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Reducing the Panic of Fecal Incontinence

Posted on November 12th, 2013 by Admin

From Mayo Clinic's Discovery's Edge magazine

Imagine the distress of waiting in a stalled checkout line, the bathrooms located at the back of the store, when your bowels begin to rumble and you have the uncontrollable urge to go. For those with fecal incontinence, panic ensues with the very thought of being caught unprepared at moments like these.

Mayo Clinic gastroenterologist Dr. Adil Bharucha has heard too many stories from his patients, mainly women over 40, about the panic created by the inability to control bowel movements, causing stool to leak unexpectedly from the rectum. In the worst cases, fecal incontinence can lead to a complete loss of bowel control.

Since one in 10 women experiences this embarrassing condition and since the prevalence increases with age, fecal incontinence was once thought to be the results of trauma during childbirth.  Dr. Bharucha discovered, however, that rectal urgency and diarrhea, rather than obstetric trauma, are the main risk factors for fecal incontinence among women

Adil Bharucha, M.D.

He also knew he needed better diagnostic tools to identify and assess anorectal function if he hoped to help women suffering from fecal incontinence. With that goal, he set about building an extensive network of collaborators both within Mayo Clinic and externally to develop new diagnostic tests and devices. This work has led him to collaborating widely across the institution to improve care for the patient.

The work of Dr. Bharucha and his research colleagues has earned international acclaim for Mayo Clinic's gastrointestinal motility clinic, the first center nationwide to introduce high resolution anorectal manometry into clinical practice; and to develop normal values and a system with which to classify patients with defecatory disorders, including fecal incontinence. It now offers a panel of tests to assess rectal stiffness, sphincter strength and urgency. This comprehensive approach provides an array of sophisticated diagnostic tools to help researchers zero in on the cause for fecal incontinence in each patient.

"Most of my collaborators had never considered working in my field," Dr. Bharucha says. "I am very grateful for their enthusiasm and expertise once they understood how common and distressing these disorders are. People say that the beauty of collaborating is that you work with smarter people. In my case, it's really true."

And, as a result, many women are also grateful to Dr. Bharucha for seeking new answers and new tests with his colleagues for this all too common and embarrassing condition.

Mayo Clinic's Genomic Study on Prostate Cancer

Posted on November 6th, 2013 by Admin

Certain types of "hard to treat" prostate cancer present an unanswerable challenge for physicians. That's a nicely worded sentence for very bad news for the patient. After hormone treatment yields no response, the patient usually has two years or less to live. Surgery isn't possible because the tumor cannot be shrunk. The reality of the condition underscores the urgency of a new study at Mayo Clinic's Center for Individualized Medicine that uses the genomic information of the patient's tumor to find possible solutions, such as more targeted drugs. For more details on the study or to learn how you might participate, check the news release Mayo issued today.

 

Regenerating Heart Tissue Through Stem Cell Therapy

Posted on November 6th, 2013 by Admin

From the pages of Mayo Clinic's Discovery's Edge --

Two years after a heart attack left him too exhausted to even tend his garden, Miroslav Dlacic is now able to walk again without becoming worn out.  An international team of Mayo Clinic doctors and researchers, led by André Terzic, M.D., Ph.D., director of Mayo Clinic’s Center for Regenerative Medicine, helped Dlacic reclaim his life by discovering a way to regenerate heart tissue through stem-cell therapy.

For decades, treating cardiac patients has typically involved managing heart damage with medication. It’s a bit like driving a car without fixing a sluggish engine; you manage the consequences as best you can and learn to live with them. But in collaboration with European colleagues, Mayo Clinic researchers have discovered a revolutionary means of repairing a damaged heart—of actually fixing the machine.

Dr. Andre Terzic

“It’s a paradigm shift,” says Dr. Terzic. “We are moving from traditional medicine, which addresses the symptoms of disease, to being legitimately able to cure disease.”

In this breakthrough process, stem cells are harvested from a cardiac patient’s bone marrow. They undergo a laboratory treatment that guides them to become cardiac cells. The treated cells are then injected into the patient’s heart in an effort to grow healthy heart tissue. The study is the first successful demonstration in human beings of the feasibility and safety of transforming adult stem cells into cardiac cells.

“We guide the stem cells to become something useful, in this case, cardioprogenitors,” Dr. Terzic explains.

This discovery has implications for millions of people. Cardiovascular disease is the leading cause of death worldwide. In the U.S. alone, about 5.8 million people have heart failure, and the number is growing. Beyond heart failure, the Mayo research also is a milestone in the emerging field of regenerative medicine, which seeks to go beyond palliative treatments to fully heal damaged tissue and organs.

 Mayo Clinic is uniquely positioned to pursue this complex therapy. In addition to its global reach, Mayo Clinic has its Center for Regenerative Medicine at the forefront of efforts to develop reparative solutions for a range of conditions.

“With the cardiopoiresis research, we have shown that regenerative medicine can really work,” Dr. Terzic says. “We are now actively working on regenerative medicine in the areas of diabetes, liver and lung disease, neurologic disorders, and orthopedic surgery.”

 To read the full story about Dr. Terzic's research into regenerative medicine, visit Discovery's Edge, Mayo Clinic's research magazine, at http://www.mayo.edu/research/discoverys-edge/regenerating-heart-tissue-stem-cell-therapy.

Dr. Eric Green – NIH Genomic Leader

Posted on September 30th, 2013 by Admin

Dr. Eric Green, head of the National Human Genome Research Institute, is now on the stage...explaining how "genomics is becoming increasingly relevant to the patient." He says this discipline is a marathon, that began 13 years ago with the initial mapping of the human genome. Now he talks of "base pairs to bedside" or "double helix to health"...and points to the strategic plan for his institute, published in 2011. He is now outlining advancements in our understanding of the genome, it's biology, how it impacts human biology and then how it can impact medical practice. Finally, he says, we must measure and demonstrate how genomics improves health care.

He also says we've learned much in the last decade, including the epigenomic code -- the impact of proteins on our genetic behavior based on environmental influences. He is essentially setting the stage for what will come later in the conference -- all of the knowledge thus far, he says, is a "Cliff Notes" version of the human genome and we have a lot more to learn -- including the differences in individual human genomes.

Does Anesthesia Cause Problems for Kids Later On?

Posted on September 5th, 2013 by Admin

A team of researchers from the Mayo Clinic Children's Center are trying to answer that question. From what they can tell from animal studies, it may cause problems with learning and memory. They've conducted a study of records -- both medical and school records - in the area around Rochester, Minn. There was some correlation: an association with learning disabilities and attention deficit disorder for some children who'd been exposed to anesthesia multiple times at a young age.

But as we know, correlation does not mean causation. So they are now working on a much larger and detailed study to test  1000 children to see if they can better define what injury or injuries may be associated with anesthetic exposure (if any).

Ultimately they hope to find if there is a problem with how anesthesia is administered or if changes are needed to minimize potential problems. It's one more way Mayo Clinic is trying to improve safety of the medical practice and share its findings with everyone.

If you, as a parent, are interested in having your child participate in this study -- and you live in the Rochester, Minn. area, you may be interested in learning more about it from this YouTube video:  

Vedolizumab Effective for Treatment of Ulcerative Colitis & Crohn’s Disease – IBD in the News

Posted on August 30th, 2013 by Admin

Sunanda Kane, M.D., a gastroenterologist at Mayo Clinic specializing in the care and evaluation of patients with IBD, discusses two studies recently published in “The New England Journal of Medicine” (ulcerative colitis study | Crohn's disease study) that found patients with ulcerative colitis or Crohn’s disease benefited from treatment with vedolizumab compared with placebo.

Dr. Kane also discusses how the mechanism of action for vedolizumab differs from other therapies currently used to treat IBD.

For more information on IBD, visit: mayoclinic.org/ibd

Tips for Maintaining a Gluten-Free Diet while Traveling

Posted on August 22nd, 2013 by Admin

Mayo Clinic gastroenterologist and celiac disease expert Joseph Murray, M.D., and Jacalyn See, a clinical dietician at Mayo Clinic discuss tips to help people with celiac disease maintain a gluten-free diet while traveling.

Among a few of the tips mentioned are:

- Before leaving, contact a celiac disease support group in that area to which you are traveling. They can provide you with firsthand information about places to eat and shop in that location.

- When traveling abroad to countries speaking foreign languages, bring a pre-printed card, translated to that country's language, that informs the food service personnel about the need for gluten-free items.

- For longer trips, booking a hotel room that has a refrigerator or kitchen facilities. That way, you can prepare some of the meals in your room.

- Do some online searching to see what airlines offer gluten-free meals.

For more information on celiac disease, visit: mayoclinic.org/celiac-disease

FDA Defines “Gluten-Free” for Food Labeling – Celiac Disease in the News

Posted on August 6th, 2013 by Admin

Mayo Clinic gastroenterologist and celiac disease expert Joseph Murray, M.D., discusses the FDA’s newly published regulations that define the term "gluten-free" for voluntary food labeling.

Among the positives, of these new regulations, Dr. Murray mentions:
-They apply to foods that have the potential for cross-contact or contamination with gluten during processing.
-When you see a label that says, “gluten-free” it must be gluten-free by a specific and standard definition that is trustworthy.
-There is now a pathway towards enforcement of labels found to be incorrect.

However, Dr. Murray also mentions some gaps. Specifically, these regulations do not cover:
-USDA regulated foods
-Distilled spirits or any wine containing greater than 7% ABV

For more information on celiac disease, visit: mayoclinic.org/celiac-disease

Cardiovascular Disease Less Prevalent Among Patients with Celiac Disease – Celiac Disease in the News

Posted on July 29th, 2013 by Admin

Mayo Clinic gastroenterologist and celiac disease expert Joseph Murray, M.D., discusses a study presented at this year’s Digestive Disease Week that found incidence and risk factors for cardiovascular disease were less prevalent among patients with celiac disease. Additionally, the same study found that patients with celiac disease were less likely to have type 2 diabetes.

For more information on celiac disease, visit: mayoclinic.org/celiac-disease

What Docs Are Saying About Our Docs

Posted on July 9th, 2013 by Admin

Trials and Fibrillations is a blog on the Heart.org, by Kentucky physician John Mandrola.  He happens to be an electrophysiologist, thus the blog title. We wanted to offer up here one of his recent posts -- for reasons very apparent you'll if you read it -- in which he outlines his recent experience at a presentation by Mayo Clinic cardiologist and long QT expert Michael Ackerman, M.D., Ph.D.

The talk is titled Five Reasons To Not Do Genetic Testing. It seems counterintuitive, but there are instances when testing isn't the best approach -- including when there's no one around to properly interpret the results.  But we'd rather that you hear Dr. Mandrola's take on the talk...and on Dr. Ackerman.   In any case, we're glad he's in the house.