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In this Issue...
Food & Diet
Rx News & Research
Missed the Last
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the show while you can!
Banana Nut Streusel Coffee Cake
It's Baking 101, and this step-by-step class will get
With a luscious banana flavor plus a nutty sweet streusel topping, this
foolproof recipe will turn a beginner into a baking pro!
Eating for IBS is the
life changing cookbook for good digestive health. Discover the delicious
behind Heather Cooks!
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the IBS newsletter!
First Year: IBS
First Year: IBS covers the
core issues of
symptom-control on a daily basis, including: travel, work concerns,
social events, restaurants, holidays, support groups, and more!
November 7, 2002
Sweet potato, basil, lemongrass...
Tangy Thai Salad is a meal
as colorful as it is delicious!
Ooh, this salad is sooo good...
And making it is half the fun!
Hello to everyone!
Welcome to the brand-new version of the Digestive Health & Happiness Newsletter!
The newsletter will be sent once or twice each month, with a focus on news,
research, and events pertaining to IBS, IBD, and general digestive health issues. We'll keep tabs on everything
and pharmaceutical studies, to digestion-friendly recipes, to
stress management for GI stability.
We have a terrific new email publishing service in Seattle, What Counts, and they've
done a wonderful job for us. I hope you
enjoy the updated format and content that we're now able to offer as a result of their terrific assistance. As always, this newsletter is for you, so please feel
free to send in comments and requests!
Heather Van Vorous
Tangy Thai Salad
Click here to come watch the new show at
Cooks, the internet's only cooking show for good digestive health!
Tangy Thai Salad is playing now.
Drop by my kitchen for the free show and click here
get the recipe!
If you live in the Seattle/King County area, you can also watch Heather Cooks on
television every week. We air on the Scan network, at
channels 77 and 29.
This salad makes a light and delicious one-dish meal. It has the delicate
balance of flavors that characterize Thai cuisine - a little sweet, a little
salty, with the tang and perfume of lime juice plus the zing and color of fresh
herbs. If you're new to Thai cooking this is a wonderful place to start, as all
of the ingredients are available at most large grocery stores.
The Thai salad is based on TVP, or textured soy protein, which is fat free but
high in soluble fiber and a nutritional powerhouse. TVP is a magic ingredient that absorbs the flavors of whatever you add to it - in this case, a
deliciously tangy dressing. Your taste buds will tell you you're eating a salad
of ground meat, but your body will know better and your digestion will stay
As always, each episode of Heather Cooks features fabulous food for good
digestive health, with a specific interest in the dietary management of
IBS and IBD. Everything we cook is low fat, high soluble
avoids all trigger foods like red meat, dairy products, and egg yolks.
fiber foods are carefully incorporated for good nutrition without risk of
attacks. Most importantly, all of the cooking is absolutely delicious -
that's a promise. If you're still a little unsure that healthy cooking
be both fun and a real treat to eat, you're in for a wonderful surprise!
Lotronex to be re-introduced for women with severe IBS-diarrhea
in November 2002
The US FDA has allowed GlaxoSmithKline to re-introduce the prescription drug Lotronex under restricted conditions of use.
Lotronex will be indicated specifically for use in women with severe
diarrhea-predominant irritable bowel syndrome who have failed to respond to
conventional therapy, whose IBS symptoms are chronic and who have had other
gastrointestinal medical conditions that could explain their symptoms ruled out.
Serious gastrointestinal events, specifically ischemic colitis and
complications of constipation, have been reported in association with the use of
Lotronex. These events have resulted in hospitalization, blood transfusion
and/or surgery and some fatalities. In clinical trials, about three women in
1,000 developed ischemic colitis over six months. Lotronex was voluntarily withdrawn by GSK in November 2000 when the company
and the FDA were unable to agree on a Risk Management Plan that would guide
appropriate use of Lotronex without presenting undue obstacles to patients.
However, GSK and the FDA resumed discussions in January 2001, after thousands of
patients who had successfully used Lotronex implored both the company and the
Agency to work out a plan that would allow them access to Lotronex. These
discussions culminated with the risk management plan below.
Lotronex Risk Management Plan
The risk management plan approved by the FDA includes, among other
- Updated warnings in product labeling, including a Medication Guide for
patients that explains to patients what to do if they get constipated or have
signs of ischemic colitis.
- A lower starting dose than previously approved.
- A prescribing program for physicians to be enrolled into, based on
self-attestation of qualifications and acceptance of certain responsibilities in
prescribing the medicine.
- An agreement for patients to sign, attesting that they are informed about
risks and benefits of Lotronex and agree to follow directions that are elements
of the plan.
- Stickers affixed on all prescriptions for Lotronex to alert pharmacists that
the prescribing physician is enrolled in the Prescribing Program for Lotronex
- Directions to prescribers for active follow-up and management of patients.
- Measures to actively monitor and evaluate the plan.
GSK has committed to post-marketing (Phase IV) studies that would evaluate
the safety and efficacy of lower doses of Lotronex and of taking Lotronex on an
"as needed" basis. GSK will also conduct further studies to investigate ischemic colitis and small bowel ischemia. In addition, the company
will monitor the risk management program.
Zelnorm now available for IBS-constipation in women
The FDA has approved Zelnorm as the first and only prescription drug for abdominal pain and discomfort, bloating, and constipation in women
with IBS. It is meant for the short-term (4-6 week)
treatment of women with IBS whose primary bowel
symptom is constipation. Until now, no prescription medication has been approved
in the United States to treat the multiple symptoms of abdominal pain and
discomfort, bloating, and constipation associated with IBS. The medical
community has recognized that therapies traditionally used to treat these
symptoms have been generally ineffective or poorly tolerated.
Zelnorm is the first agent in a new class of drugs developed to target the GI tract. Zelnorm stimulates the peristaltic reflex and normalizes impaired
motility in the GI tract. The FDA approval of Zelnorm is based on clinical trials
that show Zelnorm provides relief of the abdominal pain and discomfort, bloating
and constipation in women with IBS.
Three multicenter, double-blind,
placebo-controlled studies involved 2,470 women with at least a three-month
history of IBS symptoms prior to the study baseline period. Patients received
either Zelnorm or placebo over a three-month period.
week, participants rated their responses to the "Subject's Global Assessment of
Relief," a measurement tool which takes into account overall well-being,
symptoms of abdominal pain and discomfort, and constipation. Based on this
assessment, more patients on Zelnorm experienced relief than patients on
placebo. In addition, Zelnorm was shown to provide relief of the individual
symptoms of abdominal pain and discomfort, bloating, and constipation.
clinical studies, Zelnorm was generally well tolerated. Side effects that
occurred more often with Zelnorm than with placebo were headache (15% vs. 12%)
and diarrhea (9% vs. 4%). The majority of the Zelnorm patients reporting
diarrhea had a single episode. In most cases, diarrhea occurred within the first
week of treatment. Typically, diarrhea resolved with continued therapy. Zelnorm
is not indicated for patients who are currently experiencing or frequently
experience diarrhea. The safety and effectiveness of Zelnorm in men have not
Zelnorm was discovered and developed by Novartis Pharmaceuticals.
Zelnorm, known internationally as Zelmac, is approved in more than 30 countries
including Australia, Switzerland, Canada, and Brazil. Novartis also is
conducting clinical assessments of Zelnorm as a potential treatment for other
important gastrointestinal disorders such as chronic constipation and functional
dyspepsia. Click here for more information...
Subtle inflammation may play a role in developing IBS
There is growing evidence that inflammation in the gastrointestinal mucosa may
play a role in the origins of at least a sub-set of IBS (however, it's important to note that
overt colonic inflammation precludes a diagnosis of IBS). Experimental data
shows that inflammation, even if mild, could lead to persistent changes in
gastrointestinal nerve and smooth muscle function, resulting in dysmotility,
hypersensitivity and gastrointestinal dysfunction.
Click here for more information...
"Inflammatory Bowel Disease Act" introduced in the United States House of
This legislation is identical to the bill recently introduced in the
U.S. Senate. These
bills represent the first IBD specific legislation ever introduced in the United
The legislation would do the
1) Expand and enhance IBD research at the National Institutes
2) Establish an IBD prevention and epidemiology program at
the Centers for Disease Control and Prevention.
3) Require federal
studies to identify barriers that IBD patients encounter when seeking insurance
coverage and applying for Social Security Disability.
"I have awful bloating. What can I do?"
Bloating is one of the most frustrating IBS symptoms, and unfortunately one of the most difficult ones to treat. There
is good news, though. Fennel tea can work wonders to ease both bloating and gas. You can buy fennel seeds in bulk
from the spice section of a health food market or at a spice shop. Just brew a tablespoon or so of the seeds in a
tea strainer and drink several cups a day. Fennel tastes like licorice and has anti-gas as well as anti-spasmodic properties,
making it especially helpful for IBS. It's also a very safe herbal remedy that you can use daily without any risks.
The other factor to consider in treating bloating with IBS is your choice of soluble fiber supplement. Soluble fiber is a miracle worker
for many people in managing all IBS symptoms, whether cramping, diarrhea, and/or constipation. However, one of the most
common soluble fiber supplements is psyllium (sold as Metamucil, Konsyl, Fibrogel, or as bulk husks). Psyllium can cause bloating for
some IBS patients, and if this happens to you try an alternate supplement. Citrucel, Benefiber, and Fibercon are all effective soluble
fiber supplements that do not contain psyllium and should not cause bloating.
One last thing to try is eliminating all carbonated beverages from your diet. Carbonation in general is a potential trigger for IBS
attacks, and it's particularly likely to exacerbate bloating. Have a nice hot cup of the fennel tea instead of soda pop or sparkling water.
Northwest Bookfest! What a Success!
Thanks to the thousands of people who came by my booth, sampled the Peppermint Fudge Cake, watched the Heather Cooks show,
and shared their IBS stories. I was overwhelmed by the interest in our sneak
preview IBS product and will let everyone know as soon as it's available. I was also delighted by the interest of Seattle-area hospital GI nurses, doctors
and naturopaths in the Eating for IBS diet. Many Physicians' Packets were distributed with dietary
guidelines, website resources, and other helpful information for patients.
And the winner of our Bookfest Contest is...Aileen Boustedt! Congrats to Aileen!
Thanks to everyone who participated in the drawing to win a free copy of The First Year: IBS .
Aileen will be receiving her autographed book in the mail this week!
2003-2003 Marquis Who's Who in Medicine and
Based on the groundbreaking IBS diet and books, I have been selected for inclusion
in the new edition of Who's Who in Medicine and Healthcare. It is a HUGE honor to be selected for
"earning a place among the most notable men and women in the medical field...featuring the
highest achievers from both the United States and around the world...for contributions in the
teaching, practice, planning, financing, and delivery of healthcare from more than 100 distinct specialties."
Thank you to the unknown readers who nominated me for this honor.
I had no idea I was even being considered for the award until I received the notification from Marquis. I am truly touched by those
of you who reached out on my behalf. I really appreciate this. ~ Heather
Heather & Company is dedicated to serving people with
IBS. Our mission is to offer education, services, and products
allow people with IBS to successfully manage their symptoms
through lifestyle modifications. We currently offer the books
Eating for IBS and
First Year IBS, web
resources, seminars and classes, and Heather Cooks!, a healthy cooking
show on the internet and television. We will soon have other IBS services
available. Heather Van Vorous, an IBS sufferer since age 9, is the company
founder and president.
Our websites receive over 250,000 unique visitors each year, and our newsletter
is received by 11,000 people 1-2 times monthly. Every week over 100 new people join
our mailing list. Heather & Company and Heather Van Vorous offer the following...
The world's best-selling book for IBS
Sponsorship opportunities are available for the websites and this newsletter.
click here to contact us for information.
The internet's only full-length cooking show, with thousands of subscribed viewers
Excerpts and recipes from Eating for IBS licensed by Novartis Pharmaceuticals
Dietary information used by the Radiology Department of the Cancer Centre in Birmingham, England, for treatment of radiation enteritis
Information requested by gastroenterologists and family physicians across the USA, Canada, UK, and Australia for IBS patient distribution
The "Authorized Expert" for Diet & Nutrition at the IBS Association and IBS Self Help Group forums
Finalist for an IACP Julia Child Cookbook Award 2001 - Eating for IBS
#17 on the Library Journal's Cookbook Bestseller list for 2000 - Eating for IBS
Work with corporate HR departments to offer employee IBS education programs.
Nominated for a Woman of Strength Award by Oxygen.com
Over 4,000 personal thank you letters received from readers worldwide for IBS dietary information
Foremost patient-expert on IBS in America
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