health

Study Shows Over-the-Counter Pain Meds Ease Emotional Suffering

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 30th, 2018

Dear Doctor: I recently heard a radio report that said Tylenol could ease the pain of hurt feelings. That seems hard to believe. If it's true, how does it work?

Dear Reader: When you consider the language we use to express how it feels when someone is unkind, it's filled with pain. Their words sting, you ache, you're wounded, your heart is broken, you're torn up inside. Now, new research is shining an unexpected light on how accurate that imagery turns out to be.

Here at UCLA, Naomi Eisenberger, Ph.D., the director of the Social and Affective Neuroscience Laboratory, has been at the leading edge of research into the physical and emotional effects of loneliness and social isolation. Part of that is looking at how emotional distress affects the body. In an experiment conducted by Eisenberger and some colleagues, the group was surprised to find that the same neural circuitry that gets activated by physical pain also lights up in brain scans of individuals undergoing emotional pain.

This particular study centered on an online game of catch. Several players seated at computers in different locations "tossed" a ball to each other. One of those players was the test subject, whose brain activity was being scanned.

At first the ball is thrown equally between all of the players in the game. But at a certain point, the other players begin to exclude the test subject. As the test subjects begin to realize that they are being ostracized, their brain activity changes. It mirrors what you would see when someone is experiencing physical pain.

A further twist to the findings involved how each test subject responded to being excluded. Those who became visibly angry or upset showed a marked increase in activity in two regions of the brain associated with physical pain. The players who shrugged off the change in the game -- Who cares? this isn't important -- showed significantly less activity in the physical pain centers.

Then the researchers reverse-engineered the experiment. They gave over-the-counter pain medications to some of the subjects for a period of three weeks, and again measured their brain activity during the online game. This time, the subjects who received the medication and not a placebo had significantly less activity in the physical pain centers of their brains.

It turned out that the same pain meds that eased physical aches also provided relief for emotional pain. This strongly suggests that the brain processes both types of pain in the same way. As a result, the meds work on both types of pain.

As for why this would be, researchers suspect it's because living in interconnected groups was crucial to the survival of our earliest ancestors. Physical pain alerts us to injury. Emotional pain warns us that we may be drifting too far from our fellow humans. Both put us at grave risk. So, over time, the two types of warning signs -- physical pain and emotional pain -- began to share the same neural pathways.

The bottom line? We need to take emotional pain just as seriously as we do physical pain.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Colonoscopies Still Best Method for Detecting Colon Cancers

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 29th, 2018

Dear Doctor: I know that colonoscopies are more thorough than the at-home DNA stool test for colon cancer. But how much better? I have such a terrible time with anesthesia and gas. Both make me nauseated for several days. No one in my family has ever had any colon problems or polyps. I'd really like to pass, if possible.

Dear Reader: As we discussed in a previous article, although colonoscopy remains the gold standard in colon cancer screening, it does indeed pose the risk of complications, leading some people to skip the procedure. If you have problems with anesthesia -- which isn't required but makes the procedure more tolerable -- I can understand your additional worry. As for the DNA stool test, known as Cologuard, it's relatively new (approved by the FDA in 2014), but can provide an option in some cases.

Let's take a look at how the test works. It helps to understand that colon cancer arises from a series of genetic changes and alterations in how genes transmit their information. An effective way to detect these genetic markers in stool tests had been unsuccessful until the advent of Cologuard. The test looks at four molecular DNA markers in addition to a highly specific test for hemoglobin in the stool.

A 2014 study published in the New England Journal of Medicine compared the Cologuard test with FIT screening (a test that simply looks for hemoglobin in the stool); 9,989 people had both of the tests and then had a colonoscopy 90 days later. Of the 9,989, 65 people were found to have colon cancer. FIT detected about 73.8 percent of these cancers, while Cologuard detected 92.3 percent. That sounds good, doesn't it? But when it comes to advanced precancerous polyps, Cologuard detected 42.4 percent, while FIT detected only 23.8 percent. For non-cancerous polyps, Cologuard detected only 17.2 percent, while FIT detected 7.6 percent.

The problem in not being able to accurately detect non-cancerous polyps is that such polyps can develop into cancer that goes undetected until the next time you screen for colon cancer, by which point it may be advanced. Currently, the recommendation for Cologuard is to test every three years. Although you could conceivably test more frequently to detect precancerous lesions as they become cancerous, Cologuard has a high false-positive rate of 16.1 percent.

Here's why that matters in practical terms: Each positive result with Cologuard means a patient then must undergo a colonoscopy. So high rates of false positives ultimately lead to more colonoscopies.

Cologuard is a good test for colon cancer, but its inability to find non-cancerous colon polyps, its high false-positive rate and its cost ($599) prevent it from being a great test. It would be a good choice for people who simply cannot undergo a colonoscopy. That includes people with illnesses that increase the complication rate of colonoscopy, such as severe diverticulitis, diabetes, heart failure and cancer, and people over the age of 75.

Remember, you don't have to use anesthesia to undergo a colonoscopy. If you can tolerate the procedure, I would still recommend colonoscopy. It's the best colon cancer screening test for a healthy person.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Although Rare, Type 1 Diabetes Can Be Diagnosed in Adulthood

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 27th, 2018

Dear Doctor: I always thought Type 1 diabetes developed when you were a child, or not at all. But now they're saying it can happen as an adult, which is very alarming. How do I know if I develop it?

Dear Reader: While there are several different types of diabetes and different pathways through which the disease develops, they all have one basic thing in common -- the body has lost the ability to adequately regulate the levels of glucose in the blood.

When things are working properly, this glucose control is achieved by insulin, a hormone produced by the pancreas. Insulin makes it possible for the body to either use the glucose that enters the blood after digestion, or to store it for future use. Over time, people with chronic high blood glucose levels will face serious health problems like heart disease, kidney disease, nerve damage, eye problems, poor wound healing, foot problems and even stroke.

In Type 2 diabetes, which can develop at any age, the body has either stopped responding to insulin, or no longer produces enough to properly regulate blood sugar and keep it within optimal levels. In Type 1 diabetes, often referred to as "juvenile diabetes," the body's immune system goes haywire and attacks the insulin-producing cells of the pancreas. Genetics is believed to play a role in Type 1 diabetes, and recent research has shown that viruses may also be involved.

Because Type 1 diabetes is an autoimmune disease, the attack on the insulin-producing cells, known as the islets of Langerhans, is a sustained one. Unlike in Type 2 diabetes, which can sometimes be managed through diet and lifestyle changes, there is no middle ground in Type 1 diabetes. The insulin-producing cells of the pancreas are destroyed and in order to keep blood glucose within a safe range, insulin must be introduced to the body at regular intervals.

Type 1 diabetes is most commonly identified in childhood, but according to the National Institutes of Health, up to 25 percent of cases get diagnosed in adults, some as old as 80 or 90. When certain characteristics are present, this type of diabetes is referred to as latent autoimmune diabetes of adults, or LADA.

Symptoms of Type 1 diabetes, which can occur quite suddenly, may include:

-- Extreme thirst that cannot be quenched

-- Frequent urination

-- Lethargy or exhaustion

-- High sugar content in urine

-- Sudden changes to vision

-- An increased appetite

-- Unexpected weight loss

-- A sweet or fruity scent on the breath

-- Loss of consciousness

If you experience any of these symptoms, get in touch with your health care provider right away.

At this time, there is no cure for Type 1 diabetes. However, in the vast majority of cases the disease can be successfully managed with insulin, diet and exercise. And in the meantime, research continues. Of particular interest is the field of immunotherapy, in which gene splicing and gene editing are used to reprogram the immune system's T cells, which attack the pancreas. What would have sounded like science fiction just a decade ago could someday lead to a long-term cure.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Next up: More trusted advice from...

  • How Do I Find People Willing To Date Me When I Have Bipolar Disorder?
  • How Do I Find New Friends (After Losing All My Old Ones)?
  • How Do I Stop Feeling Unworthy of Love?
  • Will Trusts Have To Disclose Ownership Information?
  • A Vacation That Lasts a Lifetime
  • The Growth of 401(k)s
  • Make the Most of a Hopeful Season With Festive Home Looks
  • Designing a Holiday Tabletop for a Season Like No Other
  • Light It Up: New Designs Brighten Home Decor
UExpressLifeParentingHomePetsHealthAstrologyOdditiesA-Z
AboutContactSubmissionsTerms of ServicePrivacy Policy
©2023 Andrews McMeel Universal