Antibiotic-resistant bacteria is a worldwide health problem.  When antibiotics are misused it helps to create resistant microorganisms that produce infections that are more difficult to treat. It’s why MRSA (methicillan resistant staphylococcus aureus) exists today. Antibiotics should always be used under a health care provider’s guidance. They can be used for some fungal infections, certain parasites and bacterial infections.  But they can lose their effectiveness against disease causing bacteria when used inappropriately for viruses like the flu.  The resistant bacteria can easily spread to coworkers and family members.  Taking antibiotics unnecessarily may cause side effects like stomach discomfort, diarrhea and nausea. A bout of antibiotics can cause irritation and swelling of the large intestine referred to as Clostridium difficilecolitis (or C. difficile colitis). They can affect the balance of naturally occurring bacteria in the intestine causing bad bacteria to thrive. Stomach cramps, fever and diarrhea can occur as a result.  Women may experience yeast infections after a course of antibiotics also.

The concept of using bacteria to enhance one’s health has been around since the early 1900s. The human body contains billions of bacteria that help maintain a person’s health. The bulk of the bacteria lie within the intestines. This type of “good” bacteria supports the digestion of food. For example, the absorption of vitamin K which helps blood to coagulate would not be possible without these bacteria.

Prebiotics are indigestible carbohydrates that serve as food for probiotics. Prebiotics help probiotics to flourish and when the two are combined they form a symbiotic. They are live bacteria that exist in foods like kefir (a creamy drink made from fermented cow’s milk) or yogurt as well as other fermented dairy products. Prebiotics can be found in foods such as bananas, whole grains, honey, artichokes and yogurt. Many foods contain added prebiotics and probiotics and are also available in dietary supplement forms. They can help with digestion and may give the body protection from bacteria that are harmful. Some recent research has shown probiotics may offer help with reducing or preventing the severity of colds, treating IBS and decreasing the recurrence of bladder cancer. Other benefits include preventing and treating eczema in children, yeast infections, urinary tract infections, and treating diarrhea especially after treatment with specific antibiotics.

Other foods that prebiotics can be found in include red wine, maple syrup, asparagus and legumes. Keep in mind that eating food containing prebiotics feeds the already present good bacteria in the digestive tract. Some studies show that probiotics may help ease lactose intolerance, and tame gas. Unpasteurized sauerkraut and Korean kimchi contain lactobacillis, leuconostoc, and pediococcus, all probiotics. A tasty Japanese broth called Miso soup, has more than 160 bacteria strains, is low in calories, high in B vitamins, and full of antioxidants. Sour pickles fermented using water and sea salt can provide some digestive benefits and so can sourdough bread with lactobacilli probiotics. Gouda cheese has the lactobacillus strain and buttermilk cultured with lactic acid bacteria has good probiotics too. But when prebiotic or probiotic foods are not readily available or one’s lifestyle is on the ever constant go, supplements whether liquid, capsule, tablet or powder form, can prove to be a healthy but more convenient alternative.

Works Cited

Jaret, Peter. “The Best Ways to Use Probiotics.” WebMD.com. 14 Jan. 2013. 23 Mar. 2013.

http://www.webmd.com/digestive-disorders/features/best-probiotics-use?page=1.

Sproule-Willoughby, Kimberley. “The Difference Between Probiotic and Prebiotic.” Livestrong.com. 5 Jan. 201.. 24 Mar. 2013.

http://www.livestrong.com/article/335114-the-difference-between-probiotic-prebiotic/

Zeratsky, RD, LD Katerhine. “Is it Important to Include Probiotics and Prebiotics in a Healthy Diet?” MayoClinic.com. 15 Sept. 2011. 23 Mar. 2013.

http://www.mayoclinic.com/health/probiotics/AN00389.

Antibiotics:  Misuse Puts You and Others at Risk. MayoClinic.com. 4 Feb. 2012. 21 Mar. 2013.

http://www.mayoclinic.com/health/antibiotics/FL00075.

The Truth About Probiotics and Your Gut. WebMD.com. 3 Jan. 2013. 23 Mar. 2013.

http://www.webmd.com/digestive-disorders/probiotics-10/slideshow-probiotics.

Top Foods for Probiotics. WebMd.com. 3 Jan 2013. 23 Mar. 2013.

http://www.webmd.com/digestive-disorders/probiotics-10/slideshow-probiotics.

Using Antibiotics Wisely. WebMd.com. 14 Mar. 2011. 23 Mar. 2013.

http://www.webmd.com/a-to-z-guides/using-antibiotics-wisely-topic-overview.

We have all heard of probiotics, often referred to as “good bacteria”. Even if you have not heard the term, you certainly know about

The “good bacteria” in your gastrointestinal system can provide you with optimum health especially if the proper balance of different strains of bacteria is maintained. Your gastrointestinal (GI) microflora is made up of three and a half pounds of bacteria that can be classified as good, neutral, changing and bad. All of these make up major parts of your digestive and immune systems. When the balance of these various strains of bacteria are harmonious, your body will operate in peak form. It is when this optimal balance is disturbed that problems can arise. Probiotics can have a profound effect not just on your gastrointestinal health, but on your overall health as well. Many studies show that 80% of your immune system resides in your gut. It is thought that probiotics may benefit our immune system by protecting us from harmful pathogens. Presumably, the active bacteria compete for growth in our bodies, stimulating the production of our body’s natural infection-killing cells.

Research has suggested that probiotics can be beneficial for those dealing with stomach and intestinal disorders, such as irritable bowel syndrome and Crohn’s disease. Probiotics can also prevent diarrhea, gas, and cramping. Additionally, supplementation after a course of antibiotics is wise. Antibiotics kill “good” (beneficial) bacteria along with the bacteria that cause illness. A decrease in beneficial bacteria may lead to digestive problems and may also lead to other infections, such as vaginal yeast and urinary tract infections, and symptoms such as diarrhea from intestinal illnesses. Taking probiotics may help replace the lost beneficial bacteria.

Cholesterol levels may be reduced by consuming lactic acid bacteria in supplements. Some studies have shown reductions in blood pressure associated with consuming these powerful microbes.

Duke and the Doctor recommend taking Natren’s Healthy Trinity to ensure all the benefits of probiotics. An additional source of healthy bacteria is yogurt. Unfortunately store bought brands are sometimes lacking in the beneficial nutrients due to additives included. A good solution is to make your own at home with only two ingredients: Milk and a yogurt starter. As always, visit shopihl.com to find these and other Doctor McBarron recommended products.

We often read about the benefits of fiber in the digestive system. These days, it’s prominently featured in food staples as a natural attribute or as an additive. Likewise, a plethora of supplemental fiber products are available online, stocked in grocery stores and on drug store shelves, to give us that added fiber we may be missing in our less than complete diet. But what does fiber really do for us and how much should we be taking in? It’s a well-known fact we need dietary fiber for our bodies to function properly.

Some vegetarians get their share of daily fiber through natural foods, leaving the additives and supplements for those of us more fiber-challenged from our normal dietary habits. Whatever the source, fiber is important for digestive health in people of any age and it’s helpful in the prevention of many conditions, including acid reflux (or GERD), inflammatory bowel syndrome (IBS), obesity and diverticulitis.  Fiber is essential in maintaining “regularity”. Regularity is a “nice” word to use, in an effort to avoid any unpleasant sounding terms to describe proper digestion and elimination of our waste. No one really wants to utter the words, “constipation”, “diarrhea”, “irritable bowel syndrome” or other such colorful words or phrases, but everyone goes through a period of discomfort and no one is immune. We just need to do our best to limit the times when we do have issues, principally by making sure we get our daily fiber.

What’s the difference between soluble and insoluble fiber and do we need both? Insoluble fiber is the most important component in moving food through the digestive track. This type of fiber is largely indigestible, helping to bulk up stools and reduce constipation. Insoluble fiber is found in whole fruits and vegetables, seeds and whole grains.

Soluble fiber plays a different but still important role. Rather than passing through the digestive tract intact, as does insoluble fiber, soluble fiber is digested into a gel-type substance, absorbing water and slowing down digestion but also providing a prebiotic effect. Prebiotics, like those found in some soluble fiber sources, promote the growth of healthy digestive bacteria in the intestinal tract, allowing foods to be broken down more easily and aiding absorption of vital nutrients. So, as with most check and balance systems, the two types of dietary fiber work together but with separate functions, to aid in healthy digestion.

We now understand a little better how the process works. The next question is, how much do we need and are we typically getting enough fiber in our diet?
The answer to the latter part of the question is that many of us do not ingest enough healthy fiber in our diets. The typical American gets about half of the daily recommended supply of dietary fiber each day. Daily fiber needs differ with age and gender, so it’s not a one-size-fits-all recipe. The following are guidelines for recommended daily fiber needs:

• Women and Adolescent Girls—25 grams
• Women age 50 and over—21 grams
• Men and Teenage Boys—38 grams
• Men age 50 and over—30 grams
• Children age 4 to 8—25 grams
• Toddlers age 1 to 3—19 grams
• Women and Adolescent Girls—25 grams

*All figures represent daily recommended total fiber (including soluble and insoluble combined)

We have the numbers. Now for the best sources of fiber in the foods we love to eat and in dietary supplements:

You can never go wrong with eating more fruits and vegetables! Whether for the rich sources of essential vitamins often lost in prepared fruits and vegetables or for fiber needs, the fresh stuff is always the better choice at meals or at snack times. Then there are whole grains. Whole grain cereals and breads retain those all-important sources of insoluble fiber, providing better digestion and even contributing to heart health! Stay away from refined grains. They may be a little tastier going down but your body will prefer the whole grains to the refined flours any day!

Supplements offer a great way to take in that fiber we just can’t seem to get in our daily diet. Many choices are out there, including fully dissolving powders, whole food supplements and additives like flax seed that we can sprinkle over our foods for an extra boost of fiber. No longer are we left with the old standards of prunes or gritty mixes for our fruit juices in the mornings. With all the advances in fiber delivery these days, there’s really no excuse for not getting our fiber needs from our foods or from fiber supplements.

Make a friend with fiber, and incorporate dietary fiber into your routine daily for better health.

Do you really have 4.5 pounds of undigested waste in your body? If you do not cleanse and detoxify your system, you could be carrying around toxic substances in your large intestine and your colon. We have all experienced occasional constipation and discomfort in digestion and elimination. Cleansing can help restore regularity by giving your digestive system a fresh start. It is also beneficial to cleanse the body of toxic substances that may linger in the bowels from microscopic toxic waste.

When eating the wrong foods and skipping on beneficial sources of fiber, we sometimes experience difficulty in eliminating waste naturally. Think of fiber as a natural lubricator for the digestive system. Fiber is our digestive friend and fiber is an essential component of a healthy diet. Whether through food sources or via supplements, we must incorporate fiber in our diet to function properly.

Unfortunately, we may experience occasional constipation and bloating by following a pattern of eating the wrong foods over an extended period of time. After battling the problem for days some resort to a harsh chemical laxative. An over-the-counter laxative will probably do the trick but chemical laxatives fool the bowels into elimination, rather than solving the problem naturally.

By contrast, a quality program using natural laxative remedies are healthier for our bodies. Natural alternatives to cleansing and detoxification can resolve digestive challenges by restoring the body’s natural digestive processes more gently. In addition, cleansing and detoxification can help us eliminate toxins to position us on a better path towards wellness and greater health.

A ‘high-potency’ lactic acid bacteria supplement may ease the symptoms of irritable bowel syndrome (IBS) in children, says a new study that echoes results from adult studies.

A daily dose of VSL Pharmaceuticals VSL#3 branded probiotic was found to reduce measures of abdominal pain and discomfort and levels of bloating and gassiness, according to findings published in the Journal of Pediatric Gastroenterology and Nutrition.

“There is evidence that some probiotics […] have a beneficial role in the dietary management of children and teenagers suffering with IBS,” said Stefano Guandalini, MD, lead researcher and professor at the University of Chicago. “This has the potential to make a real difference for kids who suffer from pain, bloating and discomfort of IBS.”

The precise numbers of IBS suffers in the US are not known, as many people (adults and children) with mild symptoms do not consult a physician, but it is believed to be between 15 and 30 million.

The long-term condition, from which more women suffer than men, involves abdominal discomfort accompanied by diarrhoea or constipation. Although it is not life threatening and dose not lead to other, more serious health conditions, IBS is untreatable. At present, intervention involves management of symptoms.

Furthermore, when it comes to managing IBS in children very little is known about dietary approaches, according to the Chicago-based scientists.

Study details

Prof Guandalini and his co-workers conducted their randomized, double-blind, placebo-controlled, crossover study with four to 18 year olds. The children and adolescents were randomly assigned to receive placebo or the probiotic supplement (450 billion CFU) for six weeks. At the end of the intervention, the children underwent a two-week washout period and then crossed over for six weeks of the other intervention.

The data showed that, for the 59 children who completed the study, the placebo “was effective in some of the parameters and in as many as half of the patients”. However, the probiotic was “significantly superior to it in the primary endpoint, the subjective assessment of relief of symptoms”.

In addition, significant reductions were observed in the active supplement group for abdominal pain and discomfort, abdominal bloating and gassiness, and family assessment of life disruption, added the researchers.

On the other hand, no differences between the groups were observed for stool pattern.

Finally, no adverse events were recorded by the researchers, supporting the tolerability of the supplement.

Strain specificity

The benefits of probiotics are specific to the strain of bacteria. Earlier this year, research from Institut Rosell found that Lactobacillus plantarum 299v may also reduce the symptoms of IBS like abdominal pain and bloating. The results were presented at Digestive Disease Week in New Orleans in May.

(NaturalNews) Ulcerative colitis is a type of inflammatory bowel disease (IBD) that brings untold pain and misery to about 120,000 people of all ages in the UK and over a million in the US. It produces inflammation and sores in the lining of the rectum and colon that bleed, produce pus and cause frequent diarrhea. This is a serious disease that often causes hospitalization. In fact, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 25 to 40 percent of people suffering from ulcerative colitis eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer.

Powerful side effect-laden drugs like steroids are used to dampen down symptoms but there’s no cure. However, scientists at the University of East Anglia (UEA) have discovered there could be a way to stop ulcerative colitis from developing in the first place. The preventative treatment is simple, healthy, inexpensive and easy to find — olive oil.

UEA researchers announced this news recently at the Digestive Disease Week conference held in New Orleans. Their findings revealed that people with a diet rich in oleic acid are far less likely to develop ulcerative colitis. Oleic acid is a monounsaturated fatty acid found in abundance in olive oil. It is also a component of peanut oil, grapeseed oil and butter.

The research team, led by Dr. Andrew Hart of UEA’s School of Medicine, studied over 25,000 people between the ages of 40 and 65 who lived in Norfolk, in the UK. The research participants were part of the EPIC (European Prospective Investigation into Diet and Cancer) study between 1993 and 1997. None of these EPIC participants were diagnosed with ulcerative colitis at the beginning of the study. They all kept detailed food diaries which were later studied by nutritionists who analyzed exactly what nutrients and fatty acids the study participants were consuming.

By 2004, 22 of the research subjects had developed ulcerative colitis. When the researchers compared the diets of these people to those who did not develop the disease, they found the study participants with the highest intake of oleic acid had a 90 per cent lower risk of developing ulcerative colitis.

“Oleic acid seems to help prevent the development of ulcerative colitis by blocking chemicals in the bowel that aggravate the inflammation found in this illness,” Dr. Hart said in a statement to the media.”We estimate that around half of the cases of ulcerative colitis could be prevented if larger amounts of oleic acid were consumed. Two-to-three tablespoons of olive oil per day would have a protective effect.”

Additional studies are underway in several countries to further document the potential of oleic acid to prevent colitis, the UEA researchers stated. In addition, they noted that oleic acid should also be assessed in the future as a possible treatment for those already suffering from the disease.

Related topics: Phytochemicals, plant extracts, Gut health

Dietary supplementation of resveratrol can have a significant beneficial effect in chronic DSS-induced colitis, according to a new study from Spain.

The researchers claim the findings of their study suggest that the anti-inflammatory effects of resveratrol seem to be related to a cytokines modulation and a reduction of PGES-1, COX-2 and iNOS expression in colonic mucosa, in addition to other possible mechanisms, via down regulation of p-38 MAPK pathway.

The research was published in the European Journal of Pharmacology.

The authors note no previous research undertaken on dietary resveratrol in relation to chronic colitis and thus their goal was to examine the protective/preventive effects of dietary resveratrol intake on chronic dextran sulphate sodium (DSS)-induced colitis to help identify and validate new therapies for treatment of inflammatory bowel disease (IBD).

They explain that IBD is a chronic pathology by uncontrolled inflammation of the intestinal mucosa which can affect part of the gastrointestinal tract, with causes including genetic factors, immune dysregulation, barrier dysfunction, and a loss of immune tolerance toward the enteric flora.

Reported benefits of resveratrol

Resveratrol (trans-3,4,5-trihydroxystilbene), a natural polyphenol, is found in a large number of fruits and vegetables and is abundant in grapes and in red wines.

Recent studies looking at the benefits of resveratrol have reported anti-cancer effects, anti-inflammatory effects, cardiovascular benefits, anti-diabetes potential, energy endurance enhancement, and protection against Alzheimer’s.

The method

The authors said that six-week-old mice were randomized into two dietary groups, with one group on a standard diet and the other on a model enriched with resveratrol consuming an average of 3 g/day of diet resulting in a dose of 3 mg/kg body weight of resveratrol ingested.

The authors said that the administered dose of resveratrol was chosen based on analyses described in previsou studies and added that it was equivalent to 0.429 mg/kg/day in humans (30 mg resveratrol in a 70 kg person)

After 30 days, mice were exposed to 3 per cent DSS for five days developing acute colitis that progressed to severe chronic inflammation after 21 days of water, they added.

Findings

Results, said the research team, indicate that dietary administration of resveratrol reduced the severity and extension of progressive chronic colonic damage and also significantly counteracted the clinical signs reducing the inflammatory process.

The results, continued the authors, demonstrated that the polyphenol group significantly attenuated the clinical signs such as loss of body weight, diarrhoea and rectal bleeding improving results from disease activity index and inflammatory score.

They said that three weeks after DSS removal, the polyphenol caused substantial reductions in the rise of pro-inflammatory cytokines, TNF-? and IL-1? and an increase of the anti-inflammatory cytokine IL-10.

The team reported an attenuation also of morphological signs of cell damage in the resveratrol group, with the colonic mucosa showed areas of exfoliation of epithelial cells, reduction of inflammatory cells infiltration and glandular hypertrophy, as well as some areas of intact epithelium.

Moreover, the totality of resveratrol-fed animals survived and finished the treatment while animals fed with standard diet showed a mortality of 40 per cent, they said.

“An important finding was the high reduction of mortality in DSS resveratrol animals. The mechanism by which resveratrol reduces DSS-induced mortality are not clear, although its antioxidant, anti-inflammatory and anti-infectious properties may play a role,” stated the authors.

They concluded that a resveratrol diet represents a novel approach to the treatment of chronic intestinal inflammation.

Source: European Journal of Pharmacology

A new British study finds that people who take aspirin every day have a higher risk of developing Crohn’s disease, a potentially devastating digestive illness.

But it’s still not very likely that aspirin users will develop the condition, and the study’s lead author said patients should keep in mind that aspirin lowers the risk of heart disease.

“If the link with aspirin is a true one, then only a small proportion of those who take aspirin — approximately one in 2,000 — may be at risk,” said study author Dr. Andrew Hart, a senior lecturer in gastroenterology at University of East Anglia School of Medicine. “If aspirin has been prescribed to people with Crohn’s disease or with a family history by their physician, then they should continue to take it. Aspirin has many beneficial effects and should be continued.”

An estimated 500,000 people in the United States have Crohn’s disease, which causes digestive problems and can boost the risk of bowel cancer. In some cases, patients must undergo surgery; many have to take medications for the rest of their lives.

While aspirin is known for its ability to reduce the risk of heart disease, it can cause stomach ulcers, and research in animals has suggested it can be hard on the intestines, too. The study authors decided to see if it had the same effect in humans, Hart said.

In the new study, researchers tracked 200,000 volunteers, aged 30 to 74, from several European countries.

The researchers found that aspirin use for a year or more boosted the risk of Crohn’s disease by five times.

However, the study only suggests there’s a link between aspirin use and the disease; it doesn’t prove that aspirin actually increased the risk. And the researchers didn’t know how much aspirin each person took.

Why might aspirin boost the risk of Crohn’s disease? Dr. William J. Sandborn, vice chair of Mayo Clinic’s Division of Gastroenterology and Hepatology, said it might have something to do with aspirin damaging the lining of the bowel, potentially triggering the condition in those who are susceptible to it because of their genetic makeup.

Sandborn, who’s familiar with the findings, agreed with Hart that patients need to think about the benefits of aspirin use, including the reduced risk of not only heart disease but also colorectal cancer.

The study found no link between aspirin use and ulcerative colitis, another digestive disorder.

Future research is needed to confirm the aspirin-Crohn’s disease link and determine what aspirin has to do with the higher risk, Hart said.

“If it does turn out to be a true link in the future, then it will be only one of many factors involved in causing Crohn’s disease,” he said. “Because aspirin has benefits, users should continue with it.”

The study was to be presented Monday at the Digestive Disease Week conference in New Orleans.

Saturday May 1, 2010

Increasing your intake of olive oil may help protect against ulcerative colitis, a new study finds.

Ulcerative colitis is an inflammatory bowel disease that causes ulcers in the lining of the rectum and colon, resulting in abdominal pain, diarrhea and weight loss. This study found that people whose diet was rich in oleic acid were far less likely to develop ulcerative colitis.

Oleic acid is a monosaturated fatty acid found in foods such as olive oil, peanut oil, grapeseed oil, butter and some margarines.

This study included more than 25,000 people, aged 40-65, in Norfolk, U.K. who were recruited between 1993 and 1997. None of the participants had ulcerative colitis at the start of the study. By 2002, 22 participants had developed ulcerative colitis. The researchers compared the diets of these people to those who didn’t develop the disease and found that those with the highest intake of oleic acid were 90 percent less likely to develop ulcerative colitis.

“Oleic acid seems to help prevent the development of ulcerative colitis by blocking chemicals in the bowel that aggravate the inflammation found in the illness,” study leader Dr. Andrew Hart, of the University of East Anglia’s School of Medicine, said in a news release.

“We estimate that around half the cases of ulcerative colitis could be prevented if larger amounts of oleic acid were consumed. Two-to-three tablespoons of olive oil per day would have a protective effect,” he said.

The study was presented Saturday at the Digestive Disease Week conference in New Orleans.

March 23, 2010

(Reuters Health) – People who eat plenty of fish oil and other omega-3 fatty acids could cut their risk of colon cancer, new research hints.

Studies in animals and a couple of small trials in people suggest that fish oil supplementation can fight inflammation and may have cancer-fighting properties, Dr. Sangmi Kim of the National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, and colleagues note. But so far studies looking at the diets of larger groups of people have had equivocal results.

To investigate further, Kim and colleagues examined the relationship between polyunsaturated fatty acid intake and bowel cancer risk in 1,503 whites (including 716 colon cancer patients and 787 healthy controls) and 369 African Americans (213 with colon cancer, 156 controls).

Among whites, the researchers found, those in the top fourth based on their omega-3 consumption had half the risk of colon cancer compared to those in the bottom fourth.

When the researchers looked separately at the two main fatty acids contained in fish oil –eicosapentaenoic acids and docosahexaenoic acids — they found risk also fell with increasing intake.

When the researchers looked at whites and blacks together, they also found a reduced risk of colon cancer with increasing omega 3 intake; separate analysis of the black study participants didn’t find this relationship.

They also found that people who consumed more omega-6 fatty acids in relation to omega-3s were more likely to have colon cancer, although omega-6 intake in and of itself didn’t affect risk.

In addition to fish oils, omega-3 fatty acid sources include seed oils, such as walnut oil and flax-seed oils, and leafy green vegetables. People in the US typically eat more omega-6 fatty acids than omega-3s; top sources include palm oil, soybean oil, and sunflower oil.

The researchers also found an “unexpected” association between higher omega-3 intake and colon cancer in African-Americans, but urged caution in interpreting this finding, which they say “may have been due to chance.” Nevertheless, they conclude, “whether the possible benefit from this dietary modification varies by race warrants further evaluation.”

SOURCE: American Journal of Epidemiology, online April 14, 2010.

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March 17th, 2010

Some 40% of commercial disinfectants used to clean surfaces are believed to be ineffective in eliminating noroviruses, a group of viruses responsible for more than half of all foodborne gastroenteritis outbreaks. According to a recent study published by Université Laval researchers in the Journal of Food Protection, only bleach-based disinfectants drastically reduce the concentration of these viruses.

Noroviruses spread directly via contact with infected persons or indirectly through contaminated objects, foods, or surfaces. The effectiveness of disinfectants used to clean surfaces at home or at businesses in the food sector is therefore crucial for limiting the spread of these viruses, which affect over 21 million people every year in the United States alone.

The team of researchers led by Julie Jean, professor at the Faculty of Agriculture and Food Sciences, tested the efficacy of three major categories of household disinfectants in eliminating noroviruses: bleach-based products, alcohol-based products, and quaternary ammonium-based products.

Lab tests showed that five minutes of contact with a bleach-based disinfectant reduced the concentration of noroviruses on a stainless steel surface by a factor of 1,000. Alcohol- and quaternary ammonium-based products proved 100 times less effective.

“Our results are of particular concern considering that some 40% of the commercial surface disinfectants on the market are alcohol or ammonium based,” stressed Professor Jean, who is also a researcher at the Institute of Nutraceuticals and Functional Foods (INAF).

Julie Jean’s team also discovered that it takes only ten minutes for human noroviruses to firmly latch on to a stainless steel surface. “Once attached, these viruses can survive for weeks and potentially contaminate anyone who touches them. And it’s highly probable that our findings on stainless steel surfaces also apply to other materials,” concluded Professor Jean.

Provided by Universite Laval

March 10, 2010

By Anne Harding

NEW YORK (Reuters Health) – A serious bout with a stomach bug can raise a child’s risk of having irritable bowel syndrome (IBS) later on, new research shows.

People with IBS often have stomach pain, bloating, gas and altered bowel habits such as diarrhea and constipation. While the root cause of the condition isn’t known, adults who have had stomach infections are known to be at greater risk. The relationship between these infections and IBS in children is not as clear.

To investigate, Dr. John K. Marshall of McMaster University in Hamilton, Ontario and his colleagues looked at children participating in the Walkerton Health Study, the largest-ever study of IBS after gastrointestinal infection.

In 2000, an outbreak of bacterial gastroenteritis sickened at least 2,300 people in this Ontario town, and killed seven; the researchers have been following Walkerton residents since 2002.

In the current study, they looked at 467 boys and girls who were younger than 16 at the time of the outbreak, but turned 16 during the eight-year follow-up period. None of them had been diagnosed with IBS before the outbreak occurred.

Among the 305 who had been sickened during the outbreak, around 10 percent reported IBS symptoms eight years later, compared to only about 2 percent of the 162 who hadn’t gotten sick. This meant the outbreak victims were nearly five times as likely to have IBS as the healthy controls; when the researchers looked only at the 130 study participants whose illness had been diagnosed by a doctor (rather than just having been self-reported), the risk of IBS symptoms was more than seven times greater compared to those who had escaped the illness.

Experts still don’t understand what exactly is wrong in people with IBS, Marshall noted. “We kind of try to help the symptoms but at the end of the day we don’t have a treatment that goes to the root cause and fixes it.”

This can include helping people to manage stress and manage their diet, he added, and to be aware of other potential triggers for their symptoms, and also giving them medications to control symptoms such as diarrhea or constipation.

“If you go ask people door to door, you’ll find that a surprising number of people have these syndromes and will fulfill the criteria for IBS,” Marshall said. “Of course, not all those people are equally troubled by these symptoms.”

SOURCE: The American Journal of Gastroenterology, published online February 23, 2010.

February 26, 2010

NEW YORK (Reuters Health) – A serious bout with a tummy bug may mean heartburn years later, new research shows.

Serious bacterial or viral infections of the digestive system-known medically as infectious gastroenteritis-may lead to some cases of irritable bowel syndrome, possibly by causing low-grade inflammation in the intestine, Dr. Alex Ford of McMaster University Medical Center in Hamilton, Ontario and his colleagues note.

Studies have suggested that such infections could also be linked with functional dyspepsia-basically, symptoms of heartburn, fullness and indigestion with no known cause-but the evidence isn’t as strong.

To investigate, Ford and his team looked at a group of people who had been living in the small rural town of Walkerton, Ontario, during a 2000 outbreak of bacterial gastroenteritis after the municipal water supply became contaminated with cow manure. At least 2,300 people were sickened, and seven died.

Two years after the outbreak, in 2002, the researchers enrolled a representative sample of the town’s population in an ongoing study. In 2008, they followed up with 1,088 of the study participants, about two-thirds of whom reported having gotten sick during the outbreak. About 40 percent of the entire group reported dyspepsia symptoms, such as heartburn and unpleasant sensations of fullness after a meal.

Among those who’d been sickened in the outbreak, half had dyspepsia symptoms, compared to 30 percent of the people who hadn’t gotten sick during the outbreak. The risk was more than twice as high for the outbreak victims, and this remained true even when the researchers used a stricter definition for dyspepsia.

The findings suggest, the researchers conclude, that gut infections “have the ability to trigger symptoms that affect the upper, as well as the lower gastrointestinal tract, with long-lasting consequences.”

SOURCE: Gastroenterology, online February 1, 2010.

Consumption of fibre-rich rye bread may ease constipation and perform commercial laxatives, according to a new study from Finland.

Writing in the Journal of Nutrition, researchers from the University of Helsinki report that whole-grain rye bread performed better than laxatives and white wheat bread in the easing of symptoms of constipation, a condition reported to affects up to 27 per cent of the population of Western countries, according to the researchers.

“To the best of our knowledge, this study is the first to evaluate the effects of rye bread in treating constipation as compared with laxatives and to simultaneously investigate the changes in the colonic metabolism,” wrote the researchers, led by Reetta Holma.

“The results are encouraging,” they added.

The beneficial effects of rye were put down to its fibre content, which could fermented by bacteria in the colon, and lead to an increase in colonic short chain fatty acids (SCFA).

“Arabinoxylan, which is abundant in rye, appears to be a preferred substrate for fermentative generation of SCFA,” noted the researchers. “SCFA may induce propulsive contractions, leading to accelerated transit and relief of constipation.

“The decrease in fecal pH caused by rye bread consumption, which was found in the present study, is a natural consequence of increased fecal SCFA and also decreased intestinal transit time. The importance of maintaining a slightly acidic environment is critical, because the majority of harmful bacterial enzymes operate optimally at a neutral to slightly basic pH,” they added.

Study details

The Finnish researchers recruited 51 constipated adults and randomly assigned them to one fo five groups: One group received the whole-grain rye bread (240 grams per day), one group received buttermilk containing Lactobacillus rhamnosus GG (LGG), one group received both rye bread and LGG, the fourth group received white wheat bread, and the final group received laxatives.

At the end of the study an increase in intestinal transit time of 23 and 41 per cent was reported for the rye bread group, compared with white wheat bread and laxatives, respectively, and the average number of weekly defactions increased by 1.4.

On the other hand, LGG supplementation did not affect constipation, they noted.

“In conclusion, rye bread relieves mild constipation and improves colonic metabolism compared with white wheat bread and commonly used laxatives without increasing gastrointestinal adverse effects,” wrote Holma and her colleagues.

Source: Journal of Nutrition
Published online ahead of print, doi: 10.3945/jn.109.118570
“Constipation Is Relieved More by Rye Bread Than Wheat Bread or Laxatives without Increased Adverse Gastrointestinal Effects”
Authors: R. Holma, S.-M. Hongisto, M. Saxelin, R. Korpela

February 9, 2010

Summary:The project originated as an attempt to see whether various types of dietary fibre and health-promoting bacteria, so-called probiotic bacteria such as lactobacillus and bifidobacteria, can help alleviate and prevent the risk of ulcerative colitis and colorectal cancer.

9 Feb 2010 — It is already known that blueberries are rich in antioxidants and vitamins. New research from the Lund University Faculty of Engineering in Sweden shows that blueberry fibre are important and can alleviate and protect against intestinal inflammations, such as ulcerative colitis. The protective effect is even better if the blueberries are eaten together with probiotics.

The project originated as an attempt to see whether various types of dietary fibre and health-promoting bacteria, so-called probiotic bacteria such as lactobacillus and bifidobacteria, can help alleviate and prevent the risk of ulcerative colitis and colorectal cancer.

“But new knowledge of this field is also of interest to those who don’t believe they run the risk of developing any intestinal diseases. In recent years the research world has been realizing that our health is governed to a great extent by what happens in our large intestine,” explain Camilla Bränning, a PhD in Applied Nutrition and Åsa Håkansson, a doctoral candidate in Food Hygiene at the Division of Applied Nutrition and Food Chemistry.

The researchers tested various types of diets of blueberry husks, rye bran and oat bran with or without a mixture of probiotic bacteria. The results showed that the protective effect of blueberries was reinforced if they were eaten together with probiotics.

“The probiotics proved to have a protective effect on the liver, an organ that is often negatively impacted by intestinal inflammations,” explains Åsa Håkansson.

Blueberries are rich in polyphenols, which have an antimicrobial and antioxidative effect. The combination of blueberries and probiotics reduced inflammation-inducing bacteria in the intestine at the same time as the number of health-promoting lactobacilla increased.

Åsa Håkansson and Camilla Bränning also noted that if blueberries are eaten together with probiotics, the content of butyric acid and propionic acid increased in the blood, two substances that are formed when fibre are broken down and that have previously been known to be important energy sources for intestinal cells. In recent years they have also been shown to favourably impact the immune defence. It seems as if the absorption of these components is facilitated by the presence of probiotics.

“What surprised us was that such a large share of the butyric acid not only was taken up by the intestinal cells but was also transported onward to the blood. Previously it was thought that the intestinal cells used all of the butyric acid, but this is not at all the case,” says Camilla Bränning, who recently defended her dissertation on the subject.

“A further explanation for the extremely positive effect of blueberries may be that the blueberry fibre are not degraded to such a high degree in the large intestine. This means that inflammation-inducing substances do not come into contact with the mucous lining of the intestine but are embedded in the fibre instead. Then these substances are transported out of body together with the faeces,” explains Camilla Bränning.

The researchers also found that rye bran was broken down in the large intestine, in the same place that ulcerative colitis and large-intestine cancer often occur, and that the rye bran provided a rich supply of butyric acid and propionic acid. On the other hand, the fibre in oat bran were degraded earlier in the large intestine. The most striking result, however, was that blueberries themselves had such a favourable effect compared with both rye bran and oat bran.

Some 15-20 percent of all Swedes suffer from stomach pains, diarrhoea, or constipation, complaints resulting from intestinal disorders and more undefined intestinal problems. The disease ulcerative colitis is one of the inflammatory intestinal diseases included under the general name IBD, inflammatory bowel diseases. It can lead to colorectal cancer and afflicts about 1,000 Swedes per year.

January 28, 2010

By Ted Agres

NEW YORK (Reuters Health) – Patients who have surgery to treat severe heartburn — also known as gastroesophageal reflux disease or GERD — continue to have a very high risk of developing cancer of the esophagus even after 15 years or more, a new study has found.

GERD is a known risk factor for esophageal cancer. “This study should put to rest the notion that antireflux surgery prevents esophageal cancer. It was always a viewpoint based more on hope than data but, now that the data are in, the conclusions should be accepted,” said Dr. Peter J. Kahrilas, professor of medicine at Northwestern University’s Feinberg School of Medicine in Chicago, who was not involved in the study.

“This population-based data set spanned 40 years and encompassed essentially the entire Swedish population. There was not even a trend toward cancer prevention, even decades after the surgery,” Kahrilas added in an email to Reuters Health.

The researcher who headed the study, Dr. Jesper Lagergren, professor of surgery at the Karolinska Institute in Stockholm, told Reuters Health, “We expected a decreased risk of cancer with increased time after surgery, but we didn’t find it. There is no evidence to support the idea that antireflux surgery prevents cancer development of the esophagus.”

GERD is a common disease in which fluid from the stomach backs up into the esophagus, typically causing heartburn and other symptoms. Although GERD can be controlled through lifestyle changes and medication, some patients require surgery to reinforce the valve between the esophagus and stomach. Antireflux surgery has been shown to provide long-term improvement and resolution of GERD symptoms.

To gauge the effect of antireflux surgery on the risk of throat cancer, Lagergren and colleagues analyzed the medical records of Swedish citizens from 1965-2006.

Among 14,102 patients who had antireflux surgery, the overall risk of esophageal cancer was 12 times that in the general Swedish population. The risk did not decrease with time after surgery, they report in the journal Gastroenterology.

According to Kahrilas, “I think that this is now the definitive study assessing whether or not there is a protective benefit of antireflux surgery with respect to preventing esophageal adenocarcinoma, and the answer is a resounding no!”

Why doesn’t antireflux surgery protect against cancer? Possible reasons include the continuation of reflux after surgery, the length of time patients had reflux prior to surgery, and its severity, Lagergren said.

To investigate the causes, he and his colleagues are delving deeper into the data. “We are evaluating the surgery itself as well as other risk factors, for example obesity, surgeon experience, and the recurrence of reflux,” he said.

SOURCE: Gastroenterology, online January 18, 2010.

Copyright © 2010 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Children with inflammatory bowel disease have a high prevalence of vitamin D deficiency, according to a new study published in the journal Pediatrics.

Inflammatory bowel disease refers to the inflammation of the large or small colon and is characterized by diarrhea, abdominal pain and cramping, bloody stool, weight and appetite loss, and ulceration of the bowel lining. Crohn’s disease and ulcerative colitis are two common types of inflammatory bowel disease.

Other studies of vitamin D in children with inflammatory bowel disease have produced mixed results, Dr. Helen M. Pappa and colleagues from Children’s Hospital, Boston, note. To further investigate, they evaluated 130 subjects with inflammatory bowel disease who were between the ages of 8 and 22 years old. Of these, 94 had Crohn’s disease and 36 had ulcerative colitis.

The team measured the patients’ blood levels of 25-hydroxy-vitamin D, a frequently used and accurate means of estimating vitamin D levels in the body. They measured levels of intact parathyroid hormone, which is secreted by the parathyroid gland and works with vitamin D to form new bone tissue. The bone mineral density of the lower spine was also measured.

Thirty-five percent of the children had vitamin D deficiency and 11 percent had severe deficiency. The rates of vitamin D deficiency were similar in patients with Crohn’s disease and ulcerative colitis.

Blood levels of 25-hydroxy-vitamin D were 53-percent lower among children with darker skin complexions, 33-percent lower during the winter months and 32-percent higher among children who were receiving vitamin D supplements compared with those who were not, Pappa’s team reports.

The researchers also observed a positive correlation between 25-hydroxy-vitamin D and weight, bone mineral density, disease duration and blood levels of albumin.

Patients with Crohn’s disease that affected the upper gastrointestinal tract were more likely to be vitamin D deficient than those without it, according to the authors. No association was found between 25-hydroxy-vitamin D levels and bone mineral density of the lower spine or blood levels of parathyroid hormone.

The mechanism involved in vitamin D deficiency in patients with inflammatory bowel disease is not completely clear, and additional studies are needed to better understand this process and to develop successful treatment, the investigators conclude.

SOURCE: Pediatrics, November 2006.

In their study they tested different doses of grapefruit seed extract on rats with stomach ulcers. Results showed a drop in gastric acid, which irritates and damages stomach tissue. Treatment with grapefruit seed extract also resulted in a shrinking of the ulcer size and an increase in blood flow to the ulcers, which may help them heal.

Grapefruit seeds aren’t normally eaten, but supplements of grapefruit seed extract are available. However, the researchers aren’t recommending (or rejecting) such supplements. Their study did not include any people.

The findings were presented in Chicago at the Digestive Disease Week 2005 conference.

Rat Test: Ulcers vs. Extract

Doses were scaled to the rats’ weight. At a dose of 10 milligrams/kilogram, acid secretion was halved in rats with stomach ulcers. The ulcers also shrank progressively by the sixth and ninth days of treatment and had completely healed after 16 days, according to the study.

The rats also showed a significant increase in blood flow to the ulcers, and they released more of an ulcer-healing chemical called gastrin, say the researchers, who included Thomas Brzozowski, MD, PhD, of Poland’s Jagiellonian University Medical College.

The extract could have something to do with Cox-1 and Cox-2 activity, say Brzozowski and colleagues.

Cox-1 is an enzyme found in many parts of the body, including the stomach. It helps the stomach produce mucus, which protects it from tissue-damaging acids. Many common pain relievers, like aspirin, inhibit this enzyme, reducing mucus production in the stomach, which increases the risk of ulcers and severe irritation with bleeding.

Cox-2 enzymes also produce chemicals linked to inflammation. The popular pain reliever Celebrex inhibits Cox-2.

When the researchers paired the extract with drugs that inhibit the Cox enzymes, the extract’s effects in healing ulcers were inhibited or completely wiped out.

Grapefruits Too Tart to Eat?

Grapefruits aren’t off limits for people with ulcers, says Brzozowski in a news release.

“Because grapefruit is acidic in nature, people with ulcers might assume that they should not include the fruit in their diet. However, this research suggests the exact opposite,” he says.

Antioxidants in the extract may be the key ingredient, he says.

The antioxidant properties found in grapefruit and the ability of the extract to limit damage in the stomach’s lining have therapeutic implications that when combined with other therapies can be beneficial for healing stomach ulcers, he says.

Supplement Savvy

Grapefruit and grapefruit juice may increase the amount of some medications in the bloodstream. That includes cholesterol-fighting statin drugs, calcium-channel blocker drugs for high blood pressure, and some antihistamines.

Consult a doctor with any questions about grapefruit’s effects or an appropriate amount to consume. Also, tell your doctor about any supplements you’re taking, including over-the-counter items, herbal products, and vitamins. That way, your doctor can watch out for possible drug interactions and discuss the pros and cons of treatments.

Consumers may also want to keep in mind that the U.S. government does not regulate dietary supplements.

People who consumed at least 1,000 mg a day of calcium (from food and/or supplements) had about a 20 percent lower risk of colon or rectal cancer than those who got less than 500 mg a day. And those who drank one or more glasses of milk a day had a 1 5 percent lower risk than those who averaged less than a quarter of a glass a day.

What to do: It’s too early to know if milk reduces the risk of colon or rectal cancer, but other studies have found that calcium does. Shoot for 1,000 mg a day (if you’re under 50) and 1,200 mg a day (if you’re older), from food and supplements combined. But don’t go overboard, especially if you’re a man. A recent study suggests that more than 1,200 mg a day may increase the risk of prostate cancer.

NEW YORK (Reuters Health) – Obese people appear to be at increased risk for diverticulitis and for bleeding diverticula, results of a new study indicate.

Diverticula are small pouches that form in the lining of the colon and are very common in older adults. Diverticulitis occurs when the diverticula become inflamed and infected, which can be a serious, even life-threatening, problem. Diverticula may also bleed, which can be an equally serious problem.

“A number of digestive diseases have been associated with obesity,” note Dr. Lisa L. Strate, of the University of Washington School of Medicine, Seattle, and colleagues. “Some of the obesity-related (factors) believed to play a role in these disorders may also influence diverticular complications, most notably the link between obesity and chronic inflammation.”

To investigate further, the team examined data for 47,228 men enrolled in the Health Professionals Follow-up study. They were between the ages of 40 and 75 years and free of diverticular disease when the study began in 1986 and were followed until 2004.

A total of 801 cases of diverticulitis and 383 cases of diverticular bleeding occurred during follow-up, according to the report, published in the journal Gastroenterology.

The analysis showed that obese men were 78 percent more likely to develop diverticulitis and 219 percent more likely to develop diverticular bleeding than were normal weight men.

Similarly, a big waistline increased the odds of diverticulitis and diverticular bleeding by 56 and 96 percent, respectively.

Lastly a high waist-to-hip ratio was also linked to both problems, regardless of whether the man was obese or not.

“An association between body fat and diverticular complications has important clinical implications,” they conclude, “given the increasing prevalence of these disorders and the considerable risk of recurrent complications.”

SOURCE: Gastroenterology, January 2009.

NEW YORK (Reuters Health) – People with bleeding peptic ulcers who are admitted to a hospital on a weekend for have poorer survival than those admitted on a weekday, according to the results of a new study.

Dr. Abdel Aziz M. Shaheen, from the University of Calgary, Alberta, analyzed data from the 1993-2005 US Nationwide Inpatient Sample, featuring 237,412 admissions to 3166 hospitals for peptic ulcer-related bleeding.

Mortality was 3.4 percent among cases admitted on weekends but 3.0 percent among cases admitted on weekdays, the team reports in the medical journal Clinical Gastroenterology and Hepatology.

Weekend-admitted patients were also more likely to undergo surgery, had longer hospital stays, and incurred greater hospital charges.

The average time before being examined by endoscopy was 2.21 days for weekend-admitted cases versus 2.06 days for those admitted on a weekday.

However, this delay did not seem to be the reason for the weekend effect on mortality, Shaheen’s team states. Further studies are needed to uncover the reasons.

SOURCE: Clinical Gastroenterology and Hepatology, March 2009.

Millions of Americans take drugs like Nexium, Prevacid and Prilosec to ease the erosive effects of acid reflux, but do these medicines put patients at risk for other health problems?

Experts remain divided on the potential dangers these common prescription medications might pose.

The drugs belong to a class of pharmaceuticals called “proton pump inhibitors,” or PPIs, which are generally considered safe and effective. But lately these acid-reducing medications have been the subject of studies linking their use to a number of health risks, from an increased rate of hip fracture to a greater likelihood of diarrhea and community-acquired pneumonia.

Dr. Kenneth W. Altman, an associate professor of otolaryngology at Mount Sinai School of Medicine in New York City, draws attention to some of the potential consequences of PPI use in a commentary published in the November issue of Otolaryngology — Head and Neck Surgery.

“I really want to emphasize this is an important class of medication and it’s helping a lot of people,” Altman said. Still, the scientific literature raises questions that require further study, he said, such as how the body’s metabolism of PPIs affects blood levels of other drugs processed in the liver.

But Dr. David A. Johnson, chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Va., doesn’t think the current wave of studies meet the rules of evidence to “clearly implicate” PPIs. Furthermore, the studies fail to weigh the benefits of treatment against any potential risk, he said.

Most people experience occasional heartburn. But when the burn is severe or frequent, it may be due to gastroesophageal reflux disease (GERD), a condition that occurs when the valve that closes off the stomach from the esophagus fails to work properly, according to the American College of Gastroenterology.

When stomach acid backs up all the way to the throat or even the nasal airway, it’s called laryngopharyngeal reflux, according to the American Academy of Otolaryngology — Head and Neck Surgery.

PPIs are widely prescribed for treating for both conditions.

In 2008, proton pump inhibitors were the third largest-selling therapeutic class in the United States, ringing up $13.9 billion in U.S. sales, according to IMS Health, a Norwalk, Conn.-based health-care data company. With 113.4 million prescriptions, they were the 6th most widely dispensed retail prescription medications, IMS reported.

Of the various health problems being linked to PPIs, one of the most concerning involves its interaction with the blood thinner clopidogrel (Plavix). One study linked the drug combination to a 70 percent increased risk of heart attack or unstable angina and a 48 percent increased risk of stroke.

On that news, the Society of Cardiovascular Angiography and Interventions urged health-care providers treating patients with the clot-prevention therapy to consider prescribing antacids or other acid-blockers instead of PPIs. The U.S. Food and Drug Administration also recommended that health-care providers reevaluate PPI use in Plavix patients.

Yet there was no evidence from prospective randomized trials to support those cautionary statements, according to Johnson, who is also past president of the American College of Gastroenterology. “It was all retrospective, or subject to potential biases,” he said.

Since then, three prospective studies, including papers published in The Lancet and data presented at a major cardiology meeting, have shown no adverse cardiac outcomes from the drug combination, Johnson noted.

Dr. Michael F. Vaezi, clinical director in the department of gastroenterology at Vanderbilt University Medical Center in Nashville, also believes the clinical importance of the associations reported in many of the PPI studies has been “overblown.”

The studies are mostly based on epidemiologic data — information collected from a particular population, Vaezi explained. With these types of studies, it’s difficult to weed out “confounding” factors that may skew the results, he said. What’s more, he added, the associations reported in many of the studies are weak.

Altman said he is mostly concerned about high-dose and long-term users of the drugs because their increased exposures boost the odds that they’ll experience some unintended consequence. He’s also worried about people who continue to use PPIs but don’t get better.

“They may not have acid reflux, or they may already have a more severe complication of acid reflux than they’re aware of,” he said.

Patients who have concerns about the use of these drugs should speak with their physicians, Vaezi said. But he also said that people need to recognize that the findings of these studies merely suggest an association with a particular outcome — not a cause.

“The message to the public is, ‘Let’s not overreact,’” he said.

WASHINGTON, D.C. (Ivanhoe Newswire) — It starts off as heartburn but can turn into something much more serious. Three-point-three million people in the United States have Barrett’s esophagus, a condition that can lead to cancer. Doctors are using a tool that burns away dangerous cells and lowers the cancer risk.

If someone breaks it, there’s a good chance John Davies can fix it. The former Royal Australian Air Force wing commander spent 29 years working on planes — a high stress job that took a toll on his health.

“It just would last just about all night, just terrible pain,” Davies told Ivanhoe.

That stomach pain came from Davies’ long battle with heartburn and acid reflux disease. It turned into a more serious problem called Barrett’s esophagus. The stomach acid causes cells that line the esophagus to change, putting Davies at a 40 percent higher risk of developing cancer.

“You really get scared, which I was,” Davies said.

Davies had two procedures to cut out the Barrett’s, but it returned. Doctors then turned to a radiofrequency treatment to burn off the pre-cancerous cells.

“Essentially, [you are] using thermal energy to go ahead and damage the tissue and destroy the cells,” John Carroll, M.D., Assistant Professor of Medicine in the Division of Gastroenterology at Georgetown University Hospital in Washington, D.C., told Ivanhoe.

An endoscope with a tiny balloon or probe at the tip goes into the esophagus. It delivers radiofrequency energy through heat coils, destroying the thin layer of tissue where the problem cells live.

“It burns off the superficial layer but doesn’t go deeper,” Dr. Carroll said. “The esophagus heals remarkably quickly.”

In traditional surgery, doctors remove a portion of the esophagus and reconnect it to the stomach. It keeps patients in the hospital for three weeks, and eating can be a challenge. The new radiofrequency treatment is an outpatient procedure that takes about 30 minutes. People can eat the next day.

“It’s like the weight of the world had come off your shoulders, thinking at one point you’re going go through this major surgery,” Davies said.

Davies has regular check-ups to monitor his esophagus.

“I expect the best,” he said. “I don’t expect to see it again hopefully in the rest of my life.”

A handyman who is grateful doctors found a way to fix him up without surgery.
In one study, 74 percent of people had no evidence of Barrett’s esophagus in their biopsies after the radiofrequency treatment. Patients will typically take medication after the procedure to prevent acid reflux from returning.

MONDAY, Nov. 5 (HealthDay News) — Doctors may be overprescribing anti-reflux medications to infants, new research suggests.

The study found that fewer than one in five babies given anti-reflux medications, which work by lowering levels of stomach acid, actually had elevated acid levels. That means four out of five infants included in the study likely didn’t need anti-reflux medications, and may have simply been experiencing normal infant regurgitation commonly referred to as “spitting up.”

“In the absence of red flags, such as a child who is not gaining weight, has feeding problems or a learned aversion to food, a chronic cough or recurrent respiratory problems or apnea, regurgitation may not require medication,” said study author Dr. Vikram Khoshoo, a pediatric gastroenterologist at the Pediatric Specialty Center at West Jefferson Medical Center in New Orleans.

“Regurgitation won’t improve with anti-reflux medications. Acid suppression will improve irritability and feeding problems, but it won’t change spitting up. As long as the child is gaining weight and happy, and has no recurrent red flags, regurgitation is a laundry problem, not a medical problem,” Khoshoo said.

The findings are published in the November issue of Pediatrics.

Reflux is common in infants. In fact, more than half experience reflux symptoms during the first three months of life, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms of reflux include spitting up, vomiting, coughing, feeding difficulty and irritability.

Khoshoo and his colleagues reported that back in 1998 and 1999, infants with regurgitation made up about 14 percent of their referrals, and about 40 percent of those babies were already on anti-reflux medication or on special easier-to-digest formula. But by 2006 to 2007, infants with regurgitation accounted for 23 percent of their referrals, and 90 percent were already on medications or special formula.

“We felt it was unlikely that the incidence had increased so suddenly,” Khoshoo said.

To measure whether or not these infants’ symptoms were caused by acid reflux, the researchers conducted pH studies on 44 babies with persistent regurgitation. The average age of the babies was 18 weeks.

To complete a pH study, doctors must thread a wire down the nose and leave it in place for 24 hours, Khoshoo said, so it’s not a test that would be practical to do on every child with regurgitation.

Of the 44 babies tested, only eight showed elevated pH levels, meaning they had excess levels of stomach acid, and anti-reflux medications would be indicated in these cases. However, 42 of the babies were already on such medications, meaning that many were taking a medication they didn’t need.

While these medications are generally considered safe, Khoshoo said there is some concern that they may affect calcium metabolism, and they’ve been associated with osteoporosis in older people who take them for long periods of time.Because infants are building new bones, this potential side effect is even more concerning, Khoshoo added.

Dr. David Keljo is a pediatric gastroenterologist and director of the Inflammatory Bowel Disease Center at Children’s Hospital of Pittsburgh. He said, “Reflux in babies is a tough issue, and I think the concerns in this study are well-raised. Babies may be cranky from reflux or from something else. The vast majority will outgrow their reflux whether we do anything or not.”

Both Khoshoo and Keljo said these medications are probably overprescribed because parents want to do something, anything to try to stop their babies’ regurgitation and irritability.

Khoshoo said that taking care not to overfeed your infant and making sure he or she is positioned so that their bodies are at least somewhat upright after eating will help to lessen reflux symptoms. Another critical thing parents can do, he said, is make sure that children aren’t exposed to secondhand smoke, which can increase reflux symptoms.

Keljo said there are certain signs that indicate your baby should be evaluated by a specialist. If your child throws up blood, a substance that looks like coffee grounds, or if there’s green in the vomit, your child should be seen right away. Also, if your child isn’t gaining weight or is even losing weight, if you can hear significant choking sounds, if there’s a chronic cough or hoarseness that accompanies regurgitation, your child should see a gastroenterologist, he said.

This band of muscle, called the lower esophageal sphincter (LES), surrounds the passage from the esophagus to the stomach. Temporary relaxations are normal and allow food to pass into the stomach. But when the LES is weak or relaxes inappropriately, stomach acids can churn up in the esophagus and cause heartburn symptoms.

Among the healthy volunteers, acupoint stimulation of a specific point on the wrist reduced LES relaxations by 40 percent. Ultimately, reducing LES relaxations stands as a potential way to keep stomach acids in their place, according to Dr. Richard H. Holloway of the University of Adelaide, the lead author of the new study.

Holloway said that LES relaxations have become “an area of great interest” in drug industry research. But his team’s findings, published in the American Journal of Physiology-Gastrointestinal and Liver Physiology, point to the potential of the 2,000-year-old practice of acupuncture.

The acupoint stimulation used in Holloway’s study is a modern twist on the ancient procedure. In place of needles, acupoint uses electrodes to send a small electrical pulse to specific acupuncture points on the skin. According to traditional Chinese medicine, these points are connected to internal pathways that conduct energy throughout the body; stimulation of these points is thought to promote a healthy flow of energy.

No one knows for sure how acupuncture works, though a number of recent studies have confirmed that it may ease chronic pain and nausea. Some scientists speculate that acupuncture alters signals among nerve cells or affects the release of various chemicals of the central nervous system.

Acupuncture has long been used in traditional medicine to treat stomach ailments, Holloway said, but until now there had been no evidence that acupoint stimulation affects LES relaxations. Still, the reason for the LES effects is “completely unclear,” Holloway said.

Indeed, Holloway and his colleagues had speculated that acupoint stimulation might prevent LES relaxations by affecting the body’s release of endorphins or other pain-killing chemicals called enkephalins. But in a second experiment, where volunteers received a medication that blocks these chemicals, acupoint stimulation still reduced LES relaxations.

Holloway described the findings as “very preliminary,” in that they showed only that LES relaxations declined during acupoint stimulation. The remaining, and significant questions are whether the effects last once the procedure is over—and whether they will in fact prevent acid reflux.

An important next step, Holloway noted, will be to see whether acupoint stimulation reduced acid reflux after a meal. Despite the early promise, heartburn sufferers should hold off on making that acupuncture appointment just yet, Holloway said.

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U.S., German, and Swedish researchers conducted a study of about 3,000 residents of two northern Swedish villages and found that 2 percent of them had Barrett’s esophagus. When that rate is applied to the U.S. population, it translates into roughly three million Americans with the condition.

The study, the first to provide population-based estimates of Barrett’s esophagus, also found that the disease does occur in people who don’t have gastroesophageal reflux disease (GERD), believed to be a precursor to Barrett’s esophagus.

The findings appear in the December issue of the journal Gastroenterology.

“Barrett’s esophagus is associated with one of the most rapidly increasing cancers in the Western World and to this point, data on the prevalence of the disease in the general population have been unavailable,” study lead author Dr. Jukka Ronkainen, of the Karolinksa Institute in Sweden, said in a prepared statement.

“This Swedish-based study has helped lay the foundation for researching the true prevalence of Barrett’s and could serve as a basis for future studies in different communities,” Ronkainen said.

In an accompanying editorial, Dr. Richard E. Sampliner, of the Southern Arizona VA Health Care System, wrote: “The definition put forth in this study of the prevalence of Barrett’s esophagus in the general adult population represents a major step forward. The next step for researchers and practitioners is to focus on screening for Barrett’s in people without reflux disease and accurately identifying those at-risk or living with the disease.”

Men and women who consume two or more alcoholic drinks a day could increase their risk of developing pancreatic cancer, according to a study published in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

Previous studies have been unable to confirm the association between drinking and the risk of pancreatic cancer, but most studies depended on a person’s recall of alcohol intake. Still, many hypothesize about the relationship between alcohol and pancreatic cancer because drinking is associated with the risk of pancreatitis and diabetes, and both of these conditions are known risk factors for developing the disease.

Unlike the previous studies, this current research pools data collected prospectively from 14 research studies, which included 862,664 individuals (319,716 men and 542,948 women). Data collected prospectively means information about dietary and environmental exposures were collected prior to diagnosis with pancreatic cancer. Researchers identified 2,187 individuals diagnosed with pancreatic cancer during the study.

“This is one of the largest studies ever to look at dietary factors in relation to pancreatic cancer risk,” says lead author Jeanine M. Genkinger, Ph.D., an assistant professor at Georgetown University’s Lombardi Comprehensive Cancer Center.

If individuals consumed 30 or more grams of alcohol per day (approximately two drinks), compared with no alcohol per day, their risk of pancreatic cancer was slightly increased, researchers said. A drink is defined as 12 ounces of beer, four ounces of wine, or 1.5 ounces of 80-proof distilled liquor.

Although, there was no statistically significant difference between men and women when comparing alcohol intake with risk of pancreatic cancer, the association was seen in women at two or more drinks per day. Comparatively, the researchers observed a higher risk among men who consumed three or more drinks a day.

No difference was observed by type of alcohol when comparing beer, distilled liquor or wine, according to Genkinger.

“Despite being a deadly disease, there are few known risk factors for developing pancreatic cancer,” explains Genkinger. “At this point, it’s important to understand any protective or risk factors for this dangerous disease even if the risks are weak or modest.”

Source: Georgetown University Medical Center

NEW YORK (Reuters Health) – People who have undergone surgery for pancreatic cancer and are classified as obese don’t live as long as those who are not obese, according to a new report.

Dr. Jason B. Fleming, from the University of Texas, Houston, and colleagues looked at the outcomes of 285 patients with pancreatic cancer who were all treated at the M. D. Anderson Cancer Center. Obesity was classified as a body mass index or BMI of 30 or more.

Cancer was 12 times more likely to be found to have spread to the lymph nodes in patients with BMIs of 35 of more, compared to those with lower BMIs, the investigators report in the Archives of Surgery.

For patients with a BMI higher than 35, average survival was 13.2 months, compared with 27.4 months for those with a BMI of less than 23.

The cancer recurred in 95% of patients with a BMI above 35, while those with lower BMIs had a recurrence rate of 61%, the researchers note.

The results, they conclude, “suggest that obesity is a host factor affecting tumor biology independent of the difficulties… involved in delivering oncologic care in obese patients.”

SOURCE: Archives of Surgery, March 2009.

Drinking one glass of wine a day may lower the risk of Barrett’s Esophagus by 56 percent, according to a new study by the Kaiser Permanente Division of Research in the March issue of Gastroenterology. Barrett’s Esophagus is a precursor to esophageal cancer, the nation’s fastest growing cancer with an incidence rate that’s jumped 500 percent in the last 30 years.

Barrett’s Esophagus affects 5 percent of the population and occurs when heartburn or acid reflux permanently damages the esophageal lining. People with Barrett’s Esophagus have a 30- to 40-fold higher risk of developing esophageal adenocarcinoma (a type of esophageal cancer) because the Barrett’s Esophagus cells can grow into cancer cells.

Because there are no symptoms or warning signs of Barrett’s Esophagus, people discover they have Barrett’s Esophagus when an endoscopy for anemia, heartburn or a bleeding ulcer reveals esophageal cells that were damaged, then changed form during the healing process. Currently nothing can be done to treat Barrett’s Esophagus; it can only be monitored.

This is the first and largest population-based study to examine the connection between alcohol consumption and risk of Barrett’s Esophagus. Funded in part by the National Institutes of Health, the Kaiser Permanente study looked at 953 men and women in Northern California between 2002 and 2005 and found that people who drank one or more glasses of red or white wine a day had less than half the risk (or 56 percent reduced risk) of Barrett’s Esophagus. There was no reduction of Barrett’s Esophagus risk among people who drank beer or liquor.

“The rate of esophageal adenocarcinoma in this country is skyrocketing yet very little is known about its precursor, Barrett’s Esophagus. We are trying to figure out how to prevent changes that may lead to esophageal cancer.” said Douglas A. Corley, MD, a Kaiser Permanente gastroenterologist and the study’s principal investigator.

The study findings are echoed by two other studies published in the same issue of the Gastroenterology journal: Australian researchers found that people who drank wine were at a lower risk of esophageal adenocarcinoma, and Irish researchers found that people who drank wine were at a lower risk for esophagitis, an irritation of the esophagus that follows chronic heartburn and often precedes Barrett’s Esophagus and cancer.

Researchers are not certain why wine reduces the risk of Barrett’s Esophagus and esophageal cancer. One theory is that the wine’s antioxidants neutralize the oxidative damage caused by gastroesophageal reflux disease, a risk factor for Barrett’s Esophagus. Another theory is that wine drinkers typically consume food with their wine as opposed to drinking straight liquor without food, thereby reducing the potentially damaging effect of alcohol on esophageal tissue, said Ai Kubo, MD, an epidemiologist at Kaiser Permanente and lead author on the study. “But we cannot preclude the possibility that wine drinking is a proxy for other ‘health-seeking’ behavior,” Kubo added.

This study is part of larger, case-controlled Kaiser Permanente study led by Dr. Corley that looked at abdominal obesity and consumption of dietary antioxidants, fruits and vegetables in connection with Barrett’s Esophagus. It found that people can reduce their risk of Barrett’s Esophagus by eating eight servings of fruits and vegetables a day and maintaining a normal body weight.

“My advice to people trying to prevent Barrett’s Esophagus is: keep a normal body weight and follow a diet high in antioxidants and high in fruits and vegetables,” Corley said. “We already knew that red wine was good for the heart, so perhaps here is another added benefit of a healthy lifestyle and a single glass of wine a day.”

Researchers noted, though, that the protective effect of wine in terms of preventing Barrett’s Esophagus was greatest with just one or two glasses a day. The protective effect of wine did not increase with higher consumption.

“It’s not actually clear that treating the acid reflux will necessarily prevent getting someone from getting Barrett’s Esophagus,” said Dr. Corley. “The best way to prevent reflux is to maintain a normal weight.”

Source: Kaiser Permanente

NEW YORK (Reuters Health) – Researchers from Germany estimate that over 15,000 colorectal cancers will be prevented through 2010 since the country began using colonoscopy as the primary screening tool in 2002. This is all the more impressive given that participation rates were rather low.

Germany was the first country in the world to implement a nationwide colonoscopy screening program, according to the report in the April issue of the European Journal of Cancer.

In their study, Dr. Hermann Brenner, from the German Cancer Research Center, Heidelberg, and colleagues calculated the number of colorectal cancers prevented between 2003 and 2010 thanks to colonoscopy screening.

In 2010, the investigators estimate, the total burden of colorectal cancer, thanks to colonoscopy screening, will be reduced by 13 percent, 19 percent, and 14 percent in women 55 to 59, 60 to 64, and 65 to 69 years of age, respectively. The corresponding reductions in men will be 11 percent, 15 percent, and 12 percent.

The results show that screening colonoscopy can markedly reduce the prevalence of colorectal cancer, the team states.

Improving screening participation rates will yield even greater benefits, they say. For subjects between 55 and 69 years of age, colonoscopy screening participation rates were 30 percent for men and 40 percent for women.

“This is not bad for a beginning,” Brenner said in a statement, “but if we succeeded in encouraging even more people to participate in the screening program – such as by sending personal invitations to examinations due – many more cancers could be prevented.”

SOURCE: European Journal of Cancer, April 2009.