[Talissa]

"Arthritis drug Vioxx being pulled" http://www.cnn.com/2004/HEALTH/09/30/vioxx...reut/index.html "...The colon cancer trial was designed to evaluate the effectiveness of the standard 25-milligram Vioxx dose in preventing recurrence of colon polyps. Such polyps sometimes become cancerous.Vioxx was used in the colon cancer trial because some researchers theorize that inflammation, present in arthritis, may be linked to colon cancer.Merck said the heart attacks and strokes were not spotted during the first 18 months of the trial but became apparent later."

 

[floridian2]

COX-2 inhibitors like Vioxx are of interest to people with post-infective IBS, although they are not proven. There are a large number of dietary COX-2 inhibitors that are as effective as the pharmaceutical pills, and likely safer. Cherry juice, particularly black cherry, Montmorency or 'tart' varieties does the trick, and has long been used in arthritis and gout for that reason. Other Cox-2 inhibitors include turmeric or its derrivative curcumin, as does the combination of DHA (from fish oil) with soy. Olive oil downregulates cox-2 in the colonic mucosa and is associated with reduced risk of heart attack, not increased.

quote: Rev Gastroenterol Mex. 2003 Jan-Mar;68(1):55-61. [Post-infectious irritable bowel syndrome. A review based on current evidence] [Article in Spanish] Gomez-Escudero O, Schmulson-Wasserman MJ, Valdovinos-Diaz MA. Departamento de Gastroenterologia, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Tlalpan, C.P. 14000 Mexico, D.F. INTRODUCTION: Pathophysiology of irritable bowel syndrome (IBS) is multifactorial. Recent investigations have associated episodes of infectious gastroenteritis with development of IBS. This condition is named post-infectious IBS (PI-IBS). The role of inflammation-infection in IBS pathogenesis is not well understood. AIM: To review published scientific evidence on PI-IBS regarding risk factors, causal agents, histopathological changes, and treatment. MATERIALS AND METHODS: An electronic search in MEDLINE and abstracts presented at national and international GI meetings was performed, looking for information published in the past 50 years including animal studies, cohort studies, case-control studies, and series of cases and case reports, using the key words post-infectious enteritis, post-dysenteric or post-infectious irritable bowel syndrome (PI-IBS), and post-infectious colitis. RESULTS: Fifty one papers were included. These studies were classified according to pathophysiologic mechanisms, infectious agents involved, animal or human studies, and treatment. CONCLUSIONS: Current evidence shows a strong association between colonic infection and inflammation with development of IBS. Approximately 25% of patients with IBS have a history of infectious enteritis. Microbial agents related with PI-IBS include bacteria (Campylobacter, Salmonella) and parasites (Trichinella spiralis). Increased number of enteroendocrine cells, CD3 lymphocytes and mast cells within the colonic muscle wall, release of pro-inflammatory substances, and increased number of inflammatory cells with intestinal nervous endings are the most common histopathologic findings. Patients developing PI-IBS have a higher frequency of psychological disorders and stressful events prior to the gastroenteritis episode. Therapeutic interventions with steroids, COX-2 inhibitors, antibiotics and probiotics require further investigation.

 

[floridian2]

COX-2 inhibitors like Vioxx are of interest to people with post-infective IBS, although they are not proven. There are a large number of dietary COX-2 inhibitors that are as effective as the pharmaceutical pills, and likely safer. Cherry juice, particularly black cherry, Montmorency or 'tart' varieties does the trick, and has long been used in arthritis and gout for that reason. Other Cox-2 inhibitors include turmeric or its derrivative curcumin, as does the combination of DHA (from fish oil) with soy. Olive oil downregulates cox-2 in the colonic mucosa and is associated with reduced risk of heart attack, not increased.

quote: Rev Gastroenterol Mex. 2003 Jan-Mar;68(1):55-61. [Post-infectious irritable bowel syndrome. A review based on current evidence] [Article in Spanish] Gomez-Escudero O, Schmulson-Wasserman MJ, Valdovinos-Diaz MA. Departamento de Gastroenterologia, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Tlalpan, C.P. 14000 Mexico, D.F. INTRODUCTION: Pathophysiology of irritable bowel syndrome (IBS) is multifactorial. Recent investigations have associated episodes of infectious gastroenteritis with development of IBS. This condition is named post-infectious IBS (PI-IBS). The role of inflammation-infection in IBS pathogenesis is not well understood. AIM: To review published scientific evidence on PI-IBS regarding risk factors, causal agents, histopathological changes, and treatment. MATERIALS AND METHODS: An electronic search in MEDLINE and abstracts presented at national and international GI meetings was performed, looking for information published in the past 50 years including animal studies, cohort studies, case-control studies, and series of cases and case reports, using the key words post-infectious enteritis, post-dysenteric or post-infectious irritable bowel syndrome (PI-IBS), and post-infectious colitis. RESULTS: Fifty one papers were included. These studies were classified according to pathophysiologic mechanisms, infectious agents involved, animal or human studies, and treatment. CONCLUSIONS: Current evidence shows a strong association between colonic infection and inflammation with development of IBS. Approximately 25% of patients with IBS have a history of infectious enteritis. Microbial agents related with PI-IBS include bacteria (Campylobacter, Salmonella) and parasites (Trichinella spiralis). Increased number of enteroendocrine cells, CD3 lymphocytes and mast cells within the colonic muscle wall, release of pro-inflammatory substances, and increased number of inflammatory cells with intestinal nervous endings are the most common histopathologic findings. Patients developing PI-IBS have a higher frequency of psychological disorders and stressful events prior to the gastroenteritis episode. Therapeutic interventions with steroids, COX-2 inhibitors, antibiotics and probiotics require further investigation.

 

[flux]

quote:COX-2 inhibitors like Vioxx are of interest to people with post-infective IBS, although they are not proven.

Make that not even tested.

quote:There are a large number of dietary COX-2 inhibitors that are as effective as the pharmaceutical pills, and likely safer.

A large number? Where exactly is your list? As effective as drugs? Cherries certainly have been around long before these drug companies even existed. So why are there two million people taking Vioxx? And that's just one of a number of these drugs.And likely safer? How's that? Are the drugs deliberately tainted with poisons?

 

[flux]

quote:COX-2 inhibitors like Vioxx are of interest to people with post-infective IBS, although they are not proven.

Make that not even tested.

quote:There are a large number of dietary COX-2 inhibitors that are as effective as the pharmaceutical pills, and likely safer.

A large number? Where exactly is your list? As effective as drugs? Cherries certainly have been around long before these drug companies even existed. So why are there two million people taking Vioxx? And that's just one of a number of these drugs.And likely safer? How's that? Are the drugs deliberately tainted with poisons?

 

[lizbeth]

Talissa, Thanks for this thread and important information. I have been a Vioxx user since January of this year for osteoarthritis.In late August, after reports of the Vioxx study were published, I stopped taking it for two weeks.My joints started screaming out so I went back on it. Guess I'l be joining the Celebrex or Bextra crowd after I see my MD for new RX. For those of us who have had IBS beginnings after GI Infection/Disturbance of Intestinal flora. This research may lead to proven results helpful in creating a new medication for us. Let's hope this is the first step on a road to discovery about complicated body chemistry in the gut and a way to relieve our gut grief.

 

[lizbeth]

Talissa, Thanks for this thread and important information. I have been a Vioxx user since January of this year for osteoarthritis.In late August, after reports of the Vioxx study were published, I stopped taking it for two weeks.My joints started screaming out so I went back on it. Guess I'l be joining the Celebrex or Bextra crowd after I see my MD for new RX. For those of us who have had IBS beginnings after GI Infection/Disturbance of Intestinal flora. This research may lead to proven results helpful in creating a new medication for us. Let's hope this is the first step on a road to discovery about complicated body chemistry in the gut and a way to relieve our gut grief.

 

[Talissa]

quote:Let's hope this is the first step on a road to discovery about complicated body chemistry in the gut and a way to relieve our gut grief

I agree--I think and hope they're onto something...Hope you find relief with an alternate med, Yogi.

 

[Talissa]

quote:Let's hope this is the first step on a road to discovery about complicated body chemistry in the gut and a way to relieve our gut grief

I agree--I think and hope they're onto something...Hope you find relief with an alternate med, Yogi.

 

[Talissa]

 

[Talissa]

 

[SpAsMaN*]

Good news!

 

[SpAsMaN*]

Good news!

 

[Talissa]

Dr Weil offers some advice re: a natural alternative to synthetic COX-2 inhibitors~ http://www.drweil.com/u/QA/QA6019/

 

[Talissa]

Dr Weil offers some advice re: a natural alternative to synthetic COX-2 inhibitors~ http://www.drweil.com/u/QA/QA6019/

 

[floridian2]

Flux - you are right that Cox-2 inhibitors are unproven for IBS, and I am unaware of any clinical trials on this. That doesn't mean that doctors aren't prescribing them for IBS - as the abstract I quoted indicated. That makes it of concern for the people on this forum. Why would people pay money for a pill when dietary modifcation can achieve the same result? Because people are lazy and don't want to change their diet. Most people could control their cholesterol with diet, but prefer a pill. Incredible profits lead pharmaceutical companies to spend millions on marketing and they convince people that the pills are better. "And likely safer? How's that? Are the drugs deliberately tainted with poisons? " Not sure what you are asking, flux. The epidemeological evidence supports the idea that tea may offer protection against stroke and heart attack. You'll question the strength and validity of these studies, and just for discussion's sake I'll pretend there is no evidence that tea decreases the risk of heart attack and stroke. But it is clear that BILLIONS of peple have drunk tea for many years, and there is no evidence it increases the risk of heart attack or stroke. Two million people take Vioxx for 18 months, and it has to be withdrawn from the market due to a pattern of adverse effects. And you ask which is safer.And who said anything about either Vioxx or tea being tainted? Not sure what you are trying to say.

quote:Free Radic Biol Med. 2002 Oct 15;33(8):1097-105. Green tea polyphenol epigallocatechin-3-gallate inhibits the IL-1 beta-induced activity and expression of cyclooxygenase-2 and nitric oxide synthase-2 in human chondrocytes. Ahmed S, Rahman A, Hasnain A, Lalonde M, Goldberg VM, Haqqi TM.Int J Cancer. 2004 Sep 28 [Epub ahead of print] Green tea constituent epigallocatechin-3-gallate selectively inhibits COX-2 without affecting COX-1 expression in human prostate carcinoma cells. Hussain T, Gupta S, Adhami VM, Mukhtar H.J Nutr. 2003 Nov;133(11 Suppl 1):3805S-3810S. Inhibition of phorbol ester-induced COX-2 expression by epigallocatechin gallate in mouse skin and cultured human mammary epithelial cells. Kundu JK, Na HK, Chun KS, Kim YK, Lee SJ, Lee SS, Lee OS, Sim YC, Surh YJ. Biochem Pharmacol. 2001 Nov 1;62(9):1175-83. Effects of purified green and black tea polyphenols on cyclooxygenase- and lipoxygenase-dependent metabolism of arachidonic acid in human colon mucosa and colon tumor tissues. Hong J, Smith TJ, Ho CT, August DA, Yang CS.Mutat Res. 2001 Sep 1;480-481:243-68. Molecular mechanisms underlying chemopreventive activities of anti-inflammatory phytochemicals: down-regulation of COX-2 and iNOS through suppression of NF-kappa B activation. Surh YJ, Chun KS, Cha HH, Han SS, Keum YS, Park KK, Lee SS.Nutr Cancer. 2000;38(1):60-4. Suppression of azoxymethane-induced preneoplastic lesions and inhibition of cyclooxygenase-2 activity in the colonic mucosa of rats drinking a crude green tea extract. Metz N, Lobstein A, Schneider Y, Gosse F, Schleiffer R, Anton R, Raul F.

quote:Am J Clin Nutr. 2002 May;75(5):880-6. Inverse association of tea and flavonoid intakes with incident myocardial infarction: the Rotterdam Study. Geleijnse JM, Launer LJ, Van der Kuip DA, Hofman A, Witteman JC. Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands. BACKGROUND: Dietary flavonoids may protect against cardiovascular disease, but evidence is still conflicting. Tea is the major source of flavonoids in Western populations. OBJECTIVE: The association of tea and flavonoid intake with incident myocardial infarction was examined in the general Dutch population. DESIGN: A longitudinal analysis was performed with the use of data from the Rotterdam Study-a population-based study of men and women aged >or=55 y. Diet was assessed at baseline (1990-1993) with a validated semiquantitative food-frequency questionnaire. The analysis included 4807 subjects with no history of myocardial infarction, who were followed until 31 December 1997. Data were analyzed in a Cox regression model, with adjustment for age, sex, body mass index, smoking status, pack-years of cigarette smoking, education level, and daily intakes of alcohol, coffee, polyunsaturated fat, saturated fat, fiber, vitamin E, and total energy. RESULTS: During 5.6 y of follow-up, a total of 146 first myocardial infarctions occurred, 30 of which were fatal. The relative risk (RR) of incident myocardial infarction was lower in tea drinkers with a daily intake >375 mL (RR: 0.57; 95% CI: 0.33, 0.98) than in nontea drinkers. The inverse association with tea drinking was stronger for fatal events (0.30; 0.09, 0.94) than for nonfatal events (0.68; 0.37, 1.26). The intake of dietary flavonoids (quercetin + kaempferol + myricetin) was significantly inversely associated only with fatal myocardial infarction (0.35; 0.13, 0.98) in upper compared with lower tertiles of intake. CONCLUSIONS: An increased intake of tea and flavonoids may contribute to the primary prevention of ischemic heart disease.

 

[floridian2]

Flux - you are right that Cox-2 inhibitors are unproven for IBS, and I am unaware of any clinical trials on this. That doesn't mean that doctors aren't prescribing them for IBS - as the abstract I quoted indicated. That makes it of concern for the people on this forum. Why would people pay money for a pill when dietary modifcation can achieve the same result? Because people are lazy and don't want to change their diet. Most people could control their cholesterol with diet, but prefer a pill. Incredible profits lead pharmaceutical companies to spend millions on marketing and they convince people that the pills are better. "And likely safer? How's that? Are the drugs deliberately tainted with poisons? " Not sure what you are asking, flux. The epidemeological evidence supports the idea that tea may offer protection against stroke and heart attack. You'll question the strength and validity of these studies, and just for discussion's sake I'll pretend there is no evidence that tea decreases the risk of heart attack and stroke. But it is clear that BILLIONS of peple have drunk tea for many years, and there is no evidence it increases the risk of heart attack or stroke. Two million people take Vioxx for 18 months, and it has to be withdrawn from the market due to a pattern of adverse effects. And you ask which is safer.And who said anything about either Vioxx or tea being tainted? Not sure what you are trying to say.

quote:Free Radic Biol Med. 2002 Oct 15;33(8):1097-105. Green tea polyphenol epigallocatechin-3-gallate inhibits the IL-1 beta-induced activity and expression of cyclooxygenase-2 and nitric oxide synthase-2 in human chondrocytes. Ahmed S, Rahman A, Hasnain A, Lalonde M, Goldberg VM, Haqqi TM.Int J Cancer. 2004 Sep 28 [Epub ahead of print] Green tea constituent epigallocatechin-3-gallate selectively inhibits COX-2 without affecting COX-1 expression in human prostate carcinoma cells. Hussain T, Gupta S, Adhami VM, Mukhtar H.J Nutr. 2003 Nov;133(11 Suppl 1):3805S-3810S. Inhibition of phorbol ester-induced COX-2 expression by epigallocatechin gallate in mouse skin and cultured human mammary epithelial cells. Kundu JK, Na HK, Chun KS, Kim YK, Lee SJ, Lee SS, Lee OS, Sim YC, Surh YJ. Biochem Pharmacol. 2001 Nov 1;62(9):1175-83. Effects of purified green and black tea polyphenols on cyclooxygenase- and lipoxygenase-dependent metabolism of arachidonic acid in human colon mucosa and colon tumor tissues. Hong J, Smith TJ, Ho CT, August DA, Yang CS.Mutat Res. 2001 Sep 1;480-481:243-68. Molecular mechanisms underlying chemopreventive activities of anti-inflammatory phytochemicals: down-regulation of COX-2 and iNOS through suppression of NF-kappa B activation. Surh YJ, Chun KS, Cha HH, Han SS, Keum YS, Park KK, Lee SS.Nutr Cancer. 2000;38(1):60-4. Suppression of azoxymethane-induced preneoplastic lesions and inhibition of cyclooxygenase-2 activity in the colonic mucosa of rats drinking a crude green tea extract. Metz N, Lobstein A, Schneider Y, Gosse F, Schleiffer R, Anton R, Raul F.

quote:Am J Clin Nutr. 2002 May;75(5):880-6. Inverse association of tea and flavonoid intakes with incident myocardial infarction: the Rotterdam Study. Geleijnse JM, Launer LJ, Van der Kuip DA, Hofman A, Witteman JC. Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands. BACKGROUND: Dietary flavonoids may protect against cardiovascular disease, but evidence is still conflicting. Tea is the major source of flavonoids in Western populations. OBJECTIVE: The association of tea and flavonoid intake with incident myocardial infarction was examined in the general Dutch population. DESIGN: A longitudinal analysis was performed with the use of data from the Rotterdam Study-a population-based study of men and women aged >or=55 y. Diet was assessed at baseline (1990-1993) with a validated semiquantitative food-frequency questionnaire. The analysis included 4807 subjects with no history of myocardial infarction, who were followed until 31 December 1997. Data were analyzed in a Cox regression model, with adjustment for age, sex, body mass index, smoking status, pack-years of cigarette smoking, education level, and daily intakes of alcohol, coffee, polyunsaturated fat, saturated fat, fiber, vitamin E, and total energy. RESULTS: During 5.6 y of follow-up, a total of 146 first myocardial infarctions occurred, 30 of which were fatal. The relative risk (RR) of incident myocardial infarction was lower in tea drinkers with a daily intake >375 mL (RR: 0.57; 95% CI: 0.33, 0.98) than in nontea drinkers. The inverse association with tea drinking was stronger for fatal events (0.30; 0.09, 0.94) than for nonfatal events (0.68; 0.37, 1.26). The intake of dietary flavonoids (quercetin + kaempferol + myricetin) was significantly inversely associated only with fatal myocardial infarction (0.35; 0.13, 0.98) in upper compared with lower tertiles of intake. CONCLUSIONS: An increased intake of tea and flavonoids may contribute to the primary prevention of ischemic heart disease.

 

[Kathleen M.]

In most of the studies of dietary modification in IBS the results are that it does NOT work for all people all the time.It is true SOME people can control IBS by adding fiber, avoiding triggers, etc. But this will not help ALL IBSers.My only way to avoid symptoms by dietary means was to avoid eating anything at anytime at any place for any reason.Which works great until you die of starvation in a couple of weeks.I am one that over-responded to the signal "I ate" that the stomach sends out. Did not matter one bit which food was eaten.K.

 

[Kathleen M.]

In most of the studies of dietary modification in IBS the results are that it does NOT work for all people all the time.It is true SOME people can control IBS by adding fiber, avoiding triggers, etc. But this will not help ALL IBSers.My only way to avoid symptoms by dietary means was to avoid eating anything at anytime at any place for any reason.Which works great until you die of starvation in a couple of weeks.I am one that over-responded to the signal "I ate" that the stomach sends out. Did not matter one bit which food was eaten.K.

 

[floridian2]

quote:In most of the studies of dietary modification in IBS the results are that it does NOT work for all people all the time.

I agree. IBS varies from person to person. Dietary modification is not the only tool that should be applied to IBS, but it can be valuable. CBT and various mind-based therapies also work for many and have no toxic side effects. Pharmaceuticals have their place in treating IBS, anxiety/panic, etc etc. - I am not a prohibitionist when it comes to medicines, although my personal preference is to use them as a last resort whenever possible. A severe acute infection might call for an antibiotic. Not all coughs and colds do.