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Re: Stomach acid suppressing meds may cause damage to intestine

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http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

I've read with interest and conviction. Now my question is, what to do? how to

treat stomach problems whether related to excessive acid, caused by anxiety, or

GERD, especially when they've been a llifetime condition? here's the detail and

will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

I've read with interest and conviction. Now my question is, what to do? how to

treat stomach problems whether related to excessive acid, caused by anxiety, or

GERD, especially when they've been a llifetime condition? here's the detail and

will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

I've read with interest and conviction. Now my question is, what to do? how to

treat stomach problems whether related to excessive acid, caused by anxiety, or

GERD, especially when they've been a llifetime condition? here's the detail and

will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

ively to PPIs, to finding the triggers that cause it may be helpful.

The attachment on the etiology of GERD mentions the role of cytokines

causing the damage of heartburn and GERD. WE know that foods or

chemicals one may be reactive to mediate the release of cytokines in the

blood. Figuring out which foods or chemicals that do this is tricky

because the time between the symptom and the ingestion of the culprit

food(s) chemicals may be hours to 2 or 3 days. LEAP testing or

mediator release testing is a reliable way to identify common triggers.

LEAP has a very high success rate as a person eliminates the reactive

foods or chemicals. Sometimes it's as simple as eliminating few foods

to be GERD free

I also attached a file I've kept on some of the many alternatives to

PPIs from several listserves over the years. Some of these are helpful

to wean down on PPI use before using LEAP-MRT.

Pat Bollinger, MSRD

> Â

>

> I've read with interest and conviction. Now my question is, what to

> do? how to treat stomach problems whether related to excessive acid,

> caused by anxiety, or GERD, especially when they've been a llifetime

> condition? here's the detail and will appreciate all input and

> possible approaches.

>

> Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5

> years GERD, excessive acid, reflux, stomach empties rapidly but is

> small capacity. Small multiple meals tolerated fairly well exept when

> bouts of pain, reflux. During that time even innocuous foods such as

> plain yogurt, cooked cereals, potatoes & rice cause extreme pain &

> often vomiting.

>

> Chronic omeprazol use for 3 years, started on 40 mg now titrating in

> 10 mg increments. 20 mg minimum to have results but still, depending

> on the day or food some pain and acidity or what feels like it.

> Excessively gassy stomach also a problem. With nexium experienced

> naggy cough, but not so much w lower doses of omeprazol OTC.

>

> Any ideas? what to do about stomach pain and inability to eat enough?

> weight loss is sporadic but can maintain desired weight most of the

> time just by ingesting higher calorie foods when eating. BMI 22.

>

> TIA

> Digna

>

> --

> Digna Cassens, MHA, RD

> Cassens Associates

> Diversified Nutrition Consulting Services

>

> ---- Vajda <jennyvajda@...

> <mailto:jennyvajda%40sbcglobal.net>> wrote:

>

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

> my third most viewed article. still only a trickle but a voice in the

> woods, a

> light in the dark.

>

> R Vajda, R.D.

> www.GingerJens.com

>

>

> ________________________________

> From: Merav Levi <meravls@... <mailto:meravls%40msn.com>>

> To: rd-usa <rd-usa <mailto:rd-usa%40yahoogroups.com>>

> Sent: Fri, September 2, 2011 6:57:45 PM

> Subject: RE: Stomach acid suppressing meds may cause damage to

> intestine

>

> Watching a commercial for Omeprazole....The problem with PPIs & H2

> Receptor

> Antagonists is on few levels:1. It is OTC, in most, if not all cases

> (and this

> country loves pills and quick solutions)2. MDs love them too,

> especially the

> purple one (nexium). WHile there is an excuse to give them to ppl on

> vents, I am

> having hard time convincing MDs to D/C these meds in ppl who are not on

> mechanical vents.3. the pharma companies, of course, are paying $$$ for

> primetime commercials, while no one is speaking about these side

> effects (among

> others, like anemia with LT use). After all, if, for example, MSNBC

> will talk

> about the side effects of Omeprazole, they will lose the big $$$ that

> is paid

> for its commercial (the one I just watched).

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the

> moments that

> take your breath away. " - Carlin " People don't forget the truth,

> they just

> become better in lying " (Revolutionary Road)

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> CC: cda-listserv <mailto:cda-listserv%40yahoogroups.com>

> From: Dineright4@... <mailto:Dineright4%40aol.com>

> Date: Fri, 2 Sep 2011 12:19:44 -0400

> Subject: Stomach acid suppressing meds may cause damage to

> intestine

>

> As we all suspected - so many people on PPIs end up with GI issues

> later.

>

> And, then, the research that shows that GERD may just be a cytokine

>

> response to certain foods, and not acid related at all - so a lot of

> people on

>

> acid suppressants that should not be.

>

> Let's see, God created stomach acid as part of a healthy body. Why do we

>

> think turning our stomachs into a base environment is healthy for us?

>

> More below.

>

> Jan

>

> Public release date: 1-Sep-2011

>

> Contact: McGuire

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> 90-552-

>

> McMaster University

>

> McMaster study finds more gut reaction to arthritis drugs

>

> Stomach acid supressing drugs appear to cause damage to the small

> intestine

>

> Hamilton, ON (Sept. 1, 2011) âEUR " Patients often take drugs to lower

>

> stomach acid and reduce the chances they will develop ulcers from taking

>

> their anti-inflammatory drugs for conditions such as arthritis, but the

>

> combination may be causing major problems for their small intestines,

>

> McMaster researchers have found.

>

> A team from the Farncombe Family Digestive Health Research Institute has

>

> found those stomach acid-reducing drugs, known as proton pump

>

> inhibitors, may actually be aggravating damage in the small intestine

>

> caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

>

> In a study published in the medical journal Gastroenterology, principal

>

> investigator Wallace says the extent of the hard-to-detect damage

>

> caused to the small intestine has only recently been discovered through

>

> use of small video cameras swallowed like pills.

>

> " Suppressing acid secretion is effective for protecting the stomach from

>

> damage caused by NSAIDs, but these drugs appear to be shifting the

>

> damage from the stomach to the small intestine, where the ulcers may be

>

> more dangerous and more difficult to treat, " said Wallace. He is

>

> director of the Farncombe institute and professor of medicine of the

>

> G. DeGroote School of Medicine at McMaster.

>

> He added that the use of probiotics is being investigated as a potential

>

> cure for the small intestine damage.

>

> ###

>

> The study was funded by the Canadian Institutes of Health Research

>

> (CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

>

> For more information, please contact:

>

> McGuire

>

> Media Relations Coordinator

>

> Faculty of Health Sciences

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> McGuire

>

> Media Relations, Faculty of Health Sciences,

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> IMPORTANT: Effective immediately, our new mailing address

>

> Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

>

> For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

>

> L8N 3Z5

>

> _http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

>

> (http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

>

> Reflux esophagitis due to immune reaction, not acute acid burn,

>

> UT Southwestern researchers report

>

>

>

> Dr Rhonda Souza

>

> Dr Stuart

>

> _SJSpechler@... <mailto:_SJSpechler%40aol.com>_

> (mailto:SJSpechler@... <mailto:SJSpechler%40aol.com>)

>

> EMAIL HIM!!!

>

> Media Contact: LaKisha Ladson

>

>

>

> _lakisha.ladson@...

> <mailto:_lakisha.ladson%40utsouthwestern.edu>_

>

> (/mc/compose?to=lakisha.ladson@...

> <mailto:%2Fmc%2Fcompose%3Fto%3Dlakisha.ladson%40utsouthwestern.edu>)

>

> DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

>

> called gastroesophageal reflux disease (GERD) might not develop as a

>

> direct result of acidic digestive juices burning the esophagus, UT

>

> Southwestern Medical Center researchers have found in an animal study.

>

> Rather, gastroesophageal reflux spurs the esophageal cells

>

> to release chemicals called cytokines, which attract inflammatory cells

>

> to the esophagus. It is those inflammatory cells, drawn to the esophagus

>

> by cytokines, that cause the esophageal damage that is characteristic of

>

> GERD. The condition is manifested by symptoms such as heartburn and

>

> chest pain.

>

> " Currently, we treat GERD by giving medications to prevent

>

> the stomach from making acid, " said Dr. Rhonda Souza, associate

>

> professor of internal medicine at UT Southwestern and lead author of the

>

> study appearing the November issue of Gastroenterology. " But if GERD is

>

> really an immune-mediated injury, 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, researchers created GERD in rats by

>

> connecting the duodenum to the esophagus. This operation allows stomach

>

> acid and bile to enter the esophagus. Researchers were surprised to

>

> learn that esophagitis didn't develop for a number of weeks after the

>

> operation.

>

> " That doesn't make sense if GERD is really the result of an

>

> acid burn, as we all were taught in medical school, " said Dr. Stuart

>

> Spechler, professor of internal medicine at UT Southwestern and senior

>

> author of the study. " Chemical injuries develop immediately. If you

>

> spill battery acid on your hand, you don't have to wait a month to see

>

> the damage. "

>

> About 40 percent of Americans suffer symptoms of GERD at

>

> some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

>

> long term, GERD could eventually lead to esophageal cancer.

>

> Previous studies had shown that if an animal esophagus is

>

> perfused with highly concentrated acid, esophageal damage develops

>

> quickly. In humans, however, the large majority of reflux episodes do

>

> not contain such highly concentrated acid, Dr. Souza said.

>

> " In animal models of reflux esophagitis designed to mimic

>

> the human disease, researchers hadn't looked at the early events in the

>

> development of esophageal injury, " Dr. Souza noted. " Most of those

>

> investigators have been interested in the long-term consequences of

>

> GERD, and we found virtually no published data about what happens later

>

> that induces gastroesophageal reflux. "

>

> Dr. Souza, who is also a staff physician at the Dallas

>

> Veterans Affairs Medical Center and part of the Harold C.

>

> Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

>

> of gastroenterology at the Dallas VA, said the method they used to

>

> produce GERD in rats is a reasonable representation of how GERD develops

>

> in humans - acidic digestive juices from the stomach surge into the

>

> esophagus.

>

> Soon after the operation, they expected to see the death of

>

> surface cells of the esophagus, and they expected to see the injury

>

> progress later to the deeper layers. Instead, they found the opposite.

>

> Three days after the surgery, there was no damage to surface cells, but

>

> the researchers did find inflammatory cells in the deeper layers of the

>

> esophagus. Those inflammatory cells didn't rise to the surface layer

>

> until three weeks after the initial acid exposure.

>

> The next step for researchers is to conduct additional

>

> studies in humans.

>

> Other UT Southwestern researchers involved in the study

>

> included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

>

> Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

>

> Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

>

> instructor of internal medicine; Dr. Genta, clinical professor of

>

> pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

>

> professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

>

> both research associates in internal medicine.

>

> The study was supported by the Dallas VA Medical Center and

>

> the National Institutes of Health.

>

> Visit _http://www.utsouthwestern.org/digestive_

>

> (http://www.utsouthwestern.org/digestive) to learn

>

> about UT Southwestern's clinical services for digestive disorders.

>

> ###

>

> This news release is available on our World Wide Web home page at

>

> _http://www.utsouthwestern.edu/home/news/index.html_

>

> (http://www.utsouthwestern.edu/home/news/index.html)

>

> Jan Patenaude, RD, CLT

>

> Director of Medical Nutrition

>

> Signet Diagnostic Corp.

>

> Telecommuting Nationwide

>

> (Mountain Time)

>

> Fax:

>

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

>

> Certified LEAP Therapist (CLT) Training Course.

>

>

Link to comment
Share on other sites

ively to PPIs, to finding the triggers that cause it may be helpful.

The attachment on the etiology of GERD mentions the role of cytokines

causing the damage of heartburn and GERD. WE know that foods or

chemicals one may be reactive to mediate the release of cytokines in the

blood. Figuring out which foods or chemicals that do this is tricky

because the time between the symptom and the ingestion of the culprit

food(s) chemicals may be hours to 2 or 3 days. LEAP testing or

mediator release testing is a reliable way to identify common triggers.

LEAP has a very high success rate as a person eliminates the reactive

foods or chemicals. Sometimes it's as simple as eliminating few foods

to be GERD free

I also attached a file I've kept on some of the many alternatives to

PPIs from several listserves over the years. Some of these are helpful

to wean down on PPI use before using LEAP-MRT.

Pat Bollinger, MSRD

> Â

>

> I've read with interest and conviction. Now my question is, what to

> do? how to treat stomach problems whether related to excessive acid,

> caused by anxiety, or GERD, especially when they've been a llifetime

> condition? here's the detail and will appreciate all input and

> possible approaches.

>

> Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5

> years GERD, excessive acid, reflux, stomach empties rapidly but is

> small capacity. Small multiple meals tolerated fairly well exept when

> bouts of pain, reflux. During that time even innocuous foods such as

> plain yogurt, cooked cereals, potatoes & rice cause extreme pain &

> often vomiting.

>

> Chronic omeprazol use for 3 years, started on 40 mg now titrating in

> 10 mg increments. 20 mg minimum to have results but still, depending

> on the day or food some pain and acidity or what feels like it.

> Excessively gassy stomach also a problem. With nexium experienced

> naggy cough, but not so much w lower doses of omeprazol OTC.

>

> Any ideas? what to do about stomach pain and inability to eat enough?

> weight loss is sporadic but can maintain desired weight most of the

> time just by ingesting higher calorie foods when eating. BMI 22.

>

> TIA

> Digna

>

> --

> Digna Cassens, MHA, RD

> Cassens Associates

> Diversified Nutrition Consulting Services

>

> ---- Vajda <jennyvajda@...

> <mailto:jennyvajda%40sbcglobal.net>> wrote:

>

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

> my third most viewed article. still only a trickle but a voice in the

> woods, a

> light in the dark.

>

> R Vajda, R.D.

> www.GingerJens.com

>

>

> ________________________________

> From: Merav Levi <meravls@... <mailto:meravls%40msn.com>>

> To: rd-usa <rd-usa <mailto:rd-usa%40yahoogroups.com>>

> Sent: Fri, September 2, 2011 6:57:45 PM

> Subject: RE: Stomach acid suppressing meds may cause damage to

> intestine

>

> Watching a commercial for Omeprazole....The problem with PPIs & H2

> Receptor

> Antagonists is on few levels:1. It is OTC, in most, if not all cases

> (and this

> country loves pills and quick solutions)2. MDs love them too,

> especially the

> purple one (nexium). WHile there is an excuse to give them to ppl on

> vents, I am

> having hard time convincing MDs to D/C these meds in ppl who are not on

> mechanical vents.3. the pharma companies, of course, are paying $$$ for

> primetime commercials, while no one is speaking about these side

> effects (among

> others, like anemia with LT use). After all, if, for example, MSNBC

> will talk

> about the side effects of Omeprazole, they will lose the big $$$ that

> is paid

> for its commercial (the one I just watched).

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the

> moments that

> take your breath away. " - Carlin " People don't forget the truth,

> they just

> become better in lying " (Revolutionary Road)

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> CC: cda-listserv <mailto:cda-listserv%40yahoogroups.com>

> From: Dineright4@... <mailto:Dineright4%40aol.com>

> Date: Fri, 2 Sep 2011 12:19:44 -0400

> Subject: Stomach acid suppressing meds may cause damage to

> intestine

>

> As we all suspected - so many people on PPIs end up with GI issues

> later.

>

> And, then, the research that shows that GERD may just be a cytokine

>

> response to certain foods, and not acid related at all - so a lot of

> people on

>

> acid suppressants that should not be.

>

> Let's see, God created stomach acid as part of a healthy body. Why do we

>

> think turning our stomachs into a base environment is healthy for us?

>

> More below.

>

> Jan

>

> Public release date: 1-Sep-2011

>

> Contact: McGuire

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> 90-552-

>

> McMaster University

>

> McMaster study finds more gut reaction to arthritis drugs

>

> Stomach acid supressing drugs appear to cause damage to the small

> intestine

>

> Hamilton, ON (Sept. 1, 2011) âEUR " Patients often take drugs to lower

>

> stomach acid and reduce the chances they will develop ulcers from taking

>

> their anti-inflammatory drugs for conditions such as arthritis, but the

>

> combination may be causing major problems for their small intestines,

>

> McMaster researchers have found.

>

> A team from the Farncombe Family Digestive Health Research Institute has

>

> found those stomach acid-reducing drugs, known as proton pump

>

> inhibitors, may actually be aggravating damage in the small intestine

>

> caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

>

> In a study published in the medical journal Gastroenterology, principal

>

> investigator Wallace says the extent of the hard-to-detect damage

>

> caused to the small intestine has only recently been discovered through

>

> use of small video cameras swallowed like pills.

>

> " Suppressing acid secretion is effective for protecting the stomach from

>

> damage caused by NSAIDs, but these drugs appear to be shifting the

>

> damage from the stomach to the small intestine, where the ulcers may be

>

> more dangerous and more difficult to treat, " said Wallace. He is

>

> director of the Farncombe institute and professor of medicine of the

>

> G. DeGroote School of Medicine at McMaster.

>

> He added that the use of probiotics is being investigated as a potential

>

> cure for the small intestine damage.

>

> ###

>

> The study was funded by the Canadian Institutes of Health Research

>

> (CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

>

> For more information, please contact:

>

> McGuire

>

> Media Relations Coordinator

>

> Faculty of Health Sciences

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> McGuire

>

> Media Relations, Faculty of Health Sciences,

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> IMPORTANT: Effective immediately, our new mailing address

>

> Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

>

> For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

>

> L8N 3Z5

>

> _http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

>

> (http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

>

> Reflux esophagitis due to immune reaction, not acute acid burn,

>

> UT Southwestern researchers report

>

>

>

> Dr Rhonda Souza

>

> Dr Stuart

>

> _SJSpechler@... <mailto:_SJSpechler%40aol.com>_

> (mailto:SJSpechler@... <mailto:SJSpechler%40aol.com>)

>

> EMAIL HIM!!!

>

> Media Contact: LaKisha Ladson

>

>

>

> _lakisha.ladson@...

> <mailto:_lakisha.ladson%40utsouthwestern.edu>_

>

> (/mc/compose?to=lakisha.ladson@...

> <mailto:%2Fmc%2Fcompose%3Fto%3Dlakisha.ladson%40utsouthwestern.edu>)

>

> DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

>

> called gastroesophageal reflux disease (GERD) might not develop as a

>

> direct result of acidic digestive juices burning the esophagus, UT

>

> Southwestern Medical Center researchers have found in an animal study.

>

> Rather, gastroesophageal reflux spurs the esophageal cells

>

> to release chemicals called cytokines, which attract inflammatory cells

>

> to the esophagus. It is those inflammatory cells, drawn to the esophagus

>

> by cytokines, that cause the esophageal damage that is characteristic of

>

> GERD. The condition is manifested by symptoms such as heartburn and

>

> chest pain.

>

> " Currently, we treat GERD by giving medications to prevent

>

> the stomach from making acid, " said Dr. Rhonda Souza, associate

>

> professor of internal medicine at UT Southwestern and lead author of the

>

> study appearing the November issue of Gastroenterology. " But if GERD is

>

> really an immune-mediated injury, 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, researchers created GERD in rats by

>

> connecting the duodenum to the esophagus. This operation allows stomach

>

> acid and bile to enter the esophagus. Researchers were surprised to

>

> learn that esophagitis didn't develop for a number of weeks after the

>

> operation.

>

> " That doesn't make sense if GERD is really the result of an

>

> acid burn, as we all were taught in medical school, " said Dr. Stuart

>

> Spechler, professor of internal medicine at UT Southwestern and senior

>

> author of the study. " Chemical injuries develop immediately. If you

>

> spill battery acid on your hand, you don't have to wait a month to see

>

> the damage. "

>

> About 40 percent of Americans suffer symptoms of GERD at

>

> some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

>

> long term, GERD could eventually lead to esophageal cancer.

>

> Previous studies had shown that if an animal esophagus is

>

> perfused with highly concentrated acid, esophageal damage develops

>

> quickly. In humans, however, the large majority of reflux episodes do

>

> not contain such highly concentrated acid, Dr. Souza said.

>

> " In animal models of reflux esophagitis designed to mimic

>

> the human disease, researchers hadn't looked at the early events in the

>

> development of esophageal injury, " Dr. Souza noted. " Most of those

>

> investigators have been interested in the long-term consequences of

>

> GERD, and we found virtually no published data about what happens later

>

> that induces gastroesophageal reflux. "

>

> Dr. Souza, who is also a staff physician at the Dallas

>

> Veterans Affairs Medical Center and part of the Harold C.

>

> Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

>

> of gastroenterology at the Dallas VA, said the method they used to

>

> produce GERD in rats is a reasonable representation of how GERD develops

>

> in humans - acidic digestive juices from the stomach surge into the

>

> esophagus.

>

> Soon after the operation, they expected to see the death of

>

> surface cells of the esophagus, and they expected to see the injury

>

> progress later to the deeper layers. Instead, they found the opposite.

>

> Three days after the surgery, there was no damage to surface cells, but

>

> the researchers did find inflammatory cells in the deeper layers of the

>

> esophagus. Those inflammatory cells didn't rise to the surface layer

>

> until three weeks after the initial acid exposure.

>

> The next step for researchers is to conduct additional

>

> studies in humans.

>

> Other UT Southwestern researchers involved in the study

>

> included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

>

> Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

>

> Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

>

> instructor of internal medicine; Dr. Genta, clinical professor of

>

> pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

>

> professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

>

> both research associates in internal medicine.

>

> The study was supported by the Dallas VA Medical Center and

>

> the National Institutes of Health.

>

> Visit _http://www.utsouthwestern.org/digestive_

>

> (http://www.utsouthwestern.org/digestive) to learn

>

> about UT Southwestern's clinical services for digestive disorders.

>

> ###

>

> This news release is available on our World Wide Web home page at

>

> _http://www.utsouthwestern.edu/home/news/index.html_

>

> (http://www.utsouthwestern.edu/home/news/index.html)

>

> Jan Patenaude, RD, CLT

>

> Director of Medical Nutrition

>

> Signet Diagnostic Corp.

>

> Telecommuting Nationwide

>

> (Mountain Time)

>

> Fax:

>

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

>

> Certified LEAP Therapist (CLT) Training Course.

>

>

Link to comment
Share on other sites

ively to PPIs, to finding the triggers that cause it may be helpful.

The attachment on the etiology of GERD mentions the role of cytokines

causing the damage of heartburn and GERD. WE know that foods or

chemicals one may be reactive to mediate the release of cytokines in the

blood. Figuring out which foods or chemicals that do this is tricky

because the time between the symptom and the ingestion of the culprit

food(s) chemicals may be hours to 2 or 3 days. LEAP testing or

mediator release testing is a reliable way to identify common triggers.

LEAP has a very high success rate as a person eliminates the reactive

foods or chemicals. Sometimes it's as simple as eliminating few foods

to be GERD free

I also attached a file I've kept on some of the many alternatives to

PPIs from several listserves over the years. Some of these are helpful

to wean down on PPI use before using LEAP-MRT.

Pat Bollinger, MSRD

> Â

>

> I've read with interest and conviction. Now my question is, what to

> do? how to treat stomach problems whether related to excessive acid,

> caused by anxiety, or GERD, especially when they've been a llifetime

> condition? here's the detail and will appreciate all input and

> possible approaches.

>

> Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5

> years GERD, excessive acid, reflux, stomach empties rapidly but is

> small capacity. Small multiple meals tolerated fairly well exept when

> bouts of pain, reflux. During that time even innocuous foods such as

> plain yogurt, cooked cereals, potatoes & rice cause extreme pain &

> often vomiting.

>

> Chronic omeprazol use for 3 years, started on 40 mg now titrating in

> 10 mg increments. 20 mg minimum to have results but still, depending

> on the day or food some pain and acidity or what feels like it.

> Excessively gassy stomach also a problem. With nexium experienced

> naggy cough, but not so much w lower doses of omeprazol OTC.

>

> Any ideas? what to do about stomach pain and inability to eat enough?

> weight loss is sporadic but can maintain desired weight most of the

> time just by ingesting higher calorie foods when eating. BMI 22.

>

> TIA

> Digna

>

> --

> Digna Cassens, MHA, RD

> Cassens Associates

> Diversified Nutrition Consulting Services

>

> ---- Vajda <jennyvajda@...

> <mailto:jennyvajda%40sbcglobal.net>> wrote:

>

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

> my third most viewed article. still only a trickle but a voice in the

> woods, a

> light in the dark.

>

> R Vajda, R.D.

> www.GingerJens.com

>

>

> ________________________________

> From: Merav Levi <meravls@... <mailto:meravls%40msn.com>>

> To: rd-usa <rd-usa <mailto:rd-usa%40yahoogroups.com>>

> Sent: Fri, September 2, 2011 6:57:45 PM

> Subject: RE: Stomach acid suppressing meds may cause damage to

> intestine

>

> Watching a commercial for Omeprazole....The problem with PPIs & H2

> Receptor

> Antagonists is on few levels:1. It is OTC, in most, if not all cases

> (and this

> country loves pills and quick solutions)2. MDs love them too,

> especially the

> purple one (nexium). WHile there is an excuse to give them to ppl on

> vents, I am

> having hard time convincing MDs to D/C these meds in ppl who are not on

> mechanical vents.3. the pharma companies, of course, are paying $$$ for

> primetime commercials, while no one is speaking about these side

> effects (among

> others, like anemia with LT use). After all, if, for example, MSNBC

> will talk

> about the side effects of Omeprazole, they will lose the big $$$ that

> is paid

> for its commercial (the one I just watched).

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the

> moments that

> take your breath away. " - Carlin " People don't forget the truth,

> they just

> become better in lying " (Revolutionary Road)

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> CC: cda-listserv <mailto:cda-listserv%40yahoogroups.com>

> From: Dineright4@... <mailto:Dineright4%40aol.com>

> Date: Fri, 2 Sep 2011 12:19:44 -0400

> Subject: Stomach acid suppressing meds may cause damage to

> intestine

>

> As we all suspected - so many people on PPIs end up with GI issues

> later.

>

> And, then, the research that shows that GERD may just be a cytokine

>

> response to certain foods, and not acid related at all - so a lot of

> people on

>

> acid suppressants that should not be.

>

> Let's see, God created stomach acid as part of a healthy body. Why do we

>

> think turning our stomachs into a base environment is healthy for us?

>

> More below.

>

> Jan

>

> Public release date: 1-Sep-2011

>

> Contact: McGuire

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> 90-552-

>

> McMaster University

>

> McMaster study finds more gut reaction to arthritis drugs

>

> Stomach acid supressing drugs appear to cause damage to the small

> intestine

>

> Hamilton, ON (Sept. 1, 2011) âEUR " Patients often take drugs to lower

>

> stomach acid and reduce the chances they will develop ulcers from taking

>

> their anti-inflammatory drugs for conditions such as arthritis, but the

>

> combination may be causing major problems for their small intestines,

>

> McMaster researchers have found.

>

> A team from the Farncombe Family Digestive Health Research Institute has

>

> found those stomach acid-reducing drugs, known as proton pump

>

> inhibitors, may actually be aggravating damage in the small intestine

>

> caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

>

> In a study published in the medical journal Gastroenterology, principal

>

> investigator Wallace says the extent of the hard-to-detect damage

>

> caused to the small intestine has only recently been discovered through

>

> use of small video cameras swallowed like pills.

>

> " Suppressing acid secretion is effective for protecting the stomach from

>

> damage caused by NSAIDs, but these drugs appear to be shifting the

>

> damage from the stomach to the small intestine, where the ulcers may be

>

> more dangerous and more difficult to treat, " said Wallace. He is

>

> director of the Farncombe institute and professor of medicine of the

>

> G. DeGroote School of Medicine at McMaster.

>

> He added that the use of probiotics is being investigated as a potential

>

> cure for the small intestine damage.

>

> ###

>

> The study was funded by the Canadian Institutes of Health Research

>

> (CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

>

> For more information, please contact:

>

> McGuire

>

> Media Relations Coordinator

>

> Faculty of Health Sciences

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> McGuire

>

> Media Relations, Faculty of Health Sciences,

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> IMPORTANT: Effective immediately, our new mailing address

>

> Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

>

> For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

>

> L8N 3Z5

>

> _http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

>

> (http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

>

> Reflux esophagitis due to immune reaction, not acute acid burn,

>

> UT Southwestern researchers report

>

>

>

> Dr Rhonda Souza

>

> Dr Stuart

>

> _SJSpechler@... <mailto:_SJSpechler%40aol.com>_

> (mailto:SJSpechler@... <mailto:SJSpechler%40aol.com>)

>

> EMAIL HIM!!!

>

> Media Contact: LaKisha Ladson

>

>

>

> _lakisha.ladson@...

> <mailto:_lakisha.ladson%40utsouthwestern.edu>_

>

> (/mc/compose?to=lakisha.ladson@...

> <mailto:%2Fmc%2Fcompose%3Fto%3Dlakisha.ladson%40utsouthwestern.edu>)

>

> DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

>

> called gastroesophageal reflux disease (GERD) might not develop as a

>

> direct result of acidic digestive juices burning the esophagus, UT

>

> Southwestern Medical Center researchers have found in an animal study.

>

> Rather, gastroesophageal reflux spurs the esophageal cells

>

> to release chemicals called cytokines, which attract inflammatory cells

>

> to the esophagus. It is those inflammatory cells, drawn to the esophagus

>

> by cytokines, that cause the esophageal damage that is characteristic of

>

> GERD. The condition is manifested by symptoms such as heartburn and

>

> chest pain.

>

> " Currently, we treat GERD by giving medications to prevent

>

> the stomach from making acid, " said Dr. Rhonda Souza, associate

>

> professor of internal medicine at UT Southwestern and lead author of the

>

> study appearing the November issue of Gastroenterology. " But if GERD is

>

> really an immune-mediated injury, 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, researchers created GERD in rats by

>

> connecting the duodenum to the esophagus. This operation allows stomach

>

> acid and bile to enter the esophagus. Researchers were surprised to

>

> learn that esophagitis didn't develop for a number of weeks after the

>

> operation.

>

> " That doesn't make sense if GERD is really the result of an

>

> acid burn, as we all were taught in medical school, " said Dr. Stuart

>

> Spechler, professor of internal medicine at UT Southwestern and senior

>

> author of the study. " Chemical injuries develop immediately. If you

>

> spill battery acid on your hand, you don't have to wait a month to see

>

> the damage. "

>

> About 40 percent of Americans suffer symptoms of GERD at

>

> some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

>

> long term, GERD could eventually lead to esophageal cancer.

>

> Previous studies had shown that if an animal esophagus is

>

> perfused with highly concentrated acid, esophageal damage develops

>

> quickly. In humans, however, the large majority of reflux episodes do

>

> not contain such highly concentrated acid, Dr. Souza said.

>

> " In animal models of reflux esophagitis designed to mimic

>

> the human disease, researchers hadn't looked at the early events in the

>

> development of esophageal injury, " Dr. Souza noted. " Most of those

>

> investigators have been interested in the long-term consequences of

>

> GERD, and we found virtually no published data about what happens later

>

> that induces gastroesophageal reflux. "

>

> Dr. Souza, who is also a staff physician at the Dallas

>

> Veterans Affairs Medical Center and part of the Harold C.

>

> Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

>

> of gastroenterology at the Dallas VA, said the method they used to

>

> produce GERD in rats is a reasonable representation of how GERD develops

>

> in humans - acidic digestive juices from the stomach surge into the

>

> esophagus.

>

> Soon after the operation, they expected to see the death of

>

> surface cells of the esophagus, and they expected to see the injury

>

> progress later to the deeper layers. Instead, they found the opposite.

>

> Three days after the surgery, there was no damage to surface cells, but

>

> the researchers did find inflammatory cells in the deeper layers of the

>

> esophagus. Those inflammatory cells didn't rise to the surface layer

>

> until three weeks after the initial acid exposure.

>

> The next step for researchers is to conduct additional

>

> studies in humans.

>

> Other UT Southwestern researchers involved in the study

>

> included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

>

> Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

>

> Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

>

> instructor of internal medicine; Dr. Genta, clinical professor of

>

> pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

>

> professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

>

> both research associates in internal medicine.

>

> The study was supported by the Dallas VA Medical Center and

>

> the National Institutes of Health.

>

> Visit _http://www.utsouthwestern.org/digestive_

>

> (http://www.utsouthwestern.org/digestive) to learn

>

> about UT Southwestern's clinical services for digestive disorders.

>

> ###

>

> This news release is available on our World Wide Web home page at

>

> _http://www.utsouthwestern.edu/home/news/index.html_

>

> (http://www.utsouthwestern.edu/home/news/index.html)

>

> Jan Patenaude, RD, CLT

>

> Director of Medical Nutrition

>

> Signet Diagnostic Corp.

>

> Telecommuting Nationwide

>

> (Mountain Time)

>

> Fax:

>

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

>

> Certified LEAP Therapist (CLT) Training Course.

>

>

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Share on other sites

based on my recent readings limiting the glutamate content of the diet may also

be crucial for wound healing/diabetes/osteoporosis and senility but that rules

out most of the processed world of food so on to simpler ingredient discussions

instead . . .

add a few spoonfuls of slippery elm powder or marshmallow root powder to cooked

cereals based on barley, quinoa, millet or plain whole oats - leave off any

opportunities for mystery ingredients to enter into your HAACP chain. The

healthy starches of the slippery elm powder or the possibly cheaper marshmallow

root are helpful to build the protective glycocalyx lining the intestines.

Fenugreek is another super starch herb as well as cinnamon (1/2 tsp day for the

cinnamon \effevctive dose). Sweet potato and canned carrots, canned pears or

peaches would be good smoothie bases (fresh would certainly be better but I've

been trying to think of ideas for use within the current inventory room).

Try to keep the wheat and dairy and more difficult to digest foods out of his

diet if possible. Glucosamine seems essential to healing in edematous

malnutrition. It is also one of the essential sugars for building the

glycocalyx. Real beef stock made with super cheap soup bones and leftover

vegetable scraps would provide glucosamine from the marrow - processed soup

stock would probably be supplying glutamates and increasing senility etc.

Carmelized onions are a good source of the healthy fibers and peas and green

beans (cooked garbanzo bean puree, flovored/mixed any beans). Mushrooms,

echinacea, aloe vera juice/gel all have the super starches

Omega 3 fatty acids and lecithin and cholesterol are actually building blocks

for some important things (like vitamin D ;-) ). Elders having too low

cholesterol has been associated with greater risk. The push to lipitor everyone

doesn't seem sensible after a certain age and weight (low weight). . . . . eggs

are good food . . . coconut oil/spread is available and would be a good calorie

boost, also sunflower butter is mild. Hemp oil has omega 3's and CLA and GLA as

well as cannabinoids. Like the conversion of taurine from cysteine, the

production of cannabinoids endogenously seems to malfunction with age.

We are only as healthy as the chemical conversions that we can perform every

second of the day and they all need trace minerals like zinc, selenium,

magnesium (of course), B6 and the B's in greater than RDA doses all help get

the enzyme action going that we want for growth.

A medication is never going to give anyone what is necessary to grow an

intestinal cell and the magnesium deficiency that the proton pump inhibitor is

adding too is crucial for growing and maintaining those cells ( get off the PPI

period would be my goal).

Add ginger for antipain/antiulcer/anitbiotic/antiviral/antiworm and alos

parasite properties - also helps the teeth. A smidge in many things is less

obvious (for the " I don't like ginger " s; it's also available in capsules and the

only negative side effect that I ever had was increased bruising/bleeding I

think - I was eating a lot of the candied ginger as well as adding it to my

foods. 1/2 tsp powder day was the tested dose on arthritis patient's pain - in

combo with the ibuprofen was found most effective for pain and may help reduce

the ulcerative risks of ibuprofen. (aside - come to find out - my favorite pain

killer, ibuprofen acts to prevent the break down of our endogenous cannabinoid

supply). (my goal - stop using the NAISD's too)

Maybe he has that disease that occurs more in men - vomiting and restrictions

were frequent complaints. Steroidal throat sprays provided more relief with

fewer side effects during flair ups. (discussed in older RD thread)

http://www.nature.com/gimo/contents/pt1/full/gimo49.html Eosinophilic

esophagitis

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa

Cc: Vajda

Sent: Sat, September 3, 2011 12:59:25 PM

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

I've read with interest and conviction. Now my question is, what to do? how to

treat stomach problems whether related to excessive acid, caused by anxiety, or

GERD, especially when they've been a llifetime condition? here's the detail and

will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

Digna,

It must have been terrible to have all these symptoms for so long.I guess, in

chronic conditions, like yours, omeprazol is required. However, something you

might want to consider, since you said small frequent meals mostly tolerated and

since BMI is 22 (which, after the age of 70 is border-line low, as BMI 21, some

studies consider underwt/risk of malnutrition in this age group and up). In

other words - have you tried to focus on small more-frequent meals while trying

to titrate the meds further down, maybe start taking it every other day and then

twice a wk etc, while, maybe increasing the frequency of the meals to every

2-3hrs. You might gain wt a bit, but don't think it would be harmful.

But when I posted what I did, I spoke about the public at large. ppl are taking

OTC medications like it is sugar candy, thinking that OTC have no side effects,

which we all know they do.Also, today, I hope, ppl would know better not to

start chronic use of any meds, OTC or RX, at such young age as 16. But I might

be wrong. When my daughter was ~7yo it was the first time the PCP told us she

has high normal Chol (195). I told him that no way he would put my daughter on

meds at this age. I told him she is physically very active (runs a lot), we eat

healthy (most of the time) and here is a genetic component on her father's side,

so she was never on meds, to this day, 10 yrs later. I would not allow to start

" killing " her liver at this age. But, most people wouldn't know and MDs would

easily run for the Rx, which is the bigger problem, in my eyes. If we cannot

educate MDs not to write Rx so quickly (which is what they are trained for), how

can we expect that from the general public?

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: jennyvajda@...

From: dignacassens@...

Date: Sat, 3 Sep 2011 12:59:25 -0400

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

I've read with interest and conviction. Now my question is, what to do?

how to treat stomach problems whether related to excessive acid, caused by

anxiety, or GERD, especially when they've been a llifetime condition? here's

the detail and will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

Digna,

It must have been terrible to have all these symptoms for so long.I guess, in

chronic conditions, like yours, omeprazol is required. However, something you

might want to consider, since you said small frequent meals mostly tolerated and

since BMI is 22 (which, after the age of 70 is border-line low, as BMI 21, some

studies consider underwt/risk of malnutrition in this age group and up). In

other words - have you tried to focus on small more-frequent meals while trying

to titrate the meds further down, maybe start taking it every other day and then

twice a wk etc, while, maybe increasing the frequency of the meals to every

2-3hrs. You might gain wt a bit, but don't think it would be harmful.

But when I posted what I did, I spoke about the public at large. ppl are taking

OTC medications like it is sugar candy, thinking that OTC have no side effects,

which we all know they do.Also, today, I hope, ppl would know better not to

start chronic use of any meds, OTC or RX, at such young age as 16. But I might

be wrong. When my daughter was ~7yo it was the first time the PCP told us she

has high normal Chol (195). I told him that no way he would put my daughter on

meds at this age. I told him she is physically very active (runs a lot), we eat

healthy (most of the time) and here is a genetic component on her father's side,

so she was never on meds, to this day, 10 yrs later. I would not allow to start

" killing " her liver at this age. But, most people wouldn't know and MDs would

easily run for the Rx, which is the bigger problem, in my eyes. If we cannot

educate MDs not to write Rx so quickly (which is what they are trained for), how

can we expect that from the general public?

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: jennyvajda@...

From: dignacassens@...

Date: Sat, 3 Sep 2011 12:59:25 -0400

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

I've read with interest and conviction. Now my question is, what to do?

how to treat stomach problems whether related to excessive acid, caused by

anxiety, or GERD, especially when they've been a llifetime condition? here's

the detail and will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

Digna,

It must have been terrible to have all these symptoms for so long.I guess, in

chronic conditions, like yours, omeprazol is required. However, something you

might want to consider, since you said small frequent meals mostly tolerated and

since BMI is 22 (which, after the age of 70 is border-line low, as BMI 21, some

studies consider underwt/risk of malnutrition in this age group and up). In

other words - have you tried to focus on small more-frequent meals while trying

to titrate the meds further down, maybe start taking it every other day and then

twice a wk etc, while, maybe increasing the frequency of the meals to every

2-3hrs. You might gain wt a bit, but don't think it would be harmful.

But when I posted what I did, I spoke about the public at large. ppl are taking

OTC medications like it is sugar candy, thinking that OTC have no side effects,

which we all know they do.Also, today, I hope, ppl would know better not to

start chronic use of any meds, OTC or RX, at such young age as 16. But I might

be wrong. When my daughter was ~7yo it was the first time the PCP told us she

has high normal Chol (195). I told him that no way he would put my daughter on

meds at this age. I told him she is physically very active (runs a lot), we eat

healthy (most of the time) and here is a genetic component on her father's side,

so she was never on meds, to this day, 10 yrs later. I would not allow to start

" killing " her liver at this age. But, most people wouldn't know and MDs would

easily run for the Rx, which is the bigger problem, in my eyes. If we cannot

educate MDs not to write Rx so quickly (which is what they are trained for), how

can we expect that from the general public?

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: jennyvajda@...

From: dignacassens@...

Date: Sat, 3 Sep 2011 12:59:25 -0400

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

I've read with interest and conviction. Now my question is, what to do?

how to treat stomach problems whether related to excessive acid, caused by

anxiety, or GERD, especially when they've been a llifetime condition? here's

the detail and will appreciate all input and possible approaches.

Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5 years GERD,

excessive acid, reflux, stomach empties rapidly but is small capacity. Small

multiple meals tolerated fairly well exept when bouts of pain, reflux. During

that time even innocuous foods such as plain yogurt, cooked cereals, potatoes &

rice cause extreme pain & often vomiting.

Chronic omeprazol use for 3 years, started on 40 mg now titrating in 10 mg

increments. 20 mg minimum to have results but still, depending on the day or

food some pain and acidity or what feels like it. Excessively gassy stomach also

a problem. With nexium experienced naggy cough, but not so much w lower doses of

omeprazol OTC.

Any ideas? what to do about stomach pain and inability to eat enough? weight

loss is sporadic but can maintain desired weight most of the time just by

ingesting higher calorie foods when eating. BMI 22.

TIA

Digna

--

Digna Cassens, MHA, RD

Cassens Associates

Diversified Nutrition Consulting Services

---- Vajda wrote:

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

my third most viewed article. still only a trickle but a voice in the woods, a

light in the dark.

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa <rd-usa >

Sent: Fri, September 2, 2011 6:57:45 PM

Subject: RE: Stomach acid suppressing meds may cause damage to

intestine

Watching a commercial for Omeprazole....The problem with PPIs & H2 Receptor

Antagonists is on few levels:1. It is OTC, in most, if not all cases (and this

country loves pills and quick solutions)2. MDs love them too, especially the

purple one (nexium). WHile there is an excuse to give them to ppl on vents, I am

having hard time convincing MDs to D/C these meds in ppl who are not on

mechanical vents.3. the pharma companies, of course, are paying $$$ for

primetime commercials, while no one is speaking about these side effects (among

others, like anemia with LT use). After all, if, for example, MSNBC will talk

about the side effects of Omeprazole, they will lose the big $$$ that is paid

for its commercial (the one I just watched).

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: cda-listserv

From: Dineright4@...

Date: Fri, 2 Sep 2011 12:19:44 -0400

Subject: Stomach acid suppressing meds may cause damage to intestine

As we all suspected - so many people on PPIs end up with GI issues

later.

And, then, the research that shows that GERD may just be a cytokine

response to certain foods, and not acid related at all - so a lot of people on

acid suppressants that should not be.

Let's see, God created stomach acid as part of a healthy body. Why do we

think turning our stomachs into a base environment is healthy for us?

More below.

Jan

Public release date: 1-Sep-2011

Contact: McGuire

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

90-552-

McMaster University

McMaster study finds more gut reaction to arthritis drugs

Stomach acid supressing drugs appear to cause damage to the small intestine

Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

stomach acid and reduce the chances they will develop ulcers from taking

their anti-inflammatory drugs for conditions such as arthritis, but the

combination may be causing major problems for their small intestines,

McMaster researchers have found.

A team from the Farncombe Family Digestive Health Research Institute has

found those stomach acid-reducing drugs, known as proton pump

inhibitors, may actually be aggravating damage in the small intestine

caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

In a study published in the medical journal Gastroenterology, principal

investigator Wallace says the extent of the hard-to-detect damage

caused to the small intestine has only recently been discovered through

use of small video cameras swallowed like pills.

" Suppressing acid secretion is effective for protecting the stomach from

damage caused by NSAIDs, but these drugs appear to be shifting the

damage from the stomach to the small intestine, where the ulcers may be

more dangerous and more difficult to treat, " said Wallace. He is

director of the Farncombe institute and professor of medicine of the

G. DeGroote School of Medicine at McMaster.

He added that the use of probiotics is being investigated as a potential

cure for the small intestine damage.

###

The study was funded by the Canadian Institutes of Health Research

(CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

For more information, please contact:

McGuire

Media Relations Coordinator

Faculty of Health Sciences

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

McGuire

Media Relations, Faculty of Health Sciences,

McMaster University

, ext. 22169

_vmcguir@..._

(http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

IMPORTANT: Effective immediately, our new mailing address

Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

L8N 3Z5

_http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

(http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

Reflux esophagitis due to immune reaction, not acute acid burn,

UT Southwestern researchers report

Dr Rhonda Souza

Dr Stuart

_SJSpechler@..._ (mailto:SJSpechler@...)

EMAIL HIM!!!

Media Contact: LaKisha Ladson

_lakisha.ladson@..._

(/mc/compose?to=lakisha.ladson@...)

DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

called gastroesophageal reflux disease (GERD) might not develop as a

direct result of acidic digestive juices burning the esophagus, UT

Southwestern Medical Center researchers have found in an animal study.

Rather, gastroesophageal reflux spurs the esophageal cells

to release chemicals called cytokines, which attract inflammatory cells

to the esophagus. It is those inflammatory cells, drawn to the esophagus

by cytokines, that cause the esophageal damage that is characteristic of

GERD. The condition is manifested by symptoms such as heartburn and

chest pain.

" Currently, we treat GERD by giving medications to prevent

the stomach from making acid, " said Dr. Rhonda Souza, associate

professor of internal medicine at UT Southwestern and lead author of the

study appearing the November issue of Gastroenterology. " But if GERD is

really an immune-mediated injury, 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, researchers created GERD in rats by

connecting the duodenum to the esophagus. This operation allows stomach

acid and bile to enter the esophagus. Researchers were surprised to

learn that esophagitis didn't develop for a number of weeks after the

operation.

" That doesn't make sense if GERD is really the result of an

acid burn, as we all were taught in medical school, " said Dr. Stuart

Spechler, professor of internal medicine at UT Southwestern and senior

author of the study. " Chemical injuries develop immediately. If you

spill battery acid on your hand, you don't have to wait a month to see

the damage. "

About 40 percent of Americans suffer symptoms of GERD at

some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

long term, GERD could eventually lead to esophageal cancer.

Previous studies had shown that if an animal esophagus is

perfused with highly concentrated acid, esophageal damage develops

quickly. In humans, however, the large majority of reflux episodes do

not contain such highly concentrated acid, Dr. Souza said.

" In animal models of reflux esophagitis designed to mimic

the human disease, researchers hadn't looked at the early events in the

development of esophageal injury, " Dr. Souza noted. " Most of those

investigators have been interested in the long-term consequences of

GERD, and we found virtually no published data about what happens later

that induces gastroesophageal reflux. "

Dr. Souza, who is also a staff physician at the Dallas

Veterans Affairs Medical Center and part of the Harold C.

Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

of gastroenterology at the Dallas VA, said the method they used to

produce GERD in rats is a reasonable representation of how GERD develops

in humans - acidic digestive juices from the stomach surge into the

esophagus.

Soon after the operation, they expected to see the death of

surface cells of the esophagus, and they expected to see the injury

progress later to the deeper layers. Instead, they found the opposite.

Three days after the surgery, there was no damage to surface cells, but

the researchers did find inflammatory cells in the deeper layers of the

esophagus. Those inflammatory cells didn't rise to the surface layer

until three weeks after the initial acid exposure.

The next step for researchers is to conduct additional

studies in humans.

Other UT Southwestern researchers involved in the study

included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

instructor of internal medicine; Dr. Genta, clinical professor of

pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

both research associates in internal medicine.

The study was supported by the Dallas VA Medical Center and

the National Institutes of Health.

Visit _http://www.utsouthwestern.org/digestive_

(http://www.utsouthwestern.org/digestive) to learn

about UT Southwestern's clinical services for digestive disorders.

###

This news release is available on our World Wide Web home page at

_http://www.utsouthwestern.edu/home/news/index.html_

(http://www.utsouthwestern.edu/home/news/index.html)

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Link to comment
Share on other sites

I am back. In case any of you don't like taking the flu shot I just finished 2

weeks in bed, 2 weeks dragging and 2 rounds of prednasone thanks to some

fisherman who brought it into town. It has been years since I have heard anyone

recommend Fenugreek. This may be very useful in the elderly population it makes

a nice tea that is sweet with out sugar but really sweet with any sweetener

added. Fenugreek is frequently used in maple syrup subs. I frequently find that

the elderly like sweets and a nice cup of sweet tea that soothes the whole GI

track has some really good points. On top of that it has a very long tract

record of daily use without problems.

Jackie Chase RD

Dillingham AK

> based on my recent readings limiting the glutamate content of the diet may

also

> be crucial for wound healing/diabetes/osteoporosis and senility but that rules

> out most of the processed world of food so on to simpler ingredient

discussions

> instead . . .

>

> add a few spoonfuls of slippery elm powder or marshmallow root powder to

cooked

> cereals based on barley, quinoa, millet or plain whole oats - leave off any

> opportunities for mystery ingredients to enter into your HAACP chain. The

> healthy starches of the slippery elm powder or the possibly cheaper

marshmallow

> root are helpful to build the protective glycocalyx lining the intestines.

> Fenugreek is another super starch herb as well as cinnamon (1/2 tsp day for

the

> cinnamon \effevctive dose). Sweet potato and canned carrots, canned pears or

> peaches would be good smoothie bases (fresh would certainly be better but I've

> been trying to think of ideas for use within the current inventory room).

>

>

Link to comment
Share on other sites

I am back. In case any of you don't like taking the flu shot I just finished 2

weeks in bed, 2 weeks dragging and 2 rounds of prednasone thanks to some

fisherman who brought it into town. It has been years since I have heard anyone

recommend Fenugreek. This may be very useful in the elderly population it makes

a nice tea that is sweet with out sugar but really sweet with any sweetener

added. Fenugreek is frequently used in maple syrup subs. I frequently find that

the elderly like sweets and a nice cup of sweet tea that soothes the whole GI

track has some really good points. On top of that it has a very long tract

record of daily use without problems.

Jackie Chase RD

Dillingham AK

> based on my recent readings limiting the glutamate content of the diet may

also

> be crucial for wound healing/diabetes/osteoporosis and senility but that rules

> out most of the processed world of food so on to simpler ingredient

discussions

> instead . . .

>

> add a few spoonfuls of slippery elm powder or marshmallow root powder to

cooked

> cereals based on barley, quinoa, millet or plain whole oats - leave off any

> opportunities for mystery ingredients to enter into your HAACP chain. The

> healthy starches of the slippery elm powder or the possibly cheaper

marshmallow

> root are helpful to build the protective glycocalyx lining the intestines.

> Fenugreek is another super starch herb as well as cinnamon (1/2 tsp day for

the

> cinnamon \effevctive dose). Sweet potato and canned carrots, canned pears or

> peaches would be good smoothie bases (fresh would certainly be better but I've

> been trying to think of ideas for use within the current inventory room).

>

>

Link to comment
Share on other sites

 Herbs for Health & Healing by Laidlaw, RD,   has the following info

regarding Fernugreek:   Orally it can help in lowering blood sugars, and it

has the ability to lower cholesterol.  Typical dose is 5 grams of seed bid. 

But states there is a side effect of gas and possible diarrhea.   There is an

potential interaction with anticoagulants, corticosteriods, hormone therapy and

some diabetic drugs.  

Save the planet earth  -- it is the only one with chocolate 

 

Most internet quotations are not accurate. " — Abraham Lincoln

To: rd-usa

Sent: Thursday, September 8, 2011 9:32 AM

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

 

I am back. In case any of you don't like taking the flu shot I just finished 2

weeks in bed, 2 weeks dragging and 2 rounds of prednasone thanks to some

fisherman who brought it into town. It has been years since I have heard anyone

recommend Fenugreek. This may be very useful in the elderly population it makes

a nice tea that is sweet with out sugar but really sweet with any sweetener

added. Fenugreek is frequently used in maple syrup subs. I frequently find that

the elderly like sweets and a nice cup of sweet tea that soothes the whole GI

track has some really good points. On top of that it has a very long tract

record of daily use without problems.

Jackie Chase RD

Dillingham AK

> based on my recent readings limiting the glutamate content of the diet may

also

> be crucial for wound healing/diabetes/osteoporosis and senility but that rules

> out most of the processed world of food so on to simpler ingredient

discussions

> instead . . .

>

> add a few spoonfuls of slippery elm powder or marshmallow root powder to

cooked

> cereals based on barley, quinoa, millet or plain whole oats - leave off any

> opportunities for mystery ingredients to enter into your HAACP chain. The

> healthy starches of the slippery elm powder or the possibly cheaper

marshmallow

> root are helpful to build the protective glycocalyx lining the intestines.

> Fenugreek is another super starch herb as well as cinnamon (1/2 tsp day for

the

> cinnamon \effevctive dose). Sweet potato and canned carrots, canned pears or

> peaches would be good smoothie bases (fresh would certainly be better but I've

> been trying to think of ideas for use within the current inventory room).

>

>

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 Herbs for Health & Healing by Laidlaw, RD,   has the following info

regarding Fernugreek:   Orally it can help in lowering blood sugars, and it

has the ability to lower cholesterol.  Typical dose is 5 grams of seed bid. 

But states there is a side effect of gas and possible diarrhea.   There is an

potential interaction with anticoagulants, corticosteriods, hormone therapy and

some diabetic drugs.  

Save the planet earth  -- it is the only one with chocolate 

 

Most internet quotations are not accurate. " — Abraham Lincoln

To: rd-usa

Sent: Thursday, September 8, 2011 9:32 AM

Subject: Re: Stomach acid suppressing meds may cause damage to

intestine

 

I am back. In case any of you don't like taking the flu shot I just finished 2

weeks in bed, 2 weeks dragging and 2 rounds of prednasone thanks to some

fisherman who brought it into town. It has been years since I have heard anyone

recommend Fenugreek. This may be very useful in the elderly population it makes

a nice tea that is sweet with out sugar but really sweet with any sweetener

added. Fenugreek is frequently used in maple syrup subs. I frequently find that

the elderly like sweets and a nice cup of sweet tea that soothes the whole GI

track has some really good points. On top of that it has a very long tract

record of daily use without problems.

Jackie Chase RD

Dillingham AK

> based on my recent readings limiting the glutamate content of the diet may

also

> be crucial for wound healing/diabetes/osteoporosis and senility but that rules

> out most of the processed world of food so on to simpler ingredient

discussions

> instead . . .

>

> add a few spoonfuls of slippery elm powder or marshmallow root powder to

cooked

> cereals based on barley, quinoa, millet or plain whole oats - leave off any

> opportunities for mystery ingredients to enter into your HAACP chain. The

> healthy starches of the slippery elm powder or the possibly cheaper

marshmallow

> root are helpful to build the protective glycocalyx lining the intestines.

> Fenugreek is another super starch herb as well as cinnamon (1/2 tsp day for

the

> cinnamon \effevctive dose). Sweet potato and canned carrots, canned pears or

> peaches would be good smoothie bases (fresh would certainly be better but I've

> been trying to think of ideas for use within the current inventory room).

>

>

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Share on other sites

So, I read this and all the responses. What I did NOT read is the good,

old fashioned " 4R " process? I no longer provide nutrition services, but

this is where I'd start with a case like this.

Ok, guys, remind me of all the " Rs " : Remove, repair, re-inocculate.. and

can't remember the last " R " . I know we have some CCNs on the list...

I'd also consider LEAP.

Margie

Marjorie Geiser, MBA, RD, NSCA-CPT

Immediate Past-Chair, NE DPG #30

http://www.meg-enterprises.com

http://www.facebook.com/meg.enterprises

Business coach, author, speaker

" Just Jump: The No-Fear Business Start-Up Guide for Health and Fitness

Professionals "

>

> I've read with interest and conviction. Now my question is, what to

> do? how to treat stomach problems whether related to excessive acid,

> caused by anxiety, or GERD, especially when they've been a llifetime

> condition? here's the detail and will appreciate all input and

> possible approaches.

>

> Age 72 - Upper GI problems onset 16y.o. @ 17 stomach bleed. Last 5

> years GERD, excessive acid, reflux, stomach empties rapidly but is

> small capacity. Small multiple meals tolerated fairly well exept when

> bouts of pain, reflux. During that time even innocuous foods such as

> plain yogurt, cooked cereals, potatoes & rice cause extreme pain &

> often vomiting.

>

> Chronic omeprazol use for 3 years, started on 40 mg now titrating in

> 10 mg increments. 20 mg minimum to have results but still, depending

> on the day or food some pain and acidity or what feels like it.

> Excessively gassy stomach also a problem. With nexium experienced

> naggy cough, but not so much w lower doses of omeprazol OTC.

>

> Any ideas? what to do about stomach pain and inability to eat enough?

> weight loss is sporadic but can maintain desired weight most of the

> time just by ingesting higher calorie foods when eating. BMI 22.

>

> TIA

> Digna

>

> --

> Digna Cassens, MHA, RD

> Cassens Associates

> Diversified Nutrition Consulting Services

>

> ---- Vajda <jennyvajda@...

> <mailto:jennyvajda%40sbcglobal.net>> wrote:

>

http://gingerjens.blogspot.com/2011/03/prilosec-prevacid-and-nexium-use-may.html

> my third most viewed article. still only a trickle but a voice in the

> woods, a

> light in the dark.

>

> R Vajda, R.D.

> www.GingerJens.com

>

>

> ________________________________

> From: Merav Levi <meravls@... <mailto:meravls%40msn.com>>

> To: rd-usa <rd-usa <mailto:rd-usa%40yahoogroups.com>>

> Sent: Fri, September 2, 2011 6:57:45 PM

> Subject: RE: Stomach acid suppressing meds may cause damage to

> intestine

>

> Watching a commercial for Omeprazole....The problem with PPIs & H2

> Receptor

> Antagonists is on few levels:1. It is OTC, in most, if not all cases

> (and this

> country loves pills and quick solutions)2. MDs love them too,

> especially the

> purple one (nexium). WHile there is an excuse to give them to ppl on

> vents, I am

> having hard time convincing MDs to D/C these meds in ppl who are not on

> mechanical vents.3. the pharma companies, of course, are paying $$$ for

> primetime commercials, while no one is speaking about these side

> effects (among

> others, like anemia with LT use). After all, if, for example, MSNBC

> will talk

> about the side effects of Omeprazole, they will lose the big $$$ that

> is paid

> for its commercial (the one I just watched).

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the

> moments that

> take your breath away. " - Carlin " People don't forget the truth,

> they just

> become better in lying " (Revolutionary Road)

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> CC: cda-listserv <mailto:cda-listserv%40yahoogroups.com>

> From: Dineright4@... <mailto:Dineright4%40aol.com>

> Date: Fri, 2 Sep 2011 12:19:44 -0400

> Subject: Stomach acid suppressing meds may cause damage to

> intestine

>

> As we all suspected - so many people on PPIs end up with GI issues

> later.

>

> And, then, the research that shows that GERD may just be a cytokine

>

> response to certain foods, and not acid related at all - so a lot of

> people on

>

> acid suppressants that should not be.

>

> Let's see, God created stomach acid as part of a healthy body. Why do we

>

> think turning our stomachs into a base environment is healthy for us?

>

> More below.

>

> Jan

>

> Public release date: 1-Sep-2011

>

> Contact: McGuire

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> 90-552-

>

> McMaster University

>

> McMaster study finds more gut reaction to arthritis drugs

>

> Stomach acid supressing drugs appear to cause damage to the small

> intestine

>

> Hamilton, ON (Sept. 1, 2011) – Patients often take drugs to lower

>

> stomach acid and reduce the chances they will develop ulcers from taking

>

> their anti-inflammatory drugs for conditions such as arthritis, but the

>

> combination may be causing major problems for their small intestines,

>

> McMaster researchers have found.

>

> A team from the Farncombe Family Digestive Health Research Institute has

>

> found those stomach acid-reducing drugs, known as proton pump

>

> inhibitors, may actually be aggravating damage in the small intestine

>

> caused by the nonsteroidal anti-inflammatory drugs, also known as NSAIDs.

>

> In a study published in the medical journal Gastroenterology, principal

>

> investigator Wallace says the extent of the hard-to-detect damage

>

> caused to the small intestine has only recently been discovered through

>

> use of small video cameras swallowed like pills.

>

> " Suppressing acid secretion is effective for protecting the stomach from

>

> damage caused by NSAIDs, but these drugs appear to be shifting the

>

> damage from the stomach to the small intestine, where the ulcers may be

>

> more dangerous and more difficult to treat, " said Wallace. He is

>

> director of the Farncombe institute and professor of medicine of the

>

> G. DeGroote School of Medicine at McMaster.

>

> He added that the use of probiotics is being investigated as a potential

>

> cure for the small intestine damage.

>

> ###

>

> The study was funded by the Canadian Institutes of Health Research

>

> (CIHR) and a CIHR/Canadian Association of Gastroenterology Fellowship.

>

> For more information, please contact:

>

> McGuire

>

> Media Relations Coordinator

>

> Faculty of Health Sciences

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> McGuire

>

> Media Relations, Faculty of Health Sciences,

>

> McMaster University

>

> , ext. 22169

>

> _vmcguir@... <mailto:_vmcguir%40mcmaster.ca>_

>

> (http://us.mc840.mail.yahoo.com/mc/compose?to=vmcguirmcmaster (DOT) ca)

>

> IMPORTANT: Effective immediately, our new mailing address

>

> Mailing Address: 1280 Main Street West, HSC 2E46, Hamilton, ON L8S 4K1

>

> For Courier Deliveries: 1200 Main Street West, HSC 2E46, Hamilton, ON

>

> L8N 3Z5

>

> _http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php_

>

> (http://www.eurekalert.org/pub_releases/2011-09/mu-msf090111.php)

>

> Reflux esophagitis due to immune reaction, not acute acid burn,

>

> UT Southwestern researchers report

>

>

>

> Dr Rhonda Souza

>

> Dr Stuart

>

> _SJSpechler@... <mailto:_SJSpechler%40aol.com>_

> (mailto:SJSpechler@... <mailto:SJSpechler%40aol.com>)

>

> EMAIL HIM!!!

>

> Media Contact: LaKisha Ladson

>

>

>

> _lakisha.ladson@...

> <mailto:_lakisha.ladson%40utsouthwestern.edu>_

>

> (/mc/compose?to=lakisha.ladson@...

> <mailto:%2Fmc%2Fcompose%3Fto%3Dlakisha.ladson%40utsouthwestern.edu>)

>

> DALLAS - Nov. 19, 2009 - Contrary to current thinking, a condition

>

> called gastroesophageal reflux disease (GERD) might not develop as a

>

> direct result of acidic digestive juices burning the esophagus, UT

>

> Southwestern Medical Center researchers have found in an animal study.

>

> Rather, gastroesophageal reflux spurs the esophageal cells

>

> to release chemicals called cytokines, which attract inflammatory cells

>

> to the esophagus. It is those inflammatory cells, drawn to the esophagus

>

> by cytokines, that cause the esophageal damage that is characteristic of

>

> GERD. The condition is manifested by symptoms such as heartburn and

>

> chest pain.

>

> " Currently, we treat GERD by giving medications to prevent

>

> the stomach from making acid, " said Dr. Rhonda Souza, associate

>

> professor of internal medicine at UT Southwestern and lead author of the

>

> study appearing the November issue of Gastroenterology. " But if GERD is

>

> really an immune-mediated injury, 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, researchers created GERD in rats by

>

> connecting the duodenum to the esophagus. This operation allows stomach

>

> acid and bile to enter the esophagus. Researchers were surprised to

>

> learn that esophagitis didn't develop for a number of weeks after the

>

> operation.

>

> " That doesn't make sense if GERD is really the result of an

>

> acid burn, as we all were taught in medical school, " said Dr. Stuart

>

> Spechler, professor of internal medicine at UT Southwestern and senior

>

> author of the study. " Chemical injuries develop immediately. If you

>

> spill battery acid on your hand, you don't have to wait a month to see

>

> the damage. "

>

> About 40 percent of Americans suffer symptoms of GERD at

>

> some point, and 20 percent on a weekly basis, Dr. Souza said. Over the

>

> long term, GERD could eventually lead to esophageal cancer.

>

> Previous studies had shown that if an animal esophagus is

>

> perfused with highly concentrated acid, esophageal damage develops

>

> quickly. In humans, however, the large majority of reflux episodes do

>

> not contain such highly concentrated acid, Dr. Souza said.

>

> " In animal models of reflux esophagitis designed to mimic

>

> the human disease, researchers hadn't looked at the early events in the

>

> development of esophageal injury, " Dr. Souza noted. " Most of those

>

> investigators have been interested in the long-term consequences of

>

> GERD, and we found virtually no published data about what happens later

>

> that induces gastroesophageal reflux. "

>

> Dr. Souza, who is also a staff physician at the Dallas

>

> Veterans Affairs Medical Center and part of the Harold C.

>

> Comprehensive Cancer Center at UT Southwestern, and Dr. Spechler, chief

>

> of gastroenterology at the Dallas VA, said the method they used to

>

> produce GERD in rats is a reasonable representation of how GERD develops

>

> in humans - acidic digestive juices from the stomach surge into the

>

> esophagus.

>

> Soon after the operation, they expected to see the death of

>

> surface cells of the esophagus, and they expected to see the injury

>

> progress later to the deeper layers. Instead, they found the opposite.

>

> Three days after the surgery, there was no damage to surface cells, but

>

> the researchers did find inflammatory cells in the deeper layers of the

>

> esophagus. Those inflammatory cells didn't rise to the surface layer

>

> until three weeks after the initial acid exposure.

>

> The next step for researchers is to conduct additional

>

> studies in humans.

>

> Other UT Southwestern researchers involved in the study

>

> included Dr. Xiaofang Huo, postdoctoral researcher in internal medicine;

>

> Dr. Vivek Mittal, postgraduate trainee in internal medicine; Dr. ne

>

> Carmack, postgraduate trainee in pathology: Dr. Huiying Zhang,

>

> instructor of internal medicine; Dr. Genta, clinical professor of

>

> pathology and internal medicine; Dr. Kathy Hormi-Carver, assistant

>

> professor of internal medicine; and Dr. Xi Zhang and Dr. Chunhua Yu,

>

> both research associates in internal medicine.

>

> The study was supported by the Dallas VA Medical Center and

>

> the National Institutes of Health.

>

> Visit _http://www.utsouthwestern.org/digestive_

>

> (http://www.utsouthwestern.org/digestive) to learn

>

> about UT Southwestern's clinical services for digestive disorders.

>

> ###

>

> This news release is available on our World Wide Web home page at

>

> _http://www.utsouthwestern.edu/home/news/index.html_

>

> (http://www.utsouthwestern.edu/home/news/index.html)

>

> Jan Patenaude, RD, CLT

>

> Director of Medical Nutrition

>

> Signet Diagnostic Corp.

>

> Telecommuting Nationwide

>

> (Mountain Time)

>

> Fax:

>

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

>

> Certified LEAP Therapist (CLT) Training Course.

>

>

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