Diseases & Conditions Archive

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).

Having cataracts removed does not increase the risk of age-related macular degeneration (AMD), scientists report in the journal Ophthalmology. A cataract occurs when the natural lens of the eye becomes cloudy. Surgery removes the cloudy lens, but this allows more light—especially higher-energy blue light—to reach the light-sensing retina in the back of the eye. Some doctors have been concerned that the more intense light impinging on the retina could damage it and lead to AMD, a cause of vision loss in older adults.

The study involved more than 2,000 people 65 and older who had cataracts removed at Westmead Hospital in Sydney, Australia. A subset of them had cataracts removed in only one eye, allowing the doctors to see if the operated eye was any more likely to develop AMD than the non-operated eye. Over the three years the participants were followed, doctors saw no difference between the operated and non-operated eyes, confirming that in this group of people, cataract surgery does not raise the risk of AMD.

New evidence shows lycopene is not just a cancer fighter.

Here's another reason to savor tomatoes: a recent study in Neurology finds they may help lower your risk of ischemic stroke—blockage of a brain artery that starves cells of oxygen and causes them to die. "We don't understand it entirely yet, but the lycopene in tomatoes may have specific properties that protect the cell in a way other antioxidants may not," says Dr. Edward Giovannucci, a professor of nutrition and epidemiology at the Harvard School of Public Health.

Q. I heard there is a new pneumonia shot. Is it better than the old one?

A. The older pneumonia shot is the pneumococcal polysaccharide vaccine. It's recommended for all men over age 65 and anyone with certain medical conditions, such as lung disease, diabetes, heart disease, and problems with the immune system. The vaccine protects against 23 kinds of pneumococcus, which is the most common cause of bacterial pneumonia. Vaccination might not prevent you from ever getting pneumonia, but it could keep you out of the hospital and prevent the infection from spreading to your brain or bloodstream.

Are you fishing for a way to lower your risk of stroke? If so, put that jar of omega-3 supplements back on the shelf and head for the seafood aisle, according to a science review in BMJ.

Researchers identified published studies that examined the links between stroke and either consumption of fish or intake of omega-3 fatty acids. The search identified 39 separate studies involving a total of 794,000 individuals. Here are the main findings:

A cup of beans or lentils each day, when combined with a low-glycemic diet, may help lower blood sugar levels and coronary artery disease risk in patients with type 2 diabetes. Legumes help dampen blood sugar responses and lower blood pressure.

The commonly used bone-strengthening drugs called bisphosphonates may provide the same level of benefit for men as they do for women. It appears the drug zoledronic acid (Reclast) significantly reduced spinal fractures in men with osteoporosis.

Q. At what percentage of blockage of the carotid artery do you consider surgery? I am a 73-year-old man with a 70% blockage, and my doctor says to wait a year and check back then.

A. As you know, your carotid arteries are the main blood supply to a large part of your brain. Blockages definitely pose a threat to the brain, but there are risks to the treatments as well.

Q. I've heard bariatric surgery can reduce type 2 diabetes. How about type 1?

A. People who are obese are more likely to develop type 2 diabetes. People who are obese and already have type 2 diabetes find it easier to control their diabetes if they lose weight. The link between obesity and type 2 diabetes is strong, and bariatric surgery can lead to substantial weight loss. So you wouldn't be surprised if the surgery reduced the risk for type 2 diabetes. Nevertheless, in a recent study from Sweden, the magnitude of the benefit was remarkable. The researchers identified over 3,000 obese people without diabetes and followed them for 15 years. The risk of developing type 2 diabetes in those who received bariatric surgery was 83% lower than in those who didn't receive the surgery. There are different types of bariatric surgery, but they are all designed to reduce the absorption of calories in the intestine. That surely accounts for part of the weight loss seen following the surgery. However, we're now learning that the surgery also changes the levels of various hormones that affect appetite and metabolism, and that this also contributes to the weight loss—and possibly the reduced risk of developing type 2 diabetes. Most people with type 1 diabetes, which usually starts in childhood, are not obese. There is little reason to perform bariatric surgery in such patients. However, if a patient with type 1 diabetes is obese, and diet and exercise can't get the weight off, bariatric surgery could make sense. Type 1 diabetes greatly increases the risk of heart disease, and so does obesity. Bariatric surgery might not make type 1 diabetes easier to control, but it could help reduce the risk of heart disease.