But here’s the good news. Researchers have pinpointed genetic mutations in patients with BE, EAC, or both. Because the changes are unique—none were found in individuals without esophageal disease—the findings could someday improve detection and save lives.

”In the future, finding genetic mutations will allow doctors to determine who is at risk for BE and EAC,” said Charis Eng, M.D., Ph.D., Chair and Founding Director of the Genomic Medicine Institute of Lerner Research Institute at Cleveland Clinic. “These represent new tools to empower patients and their physicians to begin increased clinical screening and, thus, preempt esophageal cancer from developing.”

The study, published in the July 27, 2011 issue of The Journal of the American Medical Association and led by Dr. Eng, was conducted from 2005 to 2010 at 16 institutions across the United States and involved 298 participants with BE, EAC, or both.

Utilizing the latest in genomics approaches and state-of-the art technology along with functional genomic validation, the group identified mutations in three genes—MSR1, ASCC1, and CTHRC1—in 11 percent of the study participants, indicative of a significant genetic predisposition. Mutations in MSR1 were the most common, affecting seven percent of the patients studied.

Geneticists explain that identifying predisposition genes also gives valuable insight into how the disease occurs. Preliminary evidence from this study suggests a role for specific molecular pathways, including inflammation, in the development of BE/EAC as well as a potential link of the mutated genes to additional cancers.

“We are absolutely thrilled to now know three distinct genes that link to BE/EAC,” said Dr. Eng. “This is essential for improving risk assessment, disease management, and saving lives.”

BE is related to gastroesophageal reflux disease. At present, no one can predict which patients with BE will develop esophageal cancer. Although the risk is low in most cases, cancer experts recommend that all BE patients undergo periodic exams to find and remove precancerous cells in the esophagus.

New Clues to All-Too-Common GI Diseases The Saturday Evening Post

Two recent warnings serve as important reminders for us (and our doctors) to always carefully weigh the risks as well as the benefits of taking medicines and dietary supplements.

Calcium Supplements for Bones

Controversial research linking calcium supplements to an increased risk of heart attack published in a leading British medical journal is raising eyebrows around the world.

“A paper published in the July 2010 issue of the prestigious British Medical Journal found from 11 randomized studies (around 12 000 participants) that healthy women treated with calcium supplements (without vitamin D) had about a 30% increase in the incidence of heart attacks compared with those treated with placebo,” explains heart rhythm expert Dr. Douglas Zipes. “Studies on dietary calcium intake do not show such an increase so the risk appears to be due to the calcium supplements alone. Calcium supplements reduce the risk of bone fractures by only about 10%, so the benefits of taking them may not outweigh the risks for most individuals.”

Researchers say that even a small increase might translate into large numbers of women at risk because of the widespread use of calcium supplements. Others note that the findings are not based on studies designed to prove cause and effect.

PPIs Reduce Stomach Acid

In May, the FDA reported that high doses or long-term use of popular proton pump inhibitor (PPI) medicines for chronic heartburn may increase the risk of hip, wrist, and spine fractures.

PPIs effectively reduce stomach acid to treat heartburn, gastroesophageal reflux, and ulcers—conditions that, left untreated, can have serious consequences.

As a precautionary step, however, revised labels on prescription and over-the-counter PPIs will reflect the increased risk of broken bones, say federal health experts.

Prescription PPIs are Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, Aciphex, and Vimovo.

Over-the-counter PPIs are Prilosec OTC (omeprazole), Zegerid OTC (omeprazole), and Prevacid 24HR (lansoprazole).

“Because these products are used by a great number of people, it’s important for the public to be aware of this possible increased risk,” said Joyce Korvick, MD, deputy director for safety in the FDA’s Division of Gastroenterology Products, in an FDA press release.

Advice for Consumers

“Before discontinuing any medicine and supplement, individuals should first check with their provider about specific risks and benefits,” advises Dr. Zipes.

Future research will better clarify the risks associated with calcium supplements and PPIs.

In the meantime, read and follow all product labels and talk to your health care professional about any concerns you have about using dietary supplements and drugs.

Click here for more from Dr. Zipes and his new book. The Black Widows | Saturday Evening Post

Drug Alerts The Saturday Evening Post

Margie S.

Virginia

A swallowing study may be helpful, advises dentist Mike Brennan, at the Sjogren’s Syndrome and Salivary Disorders Center, Carolina Medical Center in Charlotte, North Carolina.

“Patients who report excess saliva are often unable to clear normal amounts from the mouth because of poor muscle control in the face and mouth or swallowing difficulties,” explains Dr. Brennan. “A swallow study may be helpful when a spit test measures less than 1 mL (about 1/4 tsp) per minute.

“Overproduction of saliva is uncommon, but when present, it is sometimes related to: prescription medications Pilocarpine (for glaucoma) and lithium (to stabilize mood); exposure to heavy metals such as iron, lead, arsenic, and mercury; and organophosphorus (acetylcholinesterase) poisoning. Excess saliva production has also been associated with gastroesophageal reflux (GERD).

“Treatment options for excess saliva are medications to decrease salivary flow, physical therapy to improve muscular control, and, in certain cases, more invasive surgical techniques involving the salivary glands. Consulting a physician, oral medicine specialist, or dentist about these options is recommended.”

Excess Saliva The Saturday Evening Post

James,

Manteca, California

Nocturnal hyperhidrosis, commonly known as night sweats, may be triggered by an underlying condition, such as sleep apnea, overactive thyroid, diabetes, or gastroesophageal reflux disease. Medications to treat depression and fever may also be to blame. In rare cases, night sweats may signal a serious illness such as tuberculosis or even certain types of cancer, which is why it’s best to consult with a doctor, especially when the symptoms recur. In addition to addressing any underlying cause, doctors may prescribe injectable Robinul or oral propranolol to tame the excessive sweating.

Night Sweats Return The Saturday Evening Post