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[DYSPHAGIA] Globus etc.
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Someone asked me recently about the reasons for the fact that =
adenocarcinoma of the esophagus is the fastest growing incident cancer =
in North America and Western Europe. No-one has the answer except =
environment (probable), junk food, poor diet etc.etc.
The following is just a reminder that the pateitn who presents with =
globus sensation and nothing apparently wrong in the oropharynx MUST be =
sent ASAP to gastroenterology:
=20
=20
=20
=20
=20
Reflux-Causing Medications Linked to Increase in Esophageal Cancer =
Incidence=20
The introduction and increasing use of several medications that can =
cause gastroesophageal reflux, particularly anticholinergic agents, may =
play an important role in the rising incidence of esophageal =
adenocarcinoma.=20
The investigators note that reflux is known to be a major risk factor =
for esophageal adenocarcinoma. They measured the link between cancer and =
the use of drugs that relax the lower esophageal sphincter - =
nitroglycerin, aminophyllines, beta-adrenergic agonists, anticholinergic =
drugs and benzodiazepines - in more than 600 patients with esophageal =
adenocarcinoma, adenocarcinoma of the gastric cardia or esophageal =
squamous-cell carcinoma, and 820 controls.=20
Long-term, daily use of esophageal sphincter-relaxing drugs =
significantly increased the risk of esophageal adenocarcinoma by =
3.8-fold. The association was strong for all classes of drugs, but =
particularly for anticholinergics. =20
Gastroesophageal reflux can lead to a rapidly fatal condition, and =
therefore is more than just a little heartburn. =20
Ann Intern Med 2000;133:165-229.
Irene.
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<DIV><FONT face=3DArial size=3D2>Someone asked me recently about the =
reasons for the=20
fact that adenocarcinoma of the esophagus is the fastest growing =
incident cancer=20
in North America and Western Europe. No-one has the answer except =
environment=20
(probable), junk food, poor diet etc.etc.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>The following is just a reminder that =
the pateitn=20
who presents with globus sensation and nothing apparently wrong in the=20
oropharynx MUST be sent ASAP to gastroenterology:</FONT></DIV>
<DIV>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <?xml:namespace=20
prefix =3D o ns =3D "urn:schemas-microsoft-com:office:office"=20
/><o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">Reflux-Causing=20
Medications Linked to Increase in Esophageal Cancer =
Incidence </SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">The=20
introduction and increasing use of several medications that can cause=20
gastroesophageal reflux, particularly anticholinergic agents, may play =
an=20
important role in the rising incidence of esophageal </SPAN><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">adenocarcinoma. </SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">The=20
investigators note that reflux is known to be a major risk factor for =
esophageal=20
adenocarcinoma. They measured the link between cancer and the use of =
drugs that=20
relax the lower esophageal sphincter — nitroglycerin, =
aminophyllines,=20
beta-adrenergic agonists, anticholinergic drugs and benzodiazepines =
— in more=20
than 600 patients with esophageal adenocarcinoma, adenocarcinoma of the =
gastric=20
cardia or esophageal<SPAN style=3D"mso-spacerun: yes"> =
</SPAN>squamous-cell=20
carcinoma, and 820 controls. </SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">Long-term,=20
daily use of esophageal sphincter-relaxing drugs significantly increased =
the=20
risk of esophageal adenocarcinoma by 3.8-fold. The association was =
strong for=20
all classes of drugs, but particularly for =
anticholinergics. </SPAN><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">Gastroesophageal=20
reflux can lead to a rapidly fatal condition, and therefore is more than =
just a=20
little heartburn. </SPAN><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt">Ann=20
Intern Med 2000;133:165-229.</SPAN></P>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 11pt; FONT-FAMILY: Arial; mso-bidi-font-size: =
10.0pt"><o:p>Irene.</o:p></SPAN></P></DIV></BODY></HTML>
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