PPIs and cancer

August's issue of Gut contains a meta-analysis that shows a 71% reduction in the risk of oesophageal cancer in patients with Barrett's oesophagus. Whether symptomatic or not, it seems that this group should be on longterm PPI therapy - but this is already the case. More interestingly, and much more controversially, is the question of whether people with reflux symptoms (but no endoscopic diagnosis) should be on the drug. Do PPIs prevent you getting cancer if you have reflux but not Barrett's?

There is much less decent information on this topic. Certainly one cannot say a resounding 'yes'. Indeed logically, the fact that they are the second most prescribed drug in this country (after statins) and we are still seeing an alarming rise in the incidence of oesophageal cancer, one could be forgiven for thinking the answer is clearly 'no'. Certainly longterm use has been linked to multiple vitamin amd mineral deficiencies and a higher rate of pneumonias and Clostridium Difficile infections. Ironically, one of the main problems is that they are too good at treating the symptoms of reflux but leaving the cause untreated. If one's life-disrupting symptoms of heartburn have gone, what is the incentive to still address those tiresome lifestyle issues that would take far more effort to turn around than just the popping of a daily pill?

More on this shortly.

Red Dolphin

Red Dolphin is an information and treatment resource for reflux, and an organisation that aims to increase awareness in the general population and medical world alike, of this under-rated symptom.

RED is because of the 'red alert' that I believe we should be attaching to the rising incidence of oesophageal cancer that is the end-point of uncontrolled reflux. It is the fastest rising incidence cancer in the West and therefore needs to be taken seriously.

DOLPHIN is because it is a common symbol in both the logos of the Universities of Bristol and Southampton, where I researched and wrote my MD thesis on aspects of the pathophysiology of oesophageal cancer and where my interest in this subject was firmly cemented.

In this blog I will aim to update the reader on new research advances, the pros and cons of various treatments, the importance of lifestyle advice, and other topics related to the field that I feel may be of interest.
Please do come and visit at www.reddolphin.org

But it's just a bit of heartburn

Whilst the general perception of reflux amongst the media and general population is that it is a benign if irritating symptom, in reality it is the starting point for the potential development of pre-cancerous changes. Oesophageal cancer is the Western world's fastest growing cancer in terms of incidence so this area is of utmost importance. 10% of the population refluxes, 10% of those get Barrett's change, and about 10% of them get cancer. It is to address this imbalance that I have set up this blog page, as well as an information and treatment resource called Red Dolphin - more soon.