What's New In GI?
This part of the patient education section provides current GI (gastroenterology) reports from the medical literature and other authoritative sources such as the Johns Hopkins Medical Letter, The Mayo Clinic Health Letter, The Harvard Health Letter and University of California at Berkeley Wellness Letter. It is meant to give you topical tidbits of GI information that you may find interesting. It is not detailed and is not advice to anyone. You should always see a qualified health professional such as your physician for specific questions on health problems.Previous Issues of What's New In GI?
Posted: March 1998
- Beware the Internet for Information on GI Disease
- Food Poisoning with Biologic Agents - Intentional and Otherwise
- Crohn's Disease - A Breakthrough in Treatment?
- Colon Cancer and You
- How to Prevent Cancer - With Food!
- GI Tidbits - Medical Dogma Bites the Dust
Beware the Internet for Information on GI Disease
A study was presented in the fall of 1997 at the American College of Gastroenterology where researchers examined 100 different sites on the Internet for patient information on a variety of GI disorders including hepatitis C, duodenal ulcer, irritable bowel and others. The findings were of interest. Where specific good treatment was available for a disorder such as peptic ulcers, no misinformation was found. However, for functional disorders such as irritable bowel syndrome, there was considerable false or misinformation on about 23% of sites visited. For hepatitis C, there was misinformation on 17% of sites and for pancreatic cancer, there was misinformation or mention of unproven remedies on 12.5% of sites. So, if you believe in scientific evidence for medical care, be careful of what you see or believe on the Net. And always look at the credentials and motives of the writer or organization behind the information.
Food Poisoning - Intentional and Otherwise
Hepatitis A - Hepatitis A causes an acute infection of the liver. Usually, it occurs because of contaminated food or water supply. Most of the time patients recover fully. An epidemic of hepatitis A occurred in Tennessee in 1994-95 which was quite severe. Over 1700 cases were proven with 5 deaths, a high number. Remarkably, this outbreak could not be traced to a single source such as contaminated well water or an infected food handler. This was a very nasty infection. Over 250 people had to be hospitalized and the medical cost was almost 1 million dollars. So how did these peopled get the infection? The investigators could not determine. They could not find any intentional cause either. There is a good vaccine against both hepatitis A and B. Some argue that everyone should get this vaccine and not just health care workers and those traveling to underdeveloped countries.Reference: Willner IR, Uhl MD, Howard SC et al. Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the united states. An Int Med. 1998;128:111-14.Salmonella salad bars - Here is one for the detective books. In 1994, a total of 751 persons in the area of the Dalles, Oregon developed salmonella gastroenteritis. Public health officials quickly incriminated salad bars in the area restaurants and closed the salad bars. Despite exhaustive investigation, the health authorities could not uncover the way this epidemic occurred. It was not until one year later that criminal investigators discovered the truth. A religious commune, Rajneeshpuram, had purchased a large ranch to develop an international commune. Certain zoning and building regulations were challenged in court and an election was subsequently planned to decide the issue. The commune members obtained the salmonella organism from a commercial lab, grew more of it, and then intentionally poisoned salad bars in the area to test whether such an action could disrupt the community enough to allow the commune members to win the subsequent zoning changes which would have required passage of a referendum at election time. The commune was disbanded and several members went to jail.
Reference: Torok TJ, Tauxe RV, Wise RP et al. A large community outbreak of salmonel-llosis caused by intentional contamination of restaurant salad bars. JAMA 1997;278:389-96.Shigella spiced donuts - Shigella is a cousin of the bacteria, salmonella, and can also cause severe gastroenteritis. In 1996, twelve laboratory workers in a large Texas medical center ate donuts and muffins left anonymously in their lunch room. They became very ill but none died. Investigation clearly indicated intentional poisoning of the muffin/donuts but to this date, a perpetrator has not been found.
Reference: Kolavic SA, Kimura A, Simons SL et al. An outbreak of salmonellosis type 2 amount laboratory workers due to intentional food contamination. JAMA 1997;278:396-98.Comment - These three reports indicate that poisoning with bacteria or viruses can occur intentionally or so mysteriously that the method of acquiring the infection is never uncovered. Other reports of intentional poisoning of food are in the medical literature. Recall the Japanese cult Aum Shinrikyo which sprayed the nerve gas, savin, in the Tokyo subways resulting in many illnesses and some deaths.
It is very hard to protect the public in an open society like ours against terrorists who are bent on spreading biochemical agents indiscriminately. A small measure of protection can be obtained by being vaccinated against hepatitis A and B, being suspicious of any but the cleanest salad bars in town, and avoiding foods that come from unknown sources.
Crohn's Disease - A Breakthrough in Treatment?
Crohn's disease is a chronic inflammatory disorder of the intestinal tract that has defied enormous efforts of researchers to uncover its cause. The disorder can cause many abdominal symptoms such as diarrhea, weight loss and stomach pain. There are treatments available - prednisone (steroids), 6MP (Purinethol), azathioprine (Imuran), mesalamine (Asacol, Pentasa), certain antibiotics and even surgery. However, there are still patients who do not do well with any of the available therapies.A new form of drug treatment shows considerable promise. The biochemical events that lead to Crohn's inflammation involve a cascade or domino effect of molecules, one triggering the next until at the tail end, inflammation is produced. These chemicals are called cytokines. One of them is called, crazily enough, tumor necrosis factor (TNF). An antibody against this TNF has been infused into patients, thereby blocking the domino cascade and leading to considerable improvement, in fact, complete remission in many patients. The drug seemed to be well-tolerated and there was prolonged remission for months after a single infusion. It is too early to say when or even if the FDA will release this drug but it is an exciting new therapy.
Reference: Targan SR, Hanauer SB, Sander JH, et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor for crohn's disease. N Eng J Med 1997;337:1029-35.Related Topics: Crohn's disease | Links
Colon Cancer and You
Colon cancer is one of the most curable of all malignancies. Yet, 55,000 people die from it each year in the U.S. The medical community has the tools to make an early diagnosis. Medicare has now approved colon cancer surveillance programs for their enrollees. Most managed care and HMO insurers encourage their clients and physicians to screen for this tumor as they save a lot of money if the cancer or adenoma type polyp, the forerunner of cancer, is found and removed. What is missing is for the patient to insist on screening. Most females get routine breast exams and men are checking their prostate regularly. Yet, colon cancer, the most curable of all, is often neglected. What to do?First, ask yourself the following questions:
- Have either of my parents, brothers or sisters or even myself ever had colon cancer or polyps?
- Do I have inflammatory bowel disease such as Crohn's or ulcerative colitis?
If the answer to either of the above is YES, then you are considered at HIGH RISK for colon cancer. Discuss the situation with your physician to determine the best way to check out your own colon. A colonoscopy often is the most effective step.
If the answers to the above questions are NO, then you are at AVERAGE RISK. The recommended surveillance is as follows. Beginning at age 50 (some physicians say 40), obtain:
- Stool smear for occult or hidden blood every year.
- Flexible sigmoidoscopy every five years to detect polyps or cancer.
- Many gastroenterologists are now recommending a single colonoscopy at age 50, rather than the above steps.
So, if you check your breasts, prostate, cholesterol and blood pressure every year, don't forget your colon. Colon cancer is a biggie and can be prevented.
Related Topics: Colon Cancer and Polyps | Colonoscopy
How to Prevent Cancer - With Food!
Yes, believe it or not, diet is now recognized as a major factor in whether you get certain forms of cancer.Cancer - The very word makes you confront your mortality. Yet, in many instances, cancer can not only be beaten, it can be prevented. Let's see just what are the cancers we should be concerned about.Lung cancer from smoking and second hand smoke leads the pack, the most common cause of cancer death. And there is no sex preference. Males and females both get it at a high rate. Diets rich in fruits and vegetables seem to reduce this risk somewhat. However, avoiding cigarette smoke is by far the best prevention.
Breast cancer risk can be reduced by a regular consumption of fruits and vegetables. These products contain phytochemicals, plant chemicals, which seem to have protective benefits. Broccoli and other cruciferous vegetables like cabbage and cauliflower contain other beneficial chemicals called isothiocyanates which likely reduce certain toxins that probably lead to breast cancer. The role of excessive dietary fat in causing breast cancer is less convincing according to some medical studies. However, being overweight, especially in post menopausal women, carries a higher risk of cancer, possibly because estrogen levels are higher in these people. For maximum protection against breast cancer, eat fruits and vegetables regularly, keep saturated fats in the diet to a minimum and keep alcohol intake down.
Colon and rectal cancer may be reduced by regular intake of vegetables, again, probably because of the phytochemicals and multiple antioxidants they contain. Of interest, regular exercise also seems to reduce this cancer risk, perhaps by stimulating movement of fecal matter through the gut and reducing the amount of time the bowel wall is exposed to toxins in the diet.
Prostate cancer is a very common cancer worldwide. Most of these tumors are tiny and remain dormant never causing problems. However, men in countries where fat consumption is high seem to develop more aggressive prostate tumors which, in many instances, actually kill them. There is a suggestion that excessive red meat may be the culprit.
Two key factors in the cancer puzzle are your genes and what surveillance program you have, if any, for early cancer detection and cure. If you have parents, brothers or sisters, with breast, colon, rectal or prostate cancer, it is critically important that your physician knows it. There are now excellent medical tests and procedures to identify these problems at a very early stage when cure is possible. Do not rely on unproven vitamins, minerals or herbs to protect you from cancer. A healthy diet and regular contact with your physician are far more effective.
Related Topics: Pyramid Diet | Mediterranean Diet | Asian Diet | Weight Loss Diet
GI Tidbits - Medical Dogma Bites the Dust
- Item - It was long held that stress caused stomach ulcers. Now we know that 90% of ulcers are caused by the H. pylori bacteria infection of the stomach or the bad effects of aspirin or arthritis drugs on the stomach. So, it's not you, your boss or spouse that causes ulcers.
Click Helicobacter pylori and peptic ulcer disease under "Patient Education" for more information.
- Item - It has always been assumed that the secretion of stomach acid decreased with age. Not true. A recent study of healthy elderly people in a Kansas City retirement community found that about 90% of them had the same amount of acid as younger people.
- Item - It has been long held that being overweight promotes the reflux of acid into the esophagus. Physicians have advised overweight patients with bad heartburn to lose weight. Now it is known that this information is incorrect. A medical study has shown that while losing weight has lots of other health benefits, it does not result in reduction of the reflux of stomach acid into the esophagus.
Patient Ed
| Diseases
| Procedures
| Diets
| Drugs
| Endoscopy Images
| Links
Jackson Siegelbaum Gastroenterology
| 423 North 21st Street, Suite 100 | 2626 North 3rd Street., Suite 3A | |
| Camp Hill, PA 17011 | Harrisburg, PA 17110 | |
| (717) 761-0930 | Phone: (717) 238-3111 |
Fax: (717) 761-0465
Email: contact@gicare.com
Web: gicare.com
© Copyright 2006 Jackson Siegelbaum Gastroenterology. All Rights Reserved.