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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.


Lymphoma & Celiac Disease

Lymphoma Risk Up in Celiac Disease
Published: Aug 5, 2013 | Updated: Aug 6, 2013, By Nancy Walsh, Staff Writer, 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

Patients with celiac disease have an elevated risk for lymphoproliferative malignancies, particularly if they have persistent villous atrophy, a population-based cohort study found.

Compared with the general population, the standardized incidence ratio for lymphoproliferative malignancy among patients with celiac disease was 2.81 (95% CI 2.10-3.67), according to Benjamin Lebwohl, MD, of Columbia University in New York, and colleagues. And for those who continued to have villous atrophy of the intestinal mucosa, the standardized incidence ratio was 3.78 (95% CI 2.71-5.12), the researchers reported in the August 6 issue of Annals of Internal Medicine.

Previous studies have suggested that patients with celiac disease are atincreased risk for lymphomas, and although the precise reason for this isn't clear, it may relate to ongoing villous atrophy in some patients, particularly those who fail to adhere to a gluten-free diet.

Because current guidelines don't clarify whether patients should have a follow-up biopsy to confirm mucosal healing, and to estimate the risk for malignancy among those with persistent villous atrophy, Lebwohl and colleagues analyzed data and biopsy reports from Sweden's pathology departments for the years 1969 to 2008.


GI Health & Cancer

Digest this: Cure for cancer may live in our intestines


ANN ARBOR—Treating a cancerous tumor is like watering a houseplant with a fire hose—too much water kills the plant, just as too much chemotherapy and radiation kills the patient before it kills the tumor.

However, if the patient's gastrointestinal tract remains healthy and functioning, the patient's chances of survival increase exponentially, said Jian-Guo Geng, associate professor at the University of Michigan School of Dentistry. Recently, Geng's lab discovered a biological mechanism that preserves the gastrointestinal tracts in mice who were delivered lethal doses of chemotherapy.

The findings, which will appear in the journal Nature, could revolutionize cancer therapy, Geng said.

"It's our belief that this could eventually cure later-staged metastasized cancer. People will not die from cancer, if our prediction is true," said Geng, who emphasized that the findings had not yet been proven in humans. "All tumors from different tissues and organs can be killed by high doses of chemotherapy and radiation, but the current challenge for treating the later-staged metastasized cancer is that you actually kill the patient before you kill the tumor.


Relationship between Gut Microbiome and Obesity

'Gut Microbiome' Key to Obesity, Metabolism
Medscape Diabetes & Endocrinology, Karine Clement, MD, PhD, Jul 19, 2013

Good morning. I am Professor Karine Clement. I'm a professor of nutrition at the Institute of Cardiometabolism and Nutrition in Paris. I'm here at the American Diabetes Association (ADA) conference to tell you about gut microbiota, metabolism, and bariatric surgery.

You all know that there has been an increase in the morbid form of obesity worldwide. There is a specific tool to improve these patients' condition: bariatric surgery. Actually, there are different tools. One is purely restrictive, where you have a diminution of food intake, using either a banding ring or a sleeve gastrectomy. But one of the most popular tools in bariatric surgery uses not only a restrictive procedure but also a malabsorptive procedure; it's called gastric bypass, or Roux-en-Y, and it has been well shown to induce major and sustained weight loss. It improves a lot of cardiometabolic risks, and there is also an improvement in systemic and tissue inflammation. This procedure is not only very effective for patients by reducing their risk, but it also has helped us better understand the factors associated with the improvements from bariatric surgery -- not only metabolic factors and inflammatory factors, but other aspects as well.

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