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Bile - Not Acid - Causes Barrett's (Len Saputo)

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Posted 2/23/2013 1:03 AM (GMT 0)
Anyone ever heard of this guy. I just happened across this, and sharing for others.

"A study published in Annals of Surgery in April of 2012 showed that bile, not acid, is the cause for Barrett's esophagus and esophageal cancer. This finding is especially important because current drug therapies for GERD focus largely on acid control. Drugs that block acid production might actually make the risk for esophageal cancer higher.

Research showed that when bile washes up from the stomach into the esophagus, it shuts of genes responsible for the normal lining of the esophagus and turn on genes that produce the intestine-like lining that is the hallmark of Barrett's esophagus and the precursor in some people of esophageal cancer. BIle is normally found in the intestinal environment, so when stem cells in the esophagus are exposed to bile, that is what they morph into...makes sense!"

http://tv.naturalnews.com/v.asp?v=1c9d3f30a0c1e209d6b2f15dd9c051b0
Posted 2/23/2013 11:13 AM (GMT 0)
I haven't hear of this guy, but there was another study in 2011 that supported that concept. In the 2011 study, PPIs did not reduce Barrett's incidence. The opposite results were found in a 2009 study, so it seems the cards aren't all in, but interesting food for thought. Cancer of the esophagus has increased, not decreased, since ppis were introduced. It seems possible that ppis only relieve symptoms, may not reduce chances of Barrett's.

Post Edited (sunbeam48) : 2/23/2013 5:45:13 AM (GMT-7)

Posted 2/24/2013 1:33 AM (GMT 0)
This guy has a Facebook page and web site, both called Dr. Saputo.com. His focus is wellness, he sells nutritional products.
Posted 2/24/2013 3:26 PM (GMT 0)
The concept makes sense, I'm leaning toward agreeing the more I think about it. If I remember correctly, isn't carafate given for bile reflux? If so, wouldn't it make sense to dump the ppi's (control reflux though diet and natural) and just take carafate to protect against bile?

Regardless of Dr. Saputo outside vested interest (selling nutritional products) the concept is solid. 

Posted 2/26/2013 3:07 AM (GMT 0)
Certain things make sense - but beware...

PPI's do NOT help with bile reflux, which is caused by the gall bladder. No acid reducer does.

I have both kinds of reflux, and the removal of my gall bladder seems to have stopped the bile part anyway, while the Nissan failed miserably :(

But I have seen so many of these 'naturalist' things.... Keep this in mind: it's FOR PROFIT. I can't find ANYTHING on the study itself. If someone can, I'd like to read it for myself.
Posted 2/26/2013 3:26 PM (GMT 0)
Any other thoughts guys?
Posted 2/27/2013 4:19 AM (GMT 0)
So what are you suppose to do if you have bile reflux? From reading this post it's worse for you and PPI's don't work.
Posted 2/27/2013 11:47 AM (GMT 0)
sixness,

I mention in my post that carafate (I believe) protects against bile reflux.

Posted 2/27/2013 2:05 PM (GMT 0)
TheSixness,

The only relief I got was having my gall bladder out. If your ph study shows bile reflux, tell your doc you want a full work up for your gall bladder, and NOT just an ultrasound. Carafate just protects the 'bad' spots, and is a pain because as soon as you have a drink it pretty much washes away. I only take it at night or before a meal that I know might cause some issues (spicy or acidic foods).
Posted 2/27/2013 3:18 PM (GMT 0)
vinylmasters,

I agree, carafate is a pain to time between food and meds, however I believe it coats your entire throat and stomach not just the bad spots. Also, I do not believe it washes away with liquids. You take it 1hr before food or drink and it last up to 4 hrs. I think Dencha can support me on the carafate facts.

Posted 2/27/2013 5:13 PM (GMT 0)
Here's another link referring to the same study. This one is from my local university medical center, the health care system I use. http://www.urmc.rochester.edu/news/story/index.cfm?id=3476

Post Edited (sunbeam48) : 2/27/2013 10:35:35 AM (GMT-7)

Posted 2/27/2013 5:36 PM (GMT 0)
I'll have to mention the gall bladder thing to my doctor. I'm still waiting for my impedance and manometry exams results, but I have long suspected I have bile reflux.

This is because for some reason PPI's just do not work, they make my symptoms more painful. Also, it really doesn't matter what I eat. I can eat safe foods for weeks and I'll still get long lasting heartburn. I can pig out on chocolate and feel the same as eating noodles or salads. I do have carafate and I find that to be only slightly helpful. It doesn't seem to coat my upper chest enough. Unfortunately, the only thing that has worked is 3 or 4 Tylenol.
Posted 2/27/2013 6:15 PM (GMT 0)
The article I linked mentions that bile is a normal part of the stomach environment. I think this article applies to everyone, not just those with gall bladder dysfunction. Our reflux contains both bile and acid, this study suggests that it is the bile, not the acid, that is doing the damage. That would mean that the ppi's are doing nothing to protect us from progression to Barrett's and beyond.

Post Edited (sunbeam48) : 2/27/2013 11:59:18 AM (GMT-7)

Posted 2/27/2013 6:22 PM (GMT 0)
wow! Thanks for the link sunbeam.
Posted 2/27/2013 8:02 PM (GMT 0)
Bile reflux scares me :-(
Posted 2/27/2013 9:30 PM (GMT 0)
I thought bile was released into the first part of the small intestine [duodenum] ie beyond the pylorus, rather than into the stomach. If so [and I may well be wrong!] does bile reflux indicate faulty action of the pylorus?

I was under the impression that the main gastric substances produced in the stomach were acid and pepsin, but not bile.

Any views welcome. I have Barretts.
Posted 2/27/2013 11:31 PM (GMT 0)
Phil, I also have Barrett's.

Both of these articles, referring to the same study, specifically mention bile moving from the stomach to the esophagus, and that bile is a normal part of the stomach environment.
Posted 2/28/2013 9:24 PM (GMT 0)
Thanks for the reply sunbeam48,

Here's a link to the Mayo Clinic bile refux page,

http://www.mayoclinic.com/health/bile-reflux/DS00651/DSECTION=causes

There's a lot of info to digest here, but it seems my thought about bile not being normal in the stomach is correct.
Posted 2/28/2013 11:00 PM (GMT 0)
I read it differently than you, Phil. But I really don't know, I have no expertise in this. Much of what I and others read seems open to interpretation.
Posted 2/28/2013 11:23 PM (GMT 0)

This article, titled "Popular Heartburn Drugs May Increase Esophageal Cancer Risk", referring to a different study, also discusses PPI's and bile:  http://seattletimes.com/html/health/2015799841_heartburn05.html

Posted 3/1/2013 2:02 AM (GMT 0)
sunbeam,

That was a great link! I need to get off these ppi's but I do have a HH and I'm white male over forty, so thats not good. I have so many symptoms that change I don't know if I'm typical or a typical? I'm looking forward to understanding the fast track diet.

I would like to ask you a few questions if you don't mind? You have barretts but no longer take ppi's (fast track diet). Do you have a haital hernia? Are you part of the "wrap club" (NF)? Have you ever got the famous lump in the throat or tight throat? How bad is your barretts? Does your LES work? I'm just trying to compare myself to you, as I have high hopes for the fast track.

Posted 3/1/2013 1:46 PM (GMT 0)
Dogbones, I don't mind personal questions.

I discontinued my PPI nearly a year ago, and went off Zantec (an h2 blocker) in December, so that I could work with the Fast Tract diet. I don't have a hiatial hernia. I have not had any surgery. I had LPR issues about a year and a half ago, mostly consisting of a severe cough and losing my singing and speaking voice. This gradually improved as I followed th Koufman diet, which I stayed on for more than a year. I have had an upper endoscopy, which found the Barrett's, and I also saw an ENT for my throat issues. I don't know how bad the Barrett's is. I'm thinking not too bad because I didn't have GERD for very long when they diagnosed it. Barrett's is fairly common but esophageal cancer is rare, and I don't have any of the risk factors, including male, overweight, smoker. I just checked the risk factors on the Mayo clinic site, and GERD with Barretts and my age (58) are my only risk factors. I haven't had specific testing done for my LES, but it doesn't feel good when I bend over repeatedly for gardening or loading the dishwasher.

Post Edited (sunbeam48) : 3/1/2013 6:52:55 AM (GMT-7)

Posted 3/2/2013 11:24 PM (GMT 0)
The Sixness said, "So what are you suppose to do if you have bile reflux?"

There are a number of bile acid sequestration drugs. These work to bind bile. They are non systemic, remaining in the gut, preventing bile re-absorbtion in the terminal ileum. Originally used to help reduce blood cholesterol, before Statins were available they have been around a long time and are known to be safe. It is possible that these could help remove or reduce bile that finds its way into the stomach.

Genzyme make a tablet, Cholestagel. Or in the US there is Welchol. Google these for more info.
Posted 3/3/2013 5:18 PM (GMT 0)
I haven't heard any US GI doctors prescribe welchol for bile reflux. Anyone else know of this?
Posted 3/21/2013 2:38 PM (GMT 0)
Well this happenned to me... I had my endoscopy yesterday and it showed bile reflux which im sure ppis gave me....now i understand why my symptoms wouldnt go awayyyy. Im so mad at the drs who gave me ppis and at me for taking them!
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