The Crohn's and Colitis Foundation of America (CCFA) is running a contest, and if you register for one of their Take Steps walks before November 30, you'll be entered to win a $50 gift card to P.F. Chang's China Bistro. P.F. Chang's now has a gluten-free menu (I've tried a few items on it -- good stuff!). Every walk site is giving away one gift card, which increases your chances of winning!

Everyone with IBD wonders what they can possibly eat that won't worsen their symptoms. The truth is that diet is extremely individual, and it may even change from year to year. A lot of people with IBD stay away from difficult-to-digest foods such as nuts and popcorn, but other people find that seemingly innocuous foods like chicken can cause problems. There are a variety of cookbooks that you can try to help yourself cook for your condition, and I've found one such book that you can get for free!

Brenda Roscher, who has Crohn's disease, has developed a cookbook of foods that she found to be both tasty and Crohn's-friendly. You can get this book for free by signing up for a newsletter at Crohn's Online, and providing some basic information such as email address, postal address, and year of diagnosis. Crohn's Online is run by Abbott Laboratories, makers of Humira.

More about IBD and Diet:

• Is There a Special Diet for IBD?
• Recipes That Go Easy on Your IBD
• Holiday Eating With IBD

The drug Accutane (isotretinoin) has been used for many years to treat severe acne. It's often seen as the last resort for those who have acne that causes pitting and scarring on the face and body. The drug is associated with severe birth defects, and women taking the drug must submit to monthly pregnancy tests and use at least two methods of birth control. Accutane was also anecdotally linked to depression and suicidal behavior, and parents pressured the Food and Drug Administration to pull the drug. The brand name version was taken off the market in June, but generic versions of the drug are still available.

The makers of Accutane, Roche Holding, pulled the drug after several lawsuits that resulted in large payments to plaintiffs who claimed that Accutane caused their inflammatory bowel disease (IBD). A recent study (presented at the American College of Gastroenterology's 2009 meeting) of 21,832 healthy people and 8,189 people with IBD showed that those who had taken Accutane were one and a half times more likely to have developed IBD. The risk further increased with long-term use of the drug. A similar study done amongst Canadians in July showed no such association: people who had taken Accutane were no more or less likely to have developed IBD than those who did not.

With this recent study and the results of the court cases, the availability of the generic version of the drug is in question. It can already be difficult to obtain, but soon it may be impossible for those who wish to take it to treat their severe acne. Dermatologists and other professionals argue that the risk of developing IBD is still very low, and that therapy with isotretinoin is very effective and can help prevent the facial scarring and that can occur with severe acne.

After weighing these arguments -- would you take Accutane to treat your acne? After voting, click on "Comments" and tell me why or why not.

_{Sources:
Crockett S, et al "Accutane use is associated with inflammatory bowel disease: A case control study using administrative data." ACG 2009; Abstract P1122.
Clara I, Lix LM, Walker JR, et al. "The Manitoba IBD Index: Evidence for a New and Simple Indicator of IBD Activity." Amer J Gastroenterol July 2009 104:1754-1763. 10 Nov 2009.}

Results from a recent retrospective cohort study presented at the American College of Gastroenterology's annual meeting has shown that people with IBD who take a class of drugs called thiopurines are at an increased risk for non-melanoma skin  cancer (NMSC). Two IBD drugs that are thiopurines are Imuran (azathioprine) and Purinethol (6-mercaptopurine).

The risk of NMSC was calculated to be 3 times greater in those with IBD who took a thiopurine when compared to people with IBD who were not taking these drugs. An open question that the study was not able to resolve was whether the risk of skin cancer was due solely to the thiopurines, or if the changes in the immune system caused by the IBD itself contribute to the risk. Because of this risk of skin cancer connected with the thiopurines, the authors of the study recommend that people taking these drugs use broad-spectrum sunscreen daily.

_{Source:
Long M, et al. "New Study Reveals Possible Link Between Therapy for Inflammatory Bowel Disease And Non-�Melanoma Skin Cancer." American College of Gastroenterology 26 Oct 2009. 5 Nov 2009.}