yet in others, acupuncture was no better than a “sham” version of acupuncture used for comparison.

“It’s difficult to interpret the results of the review,” said lead researcher Eric Manheimer, of the Center for Integrative Medicine at the University of Maryland School of Medicine.

for now, he told Reuters Health, “I think the evidence is equivocal.”

IBS is a digestive disorder that causes repeated bouts of abdominal cramps, bloating, and either diarrhea or constipation. It’s different from the similar-sounding inflammatory bowel disease — an umbrella term for ulcerative colitis and Crohn’s disease, two more-serious digestive disorders that damage the lining of the colon.

In many cases, IBS can be managed with diet changes, along with anti-diarrheal medication or, for constipation, laxatives or fiber supplements.

but people with tougher-to-treat IBS may need more. There are a few drugs for the condition — including alosetron (Lotronex), which works on nerves to relax the colon, and lubiprostone (Amitiza), which helps with constipation.

Doctors sometimes also prescribe low-dose antidepressants, anti-anxiety medications or drugs called antispasmodics, which may help with abdominal pain.

but those drugs are often limited in their effectiveness, and can have side effects.

So researchers are looking at different non-drug options. Two — namely, cognitive behavioral therapy and hypnosis — have proven effective for some people in clinical trials.

a fairly small number of studies have begun looking at acupuncture. and so far, Manheimer’s team found, those trials have yielded mixed results.

In their review, the researchers found five clinical trials that tested “true” acupuncture against a sham version of the procedure.

some studies use sham procedures to try to account for the “placebo effect” — where people feel better simply because they expect a treatment to work.

overall, Manheimer’s team found, none of the five trials showed that real acupuncture was any better than the fake version when it came to improving patients’ ratings of their symptoms or quality of life.

on the other hand, five trials done in China did find that patients reported bigger gains from acupuncture when it was tested against certain medications — which included certain anti-diarrheal, antispasmodic and anti-inflammatory drugs.

but there are limitations to both types of studies, Manheimer said.

with the trials that pitted acupuncture against drugs, the patients were recruited at hospitals for traditional Chinese medicine.

“So it’s possible that patients’ expectations played a role” in acupuncture’s higher success odds, Manheimer explained. That is, many may have believed acupuncture to be effective, or had a preference for it over medication.

with the sham-acupuncture trials, the study groups tended to be small, which may have limited their ability to pick up small benefits of true acupuncture, the researchers say.

There’s also debate over what makes for a good sham version of acupuncture. In some studies, it may involve inserting needles in the skin at sites that are not considered acupuncture points according to traditional Chinese medicine.

In others, it means using a dull needle that doesn’t penetrate the skin.

“It’s not clear that they (shams) are all inert,” Manheimer said.

That means some sham acupuncture tactics may have biological effects that are close to the real thing. no one is sure how acupuncture works, but some research suggests the needle stimulation triggers the release of pain- and inflammation-fighting chemicals in the body — even if the acupuncture doesn’t strictly follow traditional principles.

Of the five trials in this review, two were judged as having sham acupuncture that might have had real biological effects. but that doesn’t explain why the other three studies showed no benefit, the researchers say.

NOT a ‘GO-TO’ TREATMENT

In the future, Manheimer said it might be helpful to do trials that compare acupuncture against other treatments, but do it with a more general population of IBS sufferers than the Chinese studies used.

it would also be a good idea, he said, to measure patients’ expectations going into the study. That way, researchers can look at whether people who expected to improve were more likely to report benefits from acupuncture.

“This is an interesting study,” said Jeffrey M. Lackner, an associate professor at the University at Buffalo School of Medicine in New York, who was not involved in the work.

In the U.S., he noted, acupuncture would not be considered a “go-to” IBS treatment right now anyway.

Chandler and Gilbert, Ariz. – nearly 20 percent of U.S. adults have symptoms of Irritable Bowel Syndrome (IBS), making it one of the most common gastrointestinal disorders diagnosed by doctors. April is IBS awareness month and Chandler Regional and Mercy Gilbert Medical Centers, Dignity Health members, have gastroenterologists who specialize in the field of digestive and liver disorders.

IBS affects the large intestine causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. “Although symptoms may be uncomfortable, they do not cause permanent damage to the colon and can be controlled over time,” says Dr. Nelson H. Lim M.D., a gastroenterologist and hepatologist with privileges at Chandler Regional and Mercy Gilbert Medical Centers.

According to the National Digestive Diseases Information Clearinghouse (NDDIC), IBS is not a disease but a functional gastrointestinal (GI) disorder.  This means that IBS symptoms are caused by changes in how the GI tract works.

“The exact cause of IBS is unknown, but food, emotional stress and hormones are just a few factors that can affect IBS symptoms,” adds Dr. Lim. he adds that a person with IBS may have a colon that is more sensitive and reactive than usual. “Sensitivity causes spasms after stimulation by things such as certain foods or medications. Milk, chocolate and alcohol might cause constipation or diarrhea, while carbonated beverages and some fruits and vegetables may lead to bloating and discomfort. Stressful events can worsen or aggravate symptoms, but it does not cause them.”

IBS usually begins before the age of 35 and is typically seen before the age of 50.  Women and those with a family history of IBS are the most at risk for developing the syndrome.  Since women are more likely to have IBS, many of them find that signs and symptoms are worse during or around their menstrual cycle.

Managing a healthy diet, lifestyle and stress can help control IBS symptoms. Chandler Regional and Mercy Gilbert Medical Centers’ doctors work with each patient to determine the best course of treatment, which may include performing a medical screening, or a diagnostic or therapeutic procedure.  Because other disease processes may manifest with similar warning signs, it’s important to discuss symptoms with a primary doctor or gastroenterologist.   

Medical exams such as a stool test or a colonoscopy are used to diagnose IBS. Doctors at Mercy Gilbert Medical Center use the Third Eye® Retroscope® during colonoscopy procedures. The Third Eye® Retroscope® is a new imaging device that provides a way to visualize hidden areas by acting as a “rear view mirror” to visualize blind spots, allowing doctors see more of the colon than ever before. Chandler Regional Medical Center will soon add the Third Eye® Retroscope® technology to their suite of diagnostic tools as well.   

To find a doctor specializing in gastrointestinal disorders, please call ResourceLink at 480.728.5414 or email This e-mail address is being protected from spambots. you need JavaScript enabled to view it .   

Chandler Regional Medical Center is located at 1955 W. Frye rd. (corner of Dobson and Frye Roads) in Chandler.  Chandler Regional is a 243-bed, acute-care, not-for-profit provider of emergency care, family birth services, comprehensive stroke services, gastroenterology, cardiovascular services, wound healing and hyperbaric oxygen therapy, cancer treatment, neurosciences, orthopedics, general surgery and diagnostic services.     

For more information, please visit ChandlerRegional.org or call (480) 728-3000. Chandler Regional is an Equal Opportunity Employer (EOE). for information on doctor referrals, community classes or support groups, please contact ResourceLink toll-free at (480) 728-5414.   

Mercy Gilbert Medical Center is located at the intersection of Val Vista Drive and Loop 202 (south of Pecos Road and east of Val Vista Drive). Mercy Gilbert is a 212-bed, acute-care, not-for-profit provider of emergency care, family birth services, diabetes management, comprehensive stroke services, gastroenterology, sleep studies, neurosciences, orthopedics, general surgery and diagnostic services. for more information, please visit MercyGilbert.org or call (480) 728-8000. Mercy Gilbert Medical Center is an Equal Opportunity Employer (EOE). for information on physician referrals or community classes and support groups, please contact ResourceLink toll-free at (480) 728-5414.   

Dignity Health, headquartered in San Francisco, Calif., provides integrated, patient and family centered care. It is the fifth largest health system in the country with 10,000 physicians and 55,000 employees across Arizona, California, and Nevada.

Through its network of more than 150 ancillary care sites and 40 acute care hospitals, Dignity Health is committed to delivering compassionate, high-quality, affordable health care services with special attention to the poor and underserved. In 2011, Dignity Health provided $1.4 billion in charity care, community benefit and unreimbursed patient care. for more information, please visit our website at DignityHealth.org.

To comment on this article and others, please visit: Facebook.com/SanTanValleyNEWS or send us an email at This e-mail address is being protected from spambots. you need JavaScript enabled to view it

The average person has a 40 percent lifetime risk of developing cancer. your lifestyle has something to do with your risk, but many cancers just happen.

Some of the worst — colon cancer, esophageal cancer, pancreatic cancer and many others — have no symptoms and strike otherwise healthy people who have a generally healthy lifestyle. we can screen for colon, breast, and perhaps prostate cancer, but many other cancers seem to strike as randomly.

Decreased rates of smoking have reduced the rate of lung cancer, but other cancers are increasing in frequency.

Given all that, imagine if a drug company could develop a medication that reduces the risk of getting cancer by as much as 50 percent with almost no side effects. and just for good measure, this new drug also reduces the risk of heart attacks and strokes.

The drug would be a blockbuster. it would make gazillions of dollars for the lucky drug company.

As you have guessed, the medicine already exists, it is virtually free, and available over the counter at any drugstore or supermarket. as has been reported widely, our old friend aspirin is showing real promise against cancer: from prevention to death rate reduction to containment.

Three new studies in England published two weeks ago in the journal Lancet suggest that taking low-dose aspirin daily reduces the rates of cancer — in some cases by as much as 50 percent.

The studies were performed by a group of researchers from Oxford led by Dr. Peter Rothwell. they performed what is known as meta-analyses, a research process in which multiple studies of similar design are pooled to look for results that may have more statistical significance because of larger numbers of patients.

One of the studies combined 51 randomized trials that looked at patients who took low-dose aspirin for up to nine years compared to those who took a placebo. even though cancer incidence was not the outcome the studies were looking for, in retrospect the overall cancer mortality was 40 percent lower in patients that took regular aspirin for more than five years compared to patients in the control group who did not take aspirin. the benefit waned a bit with longer duration of treatment, but there was still a 22 percent lower risk of cancer in patients taking aspirin for more than 20 years.

The biggest benefit in cancer incidence was a decrease in colon cancer and other intestinal cancers where a 38 percent reduction was seen. there was also a reduction in certain types of lung cancers called adenocarcinoma, a type of cancer that is more common among nonsmokers. Aspirin use also was associated with a lower rate of esophageal cancer (the reduction was more than 50 percent), pancreatic cancer, breast cancer and prostate cancer.

In patients who already had cancer, aspirin was associated with a lower rate of spread (metastasis), especially in patients with colon cancer.

The effect was seen with low-dose aspirin, such as the dosages commonly used for heart attack prevention. Aspirin dosages as low as 75 mg were as effective as higher doses (1500 mg or above) in preventing cancer. In other words, more was not better when it came to cancer prevention. Baby aspirin, the most common dose used for heart attack prevention is 81 mg, an effective dose for preventing cancer, according to the studies.

Speaking of heart attack prevention, according to these studies, the benefit from aspirin on cancer prevention was greater than the benefit in preventing heart attacks and strokes.

The biologic mechanism that explains how aspirin prevents cancer has not been worked out, but most experts speculate that it may have to do with aspirin’s effect of reducing inflammation. but there may be other effects that have not yet been discovered.

Aspirin does have its downsides, however. the drug is an effective anticoagulant, and it promotes bleeding. it also is a direct irritant to the stomach lining, and all of the studies showed an increased risk of stomach bleeding associated with the use of aspirin. People with bleeding risks and a history of peptic ulcer disease may not be candidates for aspirin.

Curiously, two large American studies also looked at aspirin usage and did not show a reduction in cancer rates. the Women’s Health Initiative Study and the Physician’s Health Study, which looked at more than 60,000 men and women, were primarily looking at the effect of very low-dose aspirin on heart disease and stroke, but neither study showed a reduced risk of cancer. However both studies used low-dose aspirin every other day rather than daily, perhaps explaining the difference in benefit.

As promising as this research sounds, it is important to talk to your doctor before starting aspirin therapy. even though aspirin is available over the counter and is inexpensive, it obviously has enormous biological effects and is not for everyone.

But if these findings turn out to be confirmed, the implications are stunning. much more research needs to be done before we put aspirin in the water, but it is safe to say that these studies offer a ray of hope in the battle against cancer.

Dr. Bill Elliott is assistant physician in chief for Kaiser Permanente’s Novato office and Petaluma. his column appears every third Monday.

[HMNMH] – Colorectal cancer is one of the most preventable diseases, yet it is the third leading cause of cancer deaths in the United States.  Of the more than 140,000 people diagnosed each year, approximately 56,000 will die from the disease. Through routine screenings, however, colorectal cancer can be prevented and cured if detected and treated early.

Educating the Santa Clarita Valley community about colorectal cancer is a high priority for Henry Mayo Newhall Memorial Hospital and its Community Hospital Cancer Program.  A major goal is to educate the community and patients on the fact that colorectal cancer CAN, but does NOT have to be a killer. this is due largely to improved treatments and screening which allows more colorectal cancers to be found earlier.

“I am fortunate to be a colorectal cancer survivor,” said Jim Gilbert, a Henry Mayo patient.  “I experienced the best care possible during my treatment at Henry Mayo and credit the doctors, nurses and staff for my recovery.  however, had I done a routine colonoscopy when I was supposed to, I could have saved myself and my family much pain and heartache.”

It is estimated that as many as 60% of colorectal cancer deaths could be prevented if all men and women aged 50 years or older were screened routinely.  in most cases, colorectal cancer develops from precancerous polyps or abnormal growths.  It has been proven that screening tests can detect these precancerous polyps, so that they can be removed before they ever turn into cancer.  Screening tests also can find colorectal cancer early, often at the point where treatment works best and has the best chance of success.

The risk of developing colorectal cancer increases with age; more than 90% of cases occur in people aged 50 or older.  Symptoms for colorectal cancer can vary or there may be no symptoms at all, and men and women are equally at risk.

Remember, there are simple ways to reduce your risk and protect yourself.  Talk to your doctor, get screened and eat right.  to locate a physician who can provide more information on colorectal cancer screenings and prevention, call Henry Mayo Newhall Memorial Hospital’s physician referral Line at (661)253-8888 or visit scvdocs.com.

Colon Cancer Prevention Tips

* If you’re 50 or older, schedule a colon cancer screening

* Eat a balanced diet

* Maintain a healthy weight

* Maintain an active lifestyle

* consider genetic counseling

* Learn your family medical history

* Talk to a doctor about your personal medical history

Brittany Richardson would slip away during halftime to the bathroom in the locker room.

The Sultana girls basketball player often spent that eight-minute break throwing up, trying to make her stomach feel better.

Then it was back on the court where she was still a proficient player, averaging 7.2 points, 4.0 rebounds, 2.7 assists and 1.4 steals per game as a junior.

Today, Richardson is far more effective as a player, and is pain free. Now a senior, she’s the Sultans’ leading scorer at 15.4 points per game.

“I felt actually really good (when this season began),” Richardson said. “I was already healthy when it was time for the season so I felt really confident.”

But it was just a year ago that Richardson was forced off the court and into a hospital bed after being diagnosed with ulcerative colitis, an inflammatory bowel disease that affects the lining of the colon and rectum.

The pains started in December 2010. The Sultans were at a tournament when Richardson first noticed blood in her stool. Then came the stomach pains, but she kept playing basketball.

An initial visit to the hospital didn’t reveal anything and she kept playing despite the pain.

Her final game that season came against Apple Valley on Jan. 4. she contributed 10 points, six assists, three rebounds and three steals, but she was done.

“That I night I was like, I can’t go to practice no more,” Richardson said. “That night it really hit me. I started getting stomach pains that were really bad.”

Her weight was plummeting. she said she lost 10 pounds in one week from throwing up, and Mary Navarro — her teammate and best friend — said each time she saw Richardson, she’d look even skinnier than the previous time.

“you could see my bones and everything. it was bad,” said Richardson, who at her lowest point was down to 99 pounds.

Richardson finally went to see a specialist and got a colonoscopy, which revealed she had ulcerative colitis. she ended up spending much of the next month in the hospital and had seven pints of blood transfused. she credits her parents Tarius and Michelle and grandparents Cindy and Tony Serrano for watching her through that time. Teammates and coaches also made frequent visits.

“I went to visit her in the hospital and I was taken aback by it, I have to be honest,” Serbus said. “Selfishly, you want to have her on the basketball floor, but her health was more important.”

She finally left the hospital for good in late January. Although Sultana’s season didn’t end until mid-February, Richardson was in no condition to play, relieved of her symptoms but feeling weak.

“When I got out of the hospital I actually tried to shoot the ball and the ball felt really heavy,” Richardson said. “I didn’t know I was going to feel as weak as I did.”

Richardson slowly started to make her way back after the season ended. she started putting on weight and eventually built up to playing basketball again.

Today her ulcerative colitis is manageable. She’s back to her normal 127 pounds and hasn’t had a flare up since she left the hospital. she has to get a yearly colonoscopy and watch what she eats, avoiding dairy and anything else that starts to bother her stomach, but is largely back to living a normal life.

And making up for lost time on the court. Along with leading the team in scoring, she averages 5.4 rebounds and 3.4 assists per game.

“She’s been phenomenal this year,” Serbus said.Matthew Peters can be reached at or (760) 955-5365.

Reported this week in The Lancet (Jan. 27, 2012), the two studies demonstrated how the test, which measures the activity of fourteen genes in cancerous tissue, improves the accuracy of prognosis. This in turn could guide treatments for patients with the most common form of the disease, non-squamous non-small cell lung cancer.

The two independent clinical trials included one blinded study involving the analysis of tissue samples from 433 people with early-stage lung cancer in northern California and another study involving 1,006 people with early-stage lung cancer in China. in both trials, the team showed that the test could accurately predict whether the odds of death within five years of surgery to remove a lung cancer were low, intermediate, or high.

“It’s quite exciting,” said David Jablons, MD, the Ada Distinguished Professor in Thoracic Oncology and leader of the Thoracic Oncology Program at the Helen Diller Family Comprehensive Cancer Center at UCSF. “This has the potential to help hundreds of thousands of people every year survive longer.” Jablons co-led the study with Michael Mann, MD, a UCSF Associate Professor of Cardiothoracic Surgery.

Today, doctors assess early-stage lung cancers by their size, location and microscopic appearance. This information, known as staging, is then used to guide the use of additional treatment following surgery. if doctors could more precisely gauge prognosis, more people who might benefit from additional therapy could receive it immediately after surgery, before any residual cancer has had a chance to grow.

Evidence from other studies suggests that chemotherapy given in early-stage lung cancer helps thwart recurrence when there is evidence of lymph node involvement. Such involvement increases the risk of other, undetectable metastasis.

The scientists plan to design a large clinical trial that would seek to confirm that using the algorithm to guide therapy helps people with lung cancer survive longer.

The study conducted in China is the first major clinical trial result to emerge from the China Clinical Trials Consortium (CCTC), a collaboration between hospitals and universities across mainland China that was founded with the help of leaders from the UCSF Thoracic Oncology Program to confront the epidemic of lung cancer in China.

“The CCTC represents a revolutionary new collaborative approach to clinical research among Chinese and Western experts,” said Mann. “It is fitting that this body’s first major effort may support a molecular personalization of lung cancer care, and yield one of the first examples that fundamental tumor biology reaches across ethnic lines and can be used to try to improve outcomes for a large percentage of patients.”

Problems with Lung Cancer Prognosis

Lung cancer is the most common cause of cancer death in both the United States and the world. more people die from the disease each year than from breast, colon and prostate cancers combined. it claims more than 150,000 American lives annually and accounts for some 1.4 million deaths around the world. About 85 percent of Americans with all types of lung cancer die within five years of diagnosis.

Most cases result from exposure to cigarette smoke, but other causes include exposure to asbestos, chemicals, environmental factors and genetic susceptibility.

One of the challenges of treating the disease is that it often goes undetected in its early stages, when it is most treatable, because it usually does not cause symptoms. only about 30 percent of patients in the United States are detected in the earliest stage of the disease, contributing to the low overall survival rate.

Even people who have their cancer detected at the earliest stages, however, face serious odds. unlike other types of cancer, where early diagnosis has significant survival advantages, some 35 to 45 percent of people with stage I lung cancer die within five years of recurrent disease, despite successful surgery. The prognostic test would address the inability to identify these patients, said Jablons.

Lung Cancer Treatment

For people with lung cancer that has metastasized to regional lymph nodes, the standard treatment is surgery followed by chemotherapy. for people without detectable lymph node involvement, the approach generally is surgery followed by clinical observation alone. With this “watch and wait” approach, doctors recommend additional treatment — surgeries, chemotherapy, or radiation therapy — only if the cancer recurs.

The challenge for doctors is that many people with early-stage lung cancer harbor tiny, undetectable clumps of cancer cells either in their lungs or throughout their bodies that grow into tumors in the months and years after surgery, giving rise to recurrent cancer. almost half of all people with stage I lung cancer have these very early metastatic cancers.

Past studies involving people with stage II and III disease suggest that earlier treatment, before recurrent tumors can be detected, improves the chances of survival.

Given the danger of metastases even from stage I lung cancer, however, current guidelines also recommend the consideration of chemotherapy for a subset of stage I patients whose tumors have characteristics that are believed to put them at high risk for recurrence.

The data reported in The Lancet indicate that the new molecular assay does a better job at identifying patients at high risk of early death after surgery, and may therefore be a better guide for consideration of early chemotherapy.

How the Molecular Assay Predicts Lung Cancer Survival

The molecular assay is based on technology developed originally at UCSF. The assay itself was developed by Pinpoint Genomics, a company based in Mountain View, California, and relies on a standard laboratory technique known as quantitative polymerase chain reaction (qPCR).

The analysis begins with a piece of the patient’s cancerous tissue embedded in paraffin wax—the standard way of preserving all tissue samples removed during surgery. Material known as RNA, which reveals the relative activity level of genes within tissues, is then extracted from the tumors. The activity levels of 14 specific genes are then determined and compared to levels in normal lung. Eleven of these genes are linked to lung cancer biology, and the other three are common genes that are used to standardize the measurement of the cancer genes.

Pinpoint Genomics developed an algorithm for calculating risk of death after examining tissue taken from 361 patients at UCSF Medical Center who all had surgery to treat a common type of lung cancer called non-squamous, non-small cell lung cancer. The algorithm correlated the levels of these 14 genes with the clinical outcomes of these patients, the theory being that a molecular profile associated with a low, intermediate, or high risk of death in one patient could be used to predict a low, intermediate, or high risk in another patient.

To test their algorithm, the UCSF team partnered with Kaiser Permanente’s Division of Research in Oakland, CA and blindly examined lung samples taken from 433 other patients in northern California with the earliest stage of the same type of cancer. They also used a similar blinded approach to test the algorithm using tissue samples from 1,006 lung cancer patients in China, where lung cancer is one of the leading causes of death. no other clinical trial examining molecular prognostic indicators has ever demonstrated the same result in two different populations with different genetic make-ups on two continents, the team said.

The scientists found that the algorithm very accurately differentiated patients with high, intermediate or low risks of death in these larger cohorts of patients, even for patients with stage II and stage III lung cancer.

more information: “International, Large-Scale Validation of a Practical Molecular Assay Prognostic of Survival in Resected Non-Squamous, Non-Small Cell Lung Cancer”. Paper online: thelanc … 0140-6736(11)61941-7/abstract

Provided by University of California, San Francisco (news : web)

Published on 26/11/2011

Many athletes complain of a sharp, colicky pain in the left or the right upper quadrant of the abdomen during strenuous exercise. This is commonly referred to as a stitch.

This may be due to muscle spasm of the diaphragm or trapping of the gas in the liver or spleen flexure of the colon. This condition has often been thought to be associated with exercise undertaken soon after eating a solid meal.

There is no proof of this but avoidance of solid meal prior to exercise may be an appropriate treatment. Occasionally, athletes get cramping type of abdominal pain. This occurs in association with intense, endurance exercise and is thought to occur as a consequence of relative ischemia due to shunting of blood away from the gastrointestinal tract to the exercising muscles.

The effect is aggravated by dehydration. The possibility of abdominal pain being referred from the thoracic spine should always be considered. A thorough examination of the thoracic spine should be performed in any athlete complaining of abdominal pain.

Reduced mobility detected in one or more intervertebral segments should be corrected by manual therapy techniques and the effect on the athletes symptoms noted.

Diarrhoea appear to be the more frequent, with exercise especially with long distance running, as a result, the terms runners trot and runners diarrhoea have been coined to describe the condition.

Athletes may complain of an urge to defecate while running, approximately half of those who experience this urge to defecate actually complain of episodes of diarrhoea during running.

The incidence of runner’s diarrhoea seems to be related to the intensity of the exercise and occurs more commonly in competition than in training. The anxiety associated with competition may be a contributory factor. The exact cause of runner’s diarrhoea is uncertain.

Relative intestinal ischemia described above may be a contributory factor. an increase in intestinal motility may also contribute to the development of diarrhoea.

Studies of the relationship between intestinal transit time and exercise have shown conflicting results but would appear that intestinal motility is increased with intense exercise.

This increase in gut motility and changes in intestinal secretion and absorption may be related to increased level of hormones associated with exercise. When faced with an athlete with diarrhoea, the clinician should also seek a history of vitamin and mineral supplementation or ingestion of caffeine or artificial sweeteners prior to exercise.

Each of these may contribute to runner’s diarrhoea. Acute diarrhoea is usually due to an infective cause and may be viral or bacterial. This is a particular problem when the athletes are travelling away from home.

Treatment of athletes with exercise related diarrhoea involves dietary changes to include reduction of fibre content of the diet 24 hours prior to intense competitive exercise.

Dr Gondi, a medical practitioner, is a member of National Olympic Committee’s Medical Commission and board member of Regional Anti-Doping Organisation.

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Market adoption of Meridian Bioscience’s (NASDAQ:VIVO) new molecular diagnostic testing platform illumigene will go a long way toward determining the company’s future.

Cincinnati-area Meridian is betting big on the technology, hoping it’ll help rescue the diagnostic testing company from its recent struggles. the company has reported declining year-over-year earnings in several recent quarters and twice in the last few months downwardly revised its full-year earnings outlook for 2011.

Meridian’s illumigene platform provides its hospital and laboratory customers with a simpler, cheaper option to test samples for certain types of bacteria without the use of expensive instrumentation. It represents Meridian’s first foray into molecular diagnostics, a means of analyzing the makeup of an organism at the genetic level.

AdvertisementMolecular diagnostic tests tend to offer better sensitivity and specificity than their antibody-based counterparts, said Zarak Khurshid, a senior research analyst with Wedbush Securities. “the world appears to be moving in the direction of molecular tests,” he said.

So for Meridian to stay at the cutting edge of its industry and build the best products it can, the company’s push into molecular diagnostics must succeed.

“Illumigene is critically important to Meridian’s future — the reason being that the diagnostic space is fiercely competitive,” Khurshid said.

Thus far, Meridian has just one illumigene test on the market, for C. difficile, a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. CEO Jack Kraeutler said in July that Meridian expects to begin selling a second illumigene test, for Group B Streptococcus, to international markets before the end of the year.

Kraeutler said at the time that the company had achieved 500 “placements” of the test, with 90 percent of those in the U.S. Those sales contributed $6 million in revenue in 2011. (Kraeutler didn’t return calls for this article.)

That performance is a little better than Khurshid had expected, though he warned the true test of the illumigene platform will be whether it can help Meridian regain market share it’s lost to competitors like Cepheid, Becton Dickinson and Thermo Fisher Scientific.

Cepheid, in particular, has bruised Meridian with a molecular C. difficile test that came on the market in 2009. Khurshid estimates that the Cepheid test has taken a 10 percent bite out of Meridian’s market share in each of the last two years.

If Meridian is going to succeed, it needs to turn that around quickly — and that’s among the company’s biggest looming challenges.

“the jury is still out as to whether illumigene will allow Meridian to take back some of its lost market share and whether they can develop additional tests on that platform to build a meaningful, high-growth franchise in molecular diagnostics,” Khurshid said.

“he was funny — goofy funny. he loved life. he loved the water, liked motorcycles, which momma didn’t like,” Shackley said.

He enjoyed jokes. he liked to pull them, too. he would burst through a door, all 6-feet, 5-inches of him, lean against a wall and fall to the floor in laughter.

As a child, he had the occasional runny nose, strep throat and his tonsils removed. Nothing serious. he was a healthy boy.

It all changed in the summer of 2006.

Ben was diagnosed with diverticulitis. his father, Dan, remembers Ben doubled over in pain and trips to the emergency room in “unbelievable agony.”

“they kept saying diverticulitis,” Linda said.

He was on medication, but did not get better, she said.

Linda, a retired obstetrics nurse, spoke to a doctor about Ben’s condition. the doctor said he would visit Ben if his health did not improve.

Ben was admitted to the hospital in December 2006 for surgery to remove a section of colon affected by diverticulitis, Linda said.

She said the doctor told her you “could have heard a pin drop in the operating room.”

“they didn’t expect to find cancer in a 24-year-old otherwise healthy kid,” she said.

They removed 3? feet of Ben’s colon.

Ben had stage 4 colon cancer.

He coached football when he was so sick he could barely walk, Dan said. he also earned his GED less than a year before he died — going to night school while receiving chemotherapy treatment, which he had every other week for a year and a half.

He didn’t talk to his mother about cancer. Linda said the only time they discussed it was when they were informed that surgery could not be performed. Chemotherapy was no longer an option because of his weakened immune system and a diagnosis of pancreatitis, Linda said. they sat and cried for an hour. then Ben sat up in bed and told them “enough of this … let’s watch ‘Jeopardy.’ ”

He lived almost two years before he died in September 2008. Ben was just 26 years old.

The Shackleys now urge others to get screened for colon cancer. they want people to be proactive about their health and get a second opinion, or however many it takes, until they know for certain what is medically wrong.

Linda’s goal is to save one life – then another.

In honor and memory of Ben, and to raise money to fight the disease that claimed his life, Ben’s niece and nephew, Abby and Erik, make bracelets. They’ve made hundreds of them. Volunteers also make them. They’re called Ben’s Bracelets.

The idea for Ben’s Bracelets was inspired by Jo-Ellen De Luca. the 10-year colon cancer survivor spearheads the Colon Cancer Solutions Walk-Run. This year’s event starts at 8:30 a.m. Saturday at Duncan Park in Spartanburg.

The Shackley family will volunteer at the walk-run, cooking a whole hog for barbecue.

Admission to the fundraiser is $20. the meal is $5 per plate, which includes pork, baked beans, slaw, roll and a drink.

Money raised benefits get Checked, which provides support to those who have been diagnosed with colon cancer, have symptoms of colon cancer or lost someone to the disease. the support group, under the umbrella of the Colon Cancer Solutions, educates others and works to raise awareness about the disease.

The group also puts people who do not have health insurance or a physician in touch with organizations that can assist them in getting screened.

Dr. James Dunn, a general surgeon and colon-rectal surgeon in Spartanburg, will attend Colon Cancer Solutions Walk-Run to cheer people on and encourage them to get checked.

“I think the biggest misconception is that it couldn’t happen to me. I’m not having symptoms, so surely nothing could be wrong,” he said.

Like most cancers, colon cancer starts small and is painless, Dunn said. by the time a patient is symptomatic, the cancer may have grown awhile, he said.

It’s important to know your family history, which could put you at greater risk of developing the cancer.

The American Society estimates that 101,340 new cases of colon cancer will be diagnosed in 2011 in the United States. a colonoscopy is recommended every 10 years, beginning at age 50, by the American Cancer Society.

Dunn said a colonoscopy generally takes 20 to 40 minutes, depending on whether any polyps are found. he said there are risks of perforating the colon and a rare complication is bleeding with the removal of polyps. most people, he said, should set aside half a day for a colonoscopy.

“if you were to ask any survivor if they could have anything, it would be to turn the clock back to get an earlier screening and have a colonoscopy,” De Luca said.

She said the group wants people to get screened early so they won’t have to face major surgery, complications or death.

“the earlier the screening, the better the outcome,” she said.

Ten Years. Ten long years. Ten slow years. Ten years of being thankful to still be alive. Ten years of watching my friends slowly die off of illness related to their work in the toxic plume in the wreckage of the collapsed World Trade Center (WTC). Ten years of lobbying our government to do the right thing and embrace the medical issues that “The Heroes” are now riddled with. Ten years of families still waiting for DNA to connect thousands of bodily remains so that they can bury or inter some piece of their lost family member as opposed to having nothing or no place to go. Ten years.

On September 10, 2001, I was a happy, healthy new York City firefighter looking forward to the next morning and what excitement the day would bring. as we all know “that day” turned out to be a day that would change the face of the world, fracture its security, and redefine “terrorism” as a worldly concern for the U.S. as opposed to it happening everywhere but here. The world’s most televised event happening right in front of us. either standing on West Street or standing in front of your television, we witnessed horror at a level unimaginable to the American people. Firefighters and police officers running in while everyone else was trying to get out. Regular folk refusing to leave his or her fellow friends or coworkers to find their own way down. Acts of selflessness that define bravery and humanity amidst the greatest travesty and disregard for human life that anyone could think of.

The Big One

That morning as I drove across the Brooklyn Bridge, I knew what my destiny in life was. I was going to what we called, “The Big one.” I and my comrades knew that this would indeed be our last day. It was the first thing I said as we turned off the approach and were mid-span on the bridge. The officer in charge sitting across from me, a two- time Vietnam vet, cancer survivor, and 30-year veteran of the Fire Department of new York (FDNY) sat quiet and simply muttered, “This is very bad, Bobby.” I on the other hand was a bit more expressive in my words, “Holy shit, Ed! look at that! We’re gonna die.” He agreed, and we both knew that people were in dire need of rescue. to put it simple, there were twenty floors of fire over a thousand feet in the air, and we were in deep shit from the onset. People were flying out the windows from above, exploding in the street, and there was nothing we could do to stop it. as we pulled up to the foot of the WTC property on Liberty Street, everyone’s attention was suddenly drawn to a loud sound coming from the south. I looked straight up to catch a glimpse of the tail section of United flight 175 sinking into Tower 2. “This is the end of the world,” I thought. Ed and I were immediately swept into a stampeding swarm of people running for their lives.

The rest of the morning went as we all know—thousands dead, an American icon of building construction and freedom now in a smoking pile with bodies everywhere. Hell had come to earth and taken up residence in lower Manhattan. little did any of us working there realize, we all took this hell home with us…both physically and emotionally.

Many are now ill and tragically many have also died from their exposure to what then EPA Director Christine Todd Whitman called “air that is safe to breathe.” Lung cancer, heart disease, sarcoidosis, colon cancer, brain cancer, and the list goes on. Many, including myself, have an extremely diminished lung capacity, a condition called RADS or Reactive Airway Disease. It kind of feels like you were under water too long; like you’re inhaling glass shards. Sinus conditions, numerous bouts with chronic bronchitis, sleep apnea, and skin conditions. The numbers of “exposed” are in the thousands and most of us have that thought in the back of our heads, “Wonder when it’s going to be me.” no drama. no nonsense, it’s something we are now living with and will undoubtedly shorten our time on this planet and our time with family and friends.

Best Laid Plans

My plans were to be in the fire business for thirty years and retire as a captain with a group of young men that I would lead into battle and be respected for my compassion, leadership, and experience. I was in the process of transferring to Special Operations Company, which is kind of the like getting asked to play for the Yankees even though I’m a Mets fan. Something wasn’t right. I wasn’t sleeping, and to be honest I haven’t slept a solid night in ten years now. I was drinking coffee by the gallon, and I was having some pretty wicked dreams and flashbacks of people jumping from those windows. I was dreaming of my dead friends talking to me, begging me to come and get them out of “The Pile.” I was waking up soaking wet and in a panic. I tried to ignore these symptoms and just go back to work. I went to a bunch of fires, and I was most definitely on edge. I was not looking forward to going to work as I had. in fact I was actually fearing it. when I’d drive home following the end of my tour, I’d be saying, “Okay, Bobby, you lived another day.” that was not normal by any means. Eventually these daily conflicts had consumed my life, and it was time to acknowledge them. I reached out to the FDNY Counseling Unit to simply get a few weeks off so I could recharge my batteries. to the contrary and to my surprise, those “two weeks” became the rest of my life. I was eventually diagnosed with Acute Chronic Post Traumatic Stress Disorder. “What? me? PTSD? that only happens to those Vietnam guys.”

I soon learned that many of us were suffering from the same emotional injuries that combat vets suffer from. Now looking back I understand that we were in a battle that morning; a battle that became known as the first battle in “The War on Terror.” We didn’t carry rifles or wear camouflage. We wore fire helmets and fire gear. We were injured and some of us died. under all that gear though, we were human just like everyone else. We feel pain and regardless of how much you are taught in the fraternal aspect of the fire service to “not feel,” these feelings get inside of you, and they simply don’t go away. just the opposite; they stay inside of you and bounce around like a razor blade that chews you up.

Over the past twenty-five years, I’ve been told I was a “very good fireman.” I was told I was “one of the toughest guys” people had met with my ability to embrace death, blood, guts, sadness, and pain. It is what we strive for in the fire business—being that “go to guy” who gets it done. I did, and I did it well. however, having to adjust to the fact that I had become a “victim” of this attack and that I had to now care for the caregiver was not easy, and I still struggle with it ten years later. I’ve been in some form of cognitive therapy for seven years now. I retired from the FDNY in October of 2006, and my expectation of being that cranky old captain with thirty years of service? unfortunately that will remain a dream.

Never Forget

Ten years later, I am now addressing all walks of life with regard to our emotions and that we take a lot home with us. Cops, firemen, nurses, teachers, security agencies, you name it, I’m spending some time with them to expand their awareness to “emotional injury.” I’ve written articles for a number of emergency services magazines and websites. I recently finished my first book titled, Beyond Surviving, and most recently began recording podcasts and a radio forum called, “It’s okay Not to be Okay” with a renowned clinical psychologist, Dr. Mark Lerner.

I had a choice to make at a point in my “recovery.” I had to do something with what happened to me. I felt the need to teach others that we are all human and that we all feel. Most of all, I had to pass on the message that life is “one day at a time” and that we are allowed to heal. Firemen, cops, and military; we all have a tough time embracing that one. when they meet me or read an article, they can’t say, “That guy has no clue what we go through. Who is he to tell me about my emotions?” I worked for the best fire department on this planet. I worked in the busiest neighborhood and in a respected company. all validating marks that can’t be dismissed. I’ve been there and done it. Thankfully, they acknowledge that for their own well being and embrace taking care of themselves so they can continue to take care of others.

Take a moment this September 11th and those that follow to watch an American flag blow in the breeze. be thankful that you live in a country that allows you to read whatever book or magazine you want, watch whatever TV channel you choose, and either walk into or pass by the house of worship of your choice. Thank a veteran for their service and realize that tomorrow has no guarantees. Make the difference today.

NEVER FORGET. 343 37 23