DDAR Blog

ACG: What Patients Need to Know Re: New Study Linking PPIs to Dementia

A recent study plublished  by a German Health Plan suggested an association between Proton Pump Inhibitor use and dementia in the elderly.  The following statement was released by Anerican College of Gastroenterology President Kenneth R DeVault MD FACG,  "We appreciate and respect the data in the study, but believe more research is needed to understand the impact of PPIs on cognitive function, especially since studies of this type do not control for diet or lifestyle factors, nor do they establish causation. The study authors noted that this analysis of administrative data from the health plan in Germany can only provide a statistical association between PPI prescription and occurence of dementia and does not prove that PPIs caused dementia.  They further recognized that in order to evaluate the cause and effect relationship in the elderly more research in the form of randomized prospective clinical trials are needed."

In light of this study, along with other recent studies suggesting complications with long-term PPI use, The ACG urges patients to discuss the use of PPIs and any other medications with their healthcare provider.  Dr. Elliot Heller on behalf of the physician staff at Digistive Disease Associates of Rockland noted that any patients who have any concerns about continue use of PPIs should contact us and/or set up a follow-up appointment.  He further commented that any patient with serious esophageal disorders should consult with us before stopping their medication or changing the dose.  

Understanding Your Risk of Esophageal Cancer

Esophageal Cancer is one of the fastest growing cancers in the United States. Clinical Studies have shown that several factors can make a person more likely to develop cancer of the esophagus.  The most recognized factor is whether a person has Barrett’s Esophagus which can increase one’s risk of cancer of the esophagus by 50 times or more.  The following are the other factors that add to the risk of developing cancer of the esophagus.

Gender: Males are approximately 7 times more likely to develop cancer of the esophagus than females

Race: Caucasians are at higher risk of developing Barrett’s Esophagus and Cancer of the esophagus than many other racial groups.

Weight: Obesity (Body mass Index >30) increases a person’s risk of developing cancer of the esophagus by more than 2 ½ times

Smoking: If a person smokes, the risk of developing cancer of the esophagus more than doubles compared to non-smokers.

Hiatal Hernia: Having a hiatal hernia (where a part of the stomach pushes up into the chest through an opening in the diaphragm) has also been suggested to increase a person’s risk of developing cancer of the esophagus.

Who should be screened for Barrett’s Esophagus or Cancer of the Esophagus?

When determining your risk of developing cancer of the esophagus, one can look to guidelines published by the American College of Physicians, American College of Gastroenterology, and the American Society for Gastrointestinal Endoscopy regarding who might be appropriate for screening for Barrett’s Esophagus and cancer of the esophagus by performing an endoscopy exam. They include:

Age & Gender: Men older than 50 years with chronic gastroesophageal reflux disease (GERD) symptoms for more than 5 years with the additional risk factors such as: night-time reflux symptoms, hiatal hernia, overweight, particular around the belly, tobacco use and family history of Barrett’s esophagus or cancer of the esophagus.

Heartburn Along With Alarm Symptoms: A person who has heartburn along with alarm symptoms: difficulty swallowing, bleeding, anemia, weight loss, recurrent vomiting

Heartburn Symptoms Continuing Even With Medications:  A person whose GERD symptoms continue even while taking proton pump inhibitor (PPI) medications at high doses for 4-8 weeks.

Gastroesophageal Reflux Disease (GERD) Awareness Week 2015

The week of November 23rd to November 29th is Gastroesophageal Reflux Disease (GERD) Awareness Week.  GERD happens when food and liquid from the stomach move back up into the esophagus, causing irritation of the lining of the esophagus. Illustration of endoscopic view of Barrett's esophagusThe symptoms of GERD may include:

  • Heartburn or burning in the chest

  • Regurgitation (bringing food back up)

  • Chest Pain

  • Nausea after eating

  • Sour taste in mouth

  • Coughing, choking or wheezing

  • Hiccups

  • Belching or burping excessively

  • Hoarseness or change in voice

  • Sore throat

  • Feeling that food is stuck behind the breastbone

These symptoms are usually worse at night; increased by bending, stooping, lying down or eating and temporarily relieved by antacids.

If you have chronic acid reflux or frequent heartburn, you are at risk for a condition called Barrett’s esophagus.  Barrett’s esophagus is a change in the lining of the esophagus. You are more likely to have this condition if you have had GERD for a long time. Left untreated, it can lead to cancer of the esophagus. About 3.3 million American adults have Barrett’s. There are no clear symptoms that mean someone has Barrett’s Esophagus.  In fact, when developing Barrett’s Esophagus, some may think that they are getting better because symptoms of GERD sometimes get better or even disappear. This could lead to a false sense of security. But even without symptoms they can feel, people with Barrett’s Esophagus still have a much greater risk of developing esophageal cancer.  

Barrett’s Esophagus may never go away, even with medication or change in diet.  That is why your gastroenterologist will check these patients on a regular basis to make sure the condition isn’t getting worse.  It is important to talk with your doctor when symptoms of GERD begin or if they have gone away. Your doctor may perform an upper endoscopy of EGD procedure to help diagnosis Barrett’s Esophagus and/or monitor changes to the lining of the esophagus.

 

FOR MORE INFORMATION, PLEASE VISIT :  http://treatbarretts.com/

 

Hepatitis Awareness Month

May has been designated as Hepatitis Awareness Month and May 19, 2015 as Hepatitis Testing Day.  The Center for Disease Control and Prevention (CDC) in concert with all public and private healthcare providers, are working to shed light on this hidden epidemic by raising awareness of viral hepatitis and encouraging at risk populations to get tested. 

Hepatitis means inflammation of the liver, most often caused by one of several viruses.  In the United States, the most common types of viral hepatitis are Hepatitis A (HAV), Hepatitis B (HBV) and Hepatitis C (HCV), Unlike Hepatitis A, which does not cause a long-term infection, Hepatitis B and C can become chronic, lifelong infections. More than 4 Million Americans are living with Chronic Hepatitis B or Hepatitis C, but most do not know they are infected.  Chronic viral hepatitis can lead to serious liver problems, including liver cancer.  According to the CDC, at least half of the new cases of liver cancer are from chronic Hepatitis C infection. Every year 15,000 Americans die from liver cancer or chronic liver disease associated with viral hepatitis.  The number of new cases of liver cancer is highest amongst Asian and Pacific Islanders and is increasing among African Americans, baby boomers and men. 

Hepatitis A infections have dramatically declined in the United States over the past 20 years, due in large part to vaccination efforts.   The HAV vaccine is recommended for all children starting at 1 year of age; men who have sexual contact with other men; users of IV and non-injected illegal drugs; people with chronic liver disease and people working with HAV in research laboratories.

An estimated 1.2 million people in the United States are living with HBV infection.  According to the CDC, one in 12 Asian Americans is infected with HBV, and nearly two in three do not know they are infected.  Asian & Pacific Islanders make up 5% of the US population and account for more that 50% of the Americans with HBV.  Although people with HBV often have no symptoms, up to 25% of people with Hepatitis B will develop serious liver problems.   The CDC recommends HBV vaccination for all people born in Asia and the Pacific Islands; all infants; all children under the age of 19; people with sex partners who have HBV; sexually active people who are not in a long term monogamous relationship; people who share needles or other drug –injection equipment; healthcare workers; people with end-stage renal disease; residents of facilities for developmentally disabled persons; people with chronic liver disease; and people with HIV infection.

Hepatitis C ranges in severity from a mild illness lasting a few weeks to a serious lifelong illness that attacks the liver. Many people can live with HCV fror decades without having any symptoms. Left untreated, HCV can cause serious liver damage and liver failure. Chronic HCV is the leading cause of liver cancer and liver transplants.  According to the CDC, all people born between 1945 and 1965 are five times more likely to be infected with HCV than other adults. There are an estimate 3.2 million Americans with chronic HCV.  The CDC recommends that all baby boomers get tested for HCV infection.  They also recommend testing for current or former injection drug users; persons treated for blood clotting problems before1987; persons who received blood transfusions before July 1992; persons with abnormal liver tests or liver disease;  health care workers who are exposed to blood from aneedlestick puncture and persons with HIV.

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