Digestive Health Blog

Colonoscopy achieves protection from colon cancer

info@digestivehealth.com.au — Tue, 15 Feb 2011 10:50:51 +1100

A recently publshed article confirms Gastroenterologist's opinion that colonoscopy performed during the previous 10 years of a patients life has proven to be associated with a 77% lower risk for colon cancer. Colonoscopy was associated with an 84% lower risk for bowel cancer in the left colon and a 56% lower risk in the right colon. Reduced colon cancer risk was observed for all stages of cancer and in patients who had undergone colonoscopy for screening or other indications.

Every study that has examined this issue has found better protection against colon cancer when a colonoscopy is performed by gastroenterologists compared with other medical practitioners or surgeons.

Brenner H et al. Ann Intern Med Jan 4 2011

Budesonide Is Effective in Patients With Eosinophilic Oesophagitis

info@digestivehealth.com.au — Tue, 7 Dec 2010 10:31:53 +1100

Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease of the oesophagus characterized by dense tissue eosinophilia; This condition typically effects younger people, and presents with difficulty swallowing (dysphagia) and recurrent bouts of food "getting stuck" (food bolus obstruction).

A recently published trail evaluated the effect of oral budesonide (1 mg twice daily for 15 days) in patients with EoE. Pretreatment and posttreatment disease activity was assessed clinically, at Gastroscopy, and using biopsies (counting the number of eosinophils per high-power field [hpf] = oesophageal eosinophil load).

Results

A 15-day course of therapy significantly decreased the number of eosinophils in the oesophageal epithelium in patients given budesonide (from 68.2 to 5.5 eosinophils/hpf; P < .0001) but not in the placebo group (from 62.3 to 56.5 eosinophils/hpf; P = .48). Dysphagia scores significantly improved among patients given budesonide compared with those given placebo (5.61 vs 2.22; P < .0001). No serious adverse events were observed.

Conclusions

A 15-day course of treatment with budesonide is well tolerated and highly effective in inducing a histologic and clinical remission in adolescent and adult patients with active EoE. Budesonide can be made up into an oral viscous solution using 5 sachets of splenda (sucralose) mixed with 1mg nebule of budesonide. Published

November issue "Gastroenterology"

Is Undiagnosed Coeliac Disease Important?

info@digestivehealth.com.au — Thu, 4 Nov 2010 10:12:28 GMT

Coeliac disease sometimes is diagnosed by chance (i.e., at Gastroscopy or on screening blood tests) in patients without typical symptoms.

Thus, we need to know whether undiscovered or asymptomatic Coeliac disease leads to an excess mortality or complications.

The Mayo Clinic researchers analyzed stored blood samples, obtained between 1995 and 2001, from nearly 17,000 adults without known Coeliac disease; 129 people (0.8%) had undiagnosed Coeliac disease, based on positive blood test results ( Tissue transglutaminase and endomysial antibodies).

During average follow-up of 10 years, all-cause mortality and cancer-specific mortality were similar in the groups, as was the prevalence of various gastrointestinal symptoms (e.g., diarrhea, weight loss, abdominal pain). From a long list of diseases, only osteoporosis and hypothyroidism (under active thoid function) were more prevalent among case patients than among controls.

During the 10-year follow-up, 20 of the 129 patients with undiagnosed Coeliac disease (but no controls) ultimately received clinical diagnoses of Coeliac disease — most often during evaluation of iron deficiency.

Comment: In this study, middle-aged and older adults with undiagnosed Coeliac disease were not at obvious risk for premature death or major morbidity during a decade of observation. Thus, the value of a gluten-free diet among older adults with asymptomatic Coeliac disease seems questionable.

November 2010

The Digestive Health Centre is delighted to welcome Dr Rupert Hinds

info@digestivehealth.com.au — Mon, 9 Aug 2010 15:31:51 +1100

Consultant in Paediatric Gastroenterology who joins Dr George Alex in caring for children with gastroenterological problems here at the centre.

Rupert commenced working as Paediatric Gastroenterologist at Monash Medical Centre in March 2009. Prior to this he had worked in the UK as a consultant at King’s College Hospital and St Thomas’s Hospital in London from November 2004. He trained within his speciality in London including at Great Ormond Street Hospital. He manages children and adolescents with gastrointestinal problems and his clinical interests include nutrition, hepatology and inflammatory bowel disease.

For consultations with Rupert or George please call The Digestive Health Centre: 9791 8788.

Clopidogrel and possible interaction with Proton Pump Inhibitior (PPI) therapy

info@digestivehealth.com.au — Tue, 1 Jun 2010 15:24:30 +1100

There is currently conflicting and inconsistent data regarding the adverse clopidogrel–PPI interaction. With this in mind we need to be vigilant as to the potential weakened benefit of Clopidogrel in the setting of longterm PPI therapy due to the potential interference of the cytochrome P450 enzyme CYP2C19 particularly in patients following a recent coronary artery stent insertion.

Patients who benefit from stomach acid suppression should consider either taking an Histamine Antagonist such as Ranitidine and avoid PPI agents such as Nexium, Losec , Somac, Pariet and Zoton.

Recent data from the FDA, also published in the American Journal of Cardiology, reveal that 1 year data post stent insertion appears to show a near doubling of mortality and myocardial infarction in the PPI group although this has not been supported on recent meta-analysis.

Better Health Channel

info@digestivehealth.com.au — Wed, 12 May 2010 09:41:01 GMT

Bowel cancer - Better Health Channel Bowel cancer is a serious disease but, if diagnosed early, is often curable. Bowel cancer is also called colorectal cancer. Blood or mucus in the faeces (poo) may be a symptom of bowel cancer. Other symptoms may include diarrhoea or constipation, bloating or cramps and constant fatigue. Regular health checks and screening for bowel cancer from the age of 50 is recommended.

New Website

info@digestivehealth.com.au — Wed, 21 Apr 2010 19:39:21 GMT

The Digestive Health Centre is excited to announce the launch of their new look website. The website has been a collaborative effort between our doctors, staff and web designers. We hope to provide you with informative, useful and up to date information regarding digestive health disorders and particularly, our digestive health services. Our website will be updated on a regular basis. Also, look out for our soon to be released "e-Newsletter". If you would like to go on our mailing list, provide us with your details via our Contact Us page.