Research we're watching

Recent evidence suggests that antibiotics, which affect the makeup of intestinal bacteria, might be associated with an increased risk of colorectal cancer. A team led by researchers from Harvard Medical School wanted to see if antibiotic use is also associated with adenomatous polyps, precursors of colon cancer that significantly increase the risk of developing the disease.

The team analyzed data from 16,642 women ages 60 or older participating in the Nurses' Health Study. They first looked at participants' antibiotic use from ages 20 through 59 and in the most recent four years. They also checked the results with the women's colonoscopies and found 1,195 cases of adenomatous polyps.

The scope of the opioid crisis in the US has led some communities to revise their view of substance use disorders. One idea is creating supervised injection facilities that would provide a safe environment and make treatment resources available.

Some aspects of diet may diminish or heighten the effect of prescription drugs or cause harmful side effects.

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You take your pills on time each day and get your prescriptions refilled before they run out. But all that hard work to stick to your medication plan can be scuttled if your diet is undermining the drugs' effects. "I see a lot of people who don't believe in the importance of following dietary recommendations for medications. That's a concern," says Dr. Randall Zusman, a cardiologist and Harvard Medical School associate professor.

Dietary risks

The following foods, drinks, or ingredients can interfere with specific drugs.

News briefs

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In March, we reported that long-term use of a class of prescription painkillers known as opioids, such as oxycodone (Oxycontin), comes with the risk of dependence, addiction, falls, and even death. Now, a study published March 14, 2017, in The BMJ finds that opioid users who also take a benzodiazepine — such as alprazolam (Xanax) — for sleep or anxiety are more likely to end up in an emergency room. Researchers made the connection after looking at a sample of more than 300,000 privately insured adults (ages 18 to 64) over a 12-year period. People who were prescribed both types of drugs had twice the risk of ending up in a hospital as did people who used opioids only.

The study is observational and does not prove that using both medications increases overdose risk. However, the authors say we already know that about 30% of deadly opioid overdoses involve benzodiazepines in some way. Researchers suggest that opioids should be prescribed cautiously — even if only for a short-term course — among people who are also using benzodiazepines.

On call

Q. I have had acid reflux for many years, but it is well controlled with a proton-pump inhibitor. However, I am concerned about long-term damage from my reflux, even though I feel fine now. Should I have an upper endoscopy to look for possible damage?

A. Long-term acid reflux can damage the esophagus and may lead to a condition known as Barrett's esophagus, which is a precursor to esophageal cancer. Barrett's affects about 3% to 10% of older men, but within this group the risk of developing esophageal cancer is only about four in every 1,000 cases. Over all, men with Barrett's are more likely to die from another cause.

Protect yourself to ensure a speedy recovery and avoid infections and readmission.

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Whether you go in for surgery, testing, or an outpatient procedure, your hospital stay can pose further health risks if you are not careful.

"Your potential risks depend in part on why you have to go into the hospital and the facility itself, but there are steps you can take to minimize your risk, especially when it comes to developing hospital-acquired infections that can lead to a longer hospital stay or readmission," says Dr. Erica Shenoy, an infectious diseases specialist and associate chief of infection control at Harvard-affiliated Massachusetts General Hospital.

A discussion with your doctor may minimize your chance of becoming dependent on or addicted to these powerful painkillers.

Opioid misuse is now one of most important health problems in the United States, rivaling smoking as a cause of death. Although news reports tend to focus on an opioid crisis among the young, the opioid epidemic is increasingly affecting older people as well. In fact, the rates of hospitalization for opioid overdoses among Medicare recipients quintupled from 1993 through 2012. Although older people are still less likely than younger ones to become addicted or succumb to opioid overdoses, they are more likely to suffer side effects from extended opioid use, including memory and cognition problems and falls.

"Opioid use and pain management is something we deal with constantly," says Dr. Michael L. Barnett, assistant professor of health policy at the Harvard T.H. Chan School of Public Health. According to a report from the U.S. Department of Health and Human Services, nearly one-third of Medicare beneficiaries received at least one prescription for opioids in 2015, and those who did got an average of five such prescriptions or refills. Dr. Barnett and a team of his colleagues decided to investigate how Medicare recipients get opioid prescriptions in the first place.

Do calcium supplements interfere with calcium-channel blockers?

Ask the doctors

Q. I've just been prescribed the calcium-channel blocker Norvasc [amlodipine] for high blood pressure. I also take a 600-milligram calcium supplement every day for my bones. Will they cancel each other out?

A. You don't need to worry about taking a daily calcium supplement with a calcium-channel blocker. In the body, calcium not only builds bones but also powers muscle contractions. Calcium-channel blockers lower blood pressure by reducing the amount of calcium available to contract blood vessels. However, they don't prevent calcium in the blood from being incorporated into bone.

Research we're watching

Although hormone therapy was once thought to help preserve cognitive function after menopause, there is mounting evidence to the contrary, including a recent report from the Kuopio Osteoporosis Risk Factor and Prevention Study.

Researchers in that project sent questionnaires to all women ages 47 to 56 who lived in the Finnish province of Kuopio in 1987. The women completed questionnaires every five years, providing information about their lifestyles, medication use, and illnesses. The researchers checked the information in the questionnaires against prescription registries and medical records up to 2009.

Ask the doctor

Q. My uncle was told he had fluid around his heart. What does that mean, and how is it treated?

A. The heart is surrounded by a thin, two-layer sac called the pericardium. It protects the heart, limits its motion, and prevents it from expanding too much when blood volume increases. Normally, there isn't any fluid between the pericardium and the heart muscle. But there are many reasons fluid can accumulate in this space, including an infection, a heart attack, surgery, cancer, kidney failure, and a host of other conditions.