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Banana Nut Streusel Coffee Cake

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With a luscious banana flavor plus a nutty sweet streusel topping, this foolproof recipe will turn a beginner into a baking pro!

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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 from medical 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 Heather 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 stable!

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 fiber, and avoids all trigger foods like red meat, dairy products, and egg yolks. Insoluble fiber foods are carefully incorporated for good nutrition without risk of attacks. Most importantly, all of the cooking is absolutely delicious - and that's a promise. If you're still a little unsure that healthy cooking truly can 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 elements:

  • 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 (PPL).
  • Directions to prescribers for active follow-up and management of patients.
  • Measures to actively monitor and evaluate the plan.

Continued studies

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.

Each 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.

In 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 been established.

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 Representatives
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 States Congress.

The legislation would do the following:

1) Expand and enhance IBD research at the National Institutes of Health.

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 Healthcare
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 that 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 site 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

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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