suggestion for my next educational forum

Hello!

As you all know I have Crohn's with permanent ostomy but if you didn't there it is! I may have no colon but I have a tattoo of a semi-colon!

I work for my doctors and I am in charge of the next patient education event which will be somewhere in the northwest suburbs of Chicago. So here's my question:

If you had to sit through 2 lectures by top doctors that were 20 minutes long followed by a Q & A what topics would you most be interested in?

This is what we have done in the past:

Relationships, intimacy, and fertiliy in IBD (we had a sex therapist and a well known IBD doctor speak about reproduction)

The IBD Survival Education Event for Patients, Families, and Friends: included new treatments, clinical trials, how to make the most out of your doctor's visit.

Thank you for your help! I want people to come out int he dead of winter to this event so your input is really helpful!

I thought something about surgery would be interesting!

Yep top doctors....Since I started over the past year they have had: Marla Dubinsky, David Rubin, Russell Cohen. They have also bought in Marci Riess the founder of the IBD Support Foundation (www.ibdsf.com) who is also a licensed therapist and Crohn's patient too.

I am thinking of a surgery topic or nutrition. I think bringing in Tracie Dalessandro the fellow Crohn's patient, registered dietitian, and author of "What to Eat with IBD" would make for an excellent presentation.

I agree with Nanners. The ed event here on diet and what each vitamin and mineral impacts was sooo helpful. Although diet is different for everyone, an education on differing food options (we had a fantastic dietician) is useful. I also have always wanted someone to spell out what B12, D, folic acid, calcium deficiency symptoms were and how to maintain balance with supplements and more importantly food alternatives.

Here is my question for the top doctor:

1. Several opioid peptides are produced from milk and wheat protein digestion. Increased µ-opioid receptor (MOR) expression is seen on T cells that induce the inflammation associated with Crohn’s disease and ulcerative colitis.

Recent work in understanding the different result from digesting different casein has indicated higher disease (not neceassarly crohns) in particular casein variants. Proteins in bovine milk are a common source of bioactive peptides. The peptides are released by the digestion of caseins and whey proteins. In vitro the bioactive peptide beta-casomorphin 7 (BCM-7) is yielded by the successive gastrointestinal proteolytic digestion of bovine beta-casein variants A1 and B, but this was not seen in variant A2. In hydrolysed milk with variant A1 of beta-casein, BCM-7 level is 4-fold higher than in A2 milk.

Since there is increased µ-opioid receptor (MOR) expression, generally for crohns, does this indicate a problem with the mechanism of digestion of protein, particularly, casein in crohns patients, more specifically, can the increase be related to the known differences in casein variants.

2. If so, what should the prescribed medication be? An opoid antagonist such as cyprodime? Or a narcotic such as codeine, or narcotic-like drug such as lomotil?

3. Or is this question irrelevant.. as there is no relationship between protein digestion and inflammation in crohns.