Monday 30 July 2012

Junk food ingredient may be cause of bowel disease, research finds

A dairy ingredient in junk food may be responsible for rising rates of inflammatory bowel disease and other immune disorders.

Milk fat upsets the gut’s ecosystem, causing an influx of potentially harmful bacteria, scientists believe.
In some people, this can cause an extreme immune reaction, leading to irritable bowel syndrome and conditions such as Crohn’s disease and ulcerative colitis.
The discovery may explain why once rare immune disorders have become so common in the West over the past 50 years, study leader Professor Eugene Chang said.
He said this was the first mechanism that showed how western-style diets contributed to the rapid increase in IBD.
Tests carried out by the scientists have shown that milk fat – which is abundant in processed foods and confectionery – alters the composition of bacteria in the gut.
In certain people, this can disrupt the delicate balance between the immune system and the trillions of bugs – many beneficial – that live in the intestines.
After genetically susceptible mice were fed a diet high in milk fat, the rate at which they developed colitis trebled.

Listen to the bowel cancer warnings

MY BIRTHDAY last year didn't turn out as planned. Instead of an enjoyable lunch, I spent the afternoon in the company of some smart clinicians and an impressive set of Zeiss optics.

Together, they explored an intimate body cavity previously of perceived interest only to the US Department of Homeland Security. The screen of the endoscope charted all too clearly the progress of the excavation - a strange mixture of a drain survey and some peculiar form of medical archaeology.

Lumpen and ugly, the tumour, when it loomed into view, looked out of place and sinister.
Maybe it was the sedation, but my first thought on hearing the boggling diagnosis of bowel cancer was: "Great, I've just paid out for two life memberships..."

Bitterness followed soon after. A year later, after some impressive surgery, a fortnight in hospital and six bewildering months of chemotherapy I emerged chastened and thoughtful. How I had missed the warning signs of this all-too-common disease, despite a career in science that has put heavy emphasis on evidence-based reasoning, was a mystery.

Monday 23 July 2012

Bowel cancer: 'Go private for tests', says advisor

Patients should go private for bowel cancer tests, a Government advisor has said, after it emerged that half of local health authorities are failing to provide them fast enough despite millions of pounds of extra funding.

Dr Nick Summerton, who sits on the Department of Health's early cancer diagnosis panel, said some patients were having to wait months for the camera probe tests, as NHS capacity was "saturated".
The East Yorkshire GP, said: "I had a patient recently and it was three months before he got his test. He subsequently died of bowel cancer."
He said patients "should have the opportunity" to pay for faster access to bowel cancer tests if, like many, they were not deemed clinically urgent enough for tests like colonoscopies or flexible sigmoidoscopies within two weeks.

Read More -

Wednesday 18 July 2012

Ileoanal Pouch Video

Our ileoanal pouch patient information video is finally on you tube:

Gene link to higher rates of bowel cancer in men

Cancer Research UK Press Release

Scientists have shown for the first time that one of the sex chromosomes is involved in the development of a cancer that can afflict both genders, according to a Cancer Research UK-funded study in Nature Genetics1. The finding may help explain why men have higher rates of bowel cancer than women.
The international collaboration - led by The Institute of Cancer Research (ICR), the University of Oxford and Edinburgh University – was searching for changes to the DNA code that increase the risk of bowel cancer. For the first time, the scientists identified an alteration on the x-chromosome, one of two chromosomes that determine gender.
The ‘faulty’ region on the x-chromosome is linked to lower levels of a gene called SHROOM2 that controls how cells develop and take shape. Mutations in this gene have previously been linked to cancer.

Read More -

Monday 16 July 2012

Bowel screening identifies early cancers

Around 40 000 people are diagnosed each year in the UK with bowel cancer.

A bowel cancer population-screening program is now running throughout the UK using a simple stool test.

At the recent National Cancer Intelligence Network conference in Birmingham, researchers using data from the West Midlands Cancer Intelligence Unit presented a study looking at bowel cancers in the region between January 2006 and September 2011 in people aged 60-69. In total there were 5,633 cancers of which 904 were detected by screening.

Researchers compared the stage at diagnosis of bowel cancers picked up by screening and those identified from symptoms.

18.5% of bowel cancers detected by screening were at the earliest stage compared with 9.4% of the cancers detected in patients with symptoms.

Late stage (advanced) cancers were more commonly found in patients with symptoms than in the screened population.

When bowel cancer is diagnosed in its earliest stage more than 90% of patients will survive for at least 5 years

There are several studies, which show that bowel cancer screening does save lives. The West Midlands data show that bowel screening picks up cancers at an earlier stage where cure is more likely.

There remains concern about the low uptake of the bowel cancer screening by the population as a whole and particularly amongst men.

It is important that when that kit arrives, you complete test. The testing is not always diagnostic, if you have any unexplained bowel symptoms or bleeding you should always seek medical advice irrespective of the test result.

Simon Radley July 2012

Monday 9 July 2012

BUPA to cut fees to consultants

I read an interesting article in the BMA news review regarding BUPA and the latest round of fee cuts.

Most consultants in private practice will have received BUPA’s new range of fees pertaining to their speciality. Procedure fees paid to consultants have been reduced in some cases by up to 50%.

Derek Machin chair of the BMJ private practice committee has commented “this is a reduction in benefits for patients. There has not been any increase by and large for these re-imbursements for 20 years, and they have now cut some of them by 50% leading to a shortfall for patients” he goes on to say that “the British Medical Association advice is for consultants to send their bills to the patients, not to the insurer, because it is the patients that they have the relationship with’

BUPA has said that they “benchmark procedures against other relevant procedures to establish its relative complexity, time and skill required”. It is interesting that where changes have taken place the vast majority are cuts to fees rather than increase. Whilst many would agree that medical fees do need regular review as procedures change both in terms of time, complexity and risk, there are many consultants left questioning this whole process, seeing it simply as a cost cutting exercise by BUPA that has little to do with proper reimbursement for high quality healthcare.

There has been no engagement with speciality organisations, most of whom have their own private practice sub-committees.

The BMA private practice committee has sought to meet with BUPA to discuss the issue, the company have refused.

As more consultants and specialities are drawn into this inevitably patients will become concerned that they are no longer able to see the consultant of their choice and the their medical insurance will not cover the costs of their private healthcare. The parallels with the BUPA/ BMI Healthcare dispute from earlier this year are becoming clearer with once again the patient stuck in the middle.

Simon Radley July 2012

Diverticular Disease and Fibre

Some years ago I wrote a short review article on fibre and diverticular disease so I read with interest a recent article in the British Medical Journal on treating diverticular symptoms with fibre.

Whilst we know that a low fibre intake is associated with an increased risk of developing diverticulosis, there isn’t any good evidence that treating symptomatic diverticular disease with fibre is of benefit.

The article highlights the lack of scientific evidence and points out that it is unlikely that there will ever be any industry lead trial of fibre supplementation, as fibre would not be patentable.

There is however, growing interest from companies in looking at other treatments that alter gut bacteria or immunology.

Trials are currently underway looking at an anti-inflammatory drug, mesalazine, in treating symptomatic diverticular disease and also for preventing acute diverticulitis as well as studies of Lactobacillus in uncomplicated diverticular disease. The results of these trials may lead to some new treatments for diverticular disease.

In the meantime, I agree with the conclusions of the authors.

It is always important to let patients understand the lack of evidence around treatments for diverticular disease and fibre in particular.

Fibre can be beneficial for patients, in particular relieving constipation but it is important to warn them that it can also increase flatulence and can sometimes exacerbate pain. If patients are already taking a high fibre diet it can be beneficial for them to reduce their fibre intake a little. This strategy certainly works well for irritable bowel sufferers already on a high fibre diet.

Obesity has been associated with increased risk of symptoms from diverticular disease, a high fibre diet in the overweight patient may well help them lose weight as well as providing symptomatic relief.

It is likely that fibre supplementation will continue to be helpful for many, together with the promising new treatments currently being evaluated.

SimonRadley July 2012

Wednesday 4 July 2012

£2 drink that could ease IBS misery for millions available over the counter

British doctors are claiming a major breakthrough in treating a stomach condition which causes misery for millions.

They proved that a drink containing ‘friendly’ bugs relieves bloating and stomach pain for long-term sufferers of irritable bowel syndrome.

Around 12million people in the UK are affected by IBS. Three in four sufferers are women.

The probiotic drink called Symprove is already available online and in some Tesco stores and a daily dose costs around the same as a cappuccino at £2.

The study, run to the same standard as a drugs trial and sponsored by King’s College Hospital, London, involved 186 people, aged 18 to 65, who had been diagnosed with moderate to severe IBS.

Read more:

Why a daily aspirin could have saved Bee Gee Robin: Breakthrough for families living with 'death sentence' bowel cancer gene

Tributes are still pouring in for Robin Gibb, one of the world’s finest singer/songwriters, who died last month aged 62.
Sadly, it was of a disease that is preventable and curable – bowel cancer.

Even sadder is the fact that he had a family history of bowel cancer.
All the success – the hit records, the millions the Bee Gees earned – couldn’t save him.
But I believe he could, and should, be alive today if we tried harder to find and to protect families such as his.

I’ve been on the steering committee of a worldwide genetic trial for bowel cancer and it’s had an amazing breakthrough. Trial results suggest that a daily aspirin could stop two-thirds of many family cancers in their tracks.
Yet most affected families don’t know they can be tested for rogue genes, aren’t aware they should be offered regular surveillance and don’t know how to take avoiding action. Families such as the Gibbs.