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January 3, 2008, 8:42 PM CT

Acid Reflux and Survival

Acid Reflux and Survival
Gastroesophageal reflux disease (GERD), often known as acid reflux, is a common problem that has been linked to cancers, asthma, recurrent aspiration and pulmonary fibrosis. A new study published in The American Journal of Gastroenterology examines whether GERD sufferers may have shorter lifespans than those without the disease.

Drawing on over 50,000 person-years of data, the study provides reassuring evidence that people with acid reflux symptoms do not have an increased risk of death, finding no difference in survival rates between sufferers and non-sufferers.

In fact, the study finds that people with infrequent acid reflux may actually have better survival rates than those with either daily symptoms, or none at all. "It may be that occasional reflux symptoms are a reflection of potential protective behaviors that are linked to reflux, such as regular exercise or modest amounts of alcohol ingestion," suggest Nicholas J. Talley and G. Richard Locke, III, co-authors of the study.

The study adds perspective to the risk of acid reflux symptoms. While there are a large number of acid reflux sufferers in the U.S., incidences of related cancer are extremely rare. "Eventhough extraesophageal manifestations occur in some people with reflux disease, our results suggest that this disease is a non-malignant condition in the vast majority of sufferers," say the authors.........

Posted by: Sue      Read more         Source


December 10, 2007, 10:59 PM CT

bacteria in cows milk may cause Crohn's disease

bacteria in cows milk may cause Crohn's disease
Crohn's is a condition that affects one in 800 people in the UK and causes chronic intestinal inflammation, leading to pain, bleeding and diarrhoea.

The team observed that a bacterium called Mycobacterium paratuberculosis releases a molecule that prevents a type of white blood cell from killing E.coli bacteria found in the body. E.coli is known to be present within Crohn's disease tissue in increased numbers.

It is thought that the Mycobacteria make their way into the body's system via cows' milk and other dairy products. In cattle it can cause an illness called Johne's disease - a wasting, diarrhoeal condition. Until now, however, it has been unclear how this bacterium could trigger intestinal inflammation in humans.

Professor Jon Rhodes, from the University's School of Clinical Sciences, explains: "Mycobacterium paratuberculosis has been found within Crohn's disease tissue but there has been much controversy concerning its role in the disease. We have now shown that these Mycobacteria release a complex molecule containing a sugar, called mannose. This molecule prevents a type of white blood cells, called macrophages, from killing internalised E.Coli." .

Researchers have previously shown that people with Crohn's disease have increased numbers of a 'sticky' type of E.coli and weakened ability to fight off intestinal bacteria. The suppressive effect of the Mycobacterial molecule on this type of white blood cell suggests it is a likely mechanism for weakening the body's defence against the bacteria.........

Posted by: Sue      Read more         Source


November 24, 2007, 8:14 AM CT

Age, burden, divorce and heavy tea consumption

Age, burden, divorce and heavy tea consumption
Gastroesophageal reflux disease (GERD) is a common disorder with a high incidence rate in adults of 10 - 38%. The diagnosis and therapy of GERD are therefore important because the disease, in addition to the highly disturbing typical symptoms, has a series of known consequences. The presence of GERD may affect patients' quality of life, decrease functional activity, and increase the risk of esophageal carcinoma.

Eventhough a number of researchers have reported the prevalence of erosive esophagitis, the prevalence of non-erosive reflux disease (NERD) has not been investigated in China.

A research article reported in the issue 45 of the World Journal of Gastroenterology addresses this question. The research team led by Dr. You-Ming Li analyzed a spectrum of GERD subjects based on presenting symptoms and endoscopic findings.

One conclusion reported by the researchers is that of the 2231 recruited participants, 31.4% were diagnosed as having GERD, 10.6% were NERD patients, while 20.80% had objective findings of reflux esophagitis, including 19.5% patients with grade A or B reflux esophagitis, 0.90% with grade C and 0.40% with grade D.

Another conclusion is that old age, being male, having a moderate working burden, being divorced/widowed and heavy tea consumption remained significant independent risk factors for erosive esophagitis. Routine consumption of greasy food and constipation were considered significant independent risk factors for NERD.........

Posted by: Sue      Read more         Source


November 13, 2007, 10:01 PM CT

New therapeutic targets in the treatment of ulcerative colitis

New therapeutic targets in the treatment of ulcerative colitis
Social, environmental and dietary changes are linked to the changes of disease spectrum in a country. Ulcerative colitis has become a usually seen disease in China, probably due to extensive consumption of Western foods in recent years. Unfortunately, the etiology and pathogenesis of ulcerative colitis have not been clarified yet. Therefore, no effective etiological therapy is available at present. But a recent study published in issue 44 of the World Journal of Gastroenterology may offer new insight into this difficult-to-treat disease.

A research team from the First Affiliated Hospital of Dalian Medical University's Department of Gastroenterology, China, led by Professor Ying-De Wang, investigated the expression of matrix metalloproteinase-1 (MMP-1) and tumor necrosis factor- (TNF-alpha). MMP-1 is a peptidase that degrades the extracellular matrix in the colonic mucosa, while TNF-alpha is an important and harmful inflammatory cytokine produced in macrophages in colon. The research team observed that both MMP-1 and TNF-alpha were over expressed in the colonic mucosa of patients with ulcerative colitis. The over expressed MMP-1 excessively degrades the extracellular matrix, and subsequently damages the colonic mucosa and causes ulceration and inflammatory changes in ulcerative colitis, and the over expressed TNF-alpha directly damages the colon mucosa. MP-1 and TNF-alpha proteins have the so-called synergistic action. The study revealed that the excessively expressed TNF-alpha stimulated MMPs secreting cells to produce more MMP-1, aggravating the mucosa damage. Meanwhile, MMP-1 promoted secretion of TNF-alpha in a positive feedback manner to cause further injury in the mucosa of colon. So it is very likely both MMP-1 and TNF-alpha play a central role in the development of ulcerative colitis.........

Posted by: Sue      Read more         Source


October 23, 2007, 10:15 PM CT

MRI predicts liver fibrosis, study says

MRI predicts liver fibrosis, study says
Moderate to severe chronic liver disease can be predicted with the use of diffusion-weighted MRI (DWI), as per a recent study conducted by scientists at New York University Medical Center in New York, NY.

Due to the increased occurence rate of chronic hepatitis in the United States, especially hepatitis C, there is a strong need for non-invasive methods to replace or supplement liver biopsy, which is relatively invasive and limited by interobserver variability and sampling error, said Bachir Taouli, MD, lead author of the study. DWI appears promising in that purpose, eventhough it needs validation in larger series, he said.

The study included 23 patients with chronic hepatitis and 7 volunteers. The scientists compared apparent diffusion coefficients (ADCs) or the quantification of water diffusion in a tissue between patients who had stage 2 or greater versus stage 1 or less fibrosis and stage 3 or greater versus stage 2 or less fibrosis. In liver fibrosis and cirrhosis, decreased ADC (i.e. restricted water diffusion) is possibly correlation to increased collagen deposition and decreased perfusion. The study showed that hepatic ADC was a significant predictor of stage 2 or greater and stage 3 or greater liver fibrosis.

At this point, this is an experimental method that needs to be tested in a larger series. It should also be compared with other methods such as FibroTest (a score based on a combination of basic serum markers) or FibroScan (an ultrasound based method to measure liver stiffness) in order to be validated, said Dr. Taouli. However, diffusion imaging does show potential for decreasing the number of biopsies and decreasing the number of antifibrogenic drug trials, he said.........

Posted by: Sue      Read more         Source


October 15, 2007, 6:09 PM CT

Night-time acid reflux can impact sleep

Night-time acid reflux can impact sleep
As per results of a survey presented at the 72nd Annual Scientific Meeting of the American College of Gastroenterology, nighttime acid reflux, along with some of the less typical manifestations or symptoms of gastroesophageal reflux disease (GERD), is linked to significant sleep impairment.

In a recent national survey, scientists assessed the prevalence of sleep impairment among people with GERD and people without GERD based on response to an Internet survey of a general population of U.S. adults. Using a validated GERD screening tool, 701 respondents were identified with GERD and the remaining were controls. Bonnie Dean, MPH, PhD, of Cerner LifeSciences, Ronnie Fass, MD of the University of Arizona and their research team observed that sleep impairment was more common among people with GERD (41.9 percent) than those without GERD (19.4 percent). Scientists observed that 49.5 percent of respondents with nighttime GERD reported sleeping poorly often or most of the time, in comparison to 36.7 percent of people with daytime GERD.

Using the survey, scientists also assessed sleep impairment among patients experiencing frequent nighttime atypical manifestations of GERD. In this case, Dr. Dean and her colleagues reviewed the subgroup of respondents with GERD, as identified using the validated GERD screener. They observed that atypical manifestations or symptoms of GERD (i.e. coughing, sore throat, snoring, wheezing, choking, and chest pain) were common among those with acid reflux. Of GERD patients, 74 percent had at least one nighttime atypical manifestation. For almost every daytime and nighttime atypical manifestation assessed, more than 20 percent of GERD patients reported their occurrence as frequent (more than 2 days or nights per week). Scientists also observed that sleep impairment was more common among GERD patients with atypical manifestations in comparison to GERD patients with only typical or classic symptoms such as heartburn and acid regurgitation. For eight of the nine nighttime atypical manifestations assessed, the proportion of GERD cases reporting sleep impairment was significantly higher for GERD cases with the atypical manifestation compared with GERD cases without the atypical manifestation.........

Posted by: Sue      Read more         Source


October 15, 2007, 4:53 PM CT

Serious, manifestations of acid reflux

Serious, manifestations of acid reflux
A number of people may not realize that symptoms such as chronic cough or chest pain can be caused by acid reflux into the esophagus, because they do not experience classic heartburn symptoms or acid regurgitation. Two new studies presented at the 72nd ACG Annual Scientific Meeting highlight the little known correlation between gastroesophageal reflux and seemingly unrelated problems.

Scientists at the Brigham & Womens Hospital in Boston studied patients in emergency rooms who complained of serious chest pain. They measured and recorded pH levels in the esophagus of 31 patients for two days to determine whether excessive acid caused their chest pain. Scientists found more women than men were being rushed to the emergency room with chest pain that was not correlation to the heart. Abnormal reflux of acid that would fit the diagnosis of GERD was seen in 57 percent of patients. There are two types of acid reflux, supine, which occurs when the patient is sleeping, and upright which occurs when the patient is awake. In this study, men had more upright reflux, while women experienced both reflux during sleep and while they were awake.

As per lead investigator Dr. Julia J. Liu, Often the role of acid reflux has been overlooked as a potential factor in the diagnosis and therapy of patients with serious chest pain. But, it is important for patients never to assume their chest pain is caused by GERD until they have been thoroughly reviewed by a doctor to rule out heart disease. If they experience persistent chest pain, they should seek emergency medical care.........

Posted by: Sue      Read more         Source


September 26, 2007, 8:27 PM CT

Capsule Endoscopy Diagnoses More Crohn's Disease

Capsule Endoscopy Diagnoses More Crohn's Disease
Image courtesy of Yale Medical Group
Research from La Fe University Hospital in Valencia, Spain shows that capsule endoscopy diagnoses more Crohn's disease recurrence after surgery than colonoscopy. Capsule endoscopy led to changes in treatment for more than half of the patients studied. The research appears in the recent issue of Gastrointestinal Endoscopy, the monthly peer-evaluated scientific journal of the American Society for Gastrointestinal Endoscopy.

Crohn's disease is a chronic condition that causes inflammation in the gastrointestinal tract, most usually affecting the small intestine and colon (large intestine). As per the Crohn's and Colitis Foundation of America, approximately half a million people in the United States have Crohn's disease. Scientists do not know what causes the disease and there is no cure, so the goal of therapy is to reduce the inflammatory response. Surgery becomes necessary when medicine can no longer control symptoms. In most cases, the diseased segment of the intestines is removed, this is called a resection. The two sections of the remaining healthy intestines are joined together in a procedure called anastomosis. While patients may live symptom-free for years, surgery is not a cure and disease frequently recurs at or near the site of the anastomosis.

Colonoscopy is the gold standard in screening for colorectal cancer, which develops in the large intestine. It is effective in diagnosing diseases of the large intestine and in viewing the end part of the small intestine. Capsule endoscopy allows physicians to view the entire small intestine, but is not currently a method used to view the large intestine.........

Posted by: Sue      Read more         Source


September 14, 2007, 5:15 AM CT

Correlation between GERD and obesity in females

Correlation between GERD and obesity in females
A group of researchers recently discovered an association between being overweightand a disease called gastro-esophageal reflux disease (GERD) in women.

This discovery was reported in the Sept. 14 issue of the World Journal of Gastroenterology by a research group led by Dr. Corazziari from the University La Sapienza of Rome. Dr. Corazziari has been a leader in the field of gastroenterology for a long time and published over 200 research articles and 20 professional books. He and his fellow scientists (with Dr. Piretta being the first author of this article) discovered that, compared to average population, overweight and obesity are risk factors for GERD in women and not so much in men.

GERD is a disease with chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus. Heartburn (burning discomfort behind the breastbone) is the major symptom of GERD because the gastric acid gets into esophagus.

It is known that fatty foods produce a prolonged inhibitory effect on the lower esophageal sphincter (LES), especially following intra-duodenal lipid perfusion, but this inhibitory effect would appear due to a cholecystokinin-mediated action on LES. An epidemiological study revealed that overweightedness, but not excess fatty food intake, increases the risk of hospitalisation for GERD. Gastric distention following a copious meal also relaxes LER and increases the possibility of GERD.........

Posted by: JoAnn      Read more         Source


September 6, 2007, 9:57 PM CT

Preventing variceal bleeding

Preventing variceal bleeding
Beta blockers should be the first line of prevention against variceal bleeding in patients with cirrhosis and portal hypertension. While banding is similarly effective in reducing the occurence rate of such bleeding, it can have fatal complications and is more expensive. These findings appear in the recent issue of Liver Transplantation, a journal by John Wiley & Sons. The article is also available online via Wiley Interscience at http://www.interscience.wiley.com/journal/livertransplantion.

Patients with liver disease often develop portal high blood pressure from a blockage in the blood flow through the liver. The increased blood pressure in the portal vein causes large veins, called varices, to develop across the esophagus and stomach to bypass the blockage. The se varices become fragile and can bleed easily, causing frightening symptoms like vomiting blood, as well as ascites and encephalopathy. Two ways to prevent variceal bleeding are beta blockers and endoscopic variceal ligation, however it is unclear which is better for patients.

To compare the safety and efficacy of the two therapies in the prevention of primary variceal bleeding, scientists led by Lorenzo Norberto and Lino Polese of the University of Padova in Italy, conducted a randomized controlled trial among patients awaiting liver transplantation. Between September 2001 and December 2005, they enrolled sixty-two patients with Child-B-C cirrhosis and high-risk esophagal varices into their study. The patients were randomly divided between therapy with the beta blocker, propranolol, or variceal banding. All patients had an EGD and a clinical examination every 6 months after beginning therapy.........

Posted by: Sue      Read more         Source



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Did you know?
The number of bariatric surgeries performed in the U.S. increased by 450 percent between 1998 and 2002, a growth the scientists say could be linked with use of the minimally invasive laparoscopic technique, according to an article in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

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