GASTRIC GOLD'S BLOG

Labels: acid reflux, GERD

Labels: Ger, GERD

Stomach acid may only be part of the problem when it comes to esophagus injury related to gastroesophageal reflux disease (GERD). A new study suggests that an immune system response may be the real culprit behind reflux esophagitis.

Researchers say it's been assumed that reflux esophagitis develops when cells in the lining of the esophagus become burned and damaged by stomach acid backing up into the esophagus.

But in a rat model of GERD, researchers found that this acid reflux didn't directly damage the lining of the esophagus. Instead, the acid triggered the release of chemicals called cytokines that attract inflammatory immune cells to the area, which were responsible for the real damage.

If further studies in humans confirm these results, researchers say new GERD treatments that target this immune response may be needed to effectively manage the disease.

"Currently, we treat GERD by giving medications to prevent the stomach from making acid," says Rhonda Souza, MD, associate professor of internal medicine at the University of Texas Southwestern Medical Center, in a news release. She says "maybe we should create medications that would prevent these cytokines from attracting inflammatory cells to the esophagus and starting the injury in the first place."

In the study, published in Gastroenterology, researchers created GERD in rats by performing an operation to connect the duodenum (first section of the small intestine) to the esophagus, allowing stomach acid and bile to enter the esophagus.

The results showed damage to the lining of the esophagus did not occur immediately after exposure to the stomach acids. It happened weeks later.

"That doesn't make sense if GERD is really the result of an acid burn," says researcher Stuart Spechler, MD, professor of internal medicine at UT Southwestern, in the news release. "Chemical injuries develop immediately. If you spill battery acid on your hand, you don't have to wait a month to see the damage."

Within three days after the operation, researchers found no damage to the cells on the surface layer of the esophagus, but they found inflammatory cells in the deeper layers. Those inflammatory cells rose to the surface three weeks later after the initial stomach acid exposure.

WebMD

Labels: acid reflux, GERD

Irritable bowel syndrome greatly disrupts the lives of people who suffer from it. But unlike other gut diseases, such as inflammatory bowel disease, IBS has no known physical cause. And it presents in different ways: with unpredictable diarrhea, with extreme constipation, or both.

"IBS is a disorder with no structural abnormality like ulcers or cancers so it takes on a lower level of legitimacy for doctors and patients," IBS expert Douglas A. Drossman, MD, tells WebMD. "People say it isn't real, and patients say, 'Well then, I must be crazy.'"

That would be a lot of crazy people. An estimated 7% of the U.S. population has IBS. In the U.K., the estimate is even higher: about 10% to 20% of the population.

Lacking a yardstick, doctors have had a hard time judging IBS severity. The FDA recently ruled that new IBS treatments must be evaluated in terms of whether patients feel better. But what do patients say IBS is like?

"Nobody was looking at how patients characterize their illness," says Drossman, co-director of the University of North Carolina Center for Functional GI and Motility Disorders.

So Drossman and colleagues designed two studies. In one, the researchers enrolled 32 IBS patients in small focus groups. In the other, Drossman's team performed an international survey of nearly 2,000 people with an IBS diagnosis.

As expected, patients reported bowel symptoms:

• 80% experienced pain.
• Three-fourths of patients reported bowel difficulties.
• Half of the patients with diarrhea-predominant or mixed-type IBS reported fecal incontinence.
• Nausea, muscle pains, and, for those with diarrhea, gas, mucus in stool, and belching were common.
• More than two-thirds of patients reported bloating.

But just as common -- and, as the focus group members reported, at least as bothersome -- was the way IBS affected their daily function, their thoughts, and their feelings.

"The impairment in their life was far greater than you would imagine -- their own sense of degradation and the stigma they experience from others," Drossman says. "Even when they are not symptomatic, the condition still pervades their life and how they think and feel about it."

IBS: Uncertainty, Loss Add to Suffering

Stigma from friends, family, and doctors was a dominant theme, Drossman found. Patients often said that nobody understood what they were going through or truly believed they were ill. This created as great a barrier to daily function as the disease itself.

Another major theme was uncertainty, a sense of having no control over the condition. Most patients end up greatly restricting their daily activities, which results in a sense of loss: loss of freedom, loss of spontaneity, and loss of social contacts.

All of this leads to emotional responses: fear, shame, embarrassment, and degradation. A big issue, Drossman says, is that patients refrain from sex because of fear of incontinence or other symptoms -- thus straining their relationship with their spouse.

To get a measure of the extent of this suffering, the Drossman team's survey asked IBS patients what they'd give to be free of their symptoms. On average, they said they'd give up a fourth of their remaining years of life.

There isn't a cure for IBS. But treatment can be effective. Drossman says that 90% of the treatment is helping people understand their condition and come to feel they can manage it.

"The feelings of fear, distress, and frustration may be generic and affect all people with IBS, but how people deal with those feelings varies," he says. "In addition to all the disease management aspects, we focus on understanding where the patients are, validating their experience, and helping them move forward. It is a focus on the person with the condition, and not on an organ."

webmd

Labels: IBS, Irritable Bowel Syndrome

Those scientists took a bacterium called Bacteroides ovatus, which people naturally have in their gut, and genetically altered it to secrete a protein called KGF-2 when exposed to a sugar called xylan.

The point is to bump up the presence of KGF-2, which is a human growth factor that could help heal damage done by inflammatory bowel diseases.

Why not just give human growth factors directly? Because "they are unstable when administered orally and systemic administration requires high doses, increasing the risk of unwanted side effects," the researchers write in the online edition of the journal Gut.

Their study focused on mice with colitis, a type of inflammatory bowel disease. The scientists gave the genetically engineered bacteria orally to some of the mice every other day, and also laced the drinking water of some of the mice with xylan. For comparison, other mice didn't get the bacteria and/or the xylan drink.

Compared to the other mice, the mice treated with bacteria and xylan had a reduction in rectal bleeding, inflammation, and weight loss; they also had faster healing of colitis-damaged tissue and an improvement in their stool consistency.

Tests need to be done in people, and one of the researchers, Simon Carding, PhD, discussed the treatment with WebMD via email. Carding is a professor of mucosal immunology at England's University of East Anglia Medical School and the director of integrated biology of the gastrointestinal tract research program at the Institute of Food Research in Norwich, England.

Carding writes that the bacteria used "are present in the gut of everyone, so patients will be taking something that they already have and the treatment should be well tolerated. The outstanding questions concern formulation and dosing protocols, which we plan to address as part of our phase of studies."

It might be possible to do a short, one-time bacteria dosing regimen that would establish a permanent colony of the genetically engineered bacteria. Another option would be to establish a temporary colony, repeating those treatments when the disease flares up.

Carding says natural sources of xylan -- tree bark, rice husks, and oat kernels -- aren't commonly found in the diet, so patients would need to supplement their diets with xylan, such as in a drink.

"Animals tolerate high concentrations of xylan [in] their drinking water very well and have never exhibited any adverse signs from excessive xylan consumption," Carding writes.

Carding notes that the bacteria strategy could be used to treat various gut diseases, including delivering agents to interfere with the formation of new blood vessels that feed intestinal tumors and delivering vaccine antigens to build the gut's immunity against viruses, bad bacteria, and infection.

Labels: IBS, Irritable Bowel Syndrome, Ulcerative Colitis

Proton pump inhibitors are highly effective treatments for acid reflux symptoms, but taking prescription-strength dosages of the drugs for just a few months can lead to dependency, new research suggests.

Healthy adults in the study with no history of acid reflux symptoms -- such as chronic heartburn, indigestion, or acid regurgitation -- developed such symptoms when they stopped taking the drugs after eight weeks of treatment.

The findings provide the best evidence yet that withdrawal from acid-blocking proton pump inhibitor (PPI) therapy is associated with a clinically meaningful increase in acid production above pre-treatment levels, researchers say.

PPIs like Aciphex, Prilosec, Prevacid, Nexium, and Protonix are among the most widely used prescription medications in the world. By one estimate, 5% of adults in developed countries take the acid-reducing drugs.

“We have known for years that long-term treatment with PPIs induces a temporary increase in the secretion of acid, but the thinking has been that this probably wasn’t clinically relevant,” lead researcher Christina Reimer, MD, of Copenhagen University tells WebMD.

PPI-Related Rebound

Reimer and colleagues recruited 120 healthy adults with no history of acid reflux disease for the study.

Half the study participants were treated with daily 40 milligram doses of the PPI Nexium for eight weeks, followed by four weeks on a placebo. The rest took a placebo pill throughout the 12-week trial.

Each week, the participants completed a standardized questionnaire designed to rate the severity of gastrointestinal (GI) symptoms.

Although symptoms were similar in the two treatment groups at the start of the study, a big difference in symptoms was seen in the weeks after the active treatment group stopped taking the PPI.

In the PPI group, 44% reported at least one acid-related symptom in weeks nine through 12, compared to 15% of the placebo group.

By week 12, when the PPI group had been off active treatment for four weeks, about 21% reported symptoms of heartburn, indigestion, or acid regurgitation, compared to slightly less than 2% of those who never took a PPI.

The study appears in the July issue of the journal Gastroenterology.

Calls to study participants three months after PPI treatment was stopped confirmed that these symptoms had resolved, Reimer says.

“We don’t know how long this rebound effect lasts, but we can say that it is somewhere between four weeks and three months,” she says.

This rebound is theorized to the result of an overproduction of the stomach acid-stimulating hormone gastrin in response to PPI-related acid suppression.

When the medication is stopped, the extra gastrin in the blood signals the stomach to work overtime to produce acid. When gastrin levels return to normal, acid secretion slows, writes Reimer.

“PPIs Over-Prescribed”

Reimer says the phenomenon, known medically as rebound acid hypersecretion, is not likely to occur in people who take the over-the-counter version of the PPI Prilosec for short periods.

She adds that the benefits of PPI treatment still appear to far outweigh the risks for patients with established acid reflux disease.

“Most patients with acid reflux disease need an acid-suppressing drug and they should not be concerned about this,” she says. “But millions of people are prescribed these drugs for uncertain indications and in these patients we run the risk of inducing the symptoms that these drugs are used to treat.”

PPI researcher Kenneth McColl, MD, of the University of Glasgow, tells WebMD that the drugs are now widely prescribed for a host of upper GI complaints even though there is little evidence that they are effective for these uses.

“It is clear that doctors need to be more selective in prescribing these drugs,” he says. “They should not be given to patients with upper GI symptoms on the off chance that the symptoms are acid related.”

In response to the study, a spokesman for AstraZeneca Pharmaceuticals, which markets Prilosec and Nexium, questioned the study design and its relevance to patients with acid reflux symptoms.

“This study was conducted in healthy volunteers, and the authors acknowledge that they can’t be sure that the conclusion can be carried over to patients who have started PPI therapy because of dyspeptic symptoms,” Blair Hains tells WebMD.

Hains cited a 2007 review of research examining rebound acid hypersecretion, which concluded that there was not strong evidence that withdrawal from PPIs is associated with a clinically relevant increase in acid production.

Calls to Takeda Pharmaceuticals, which manufacturers Prevacid, were not returned by publication time.

webmd

Labels: acid reflux

Indigestion

Indigestion is often a sign of an underlying problem, such as gastroesophageal reflux disease (GERD), ulcers, or gallbladder disease, rather than a condition of its own.

Also called dyspepsia, indigestion is a term used to describe a feeling of fullness or discomfort during or after a meal. It can be accompanied by burning or pain in the upper stomach.

What Are the Symptoms of Indigestion?

The symptoms of indigestion include:

• Bloating (full feeling)
• Belching and gas
• Nausea and vomiting
• Acidic taste
• Growling stomach
• Burning in the stomach or upper abdomen
• Abdominal pain

These symptoms may increase in times of stress.

People often have heartburn (a burning sensation deep in the chest) along with indigestion. But heartburn is caused by stomach acids rising into the esophagus.

Who Is at Risk for Indigestion?

People of all ages and of both sexes are affected by indigestion. It's extremely common. An individual's risk increases with excess alcohol consumption, use of drugs that may irritate the stomach (such as aspirin), other conditions where there is an abnormality in the digestive tract such as an ulcer and emotional problems such as anxiety or depression.

What Causes Indigestion?

Indigestion has many causes, including:

Diseases:

• Ulcers
• GERD
• Stomach cancer (rare)
• Gastroparesis (a condition where the stomach doesn't empty properly; this often occurs in diabetics)
• Stomach infections
• Irritable bowel syndrome
• Chronic pancreatitis
• Thyroid disease

Medications:

• Aspirin and many other painkillers
• Estrogen and oral contraceptives
• Steroid medications
• Certain antibiotics
• Thyroid medicines

Lifestyle:

• Eating too much, eating too fast, eating high-fat foods, or eating during stressful situations
• Drinking too much alcohol
• Cigarette smoking
• Stress and fatigue

Swallowing excessive air when eating may increase the symptoms of belching and bloating, which are often associated with indigestion.

Sometimes people have persistent indigestion that is not related to any of these factors. This type of indigestion is called functional, or non-ulcer dyspepsia.

During the middle and later parts of pregnancy, many women have indigestion. This is believed to be caused by a number of pregnancy-related factors including hormones, which relax the muscles of the digestive tract, and the pressure of the growing uterus on the stomach.

How Is Indigestion Diagnosed?

If you are experiencing symptoms of indigestion, make an appointment to see your doctor to rule out a more serious condition. Because indigestion is such a broad term, it is helpful to provide your doctor with a precise description of the discomfort you are experiencing. In describing your indigestion symptoms, try to define where in the abdomen the discomfort usually occurs. Simply reporting pain in the stomach is not detailed enough for your doctor to help identify and treat your problem.

First, your doctor must rule out any underlying conditions. Your doctor may perform several blood tests and you may have X-rays of the stomach or small intestine. Your doctor may also use an instrument to look closely at the inside of the stomach, a procedure called an upper endoscopy. An endoscope, a flexible tube that contains a light and a camera to produce images from inside the body, is used in this procedure.

What Is the Treatment for Indigestion?

Because indigestion is a symptom rather than a disease, treatment usually depends upon the underlying condition causing the indigestion.

Often, episodes of indigestion go away within hours without medical attention. However, if your indigestion symptoms become worse, you should consult a doctor. Here are some helpful tips to alleviate indigestion:

• Try not to chew with your mouth open, talk while chewing, or eat too fast. This causes you to swallow too much air, which can aggravate indigestion.
• Drink fluids after rather than during meals.
• Avoid late-night eating.
• Try to relax after meals.
• Avoid spicy foods.
• Stop smoking.
• Avoid alcoholic beverages.

If indigestion is not relieved after making these changes, your doctor may prescribe medications to alleviate your symptoms.

How Can I Prevent Indigestion?

The best way to prevent indigestion is to avoid the foods and situations that seem to cause indigestion. Keeping a food diary is helpful in identifying foods that cause indigestion. Here are some other suggestions:

• Eat small meals so the stomach does not have to work as hard or as long.
• Eat slowly.
• Avoid foods that contain high amounts of acids, such as citrus fruits and tomatoes.
• Reduce or avoid foods and beverages that contain caffeine.
• If stress is a trigger for your indigestion, re-evaluating your lifestyle may help to reduce stress. Learn new methods for managing stress, such as relaxation and biofeedback techniques.
• Smokers should consider quitting smoking, or at least not smoking right before or after eating, as smoking can irritate the stomach lining.
• Cut back on alcohol consumption because alcohol can irritate the stomach lining.
• Avoid wearing tight-fitting garments because they tend to compress the stomach, which can cause its contents to enter the esophagus.
• Do not exercise with a full stomach. Rather, exercise before a meal or at least one hour after eating a meal.
• Do not lie down right after eating.
• Wait at least three hours after your last meal of the day before going to bed.
• Raise the head of your bed so that your head and chest are higher than your feet. You can do this by placing 6-inch blocks under the bedposts at the head of the bed. Don't use piles of pillows to achieve the same goal. You will only put your head at an angle that can increase pressure on your stomach and make heartburn worse.

When Should I Call the Doctor About Indigestion?

Because indigestion can be a sign of a more serious health problem, call your doctor if you have any of the following symptoms:

• Vomiting or blood in vomit (the vomit may look like coffee grounds).
• Weight loss.
• Loss of appetite.
• Black, tarry stools or visible blood in stools.
• Severe pain in upper right abdomen.
• Pain in upper or lower right abdomen.
• Discomfort unrelated to eating.

Symptoms similar to indigestion may be caused by heart attacks. If indigestion is unusual, accompanied by shortness of breath, sweating, or pain radiating to the jaw, neck or arm, seek medical attention immediately.

webmd

Labels: GERD, Heartburn, indigestion

Researchers have identified a protein that plays an important role in the development of stomach cancers and that could one day be a target for new treatments for the disease, according to research published in the British Journal of Cancer.

Scientists based at the Chinese University of Hong Kong explored the role of a protein called RAMP in stomach cancer cell lines and tissues, finding that it is more common in these cells compared to surrounding normal tissues.

The increased presence of RAMP suggests that this protein may play a pivotal role in the multi-step development of stomach cancer. Higher levels of the protein were seen in the very early stages of stomach cancer and were also present throughout the development of the disease. To add further evidence to RAMP's role in this cancer they found that the protein also encouraged cells to grow, fuelling the disease further.


Source
Cancer Research UK
This is the first study to establish a possible link between RAMP and stomach cancer and could help doctors to gain a better understanding of the disease, leading to more effective treatments.

Next the scientists proceeded to 'knock out' RAMP's function in two human gastric cancer cell lines. This slowed down the growth of the cancer in these cell lines and even led to cell death.

It is hoped that these findings could be the first step to developing a new approach to treating stomach cancer by developing treatments that 'switch off' RAMP. This could halt the growth of these tumours and even reduce tumour size.

Study author Dr WK Leung said: "We have established for the first time the role that RAMP plays in stomach cancer. Working out a role for RAMP in stomach cancer gives us more information about the common, but poorly understood steps that lead to the development of this cancer.

"We're very excited about with these results. The next stage of our research will aim to discover more about RAMP's specific role in stomach cancer and begin exploring the possibility of developing new drugs that can stop RAMP in its tracks."

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "This interesting study helps us understand more about the mechanisms behind the development of stomach cancer. One of the reasons that survival rates for stomach cancers remain low is because they are often at an advanced stage when diagnosed, so making it harder to treat successfully. We welcome new research that could one day help those with stomach cancer face a better prognosis."

In the UK more than 7,700 people are diagnosed with stomach cancer each year, with 95 per cent of cases among the over 50's. Over the last 25 years five-year survival rates have tripled in the UK, but the disease remains very difficult to treat successfully and five year survival is still low at around 15 per cent.

Labels: Cancer, stomach ulcer

Using the Vienna classification system, it has been shown in clinic-based cohorts that there can be a significant change in disease behavior over time, whereas disease location remains relatively stable. Clinical and environmental factors as well as medical therapy might be relevant in predicting disease behavior change in patients with CD. In previous studies, early age at diagnosis, disease location, perianal disease and, in some studies, smoking were associated with the presence of complicated disease and surgery.

The combined effect of markers of disease phenotype (e.g., age, gender, location, perianal diesease) and medical therapy (steroid use, early immunosupression) on the probability of disease behavior change were, however, not studied thus far in the published literature.

A research article published in the World Journal of Gastroenterology addresses this problem. Members of the Hungarian IBD Study Group led by Dr Peter Laszlo Lakatos from the Semmelweis University investigated 340 well-characterized, unrelated, consecutive CD patients (M/F: 155/185, duration: 9.4 ± 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits.

They found that perianal disease, current smoking, prior steroid use, early azathioprine or azathioprine/biological therapy are predictors of disease behavior change in CD patients.

The new data with easily applicable clinical information as presented in the article may assist clinicians in practical decision-making or in choosing the treatment strategy for their CD patients.


Source:
Lai-Fu Li
World Journal of Gastroenterology

Labels: Crohn's disease

ecently, the number of patients with GERD has increased in Japan. However, there have been few reports about the pathological findings in the esophageal squamous epithelium, and there are differing opinions among pathologists about the findings considered characteristic of chronic reflux esophagitis.　

Dr. Daisuke Asaoka and his colleagues from Juntendo University (Japan) used a rat model of chronic acid-reflux esophagitis to explore the esophageal mucosal damage macroscopically and microscopically throughout the entire esophagus, including the upper esophagus close to the hypopharynx, and to investigate the protective effects of ecabet sodium (ES) on the esophageal mucosa. This was published in the World Journal of Gastroenterology.

Their research revealed that epithelial thickening occurs at the same time as inflammatory cell infiltration in the middle to lower esophagus in chronic acid-reflux esophagitis. Furthermore, they demonstrated that inflammatory cells infiltrated the epithelium of the upper esophagus close to the hypopharynx, where there was no evidence of ulcers. These findings suggested that the reflux of gastric juice can extend to the upper esophagus close to the hypopharynx.

Moreover, the research also demonstrated that ES inhibited the epithelial thickening of the lower and middle esophagus, which suggested that ES may play a useful defensive role in the prevention of reflux esophagitis.


Source:
Lai-Fu Li
World Journal of Gastroenterology

Labels: esophagitis, GERD

Is your heartburn triggered by running, aerobics, or other forms of exercise?

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

webmd

Labels: Heartburn

Study Shows Food-Borne Infections Are Linked to Risk of Inflammatory Bowel Disease

Salmonella or campylobacter food poisoning triples the risk of inflammatory bowel disease (IBD) -- for at least 15 years.

IBD typically refers to Crohn's disease and ulcerative colitis. It's not clear exactly what causes IBD. Genetics, environment, diet, abnormal blood vessels, infections, immune-system overreaction, and psychological factors all have been blamed.

To see whether infections play a role, Henrik Nielsen, MD, of Aalborg Hospital in Denmark took advantage of his nation's system of tracking citizen's health records.

The system allowed Nielsen and colleagues to look at whether people who've been treated for certain infections are at higher risk of developing IBD.

The researchers looked at two kinds of food poisoning: salmonella and campylobacter. They identified 13,149 people treated for either infection and compared their health records to those of people who never suffered these infections.

People who had one or the other kind of food-borne infection had a 1.2% risk of getting IBD over the next 15 years. Those who never had either infection had only a 0.5% risk of IBD. Statistical analysis showed that the food-borne infections tripled IBD risk for at least the next 15 years.

"If we can reduce and prevent the spread of food bacteria and infections, we may reduce or even largely eliminate IBD in the long term," Nielsen says in a news release.

Nielsen reported the findings in a presentation to this week's Digestive Disease Week (DDW), held May 30 to June 4 in Chicago. DDW is an annual conference sponsored by the American Gastroenterological Association, the American Association for the study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.

Labels: Inflamatory Bowel Disorders

There are many good reasons to quit smoking. They range from curing your bad breath to reducing your risk of cancer, heart disease, and lung disease. But here's another reason to add to that long list: tobacco -- not just in cigarettes, but in cigars, pipes, chew, and snuff -- can cause heartburn.

"Tobacco makes acid reflux worse," says David Carr-Locke, MD, director of endoscopy, Brigham and Women's Hospital, Boston. "It's definitely a risk factor."

And unlike a heightened risk of serious diseases -- which might seem rather abstract, especially when you're young -- heartburn is a consequence of tobacco use that you can feel right now. And chronic heartburn, due to gastroesophageal reflux disorder (GERD), can cause more than serious pain; it can disrupt your sleep and interfere with your life. Sleeping With Heartburn Carries Cancer Risks.
Healing the Heartburn

According to some experts, there's a simple solution to the heartburn/tobacco equation, although you've probably heard it before: quit.

"For some people, quitting tobacco use can be the difference between having GERD and not having it," says Lawrence J. Cheskin, MD, co-author of Healing Heartburn and associate professor at Johns Hopkins School of Medicine in Baltimore. "If you stop, your symptoms will probably get better quickly. It also really lowers the risks of having further complications down the road."

However, not everyone thinks that quitting tobacco use will necessarily have a dramatic effect on heartburn.

"I think that quitting only has a modest impact on GERD symptoms," says J. Patrick Waring, MD, a gastroenterologist at Piedmont Hospital in Atlanta. But he still strongly encourages anyone who uses tobacco to kick the habit.
How Does Tobacco Affect GERD?

When you eat, a muscular ring between the end of the esophagus and the entrance to the stomach -- called the lower esophageal sphincter (LES) -- relaxes to let food in. Once it has closed again, the stomach releases acids and enzymes to break down the food.

Usually, these acids stay put in the stomach. But in people with GERD, the sphincter may stay relaxed or relax at the wrong time. This allows stomach contents containing acids and enzymes to wash back up, irritating the tissue of the esophagus.

Experts believe tobacco might worsen heartburn in a number of ways, including:

* Impairing the function of the LES. "The nicotine in tobacco seems to lower the pressure in the lower esophageal sphincter," says Cheskin. The reduced pressure could allow stomach acids and enzymes to back into the esophagus.
* Increasing acidity. Nicotine increases the production of stomach acid, says Carr-Locke.
* Harming the esophagus. Tobacco smoke seems to directly irritate the esophagus lining, says Cheskin.
* Reducing saliva production. This causes two problems. When you swallow, saliva helps push acid down, out of the esophagus and into the stomach. Saliva also contains bicarbonate, which is a mild acid neutralizer, says Cheskin. So a reduction in saliva can make your acid reflux worse.

Only the effects of smoked tobacco have been seriously studied on GERD symptoms, say experts. But anything with nicotine is likely to worsen GERD. Waring says that chew might pose specific problems.

"Smoking a cigarette only takes a few minutes," he says. "But people use chewing tobacco all day. That could lead to more irritation."

By the same token, nicotine gum could also pose a risk, say experts. "I don't know of any studies on nicotine gum and GERD," says Cheskin. "But I would worry that anything with nicotine would increase the risk of acid reflux."

Tobacco use also increases the long-term risks of GERD. Acid reflux is more likely to damage the esophagus in people who use tobacco than in people who don't. The damage will heal more slowly too, Cheskin says. Over time, tobacco users are more likely to face complications of GERD. These include chronic inflammation of the esophagus and even esophageal cancer.
Quitting: Will It Help Your Heartburn?

Cheskin says that cutting out tobacco will almost certainly ease heartburn symptoms.

"I think most people would feel the benefit of quitting within a few days," says Cheskin. He says that it's possible that cutting down your tobacco use -- rather than stopping cold turkey -- might help. But he strongly encourages people to quit.

Yet not everyone is sure that quitting makes a big difference.

"It's true that people with GERD who smoke tend to have symptoms that are more pronounced than people who don't smoke," says Waring. But there isn't good evidence that symptoms improve when people quit using tobacco, he says.

"I think tobacco only plays a minor role in acid reflux," he tells WebMD.

The results of research have been mixed. One 2004 study published in the journal Gut found that smoking tobacco had a strong cumulative effect on GERD symptoms. For instance, the study found that people who smoked everyday for twenty years were 70% more likely to have GERD than those who smoked daily for less than a year.

But a 2006 analysis published in the Annals of Internal Medicine found that while there was a connection between smoking and GERD, quitting didn't necessarily help resolve the symptoms.

So cutting out tobacco use may not cure you. Even if you ditch the cigarettes or chew, you might still have heartburn symptoms. But these may be controlled by other lifestyle changes or medicine.
Getting Control of Your Heartburn

Obviously, quitting tobacco isn't easy. Talk to your doctor about different strategies. You'll certainly need the support of your family and loved ones. You might also consider joining a support group to help you cope.

But just remember that while quitting is tough, you will probably feel a lot better for it. While many people might think of heartburn as an occasional discomfort, people with GERD know how painful and debilitating it can be. Quitting tobacco use could be a first and important step in getting control of your condition.

"If there already weren't enough reasons for you to quit smoking," says Cheskin, "resolving your heartburn is one that you can really feel."

WebMd

Labels: Heartburn, Tabacco

Featured below is an interactive Google map pinpointing outbreaks of H1N1 swine flu in 2009, together with source attributions, report dates, and current known statuses. This map is updated throughout the day with the latest suspected and confirmed cases of swine flu, as reports come in. Please note that this swine flu map is not owned or updated by Medical News Today staff and, therefore, we cannot guarantee the accuracy of the information provided by it.

How to use the H1N1 map

You can zoom in and out and scroll around to view any country that you like, or any region that you like. To view information on a specific case, simply click on a map marker.

Swine Flu Map

• Red markers are confirmed infections of swine flu H1N1
• Pink markers are probable infections
• Black markers are confirmed deaths
• Grey markers are unconfirmed deaths
• Blue markers are influenza-like illness

Click on any marker to view information on that case.

Labels: H1N1, Influeza, Swine Flue

Family members of children diagnosed with non-alcoholic fatty liver disease (NAFLD) should be considered at high risk for the disease and tested for it as part of a routine medical examination, even if they don't show symptoms, according to a recent study by researchers at the University of California, San Diego School of Medicine. The results will be published in the May edition of the journal Gastroenterology.

"As we suspected, NAFLD is not simply about weight, but rather is highly familial and likely genetic," said principal investigator Jeffrey B. Schwimmer, MD, associate professor of pediatrics and director of the Fatty Liver Clinic at Rady Children's Hospital San Diego.

NAFLD is now the most common cause of chronic liver disease is the United States. NAFLD refers to a spectrum of liver disease that begins with liver cells abnormally storing fat, in the absence of chronic alcohol use. NAFLD can be mild in some people, but in a subset with the progressive form (steatoehepatitis or NASH) there is risk for cirrhosis, liver cancer, and liver-related death. Based upon clinical observation, doctors have speculated that NAFLD may be a genetic disease, but lacked scientific support for this idea.

The current study takes a major step in building the case that NAFLD is a genetic disease. The research team studied 44 children with and without NAFLD and 152 family members of these children. In order to determine the amount of fat in the liver of each participant they used a state of the art magnetic resonance imaging (MRI) technique developed at UC San Diego. The researchers also performed tests to exclude other factors that can cause a fatty liver other than NAFLD.

The researchers found that whether or not a given person had NAFLD was highly heritable whether or not the child had NAFLD was a major determinant of the amount of liver fat present in the other family members. In the families of overweight children without NAFLD, siblings and parents had NAFLD at rates that were similar to the background population's rates of NAFLD. The rates of NAFLD were much higher in family members of children with NAFLD; it was present in 59% of siblings and 78% of parents. In most cases the person did not know that they had the disease. In a few cases the disease was already very advanced even in the absence of symptoms.

"Being overweight is a risk factor for NAFLD, but this is strongly modified by the underlying genetics," said Schwimmer. "So some people can have high body weights without any storage of fat in the liver. But in susceptible families, there's an additive effect. Regardless of weight, they are more likely to have NAFLD for genetic reasons. In addition, the more overweight such a person is, the more likely they are to have dangerous amounts of fat in their liver."

The researchers recommend that if one family member tests positive for NAFLD, other family members should talk to their doctors immediately. Early detection could catch NAFLD at a stage where the disease is reversible and further complications may be prevented before cirrhosis sets in.

Schwimmer hopes that further studies will disclose specific genetic and environmental factors that influence the development and severity of the disease, which could provide helpful information to a wide array of health care practitioners.

"Understanding that this disease runs in families may help an entire family create a healthy lifestyle with regular exercise and a heart-healthy liver healthy diet," said Schwimmer.

After participating in the study, Susanne Hernandez and her family have already changed the way they live. Like so many children with NAFLD, her 12 year-old son was identified on accident. Because of his asthma, he was scheduled to participate in a clinical trial for asthma management, but first had screening blood tests including an ALT. This test led to evaluation by a gastroenterologist and the surprising finding of severe liver disease. A quick web search led to the family becoming part of Schwimmer's research. Debbie, her son and her husband are now being treated for liver disease. Luckily, their daughter is not affected.

"This study made us more aware that we have to make changes," explained Hernandez. "After getting proper attention, my son is much more alert, and we pay attention to his fatigue, keeping him hydrated and we're on a good nutrition routine."

Previous studies by UC San Diego investigators showed that:

-- NAFLD is present in 9.6 percent of the children and adolescents living in San Diego County

-- Nearly all children with NAFLD are insulin resistant

In children, NAFLD is a major risk factor for and cardiovascular disease.

Additional contributors include Manuel Celedon, Joel Lavine, MD, PhD, UCSD department of pediatrics; Takeshi Yokoo, MD, Masoud Shiehmorteza, Michael S. Middleton, MD, PhD, and Claude B. Sirlin, M.D., and Alyssa Chavez, UCSD department of radiology; Rany Salem, PhD, Nzali Campbell, PhD and Nicholas Schork, PhD, Scripps Health and The Scripps Research Institute.

This work was funded by grants from the National Institutes of Health, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center of Minority Health and Health Disparities and the National Center for Research Resources.

Source: University of California, San Diego

Labels: Gastrointestinal, Liver

It is well known that non-cardiac chest pain is closely related to gastroesophageal reflux diseases (GERD). Chest pain of esophageal origin can be difficult to distinguish from that caused by cardiac ischemia because the distal esophagus and the heart share a common afferent vagal supply, and GERD can cause episodes of non-cardiac chest pain that resemble ischemic cardiac pain.

A research team led by Dr. Yoshihisa Urita from Toho University School of Medicine investigated the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. Their study was published on April 14, 2009 in the World Journal of Gastroenterology.

One thousand nine hundred and seventy consecutive patients were enrolled in this study. All of the patients who first attend their hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as ST segment depression based on the Minnesota code.

Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of the 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients).

The study results suggest that an extra-esophageal condition causes GERD symptoms and that angina may be misclassified as GERD. Since patients with GERD have an increased risk of angina pectoris in the year after GERD diagnosis, physicians have to be concerned about missing clinically important CAD while evaluating patients for GERD symptoms.

Reference: Kato H, Ishii T, Akimoto T, Urita Y, Sugimoto M. Prevalence of linked angina and gastroesophageal reflux disease in general practice. World J Gastroenterol 2009; 15(14): 1764-1768. http://www.wjgnet.com/1007-9327/15/1764.asp

Correspondence to: Dr. Yoshihisa Urita, Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo

Source:
Lai-Fu Li
World Journal of Gastroenterology

Labels: Angina, Gastrointestinal, GERD

Scientists at The University of Nottingham are investigating whether stem cell markers could have a role to play in speeding up wound healing in patients suffering from inflammatory bowel disease (IBD).

The study could eventually lead to the development of new drugs which use natural molecules to spark the recovery of patients suffering from ulcerative colitis and Crohn's disease, reducing their risk of associated complications such as scarring, bowel obstructions and tumour growth.

Funded with a £118,500 grant from the National Association for Colitis and Crohn's Disease (NACC), the two-year project is being led by Professor Mohammad Ilyas in the University's Division of Pathology.

He said: "The study will focus on the molecule CD24 which is a stem cell marker and which plays a key role in cell proliferation and the migration of healthy cells to a damaged area to restore normal tissue.

"CD24 is a small molecule attached to the cell membrane which has been recently reported as a marker of stem cells in the colon. It occurred to us that CD24 might have a role to play in IBD and during further studies we found that it was indeed present in sections of diseased bowel."

IBD affects around one in 400 people in the UK. Common symptoms include inflammation and ulceration of the intestine and colon, pain, severe diarrhoea, tiredness and weight loss. The cause of the disease is yet to be definitively identified, although scientists believe it could be due to a combination of genetic predisposition and environmental factors. Currently, there is no cure and patients manage their condition with a mixture of lifestyle changes, anti-inflammatory drugs and, in severe cases, surgery.

Professor Ilyas added: "The power of the gut to heal the damage caused by acute episodes of inflammation is remarkable and frequently the gut lining reverts to normal. Anti-inflammatory drugs help this process along and allow the wound healing to begin earlier than it would naturally.

"In the future, it may be possible to use a variety of therapies (possibly including gene therapy) to manipulate the expression of the CD24 molecules on cells to promote even more rapid healing. This may mean less scarring, bowel obstruction and fistulation and less chance of developing tumours resulting from persistent inflammation. As a result of this, it may also reduce the chance of needing surgery further down the line."

In the early stages of the project, the pathologists will be using cell lines in the lab to study CD24 at a cellular and molecular level to discover the mechanisms by which it operates and encourages cell migration and other associated molecules that are co-expressed.

They will then examine diseased IBD tissue to establish whether what they have observed in the lab is occurring in reality.

It is hoped the findings will lead to further clinical work to look at the possible benefits of CD24 in allowing IBD patients to more effectively manage their disease.

The CEO of NACC, Richard Driscoll, explains, "Since 1984, NACC members have raised over £4.5 million and more than 100 research awards have been made to hospitals and universities throughout the United Kingdom. This year our Medical Research Committee selected three studies to receive NACC research awards which we hope will contribute to finding improved treatments and ultimately a cure for IBD. We welcome Professor Ilyas' work on CD24 in seeking a better understanding of the gut healing process and how it may be enhanced in inflammatory bowel disease."

Source:
Professor Mohammad Ilyas
University of Nottingham

Labels: IBD, IBS, Inflamatory Bowel Disorders, Irritable Bowel Syndrome

While more than six per cent of Canadians suffer from this troublesome disease characterized by on-going abdominal pain, discomfort, bloating, and severe bouts of either diarrhoea or constipation most Canadians, including many physicians, know little about it.

New Canadian research is exploring the causes of this disease, including bacterial infections from food or water poisoning, which lead to a chronic low-level infection that in turn results in IBS symptoms. The research is also providing some hope for potential cures, including the use of probiotics and treatments to reduce stress levels.

Experts:

The following CIHR-funded researchers are available to talk about IBS:

How pathogenic bacteria act to survive and thrive in the gut and how certain treatments, like probiotic yogurt can thwart them

Dr. Philip Sherman, Scientific Director, CIHR-Institute of Nutrition, Metabolism, and Diabetes (Toronto)

How food or water poisoning, can trigger chronic IBS, and on the potential of probiotics to treat it.
Dr. Stephen Collins, McMaster University (Hamilton)

The role of sex hormones in women suffering from IBS pain.
Dr. Serge Marchand, Sherbrooke University

How gut talks and listens to the brain and spinal cord and how the gut uses cannabinoids (chemicals related to the active ingredient in marijuana) to control its movements and sensations - including pain.
Dr. Keith Sharkey, Hotchkiss Brain Institute, University of Calgary

How food and stress interact as triggers to exacerbate IBS, and how low levels of inflammation may persist and contribute to IBS symptoms even though the bowel appears to be normal.
Dr. Stephen Vanner, Queen's University. (Kingston)

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to nearly 12,000 health researchers and trainees across Canada.

Source: Canadian Institutes of Health Research (CIHR)

Labels: IBS, Irritable Bowel Syndrome

What evidence supports the recommendation that patients with diverticulosis avoid nuts, popcorn, and other high-residue foods?

A patient comes to her physician for instructions consequent to the discovery of diverticular disease. She is cautioned to avoid high-residue foods, such as nuts, seeds, popcorn, and corn either on or off the cob, because the by-products of these foods might lead to trauma or obstruction at the diverticular opening in the colon, resulting in brisk bleeding or infection.

For a long time, this clinical scenario has represented common practice. The problem is that the recommendation to avoid high-residue foods may seem rational at first glance, but it lacks empiric proof. In addition, one of the proscribed foods, nuts, actually has a number of health benefits.¹

A REVERSAL OF A LONG-ACCEPTED PRACTICE

A cohort study of 18 years’ duration that included 47,228 men, aged 40 to 75 years, addressed the practice of advising patients with diverticular disease to avoid high-residue foods.¹ At the outset of the study, all participants were free of diverticula. During follow-up, there were 801 cases of diverticulitis and 383 episodes of diverticular bleeding in those enrolled.

The surprising finding in this study was that there was an inverse association between the consumption of nuts and popcorn and the risk of diverticulitis. Compared with men who had the lowest intake of these foods, those with the highest intake of nuts had about a 20% decrease in the risk of diverticulitis and those with the highest intake of popcorn had about a 28% decrease. Corn, either on or off the cob, neither increased nor decreased the risk of diverticulitis. Finally, there was no association between any of the high-residue foods and diverticular bleeding.

WHAT TO TELL PATIENTS

Tell patients with diverticular disease that nuts and popcorn actually decrease the likelihood of diverticulitis and that nuts have a number of other health benefits. For most patients with this common malady, this will be welcome news.

Labels: diverticulosis

Bacteria naturally present in the human gut could produce substances that help to protect against colon cancer and provide therapy for inflammatory bowel disease. In a paper published in the journal Microbiology, researchers from the University of Aberdeen Rowett Institute of Nutrition and Health and from the MTT Agrifood Research Institute in Finland report initial studies showing that bacteria in the human gut convert linoleic acid, a naturally-occurring fat in the diet, into a form called conjugated linoleic acid (CLA) which is absorbed by the gut wall.

There are different types of CLA and not all of them have beneficial effects. The "good" form of CLA is present in dairy foods such as milk and cheese," said Dr John Wallace of the Rowett Research Institute, "but eating lots of dairy foods won't necessarily help our gut health as most of the fats are digested in the small intestine before they get to the large intestine, where most of our gut bacteria are found." The results of these latest studies showed that several different forms of CLA are produced by gut bacteria. Fortunately, most was of the "good" kind, but Dr Wallace stressed that more extensive studies are needed. One subject produced small amounts of a CLA whose beneficial or otherwise effects are much less clear.

The implications are that, if small quantities of dietary linoleic acid can be delivered to the large intestine, the effects on gut health will be generally beneficial in most people. He added, "The results are of special interest for individuals using anti-obesity treatments that prevent the small intestine from absorbing fats. This means that those fats - including linoleic acid - will pass into the large intestine and the gut bacteria will produce CLA. It has to be the correct CLA, so it is important to understand how individuals produce different CLA. This must depend on which types of bacteria are present."

Labels: Cancer, IBD, Inflamatory Bowel Disorders, Irritable Bowel Syndrome

The following is a statement in response to the breaking news about Supreme Court Justice Ruth Bader Ginsburg being diagnosed with pancreatic cancer from Julie Fleshman, President and CEO of the Pancreatic Cancer Action Network, the only national organization creating hope in a comprehensive way through research, patient support, community outreach and advocacy for a cure.

"Our thoughts are with Justice Ginsburg as we learn of her pancreatic cancer diagnosis and subsequent surgery and we wish her well on her recovery.

"The diagnosis of pancreatic cancer in the early stages is encouraging news for all patients. However, only 20 percent of patients are diagnosed early enough to qualify for surgery. The incidental discovery of pancreatic cancer in Justice Ginsburg reminds us of the urgent need for additional research funding to find early detection methods for the fourth leading cause of cancer death in the United States.

"The Pancreatic Cancer Research and Education Act (H.R. 745) was introduced in Congress last week by U.S. Representatives Anna Eshoo (D-CA) and Ginny Brown-Waite (R-FL) and is the first substantive legislative effort dedicated to advancing pancreatic cancer research and addressing the critical needs facing our research community. Once enacted and fully funded it will provide a greater focus on this disease and will provide the National Cancer Institute with the tools it needs to develop the early diagnostic methods and treatments that are currently lacking for pancreatic cancer patients."

About the Pancreatic Cancer Action Network

The Pancreatic Cancer Action Network is the only national organization creating hope in a comprehensive way through research, patient support, community outreach and advocacy for a cure. The organization raises money for direct private funding of research--and advocates for more aggressive federal research funding of medical breakthroughs in prevention, diagnosis and treatment of pancreatic cancer.

The Pancreatic Cancer Action Network fills the void of information and options by giving patients and caregivers reliable, personalized information they need to make informed decisions. We create a sense of hope and community so no one has to face pancreatic cancer alone. The organization helps support individuals and communities all across the country work together to raise awareness and funds to find a cure for pancreatic cancer.

Pancreatic Cancer Action Network
http://www.pancan.org

Labels: Cancer, pancreatitis