Why does acid reflux get worse after treatment?

Chronic acid reflux can be annoying and uncomfortable. Many times, when people are struggling with chronic acid reflux their healthcare provider prescribes them with a proton pump inhibitor, a proton pump inhibitor stops gastric acid secretion into the stomach and is commonly taken in combination with a protectant like sucralfate to in case there is damage done to the esophagus tissue or stomach lining (ulcer) which will coat theses part of the body to prevent and heal damage. Short term use of PPIs is the most effect and safe, but many people experience something called “rebound acid hypersecretion" which is an sudden increase in acid reflux and indigestion right after they finishing taking a PPI. It was found that the increase acid production was quicker than before they had taken the PPI and the release enterochromaffin-like cells had begun which also cause more acid production by releasing histamine.

Acid reflux and gastroesophageal reflux disease are very common problems for many people, but I choose to talk about how acid reflux can get worse after the most common treatment, which is PPI use, because I think the acid reflux is a lot more difficult to treat than people realize. When you look up treatments for acid reflux you will see articles saying to try multiple different diets, cleanses, apple cider vinegar, take medication, don’t take medication and it can be confusing how why is the most effective way. The reading I read suggests not abruptly stopping PPI and slowly decrease the amount you take to prevent rebound acid hypersecretion, but I think that more research would be helpful to see ways to treat acid reflux. 

I think this can show a valuable need for change in the experimental planning and publishing. I think when complex conditions and diseases like acid reflux are researched it can lead to a wide array of possible solutions because some treatments can work well on certain people or under certain circumstances. But I noticed that many times when information is published, it can be spread and lead people to misunderstanding how to treat and understand their own disease or condition. The best thing for people to do is to talk to their doctor about their specific illness and symptoms and there be more control over how information is published so that people are encouraged to talk to their doctor before becoming confused. In terms of research, more time should be put into test the effects of abruptly stopping a drug to prevent people from suffering from worsening symptoms. 

Citation: https://www.medsafe.govt.nz/profs/PUArticles/June2019/Proton-pump-inhibitors-and-rebound-acid-hypersecretion.htm

Antidepressants for IBS?

One of the most common gastrointestinal disorders is irritable bowel syndrome, which causes recurrent cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is related to abnormal motility (too fast causing diarrhea or too slow causing constipation), visceral hypersensitivity which is increased sensitivity in the nerves in the GI tract which leads to discomfort and cramping. Lastly, it also shows poor brain-gut function where the brain is overly responsive to the pain signals coming from the GI tract and is worsened when an individual is experiencing stress. Antidepressants like SSRIs (selective serotonin reuptake inhibitors) and SNRIs (Serotonin-Norepinephrine reuptake inhibitors) have been shown to help with the brain and spinal cord function properly and help reduce visceral hypersensitivity. 

What is not talked about though is that there is a lot of strain on the people who have IBS, not feeling well all the time can make it difficult to not be worried and stressed. Being worried and stressed worsens the symptoms and creates a very difficult cycle for someone to be stuck in. These drugs can help reduce depression and anxiety symptoms and help people feel better. 

 

I wanted to talk about this since I learned that SNRI’s have a been effective in reducing the symptoms of IBS which was interesting, and I wanted to know what the physiology was behind it. I think IBS is an illness that is complex and can be caused by multiple different things, and it seems like every person with IBS has different experiences. I do find it very interesting to see stress has a big role on digestion and a decrease in norepinephrine can lead to improvement in symptoms, which I think shows how dependent all of the different systems in the body are on each other and sometimes the solution to one system starts somewhere else. 

In terms of how this can relate to ethics in science, I think it can show how experimental design can be altered to broaden how we think and measure the human body, for example recently more research is being done on how the microbiome effects the immune system, mental illness, and even likelihood of developing cancer. It is very interesting, and many people may assume that the bacteria in our intestines have very little to do with mental health, but according to new studies that is not true. I think experimental designs in physiology is moving towards being more wholestic when it comes to looking at small part of the body or dieases which I think will lead to more effective and unique research. 

Citation: https://www.med.unc.edu/ibs/wp-content/uploads/sites/450/2017/10/IBS-and-Antidepressants.pdf

Starbucks for Kids

I grew up in a family of coffee drinkers. As a child, I spent tons of time in local coffee shops or going on frequent Starbucks runs with my parents. I started drinking espresso in middle school and this became a daily habit when I was in high school. What  kind of effects can caffeine consumption have on a developing body? The idea that caffeine stunts a child's growth has been debunked, because coffee consumption does not cause osteoporosis (Harvard Health Publishing, 2020). Additionally, bone growth cannot be reversed, so teens will not shrink once they start regularly drinking coffee. Many people shrink due to compression fractures from osteoporosis or the compression of disks above and below spinal bones, but this has not been linked to coffee consumption (2020). Some studies have linked coffee consumption to reduced liver disease, arrhythmia, Alzheimer's disease, and Parkinson’s disease (2020). With linked health benefits and no impact on bone growth, coffee seems to be a very beneficial stimulant for humans. However, caffeine tolerance in children is much lower than adults. Coffee and caffeinated beverages produced are commonly targeted towards adults, who typically tolerate high caffeine levels better. Children drinking coffee or caffeinated beverages can face health risks and potential reduced cognitive function (Perlman, Ph.D., 2021). The Department of Biomedical Engineering at the National University of Singapore conducted a study that demonstrated an association between children who regularly consumed large amounts of caffeine and lower scores of cognitive function than their non-caffeinated counterparts (2021). The categories included, cognitive flexibility, processing speed, episodic memory, working memory, inhibitory control, reading decoding, and comprehension. An important note is association is not equivalent to causation, so it is unfair to assume high consumption levels of caffeine lead to impeded cognitive abilities.  

More research is being conducted on the impacts of coffee on child development and how this would impact the person through adulthood (McVay, 2020). For now, there is very limited research on the impacts of coffee and high doses of caffeine on children. Caffeine can disrupt sleep patterns and reduce sleep quality, which can be damaging for a child because quality sleep during adolescents is crucial for brain and body development (Lodato, 2013). Is it right to buy your children Starbucks beverages and highly caffeinated energy drinks? Everything can be done in moderation, and without significant data supporting detrimental effects to child development, it’s the parents decision. 

References:

Harvard Health Publishing. (2020, January 7). Can coffee really stunt your growth?Harvard Health. Retrieved November 29, 2021, from https://www.health.harvard.edu/staying-healthy/can-coffee-really-stunt-your-growth.

Lodato, F., Araújo, J., Barros, H., Lopes, C., Agodi, A., Barchitta, M., & Ramos, E. (2013, August 1). Caffeine intake reduces sleep duration in adolescents. Nutrition Research. Retrieved November 29, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0271531713001528. 

McVay, E. (2020, February 19). Is coffee bad for kids?Is Coffee Bad for Kids? - Johns Hopkins All Children's Hospital. Retrieved November 29, 2021, from https://www.hopkinsallchildrens.org/ACH-News/General-News/Is-Coffee-Bad-for-Kids. 

Perlman, W. R. (2021, May 28). Childhood caffeine exposure may negatively affect cognitive functioning. National Institute on Drug Abuse. Retrieved November 29, 2021, from https://www.drugabuse.gov/news-events/nida-notes/2021/04/childhood-caffeine-exposure-may-negatively-affect-cognitive-functioning. 

Microbiota passed through breast milk

Gut microbiota play an important role in human development. The flourishing group of symbiotic bacteria plays a crucial role in digestion, immune health, and homeostasis (Harvard, 2020). The microbiota is crucial for child brain development through the gut-brain axis (Ihekweau M.D. et. al., 2018). A child’s microbiota development begins in utero and further develops during the birthing process (2018). The first year of life is a pivotal time period for microbiome development because this when gut microbiota diversifies, and this development will impact the person through adulthood (Ma, 2020). A mother’s gut microbiota can be passed through breast milk and can heavily influence the infant's microbiota (Fehr, 2020). Breast milk is rich in vitamins, minerals, amino acids, and good bacteria. Prebiotic human milk oligosaccharides found in breast milk supports the development of the microbiota in an infant (2020). Microbiota passed through breast milk can also have an effect on a child’s allergy and disease risk (Van Den Elsen et. al., 2019).

It is well known that breastfeeding and formula provide an infant with exposure to microbiota and equivalent nutritional benefits (Bhandari, 2018). This makes both feeding methods adequate and acceptable forms of nutrition. Formula provides an infant with a different set of bacteria that is less abundantly found in breast milk, and vice versa (2018). It is currently unclear if the mode of breastfeeding has an impact on an infant’s gut microbiota. Nursing and pumping methods have been compared to determine if the infant’s microbiota differed. One study found that pumping breast milk may reduce the amount of shared microbiota between the mother and infant (Fehr, 2020). Additionally, a common source of microbes an infant receives comes through direct skin contact with the mother (2020).

Many women have strong opinions on how a mother should feed their child. If a primary source of transferring microbes is through skin contact, the infant is likely exposed to beneficial microbes through general nurturing. With so many uncertainties surrounding how gut microbiota is passed from mother to a child, it is unfair to judge or control a woman’s choice for feeding mode, whether that is through nursing, pumping, or formula. 

References: 

Bhandari, T. (2018, December 27). Breast milk, formula nurture similarities, differences in gut microbes. Washington University School of Medicine in St. Louis. Retrieved November 29, 2021, from https://medicine.wustl.edu/news/infant-formula-breast-milk-nurture-similarities-differences-in-gut-microbes/. 

Fehr, K., Moossavi, S., Sbihi, H., Boutin, R. C. T., Bode, L., Robertson, B., Yonemitsu, C., Field, C. J., Becker, A. B., Mandhane, P. J., Sears, M. R., Khafipour, E., Moraes, T. J., Subbarao, P., Finlay, B. B., Turvey, S. E., & Azad, M. B. (2020, July 10). Breastmilk feeding practices are associated with the co-occurrence of bacteria in mothers' milk and the infant gut: The child cohort study. Cell Host & Microbe. Retrieved November 29, 2021, from https://www.sciencedirect.com/science/article/pii/S1931312820303504?via%3Dihub#bib30. 

Harvard. (2020, May 1). The microbiome. The Nutrition Source. Retrieved November 29, 2021, from https://www.hsph.harvard.edu/nutritionsource/microbiome/. 

Ihekweazu, F. D., & Versalovic, J. (2018, August 21). Development of the pediatric gut microbiome: Impact on health and disease. The American Journal of the Medical Sciences. Retrieved November 29, 2021, from https://www.sciencedirect.com/science/article/pii/S0002962918303021. 

Ma, J., Li, Z., Zhang, W., Zhang, C., Zhang, Y., Mei, H., Zhuo, N., Wang, H., Wang, L., & Wu, D. (2020, September 25). Comparison of gut microbiota in exclusively breast-fed and formula-fed babies: A study of 91 term infants. Nature News. Retrieved November 29, 2021, from https://www.nature.com/articles/s41598-020-72635-x. 

Van Den Elsen, L. W. J., Garssen, J., Burcelin, R., & Verhasselt, V. (2019, February 27). Shaping the gut microbiota by breastfeeding: The gateway to allergy prevention?Frontiers in Pediatrics. Retrieved November 29, 2021, from https://www.frontiersin.org/articles/10.3389/fped.2019.00047/full.

Are school lunches healthy?

    A book I read called Food Fix touches on how schools provide meals for many of their students, but that is not enough as it is unhealthy in many cases. Diet impacts human health, so when there are specific nutrient inadequacies, especially during childhood, it can affect brain development and have lifelong health consequences. For example, school lunches can contribute to unhealthy meals for children because so many children rely on them for the nutrition they need, but they are loaded with sugar, salt, processed card, and industrial fats. Some companies lobby for bills that count tomato paste as a vegetable, making pizza count as a vegetable. It was surprising that there was such a bill because pizza should not compare to something nutritional and the use of " smart food" in schools, which is junk food marketed to be "reduced fats" or healthier, which are not. Healthy food should be accessible to every child, especially to poorer neighborhoods that truly depend on them.

    An article I can across focused on breakfast and how it is disproportionately prevalent among school-aged urban minority youth, which harms academic achievement by affecting cognition. On an average day, about 46% of children participating in free or reduced-price lunch also participated in the School Breakfast Program for which they were also eligible. Since there is a link between eating breakfast and academic achievement, children should eat breakfast. Research has identified the molecular and cellular processes by which dietary behavior influences neuronal activity and synaptic plasticity. The study found that availability of the School Breakfast Program (vs. no program) improved children's nutrient intakes: children were less likely to be deficient in serum levels of vitamin C, vitamin E, and folate, more likely to meet recommendations for intakes of fiber, potassium, and iron, have overall better dietary quality and consume fewer calories from fat while not consuming more overall calories (Basch, 2011).

Basch CE. Breakfast and the achievement gap among urban minority youth. J Sch Health. 2011 Oct;81(10):635-40. doi: 10.1111/j.1746-1561.2011.00638.x. PMID: 21923876.

HYMAN, M. A. R. K. (2022). Food fix: How to save our health, our economy, our communities, and our planet--one bite at a time. LITTLE BROWN SPARK.

Anti-diabetic drugs can treat Secondary Amenorrhea

Secondary Amenorrhea is when a woman does not have a period for more than three months. There are multiple reasons why a woman would experience secondary amenorrhea including polycystic ovarian syndrome, being overweight or underweight, hypothyroidism, increased stress, and hormonal imbalances. The hormone most responsible for menstruation is estrogen, a woman may have secondary amenorrhea when she is not producing enough estrogen or has high amounts of testosterone that interfere with the production of estrogen. There are many ways to treat secondary amenorrhea and the most common are birth control and lifestyle changes. While birth control is effective and helpful for many women it can be inappropriate for women who’s secondary amenorrhea more complex. Surprisingly, Metformin, an anti-diabetic drug that can decrease the body’s blood sugar and decrease insulin resistance has been found to increase ovulation, regulate periods, and increase fertility because it also reduces androgens like testosterone in the body which rebalances the hormones. It also helps with weight loss and prevents weight gain which is very helpful for those who have secondary amenorrhea due to being overweight. Personally, knowing people who have experienced having PCOS and secondary amenorrhea, it is very interesting to see how an anti-diabetic drug plays a role in menstruation. Someone I know described not being able to get a period as a suffocating feeling, they constantly felt as if they were bloated or full and felt uncomfortable. When taking birth control for this issue, they felt no different if not worse during the time they had to take the pills and when their period began, they felt better but it was only temporary. This person was also struggling with weight and diet issues. When they talked to their doctor, they were prescribed metformin, and it changed the way they felt. They lost weight after a few months of taking it, they have a consistent period, and no longer feel bloated and full. They feel significantly better now and have been able to manage their diet and PCOS. This raises questions about the effects of the diets and metabolism with how hormones are released in the body and how that creates symptoms and moods. This showed me that periods are a lot more complex than hormone levels.

In general, looking into different drugs used for women’s reproductive system I found that research on the female anatomy has been narrow or difficult to have a straight answer on. I think part of the reason some solution to women’s health issues is slow in progress compared to other issues. In terms of data collection in the scientific field and in historical context, issues like secondary Amenorrhea should not only have better research advancement and better understanding.

 Citations:

1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712235/

2.  https://nyulangone.org/conditions/polycystic-ovary-syndrome-in-adults/treatments/medication-for-polycystic-ovary-syndrome-in-adults

Bone Loss in Menopause Starts Earlier Than You Think!

 Menopause is defined as the 12 month period after a women has her last menstrual period. The time leading up to menopause (perimenopause) can last for a total of four to eight years, but varies with each individual. During this time, a woman's ovarian function begins to decline, decreasing the amount of hormone released and increasing bone loss. 

A study aimed to specify the amount of bone density loss during menopause, found that the decline in bone mineral density began before the final menstrual period (FMP). The authors divided the FSH levels of menopause into categories, with four different requirements. Stage 1,2,3, and 4, depending on the amount of FSH present. In Lumbar Spinal regions, the bone loss was measured in relation to the FSH levels and stages. In stage one (7 years before the FMP), 17% of bone was lost, in stage two (7-2 year before FMP), 44% of bone was lost. In the last two FSH stages, from 2 years until FMP to 6 years after FMP, bone loss increased exponentially. 

When comparing BMI, the study found that obeseity protected women from bone loss during perimenopuse, as compared to non-obese women who lost more bone mass. The authors predicted this difference was due to estradiol (a hormone that can reverse symptoms of menopause) and other hormones in adipose tissue around the body. 

Bone loss in women experiencing menopause is extensive. This loss in bone density can increase risk of osteoporosis, fractures or other injuries. Recent findings have increased the hope for treatment of post-menopausal osteoporosis. Researchers at Tokyo Medical University believe that Sema3A (a protein secreted by osteocytes) could reverse this problem. They found that drop off of estrogen levels caused a decrease in Sema3A. Sema3A is important for maintaining bone and bone density, without this protein, osteocytes begin to die and bones deteriorate. This could be an important finding for treatments and prevention of menopausal osteoporosis.

How does estrogen protect bones? Unraveling a pathway to menopausal bone loss. (2019, April 11). Women's Health Weekly, 425. https://link.gale.com/apps/doc/A581549939/ITBC?u=regis&sid=ebsco&xid=418eeb7f

Sowers, M. R., Zheng, H., Jannausch, M. L., McConnell, D., Nan, B., Harlow, S., & Randolph, J. F., Jr (2010). Amount of bone loss in relation to time around the final menstrual period and follicle-stimulating hormone staging of the transmenopause. The Journal of clinical endocrinology and metabolism, 95(5), 2155–2162. https://doi.org/10.1210/jc.2009-0659