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New thinking on peripheral neuropathy

Nerve damage might be causing everything from low blood pressure to gastrointestinal distress without your knowing it.

Doctors have long known peripheral neuropathy as a nerve condition that causes reduced sensation, tingling, weakness, or pain in the feet and hands. But those symptoms may be just the tip of the iceberg. Doctors are now learning that neuropathy can cause many more problems.

What is peripheral neuropathy?

Peripheral neuropathy refers to damage to the peripheral nerves throughout the body. These nerves carry messages to and from the brain.

Why did the FDA issue a fecal transplant warning?

Ask the doctors

Q. I heard that the FDA recently issued a warning related to a specific treatment for Clostridium difficile infections. Can you explain what this warning is about?

A. The FDA issued a warning in June aimed at health care providers who are using fecal transplants to treat Clostridium difficile (C. difficile) infections that have not responded to traditional treatments, such as antibiotics. Doctors perform fecal transplants (which are still considered investigational by the FDA) by introducing stool from a healthy donor into the gastrointestinal tract of the person infected with C. difficile. The introduction of healthful bacteria can sometimes treat the infection, which typically inflames the colon causing symptoms such as severe diarrhea, cramps, and fever. The FDA issued its warning after two immunocompromised adults developed infections from an antibiotic-resistant strain of Escherichia coli (E. coli) following transplants from stool contaminated with the bacteria. Both people got transplants from the same donor. One of the two people died following the infection. To prevent similar problems in the future, the FDA now recommends that doctors performing these transplants follow some new safety measures, including the following:

The state of gas

Excess gas can be annoying, but is it cause for concern?

Gas is a normal — yet embarrassing — part of digestion. "We're all pretty gassy as individuals," says Dr. Kyle Staller, a gastroenterologist with Harvard-affiliated Massachusetts General Hospital.

In fact, the average person produces between 1/2 and 1 liter of gas every day and passes gas about 10 to 20 times. "While people may not like it when they do it, especially at inappropriate times, it's just a sign of a regular, healthy digestive system at work," says Dr. Staller.

Colorectal cancer screening before age 50?

While the incidence of colorectal cancer has declined among older adults, it has increased in people younger than 50. The American Cancer Society now recommends that adults be screened for this condition starting at age 45.

By the way, doctor: Does long-term use of Prilosec cause stomach cancer?

Q. I've been taking Prilosec for many years for GERD. Recently, I once read that long-term use of proton pump inhibitors could increase the risk of stomach cancer. Your opinion?

A. Prilosec is a pump inhibitor (PPI). These drugs have revolutionized the treatment of gastroesophageal reflux disease (GERD), in which stomach acid flows back into the esophagus and causes heartburn.

By the way, doctor: What can I do about excessive belching and feeling full?

Q. I belch a lot and get a feeling of fullness in the upper abdomen. Is excessive belching  a common condition? What are the causes and cures? I would prefer natural remedies.

A. Belching and feeling full are normal, everyday experiences. So, what makes them "excessive"? There's no precise definition. But if you start belching or feeling full more often than you have in the past, or if belching and fullness are causing you distress and discomfort, then I'd consider that excessive belching and a problem that you should try to solve.

Eating more ultra-processed foods may shorten life span

In the journals

Need another reason to monitor your intake of ultra-processed foods? Cutting down on your amounts could help you live longer.

In an observational study published online Feb. 11, 2019, by JAMA Internal Medicine, almost 45,000 adults ages 45 and older completed several dietary assessments over a two-year period. On average, ultra-processed foods made up about 15% of their daily diet as measured in grams.

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