Obesity rate in children drops almost in half, report shows.

March 7, 2014

The Journal of American Medical Association recently reported that there has been a substantial decline in the obesity rate among children in the United States.  Obesity in children ages 2-5 dropped almost in half, 43% to be exact, in the past decade.

While there are no direct causes, researchers believe that the major decrease can be attributed to a number of different reasons.  From better choices at fast food restaurants to parents taking a more active role in what their children are consuming, the obesity rate in this group of children from 2-5 is at 8.4%.  That is quite a difference from the previous obesity rate of 13.9% in 2003-2004.

This is especially beneficial in regards to a lowered risk of esophageal cancer.  A study conducted in 2013 linked overweight and obese adolescents to “a more than two-fold increased risk of developing esophageal cancer later in life,”  Study author Dr. Zohar Levi of the Rabin Medical Center in Israel suggested that this risk could possibly be attributed to reoccurring “reflux that they have throughout their life.”

The New York Times reported the following:

“This is the first time we’ve seen any indication of any significant decrease in any group,” said Cynthia L. Ogden, a researcher for the Centers for Disease Control and Prevention, and the lead author of the report, which will be published in JAMA, The Journal of the American Medical Association, on Wednesday. “It was exciting.”

However, a third of US children and teens are still considered obese or overweight.  Odgen told the New York Times “Still, the lower obesity rates in the very young bode well for the future.”

For more information, please visit the following sources:

CNN.com 
BBC.com 
NYTimes.com 
AP.org
Health.com
 
 
The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


Study links abdominal fat (visceral) to increased risk of Barrett’s esophagus

February 14, 2014

A recent study shows that carrying more weight in the midsection may increase one’s risk of developing Barrett’s esophagus, a precursor to esophageal cancer.

Barrett’s esophagus is “a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid and changed to a lining similar to that of the stomach.”*  Barrett’s esophagus has been shown to be a precursor to esophageal cancer.  

This study linked a higher amount of visceral fat to a greater risk of Barrett’s esophagus.

The fat located in the abdominal region is either defined as visceral or subcutaneous. Visceral fat surrounds the organs in the abdominal region, while subcutaneous fat is located between the skin and the abdominal wall. 

Researchers reported that the elevated risk of Barrett’s esophagus related to the increase of visceral abdominal fat was found in both those who have gastroesophageal reflux disease (GERD) symptoms and also those who do not experience GERD symptoms.

For a more information on the study, please refer to the following two articles:

“Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett’s oesophagus: a case-control study.” National Center for Biotechnology Information, U.S. National Library of Medicine

“Visceral adipose tissue increased risk for Barrett’s esophagus.” Healio Gastroenterology

*“Barrett’s esophagus.” National Center for Biotechnology Information, U.S. National Library of Medicine 

 

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


Is your heartburn impacting your sleep?

February 11, 2014

Suffering from heartburn, whether be it during the day or at night, is an annoyance that many Americans cope with, some on a daily basis. An alarming 60 million Americans experience it at least once a month and 25 million Americans suffer from heartburn every day. When heartburn is this frequent or severe, people may be diagnosed with Gastroesophageal Reflux Disease, more commonly known as GERD.

The United States National Library of Medicine defines GERD as “a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach).” This occurs when the lower esophageal sphincter (LES), the muscle between the esophagus and stomach, becomes damaged or weakened.

If not properly treated, long-term sufferers of GERD can develop serious medical conditions, which include chronic cough or hoarseness, esophagitis, bleeding, scarring or ulcers of the esophagus and Barrett’s esophagus, an abnormal change in the lining of the esophagus that can potentially raise the risk of developing esophageal cancer.

It is important to note that many patients who are diagnosed with GERD do not experience heartburn at all. Below are the most frequently reported symptoms of GERD:

• Heartburn (a symptom of acid reflux)
• Bad breath
• Burning or pain in the chest or throat
• Chronic cough
• Hoarseness or chronic sore throat
• Bitter taste in mouth
• Inflammation in the mouth and erosion of teeth
• Problems swallowing
• Asthma-like symptoms
• Excessive belching

GERD is amongst the most prevalent upper gastrointestinal (GI) disorders and most likely one of the most common disease diagnosed by Gastroenterologists across our nation.

For many, GERD does not just disrupt their daily routine, but their sleep as well. GERD sufferers who have trouble sleeping at night could also go on to experience other health problems such as insomnia, sleep apnea, sleepiness during the day and restless leg syndrome.

It is best to first speak to a gastroenterologist or a primary health care provider to see what options are available to treat GERD effectively. Below are some helpful tips in order to reduce GERD symptoms and enjoy a better night’s sleep.

• Eat smaller meals
• Chew food slowly and thoroughly
• Say upright after meals
• Avoid foods which trigger your GERD symptoms (fats, spicy foods, alcohol)
• Keep a food journal to track your “trigger foods”
• Try sleeping with your head elevated. Either with extra pillows or a wedge pillow
• Restrict your eating in the evening
• Do not eat or drink anything two hours before bedtime (with the exception of water for medications.)

Again, please consult your doctor if you are having problems sleeping at night or are experiencing frequent or severe heartburn.  These suggestions are intended for informational purposes only.

 
 
 
 
 
 
Sources:
National Sleep Foundation
WebMD
American College of Gastroenterology 
 
 
 
The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

‘Missed Opportunities in GERD Complication Screenings’

January 30, 2014

High-risk patients don’t always get endoscopic examination for Barrett’s esophagus, cancer, say researchers.
Outpatient Surgery Magazine

Men aged 65 years and older are much more likely to suffer the complications of gastroesophageal reflux disease (GERD), such as Barrett’s esophagus and esophageal, gastric or duodenal cancer, but they’re much less likely to undergo endoscopic screenings that can detect these complications, according to recent research.

Go to full story in Outpatient Surgery here.

 

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

 

 


RefluxMD: “Diagnosing GERD: The First Step Towards Treatment”

January 16, 2014

Gastroesophageal Reflux Disease (GERD) elevates one’s risk of developing esophageal cancer (adenocarcinoma.)  The risk further increases based on the severity of symptoms (ie. heartburn and regurgitation from the stomach) and how long it goes without being properly treated.

The United States National Library of Medicine defines GERD as “a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach).” This occurs when the lower esophageal sphincter (LES), the muscle between the esophagus and stomach, becomes damaged or weakened.

Esophageal cancer adenocarinoma is the fastest growing cancer in the United States and also one of the deadliest cancers.  Since the cancer is often detected late, the survival rate is extremely low.   Therefore, it is crucial to speak to your doctor if you or someone you know is suffering from frequent heartburn and/or regurgitation.

There are many tests that can be performed to accurately diagnose GERD.  Too often, PPIs (proton pump inhibitors) are prescribed by doctors for the treatment of GERD.  PPIs function are to only manage GERD symptoms they do not repair the lower esophageal sphincter (LES). Unfortunately, these medications do not relieve all patients from their GERD symptoms and they are not intended to be taken for a long period of time as they can cause serious long-term health effects.

Our friends at RefluxMD put together a fantastic article which describes the various ways your doctor can assess your condition.  Don’t ignore frequent heartburn!  Take the very first step in managing your GERD symptoms by reading this article.  Click here to learn more.

We are thankful for resources such as our friends at RefluxMD.  By working together, we can continue to raise awareness of esophageal cancer and dangerous risk factors such as GERD.


Abdominal Fat Linked to Esophageal Cancer; Tips to Trim Your Waistline

November 22, 2013

New research shows that central adiposity (an accumulation of fat in the abdomen area) is associated with an increased risk of esophageal cancer. This research was published in the November issue of Clinical Gastroenterology and Hepatology.

 

Being overweight, particularly in the mid-section, elevates not only the risk of developing esophageal cancer, as this new research states, but a number of other diseases, proven in other studies. Below are some tips to help reduce “belly fat” and improve overall health and wellness.

Eat one less cookie a day

Dr. Mehmet Oz, MD, suggests in his book, YOU on a Diet: The Owner’s Manual for Waist Management to reduce your caloric intake by just 100 calories per day. That means, eat one less cookie, candy bar, can/bottle of soda or piece of holiday pie. This seemingly small change can have a huge impact. Dr. Oz suggests that it may help you to lose about 12 pounds per year*.

Get moving

Refer to Sir Isaac Newton’s Frist Law of Motion: “An object at rest stays at rest and an object in motion stays in motion.” Basically, the more you exercise the more you will burn and the more you rest, the more you will gain. Whether you are a triathlete or a couch potato, workout at your speed.

Count sheep

Studies have shown that when we are tired and are not sleeping properly, it negatively affects our appetite, which causes us not only to gain weight but make improper food choices. Keep your sleeping area calming, avoid technology right before bed and make sure you are getting at least 7 hours of sleep per night.

Build muscle

Strengthening your core (abdominal) and lower back muscles will help you shed belly fat fast. Remember to always practice safe lifting while exercising. It may also be helpful to consider working with a personal trainer for even just a few lessons to make sure you are working out right and to avoid injury. Ladies, muscle burns fat. Pay no attention to the myth that if lifting weights will cause your body to transform into a bodybuilder’s.

Eat breakfast, lunch, dinner AND snacks!

According to research, eating healthy meals and snacks regularly throughout the day will not only benefit your health but keep you more focused and energized. When we do not eat regularly, we make poor food choices and our body can go into “starvation-mode”, which can cause it to hold on to more fat. Dr. Oz recommends his patients avoid eating processed foods because they can cause you to still be hungry soon after you’re done brushing the crumbs away.

Ditch the elevator

For many, the majority of our day is spent sedentary. Whether we are at a desk in front of a computer at work, watching TV, playing video or online games, eating meals or driving in the car, we sit, sit and sit some more. The best way to burn extra calories every day is to move around more. It sounds simple, but you can burn a significant amount of calories by taking extra trips to the water cooler during the day at work, parking your car further away from the door, taking the stairs instead of the elevator or escalator and even walking a bit further with your dog. Here are some tips to “workout” when you are at work!

Keep healthy snacks on hand

Pack healthy snacks and take them with you when you are on-the-go. Choose foods like almonds, celery, carrots, greek yogurt, berries and whole grain crackers. Keeping healthy options on-hand can help you avoid the dreaded vending machine and quiet your grumbling stomach. Again, sometimes when we are hungry, we end up making poor food choices.

Stress less

Easier said than done, right? Reduce your daily stress by meditating, practicing yoga, taking a walk, reading a book or sipping tea. Stress affects many aspects of our mental, emotional and physical health. Check out our Pinterest board “Namaste” for some great Yoga tips.

Don’t give up

Author Louis Sachar once stated ‘It is better to take many small steps in the right direction than to make a great leap forward only to stumble backward.’  Keep going, don’t give up and remember to be proud of all your achievements, no matter how big or how small. Positive thinking will keep you going through the good times and the bad.

As always, consult your physician before making any changes to your diet, exercise or lifestyle. The aforementioned is for informational purposes only and should not be misconstrued for medical advice.

 

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


RefluxMD: Don’t be fooled, your heartburn could be serious

June 20, 2013

RefluxMD: Don’t be fooled, your heartburn could be serious

by Dr. Dengler

Heartburn can become an escalating problem if ignored. It can also be a dangerous condition if it is masked by just taking antacids.

Most people believe, however, that recurring acid reflux is a normal part of over-eating or sampling spicy food. These acid reflux sufferers don’t realize that one out of every three adults struggle with heartburn and regurgitation on a monthly basis, with 50 million people battling symptoms several times per week.

A nagging problem of heartburn and acid reflux seems easy to fix when watching the many pharmaceutical commercials claiming that a colored pill, taken daily, can solve the problem; in fact many Americans have accepted big pharma’s suggested solution as an easy fix to their woes.

Today, the drug industry sells over $14 billion in heartburn medications. The popular drug is in a class called proton pump inhibitors (PPIs) that work by reducing the amount of acid produced within the stomach.

Unfortunately, the millions of people who take these prescription drugs or over the counter medications are masking a serious and developing problem.

Unknown to millions of people regularly taking PPI pills to solve their heartburn is that the U.S. Food and Drug Administration warning labels on these prescription drugs clearly states that patients should take the pills for no more than 14 days of temporary relief.

Two weeks of blocked calcium production in your stomach is the maximum timeframe recommended by medical doctors to mask acid reflux without being under the care of a physician—any longer can have serious negative consequences.

If you have heartburn for longer than 14 days then you have a bigger problem than a pill can help solve.

The stomach pains or burning sensation you feel are signals from your body that something is wrong. An acidic stomach is normal and is necessary for the efficient digestion of food.

So why are you getting those pains frequently? Simple, it is due to a small valve at the end of your esophagus called the LES, or your lower esophageal sphincter.

A healthy LES acts as barrier in keeping stomach contents where they belong — in your stomach.

The LES frequently becomes damaged, and when it does, those acidic stomach contents can flow up into the esophagus. When stomach acid leaves your stomach, it can be painful.

In fact, over 200,000 individuals visit emergency rooms each year believing they are having a heart attack only to learn that their pain was from acid reflux and not from a heart problem.

Unfortunately, for a segment of those with reflux disease, heartburn can progress to a precancerous condition called Barrett’s Esophagus, and in some cases, it can advance to adenocarcinoma, better known as esophageal cancer.

In fact, the incidence of esophageal cancer is the fastest growing of all cancers in the U.S., outpacing melanomas, breast and prostate cancers.

PPIs have proven to relieve symptoms, and for several medical conditions, they are highly valuable for short to mid-term use.

However, they are not a cure.

As they cannot strengthen or repair the LES, the cause of gastroesophageal reflux disease, they can only mask the symptoms. As a result, the disease continues indefinitely.

At a recent gastroesophageal conference, Dr. David Kleiman with the Department of Surgery at New York Presbyterian Hospital and Weill Cornell Medical College presented a research study documenting that 32% of PPI use beyond an initial 8-week trial was unnecessary since there was “no evidence of reflux disease” with those individuals.

According to Dr. Kleiman, “PPIs continue to be misused and overused in a large percent of our population.”

If you are experiencing regular heartburn and think you are solving your problem by consistently taking an acid production blocker, you may be masking a serious problem.

Even worse, you could be increasing your troubles by subjecting yourself to the dangerous and common side-effects of routine PPI usage.

Instead of turning to costly, unnecessary, and often dangerous pills, you should consult your physician and create a real plan to manage your acid reflux.

Read more: http://www.foxnews.com/opinion/2013/06/13/dont-be-fooled-your-heartburn-could-be-serious/

 

 

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


Register today! 2nd Annual Esophageal Cancer Walk/Run

May 24, 2013

Join us Saturday, June 15, 9 AM at Warwick City Park for the 2nd Annual Esophageal Cancer Walk/Run!

Tickets are $20 in advance or $25 the day of the event.

Whether you decide to walk or run, or a little bit of both, get your team together today!

Be sure to bring your friends, family, co-workers and pets, too!

Children 12 and under and pets are FREE!

Register online: http://salgiwalkrun.eventbrite.com

We look forward to another fun and successful event to support esophageal cancer research!

Thank you!

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Four common heartburn myths

May 3, 2013

Four common heartburn myths

by: Dr. Dengler of RefluxMD

What would you do if you had recurring muscle aches a few times each month that you could manage with over-the-counter medication? Ignore it, right? It’s just a nuisance. What if on occasion those pains were so severe that you lost sleep, missed work, or even cancelled important plans? Still just a nuisance?

One in three American adults suffer from such a nuisance – heartburn – and they suffer monthly. Twenty percent of all adults lose sleep, miss work, and change their plans due to heartburn symptoms. The incidence of people suffering from these symptoms is increasing at a rate of 30% every decade.

For many, a condition called gastroesophageal reflux disease, or GERD, causes these symptoms. Heartburn, that burning sensation in the chest and the feeling of fullness that often results from eating too much, is the most common symptom of GERD, but some also experience regurgitation, difficulty swallowing, a persistent cough, and/or hoarseness. Over time, GERD symptoms can become more and more frequent – and much more severe. Many medical experts view reflux disease as an epidemic, yet most sufferers continue to think of this as a nuisance.

Here is what you need to know:

Myth #1: Food is the reason for heartburn

Heartburn is just a result of what we eat, right? WRONG!

Heartburn is a symptom of reflux disease, a progressive, long-term condition caused by a weak lower esophageal sphincter, or LES. The LES is a ring of muscle in the lower end of the esophagus just above the stomach. It acts as a valve, opening to allow food to pass into the stomach and then closing to prevent the contents of the stomach from flowing, (or “refluxing”) back into the esophagus. Because the contents of the stomach are highly acidic, reflux can irritate the lining of the esophagus and cause the painful symptoms many sufferers know all too well.

Malfunction of the LES can happen for a variety of reasons – overeating, obesity, smoking, or excessive drinking. When it happens on occasion, reflux usually has no long-term consequences. Over time, though, the more you reflux, the weaker the LES becomes and the more you damage the esophagus. Reflux disease develops when the LES no longer functions as an effective barrier. Reflux disease can lead to complications such as inflammation, erosion of the lining of the esophagus, narrowing of the esophagus, Barrett’s Esophagus (a pre-cancerous condition), and esophageal cancer.

Myth #2: Heartburn is just a nuisance.

No one ever died from heartburn, right? WRONG!

Esophageal adenocarcinoma, a type of cancer of the esophagus, is directly linked to reflux disease. In fact, reflux disease is the only cause of this type of cancer. The number of esophageal cancer cases has grown more than 600 percent since 1975, making this deadly disease the fastest growing type of cancer in the United States. When charted against the incidence of all other cancers, esophageal cancer is in a league of its own. Sadly, esophageal adenocarcinoma is also one of the most lethal types of cancer. The overall likelihood of surviving five years is only 10-15 percent. This year alone, approximately 20,000 deaths will result from reflux-induced esophageal cancer.

Myth #3: Today’s medications cure reflux disease.

Over-the-counter and prescription medications stop the reflux, right? WRONG!

Many times when a patient experiences the symptoms of reflux disease, he simply purchases one of the many medications available over-the-counter at a drug store. If he complains to his doctor, the doctor will likely prescribe a proton pump inhibitor, or PPI, such as Prilosec, Prevacid, or Nexium to relieve his symptoms. All of these drugs work by reducing the amount of acid produced by the stomach, which helps minimize or even eliminate heartburn symptoms, but they don’t stop the reflux.

Reducing heartburn doesn’t mean that the reflux disease is cured. Unfortunately, even when taking PPIs and other acid reducing medications, the reflux continues! You just can’t feel it. Furthermore, it can continue to damage and deteriorate the LES. The disease progresses even though the symptoms aren’t apparent. Treatment with PPIs does not prevent the complications associated with reflux disease, and the conditions can still progress to Barrett’s esophagus and cancer.

Myth #4: PPIs can be taken with no risk as long as necessary.

Those PPIs must be safe since they are sold over the counter and don’t require a prescription, right? WRONG!

Consumers spend more than $24 billion worldwide each year on PPIs ($14 billion in the US annually), looking for relief from their reflux symptoms. While they have helped millions of people manage their symptoms, there are risks that users must understand.

Reflux disease is a chronic, progressive disease, so once PPIs are started, use typically continues on a daily basis indefinitely. Studies have shown that long-term daily use of these drugs may be correlated to an increase in the incidence of:

  • Bone fractures
  • Clostridium difficile colitis (a potentially deadly infection of the intestines)
  • Pneumonia
  • Low magnesium levels

PPIs are also known to interact with other drugs. The most important of these is Plavix, a blood thinner used for prevention of heart attacks and strokes.

What’s most concerning is that several studies have demonstrated that 30 percent of PPI users don’t even have reflux. That means that millions of people are at risk for these drug-related side effects when they don’t even need the medication.

PPIs do have a role in the management of reflux disease, but they must be used carefully as a maintenance medication and only under the care of a well-informed physician. Never take over-the-counter PPIs for more than 14 days without consulting a physician. And remember, even when they are used appropriately to treat reflux disease, PPIs simply control the symptoms of the disease. They don’t stop or cure reflux, they don’t reverse the damage to the LES, and they don’t stop reflux disease from progressing.

Fact #1: You can manage your reflux disease

There must be something that can be done to stop the progression of reflux disease, right? RIGHT! 

The good news is that, although reflux disease cannot be reversed, most people in the early stages of the condition can effectively manage their disease. By creating an action plan and following it, most can find relief for their symptoms AND keep their GERD from getting worse.

If you’re suffering from reflux disease, your first step should be to learn where you are in the progression of the disease. Then, you can identify the steps you can take to manage your condition, including working with a knowledgeable physician to design a personalized reflux disease management plan. Your plan will likely include monitoring your symptoms, incorporating lifestyle changes, taking intermittent medications, and/or undergoing minimally invasive surgery based upon the progression of your reflux disease.

Don’t be discouraged. The reality is that you are in control. And you don’t have to suffer. 

 

This article was shared from RefluxMD website. It was written by Dr. Dengler and has also appeared on Newsmax.  Visit http://www.refluxmd.com/ for more information!

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


The simple things can be the big things in life

May 1, 2013

Imagine your favorite food.  Now imagine that simple act of eating being taken away from you.  Too often we take for granted the small and simple things that make life so enjoyable.

The following story is proof that the small things, such as the ability to eat, sometimes end up being the big things in life.

Thank you to Elizabeth Martin and The Digestive Disease Institute at Virginia Mason (DDI) for sharing.

 

A New Appreciation for eating

 

Fernando Fraga is a 39-year-old artist who has visited dozens of cities exhibiting his work.  Recently he journeyed from his native Uruguay to Seattle, not to celebrate art, but to regain a normal life.

A tuberculosis infection of the lymph nodes in Fernando’s chest ravaged his esophagus, causing a life-threatening perforation.  Surgery in Uruguay to remove the heavily damaged organ saved his life but resulted in a one-month hospital stay, leaving Fernando dependent on a feeding tube.  A bag affixed to the side of his neck to catch saliva was a painfully visible mark of his illness.  After the operation, the tuberculosis required eight more months of treatment before reconstruction could be considered. The only way back to the life he knew before meant restoring the ability to eat normally. Fernando had not eaten or taken any fluids by mouth for 10 months.

Fernando’s gastroenterologist in Uruguay, Henry Cohen, MD, FACG, contacted Richard Kozarek, MD, executive director of the Digestive Disease Institute at Virginia Mason (DDI) and recent president of the World Gastroenterology Organisation (WGO).  Given Dr. Kozarek’s role, Dr. Cohen knew where to turn to help his patient.  The question was where could Fernando safely undergo the extremely difficult surgery to reconstruct his esophagus, in a chest cavity riddled with scar tissue? The answer was the Esophageal Center of Excellence, part of the DDI at Virginia Mason.  Under the direction of surgeon Donald Low, MD, FACS, FRCS(C), the mortality rate in more than 600 esophageal resections at Virginia Mason is less than 0.5 percent, compared with a national average of about 7 percent. There are no better published results in the world.

“First, we thought of travelling somewhere near Uruguay, then to other clinics inside the United States,” says Fernando. “But after seeing the curriculum vitae of Dr. Low, we knew he was the one we were looking for. We were afraid because it was really far away, it was the longest trip we could have chosen inside the U.S., and we didn’t know if I could endure the trip with my feeding tube.”

Fernando became acquainted with the DDI team long before he got on the plane. Sonia Kunz, RN, and Jean Hong, ARNP, worked to set up the rapid series of consults and procedures he would need on his arrival and stayed in regular contact with Fernando and his family. Dr. Low sent a letter from England, where he was presenting at a conference, to reassure Fernando about the planned treatment.

“After the first contacts with Dr. Low and his team, we knew that Virginia Mason was the best decision we could have made,” says Fernando. “They gave us so much confidence and peace. It seemed that they knew us from long ago.”

Surgery to restore esophageal function typically refashions the stomach to replace the organ.  To ensure Fernando’s stomach was appropriate to use to reconstruct the esophagus, he underwent a procedure known as gastroscopy.  This procedure involves inserting an endoscope — a thin, flexible instrument with a light and camera — into the body, which then transmits images to a viewing screen.

In Fernando’s case, the pediatric endoscope had to enter the small bowel through the orifice created for his feeding tube to pass up the bowel into the stomach.  This atypical procedure was managed in the DDI’s Therapeutic Endoscopy Center of Excellence.  Dr. Kozarek performed the gastroscopy and was able to assure the team his stomach was appropriate to use to restore Fernando’s ability to eat normally.

After months of planning and traveling 7,000 miles from home, Fernando and his surgical team made a bid for a renewed life of eating and swallowing, a life without the bag he could never hide.  Virginia Mason ENT (ear, nose and throat) surgeon Stephen Bayles, MD, FACS, opened Fernando’s neck to mobilize the remaining short stump of esophagus.  Dr. Low accessed Fernando’s abdominal cavity to reshape his stomach from a bag into a long tube that was extended up the neck.  A normal esophagus resides behind the heart and in front of the spine.  In Fernando’s case the area was heavily scarred due to his perforation.  To bypass the damaged area, Dr. Low created a tunnel behind the breast bone and in front of the heart to reconnect the stomach tissue with Fernando’s remaining esophagus.

Normally a patient undergoing esophageal resection, even one less complicated than Fernando’s, could expect a 10- to 15-day hospital stay.  Fernando stayed five days.  Dr. Low encouraged Fernando to stay in Seattle for at least a week to recuperate following surgery.  During his recuperation, Fernando created gifts of paintings for the members of his care team.

“It was very important for me, coming from another country and speaking Spanish to have my family with me, encouraging me all the time.  To walk, to do the exercises, to get well,” says Fernando.

Dr. Low also credits Fernando’s remarkable outcome to the highly experienced, highly coordinated clinical team that is garnering international recognition. In 2011, the Esophageal Center of Excellence hosted visiting physicians from the United States, Europe and Australia to learn firsthand how a coordinated care team in a high-volume center can improve outcomes and enhance recovery for patients.

Before leaving Seattle, Fernando tasted his first soft food in more than a year, the same way anyone else would.

 

——-

The Digestive Disease Institute at Virginia Mason (DDI) is recognized as a leader in the multidisciplinary care of digestive disorders and has received international acclaim for excellent survival rates of colon, esophageal and pancreatic cancer patients. For more than 20 years, DDI’s teams of expert physicians and staff have collaborated to achieve breakthroughs in digestive disease, translating their findings into improved patient outcomes and advanced quality care.

In 2011, Virginia Mason received the 2012 HealthGrades Gastrointestinal Care Excellence AwardTM for the third year in a row. Virginia Mason also ranked No. 1 in Washington for GI Services and GI Medical Treatment, according to HealthGrades’ 2011 Healthcare Consumerism and Hospital Quality in America report.

 

The Salgi Esophageal Cancer Research Foundation is a 501 (c) (3) non profit organization as recognized by the Internal Revenue Service.

Content found on Salgi.org is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.