Proof that MDs don't actually have ALL the answers

[JackieCalifornia]

Friends,

The next time your MD gives you a hard time about how 'evidence-based medicine' and the Infectious Disease Society of America (IDSA) have all the final answers on Lyme diagnosis and treatment and therefore you can't even possibly be ill after 2 wks of doxy, remember this little story that just came out in a very mainstream medical newsletter I subscribe to.

We have been hearing for years that 'an aspirin a day' will help prevent heart attack and it's no problem to take.  Well.... maybe, but at a price -- however you should keep taking it anyway!  The article is pasted below so you can see context for yourself, but here are the highlights:

--- aspirin "can cause stomach ulcers, and research in animals has suggested it can be hard on the intestines, too"

--- "aspirin use for a year or more boosted the risk of Crohn's disease by five times"

--- "However, the study only suggests there's a link between aspirin use and [Crohn's] disease; it doesn't prove that aspirin actually increased the risk." --- gee, that's good news.  I think. /sarc/

--- "Why might aspirin boost the risk of Crohn's disease? The ... vice chair of Mayo Clinic's Division of Gastroenterology and Hepatology, said it might have something to do with aspirin damaging the lining of the bowel ... [He says:] If it does turn out to be a true link in the future, then it will be only one of many factors involved in causing Crohn's disease," he said. "Because aspirin has benefits, users should continue with it."

That's my favorite line:  keep using it nevertheless!

MDs are only human, and they make mistakes constantly.  I don't begrudge them that -- what does annoy me endlessly is the inclination of MDs to make flat statements about things like aspirin being wonderful for everybody every day, but oops it's not, but hey keep taking it everyday anyway because when we finally find out why it's bad for you, it won't be the only reason you got harmed, but we can't prove that now of course.  Does this sound familiar to anyone following the Lyme Wars?  Yeah, I thought so.

NOTE:  This is NOT a recommendation that you not take aspirin or listen to your MD.  This is a recommendation to be skeptical and look out for yourself.  Don't ever be afraid to ask questions, and if you don't get an understandable answer, ask again till you get one.  

===text below fwiw===

MONDAY, May 3 [2010] (HealthDay News) -- A new British study finds that people who take aspirin every day have a higher risk of developing Crohn's disease, a potentially devastating digestive illness.

But it's still not very likely that aspirin users will develop the condition, and the study's lead author said patients should keep in mind that aspirin lowers the risk of heart disease.

"If the link with aspirin is a true one, then only a small proportion of those who take aspirin -- approximately one in 2,000 -- may be at risk," said study author Dr. Andrew Hart, a senior lecturer in gastroenterology at University of East Anglia School of Medicine. "If aspirin has been prescribed to people with Crohn's disease or with a family history by their physician, then they should continue to take it. Aspirin has many beneficial effects and should be continued."

An estimated 500,000 people in the United States have Crohn's disease, which causes digestive problems and can boost the risk of bowel cancer. In some cases, patients must undergo surgery; many have to take medications for the rest of their lives.

While aspirin is known for its ability to reduce the risk of heart disease, it can cause stomach ulcers, and research in animals has suggested it can be hard on the intestines, too. The study authors decided to see if it had the same effect in humans, Hart said.

In the new study, researchers tracked 200,000 volunteers, aged 30 to 74, from several European countries.

The researchers found that aspirin use for a year or more boosted the risk of Crohn's disease by five times.

However, the study only suggests there's a link between aspirin use and the disease; it doesn't prove that aspirin actually increased the risk. And the researchers didn't know how much aspirin each person took.

Why might aspirin boost the risk of Crohn's disease? Dr. William J. Sandborn, vice chair of Mayo Clinic's Division of Gastroenterology and Hepatology, said it might have something to do with aspirin damaging the lining of the bowel, potentially triggering the condition in those who are susceptible to it because of their genetic makeup.

Sandborn, who's familiar with the findings, agreed with Hart that patients need to think about the benefits of aspirin use, including the reduced risk of not only heart disease but also colorectal cancer.

The study found no link between aspirin use and ulcerative colitis, another digestive disorder.

Future research is needed to confirm the aspirin-Crohn's disease link and determine what aspirin has to do with the higher risk, Hart said.

"If it does turn out to be a true link in the future, then it will be only one of many factors involved in causing Crohn's disease," he said. "Because aspirin has benefits, users should continue with it."

===end===

[JackieCalifornia]

Now if we could only convince the IDSA there is definitely more that THEY don't know, we might make some progress.  :)

[kamrynkade]

I was just thinking about the h. pylori/ulcer connection.  H pylori is also spiral shaped (though not technically a spirochete).  I agree with 22dreams....definatley more that we don't know.  

[wonko]

To follow up on 22dream's chronology of the H. pylori-ucler connection, the Nobel Prize in Physiology or Medicine for 2005 was jointly awared to  Barry J. Marshall and J. Robin Warren for their discovery of "the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease."

This is one of my favorite examples of how a medical discovery that was initially laughed out of the country ultimately became universally accepted and awarded.

[22dreams]

and now ADHD (which was thought to be mostly inherited)
they are questioning or found a link between that and pesticide exposure.

http://www.thebostonchannel.com/health/23574493/detail.html

Of course, it could be one's genetic predisposition to not be able to detox as others can.
but "back-when" people weren't exposed to pesticides as they have been in recent generations.

There is more that modern medicine doesn't know than they do know.

[22dreams]

Not unlike the history of peptic ulcers.

Even AFTER a bacterial link was found it took a long time before your local doctor started treating ulcers with antibiotics.

We are seriously in the primordial stages--or rather, stuck there--
of understanding lyme disease even though the bacteria causing it was isolated in the early 1980s. It came to light at a time when HIV and AIDS research was emerging and a feather in the hats of infectious disease mds/researchers.

and now, the wave of fear over "superbugs" >
despite prolonged abx treatment for things like acne, coz lord knows how you look is more important than how you feel or function >
is used as justification for denying patients treatment that would help them.

_______________________________________

Helicobacter pylori and Peptic Ulcer Disease

History of Ulcer Diagnosis and Treatment

The road to a cure for ulcers has been a long and bumpy one. Recent news that ulcers are caused by a bacterium and can be cured with antibiotics has changed traditional thinking. Physicians and consumers have not been informed of the good news.

Early 20th Century

Ulcers are believed to be caused by stress and dietary factors. Treatment focuses on hospitalization, bed rest, and prescription of special bland foods. Later, gastric acid is blamed for ulcer disease. Antacids and medications that block acid production become the standard of therapy. Despite this treatment, there is a high recurrence of ulcers.

1982
Australian physicians Robin Warren and Barry Marshall first identify the link between Helicobacter pylori (H. pylori) and ulcers, concluding that the bacterium, not stress or diet, causes ulcers. The medical community is slow to accept their findings.

1994
A National Institutes of Health Consensus Development Conference concludes that there is a strong association between H. pylori and ulcer disease, and recommends that ulcer patients with H. pylori infection be treated with antibiotics.

1995
Data show that about 75 percent of ulcer patients are still treated primarily with antisecretory medications, and only 5 percent receive antibiotic therapy. Consumer research by the American Digestive Health Foundation finds that nearly 90 percent of ulcer sufferers are unaware that H. pylori causes ulcers. In fact, nearly 90 percent of those with ulcers blame their ulcers on stress or worry, and 60 percent point to diet.

1996
The Food and Drug Administration approves the first antibiotic for treatment of ulcer disease.

1997
The Centers for Disease Control and Prevention (CDC), with other government agencies, academic institutions, and industry, launches a national education campaign to inform health care providers and consumers about the link between H. pylori and ulcers. This campaign reinforces the news that ulcers are a curable infection, and the fact that health can be greatly improved and money saved by disseminating information about H. pylori. Medical researchers sequence the H. pylori genome. This discovery can help scientists better understand the bacterium and design more effective drugs to fight it.

[juliva]

Awwww.. that's amazing but not surprising!