Digestive Health Archive

Ask the doctor

Q. I've read news reports that the heartburn drug I take may cause heart attacks. Should I worry about this?

A. Several studies have reported an association between proton-pump inhibitors (PPIs) and heart attacks. PPIs are medications for heartburn, such as omeprazole (Prilosec) and pantoprazole (Protonix). Overall, however, the evidence suggests these medications are not risky for your heart.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

The purpose of treating ductal carcinoma in situ (DCIS)—the earliest, noninvasive form of breast cancer (often called "precancer")—is to prevent those lesions from becoming invasive and thereby greatly reduce the risk of dying from breast cancer. As mammography has become more precise, it has detected more DCIS, and more women get treatment with surgery and often radiation as well. An analysis published online by JAMA Oncology on Aug. 20, 2015, adds to increasing questions about the best way to manage DCIS in most women diagnosed with it.

Canadian researchers analyzed 20 years of data from 108,000 women with DCIS in a database maintained by the National Cancer Institute. Most women were treated with lumpectomy, often followed by radiation, or mastectomy. The researchers found that treatment with radiation or mastectomy did not lower the overall breast cancer death rate in women with DCIS. It remained at 3.3%—the average death rate from all breast cancers. However there were some groups—including African American women and women under 40—in whom the death rate was higher (7% to 8%).

Q. I've been having abdominal pain that may be due to gallstones. Is surgery the best solution, or are there other things I can try first?

A. The first thing to determine is whether your abdominal pain is in fact due to gallstones. They typically cause pain on the upper right side or in the center of the abdomen just below the breastbone that radiates to the back or right shoulder. The pain is often brought on by eating—especially fatty foods—or may occur at night. Sometimes gallstone pain is accompanied by sweating, bloating, nausea, or vomiting.

Q. Some of my friends take saw palmetto supplements to reduce urinary problems caused by an overgrown prostate, which I was recently diagnosed with. My friends swear by it, but is there any good evidence this stuff helps? Is saw palmetto safe?

A. The short answer is that we don't have great scientific evidence that taking saw palmetto truly reduces male urinary problems. On the other hand, it doesn't appear to cause major side effects either.

Q. I am currently receiving annual chest CT scans to check for hidden lung cancer (I used to be a heavy smoker). Should I be concerned about the cumulative effects of radiation exposure?

A. Radiation from medical scans can cause cancer, but the level of exposure considered potentially dangerous appears to be many times greater than the average CT scan. In addition, cancer from medical scans takes decades to develop, which makes it less of a concern for men being screened for lung cancer, which is currently only recommended for current or former smokers ages 55 and older. Radiation from CT scans is a bigger concern for children and young adults, who have more time to develop cancer after exposure to medical x-rays.

For optimal results, you need to take your medication regularly and time it correctly to your meals.

Have you tried to cool the burning discomfort of heartburn with medication and failed to get full relief? If so, a few simple adjustments to optimize your treatment may be all you need.

You may drink coffee because it tastes good or helps you wake up. But the popular brew is also associated with health benefits, such as reducing the risk for heart disease, stroke, and type 2 diabetes. Now a study from Harvard-affiliated Dana-Farber Cancer Institute published Aug. 17, 2015, in the Journal of Clinical Oncology suggests that regular consumption of caffeinated coffee may be associated with a reduced recurrence of colon cancer, and even a reduced risk of death. The study included nearly 1,000 people with stage 3 colon cancer. They filled out questionnaires about their dietary patterns during chemotherapy, and then again six months after treatment was completed. People who drank four or more cups of coffee per day were 42% less likely to have cancer return than non-coffee drinkers, and were 34% less likely to die from cancer or any other cause.

This type of study doesn't prove that coffee drinking caused the lower chance of cancer recurrence and death. A randomized trial is needed to show cause and effect. But researchers are encouraged by the results. "Regular coffee intake has been associated with a reduced risk of type 2 diabetes, and it may be that through a similar mechanism, coffee may also improve outcomes for people with advanced colon cancer," says Dr. Charles Fuchs, senior author on the paper.

Improve digestive health by addressing underlying causes of irregularity, as well as fluids, diet, and exercise.