2013 Update: When Should You Get Your Pap?

The national pap guidelines seem to have changed a lot over the years with new guidelines debuting in 2009, some updates again in 2012 and now in 2013 it appears that some final decisions have been approved.  It used to be that a woman started having their pap smears in the teenage years and went yearly for the rest of her life.  While yearly physicals with her health care provider are important, a yearly pap is not necessarily required. 

According to most major women’s health and gynecology groups, a woman should have her first pap smear at 21 years of age.  This is different from 18 years old or age of first intercourse.  The younger a woman’s age, the healthier her immune system is therefore she is more likely to clear any abnormal cells caused by the human papilloma virus (HPV).  Additionally, if the results are normal, she is to have a pap test every 3 years.  Abnormal results may require more frequent follow up testing.

Once a woman turns 30 years old, the HPV test is added on to her pap smear as various factors, including age and immune system, may reduce her ability to clear the virus from her cervix.  If her pap smears continue to remain normal, she can continue with the ‘every 3 years’ recommendation.  If her results are abnormal, she again may require additional work-up and more frequent testing.

The new guidelines state that unless a woman has a history of a higher grade abnormal pap result, she can stop having pap smears at 65 years of age.  She should continue to have yearly physicals with her health care provider however.  Additionally, if a woman has had a total hysterectomy in which her cervix was also removed for non-cancerous reasons she does not need further pap smear testing however if she still has her cervix or if her hysterectomy was due to higher grade lesions or cancer, she will need to talk with her health care provider as she still needs some screening.

Remember that the purpose of pap smear screening is to evaluate the cells of the cervix for abnormal changes due to HPV and cervical cancer.  According to the Centers for Disease Control, cervical cancer used to be the most common cause of cancer death amongst women however with the increase in education and awareness for pap smear testing and HPV checks, the levels have greatly declined.  In fact in 2009, 12,357 women were diagnosed with cervical cancer and 3,909 died from it.  Therefore, if you have not had a pap smear test in the last 3 years or are not following up from an abnormal result, please do not be a statistic and make an appointment with your health care provider today.

For more information, read the women's health website Empowher, here!

References:

1.      Barclay, L.  (2013). Cervical Screening Guidelines Updated.  Web.  23 March, 2013.  http://www.medscape.com/viewarticle/781190

2.      Broder, J.  (2012). Pap Test Less Frequent Under New Guidelines.  Web. 23 March, 2013.

http://www.medscape.com/viewarticle/773282

3.      Centers for Disease Control (CDC).  (2012). Cervical Cancer Statistics.  Web. 23 March, 2013.

http://www.cdc.gov/cancer/cervical/statistics/

5 Facts About Gastroesophageal Reflux Disease (GERD)

Millions of people experience gastroesophageal reflux disease (GERD) on a regular basis.  When food passes from the esophagus down into the stomach, there is a ring known as the lower esophageal sphincter that is responsible for opening up to let food in and then close to keep it in the stomach.  If the ring is weak and does not close tightly it can cause food and stomach acid to come back up into the esophagus resulting in mucosal changes and symptoms of heartburn.  Here are five facts about GERD you may not know:

1.      Diagnosis is often made by symptoms however endoscopy, where a tube with a camera on the end is passed through the mouth and down the throat in order to best view all the tissue down into the stomach.  If warranted, a biopsy may need to be done.

2.      Extra weight around the middle is considered a real risk factor for those with both GERD and heartburn.  A primary treatment is weight loss as it may help avoid taking acid blockers.

3.      Eosinophilic esophagitis is being seen more regularly with patients who have GERD.  This condition has an increased number of particular white blood cells known as eosinophils that cause a number of chronic symptoms such as difficulty swallowing, sensation or actual choking, coughing, regurgitation, chest pain particularly behind the breast bone and vomiting.  A biopsy of the esophagus will help determine if someone has this disease.

4.      Consider food allergy elimination from the diet.  In eosinophilic esophagitis, the most common food allergies to remove are dairy, gluten, soy, eggs, peanuts, fish/shellfish.  These foods are also the most common food allergies to humans therefore if someone eats a food that causes inflammation, GERD may occur.

5.      Most that have GERD symptoms are on some form of acid blocker, either as needed or daily.  In fact, some take them twice a day because their symptoms are so severe.  Unfortunately, long term use of acid blockers also blocks the absorption of important minerals such as calcium and magnesium as well as vitamin B12.  These vitamins are critical for bone health, muscles, energy, brain health and more.

If you are experiencing symptoms of heartburn or are looking for different treatments to help your upper gastrointestinal problems, talk with your health care provider about options and consider taking out those common food allergens for six weeks and see how you feel.

 

Learn more at www.empowher.com

 

References:

1.      Reuters. (2013). New Guidelines for Diagnosis and Management of GERD.  Web.  17 March, 2013.

http://www.medscape.com/viewarticle/780737

2.      Johnson, D. (2012).  The Food-Elimination Diet in Adult Eosinophilic Esophagitis. Web. 17 March, 2013. 

http://www.medscape.com/viewarticle/768563

3.      Cochran Upper Gastrointestinal and Pancreatic Diseases Group. (2012).  Medical Treatments for Eosinophilic Esophagitis (a chronic disease associated with increased numbers of eosinophils in the esophagus and symptoms of esophagitis).  Web.  17 March, 2013.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012515/

4.      The Harvard Medical School Family Health Guide.  (2006).  Do PPIs Have Long Term Side Effects.  Web.  17 March, 2013.

http://www.health.harvard.edu/fhg/updates/do-ppis-have-long-term-side-effects.shtml

How Much Alcohol do you Drink?

Alcohol consumption is a large part of the American culture in that it is used in celebration, toasts, as a form of bonding, at sporting events, after bad days and during the holidays.  It is advised that men not drink more than 2 drinks per day, and women keep it to 1 drink per day however recent research in the February 2013 Journal of the Academy of Nutrition and Dietetics found that 18 percent of men and 11 percent of women are drinking above and beyond this recommendation. 

In a given week, how many alcoholic beverages do you drink?  Wine with dinner? Cocktails with the girls? A beer to relax?  While moderation is important and the occasional drink may be okay, remember that alcohol has other implications that may get in the way of your health.  First, alcohol increases the risk of certain cancers, particularly breast, liver, mouth, colorectal, and throat.   Second, alcohol requires a lot of processing by the liver which can interfere with the processing of other important substances such as medications, chemicals, and hormones.  Third, liver processing, especially at night, can lead to insomnia or 3am wake-ups.  Fourth, alcohol is not calorie free therefore it can cause weight gain and (depending what your drink of choice is) increases in blood sugar levels.  Fifth, ongoing alcohol consumption can further depress mood disorders, lead to a decreased memory and worsen psoriasis and other skin disorders.

Alcohol addiction is an important health concern to recognize in both yourself and the people you love.  Many choose alcohol as their coping mechanism when times are stressful or things are tough however other healthier options are available.  Even though the current recommendation for women is 7 drinks per week, remember that a drink is typically considered 5 ounces of wine, 1.5 ounces of hard liquor or 12 ounces of beer and 7 drinks may be too many for you and your health goals.  With that said, how many drinks do you really have? 

References:

1.       Grens, K.  Too Many Americans still Drink too Much: Study. Web.  25 February, 2013

http://www.nlm.nih.gov/medlineplus/news/fullstory_134308.html

2.       Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V.,   Scotti, L., M., Jenab, Turati, F., Pasquali, E.,  Pelucchi, C., Bellocco, R.,  Negri, E., Corrao, G., Rehm, J., Boffetta, P., and  La Vecchia, C. Light Alcohol Drinking and Cancer.  Web. 25 February, 2013.         http://www.medscape.com/viewarticle/778949

3.       Kazakevich, N., Moody, M., Landau, J., and Goldberg, L.  Alcohol and Skin Disorders.  Web.  25 February, 2013.

http://www.medscape.com/viewarticle/742538

What is the Mediterranean Diet?

The mere mention of the word ‘Mediterranean’ conjures up colorful images of crystal blue seas, white wash buildings and islands such as Crete, Malta and Cyprus often visited by cruises.  Besides its beauty, the Mediterranean area is also well known for its cuisine that has a number of health benefits.  Health care providers and well known books on wellness commonly recommend this particular diet therefore it is important to understand exactly what to eat.

The basics of the diet break down as follows; people should choose a fresh and vast array of vegetables.  Branch out from the typical peas and carrots and choose leafy greens (lots of them), zucchini, mushrooms, sun dried tomatoes, artichokes and artichoke hearts, cucumbers, onions, garlic, bell peppers, squash, sweet potatoes and more.  Rotate your vegetables and aim for a serving (or more!) at every meal.  Next, add in some fruit as a snack or dessert.  Use fresh or frozen berries when the sweet tooth monster strikes.  Slice up an apple with some almonds.  Blend half of a banana with your greens and protein powder for your morning smoothie.  Be careful not to eat more fruit than vegetables – it is about balance.

Learn to eat healthy oils.  The Mediterranean diet focuses on olive oil, olives, avocado and healthy nuts and seeds such as almonds, walnuts, pecans, pumpkin and sesame seeds.  Peanuts are not really a nut and therefore should be limited.   Fresh cheeses and unsweetened yogurts are a primary dairy/protein choice but only for those who can tolerate dairy.  Be careful of how over-processed dairy products are as that is not beneficial for health.  Choose organic/free-range fish, chicken and eggs to be consumed a through the week but go light on the red meat.  Add in lentils to round out the protein mixture.  Because of the location of the Mediterranean Sea so near to Italy, wine is often encouraged however please drink with moderation as the alcohol has a lot of sugar, may do damage to the liver and is not good for the hormone estrogen.

Benefits of the diet are a focus more on fruits, vegetables, good fats and lean proteins as opposed to heavy, processed carbohydrates or calorie empty foods.  This diet has been associated with benefiting cardiovascular disease, high insulin, diabetes and weight loss in research which is why several in the medical field tend to recommend it.  If you are considering switching your diet to a more Mediterranean style, talk with your health care provider otherwise follow these suggestions to get started on overhauling your health today.

Read more about this article at empowher!

References:

1.       Wood, S. Mediterranean Diet Beats Low Fat for CVD Prevention.  Web.  10 March, 2013.

http://www.medscape.com/viewarticle/779831

2.       Tucker, M. Insulin Sensitivity Improved with Mediterranean-Style Diet. Web. 10 March, 2013.

http://www.medscape.com/viewarticle/776109

3.       Reuters Health. Mediterranean Diet May Be Best for Diabetes.  Web. 10 March, 2013.

http://www.medscape.com/viewarticle/778917