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Dr. Lamm's weekly review of relevant articles and research

There is an increasing amount of information available about the gut.  Here are a few informative articles you may find valuable.

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Sitting Too Much May Raise Risk of Colon Cancer

Sitting Too Much May Raise Risk of Colon Cancer
Published: Oct 30, 2013 | Updated: Oct 31, 2013. By Michael Smith, North American Correspondent, MedPage Today, Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner.

Men who spend most of the day sitting might be increasing their chance of colorectal cancer, a researcher said.

In a pooled analysis of participants from two phase III clinical trials, men who were largely sedentary had an increased risk of recurring adenomatous polyps, according to Christine Sardo Molmenti, PhD, ofColumbia University Mailman School of Public Health in New York City.

On the other hand, there was no link between recurrence and sedentary behavior among women, Sardo Molmenti told reporters at the American Association for Cancer Research prevention conference in National Harbor, Md.

The clinical implication, she told MedPage Today, is that "clinicians should be encouraging patients to move, to stand, or really to do anything but stay in a sitting position for a large portion of time."

"There's a lot of value for these light, household activities, where you're not completely at rest, but you're not breaking a sweat to work out," she said.

The report comes the same week that European researchers also targeted sedentary behavior as a player in the development of metabolic syndrome and cardiovascular disease.

Doctors have tended to focus on the benefits of activity, rather than the risks of inactivity, commented Paul Limburg, MD, of the Mayo Clinic in Rochester, Minn., who was not part of the study but who moderated a press conference at which some details were presented.

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Antibody Test Spots IBS

Antibody Test Spots IBS
Published: Oct 15, 2013, By Nancy Walsh, Staff Writer, MedPage Today

SAN DIEGO -- Testing for antibodies to the protein vinculin may offer a serologic means of diagnosing irritable bowel syndrome (IBS), a researcher said here.

Measurement of anti-vinculin antibodies in serum demonstrated higher levels of these autoantibodies in IBS patients, compared with those without the disorder, with positive predictive values between 90% and 100% depending on the cutoff values used, reported Mark Pimentel, MD, of Cedars-Sinai Medical Center in Los Angeles, and colleagues.

For instance, with a cutoff using optical density above 0.8, the specificity was 81% and the positive predictive value was 93%, Pimentel said at the annual meeting of the American College of Gastroenterologyhere.

"Irritable bowel syndrome has been a diagnosis of exclusion, where we first have to rule out all sorts of other diseases and then apply the Rome criteria. But those criteria aren't specific, and in one study we found that only 67% of IBS patients met those criteria," he said.

There has not been a valid biomarker of the disorder, so most patients undergo extensive and expensive testing.

To address this diagnostic gap, he and his colleagues have been exploring the pathophysiology of IBS, and have found that in many cases, the condition arises after an episode of gastroenteritis, with bacterial overgrowth in the small intestine resulting from neuromuscular damage.

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The Mood-Gut Link

Mood-Gut Link Seen in IBS
Published: Oct 14, 2013 | Updated: Oct 14, 2013, By Charles Bankhead, Staff Writer, MedPage Today

SAN DIEGO -- Psychological comorbidity had a significant association with levels of an inflammatory cytokine in patients with irritable bowel syndrome (IBS), suggesting a centrally mediated effect, investigators reported here.

Patients had higher levels of interleukin-6 (IL-6) on initial and follow-up measurements as compared with a group of healthy individuals (7.72 to 8.95 pg/mL versus 5.77 pg/mL). Multivariate analysis showed that higher levels of IL-6 had significant associations with anxiety and depression but not with common symptoms of IBS.

Additionally, the patients had significantly lower levels of interferon-gamma, a key mediator of immune function.

Though suggestive, the results do not prove that psychological comorbidity in IBS is a driving force in the condition, Orla Craig, MB BCh, of University College Cork in Ireland, said at theAmerican College of Gastroenterology meeting.

"The elevations of IL-6 were higher than normal, but they were not very high elevations, which may indicate that IL-6 is not a very good marker for the association with psychological comorbidity," Craig told MedPage Today.

"These patients did not have severe depression but the mild type of depression that is often seen in patients with IBS," she added.

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