November 2, 2011

New E-Card Contest on Facebook!

Would you like your design to be included on CCFA's new E-Cards to send to family and friends? Then create a design and join our contest!

The Crohn's and Colitis Foundation of America is running an E-Card contest on Facebook to find the best E-Card design to use this winter!

You can submit your E-Card, or vote for a friend's design from Tuesday, Nov. 1 until Wednesday, Nov. 30, 2011. The top three designs will be chosen by votes from the public, and the final winners will be announced on Monday, Dec. 5.



To submit your design:

1. Visit our National Facebook Fan Page
2. Click "Like", at the top of the page
3. Click "Holiday E-Card Contest" on the left-hand side menu
4. Click "Enter to Win", and send us your E-Card design!


To vote for designs:

1. Visit our National Facebook Fan Page
2. Click "Like", at the top of the page
3. Click "Holiday E-Card Contest" on the left-hand side menu
4. Click "View and Vote", to view the E-Cards and vote for your favorite!


We can't wait to see your beautiful cards this holiday season!

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October 20, 2011

Macon Patient Education Program-November 30, 2011

Educational Program on Treatments for Inflammatory Bowel Diseases

An interactive event for patients, families, and caregivers in Macon, GA on November 30, 2011.

The Crohn’s & Colitis Foundation of America invites patients, families, and caregivers living with Crohn’s disease and ulcerative colitis to the educational program Treatment Approaches in IBD: Options to Consider. Consisting of a live and interactive presentation by Dr. Shahriar Sedghi as well as a question-and-answer session, the program will be held in the auditorium in the West Tower at the Medical Center of Central Georgia on November 30, 2011 at 7 PM.

Register today at http://online.ccfa.org/site/Calendar?id=115841&view=Detail or call Mary Ball, Regional Education and Support Manager at 404-982-0616.

Crohn’s disease and ulcerative colitis are chronic digestive disorders of the intestines. These illnesses are collectively known as inflammatory bowel diseases, or IBD, because many of their symptoms and complications are similar. It is estimated that 1.4 million Americans suffer from IBD, with approximately 30,000 new cases diagnosed each year.

This program will address the following topics:

· Similarities and differences between Crohn’s disease and ulcerative colitis
· Risks and benefits of medication, surgery, and integrative treatments in IBD
· Impact of treatment adherence on disease management and quality of life
· Talking with your health care team about your treatment plan

This educational program is supported by an educational grant from Janssen Biotech, Inc.

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September 14, 2011

Columbus Education Program-October 25,2011

Join us for the Columbus Patient Education Program!
Tuesday, October 25, 2011
Check-in from 6:00-6:30 pm
Presentation from 6:30-7:30 pm

Hosted by the Crohn's and Colitis Foundation of America
at the Columbus Regional Conference Center at The Medical Center
710 Center Street-Columbus-GA-31901

"Nutrition and Diet for Crohn's disease and ulcerative colitis: Choices for adults and kids"
Presented by: Beth K. Arnold, M.A.,R.D., L.D., specializing in IBD

*There will be sandwiches and refreshments provided for all registered participants.

PLEASE CLICK HERE TO REGISTER ONLINE.

For more information about this program please contact Mary Ball at the CCFA at mball@ccfa.org or (404)982-0616.

This program is free of charge thanks to our supporters: Salix Pharmaceuticals, Janssen Biotech and Prometheus Therapuetics and Diagnostics

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July 22, 2011

Take Steps Walk 2011

Take Steps, CCFA’s largest fundraising event nation-wide, is a non-competitive walk that takes place multiple times per year. Participants raise funds and awareness to prepare for the walk, and to make noise and be heard about the steps taken towards a cure for Crohn’s disease and ulcerative colitis.

The next Take Steps event taking place in Georgia will be in Savannah, with the Kickoff Party on Wednesday, August 3, 2011 at Grayson Stadium, at the Savannah Sand Gnats vs. Augusta Green Jackets game. The Kickoff Party will start at 6:00 p.m., and admission is $7 per person.

The Take Steps Savannah walk will be held on Sunday, October 30, 2011 at Daffin Park, with registration open at 2:00 p.m., and the walk starting at 3:00 p.m. The Honored Hero for the walk is Elizabeth Sevier, and there will also be music, and a Kids’ Corral with crafts and games for your children. Additional last-minute attendees are welcome, with a donation to CCFA at registration.

Also coming soon is the Macon Take Steps walk, a new addition to the Georgia chapter calendar of events, taking place on Sunday, October 2, 2011.

To sign up or for more information, visit http://www.cctakesteps/savannah , or http://www.cctakesteps.org. You’re also welcome to email our Walk Manager Grace Murphy, at gmurphy@ccfa.org, or call our office at (404) 982-0616.

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July 21, 2011

Anjali Shroff, B.S.
Kristopher Lewis, M.D., Assistant Professor of Radiology, MCG
Clarence Joe, D.M.D., M.D., F.A.C.R.
Sateesh R. Prakash, M.D., SGS Research and Educational Institute, LLC

Radiologic Imaging in Inflammatory Bowel Disease (IBD)
Crohn’s disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel disease, are increasingly prevalent in the United States with an estimated incidence of 400 patients per 100,000 individuals.1 In addition to the endoscopic evaluation and clinical symptoms, radiologic evaluation is an important component to the diagnosis and management of IBD.2


Various imaging studies are utilized by physicians in treating CD and UC. Plain radiographs, computerized tomography (CT scans), and magnetic resonance imaging (MRI) are a few examples of such studies. In evaluating which method to use, doctors must take into account the patient’s age, possible complications associated with imaging, financial cost, radiation exposure, and availability of tests. Older methods of imaging include radiographs which can evaluate for complications of disease such as obstruction and amount of stool, though they are not used for diagnosis of IBD. CT scans are increasingly utilized in the acute setting to evaluate for complications of IBD which include small bowel obstructions, abscesses, and perforations.1 Relatively newer techniques such as CT enterography, which uses a CT scanner with oral contrast for imaging, and MR enterography, which uses magnetic resonance imaging, have been shown to be successful in assisting with the diagnosis of IBD particularly the extent of involvement including fistulization, perianal disease and small bowel involvment. MR enterography is specifically more desirable due to its lack of radiation and increased accuracy.1 However increased costs and lack of availability are drawbacks to MR enterography. MR and CT enteroclysis are techniques that employ contrast administered through a nasojejunal tube in order to distend bowel. MR enterography is more commonly used in children due to the specialized skill needed and lack of availability of MR enteroclysis.1 CT enteroclysis is usually better suited for acute situations such as obstruction or abscess. To assess for perirectal abscesses or fistulas, literature has shown MRI to be the best imaging modality to determine presence, type, location, and associated findings of fistulas.1


Traditionally, small bowel follow-through (SBFT), which is an xray of the bowel after ingestion of contrast, or enteroclysis, a fluoroscopic evaluation of the small intestine, were used as a gold standard to evaluate bowel disease.3 Drawbacks to SBFT include the high radiation dose, poor imaging of the bowel causing difficulty in evaluation of the disease, and inability to evaluate disease spread outside the bowel.1 Recently, video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) have allowed for more diagnostic techniques to fully evaluate bowel disease and the extent of CD. VCE involves swallowing a small capsule containing a camera which takes pictures of the bowel.3 One of the limitations of using a capsule is capsule retention resulting from a stricture or other obstructive process in the bowel lumen.4 In addition to visualizing the entire small bowel, DBE allows for biopsies and therapeutic intervention.3


In order to evaluate all layers of the bowel, other imaging techniques such as ultrasound (US), CT scans, or MRI may be used. For US, the patient is usually required to fast for 4 hours or overnight, depending on the situation.3 Using Doppler US also allows for evaluation of vessels that supply the bowel.3 Other findings on US that can help identify IBD include deep abscesses, ulcers, fistulas, and changes to the bowel wall.3 The stratification pattern of the bowel wall is an important feature of distinguishing CD from UC since it is variable with CD.3 Some disadvantages of using US to detect IBD is that certain parts of the small bowel, such as the duodenum, jejunum, rectum, and sigmoid colon, are not clearly visualized, the extent of disease cannot be fully evaluated, sensitivity is low for detection of superficial mucosal disease,4 and small abnormalities may not necessarily be detected.3 However, if an imaging technique is required, US is a good initial imaging option since it is inexpensive and easily conducted.3
For a CT scan, patients are usually asked to fast for a few hours and oral and intravenous (IV) contrast is used.3 As with US, IBD is diagnosed by thickening of the bowel wall of greater than 3 mm. With IV contrast, an increase in enhancement with CT imaging of the bowel wall, especially throughout all the layers, can also suggest IBD.2 One disadvantage of the CT scan is significant radiation exposure.
For MRI, depending on the facility, fasting or bowel cleansing methods are used prior to the exam. The bowel must be distended with contrast to fully elucidate any pathology. An advantage of MRI is the lack of radiation exposure.3 With MRI, a thickened bowel wall (>3mm) is used to diagnose IBD as well as enhancement of the bowel wall.3 MRI is very sensitive in detecting fistulas, abscesses, and enlarged lymph nodes.1 Some disadvantages of MRI include the prolonged imaging time and the possible necessity of medications to slow gut motility for improved imaging.
IBD in the pediatric population usually presents more extensively and severely.2 Due to the possibility of vitamin malabsorption and subsequent growth retardation, diagnostic accuracy in this population is essential.2 MRI can be used to help detect strictures, disease through all layers of the bowel, and other pathology in children since there is no radiation exposure.4 Radiation with fluoroscopy and CT studies is a concern, especially in the pediatric population, hence other studies such as MRI, US, or capsule endoscopy are preferred.2 In emergencies, CT is still a useful tool for rapid imaging in children and to evaluate complications of IBD.4


Overall, it is important to discuss radiographic tests with your doctor to identify the appropriate tests in the management of your IBD.

1. Pediatr Radiol. 2009: 39(2): 149-152. Imaging choices in inflammatory bowel disease. Anupindi SA, Darge K.

2. Dig Dis. 2009: 27: 269-277. Inflammatory Bowel Diseases: Controversies in the Use of Diagnostic Procedures. Vucelic B.

3. Abdominal Imaging. 2008 July: 33: 407-416. Detection of inflammatory bowel disease: diagnostic performance of cross-sectional imaging modalities. Horsthius K, Stokkers PC, Stoker J.

4. Pediatr Radiol. 2008: 38 (3): 512-517. Imaging of inflammatory bowel disease. How? Hiorns, MP.

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June 15, 2011

Join us for the 2nd annual Bottoms Up for Crohn's & Colitis event!



Please join us for the 2nd annual Bottoms Up for Crohn’s & Colitis event on Saturday, August 20th at CosmoLava in midtown. Bottoms Up is the Georgia chapter of the Crohn's & Colitis Foundation's newest fundraiser that specifically targets a younger generation of charity-minded attendees.

Ticket price includes hors d'oeuvres, four drink tickets, silent auction, music and dancing at Atlanta's "Ultimate Midtown Experience"...CosmoLava!

For event info and tickets, visit www.bottomsupforccfa.org. For additional questions, contact Amy Suiter at 404-982-0616 or asuiter@ccfa.org.

All proceeds benefit the Crohn's & Colitis Foundation of America, Georgia Chapter.

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May 17, 2011

Free Stress Management Workshop

Free Stress Management Workshops

Where: Cohen Chiropractic Centre2140 Peachtree Rd NW, Suite 203Atlanta GA 30309

Speaker: Dr. Austin Cohen

Directions: http://www.cohenchiropracticcentre.com/

Main Line: 404-355-5499

May 17th - 6:30 - 7:30 PM - Stress: The Silent Killer (This workshop we willtalk about all of the Physical, Chemical, and Emotional stresses that happento the body. From there we discuss the human physiology and the processesthat happen to the human body. This leads us to the effects that happen whenthe body is chronically under stress and we talk about not treating theeffects but actually correcting the Cause. The Cause lies in the following 3workshops where we will tackle the Physical Stresses such as exercise andposture, then to Chemical Stress which will focus mostly on nutrition, andfinally to Emotional Stress which will be very motivational and be all aboutcreating an abundant life through positive thinking, goal setting, andaffirmations.

July 19th - 6:30 - 7:30 PM - Balancing Your Physical Stress

September 20th - 6:30 - 7:30 PM - Balancing Your Chemical Stress (thisworkshop includes a shopping trip to Whole Foods!)

November 15th - 6:30 - 7:30 PM - Balancing Your Emotional Stress

For more information please contact Mary Ball at the Crohn's and Colitis Foundation at 404-982-0616 or mball@ccfa.org

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April 12, 2011

Health Prevention in IBD: Vaccinations

Health Prevention in Inflammatory Bowel Disease: Vaccinations
Nichole McCollum, B.S.1 , Sateesh R. Prakash, M.D.2,3

Mercer University School of Medicine1, SGS Research and Educational Institute2, and Medical College of Georiga3

Vaccinations play an important role in preventing illnesses. Inflammatory bowel disease (IBD) patients, including patients with Crohn’s Disease and Ulcerative Colitis, may be at increased risk for infection when compared to the general population. Reasons for the increased risk include underlying disease, malnutrition, surgery or immunosuppressive therapy. 1

In recent years many patients have benefitted from treatment with immunomodulators (Azothiopurine or 6-Murcaptopurine) and biologic therapy (anti-TNF therapy including Humira, Remicade, and Cimzia). While these newer therapies have improved disease activity, decreased frequency of hospitalizations and improved quality of life for IBD patients, they are associated with increased susceptibility to acquiring and fighting off various illnesses. 2 The degree of susceptibility is related to the degree of immunosuppression accompanied with the IBD patient’s treatment regime. 1 As more physicians and patients become aware of the increased risk of infection associated with IBD therapies, increased efforts and resources are utilized to vaccinate IBD patients for preventable illnesses. 2 Unfortunately, many worry that an IBD patient’s immune response will not be adequate because of immunosuppressive therapy.3 It is imperative that IBD patients stay up to date on immunizations to avoid common and preventable illnesses.

Recommended Vaccines for IBD Patient

In general, IBD patients should follow the recommended vaccine schedule for adults with the exception of patients on anti-TNF or biologic therapy. These patients should not receive any live virus vaccines which include Influenza inhaled (LAIV), Mumps-Measles-Rubella (MMR), Varicella, and Zoster vaccines. Other live virus vaccines less commonly administered in the United States include Typhoid (oral) and Yellow Fever vaccines. A live virus vaccine contains “living” virus that is used to produce immunity, usually without causing illness.

Patients on anti-TNF therapy should avoid live virus vaccines due to the increased risk of causing illness.3 In addition to the regular vaccine schedule for adults in the United States, it is recommended that IBD patients receive a few extra vaccines3. Studies have shown that women with IBD have a higher incidence of abnormal PAP smears than the general population. The increased risk for HPV infection and abnormal PAP smears may be greater in women on immunosuppressive therapy4. Thus, in addition to all females age 9-26 years old receiving the HPV vaccine, females with IBD older than 26 years of age who are negative for HPV should be considered as well. Furthermore there is an increased incidence in anal cancer with perianal Crohn’s disease and males should be considered for vaccination against HPV5. However, individuals with IBD should discuss these vaccinations with his or her health care provider. Pneumococcal infections and influenza are two common adult vaccine preventable diseases. All IBD patients should be up to date on their pneumococcal and influenza vaccinations.3 Pneumococcal vaccines are given earlier in IBD patients compared to the general population5. Vaccination with pneumococcal polysaccharide vaccine and inactivated influenza vaccine is safe and well tolerated by all patients. These vaccines may be administered simultaneously. 2 Adults with IBD who are not on anti-TNF therapy and have no reliable history of varicella illness or vaccination should be vaccinated for varicella.3 Physicians and patients should recognize the importance of live virus vaccinations PRIOR to beginning anti-TNF or biologic therapy. Mortality rates are typically much higher in adults who experience varicella compared to children with the same disease. For this reason alone, effort should be made to ensure every adult IBD patient is immune to varicella.2

The recommended vaccines for adults in the United States are listed below
6:

-Tetanus, diphtheria, pertussis (Td/Tdap): Adults receive a one-time Tdap booster, then Td booster every 10 years thereafter

-Human Pailloma virus (HPV): 3 doses administered to females ages 9-26 years old

-Influenza: one dose annually

-Pneumococcal: 1 dose between ages 19-26 years old then booster after 5 years

-Hepatitis A: 2 doses administered to at risk populations

-Hepatitis B: 3 doses administered to at risk populations

-Meningococcal : administered to 1st year college students, military recruits and persons traveling to endemic areas

-MMR (*live vaccine):2 doses between 19-49 years old for adults born after 1957 or if serology does not show immunity, female

-Varicella(*live vaccine): all adults without evidence of immunity or prior vaccination

-Zoster/Shingles(*live vaccine): all adults age 60 or older; not recommended for those who received varicella vaccine

*all live vaccines are contraindicated for patients on biologic therapy

Travel Vaccinations

All persons traveling to areas where Typhoid and Yellow Fever are endemic are recommended to be vaccinated prior to travel. IBD patients on biologic therapy should only receive the intramuscular Typhoid vaccine as the oral Typhoid vaccine is a live virus vaccine. IBD patients on biologic therapy should not be vaccinated for yellow fever as it is a live virus vaccine3. IBD Patients’ Immune Response to Vaccines. Studies have shown IBD patients develop an adequate immune response to vaccine, though sometimes at lower levels than the general population. Thus, it is recommended that IBD patients be vaccinated with all vaccines not contraindicated due to therapy. Some immunosuppressive medications may lessen the immune response to vaccines, specifically IBD patients receiving combination immunosuppressive therapy. This population of IBD patients may benefit from vaccine boosters1. Vaccines have not been proven to worsen clinical activity of IBD. Vaccines are typically tolerated well by the general population and the same holds true for IBD patients3. For more information about vaccinations, please consult your physician. Vaccinations should be individualized and the decision to be vaccinated should be done for the appropriate vaccine after discussion and consultation with your gastroenterologist or primary care physician.

1. Lu Y JD, Bousvaros A. Immunizations in Patients with Inflammatory Bowel Disease. Inflammatory Bowel Disease 2009;15:1417-23.

2. GY M. Vaccination Strategies for Patients with Inflammatory Bowel Disease on Immunomodulators and Biologics. Inflammatory Bowel Disease 2009;15:1410-6.

3. Sands BE. CC, Katz J, Kugathasan S, Onken J, Vitek C, Orenstein W. Guidelines for Immunizations in Patients With Inflammatory Bowel Disease. Inflammatory Bowel Disease 2004;10:677-92.

4. Kane S KB, Reddy D. Higher Incidence of Abnormal Pap Smears in Women with Inflammatory Bowel Disease. American Journal of Gastroenterology 2008;103:631-6.

5. Moscandrew M MU, Kane S. General Health Mainenance in IBD. Inflammatory Bowel Disease 2009;15:1399-408.

6. Practices ACoI. Recommended Adult Immunization Schedule: United States, 2009. Annals of Internal Medicine 2009;150:40-4.

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