Dr. Snow's Blog

What are FODMAPs?

Many people suffer from gas and bloating.  There is research that this can be triggered and exacerbated by certain foods, called FODMAPs.  By eliminating these foods, with a low FODMAP diet, one can have improvement in these symptoms.  Often, these foods can be important to long term colon health, so they should be reintroduced one at a time after symptoms improve.  The following is a link from the University of Michigan which can help you understand this process.   Read More

 


What's the Big Deal with Gluten?

Many people have issues with wheat, and particularly gluten, a protein component of wheat and many other grains.  This is a link to a TED talk which discusses various types of wheat associated symptoms. William Chey, a professor of gastroenterology at University of Michigan, designed this free TED talk for his patients.   Read More

 


Is Sugar the World's Most Popular Drug?

For years, I have been talking to patients about the dangers of sugar.  It has been associated with non alcoholic fatty liver disease, and the metabolic syndrome.  The following link discusses some of the history of sugar. Read More

 


Treating Gastrointestinal Disorders Through Improved Sleep

Physicians are becoming more aware of the importance of a good night’s sleep.  It is important to the health of our GI tract.  Here is a video and transcript from one the experts is GI diseases on the importance of sleep. Read More

 


The Microbiome and Risk for Obesity and Diabetes

As we enjoy this holiday season, typically where each of us gain a couple pounds.  The role of the microbiota is still poorly understood, but the science is progressing rapidly.  This article discusses the role of the fecal micro biome in obesity and diabetes. I hope you find this article from JAMA interesting. Read More

 


Questions and Answers about Quality in Colonoscopy

We are committed to the very highest quality of healthcare. In an effort to keep you informed, we would like to share this link to the American College of Gastroenterology.

Although colonoscopy has been available in clinical practice for more than 40 years, only in the past 15 years has awareness developed that the success of colonoscopy in preventing colorectal cancer and minimizing complications is very dependent on the skill and competence of the colonoscopist. Read More

 


Do Proton Pump Inhibitors Increase Risk for Dementia?

Many of you have questions regarding the side effects of proton pump inhibitor's and their side effect of dementia. The following article does addressed these risks. Though there may be some risks according to this article, they have not been confirmed, and seem to be small. That said, if you do not need to take a medication to control symptoms, that is best.

The question was: In older patients, is the exposure to proton pump inhibitor (PPI) medications as compared to no exposure associated with increased risk of dementia?

 


USPSTF CRC Guidelines are Incomplete

Last week, the U.S. Preventive Services Task Force (USPSTF) published updated recommendations for colorectal cancer (CRC) screening of average-risk, asymptomatic individuals...

New report includes an unranked menu of screening options and is silent on the importance of patient adherence and test quality

 


A TEACHABLE MOMENT ON THE NEED FOR COLON CANCER SCREENING

Although colorectal cancer is the third most common cancer, it is the second leading cause of cancer deaths, after lung cancer. Detection guidelines call for screening to begin at 50...

A Teachable Moment on the Need for Colon Cancer Screening

 


WHY SCREEN FOR COLORECTAL CANCER?

 


 WHAT MAKES A HIGH QUALITY COLONOSCOPY?

 


PROTON PUMP INHIBITORS (PPIs) AND DIMENTIA

Proton pump inhibitors (PPIs), such as omeprazole, pantoprazole, lansoprazole and others are one of the most commonly used medications,particularly in our practice. They have been used in this country for more than a quarter of a century.  Periodically, large, retrospective studies have suggested that these medications cause issues in a small minority of patients. Recently JAMA Neurology  published an article, linked below suggesting an association between PPI use and dementia. This article does not show causation, and is based on a review of insurance claims in Germany. This is not a top ranked journal, and is ranked 641th of all medical journals, and 12th of all clinical neurology journals. The following analyses  state, "The research behind the story provides no strong reason to stop taking PPIs as prescribed." That said, if you do not need the PPIs then do not take them.
 
Please read the articles below for a more complete analysis: 

Link between indigestion drugs and dementia 'inconclusive'

Our psychiatrist-reviewer analyzes news about proton pump inhibitors & dementia risk

 


COFFEE REDUCES THE RISK OF PREMATURE DEATH IN NON SMOKERS

A large study has found that drinking coffee is associated with a reduced risk of dying from heart disease and certain other causes. Click on the link below to read the details!

Coffee tied to lower risk of dying prematurely - New York Times

 


ASPIRIN MAY REDUCE COLON CANCER RISK

This new study suggests that aspirin will reduce your risk of colon cancer if it's taken daily for five years.  Click on the link below to read the details!

Annals of Internal Medicine - Aspirin May Reduce Colon Cancer Risk Article


AMERICANS ARE FINALLY EATING LESS

It appears that cutting sugar, particularly in soda, is making a difference in rates of obesity.  Click on the link below to get the rest of the information.

Americans Are Finally Eating Less - The New York Times

 


FOOD ADDITIVES, OBESITY AND COLITIS

One of the reasons I went into gastroenterology was because of the interaction of food and health.  With increased knowledge of the bacteria in the GI tract, their needs and responses, it has become clear that this interaction is quite complex.  2 recent studies have been associated with food additives and obesity as well as other health issues.
 
The first of these shows that artificial sweeteners change the bacteria of the gut so that people become more sensitive to developing obesity.  These seemed to cause the same detrimental effects as the ingestion of sugar itself.
 
The second, more recent study, shows that food emulsifiers, can cause inflammation and obesity.  These food emulsifiers are present in many process foods, and stabilize them for longer shelf lives.  They keep food to like mayonnaise from separating.  Presumably, by thinning the mucus layer in the GI tract, they allow bacteria easier access to the cells of the lining.  This incites an inflammatory process which leads to the detrimental health effects.  
 
Both of these studies were published in nature, and the news reports associated with these particles are in the links below.  The bottom line is to try to minimize sugar, artificial sweeteners and processed foods to minimize detrimental health effects.

 


Sugar substitutes linked to obesity


Artificial sweetener seems to change gut microbiome.  Click Here to read the article.

 


Food preservatives linked to obesity and gut disease

Mouse study suggests that emulsifiers alter gut bacteria, leading to the inflammatory bowel condition colitis.   Click Here to read the article.

 


SODA IS THE GI TRACT'S ENEMY

It seems I have been talking about the harm sodas do to the GI tract forever. Here is an interesting new reason from the Cleveland Clinic on why not to drink sodas.  

 

Cleveland Clinic (@ClevelandClinic)

18/09/2014 10:02 Drinking 1 can of soda per day, sugar-sweetened or diet, increases a person’s risk of stroke over time by 16%. Follow us for health tips!


ARTIFICIAL SWEETENERS MAY LEAD TO DIABETES

The human microbiota is becoming a major focus of what makes us healthy.
This is an interesting first study that suggests artificial sweeteners
lead to changes associated with the development of the metabolic
syndrome, which includes diabetes, sleep apnea and fatty liver.  The
general recommendation remains, "eat food, mostly vegetables, not too
much." Check out the USA Today article by clicking here.

 


BONE MINERAL DENSITY CHANGES AMONG WOMEN

We do receive many questions about PPI use and bone density.  The abstract in the link below is one of the best articles I have seen on it. The salient sentence from the abstract is, "Longitudinal analyses plus similar prior studies argue against an association between PPI use and bone mineral density loss."  In other words, they find no association between PPI use and osteoporosis.  You should certainly discuss these findings with your health care provider if you have any questions.  Click here to view the study.

 


HERE'S A HORRIFYING PICTURE OF WHAT SLEEP LOSS WILL DO TO YOU

The following is a picture illustrating the problems Of sleep deprivation that I thought worth showing.    Good, regular sleep hygiene can improve bowel and gastrointestinal function as well. 

Click Here To View The Infographic

 


DIETARY FIBER MAY INFLUENCE ASTHMA RATES

Dietary fiber has had many potential beneficial effects.  Not only is it useful in constipation, but it may have effects on rates of colon cancer, diabetes, diverticulosis, and now may even effect asthma incidence.   This is a provocative study in mice, which showed that mice fed a high fiber diet had lower inflammation in the lungs than mice fed a low fiber diet.  The rate of asthma has been increasing in people, and as we are eating a lower fiber diet, this may be one of the mechanisms.  Check out the bbc article by clicking here and for the original reference material, click HERE.


COLONOSCOPY PREP TIPS

Reader's Digest recently published an informative article on colonoscopy prep tips and questions which could be helpful for you! Check out the article by clicking here.

 


ARE YOU DRINKING THE WRONG KIND OF MILK?

Milk and milk intolerance are very digestive issues. This new study suggests that something other than lactose may be a contributing factor. Most of us do not have a choice as to what cows we get our milk from. Perhaps, this will change. Click here to view the article.

 


MARCH IS COLON CANCER AWARENESS MONTH

The following link, produced by the three major gastrointestinal societies, discuss the prevalence of this disease, how much progress was have made, but also how much better we could do.

Click Here To View The Article.

As the following shows, we as gastroenterologists are having a significant impact on colon cancer. Please encourage your friends to read this article, during colon cancer awareness month.

Click Here To View The Article.

We have done a good job reducing the incidence of and mortality from colon cancer, but there is room for improvement. Here is an editorial from the New England Journal of Medicine which describes fecal DNA testing as a promising technique to build upon our success. It is likely that the cost will improve in the future.

Click Here To View The Article.

 


HAZARDS OF HINDSIGHT - MONITORING THE SAFETY OF NUTRITIONAL SUPPLEMENTS - NEJM

This is a recent article on dietary supplements and that they may have potential serious side effects. A recent analysis of supplements showed they did not always contain what they said they did. For a Gastro practice, they are occasionally a cause of liver abnormalities. That is why I am posting this.

Click Here To View The Article


LEDIPASVIR–SOFOSBUVIR FOR PREVIOUSLY TREATED HCV | NOW@NEJM

I'm sure many of you have already heard about the success that the medical community has had with hepatitis c. When I started practicing, we had called it non A non b. the first treatments were long and onerous, and barely effective. Now this is good news.

Click Here To View The Article

 


LOW VITAMIN D LEVELS TIED TO INCREASED CANCER RISK IN IBD

The study reviewed in this link shows that low vitamin d levels can increase the risk of cancer in patients with Crohn's or ulcerative colitis. These patients often have low vitamin d levels because of potential malabsorption, potential dietary restrictions and/or sun avoidance because of medication. It may be worthwhile to have your vitamin d levels monitored to see if they are low. In an accompanying editorial, a doctor from Canada says he just assumes his patients are low in this vitamin, as they live so far north, and so he supplements them all. The risks of vitamin d supplementation seem low at present.

Click Here To View The Article

 


COLON CANCER SCREENING

We are proud of what we have been doing. Virginia has been out in front of this issue, in part because of Katie Couric and her interest in this subject almost 2 decades ago. Please read the article below.

From The New York Times:

Colon Cancer Screening Saves Lives

Widespread screening for colorectal cancer has helped prevent an estimated half-million cases of the disease since the mid- 1970s, a new study suggests.

Click Here To View The Article