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Re: Chronic PKD pain	Diane
	Nov 04, 2009 16:40 PST

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I do not remember why, but I remember something about the whole
berries not being good for one, perhaps they are too high in oxalates?
Don't remember.

~Diane

Diane -
I do like cranberry sauce, especially honey-sweetened with whole
cranberries in it, but I don' t like cranberry juice.

I'll stick with blueberry juice.

Vicki

*****

--- On Tue, 11/3/09, Diane <Dia-@pkdiet.com> wrote:

From: Diane <Dia-@pkdiet.com>
Subject: Re: PKD-PLD Chronic PKD pain
To: pk-@topica.com
Date: Tuesday, November 3, 2009, 6:53 PM

Vicki,
You are absolutely correct. A few years back I wrote and telephone
the cranberry-blueberry researchers from Rutgers University:

http://pemaruccicenter.rutgers.edu/

For more on cranberries
http://www.pkdiet.com/pages/herbs/food/cranberry.htm
And on blueberries
http://www.pkdiet.com/pages/herbs/food/blueberry.htm

For a page on foods try:

http://www.pkdiet.com/pages/herbs/food.htm

Thanks Vicki

Warmly,
Diane
On Nov 3, 2009, at 10:22 AM, Vicki Jones wrote:

Craig -
A few years back, my husband found information online that said
studies show blueberry juice is just as effective as cranberry
juice, for the urinary tract.

Is that true, Diane? I drink 4 oz blueberry juice a day, rather
than cranberry juice, and haven't had a bladder infection since I
started doing that. It certainly tastes better to me than cranberry
juice, and my stomach can't take cranberry juice (too acid when it
hits my stomach).

Vicki

*******

--- On Tue, 11/3/09, Craig Wolf <craig-@wswa.org> wrote:

From: Craig Wolf <craig-@wswa.org>
Subject: RE: PKD-PLD Chronic PKD pain
To: "pk-@topica.com" <pk-@topica.com>
Date: Tuesday, November 3, 2009, 9:55 AM

FYI –

A similar story to JC in terms of results, although I haven’t ever
experienced the same level of pain she did or experienced any
ruptures to my knowledge. But I used to have fairly regular
achiness bilaterally – especially noticeable after certain food
intake. Then I changed my diet and became much more active
physically and really don’t have that issue any more.

I no longer eat red meat, pork, chocolate, soda’s, chips/pretzels,
milk, potatoes (except for sweet potato at Thanksgiving). No
caffeine period. And I have gradually been reducing my protein
intake, sometimes not eating any chicken or seafood for a day or
two in a row. And I drink a glass of cranberry juice almost daily
as well (sometimes mixed with apple or orange juice for variety and
flavor).

I also run/exercise 4-5 times a week – just completed the Army Ten
Miler in DC.

Craig

From: jcro-@aol.com [mailto:jcro-@aol.com]
Sent: Tuesday, November 03, 2009 9:42 AM
To: pk-@topica.com
Subject: Re: PKD-PLD Chronic PKD pain

Dear Diane,

At the beginning of my journey with PKD some 14 years ago, I had a
lot of cyst ruptures, excruciating pain that would leave me
bedridden for days. I was 28 years old. Then, I started reading
and searching until I learned about you, the diets and how to
change my diet to improve things. Although, I am not 100%
vegetarian, I did changed many items of my diet and added some
others. I can honestly say that I have not had any pain episodes
in years. I can't tell you when was the last time because I truly
do not remember.

Both my natives are larger than they were then but I do not have
not had any more ruptures or pain. I think for me the secret has
been: no red meats, no artificial foods. I also drink nothing but
natural juices and water. I do not drink sodas, whole milk or
alcohol and I drink a tall glass of cranberry juice every single
morning and some afternoons for the last 14 years.

BTW...I am reading The China Project. What an amazing and
interesting book. You are living proof that what they found does
work. I can wait to finish reading it.

Rgds,

JC

In a message dated 10/29/2009 7:40:33 P.M. Eastern Standard Time, Dia-@pkdiet.com
writes:

I understand what you are saying JC. Many many years ago, in my
hippy days, I traveled extensively throughout Asia, it was so sad
to meet up with fellow travelers later after they had become
addicted to opium or heroin. They were like walking skeletons.

Opiates happen to be something I cannot take. I just throw up and
cannot keep it down. Following my liver resection surgery the docs
got very creative on what to give me to relieve pain.

There are several with PKD who have written to me that the only way
they can function is by taking opiates to control the daily chronic
pain from PKD.

By removing a cystic PKD kidney this has been shown to lessen
painful episodes. A very observant surgeon developed a denervation
procedure of PKD kidneys as another treatment to lessen severe PKD
pain.

There is a PKD pain study underway at the Mayo Clinic with Dr.
Marie Hogan that utilizes an interventional procedure known as -
Videothracoscopic Splanchnicectomy (VSPL) similar to
Videothoracoscopic splanchnicectomy done for pancreatitis pain. For
more information on this clinical trial :

http://www.pkdiet.com/pages/pain/painchronic.htm

I too did not realize how difficult and how severe PKD pain can
become with some individuals until I went to PKD conference and met
with a few individuals using fentanyl patches and more to function.

"FDA announced on February 12, 2008, that PriCara, Division of
Ortho-McNeil-Janssen Pharmaceuticals, Inc.has recalled all lots of
25 mcg DURAGESIC® (fentanyl transdermal system) patches sold by
PriCara in the United States and all 25 mcg/hr fentanyl patches
sold by Sandoz Inc.(See:Sandoz Fentanyl Patch Recall) in the United
States are being voluntarily recalled."

At this same PKD conference there was a PKD pain lecture given by
both Dr. Torres [giving the medical aspects of PKD pain relief] and
the laparoscopic surgeon who developed the denervation procedure. I
always learn so much from these conferences, though I have not gone
to one since Dr. Torres stopped going.

Warmly,

Diane

<image001.jpg>

On Oct 29, 2009, at 12:23 PM, jcro-@aol.com wrote:

I refused to take Opiates at all cost. Part of my work is working
with drug addicted patients and I have seen what Opiates do to a
persons life. It literally destroys them physically, financially,
mentally and emotionally to the point that they can not function.
It is very sad. Do not take them if you can help it. They are
extremely addictive.

Rgds,

JC

In a message dated 10/29/2009 2:40:55 P.M. Eastern Daylight Time, Dia-@pkdiet.com
writes:

Some members have chronic pain from PLD and take opiods which can
lead to constipation. Here is a new drug to ask your docs about if
this applys to you.

ACG: Compound Eases Constipation for Opioid Patients

By Kristina Fiore, Staff Writer, MedPage Today
Published: October 28, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

<16658.jpg>

SAN DIEGO -- An investigational drug increased spontaneous bowel
movements for patients with opioid-induced constipation,
researchers said here.

Bowel movements per week increased from about one at baseline to
five or six, depending on the dose used, Lynn Webster, MD, of
Lifetree Clinical Research in Salt Lake City, and colleagues
reported at the American College of Gastroenterology meeting here.

The drug, NKTR-118, "increased the frequency of bowel movements
without a reversal of analgesia, and it was reasonably safe with no
serious problems in this study," Webster said.

He said constipation is a common side effect of opioid therapy,
affecting about 40% to 60% of patients on chronic or acute
treatments.

The investigational compound is a polymer form of naloxone that
antag onizes peripheral opioid receptors in the gut. It can act
selectively, preventing it from reversing opioid pain management,
the researchers said.

For their Phase-II, randomized, double-blind, placebo-controlled
trial, the researchers recruited patients on stable regimens of
opioids who consistently had fewer than three spontaneous bowel
movements per week.

A total of 208 patients were randomized to either a 5-mg, 25-mg, or
50-mg dose of NKTR-118 or placebo for four weeks.

The researchers found that spontaneous bowel movements increased
significantly for patients on the 25-mg and 50-mg dose compared
with placebo.

Patients on the 25-mg dose increased to five spontaneous bowel
movements per week, up from 1.4 per week at baseline, whereas
placebo patients increased to just 3.1 per week from 1.2 at baseline.

Those on the 50-mg dose had six spontaneous bowel movements per
week, up from 1.6 at baseline -- a significant improvement compared
with those on placebo, who increased to 3.3 per week from 1.4 at
baseline.

Spontaneous bowel movements for patients on the 5-mg dose did not
differ significantly from those on placebo, the researchers said.

The median time to first bowel movement was 6.6 hours for those in
the 25-mg dose, compared with 48.6 hours for those on placebo
(P=0.001). It was 2.9 hours for those on the 50-mg dose, compared
with 44.9 hours with placebo (P=0.002).

Webster said that there was no change in patient pain, and there
were no changes in the amount of opioid used for any patient.

However, dropout rates were significantly higher for the 50-mg dose
of the drug compared with placebo, "probably due to the side effect
profile," Webster said.

The most sign ificant side effects associated with the drug were
gastrointestinal in nature, and included nausea and abdominal pain.

Side effects were not significantly different for the 5-mg dose
compared with placebo, and there was more nausea in the placebo
group for the 25-mg dose, but side effects were significantly
higher in the 50-mg dose compared with placebo.

There was also one serious adverse event in the 50-mg dose, with a
patient admitted to the hospital for excessive abdominal cramping.

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<html><head></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space; ">I do not remember why, but I remember something about the whole berries not being good for one, perhaps they are too high in oxalates? Don't remember.<div><br></div><div>~Diane<br><div><br class="Apple-interchange-newline"><blockquote type="cite"><table cellspacing="0" cellpadding="0" border="0"><tbody><tr><td valign="top" style="font: inherit;">Diane - <br>I do like cranberry sauce, especially honey-sweetened with whole cranberries in it, but I don' t like cranberry juice. <br><br>I'll stick with blueberry juice. <br><br>Vicki <br><br>*****<br><br>--- On <b>Tue, 11/3/09, Diane <i><<a href="mailto:Dia-@pkdiet.com">Dia-@pkdiet.com</a>></i></b> wrote:<br><blockquote style="border-left: 2px solid rgb(16, 16, 255); margin-left: 5px; padding-left: 5px;"><br>From: Diane <<a href="mailto:Dia-@pkdiet.com">Dia-@pkdiet.com</a>><br>Subject: Re: PKD-PLD Chronic PKD pain<br>To: <a href="mailto:pk-@topica.com">pk-@topica.com</a><br>Date: Tuesday, November 3, 2009, 6:53 PM<br><br><div id="yiv1121605326">Vicki,<div>You are absolutely correct. A few years back I wrote and telephone the cranberry-blueberry researchers from Rutgers University:</div><div><br></div><div><a rel="nofollow" target="_blank" href="http://pemaruccicenter.rutgers.edu/">http://pemaruccicenter.rutgers.edu/</a></div><div><br></div><div>For
more on cranberries</div><div><a rel="nofollow" target="_blank" href="http://www.pkdiet.com/pages/herbs/food/cranberry.htm">http://www.pkdiet.com/pages/herbs/food/cranberry.htm</a></div><div>And on blueberries</div><div><a rel="nofollow" target="_blank" href="http://www.pkdiet.com/pages/herbs/food/blueberry.htm">http://www.pkdiet.com/pages/herbs/food/blueberry.htm</a></div><div><br></div><div>For a page on foods try:</div><div><br></div><div><a rel="nofollow" target="_blank" href="http://www.pkdiet.com/pages/herbs/food.htm">http://www.pkdiet.com/pages/herbs/food.htm</a></div><div><br></div><div>Thanks Vicki</div><div><br></div><div><br></div><div>Warmly,</div><div>Diane<br><div><div>On Nov 3, 2009, at 10:22 AM, Vicki Jones wrote:</div><br class="Apple-interchange-newline"><blockquote type="cite"><table border="0" cellpadding="0" cellspacing="0"><tbody><tr><td style="font-family: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit;
font-size: inherit; line-height: inherit; font-size-adjust: inherit; font-stretch: inherit; -x-system-font: none;" valign="top">Craig - <br>A few years back, my husband found information online that said studies show blueberry juice is just as effective as cranberry juice, for the urinary tract. <br><br>Is that true, Diane? I drink 4 oz blueberry juice a day, rather than cranberry juice, and haven't had a bladder infection since I started doing that. It certainly tastes better to me than cranberry juice, and my stomach can't take cranberry juice (too acid when it hits my stomach). <br><br>Vicki <br><br>*******<br><br>--- On <b>Tue, 11/3/09, Craig Wolf <i><<a rel="nofollow" ymailto="mailto:craig-@wswa.org" target="_blank" href="x-msg://37/mc/compose?to=crai-@wswa.org">craig-@wswa.org</a>></i></b> wrote:<br><blockquote style="border-left: 2px solid rgb(16, 16, 255); margin-left: 5px; padding-left: 5px;"><br>From: Craig Wolf <<a rel="nofollow" ymailto="mailto:craig-@wswa.org" target="_blank" href="x-msg://37/mc/compose?to=crai-@wswa.org">craig-@wswa.org</a>><br>Subject: RE: PKD-PLD Chronic PKD pain<br>To: "<a rel="nofollow" ymailto="mailto:pk-@topica.com" target="_blank" href="x-msg://37/mc/compose?to=-@topica.com">pk-@topica.com</a>" <<a rel="nofollow" ymailto="mailto:pk-@topica.com" target="_blank" href="x-msg://37/mc/compose?to=-@topica.com">pk-@topica.com</a>><br>Date: Tuesday, November 3, 2009, 9:55 AM<br><br><div id="yiv825271772">

<style>

</style>

<div class="Section1">

<div>

<div style="border-style: solid none none; border-color: rgb(181, 196, 223); border-width: 1pt medium medium; padding: 3pt 0in 0in;"><p class="MsoNormal"><b><span style="font-size: 10pt;">FYI
–</span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;"> </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;">A
similar story to JC in terms of results, although I haven’t ever experienced
the same level of pain she did or experienced any ruptures to my knowledge.
But I used to have fairly regular achiness bilaterally – especially noticeable
after certain food intake. Then I changed my diet and became much more
active physically and really don’t have that issue any more.</span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;"> </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;">I
no longer eat red meat, pork, chocolate, soda’s, chips/pretzels, milk, potatoes
(except for sweet potato at Thanksgiving). No caffeine period. And I have
gradually been reducing my protein intake, sometimes not eating any chicken
or seafood for a day or two in a row. And I drink a glass of cranberry
juice almost daily as well (sometimes mixed with apple or orange juice for
variety and flavor). </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;"> </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;">I
also run/exercise 4-5 times a week – just completed the Army Ten Miler in
DC.</span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;"> </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;">Craig</span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;"> </span></b></p><p class="MsoNormal"><b><span style="font-size: 10pt;">From:</span></b><span style="font-size: 10pt;"> <a rel="nofollow" ymailto="mailto:jcro-@aol.com" target="_blank" href="x-msg://37/mc/compose?to=jc-@aol.com">jcro-@aol.com</a>
[mailto:jcro-@aol.com] <br>
<b>Sent:</b> Tuesday, November 03, 2009 9:42 AM<br>
<b>To:</b> <a rel="nofollow" ymailto="mailto:pk-@topica.com" target="_blank" href="x-msg://37/mc/compose?to=-@topica.com">pk-@topica.com</a><br>
<b>Subject:</b> Re: PKD-PLD Chronic PKD pain</span></p>

</div>

</div><div> <br class="webkit-block-placeholder"></div>

<div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Dear Diane,</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">At the beginning of my journey with PKD some 14 years ago, I had a
lot of cyst ruptures, excruciating pain that would leave me bedridden for
days. I was 28 years old. Then, I started reading and searching
until I learned about you, the diets and how to change my diet to improve
things. Although, I am not 100% vegetarian, I did changed many items of
my diet and added some others. I can honestly say that I have not had any
pain episodes in years. I can't tell you when was the last time because I
truly do not remember.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Both my natives are larger than they were then but I do not have
not had any more ruptures or pain. I think for me the secret has been: no
red meats, no artificial foods. I also drink nothing but natural juices
and water. I do not drink sodas, whole milk or alcohol and I drink a
tall glass of cranberry juice every single morning and some afternoons for the
last 14 years.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">BTW...I am reading The China Project. What an amazing and
interesting book. You are living proof that what they found does
work. I can wait to finish reading it.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Rgds,</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">JC</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">In a message dated 10/29/2009 7:40:33 P.M. Eastern Standard Time,
<a rel="nofollow" ymailto="mailto:Dia-@pkdiet.com" target="_blank" href="x-msg://37/mc/compose?to=D-@pkdiet.com">Dia-@pkdiet.com</a> writes:</span></p>

</div>

<blockquote style="border-style: none none none solid; border-color: blue; border-width: medium medium medium 1.5pt; padding: 0in 0in 0in 4pt; margin-left: 3.75pt; margin-top: 5pt; margin-bottom: 5pt;"><p class="MsoNormal"><span style="font-size: 10pt; color: black;"><br>
I understand what you are saying JC. Many many years ago, in my hippy days, I
traveled extensively throughout Asia, it was so sad to meet up with fellow
travelers later after they had become addicted to opium or heroin. They were
like walking skeletons. </span></p>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Opiates happen to be something I cannot take. I just throw up and
cannot keep it down. Following my liver resection surgery the docs got very
creative on what to give me to relieve pain. </span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">There are several with PKD who have written to me that the only
way they can function is by taking opiates to control the daily chronic pain
from PKD. </span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">By removing a cystic PKD kidney this has been shown to lessen
painful episodes. A very observant surgeon developed a denervation procedure of
PKD kidneys as another treatment to lessen severe PKD pain.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">There is a PKD pain study underway at the Mayo Clinic with Dr.
Marie Hogan that utilizes an interventional procedure known as -
Videothracoscopic Splanchnicectomy (VSPL) similar to Videothoracoscopic
splanchnicectomy done for pancreatitis pain. For more information on this
clinical trial :</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;"><a rel="nofollow" target="_blank" href="http://www.pkdiet.com/pages/pain/painchronic.htm" title="http://www.pkdiet.com/pages/pain/painchronic.htm">http://www.pkdiet.com/pages/pain/painchronic.htm</a></span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">I too did not realize how difficult and how severe PKD pain can
become with some individuals until I went to PKD conference and met with a few individuals
using fentanyl patches and more to function. </span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span class="apple-style-span"><i><span style="font-size: 9pt; color: black;">"FDA announced on February
12, 2008, that PriCara, Division of Ortho-McNeil-Janssen
Pharmaceuticals, Inc.has recalled all lots of 25 mcg DURAGESIC®
(fentanyl transdermal system) patches sold by PriCara in the United States
and all 25 mcg/hr fentanyl patches sold by Sandoz Inc.(See:Sandoz Fentanyl
Patch Recall) in the United States are being voluntarily
recalled."</span></i></span><span style="font-size: 10pt; color: black;"></span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">At this same PKD conference there was a PKD pain lecture given by
both Dr. Torres [giving the medical aspects of PKD pain relief] and the
laparoscopic surgeon who developed the denervation procedure. I always learn so
much from these conferences, though I have not gone to one since Dr. Torres
stopped going.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Warmly,</span></p>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Diane</span></p>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;"><span><image001.jpg></span><br>
</span></p>

<div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">On Oct 29, 2009, at 12:23 PM, <a rel="nofollow" title="mailto:jcro-@aol.com">jcro-@aol.com</a> wrote:</span></p>

</div><p class="MsoNormal"><span style="font-size: 10pt; color: black;"><br>
<br>
</span></p>

<div>

<div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">I refused to take Opiates at all cost. Part of my work is
working with drug addicted patients and I have seen what Opiates do to a
persons life. It literally destroys them physically, financially,
mentally and emotionally to the point that they can not function. It is
very sad. Do not take them if you can help it. They are extremely
addictive.</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Rgds,</span></p>

</div>

<div><div><span style="font-size: 10pt; color: black;"> </span><br class="webkit-block-placeholder"></div>

</div>

<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">JC</span></p>

</div>

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<div><p class="MsoNormal"><span style="font-size: 10pt; color: black;">In a message dated 10/29/2009 2:40:55 P.M. Eastern Daylight Time, <a rel="nofollow" title="mailto:Dia-@pkdiet.com">Dia-@pkdiet.com</a>
writes:</span></p>

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<blockquote style="border-style: none none none solid; border-color: blue; border-width: medium medium medium 1.5pt; padding: 0in 0in 0in 4pt; margin-left: 3.75pt; margin-top: 5pt; margin-bottom: 5pt;"><p class="MsoNormal"><span style="font-size: 10pt; color: black;">Some members have chronic pain from PLD and take opiods which can
lead to constipation. Here is a new drug to ask your docs about if this applys
to you. </span></p>

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<h1><span style="font-size: 14.5pt; color: rgb(0, 51, 153);">ACG:
Compound Eases Constipation for Opioid Patients</span></h1>
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      <td style="padding: 3.75pt 0in;"><p class="MsoNormal"><span style="font-size: 8.5pt; color: black;">By Kristina Fiore, Staff Writer, MedPage Today<br>
      </span><span style="font-size: 8.5pt; color: rgb(102, 102, 102);">Published: October 28, 2009</span><span style="font-size: 8.5pt; color: black;"><br>
      Reviewed by <a rel="nofollow" target="_blank" href="http://www.medpagetoday.com/reviewer.cfm?reviewerid=30" title="http://www.medpagetoday.com/reviewer.cfm?reviewerid=30"><span style="font-size: 9pt; color: rgb(0, 0, 153); text-decoration: none;">Zalman S.
      Agus, MD</span></a>; Emeritus Professor <br>
      University of Pennsylvania School of Medicine and<br>
      Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner</span><span style="font-size: 8.5pt;"></span></p>
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      <td style="padding: 0.75pt;" valign="top"><p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 8.5pt;"><16658.jpg></span></p>
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    <div><p class="MsoNormal" style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">SAN DIEGO -- An
    investigational drug increased spontaneous bowel movements for patients
    with opioid-induced constipation, researchers said here.<br>
    <br>
    Bowel movements per week increased from about one at baseline to five or
    six, depending on the dose used, Lynn Webster, MD, of Lifetree Clinical
    Research in Salt Lake City, and colleagues reported at the American College
    of Gastroenterology meeting here.<br>
    <br>
    The drug, NKTR-118, "increased the frequency of bowel movements
    without a reversal of analgesia, and it was reasonably safe with no serious
    problems in this study," Webster said. </span></p>
    <div><div style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);"> </span><br class="webkit-block-placeholder"></div>
    </div><p class="MsoNormal" style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">He said constipation is a
    common side effect of opioid therapy, affecting about 40% to 60% of
    patients on chronic or acute treatments. </span></p>
    <div><div style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);"> </span><br class="webkit-block-placeholder"></div>
    </div><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">The investigational compound is a
    polymer form of naloxone that antag onizes peripheral opioid receptors in
    the gut. It can act selectively, preventing it from reversing opioid pain
    management, the researchers said.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">For their Phase-II, randomized,
    double-blind, placebo-controlled trial, the researchers recruited patients
    on stable regimens of opioids who consistently had fewer than three
    spontaneous bowel movements per week.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">A total of 208 patients were randomized
    to either a 5-mg, 25-mg, or 50-mg dose of NKTR-118 or placebo for four
    weeks.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">The researchers found that spontaneous
    bowel movements increased significantly for patients on the 25-mg and 50-mg
    dose compared with placebo.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">Patients on the 25-mg dose increased to
    five spontaneous bowel movements per week, up from 1.4 per week at
    baseline, whereas placebo patients increased to just 3.1 per week from 1.2
    at baseline.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">Those on the 50-mg dose had six
    spontaneous bowel movements per week, up from 1.6 at baseline -- a
    significant improvement compared with those on placebo, who increased to
    3.3 per week from 1.4 at baseline.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">Spontaneous bowel movements for
    patients on the 5-mg dose did not differ significantly from those on
    placebo, the researchers said.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">The median time to first bowel movement
    was 6.6 hours for those in the 25-mg dose, compared with 48.6 hours for
    those on placebo (<em><span style="">P</span></em>=0.001).
    It was 2.9 hours for those on the 50-mg dose, compared with 44.9 hours with
    placebo (<em><span style="">P</span></em>=0.002).</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">Webster said that there was no change
    in patient pain, and there were no changes in the amount of opioid used for
    any patient.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">However, dropout rates were
    significantly higher for the 50-mg dose of the drug compared with placebo,
    "probably due to the side effect profile," Webster said.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">The most sign ificant side effects
    associated with the drug were gastrointestinal in nature, and included
    nausea and abdominal pain.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">Side effects were not significantly
    different for the 5-mg dose compared with placebo, and there was more
    nausea in the placebo group for the 25-mg dose, but side effects were significantly
    higher in the 50-mg dose compared with placebo.</span></p><p style="line-height: 11.25pt;"><span style="font-size: 9pt; color: rgb(21, 21, 21);">There was also one serious adverse
    event in the 50-mg dose, with a patient admitted to the hospital for
    excessive abdominal cramping.</span></p>
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<pre><span style="color: black;">--^^---------------------------------------------------------------</span></pre><pre><span style="color: black;">This email was sent to: <a rel="nofollow" ymailto="mailto:craig-@wswa.org" target="_blank" href="x-msg://37/mc/compose?to=crai-@wswa.org">craig-@wswa.org</a></span></pre><pre><span style="color: black;"> </span></pre><pre><span style="color: black;">EASY UNSUBSCRIBE click here: <a rel="nofollow" target="_blank" href="http://topica.com/help/unsub.html.Y3JhaWcu">http://topica.com/help/unsub.html.Y3JhaWcu</a></span></pre><pre><span style="color: black;">Or send an email to: <a rel="nofollow" ymailto="mailto:pkd-unsu-@topica.com" target="_blank" href="x-msg://37/mc/compose?to=pkd-un-@topica.com">pkd-unsu-@topica.com</a></span></pre><pre><span style="color: black;"> </span></pre><pre><span style="color: black;">For Topica's complete suite of email marketing solutions
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