[DYSPHAGIA] Reflux

[icampbelltaylor@sympatico.ca (I Campbell-Taylor)]

That is the manufacturer's recommendation. It's not supposed to be used for
ever.
Irene.
----- Original Message -----
From: "Pressman, Hilda" <pressmah@sjhmc.org>
To: "'Andrea Parham'" <aparham@mediaone.net>; "I Campbell-Taylor"
<icampbelltaylor@sympatico.ca>; <dysphagia@medonline.com>
Sent: Tuesday, April 17, 2001 8:32 AM
Subject: RE: [DYSPHAGIA] Reflux


> Interestingly, my medical insurance company is limiting the amount of
> Prevacid or Prilosic that they will pay for in a year as they quote the
FDA
> as stating that 8 weeks of treatment is all that is needed.  They said
that
> they would cover a total of 24 weeks for the year.  I would fight them but
> am about to change companies.
>
> -----Original Message-----
> From: Andrea Parham [mailto:aparham@mediaone.net]
> Sent: Monday, April 16, 2001 9:48 PM
> To: I Campbell-Taylor; dysphagia@medonline.com
> Subject: Re: [DYSPHAGIA] Reflux
>
>
> Irene,
> Thanks for the info....  You confirmed what I thought.  The bottom line is
> to get the reflux under control.  I, for one, was very disappointed when
> cisapride left the market.  I know of people buying it in Mexico and from
> Swiss pharmacies.
>
> FYI, my daughter's reflux was diagnosed at about age 4.5 months when she
had
> a modified barium swallow study.  It was good to catch it early.  It has
> gotten worse and better at times.  GI said this is common and they don't
> exactly know why.
>
> I will do more research.  Thanks again.
> --Andrea
>
> ----- Original Message -----
> From: I Campbell-Taylor <mailto:icampbelltaylor@sympatico.ca>
> To: Andrea Parham <mailto:aparham@mediaone.net>  ; dysphagia@medonline.com
> <mailto:dysphagia@medonline.com>
> Sent: Monday, April 16, 2001 8:50 PM
> Subject: Re: [DYSPHAGIA] Globus etc.
>
>
> The consensus of opinion remains that it is the reflux that is the main
> problem.  Recently, there have been so many problems with drugs like
> cisapride, for example, having to be taken off the market, and others with

> serious side effects like Reglan (metoclopramide) that gastroenterologists
> are searching for reasons for the increase in esophageal cancers and, at
the
> same time, taking a closer look at medications with anticholinergic
effects
> (of which there is a multitude) and asking whether these drugs are somehow
> contributing to the problem. Certainly, we are seeing more and more drugs
> enter the marketplace and many cause or exacerbate reflux so it's not an
> insignificant question. One of the most scary scenarios, and one seen very
> often, is the person with GER who is diagnosed as "asthmatic" because of
the
> bronchconstriction and wheezing caused by the reflux, is put on one of the
> xanthine bronchodilators like theophylline and... Theophylline and its
> brothers, lower the tone of the LES in everybody, increase (or even cause
> reflux) and... This is part of the problem currently being debated.
> What I posted was a news announcement. One would have to go to the
original
> article for the full story and that is still in hot debate.  My main point
> is that one can't take reflux lightly - EVER- and, in adults the first
> symptomsare often globus sensation or chronic dry cough or "asthma". It is
> not acceptable to do VFSS on such a patient, see no oropharyngeal
impairment
> and let them just leave.
> Irene.
>
> ----- Original Message -----
> From: Andrea  <mailto:aparham@mediaone.net> Parham
> To: I Campbell-Taylor <mailto:icampbelltaylor@sympatico.ca>  ;
> dysphagia@medonline.com <mailto:dysphagia@medonline.com>
> Sent: Monday, April 16, 2001 6:33 PM
> Subject: Re: [DYSPHAGIA] Globus etc.
>
> Irene,
> I am unclear on this.  Is it soley the reflux (or is it also the drugs
> mentioned) that increases the risk of cancer?  And if so, why?  Thanks in
> advance for the information.
> --Andrea, mom to a 5.5 year old with reflux (but can eat great orally
since
> e-stim therapy over a year ago!)
>
> Reflux-Causing Medications Linked to Increase in Esophageal Cancer
Incidence
>
>
> 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.
>
> 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.
>
> 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.
>
>
> Gastroesophageal reflux can lead to a rapidly fatal condition, and
therefore
> is more than just a little heartburn.
>
> Ann Intern Med 2000;133:165-229.
>
> Irene.
>
>

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