hummus, a piece of fruit or a Greek yogurt.

4. Understand food labels.
Food labels are great tools to use. They tell us about the nutritional value of the food we are buying and eating. Pay attention to the serving size, which is located at the very top of the label. The information on the food label pertains to the serving size listed. Sometimes a food will seem a lot less healthy when you realize it is meant to be consumed in two or three servings instead of one.

Investigate labels to make sure you're getting the correct amount of nutrients. The protein value should be higher than the amount of fat per serving. Keep your sodium down by buying low salt foods, which have less than 140 milligrams of sodium per serving. Foods with sugar should contain less than 6 grams of sugar per serving. When buying yogurt, make sure it does not have more than 15 grams of sugar per serving.

Keeping these tips in mind when you shop for food will help to ensure that you get balanced nutrition and maintain a healthy weight.

From COMP to 5K: Going the Extra Mile for the NICU

Every Father's Day, GBMC's campus is flooded with people running, jogging and walking a 5K to benefit the Neonatal Intensive Care Unit (NICU). Sounds overwhelming? Prepare to be inspired by Team COMPto5K, a group of more than 125 Comprehensive Obesity Management Program (COMP) patients participating in the event. "There is no reason to be nervous or scared about a 5K," says COMP patient Angie Obrigkeit. "It's about getting out there and doing your best."

The members of the COMPto5K Team have all had (or are scheduled to have) weight loss surgery and have been training for the 5K together since December, meeting for weekly group workouts. "I never thought for one second I would ever be a runner. Now I look in the mirror and see an athlete," Angie says.

Dr. Elizabeth Dovec, one of GBMC's board-certified surgeons who performs weight loss surgery, is amazed at Team COMPto5K’s success. "I see patients' excitement and confidence growing as their positive changes pay off," she says. "It's one of the coolest things I've ever been a part of, and it's made me a more empathetic and sensitive physician."

Dr. Dovec started an online community – www.COMPto5K.com – where patients share recipes, inspirational photos, tips and most importantly, support. "I love the camaraderie," says COMP patient Sean Miller. "We progress as a group and celebrate each other's victories. I've reached out to the group for help. Now I strive to be a mentor for others. It's been life-changing."

Beyond conquering personal goals, race participants are raising money for the NICU, which provides round-the-clock care for sick newborns and premature infants. All 5K proceeds will help the NICU to maintain its sensitive equipment and technology, which is critical to caring for fragile babies.

The race will take place on Sunday, June 19 at 8 a.m. and though there are awards and prizes, the COMPto5K team knows it's not about coming in first. "There is nothing competitive about it," Angie says. "Don't forget to pat yourself on the back and be proud. In this case, trying is succeeding."

Click here to register for GBMC's 28th annual Father's Day 5K. If you'd rather cheer from the sidelines, you can still play an important role in supporting GBMC's tiniest patients: fundraise for the NICU by making a race pledge to support a friend or family member, or simply make a donation.

Cancer Survivors Confront Weight Gain Together

Friends & cancer survivors Karen
Cherelstein (left) and Diane McClyment
often exercise together

Karen Cherelstein had a normal mammogram in October 2006, but a self-examination in January 2007 revealed a lump. A visit to her OB-GYN and a biopsy confirmed her fears: she had Stage 1 cancer with a small tumor just before her 50^th birthday. “When my internist asked for a special appointment, I knew the news wouldn’t be good,” Ms. Cherelstein says. “As more results came through, I learned that my cancer was aggressive.” She spent several months undergoing chemotherapy and radiation under the guidance of Gary Cohen, MD, then-Medical Director of the Sandra & Malcolm Berman Cancer Institute at GBMC, and has been cancer-free for eight years.

“By October 2007, I was working full-time again and my hair was growing back,” Ms. Cherelstein says, “but I was beginning to have weight issues.” At 5 feet 1 inch tall, she says that any additional weight is obvious on her body. Not realizing it might be related to her cancer, she struggled with managing her weight for years and, by October 2014, she had reached a number on the scale that she could not believe.

While Ms. Cherelstein fought to achieve a healthy weight, her friend Diane McClyment was going through similar life and body changes. Ms. McClyment was called back after a mammogram in October 2013 and a biopsy revealed she had breast cancer. Her physicians at a local hospital recommended radical treatments, which had her on edge. Ms. Cherelstein suggested a second opinion with Dr. Cohen. “The minute I met him, I knew he was the right doctor for me,” Ms. McClyment says. “He handled everything, even contacted a physician I had 25 years ago in New York to discuss my previous lymphoma treatment.”

With Dr. Cohen overseeing her care, Lauren Schnaper, MD, performing her surgery and Geoffrey Neuner, MD, administering radiation therapy, Ms. McClyment felt she was in great hands. She had a lumpectomy and was treated with a “one and done” radiation treatment, both of which were successful. “My only complaint was the weight gain. Like Karen, I was grateful to be alive, but had a difficult time shedding excess pounds.”

At a September 2014 follow-up appointment, Dr. Cohen could tell Ms. McClyment felt negatively about her appearance. “Studies have shown that excess body weight may be linked to certain cancers, including breast cancer,” says Dr. Cohen. “Excess weight and obesity may lead to worse outcomes despite cancer treatments, and weight gain following a breast cancer diagnosis may significantly increase the risk of recurrence and cancer-related deaths.” Dr. Cohen referred Ms. McClyment to a clinical trial entitled “A Randomized Study Evaluating the Effect of a Remote-Based Weight Loss Program on Biomarkers in Women with Early Stage Breast Cancer” being offered through the Johns Hopkins Clinical Research Network (JHCRN). The JHCRN is a collaborative effort between GBMC, the Johns Hopkins Institute for Clinical and Translational Research and several other regional medical centers. It is designed to accelerate the transfer of new diagnostic, treatment and disease prevention advances from research to direct patient care. Ms. McClyment was excited about the weight control study and immediately enrolled.

“The trial is a yearlong weight loss program designed to specifically meet the unique needs of women who have completed their acute therapy for early breast cancer,” says Vered Stearns, MD, Co-Director of the Johns Hopkins Breast and Ovarian Cancer Program and a lead physician on the JHCRN research team. Study participants are randomized into two groups, self-directed weight loss or active remote intervention (Practice-based Opportunities for Weight Reduction, or POWER-remote), and each group follows a strict plan of exercise, diet tracking and health assessments. The goal of the study is to gauge the effectiveness of weight loss intervention techniques and assess the effects of weight loss on biomarkers associated with breast cancer, inflammation and obesity. This information will be used to help implement further clinical intervention techniques in breast cancer patients.

“While it is too early to determine overall benefits, we have seen an increase in awareness and attention to diet and physical activity in all participants, and several women have experienced a reduction in their weight,” says Dr. Stearns.

Ms. McClyment was placed in the active intervention POWER-remote group and has lost 37 pounds and four inches from her waist, is down four sizes and is pleased with the reasonable goals and accountability aspects of the program. Ms. Cherelstein, who could not directly take part in the study because of the time elapsed since her treatment, completed the program on her own by sharing Ms. McClyment’s study plan. Both women are thrilled with the marked improvement in their individual bodies, minds and overall health. “We started checking in with each other almost every day as the pounds started rolling off,” Ms. Cherelstein says. “It was a process, but we’ve both excelled. We talk about shopping for new clothes instead of how fat we feel! We’re grateful for the care we received and are optimistic that the odds of cancer recurrence have been decreased for both of us.”

For more information about oncology services at GBMC, visit www.gbmc.org/cancer. To learn more about the various clinical trials available at GBMC, visit www.gbmc.org/clinicaltrials or call 443-849-GBMC (4262).

Baby Spinach with Golden Raisins and Pine Nuts

Ingredients

4 tablespoons pine nuts
2 bags (10 oz each) leaf spinach, rinsed
⅔ cup golden seedless raisins
⅛ teaspoon ground nutmeg
⅛ teaspoon salt

Directions

In a medium nonstick pan over high heat, cook and stir the pine nuts until they begin to brown lightly and smell toasted, but not burnt. Set the pine nuts aside in another dish.

Return the pan to the burner over medium-high heat. Add ¼ cup water. As it begins to boil, add a small handful of spinach. Cook and stir just until it begins to wilt. Then push it to the side of the pan, and add another ¼ cup water and handful of spinach. Continue until all the spinach has been cooked, adding the raisins with the last handful of spinach.

Sprinkle with nutmeg and salt. Cook and stir until all the spinach is wilted and the raisins are warm.

Remove from heat. Press out excess water with a spoon or spatula. Place 1 cup of the spinach and raisins mixture in a serving bowl. Top with pine nuts.

Nutrition Information

Servings: 4
Calories: 76
Fat: 3 g
Sodium: 130 mg
Fiber: 3 g
Protein: 3 g
Carbohydrates: 13 g
Potassium: 510 mg

Recipe acquired from the U.S. Department of Health and Human Services, NIH, National Heart, Lung and Blood Institute. Keep the beat™ recipes