Medslant Acid Reflux Newsletter

Is Gerd an Immune Condition?

A team of researchers from the University of Texas Southwestern Medical Center reported in the November Gastroenterology that GERD may actually be an immune disease and not be caused by stomach acid. Led by Rhonda Souza, MD, the study in rats showed that acid reflux disease causes tissue in the esophagus to release immune chemicals called cytokines which in turn attract inflammatory cells which cause the heartburn that make GERD so uncomfortable. "Currently we treat GERD by giving meds to prevent the stomach from making acid", said Souza. "But if GERD is really an immune-mediated injury, maybe we should create medications that would prevent these cytokines from attracting inflammatory cells to the esophagus and starting the injury", continues Souza. Her team mimicked GERD in rats and was surprised to learn that it took weeks for erosive esophagitis to develop because they thought that the stomach acid would start to burn the esophagus immediately. Upon examination, the esophagus tissue was filled with immune cells. Additional tests using human esophagus cells in lab dishes showed that the cells sent our inflammatory signals with chemicals such as interleukin-8 when bile salts were added. More research is needed.

PPI'S and PLAVIX

We keep hearing contradictory advice about combining PPI's and Plavix. On November 10, 2009, the Food and Drug Administration issued a warning that physicians stop using a combination of certain heartburn drugs such as Prilosec, and Plavix, an anticlotting medicine. This warning was issued after studies showed that the combination may blunt the effect of Plavix and increase patient risk of a heart attack.

Bristol-Myers Squibb Co, maker of Plavix, and Sanofi Aventis, maker of the generic version of Plavix, updated the Plavix label to warn against the combination use of the two drugs. Plavix has annual worldwide sales of more than $8 billion. The drug is most commonly used to prevent clots in patients with artery opening stents or for patients who have suffered a heart attack or stroke.

Almost half of patients taking Plavix are also prescribed Nexium, made by AstraZenneca, or Prilosec, an OCT version of which is made by Procter & Gamble, or a similar PPI to prevent ulcers and stomach bleeding, both frequent side effects of Plavix.

An AstraZenneca spokesman said the company is examining the FDA warning but believes that more research is needed. A Proctor & Gamble spokeswoman says the company is evaluating whether a Prilosec OTC label change is necessary.

Mary Ross Southworth of the FDA said that the data Sanofi submitted at their request shows that drugs like Prilosec inhibit a specific enzyme that activates Plavix. The Plavix label lists 11 different drugs that can inhibit the enzyme. The FDA added that is does not seem to help even if patients take the drugs 12 hours apart. The FDA did say that both Prilosec and Plavix can provide significant benefits to patients. Their advice is to consult your physician if you are taking both drugs. The FDA added that certain other heartburn drugs such as Zantac and Pepcid work differently from Nexium and Prilosec and there is no evidence that they interfere with Plavix.

This official warning follows a May, 2009, warning from the Society for Cardiovascuar Angiography and Interventions which warned that four common heartburn drugs boosted the risk of heart attack and stroke in patients taking Plavix.

If you are taking both Plavix and any PPI or heartburn drug, please consult your physician.

SCIENTIST FINDS BEING GRATEFUL THE SECRET TO HAPPINESS

Robert A Emmons, PhD, a University of California, Davis psychologist says that a scientific study looking at the relationship between gratitude and happiness confirms that becoming more grateful will make us happier. Emmons describes gratitude as our "affirmation of a benefit we have received and our recognition that this benefit has come to us from outside of ourselves". And his research suggests that if we make an effort to become more grateful, i.e. consciously choosing to express gratitude, we will be happier. For example, say, "I feel grateful when I can sleep through the night", rather than, "Most nights I wake up every few hours." Emmons also says that religious people may have an advantage - one of the foundations of almost every religion is that we should give thanks to God and to each other. So, perhaps the message of that smiley face is really helpful!.

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We at MedSlant wish all of you and your loved ones and friends a wonderful holiday season and a very Healthy and Happy New Year.



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