GERD Watch

Pharmacy TimesSeptember 2009
Volume 75
Issue 9

Obesity and GERD: An Unhealthy RelationshipIt turns out that the US prevalence of both gastroesophageal reflux disease (GERD) and obesity are no coincidence. Increased weight has a strong causal correlation with increased esophageal acid exposure, with 13% of the variation of such exposure associated with similar variations in body mass index (BMI), according to research published in the Journal of Gastrointestinal Surgery (May 28, 2009). The degree of the connection is significantly higher than that of other links between BMI and obesity comorbidities, the researchers stated.

Concurrent with the greater acid levels found in patients with higher BMIs was the observation of an increased frequency of defective functioning of the lower esophageal sphincter (LES) in heavier individuals. Obese patients were more than twice as likely to have a defective LES, the research revealed. An additive effect is implied by increased weight and LES status decline being followed by peaks in esophageal acid exposure.

The study authors took the correlations a step further, pointing to dietary factors as triggers for both obesity and GERD.

After a Frolic in the Sand, Be Sure to Wash Your Hands The beach, typically known as a carefree place, is harboring a health threat, according to government scientists. The good news is, a simple antidote exists. New information from the US Geological Survey states that bacteria and viruses often lurk in beach sand, causing mostly mild gastrointestinal (GI) symptoms. Washing one’s hands, however, is an effective way of avoiding potential maladies.

The scientists measured how many Escherichia coli bacteria ended up on individuals’ hands after digging in beach sand from the shores of Lake Michigan. Studying past findings on illness rates to glean their data, the researchers found that if individuals were to ingest all of the sand and the associated biological community retained on their fingertips, 11 individuals in 1000 would develop symptoms of GI illness. Ingesting all material on the entire hand would result in 33 of 1000 people developing GI symptoms, the findings showed. As children are more likely to play in the sand, they are more likely to experience such symptoms.

Perhaps counterintuitively, E coli bacteria are frequently more prevalent in beach sand than in beach water. Monitoring of beach water for E coli is a mandated practice, but similar monitoring of beach sand is not required by law.

FAST FACT: Wearing tight clothing can be a GERD trigger.

Famotidine Thwarts GI Problems in Patients Taking Low-Dose Aspirin

Although the benefits of taking low-dose aspirin are welldocumented, they are accompanied by risks, including peptic ulcers and erosive esophagitis. The void left by a lack of therapeutic options may have been filled by the H-2 receptor antagonist famotidine, according to a study published in Lancet (July 11, 2009).

The phase 3 trial enrolled 404 patients, given either famotidine 20 mg twice daily or placebo twice daily. Results of endoscopies at the end of the 12-week study showed the development of gastric ulcers in 3.4% of the famotidine group, compared with 15% of the placebo group. Duodenal ulcers showed in 0.5% of patients taking famotidine, and in 17% of placebo patients. Erosive esophagitis developed in 4.4% of the famotidine group, compared with 38% of the placebo group.

Gut Inflammation, Bacteria Could Contribute to Infant Colic

The unknown cause of colic in infants presents a source of frustration for parents, but new research is helping to solve the mystery. An organism called Klebsiella is believed to be causing an inflammatory reaction in babies, triggering colic, according to study results published online in the Journal of Pediatrics (July 23, 2009).

Klebsiella—a normally occurring bacterium found in the mouth, skin, and intestines—was found by researchers in the intestines of infant study participants who also had gut inflammation and colic.

“We believe that the bacterium may be sparking an inflammatory reaction, causing the gut inflammation,” said Dr. Marc Rhoads, the study’s lead author. “Inflammation in the gut of colicky infants closely compared to levels in patients with inflammatory bowel disease. Colic could prove to be a precursor to other gastrointestinal conditions, such as irritable bowel syndrome, celiac disease, and allergic gastroenteropathies.”

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