Researchers studying the microbiology of water systems at 45 sites in seven different states across the U.S. found unusually high levels of bacteria in showerheads—almost 100 times more than any other place in the home. Although bacteria levels were high in all showerheads, some sample sites in the New York City and Denver areas had large amounts of Mycobacterium avium, a relative of the bacteria that causes tuberculosis and leprosy.

“If you’re getting a face full of water when you first turn your shower on, that means you are probably getting a particularly high load of Mycobacterium avium,” says study author Norman Pace, professor of biology at the University of Colorado.

Mycobacteria are found in soil, water, and decaying matter. Certain Mycobacteria, such as Mycobactrium avium, can cause digestive, lymphatic, and pulmonary infections. In the shower, these bacteria are delivered as aerosols. Particles are small enough to get into the lungs, and when inhaled or swallowed, can lead to a host of pulmonary problems.

The study, part of a bigger study that began as a class project, used DNA barcode testing to extract rRNA (bacterial DNA) from different parts of the shower and showerhead. Researchers sampled water flowing from the showerhead and obtained swab samples from the inside of the showerhead. Finally, samples were collected from water flowing out of the pipe after the showerhead was removed.

Homes with well water systems did not have Mycobacteria in their showerheads, a factor authors believe may be due to Mycobacteria’s chlorine resistance. Although they suggest that bathing may be safer, researchers assure that it’s not dangerous to shower.

“We did see some organisms that might be of concern if you have immune issues (such as) cystic fibrosis, AIDS, recent organ transplant, substance abuse, or are pregnant or otherwise immune compromised,” the authors wrote.

Click for more information on pulmonary disease.

A study published this month in the journal Archives of Surgery finds that two rarely-used nonsurgical treatments can help people with the symptoms of acid reflux disease, including heartburn. The treatments could help alleviate symptoms in patients who are not helped by acid-reducing drugs.

Gastroesophageal reflux disease or GERD is a relatively common chronic condition in which the contents of the stomach, including the corrosive stomach acid, seep up into the esophagus, irritating its lining and causing inflammation. This usually causes severe, persistent heartburn and it may also cause difficulty swallowing, voice hoarseness, and chronic coughing.

The study examined the use of two “endoluminal therapies” that do not involve incisions but instead use an endoscope, a long flexible instrument inserted through the mouth and down the esophagus. The first, known as full-thickness plication, involves using an endoscope to tighten the junction between the esophagus and the stomach with sutures. The other procedure, called radiofrequency therapy, delivers energy waves to the muscles of the esophagus and stomach to improve the function of the valve between the two organs. 

In the study, the researchers treated 126 GERD patients using one of the two nonsurgical techniques between 2002 and 2006. A total of 58 underwent full-thickness plication and 68 patients underwent radiofrequency treatment. After six months, among the patients who underwent full-thickness plication, the percentage of patients with moderate to severe heartburn decreased from 53 percent to 43 percent and many patients saw improvements in voice symptoms and swallowing difficulties. Among the group receiving radiofrequency treatment, moderate to severe heartburn decreased from 55 percent to 22 percent and decreases were also seen for swallowing difficulties, voice symptoms, and cough. Both groups reported using less much less medication after the treatments.

The most common treatments for GERD are a class of acid blocking medications called proton pump inhibitors. While effective for some, these medications do not work for everyone and they can be expensive. GERD returns in more than 80 percent of cases after people stop taking these medications.

Surgical options have been available since the 1990s, but these are seen as a treatment of last resort due to their invasiveness, cost, and questionable effectiveness. The most commonly used surgery, laparoscopic fundoplication, involves wrapping the top portion of the stomach around the base of the esophagus to strengthen the junction between the two organs.

The two nonsurgical treatments have been available for more than ten years but are still uncommon in part because health insurance companies typically do not pay for them.

If you have GERD symptoms that are not helped by medication or if you have “breakthrough” symptoms several times a week, you may want to talk to your healthcare provider about the nonsurgical options. If you want a more specialized medical opinion, the American College of Gastroenterology has a physician locator to help you find a GI specialist in your area.

For more information about treating GERD, join the conversation at the Healia Health Community for Acid Reflux.

_{Photo: tomsaint11, Flickr, Creative Commons}

The U.S. Centers for Disease Control and Prevention (CDC) is searching for the source of a Salmonella outbreak that has sickened nearly 400 people in 42 states so far. The CDC has not released the list of states affected nor have they provided any information about what foods may be spreading the Salmonella bacteria.

Federal health officials say that at least 388 people have contracted the same strain of Salmonella since September which has sent about 70 people to the hospital. No deaths have been reported. Other sources report that Ohio, California, and Georgia are among the states affected.

The Department of Agriculture, state health officials and the Food and Drug Administration are also involved in the investigation.

Salmonella infections are relatively common, affecting approximately 40,000 people every year in the United States, in this case all 388 people were sickened by the same strain of the bacterium, Salmonella typhimurium, as determined by genetic fingerprinting. The CDC says this type of is most common in contaminated poultry, cheese, and eggs.

Most people infected with salmonella develop fever, abdominal cramps, and diarrhea between 12 and 72 hours after infection. The illness usually lasts four to seven days, and most people recover without treatment. Infants, the elderly, and people with chronic illnesses are at the highest risk for complications.

The CDC is likely to conduct a thorough investigation before naming any foods that could be affected. In the summer of 2008, the CDC announced that tomatoes were the likely cause of a large Salmonella outbreak, only to announce later that the major cause of the outbreak was actually jalapeño and serrano peppers.

Until a cause of the outbreak is confirmed, the CDC recommends that you thoroughly cook all meats, poultry, and eggs, as well as cautioning you to avoid consuming raw or unpasteurized milk and other dairy products. Produce should be thoroughly washed as well, especially if it is eaten raw. Wash your hands frequently when preparing food and don’t use the same utensils or cookware to hold both raw and cooked meat and poultry unless they have been thoroughly washed.

For more information about Salmonella, join the Healia Health Community for Salmonella Infections.

Related blog post: The 4 Most Common Causes of Foodborne Disease


_{Photo: CDC/Janice Haney Carr, Public Health Image Library}

Bad breath can be unpleasant but it may also be more than just a nuisance. It can signal a change in the body and may even be a sign of a serious disease. The following is a list of the main causes of bad breath, some of which you may find surprising:

• Foods
  You are likely aware that certain foods can cause bad breath, onions and garlic for example. But the breakdown of food particles from some less flavorful foods can also cause odor. Foods high in protein like meat and nuts as well as dairy products are produce amino acids that bacteria along the gastrointestinal tract use for fuel. The byproduct of this is a foul smell. Eating foods that contain volatile oils, including garlic, onions, and several other vegetables and spices, causes you to emit these oils form your lungs until the food has passed through your body, meaning they can cause bad breath for as long as three days!


• Dental problems
  Poor oral hygiene can cause food particles remain in your mouth where they form a thin film called plaque. These bacteria emit hydrogen sulfide vapors, the same gas responsible for the sulfur smell in rotten eggs. Also, if you have gum disease (gingivitis or periodontitis) it can cause bad breath, regardless of your oral hygiene.


• Dry Mouth
  Saliva cleanses your mouth and without it, dead cells and bacteria can accumulate in your mouth. This happens naturally as we sleep, leading to the familiar “morning breath,” especially if you sleep with your mouth open. Other natural causes of dry mouth include aging and reduced chewing.


• Medications
  Several medications can reduce your saliva production, causing dry mouth and bad breath. Dry mouth is one of the most commonly listed side effects of medications and can occur when taking antidepressants, diuretics, antihistamines, beta blockers, chemotherapy drugs used to treat cancer, and even aspirin.


• Mouth breathing
  Day or night, breathing through your mouth can dry it out, causing bad breath. Some people breathe through their mouths naturally, while others do so because of a medical issue such as sleep apnea, snoring, or asthma.


• Respiratory tract infections
  Infections of the upper or lower respiratory tract can lead to bad breath. In addition to oral infections such as tooth and gum disease mentioned above, this may include sinus infections that cause a buildup of bacteria in the sinuses and result in post-nasal drainage into the back of your throat; throat infections such as strep throat; and even bronchitis. All of these conditions cause mucus production that can feed bacteria living along the respiratory tract.


• Chronic diseases
  Ongoing disease conditions may also cause bad breath. Chronic lung infections can cause a very foul odor to the breath, but so can several diseases that are not directly related to the respiratory tract. Some cancers can cause a distinctive breath odor. Kidney failure, which prevents the body from eliminating waste products, can cause a urine-like odor to the breath, and liver failure, which prevents the body from detoxifying chemicals, may cause a fishy odor. Gastroesophageal reflux disease (GERD), which causes stomach contents to flow up into the esophagus, can cause bad breath. Metabolic disorders such as uncontrolled diabetes can cause the breath to have a fruity smell.


• Very low carbohydrate diet
  If you don’t eat enough carbohydrates (sugars), either because you skip meals or you are on a low carb diet, your breath may take on the same fruity smell as someone with uncontrolled diabetes. In both cases, the body lacks carbohydrates to provide energy to the brain so it begins breaking down proteins and fats to make new carbs, a process which creates ketone bodies as a byproduct. The substances accumulate in the body (ketosis or ketoacidosis) and are excreted in the breath.


• Tobacco products
  Smoking dries out your mouth and causes its own unpleasant mouth odor. Both smking and chewing tobacco increase the risk of gum disease and tooth decay, which also cause bad breath.


• Alcohol
  Alcohol consumption can dry out the mouth, leading to bad breath. Also, consuming too much alcohol can make you more likely to snore or sleep with your mouth open, further drying out the mouth and causing bad morning breath.

_{Sources: Mayo Clinic, www.mayoclinic.com; U.S. News and World Report, "8 Surprising Causes of Bad Breath" By Megan Johnson, December 2, 2008.}

_{Photo: lastrandy, Flickr, Creative Commons}

Do you experience heartburn twice a week or more? This Thanksgiving week, November 23 – 29, 2008, marks the 10^th annual Gastroesophageal Reflux Disease (GERD) Awareness Week, an effort to raise awareness about this common condition that causes chronic heartburn. GERD affects an estimated 5% to 7% of the global population and as many as 10% of Americans at any one time.

GERD occurs when acid from the stomach seeps up (refluxes) into the esophagus causing pain and leading to tissue damage. There is no single cause of GERD, but the disease occurs more frequently in smokers and people who are overweight or obese.

It is no coincidence that GERD Awareness Week takes place during the week of the Thanksgiving holiday. Family gatherings are often an occasion to overeat, which can lead to heartburn by causing the stomach to secrete large amounts of stomach acid. If you only experience heartburn at annual family gatherings, you probably do not have GERD. However, if you have heartburn again later in the week, perhaps after eating leftover turkey, it may be a good idea to talk to your doctor about GERD.

The most frequently reported symptoms of GERD are heartburn that recurs several times a week and acid regurgitation (often described as a bad taste in the mouth or the back of the throat), but the disease can also cause other symptoms such as morning hoarseness, bad breath, and chronic sore throat. Most cases of GERD can be treated effectively through lifestyle changes and the use of daily medications.

However, if GERD is not treated properly, over time serious complications can occur. Acid eating away at the lining of the esophagus can cause inflammation (called esophagitis) which can lead to erosions in the lining of the esophagus, bleeding, and narrowing of the esophagus tube that make it difficult to swallow and may even cause breathing problems. A small subset of patients with GERD develop Barrett's esophagus, a precancerous condition of the esophageal lining that is a risk factor for a type of cancer called esophageal adenocarcinoma.

Many people with symptoms of GERD do not seek treatment because they think their symptoms are normal. To combat this fact, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) designated GERD Awareness Week in November 1999 to raise awareness about the symptoms of the disease and the possible complications.

Throughout this week, the urges people who experience symptoms of GERD are urged to call the IFFGD heartburn helpline or see a physician as soon as possible. There are many treatment options that can help people with GERD get relief from their symptoms and reduce the likelihood that complications will develop.

To receive information and support regarding GERD call the IFFGD Heartburn Helpline at 1-888-964-2001. For more information about GERD and the chance to connect with others who have the disease, join in the conversation at the Healia Health Community for GERD.

_{Photo: VirtualErn, Flickr, Crative Commons}

This month is Irritable Bowel Syndrome Awareness Month and the perfect opportunity to clear up some of the confusion between Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD).

According to the International Foundation for Functional Gastrointestinal Disorders (IFFGD), IBS, a disorder of the colon or rectum, is a common disorder that affects approximately 10–20% of the general population. While the cause of IBS is unknown, researchers have found that the colon muscle in people with IBS contracts more readily than in people without IBS.

• Abdominal pains or cramps (usually in the lower half of the abdomen)
• Excess gas
• Harder or looser bowel movements than average

• Chronic diarrhea
• Weight loss
• Fever
• Abdominal pain and tenderness (often on the right side of the lower abdomen)
• Feeling of a mass or fullness in the lower, right abdomen

• Diarrhea
• Severe bloody diarrhea
• Abdominal pain
• Fever