HEALTH IN OUR HANDS
The Arkansas State University Wellness Program Newsletter
www.clt.astate.edu/wellness

Contents:

Gastrointestinal Disorders - Part One
Heartburn and Gastroesophageal Reflux Disease
    - Symptoms
    - Reasons to Suspect GERD
    - Common Causes
    - Treatment
    - Lifestyle Modifications
Colon Cancer
    - Risk Factors
    - Symptoms
    - Prevention
Newsletter Sources
Important Insurance Information
University News

Gastrointestinal Disorders - Part One

     The staff of the Employee Wellness Program would like to wish everyone a safe and Merry Christmas and a Happy New Year.
      Gastrointestinal disorders affect millions of people every year.  These disorders can cause pain, embarrassment, and even hospitalization.  This newsletter will be the first in a two-part series that will discuss various gastrointestinal problems, their symptoms, and available treatments.  Today our focus will be on heartburn, gastrointestinal esophageal reflux disease, and colon cancer.

Back to top

Heartburn and Gastrointestinal Reflux Disease

     One of the most common gastrointestinal symptoms is heartburn.  This problem affects approximately 40% of Americans at least once a month.  Heartburn can be simply a symptom, or it can represent a serious disease called gastro-esophageal
reflux disease (GERD).

Back to top

Symptoms of Heartburn or GERD

     Some of the most frequent symptoms of heartburn include the following:
1) A sour or burning sensation in the upper abdomen or chest
2) A sour or burning sensation that travels into the neck or mouth and can be associated with food sticking or acid regurgitation
3) Sour or burning sensation that is worse after meals, while lying down at night, or during exercise that requires bending over.

Back to top

Reasons to Suspect GERD

    GERD can be associated with esophageal ulcers, esophageal bleeding, narrowing of the esophagus, and possibly a premalignant condition called Barrett’s esophagus.  There are certain clues that can tell you when your symptoms of heartburn
are serious enough to visit a doctor. These symptoms include:
1) Heartburn at least twice a week
2) Heartburn that does not improve with antacids or over-the-counter medicines
3) Heartburn associated with food sticking, weight loss, or low blood count

Back to top

Common Causes

     Heartburn and GERD have actual physical causes, but these problems can be worsened by bad food choices.  The usual physical cause of these problems is the frequent relaxation of a muscular valve in the lower esophagus.  This faulty valve allows acid from the stomach to travel up into the esophagus.  Other causes can be a weak esophagus muscle, lack of saliva, slow emptying of the stomach, or large hiatal hernias.
     For generally healthy people, heartburn can be made worse by poor eating habits and lifestyle choices.  Some aggravating factors include:
1) Cigarette smoking
2) Obesity
3) Certain foods such as chocolate, peppermint, spicy foods, tomato products, citrus products, coffee, and fried or fatty foods
4) Some types of people will experience heartburn more than others.  Two examples of this include the elderly and pregnant women.

Back to top

Treatment

     There are many ways to treat heartburn and related problems.  Over-the-counter antacids and new H2 blockers are effective and safe products for treating occasional heartburn symptoms.  Antacids work more rapidly, but H2 blockers are longer acting.  For this reason, H2 blockers should be taken prior to meals or activities that could cause heartburn symptoms to occur.  These over-the-counter drugs should not be used daily because they may have significant side effects such as diarrhea, altered calcium metabolism, and magnesium retention when used in excess.  For patients with mild heartburn, lifestyle changes are usually the best choice of treatment.
    GERD is a more serious problem that many people do not take seriously enough.   If you experience any of the signs of GERD listed previously, see a doctor.  Physicians can prescribe various types of medications for people with GERD. Antireflux surgery strengthens the weak muscular valve in the esophagus, but this intervention is only performed as a last resort.

Back to top

Lifestyle Modifications

     As previously mentioned, lifestyle changes may be enough to control mild heartburn in otherwise healthy individuals. Some of the most common lifestyle changes recommended are:
1) Raise the head of the bed.
2) Change eating and sleeping habits.  Do not eat for at least two hours before bedtime.
3) Avoid tight clothing.
4) Change your diet and avoid problem foods.
5) Stop habits such as excessive alcohol intake and smoking.

Back to top

Colon Cancer

     Colon cancer has become the second leading cause of cancer death in the United States.  This cancer does not favor men or women or any certain race.  One of the most dangerous aspects of colon cancer is that it often comes without any warning signs or symptoms.  People over age 50 are more susceptible to colon cancer.  This disease is highly treatable IF it is discovered very early.

Back to top

Risk Factors

     There are several risk factors that can increase the chance of developing colon cancer.   These include:
1) Family history of colon cancer or of polyps in the colon
2) Familial Polyposis Coli Syndrome
3) Personal history of colon polyps
4) Personal history of Crohn’s Disease or Ulcerative colitis

Back to top

Symptoms

     Usually symptoms of colon cancer do not show up until the disease has become very advanced.  If you experience any of the signs or symptoms, please see your doctor as soon as possible.
1) Rectal bleeding or pain
2) Unexplained anemia
3) Unexplained weight loss
4) Change in regular bowel habits
5) New onset of lower abdominal pains

Back to top

Prevention

     Regular screenings are the key to preventing the advancement of colon cancer.  Common tests for this cancer include fecal occult blood tests, sigmoidoscopy, and colonoscopy.  Doctors usually recommend an initial fecal occult blood test and sigmoidoscopy at age 50.  Every adult over age 50 should have a sigmoidoscopy screening  every 5 years and an annual fecal occult blood test for microscopic bleeding or a colonoscopy every ten years.   High risk individuals should have a yearly fecal occult blood test and sigmoidoscopy.   Screening for high risk patients should begin at age 40 or 10 years younger than the youngest family member affected with the disease.
     Research studies are currently being conducted to link certain foods with the development of colon cancer.  While these studies are ongoing, many experts make the following recommendations based on preliminary findings.
1) Reduce animal fat in your diet.
2) Increase vegetable and fiber intake.
3) Increase calcium and folic acid intake.

Back to top

** Sources for this newsletter include:

International Foundation for Functional Gastrointestinal Disorders, http://www.iffgd.org
American College of Gastroentology
http://www.acg.gi.org
American Cancer Society
http://www.cancer.org

Back to top

Important Insurance Information

     As many of you already know, insurance costs for ASU employees will be increased as of January 1, 2002.  One reason for this increase in costs is the rising number of emergency room visits by insured employees and their families.  In 1999-2000, there were 162 non-emergency visits to the ER.  In 2000-2001, there have already been 220 non-emergency visits to the ER.
     An average office visit to a physician costs $45.  An average visit to the emergency room costs $216.38.   Costs for emergency room visits continue to rise.  It is very important to consider whether an illness requires emergency care before going to the emergency room.  Many illnesses can be handled by a physician in a regular office visit.  Reducing the number of non-emergency room ER visits will help keep costs down.

Back to top

University News
** The American Heart Association Heart Walk has been rescheduled for Saturday, March 30, 2002.  Look for more information in upcoming newsletters.

Back to top

ooOoo

The Arkansas State University Employee Wellness Newsletter is published monthly during the academic year by the College of Nursing and Health Professions.  Health questions can be addressed to Dean Susan Hanrahan, Ph. D., ext. 3112 or
hanrahan@astate.edu.
Produced by Kimberly McGaughey, graduate student in the College of Nursing and Health Professions, Physical Therapy Program.