Thursday, December 9, 2010

The New Chiropractic Story

I get asked a lot about what chiropractic is, what it does, how it works, etc.  In his recent blog postFreehold, NJ Chiropractor, Russell Brokstein shares what chiropractors have fondly referred to as, "The Chiropractic Story".

As he relates in the article, the critical elements of The Chiropractic Story are:

1. The Nervous System (which includes your brain, your spinal cord, all the nerves that emanate from the spine) controls every organ and tissue in your body.  It is this system which regulates all the critical functions required for you to survive.

2. In order for survival to occur at it's optimum level, in other words, in order for once to be healthy and to truly thrive, rather than just get by while on a path of gradually increasing disability, this system needs to be unencumbered by interference of any kind.  Your nervous system has to have clear channels of communication with every organ and tissue, unimpeded by major or minor blockages.

3. Misalignments in the spine can create irritation to these delicate nerves, and interfere with that clear communication. In this way, nerve stress manifests as changes in all the tissues in the vicinity of that misalignment, all the tissues downstream which are directly innervated by the nerves that emanate from that spinal level, and this WILL lead to a cascade of events that has the potential of negatively affecting the health and function of organ systems that rely on proper efficient function of the affected tissues and nerves. Recognizing that the organism that is our body has no extra parts, it is obvious that all organ systems rely on all others and consequently, failure in one will eventually degrade all the others, either directly or indirectly.

4. Health is only achievable through a properly functioning nervous system.  These stressors, misalignments, irritations are called subluxations. Subluxations are, by definition, impediments to proper nerve function and should be resolved.  Chiropractors are the only primary care physicians that are trained to detect and correct subluxation. Chiropractic is also the only primary health care approach that does not rely on drugs or surgery to facilitate the recovery of health.

The Rest of the Chiropractic Story (with references to the corresponding numbered elements above):

Dr. DD Palmer was the one who first developed the therapeutic strategy of adjusting specific spinal vertebrae for the express purpose of relieving pressure or stress on the nerves that emanate from that portion of the spine. DD Palmer's son, Dr. BJ Palmer first referred to this classic explanation of chiropractic as "The Chiropractic Story". BJ Palmer bears most of the credit for the development of the profession now known as Chiropractic.,

With that background, and considering that it has beem nearly 113 years since the first chiropractic adjustment in Davenport, IA it is entirely understandable that a lot has been learned about anatomy, physiology and the therapeutic benefits of the chiropractic adjustment. I will not try to deliver that entire body of scientific knowledge here, but I would like to identify a few directions in which this story has developed in the last 112 years...

1.  We know that there is an automatic nervous system that is entirely voluntary requiring no conscious monitoring in order to function.  This is called the Autonomic Nervous System and includes two subsets called the Sympathetic and Parasympathetic Nervous Systems.  With injury, we will often get into a hyper-sympathetic state, created an imbalance in that normal interplay with the parasympathetic system.  This affects immuncehealing, cardiovascular function, sleep patterns, pain perception, and mental clarity, to mention a few. Studies have demonstrated a decrease in sympathetic dominance with the delivery of chiropractic care.

We also have gained a better understanding that our system of glands and hormones are an extension of our nervous system that was not appreciated early in the history of chiropractic. The secretion of hormones are directly controlled by nerves from the central nervous system which act in response to the needs of the organism perceived through communication by way of feedback again, by nerves. So we now better understand that nerves are utilized for short acting immediate actions while hormones are released into the bloodstream to affect changes that are longer lasting (ie. hours to days instead of miliseconds to minutes). This led to a better understanding of the benefits of chiropractic adjustments in hormone-influenced functions such as sleep, reproduction, immune response, etc.

2. It is clear that there is no way to have absolutely no interference.  That is impossible.  On the other hand, leaving a source of interference in place without simple efforts to minimize it, manage it, mitigate it in some way can only serve to have the situation snowball to the point at which it becomes unmanageable.  If you have ever had a low engine oil light come on in your vehicle, you know that 1) cars consume oil and so this is not cause for panic, but that 2) it is very important that oil should be replenished immediately in order for continued proper operation. Would you ever consider not putting oil in just because teh engine still sounds good, starts just as easily, accelerates with great power, and every other function of the car seems unaffected by the low oil level?   Of course not.  You know, either from your own experience or the wisdom passed to you from others that ignoring the oil light will lead to catastrophic failure of the engine, possibly without any further warning. And, if you listened, you will understand that sometimes the oil light doesn't work, so, really, you should manually check your oil every time you get gas.

Do you rely on your body any less that your vehicle?  Does it make sense to wait for symptoms of pathology or sickness to occur before you maintain your body?  The central nervous system is so important and yet so delicate that it is the only organ system completely enclosed in bone (the cranium and spine). Since this is the computer that runs the whole system, don't you think those structures deserve at least some maintenance for proper function?  You maintain your teeth.  You maintain your car.  This is obvious stuff, right?

3. We have discovered that misalignments absolutely do exist.  Irritations and their influences do exist.  But these are also controlled by your nervous system.  Chiropractors absolutely do affect alignment, but not by simply restacking the blocks (vertebrae) of your spine.  The effect of the adjustment is by way of neurological (data, information, impulse) input to the central nervous system by way of sensory receptors in joints and other body tissues. Your alignment does change, but it is not simply putting a bone back into place.  This is not a procedure like taking a pill or undergoing a surgical procedure.  What the chiropractor does is best described as a "soft reset" on your computer.  With the gentle, specific, and safe input of a chiropractic adjustment, we wipe away all the misplaced 0's and 1's that have your system spinning around in a fog and allow your brain to take new inventory of your body's state and of the influence of your environment and reset the 0's where 0's should be and the 1's where the 1's should be so that, over the next 12 to 24 hours a new strategy, that is current, appropriate and accurate, is in place to allow you to jump the hurdles that remain to the absolute healthiest function you can attain.

4.  This one is simple and it remains true as ever.  For most of the 112 years all the other health care professions denied what we do.  Now, they are beginning to recognize the absolute pure truth of the concept that was discovered first by the CHIROPRACTIC PROFESSION; that our bodies heal themselves... we have all the drugs we need, we have all the tools we need... inborn.  We simply need to maintain our bodies properly.  So as the PT's and MD's and who knows who else fall over themselves to try to claim proficiency at "spinal manipulation", the truth is that they still don't understand how to determine where to adjust or why... They still think it is a "pill".  And it doesn't work that way. Only chiropractors are trained to detect and correct subluxations.

Edward Harriott, DC
Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112

If you want to reach more from Dr. Brokstein's Freehold Chiropractic blog, fee free to visit it. If you need a chiropractor in Freehold, NJ, you can find him at:


Hometown Family Wellness Center
9 Broadway
Freehold, NJ 07728
(732)780-0044

Wednesday, December 8, 2010

Seasonal Allergies and Chiropractic Care

Omaha Chiropractor Tyler Baker recently published some useful tips for people suffering from pollen-related seasonal allergies. Specifically , Dr. Baker discusses the irrigation of the nasolarynx with Neti pots. These are small squeezable plastic bottles with tubes that create a fountain of water when squeezed. What you would do is to melt a saline packet that comes with the kit in good clean luke warm (ideally boiled and then cooled to luke warm) water. Then, you would lean over the sink and flush the solution up through the nasal passages until it comes out the mouth. You would do this whenever you come in from an area in which you were likely to have been exposed to airborne allergens. This mechanically washes away the irritating antigenic particles causing the allergic reaction. It also will help to lubricate and soothe any irritated or sensitive nasal tissues and reduce, at least temporarily, post-nasal drip which is a major cause of sore throat. This can also be helpful with colds and flus.

Dr. Baker also notes that the highest amount of air-borne pollen is released in the temperate mornings and evenings, with significant reductions in pollen release during the heat of the day and cold of the night. He advises that those suffering from seasonal allergies would do well to stay indoors during the morning and early evening hours while the temperatures are going through their greatest change.

A more allopathic approach would be to scrub the air of such allergenic particles in your homeand workplace so that you're system is not insulted in your sleep or at work. An indoor HEPA-style air filter does a good job of this.

And Dr. Baker makes a point that getting adjusted will help. How could adjusting the spine help with seasonal allergies? Well, the benefits are both direct and indirect:

  1. Very often, allergies cause a great deal of sneezing and/or coughing.  This can easily cause misalignment of the neck and upper back or lower back.  It is also very easy to misalign the heads of the ribs that make up the rib cage. These misalignments can create local joint and soft tissue irritation which will cause an increase in nerve stress for those organs served by the nerves that eminate from the spine at the affected levels.
  2. Spinal misalignments or subluxations also affect the autonomic nervous system (I like to call this the automatic nervous system because its actions require no conscious thought) which can exacerbate or amplify your immune reaction to the allergens.
In the end, someone suffering from allergies needs to develop healthy natural strategies to deal with these seasonal episodes in order to avoid the over-the-counter or prescription medications that will inevitably skew your natural biochemical internal processes in unintended ways.  While we may not notice the bad side effects of every dose of medicine we take, there are unquestionably effects that are not positive and that will affect us over a lifetime.  Those who have a condition such as this that may well last a lifetime would do well to find a natural way to deal with it.

Edward Harriott, DC

Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112
http://www.mvchiro.com

Tyler Baker, D.C

Active Motion Chiropractic
13027 Arbor Street
(402) 334-2244
ActiveMotionChiro.com
http://www.activemotionchiro.com/Blog.html

If you want to reach more from Dr. Baker's Active Motion Chiropractic blog, feel free to visit it. If you need a chiropractor in Omaha, NE, you can find him at:


Active Motion Chiropractic
Address: 13027 Arbor St., Omaha, NE 68144
Phone Number:(402)334-2244
ActiveMotionChiro.com

Tuesday, December 7, 2010

Orem Chiropractor explains Forward Head Posture

There are several standard exam elements in every chiropractic exam in my office. There are the vitals, the range of motion, the strength evaluations, the neurological tests. And, of course, there is the palpatory exam where I actually put my hands on the spine so I can see through the eyes that I have apparently managed to grow in my fingers (I am humbled and my patients are often amazed by the ability I have to find problems with the simple touch). And, sometimes, I have to get x-rays if the case indicates that is needed. But the one element of the exam that we all have the ability to do ourselves every day is the postural evaluation.

In his recent blog post, Orem Chiropractor, Dr. Ned Arthur does a great job describing a very common postural abnormality that we refer to as forward head posture. He even has a experiment for his readers to try to illustrate the effects of forward head posture.  I would like to share two common experiments that I use with those using Orem Chiropractic services from Dr. Ned...

The first one is to have the patient hold a pencil straight up in his fisted hand and put the weight of my hand on the up eraser end and remind the person that their head weight 10 to 13 pounds on average.  Then I have the person tilt the pencil forward slightly and put my hand back on the eraser and this demonstrates how little forward shift dramatically increases the load on the neck and shoulders.

Then, I ask the person to "point" his chin or tilt his head slightly forward (thereby exagerating the forward head position)  and have the person put his fingers lightly on the muscles in the back of his own neck just to the sides of the central bony spiny prominences from his neck bones. Then I ask the person to "slide" his head directly backward until his head is well back over his shoulders and have him feel those same muscles and how much less work they are doing and how much more relaxed they are.

Be sure to go read Dr. Arthur's write-up on forward head posture.  You will learn a lot about why this is such a bad situation and why we really should be doing something about it now, rather than waiting for the wraning lights to go off.


Edward Harriott, DC
Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112
http://www.mvchiro.com

If you want to reach more from Dr. Arthur's Orem Chiropractor blog, fee free to visit it. If you need a chiropractor in Orem, UT, you can find him at:


Orem Chiropractor
Address: 560 S. State #C2 Orem, UT 84058
Phone Number: 801-225-1311

Will The True Chiropractic Lifestyle Please Stand Up?

In the past, I often had patients that would wait for two weeks with some sort of pain before calling me for an "urgent" adjustment.  Sometimes, that same person would ask me something like, "Doc, are there any exercises that I can do that will stop this problem?"  The other common question was, "Are there any supplements that I should be taking considering that this keeps happening to me"?

At this point, I would worry.  I'd worry that I hadn't done my job in explaining what I offer as a chiropractor.  I'd worry that if I didn't recommend a supplement or an exercise that they would go away.  Or that if I recommended a supplement or exercise and their problem didn't disappear, that the patient would figure that I didn't know what I was talking about and go somewhere else.

But where would they go?  To the chiropractor down the street who just makes sure that he recommends enough things or difficult enough things that the patient won't comply and so he can always blame the patient? "After all, Skippy, how can you expect to get better if you don't stretch 3 hours every day like I told ya' to?"

In my own life, I can see that what we are doing as a society is contrary to a logical expectation for a healthy life.  This is constantly beaten to death in the popular media, so I won't waste your eyes reading another rehashing of all the bad stuff we do.  But as I pursue my post-graduate studies in functional medicine so that I can help those with metabolic problems, immune over-reactions and various toxicity-related pathologies  and as I continue to learn about the musculoskeletal movement pattern deficiencies that lead us like a herd of buffalo into "inevitable" and "normal" arthritic states and varying levels of "stiffness of old age" so that I can reverse that process for my patients... As I study more about how to truly help my patients, with the chiropractic adjustment that resets the microcomputer that controls the body and removes communication interference and stress from the body... Well, I am dumbfound by how screwed up we really are.

I currently am almost 47 years old.  I stand six feet tall.  A few years ago, I weighed about 215 pounds. I ate pretty well, not too many snacks, high quality veggies, good protein, blah, blah blah.  I would get out and play with my kids on the weekends and do the office warrior thing during the week.  But I figured I was "one of the smart ones" who got adjusted regularly, didn't drink to excess, didn't take drugs, didn't eat a bunch of polyunsaturated fats, or avoid fruits and veggies.  I had a small dessert after every dinner, sure, but I didn't jump at a pharmaceutical or run to the MD for every little problem. Surely, I wouldn't develop serious health problems, right?

I have to say, that as I read recent news items like the one that says 1 in 3 Americans will be diabetic by 2050 I started to wonder if I was going to be that "one" after all.  Well, I am coming to the conclusion that we are more screwed up that we even know.  And it is deeper than the dessert, or the exercise, or the prescription drug. It is in the very core of our societal being.  Chiropractic absolutely has it right.  But even chiropractors can miss the big picture... after all, we are human too.  The issue is around what is tolerable, what is unhealthy, what concerns us enough to do something different.

We have all had indigestion.  We've all had a headache.  If you have one, and you take something (or not) and it goes away... No harm, no foul.  This is par for the course.  This stuff just happens.  But if it doesn't go away... Well, NOW we've gotta do something about it. And what are you going to do?  Really... what?  Go to the drug store?  See a doctor? Heaven forbid that you body should adapt and it goes back to once a week or once a month like it was before it "wouldn't go away".  And on we go... Then, you turn 45 and it starts happening once a week again and every once in a while you'll have it two days in a row.  Must be getting older, right?  Par for the course.  Now I see what my dad was always talking about...

No, it is time that we finally go back and relearn the lessons that chiropractors have been teaching us since DD Palmer  and his son BJ Palmer first developed this wonderful approach to real health.  A symptom is not an enemy, it is a signal.  Symptoms are our friends!  Unless we don't heed the message.  If you ignore a warning light in your car, you will be sorry.  We understand that.  The car may even seem to be running fine when the low oil light comes on. But if you don't add oil, you will be sorry.  Maybe tomorrow, maybe next week, or next month, but you WILL BE SORRY.

The problem with our society is this dialogue about what is normal.  Stop it, folks!  It is normal for indigestion to occur when you are not digesting properly.  But just because someone downplayed it in your youth, on a commercial, on the radio, the billboard and everywhere else in our society... that doesn't mean you shouldn't do something about it.   And I don't mean to buy something, a Rolaid or a Tums.  Come on, what does the signal mean? Do you buy duct tape to cover that pesky oil light?

I am highly trained to provide biomechanical input with gentle, focused and controlled forces into a complex human machine and remove hurdles to a more complete and vigorous expression of that machines inborn capacity to function and heal. But beyond that miraculous thing we call the chiropractic adjustment, I help my patients on a path toward a chiropractic lifestyle where natural healthy expression of life is actually  achievable. You won't find that in an M.D.'s office.  When you find yourself there, you can be pretty sure that you waited too long to do something right.

Everyone needs a great chiropractor just like he needs advice from a friend.  Everyone needs a chiropractor, just like he needs a good meal and a glass of clean water.  Everyone needs a chiropractor like he needs a brisk walk every day.  Everyone needs a chiropractor like he needs a challenging puzzle, a funny story, a pleasant holiday with the family.

Our problem is that we still see not having a chiropractor, or good healthy food in rational quantities, or a lot of clean water, or frequent exercise, or intellectual challenges, or not provideing for times to relax alone or with friends and family... We see these things as an optional.

And they are... Just like diabetes. Optional.

Edward Harriott, DC
Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112
http://www.mvchiro.com

Tuesday, November 2, 2010

Massage Therapist Calendar Up To Date as of 8:30 pm, 11/2/10

If you care to schedule an appointment for massage, as of this evening, the online calendar represents the latest existing appointment distribution and a request for an open appointment is likely to be confirmed exactly as you request it.

I hope you can take advantage of my new LOW LOW massage and/or chiropractic rates.

See you soon,..

Friday, July 2, 2010

Thought Fructose was the Good Sugar? Think again

Dr. Harriott's Comments: 

In general, a good rule of thumb is that anything real sweet is not something you want to eat a lot of.  Tone it down or turn it down... for good health.

===================================


Fructose Linked to High Blood Pressure

By Todd Neale, Staff Writer, MedPage Today
Published: July 01, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
People who consume the amount of fructose found in two-and-a-half regular soft drinks a day appear to have a higher risk of hypertension, a cross-sectional study showed.


Consumption of at least 74 grams per day was associated with 26% to 77% greater odds of crossing various thresholds of elevated blood pressure (P<0.05 for all), compared with lower levels of consumption, according to Diana Jalal, MD, of the University of Colorado Denver, and colleagues.


"Limiting fructose intake is readily feasible, and, in light of our results, prospective studies are needed to assess whether decreased intake of fructose from added sugars will reduce the incidence of hypertension and the burden of cardiovascular disease in the U.S. adult population," they wrote online in the Journal of the American Society of Nephrology.
Action Points  

  • Explain to interested patients that this cross-sectional study could not establish a causal relationship between fructose consumption and hypertension.
  • Point out that not all previous studies exploring the link between fructose and blood pressure have identified a significant association.
There has been a recent increase in the consumption of fructose in developed nations due primarily to the addition of table sugar or high fructose corn syrup to soft drinks, bakery products, fruit drinks, dairy desserts, and candies.
At the same time, the prevalence of hypertension has been rising. However, epidemiological studies have yielded conflicting results as to an association between the two trends.
To explore the issue, Jalal and her colleagues used data from 4,528 adults without a history of hypertension included in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006.
The majority (61%) had a systolic blood pressure of less than 120 mm Hg. Another 30% were prehypertensive (systolic pressure of 120 to 139 mm Hg).
The rest of the participants had either stage 1 or stage 2 hypertension (6% and 2%, respectively).
Fructose intake was determined through a self-administered dietary questionnaire. Consumption of natural fruits was excluded to isolate intake of added sugar.
Median intake was 74 grams a day. Increasing systolic blood pressure was associated with increasing fructose intake, a trend that reached borderline statistical significance (P=0.05).
After adjustment for demographics, comorbidities, physical activity, smoking, total kilocalorie intake, and dietary confounders including total carbohydrate, alcohol, salt, potassium, and vitamin C intake, as well as other factors, fructose intake of 74 grams per day or higher was associated with higher odds of elevated blood pressure at the following thresholds (P<0.05 for all):
  • 135/85 mm Hg: OR 1.26
  • 140/90 mm Hg: OR 1.30
  • 160/100 mm Hg: OR 1.77
Additional analyses showed that fructose intake was associated with systolic -- but not diastolic -- blood pressure.
The reason this study, and not some previous studies, found an association between fructose consumption and hypertension could be because of the high level of consumption in the current study, according to Jalal and her colleagues.
In addition, some previous studies looked only at soft drink consumption or included naturally occurring fructose from fruit in their analyses.
There are several possible mechanisms that might explain the positive association between fructose and blood pressure, the authors wrote, "including stimulation of uric acid, inhibition of [the] endothelial nitric oxide synthase system, and stimulation of the sympathetic nervous system, or by directly increasing sodium absorption in the gut."
The study was limited, they wrote, by the inability to establish a causal relationship between fructose and blood pressure using cross-sectional data, the reliance on self-reports, and the possibility of confounding by glucose in the foods assessed on the dietary questionnaire.
The study was supported by grants from the National Institutes of Health.
Jalal reported no conflicts of interest. One of her co-authors is listed as an inventor on several patent applications for lowering uric acid as it relates to blood pressure and metabolic syndrome. He is also author of The Sugar Fix.

Thursday, July 1, 2010

Got Colic? Here's a Natural Treatment that really helps

Probiotic Reduces Crying Time in Infants With Colic
/www.Medscape.com

June 17, 2010 (Stockholm, Sweden) — One week of supplementation with the probiotic Lactobacillus reuteri Protectis reduced crying time in colicky babies by 74%, compared with 38% with placebo, according to a double-blind study presented here at the 43rd Annual Meeting of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition in Istanbul, Turkey.

"The data with L reuteri are convincing and confirm, in a placebo-controlled study, our earlier data with this probiotic [Pediatrics. 2007;119:e124-e130]. We believe these results will have an impact on the treatment of infants with colic," study presenter Francesco Savino, MD, PhD, from the Department of Paediatrics, Regina Margherita Children's Hospital, University of Turin, Italy, noted in a statement issued by Swedish biotechnology firm BioGaia AB, the developer and marketer of the probiotic.

In the study, 50 infants with confirmed infantile colic were randomly assigned to L reuteri Protectis (5 drops, 108 colony forming units/day) or placebo drops for 21 consecutive days. The primary outcome was a reduction (by day 21) in average crying time to less than 3 hours per day, which is the limit of colic, Dr. Savino noted.

With L reuteri, "we saw improvement after 1 week, and at the end of the study there really was a significant effect," he told conference attendees. In addition, 84% of the L reuteri–supplemented infants reached the primary outcome by day 21, compared with 43% of infants in the placebo group (P < .05), he reported.

At baseline, median crying time per day was 370 minutes in the probiotic group and 300 minutes in the placebo group. On day 7, crying time had been reduced to 95 minutes in the L reuteri group and to 185 minutes in the placebo group (P = .082).

At the study's end (day 21), there was a significant difference in median daily crying time between the groups; it was 35 minutes in the L reuteri group and 90 minutes in the placebo group (P < .05), Dr. Savino reported.

He also noted that on days 7, 14, and 21, the proportion of infants responding to the supplementation, defined as a 50% or greater reduction in median crying time, was significantly greater in the probiotic group than in the placebo group.

In an email to Medscape Gastroenterology, Eamonn Connolly, PhD, senior vice president of research for BioGaia, in Stockholm, Sweden, said complete data from the study are scheduled to be published in a medical journal shortly.

Mechanism of Action Not Clearly Established

The effects of L reuteri noted in the study "could be due to a change in the intestinal commensal bacteria," Flavia Indrio, MD, PhD, who has studied the gastrointestinal effects of probiotics extensively, noted in an email to Medscape Gastroenterology. Dr. Indrio is a pediatric gastroenterologist in the Department of Pediatrics at the University of Bari in Italy, and was not involved in this study.

"The crying infant who received L reuteri showed a reduction in Escherichia coli in the intestinal microflora, compared with the infant treated with placebo," said Dr. Indrio.

She added that "the target of the L reuteri action could be the intestinal motility pattern, as shown in the study published by me and my coworker in the Journal of Pediatrics in 2008. Another study is running in newborns to confirm this effect."

"Definitely, treatment with probiotics could open a new therapeutic approach in some gastrointestinal diseases," Dr. Indrio concluded.

The study was sponsored by BioGaia, which develops and markets probiotic products. Dr. Savino reports being an independent investigator with no relationship with BioGaia. Dr. Indrio has disclosed no relevant financial relationships.

43rd Annual Meeting of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Presented June 10, 2010.