Using a bronchoscope to visually examine the airways and collect fluid and tissue can help guide effective therapy for difficult-to-treat asthma patients, according to researchers at National Jewish Health. Reporting in the March 2012 issue of the journal Chest, the researchers identified five distinct phenotypes among the refractory asthma patients, and successfully treated four of them, often with reduced asthma medications. "While standard anti-inflammatory treatment with inhaled corticosteroids helps many asthma patients, there is a significant number of patients who need more personalized diagnosis and treatment, " said lead author James Good, MD, professor of medicine at National Jewish Health. "Bronchoscopy provides important clinical information that can help us better treat even the most difficult asthma patients.
A new study is providing clues that may answer a decades-old question about the cells that give rise to a particularly lethal form of esophageal cancer. The research, published by Cell Press in the January 17th issue of the journal Cancer Cell, links inflammation and bile acid reflux with migration of cancer-causing stomach cells into the esophagus and may help guide future strategies for early therapeutic intervention. Esophageal adenocarcinoma is a cancer of the esophagus that is associated with acid reflux disease and Barrett esophagus (BE). BE is characterized by abnormal changes in the cells that line the lower esophagus, very close to the junction with the stomach. In BE, the normal flat esophageal cells are replaced by taller cells resembling those that line the stomach or intestine.
Jack Selby, of Lansing, Mich., had suffered from heartburn all of his life, especially around the holidays when he overindulged in some of his favorite food and drink. "Special days anytime of the year, but particularly holidays, the turkeys and the gravies and all of the dishes with onions, great salads, punches and alcohol bothered me a great deal because of the stomach acid and of course you overeat and fall asleep, " says Selby, a 68-year-old retiree. "So that's not a particularly good thing to have happen." He thought over-the-counter antacids had solved his problem. It turns out they were only masking a condition known as Barrett's esophagus, a disorder that frequently leads to a form of esophageal cancer called adenocarcinoma. The incidence of esophageal adenocarcinoma has increased by 350 percent over the last decade, making it the most rapidly increasing malignancy among white males.
A long-term Norwegian study reveals the number of people who experience acid reflux at least once a week has gone up by nearly 50% in the last 10 years, with women appearing to be more susceptible to the condition than men. The findings raise concerns that this will lead to an increase in cancer of the oesophagus, a once rare but now more common malignancy that is very difficult to treat. The researchers write about their findings in the online first issue of the journal Gut, published on 21 December. Acid reflux, also known as gastro-oesophageal reflux, is where the stomach contents, which includes food and acidic digestive juices, escape upwards into the gullet or oesophagus. This can irritate the oesophagus and cause heartburn and other symptoms. The condition is linked to an increase of gullet or oesophageal cancer, which is difficult to treat successfully.
Heartburn is an uncomfortable warm and burning sensation in the chest, usually just behind the sternum (breastbone) that typically comes in waves. The pain may start in the chest area and make its way up to the neck, throat and jaw. The pain usually gets worse when the patient lies down or bends over, and is more common immediately after eating. The condition is medically known as pyrosis or acid indigestion. The word "heartburn" is a popular lay term that has nothing to do with the heart. Heartburn is usually linked to gastric reflux - the regurgitation of gastric acid; one of the main symptoms of GERD (gastroesophageal reflux disease). As heartburn may also be a symptom of ischemic heart disease, it is important that doctors bear this in mind and do not jump to a GERD diagnosis too rapidly.