Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?
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Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.
Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.
The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.
Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.
Which drugs are involved in Australia?
The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:
- Nexium (esomeprazole)
- Losec, Asimax (omeprazole)
- Somac (pantoprazole)
- Pariet (rabeprazole)
- Zoton (lansoprazole).
Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.
They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.
They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.
These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.
What do we know about the risks?
Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.
When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.
Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.
In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.
How about the cancer and kidney risk?
Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.
So what does the evidence say about the risk?
Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.
In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.
While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.
What can I do if I’m worried?
Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.
But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.
There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.
These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.
Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.
If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.
Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Avoid Knee Surgery With This Proven Strategy (Over-50s Specialist Physio)
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A diagnosis of knee arthritis can be very worrying, but it doesn’t necessarily mean a knee replacement surgery is inevitable. Here’s how to keep your knee better, for longer (and potentially, for life):
Flexing your good health
You know we wouldn’t let that “proven” go by unchallenged if it weren’t, so what’s the evidence for it? Research (papers linked in the video description) showed 70% of patients (so, not 100%, but 70% is good odds and a lot better than the alternative) with mild to moderate knee arthritis avoided surgery after following a specific protocol—the one we’re about to describe.
The key strategy is to focus on strengthening the quadriceps muscles for joint protection, as strong quads correlate with reduced pain. However, a full range of motion in the knee is essential for optimal quad function, so that needs attention too, and in fact is foundational (can’t strengthen a quadriceps that doesn’t have a range of motion available to it):
Steps to follow:
- Improve knee extension:
- Passive knee extension exercise: gently press your knee down while lying flat, to increase straightening.
- Weighted heel props: use light weights to encourage gradual knee straightening.
- Enhance knee flexion:
- Use a towel to gently pull the knee towards the body to improve bending range.
Regular practice (multiple times daily) leads to improved knee function and pain relief. Exercises should be performed gently and without pain, aiming for consistent, gradual progress.And of course, if you do experience pain, it is recommend to consult with a local physiotherapist for more personalized guidance.
For more on all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Treat Your Own Knee – by Robin McKenzie
Take care!
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- Improve knee extension:
What’s behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000s—and the reasons why aren’t always clear.
Here’s what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Once-A-Week Strategy to Stop Procrastination – by Brad Meir
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Procrastination is perhaps the most frustrating bad habit to kick!
We know we should do the things. We know why we should do the things. We want to do the things. We’re afraid of what will happen if we don’t do the things. And then we… don’t do the things? What is going on?!
Brad Meir has answers, and—what a relief—solutions. But enough about him, because first he wants to focus a little on you:
Why do you procrastinate? No, you’re probably not “just lazy”, and he’ll guide you through figuring out what it is that makes you procrastinate. There’s an exploration of various emotions here, as well as working out: what type of procrastinator are you?
Then, per what you figured out with his guidance, exercises, and tests, it’s time for an action plan.
But, importantly: one you can actually do, because it won’t fall foul of the problems you’ve been encountering so far. The exact mechanism you’ll use may vary a bit based on you, but some tools here are good for everyone—as well as an outline of the mistakes you could easily make, and how to avoid falling into those traps. And, last but very definitely not least, his “once a week plan”, per the title.
All in all, a highly recommendable and potentially life-changing book.
Grab Your Copy of “Once-A-Week Strategy to Stop Procrastination” NOW (don’t put it off!)
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Palliative care as a true art form
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How do you ease the pain from an ailment amidst lost words? How can you serve the afflicted when lines start to blur? When the foundation of communication begins to crumble, what will be the pillar health-care professionals can lean on to support patients afflicted with dementia during their final days?
The practice of medicine is both highly analytical and evidence based in nature. However, it is considered a “practice” because at the highest level, it resembles a musician navigating an instrument. It resembles art. Between lab values, imaging techniques and treatment options, the nuances for individualized patient care so often become threatened.
Dementia, a non-malignant terminal illness, involves the progressive cognitive and social decline in those afflicted. Though there is no cure, dementia is commonly met in the setting of end-of-life care. During this final stage of life, the importance of comfort via symptomatic management and communication usually is a priority in patient care. But what about the care of a patient suffering from dementia? While communication serves as the vehicle to deliver care at a high level, medical professionals are suddenly met with a roadblock. And there … behind the pieces of shattered communication and a dampened map of ethical guidelines, health-care providers are at a standstill.
It’s 4:37 a.m. You receive a text message from the overnight nurse at a care facility regarding a current seizure. After lorazepam is ordered and administered, Mr. H, a quick-witted 76-year-old, stabilizes. Phenobarbital 15mg SC qhs was also added to prevent future similar events. You exhale a sigh of relief.
Mr. H. has been admitted to the floor 36 hours earlier after having a seizure while playing poker with colleagues. Since he became your patient, he’s shared many stories from professional and family life with you, along with as many jokes as he could fit in between. However, over the course of the next seven days, Mr. H. would develop aspiration pneumonia, progressing to ventilator dependency and, ultimately, multi-organ failure with rapid cognitive decline.
What strategies and tools would you use to maximize the well-being of your patient during his decline? How would you bridge the gap of understanding between the patient’s family and health-care team to provide the standard of care that all patients are owed?
To give Mr. H. the type of care he would have wanted, upon his hospital admission, he should have been questioned about his understanding of illness along with the goals of care of the medical team. The patient should have been informed that it is imperative to adhere to the medical regimen implemented by his team along with the risks of not doing so. In the event disease-related complications arose, advanced directives should have been documented to avoid any unnecessary measures.
It is important to note, that with each change in status of the patient’s health status, the goal of treatment must be reassessed. The patient or surrogate decision-maker’s understanding of these goals is paramount in maintaining the patient’s autonomy. It is often said that effective communication is the bedrock of a healthy relationship. This is true regardless of type of relationship.
This is why I and Megan Vierhout wrote Integrated End of Life Care in Dementia: A Comprehensive Guide, a book targeted at providing a much-needed road map to navigate the many challenges involved in end-of-life care for individuals with dementia. Ultimately, our aim is to provide a compass for both health-care professionals and the families of those affected by the progressive effects of dementia. We provide practical advice on optimizing communication with individuals with dementia while taking their cognitive limitations, preferences and needs into account.
I invite you to explore the unpredictable terrain of end-of-life care for patients with dementia. Together, we can pave a smoother, sturdier path toward the practice of medicine as a true art form.
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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Walnut, Apricot, & Sage Nut Roast
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It’s important to have at least one good nut roast recipe in your repertoire. It’s something that’s very good for making a good dish out of odds and ends that are in your house, and done well, it’s not only filling and nutritious, but a tasty treat too. Done badly, everyone knows the results can be unfortunate… Making this the perfect way to show off your skills!
You will need
- 1 cup walnuts
- ½ cup almonds
- ¼ cup whole mixed seeds (chia, pumpkin, & poppy are great)
- ¼ cup ground flax (also called flax meal)
- 1 medium onion, finely chopped
- 1 large carrot, grated
- 4 oz dried apricots, chopped
- 3 oz mushrooms, chopped
- 1 oz dried goji berries
- ½ bulb garlic, crushed
- 2 tbsp fresh sage, chopped
- 1 tbsp nutritional yeast
- 2 tsp dried rosemary
- 2 tsp dried thyme
- 2 tsp black pepper, coarse ground
- 1 tsp yeast extract (even if you don’t like it; trust us; it will work) dissolved in ¼ cup hot water
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃, and line a 2 lb loaf tin with baking paper.
2) Heat some oil in a skillet over a moderate heat, and fry the onion for a few minutes until translucent. Add the garlic, carrot, and mushrooms, cooking for another 5 minutes, stirring well. Set aside to cool a little once done.
3) Process the nuts in a food processor, pulsing until they are well-chopped but not so much that they turn into flour.
4) Combine the nuts, vegetables, and all the other ingredients in a big bowl, and mix thoroughly. If it doesn’t have enough structural integrity to be thick and sticky and somewhat standing up by itself if you shape it, add more ground flax. If it is too dry, add a little water but be sparing.
5) Spoon the mixture into the loaf tin, press down well (or else it will break upon removal), cover with foil and bake for 30 minutes. Remove the foil, and bake for a further 15 minutes, until firm and golden. When done, allow it to rest in the tin for a further 15 minutes, before turning it out.
6) Serve, as part of a roast dinner (roast potatoes, vegetables, gravy, etc).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Chia Seeds vs Pumpkin Seeds – Which is Healthier?
- Apricots vs Peaches – Which is Healthier?
- Goji Berries: Which Benefits Do They Really Have?
- Ergothioneine: “The Longevity Vitamin” (That’s Not A Vitamin)
Take care!
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Biohack Your Brain – by Dr. Kristen Willeumier
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The title of this book is a little misleading, as it’s not really about biohacking; it’s more like a care and maintenance manual for the brain.
This distinction is relevant, because to hack a thing is to use it in a way it’s not supposed to be used, and/or get it to do something it’s not supposed to do.
Intead, what neurobiologist Dr. Kristen Willeumier offers us is much more important: how to keep our brain in good condition.
She takes us through the various things that our brain needs, and what will happen if it doesn’t get them. Some are dietary, some are behavioral, some are even cognitive.
A strength of this book is not just explaining what things are good for the brain, but also: why. Understanding the “why” can be the motivational factor that makes a difference between us doing the thing or not!
For example, if we know that exercise is good for the brain, we think “sounds reasonable” and carry on with what we were doing. If, however, we also understand how increased bloodflow helps with the timely removal of beta-amyloids that are associated with Alzheimer’s, we’re more likely to make time for getting that movement going.
Bottom line: there are key things we can do to keep our brain healthy, and you probably wouldn’t want to miss any. This book is a great care manual for such!
Click here to check out Biohack Your Brain and keep your brain young and fit!
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