Briefs

Corticosteroid Risk

Patients with irritable bowel disease (IBD) may be at greater risk of post-operative infections if they take corticosteroids or immunomodulators, researchers report in the August issue of Gastroenterology.

In “Corticosteroids and immunomodulators: Postoperative infectious complication risk in inflammatory bowel disease patients,” Aberra et al theorized that when this cohort of patients underwent elective bowel surgery, the use of corticosteroids and 6-mercaptopurine/ azathioprine would have a higher rate of post-operative infectious complications than patients not on such medications.

Of 159 patients in the retrospective study who underwent elective bowel surgery, 56 were receiving corticosteroids, 52 were receiving 6-mercaptopurine/azathioprine alone or with corticosteroids, and 51 were not receiving either medication.

Based on their results, the researchers determined preoperative use of corticosteroids did increase the risk of infection, while the use of 6-Mercaptopurine/azathioprine alone or the addition of 6-mercaptopurine/ azathioprine for patients receiving corticosteroids did not.

Calendar

SGNA awards nomination forms due
November 30, 2003

Awards applications due
December 31, 2003

GI Nurses and Associates Day
March 24, 2004

National Colorectal Cancer Awareness Month
March 2004

Mayo Clinic presents “GI & Hepatology 2004: Advances and Controversies”
March 5-7, 2004

Disney’s BoardWalk Resort Contact:
Mayo School of CME,
800-462-9633 or 904-953-7146; cme-jax@mayo.edu; www.mayo.edu/education

CBGNA Certification Exam
May 17, 2003 October 17, 2003

Deadlines for submission of recertification by contact hours:
May 31, 2003, October 31, 2003

SGNA’s 31st Annual Course
May 14-19, 2004 Dallas, Texas

New Research Suggests PEG-Based Laxatives May Prevent Colorectal Cancer

Laxatives containing polyethylene glycol (PEG) may reduce the risk of colorectal tumors by 50 percent, according to results of a study that was presented at the 94th Annual Meeting of the American Association for Cancer Research, July 11-14 in Washington, D.C. The results were published in abstract form in the meeting’s “2003 Proceedings,” available online.¹

The study was led by Denis E. Corpet, PhD, professor, Ecole National Veterinaire in Toulouse, France, and Etienne Dorval, MD, president of Gastroenterologists of Indre-et-Loire, France.

PEG is a nonabsorbed, nonmetabolized, water-soluble polymer that has been used to treat constipation in France since 1996, and was recently approved for use as a laxative in the United States and Canada. PEG is extremely potent in the chemoprevention of experimental colon carcinogenesis. PEG treatment of azoxymethane-induced tumors in rats has been seen to completely inhibit invasive colon cancers. These experimental studies showed that PEG is the most potent agent against precancerous colonic lesions, or aberrant crypt foci (ACF).²

In the population-based study in France, 1,165 patients (607 women, 498 men, mean age 58.3) having a routine total colonoscopy were enrolled by gastroenterologists from October 2001 to January 2002. Patients were interviewed about taking a PEG-based laxative, their risk factors for colon cancer and diet. Of the 1,165 patients, 70 percent had no tumor, 28 percent had adenomas, and 2 percent had carcinomas. Of those who used a PEG-based laxative, most used Forlax®, which contains the highest dose of PEG. The odds ratios of the other PEG-based laxatives were smaller than one, but none reached significance. Those who used Forlax reduced their risk of colorectal tumors by half.

“This research shows that people in France who used PEG to treat constipation were less likely to have a tumor, which may be a reason for physicians to prescribe PEG over other laxatives for constipation,” said Dr. Corpet.

The study was funded by French public agencies for research, notably INRA and DGER, and by the French physician association GASTRO 37.

Correction

In the August/September issue of EndoNurse, a number was inadvertently left out of the subsection Treatment of GERD, Complications in Update in Pathogenesis, Treatment of GERD. The phrase should read: “There are several nursing considerations regarding the care of a patient with GERD, including lifestyle modifications such as elevation of the head of bed more than 6 inches, avoid eating 3 hours prior to lying down, eat smaller evening meals and reduce dietary fat and caffeine intake.”

From the Mail Bag...
Southern California SGNA Supports the Colossal Colon Tour

From left to right: Nancy Rush, Mary Clark, Cathy Dye, Laura Whitlock, Molly McMaster, Enica Lewis and Nan Carder

“The Colossal Colon Tour visited Los Angeles June 18-21, 2003, on its travels to 20 cities across the USA. Over 1,500 people viewed the exhibit during its stay in Los Angeles.

Molly McMaster, 26, who has survived colon cancer, created the Colossal Colon. The tour is dedicated to Amanda Sherwood Roberts, a friend of Molly’s, who at age 27 lost her battle with colon cancer. The hope is that by sharing Amanda’s story, someone’s life will be saved.

“‘The Colon’ — at 40 feet long and 4 feet high — was modeled on real people’s colons. It provides a unique chance to ‘check your insides out’ by seeing what healthy colon tissue looks like, as well as diseases of the colon.

“Digestive tract facts, risk factors, healthy lifestyles, a video of an actual colonoscopy and videos of personal testimonies are all covered in The Colossal Colon Experience.

“Spending the morning with the tour allowed us the opportunity to meet folks from all walks of life with various reasons for attending and enabled us to do what we, as GI nurses, do best — educate.”

—Mary Clark, RN, BSN, CGRN and Nan Carder, RN C, BSN, CGRN, Providence Health System, Southern California

Submit your letter to the editor by e-mailing kdix@vpico.com.

Pizza May Protect Against Cancer

Researchers in Italy have found that regular pizza consumers had a lower risk of digestive tract cancers. The study, published in the July 21 issue of the International Journal of Cancer, found that the cohort of patients with cancers of the oral cavity, pharynx, esophagus, larynx, colon and rectum included a higher percentage of non-pizza-eaters compared with non-cancer patients.

The study compared 3,315 patients with digestive tract or laryngeal cancer with 4,999 controls admitted to hospital for other conditions.

Other studies have linked refined carbohydrates with colorectal cancer; the researchers hypothesize that the positive influence of pizza may be due to tomatoes or olive oil, which are inversely related to the risk of developing certain cancers.

“Even if the association is real,” the researchers write, “inference on specific components of pizza [such as] macro or micronutrients remains difficult, since pizza may simply represent an aspecific indicator of Italian diet.”

Additionally, the authors point out that the test population was Italian. Therefore, “it would not be warranted to assume the apparent cancer-fighting effect of pizza exists in other diets and populations.”

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