Omega-3 fatty acids may not prevent Crohn's relapse

I've been taking Omega 3 tablets since I was diagnosed. Then about a year ago I was told that only the enteric coated tablets (which are absorbed in the intestines as opposed to the stomach) were useful in the prevention of relapse in Crohn's because stomach acid basically destroys the Omega 3. So then I started taking the enteric coated ones which were three times as expensive, however it seems that it may all be in vain. This article appeared in the Journal of the American Medical Association.

Omega-3 fatty acids may not prevent Crohn's relapse

Researchers from the Robarts Research Institute at The University of Western Ontario in London, Canada have found that omega-3 fatty acids are ineffective in managing Crohn's disease.

Found in fatty fish such as salmon, mackerel, herring and sardines, omega-3 fatty acids have an anti-inflammatory effect and are therefore used in the treatment of inflammatory disorders such as rheumatoid arthritis and IgA nephropathy (a kidney disease).

"A significant amount of time and money is spent annually on alternative therapies such as Omega-3 fatty acids, without strong evidence that they are beneficial to patients with inflammatory bowel disease," said lead author Dr. Brian Feagan of Robarts Research Institute at The University of Western Ontario in London, Canada.

"I encourage Crohn's patients to focus on prescription medications that we know are effective for preventing relapse of disease, such as azathioprine, methotrexate, and TNF blockers," he added.

Researchers said that there is a widespread belief among patients and health care providers that omega-3 fatty acids are effective treatment for inflammatory bowel disease.

They said that the belief might have stemmed from a relatively small Italian research study, published in 1996 in the New England Journal of Medicine, which found a benefit for preventing relapse of Crohn's disease.

"Small, single centre clinical trials often overestimate the true effects of treatment. That's why it is important to conduct large-scale, randomized, multi-centre studies in order to confirm preliminary results," Dr. Feagan said.

The new study included two large-scale trials involving 738 Crohn's patients at clinical centres in Europe, Israel, Canada, and the United States from January 2003 to February 2007.

Both trials showed that the omega-3 fatty acid formulation offered no benefit in preventing relapse in Crohn's disease.

Researchers however found that patients who took the omega-3 fatty acid preparation did have significantly lower concentrations of triglycerides, a high level of which is a risk factor for heart disease.

The study is published in the April 9 Journal of the American Medical Association. (ANI)

Controlling Anxiety: Mapping Anxiety

Working out the root cause of Anxiety can be a difficult task. Anxiety is such an overwhelming and dis-empowering experience that it can all too quickly become another thing to feel anxious about. "I'm anxious about going to the supermarket because I just know I'll feel anxious once I'm there". It may take some time to get to the root cause of your anxiety, especially if you have been experiencing anxiety for a long time. But it's absolutely achievable. Every single one of us has the power to gain control over anxiety without the use of medication.

Things to remember:
1. Anxiety cannot hurt you.
2. You are not having a heart attack
3. It will pass

The first step is to try to map out what's happening when you experience anxiety. Documenting the severity of anxiety, the situation where you experienced anxiety, what you were thinking and what you were feeling. Automatic thoughts are usually driven by the emotions you are feeling and fuel your anxiety. By identifying them and replacing them with helpful thoughts you can start to train yourself to respond differently. Identifying the emotions your feeling will also assist you. Sometimes when my anxiety is particularly intense I feel like I want to cry. It took my awhile to realise that it was, in part, a response to the sheer helplessness I felt whenever anxiety took hold. Once I started to understand my anxiety more, I started to realise that I could beat it and that made me feel less helpless.

So...

Below is an example I completed myself about a year ago. I thought it might be more helpful to see a completed exercise rather than just the template.


Anxiety Map - Identifying unhelpful thoughts.

Score out of 10: 7

Situation: Going to the supermarket on the way home from work because I'd forgotten to get stock cubes.

Automatic Thoughts: I need to go to the toilet, I'm going to have an accident, this is a nightmare, I don't want to be here.

Emotions: Frustration, fear, helplessness

Helpful Thoughts: Getting upset will not help me, I will make it to the bathroom, it's just over there. I am strong, everything is fine.

Controlling Anxiety: Technique Three - Self Talk

"oh shit! I'm having a panic attack!" It's what most of us think when we realise we're about to have an anxiety attack. It's usually followed by such thoughts as "oh shit, oh shit, oh, shit" or "I got to get out of here" or "why now, why me" or "I'm going to pass out". They're not exactly the most soothing thoughts. Sadly most of us fuel our anxiety by focusing on our panicked thoughts. 

We use self-talk everyday in a million ways, it's a very powerful technique. Using positive, reassuring self-talk during an anxiety attack can take the power right out of Anxiety.  

So...

Part A: For use during an anxiety attack

1. Have a pre-determined short phrase to repeat to yourself. It can be anything at all that you find reassuring and/or calming. I use "It's ok, it's just panic. I'm ok, take a breath" If your phrase is 5 words long you can recite it like a mantra whilst doing the 5 count breathing and combine the two techniques! 

2. Start repeating your phrase either out loud or in your mind as soon as you start to feel anxious. If it is safe to do so, close your eyes and focus all your attention on your words. 

Part B: As a daily exercise

1. Isolate yourself in a room with a mirror. Make sure you are alone and free from distractions. 

2. Look yourself square in the eye.

3. Tell yourself that you are strong, you are confident, you have nothing to fear, Anxiety is powerless over you. 

Just a note on phrases: try to choose positive phrases such as I am fearless, as opposed to I'm not afraid. I'm not afraid easily becomes I'm afraid when in the grip of an anxiety attack. Also the brain doesn't always process the full sentence, just the key words like I'm and afraid.

Controlling Anxiety: Technique Two - Progressive Muscle Relaxation

Progressive Muscle Relation is a technique that not only has the immediate benefit of deep relaxation but it also becomes more beneficial over time. Using this one daily will help to decrease anxiety, improve sleep, relieve tension and a whole host of other things. It's not unlike meditation.

Use this in a place where you can get completely comfortable, like a comfy armchair or on your bed. When you tense a particular muscle group, do so vigorously without straining, for 7-10 seconds and concentrate on what is happening. Feel the buildup of tension in each particular muscle group. It can be helpful to visualize the particular muscle group being tensed. When you release the muscles, do so abruptly, and then relax into the feeling of limpness. Allow the relaxation to develop for at least 15-20 seconds before going on to the next group of muscles. Allow all the other muscles in your body to remain relaxed, as far as possible, while working on a particular muscle group. Tense and relax each muscle group once. But if a particular area feels especially fight, you can tense and relax it two or three times, waiting about 20 seconds between each cycle.

So...

• To begin, take three deep abdominal breaths, exhaling slowly each time. As you exhale, imagine that tension throughout your body begins to flow away.
  
• Clench your fists. Hold for 7-10 seconds and then release for 15-20 seconds. Use these same time intervals for all other muscle groups.
  
• Tighten your biceps by drawing your forearms up toward your shoulders and "making a muscle" with both arms. Hold... and then relax.
  
• Tighten your triceps--the muscles on the undersides of your upper arms--by extending your arms out straight and locking your elbows. Hold ... and then relax.
  
• Tense the muscles in your forehead by raising your eyebrows as far as you can. Hold ... and then relax. Imagine your forehead muscles becoming smooth and limp as they relax.
  
• Tense the muscles around your eyes by clenching your eyelids tightly shut. Hold... and then relax.  Imagine sensations of deep relaxation spreading all around them.
  
• Tighten your jaws by opening your mouth so widely that you stretch the muscles around the hinges of your jaw. Hold ... and then relax. Let your lips part and allow your jaw to hang loose.
  
• Tighten the muscles in the back of your neck by pulling your head way back, as if you were going to touch your head to your back (be gentle with this muscle group to avoid injury). Focus only on tensing the muscles in your neck. Hold ... and then relax. Since this area is often especially tight, it's good to do the tense-relax cycle twice.
  
• Take a few deep breaths and tune in to the weight of your head sinking into whatever surface it is resting on.
  
• Tighten your shoulders by raising them up as if you were going to touch your ears. Hold ... and then relax.
  
• Tighten the muscles around your shoulder blades by pushing your shoulder blades back as if you were going to touch them together. Hold the tension in your shoulder blades ... and then relax. Since this area is often especially tense, you might repeat the tense-relax sequence twice.
  
• Tighten the muscles of your chest by taking in a deep breath. Hold for up to 10 seconds ... and then release slowly. Imagine any excess tension in your chest flowing away with the exhalation.
  
• Tighten your stomach muscles by sucking your stomach in. Hold ... and then release. Imagine a wave of relaxation spreading through your abdomen.
  
• Tighten your lower back by arching it up. (You should omit this exercise if you have lower back pain.) Hold ... and then relax.
  
• Tighten your buttocks by pulling them together. Hold ... and then relax. Imagine the muscles in your hips going loose and limp.
  
• Squeeze the muscles in your thighs all the way down to your knees. You will probably have to tighten your hips along with your thighs, since the thigh muscles attach at the pelvis.  Hold ... and then relax. Feel your thigh muscles smoothing out and relaxing completely.
  
• Tighten your calf muscles by-pulling your toes toward you (flex carefully to avoid cramps). Hold ... and then relax.
  
• Tighten your feet by curling your toes downward. Hold ... and then relax.
  
• Mentally scan your body for any residual tension. If a particular area remains tense, repeat one or two tense-relax cycles for that group of muscles.
  
• Now imagine a wave of relaxation slowly spreading throughout your body, starting at your head and gradually penetrating every muscle group all the way down to your toes. 
  

For more information on this, look for books written by Dr Edmund Jacobson, the developer of this technique.

Lolcat Saturday

I found this over at icanhascheezburger. Enjoy.

Crohn's Disease Video's

Controlling Anxiety: Technique One - 5 Count Breathing

Anxiety and Crohn's Disease sometimes go hand in hand. Having a condition that causes stomach pain, frequent trips to the bathroom and general discomfort it's really no wonder we feel a little on edge. A lot of doctors will prescribe so called 'anti-anxiety' medication but this is really just a band-aid. These pills actually cause anxiety to get worse over time. They were never intended for long term use. There are a number of techniques you can use to control anxiety. I thought I'd devote the next few blogs to some of the better techniques.

5 Count Breathing is the best technique you'll ever have for controlling anxiety. When we become anxious our breathing becomes rapid and shallow which makes us feel lightheaded, dizzy, our heart beats faster and lights and sounds can seam further away. This makes Anxiety worse which makes us breath faster and shallower.... you can see where I'm going with this.

The 5 count breathing technique does two things, it forces us to slow our breathing down, so we breathe deeper. Secondly, it gives us something other than the rising anxiety to focus on. Both of which will lessen the anxiety.

So...

1. Breathe in to the count of 5.

2. Hold for the count of 5.

3. Breathe out to the count of 5.

4. Repeat steps 1-3 five times.

This is great to use when a panic attack comes on, it really does stop it in it's tracks. It has a cumulative effect too, over time anxiety attacks become less intense and less frequent. Some people find that spelling relax instead of counting helps. I advocate doing whatever works for you.

The key here is to breathe through your diaphragm, rather than your chest. To learn to do this is easy. Lay flat on your back and place one hand on your abdomen. Take slow deep breaths in and out. Once you feel your hand rising your doing it right. Your chest should remain fairly still.