Digestive Health Archive


Heartburn surgery outlasts drugs

Surgery for chronic heartburn relieves symptoms better than medication even after five years, according to a study in BMJ. Acid-reducing medications curb the symptoms of gastroesophageal reflux disease (GERD), in which caustic stomach contents back up (reflux) into the throat. Some men who don't want to take medication indefinitely could have a procedure, called fundoplication, to tighten up the base of the esophagus and reduce reflux. Surgery relieves GERD symptoms quickly, but does it last?

To find out, researchers compared two groups of people treated for GERD. One group was offered fundoplication and the others were kept on medication. After five years, those who had surgery reported fewer symptoms, and only a low percentage had complications. Surgery for GERD comes with a small risk of complications, so it should be considered carefully as a medication alternative. But for those who do choose fundoplication, this study suggests, surgery works better over the long term than medication.

Testing for the 'ulcer bug' makes daily aspirin safer

Being tested for the bacteria that cause many ulcers and having the infection quashed with antibiotics can prevent ulcers in many people who take daily aspirin for heart protection, suggests a study in Gastroenterology.

Daily low-dose aspirin can prevent a heart attack, but it may also put you at risk for peptic ulcers—sores in the stomach and upper intestine. Two factors that predispose aspirin users to this kind of trouble are a history of ulcers and infection with Helicobacter pylori, the bacterium that causes most peptic ulcers.

Natural ways to relieve constipation

Dietary changes, medications, and a lack of exercise often contribute to constipation in older women. Getting plenty of fiber and drinking four to six glasses of fluid each day are the best ways to prevent-and treat-constipation.

Considering a gluten-free diet

People with celiac disease must avoid all foods that contain the protein gluten, found in wheat, barley, rye, and other grains. Those with nonceliac gluten sensitivity can also benefit from a gluten-free diet.

Ask the doctor: Will probiotics help IBS?

Q. I have chronic diarrhea because of irritable bowel syndrome (IBS). Should I take probiotics?

A. Probiotics are live microbes that are taken in capsule or powder form. They're also available in some yogurt products. Probiotics are thought to help with intestinal problems by restoring bacterial balance in the gut and possibly by affecting the immune system. Many strains of bacteria and a strain of yeast are used as probiotics, but they don't all have the same effectiveness.

What you should know about: PPIs

If you suffer from chronic heartburn or another digestive disorder, you may have been prescribed a proton-pump inhibitor (PPI), which helps reduce the production of stomach acid. There are several different types of PPIs. Prescription-only PPIs include esomeprazole (Nexium) and pantoprazole (Protonix). Some PPIs are also available over the counter, including lansoprazole (Prevacid) and omeprazole (Prilosec).

How they work

PPIs work by inhibiting certain stomach cells from "pumping" acid into the stomach. When taken 30 to 60 minutes before a meal, PPIs can prevent or reduce heartburn. However, they do not work as well when taken on demand as they do when taken over a period of time. And while PPIs are generally safe when used in the short term, they do carry some risks in the long term. Unfortunately, the medications tend to be overused. "I think a lot of people get heartburn from taking medications or ingesting certain food and drinks. To treat their symptoms they get PPIs over the counter or from their physicians," says Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

Heartburn medication side effects: Should you worry?

Proton pump inhibitors (PPIs) are safe for most people, but also have potential risks you should know about.

Have you heard in the news about infections and other dangerous side effects from heartburn medications? Should you stop taking yours? If you take a drug to ease heartburn, you may have already discussed these concerns with your doctor. There are several kinds of heartburn medications, but the type under fire are the proton-pump inhibitors (PPIs). Six of these are available in the United States (see table, right).

No need for ulcer drugs after eradicating H. pylori bacteria?

After eliminating the bacterial infection that causes bleeding peptic ulcers, it may not be necessary to continue taking acid-reducing medications, according to a study in the American Journal of Gastroenterology.

Infection with the Helicobacter pylori bacteria causes ulcers. People with ulcers commonly take a drug to reduce stomach acid secretion. It's been unclear whether people should continue taking these drugs after being treated for H. pylori infection.

Stomach-soothing steps for heartburn

First, change the behaviors that contribute to heartburn. If the pain persists, medications called PPIs are highly effective.

Are you bothered by burning behind the breastbone after eating? You are not alone. One-third of us suffer from heartburn, typified by a pain and irritation in the upper gut. The underlying trouble is usually a condition called gastroesophageal reflux disease (GERD).

Not requiring a co-pay boosts colorectal screening

Eliminating co-pays may convince more people to seek colorectal cancer screening. Under the Affordable Care Act (ACA) insurers can't always charge co-pays for certain preventive procedures. In a study in Clinical Gastroenterology and In 2009, the first year the ACA's co-pay limit went into effect, the percentage of people who underwent colonoscopy increased by 18%.

People often avoid colonoscopy because of the bowel-purging "prep" it requires. However, under the ACA anyone ages 50-75 can get colonoscopy paid for every 10 years. Although a preventive service may be fully covered, the visit to the doctor's office could still carry a co-pay.

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