WASHINGTON, March 22 /PRNewswire/ -- Recent studies confirm a link between recurrent or unresolved heartburn symptoms and esophageal cancer. This research underscores the importance seeing a physician for those who experience heartburn symptoms two or more times per week.

FACT: Cigarette Smoking Causes Heartburn

How does smoking contribute to heartburn? Studies have shown that cigarette smoking dramatically decreases the LES (lower esophageal sphincter) pressure. It is well known that smoking causes a variety of life-threatening diseases, including lung cancer, emphysema, and heart disease. What is less understood by patients is that smoking has also been shown to have harmful effects on all parts of the digestive system, and especially contributes to the common disorder of heartburn.

Smoking decreases the strength of the esophageal valve, thereby allowing more refluxed material into the esophagus. To make matters worse, smoking also seems to promote the movement of bile from the intestine to the stomach to produce a more harmful reflux material. And, finally, smoking may directly injure the esophagus, possibly by reducing the amount of saliva, making it less able to resist further damage by material refluxed from the stomach.

Not all the effects of smoking on the digestive system are fully understood but it seems clear from research results that smoking plays an important role in causing some digestive problems such as heartburn.

FACT: Weight is a Contributing Factor to Heartburn (GERD)

Obesity is one of the many factors predisposing people to gastroesophageal reflux. The effects of diet and a fitness program upon gastroesophageal reflux in obese persons was studied by a group of investigators from the Duke University Medical Center in Durham, North Carolina. This study concluded that exercise and weight reduction decrease gastroesophageal reflux in obese persons.

FACT: Chocolate and Peppermint Cause Heartburn in Many People

Heartburn occurs when the lower esophageal sphincter (called the LES), located at the junction of the esophagus and the stomach, either relaxes inappropriately or is very weak. This allows the highly acidic contents of the stomach to back up into the esophagus. Both chocolate and peppermint are thought to cause the LES to relax and allow the contents of the stomach to back up into the esophagus. Other foods associated with heartburn include tomato products, citrus fruits and juices, coffee, and fried and fatty foods.

FALLACY: Hiatal Hernia Causes Heartburn

The fact is, while some people who suffer from heartburn also have a hiatal hernia, heartburn is not caused by the hernia. A hiatal hernia is the protrusion of a portion of the stomach through a teardrop-shaped hole in the diaphragm where the esophagus and the stomach join. The most frequent cause of hiatal hernia is an increased pressure in the abdominal cavity produced by coughing, vomiting, straining at stool, or sudden physical exertion. A majority of people over 60 years have hiatal hernias and, in most cases, the hiatal hernia does not cause problems. However, large hernias are usually associated with acid reflux disease.

FACT: Over-the-Counter Remedies May Help Infrequent Heartburn

The fact is that many people have discovered non-prescription antacids and newer over-the-counter medications (called H2 blockers) can be effective treatment and provide relief for infrequent episodes of heartburn. Long-term use of antacids can, however, result in side effects like diarrhea, altered calcium metabolism, and magnesium retention. Magnesium retention can be serious for patients with kidney disease. As with other non-prescription drugs, if prolonged use (longer than 3 weeks) becomes necessary, consult your doctor.

SOURCE American College of Gastroenterology

CO: American College of Gastroenterology

WASHINGTON, March 22 /PRNewswire/ -- Recent studies confirm a link between recurrent or unresolved heartburn symptoms and esophageal cancer. This research underscores the importance seeing a physician for those who experience heartburn symptoms two or more times per week.

1. Doesn't everyone get heartburn?

Heartburn is very common. Nearly 40% of Americans experiencing it at least once a month. Some people are particularly prone to heartburn. For example, nearly 50% of pregnant women will complain of heartburn in the later stages of pregnancy. Heartburn may be a troubling nuisance symptom, or it may represent a more serious disease known as gastroesophageal reflux disease (GERD). Clues that it may be something serious include: heartburn at least twice a week; heartburn not getting better with antacids or over-the-counter medicine; or heartburn associated with food sticking, weight loss, or low blood count.

2. What are the symptoms of heartburn?

Heartburn is described as a sour, burning sensation in the upper abdomen or chest. It may go up into the neck and mouth and be associated with acid regurgitation or food sticking. Heartburn is generally worse after meals, laying down at night, or exercise associated with bending over.

3. Can heartburn lead to something more serious?

For many people, heartburn is just a minor nuisance. However, some people with frequent heartburn or "warning signs" such as associated symptoms of food sticking, weight loss, or low blood count may have a disease known asgastroesophageal reflux disease. This represents a severe form of heartburn which may be associated with esophageal ulcers, esophageal bleeding, narrowing of the esophagus known as peptic stricture, and even a premalignant condition known as Barrett's esophagus. Unfortunately, the severity of symptoms does not distinguish between heartburn or GERD. Therefore, patients with frequent symptoms or associated "warning" signs need to see their physician or gastroenterologist for a more thorough evaluation.

4. What are the causes of heartburn?

Heartburn is not a result of bad lifestyle, but has a physical cause. The major cause the too frequent relation of a muscular valve in the lower esophagus known as the lower esophageal sphincter. This allows stomach acid to move upwards into the esophagus causing symptoms of heartburn and damage to the esophageal lining. Other factors potentially making heartburn worse include a weak esophagus muscle, lack of saliva, slow emptying of the stomach, or large hiatal hernias.

5. How does heartburn differ from GERD?

Heartburn and gastroesophageal reflux disease represent a spectrum. Everyone will experience occasional heartburn sometime in life. However, the progression from occasional heartburn to heartburn more than twice a week, or heartburn associated with warning signs such as food sticking, weight loss, or low blood count, suggests that you may have Gastroesophageal reflux disease. You need to see a doctor who can better diagnose the severity of your condition.

6. Can other complaints mimic or masquerade as heartburn or GERD?

GERD can masquerade as many complaints. For example, chest pain resembling a heart attack, asthma, sore throat, hoarseness, bronchitis, or wheezing can all be signs of acid refluxing into the esophagus and on to the vocal cords or into the lungs.

7. Isn't heartburn just the result of poor habits or does it have a physical cause?

In otherwise healthy people, heartburn may be made worse by poor eating habits. For example, overeating meals high in fats or excessive alcohol, or certain food products such as citrus juices, spicy tomato products, or chocolates may cause heartburn even in healthy individuals. However, those people having heartburn more than twice week or associated with other "warning" sign have a physical cause of their heartburn which often can occur completely independently of these lifestyle or behavioral factors.

8. How do I know when my antacids or over-the-counter H2 blockers aren't enough?

Over-the-counter antacids and H2 blockers are excellent and safe products for occasional heartburn. Antacids are particularly useful for rapidly relieving heartburn symptoms. Over-the-counter H2 blockers do not relieve symptoms as fast as antacids but are more long acting. Furthermore, these products may be taken prior to meals or activities that may cause reflux symptoms to occur. However, these over-the-counter products should not be used daily as they may be hiding a more severe disease and when used in excess may have significant side effects and be expensive. If you have heartburn more than twice a week or heartburn associated with food sticking, weight loss, or low blood count you need to see your doctor.

9. Does my doctor have other more powerful medicines for my severe heartburn?

10. Can anything cure my troubling heartburn?

In patients with mild heartburn, simple lifestyle changes may improve symptoms. However, patients with more severe symptoms or esophageal damage usually need either long-term medications or surgery to cure their heartburn. Similar to the treatment of high blood pressure, medications for GERD control the disease, but only are effective when taken regularly. For those who cannot achieve adequate symptom relief and healing through medical therapy, antireflux surgery offers the only potential for cure by strengthening the lower esophageal sphincter.

SOURCE American College of Gastroenterology

SAN FRANCISCO--(BUSINESS WIRE)--March 22, 1999--

Peet's Coffee & Tea teams with Vitasoy USA to provide coffee lovers with non-dairy alternative coffee drinks

During National Soyfoods Month (April), coffee lovers can enjoy all the benefits of soy just by drinking their daily latte. To attract a variety of people who do not or cannot enjoy dairy products, or customers who want to add soy to their diet, Peet's Coffee & Tea has partnered with soymilk pioneer, Vitasoy USA, to offer a special promotion on coffee drinks made with Vitasoy(R) enriched soymilk.

Throughout the month of April, customers who order a coffee drink with soymilk will be given a coupon to receive their next soy mocha or latte free. The offer will be available in all 44 coffee stores in California.

"We attract an eclectic group of customers with diverse backgrounds and personalities," said Heather Corcoran, director of marketing for Peet's. "The inclusion of Vitasoy soymilk on our menu allows us to provide a variety of options to respond to customers varying lifestyle demands, while continuing our tradition to guarantee great-tasting quality coffee."

Soymilk has long been popular among vegetarians and lactose intolerant individuals. Now, with soy attracting national attention for its many health benefits, it is also gaining a following among mainstream consumers. In the past few years, a large body of medical research has proven that soy can help prevent heart disease, certain hormone-related cancers, osteoporosis, and ease hot flashes associated with menopause.

"Soymilk sales have grown 10 to 15 percent each year since 1990 and the demand continues to soar," said Yvonne Lo, president of Vitasoy USA Inc. "We are pleased to partner with Peet's to further expand the availability of non-dairy alternatives to the mainstream market."

Vitasoy provides Peet's with its Vitasoy(R) enriched soymilk, which is made from certified organic soybeans. The company recently improved the taste and nutritional value of its soymilk to increase its appeal as a dairy alternative. Each eight ounce serving provides six grams of soy protein; is cholesterol free; low in fat; and contains 30 percent RDA of calcium, 10 percent RDA of folate, 20 percent RDA of riboflavin, six percent RDA of zinc; and 10 percent, 20 percent, and 15 percent RDA of Vitamins A, D, and B12, respectively.

The original Peet's opened its doors in Berkeley, Calif., in 1966. Since then, it has grown to 44 stores in California. With each new store, Peet's strives to carry on the flavor of its original store where it first introduced the Bay Area to a better coffee. In 1997, Peet's added soy to its menu which is now available in all 44 stores throughout California.

Headquartered in South San Francisco and founded by Yvonne Lo in 1979, Vitasoy is one of the country's largest soyfood companies with more than $40 million in sales. Vitasoy USA also manufacturers and markets tofu, Asian pastas, juices and teas under several well-known brand names including Vitasoy(R), Azumaya(TM), Nasoya(R), and Vita(R). Vitasoy's line of products can be found in major supermarkets and natural food stores throughout the U.S.

--30--cs/sf

CONTACT:

Fineman Associates Public Relations

Michael Fineman or Lori Denaro, 415/777-6933

WASHINGTON, March 19 /PRNewswire/ -- The American College of Gastroenterology notes with great interest, but not great surprise, the New England Journal of Medicine article by Dr. Lagergren, et. al. which identified "a strong and probably causal relation between gastroesophageal reflux and esophageal adenocarcinoma." The article indicates that the incidence of adenocarcinoma was nearly eight times more likely among frequent heartburn sufferers compared to persons without symptoms.

The College underscored the importance of chronic heartburn in developing a guideline published in the Archives of Internal Medicine in November 1995, a revised version of which is currently awaiting publication. Since March 1996, the College has conducted a major, national public education program which highlights the fact that heartburn is not a trivial condition, and urges patients who suffer heartburn symptoms two or more times per week to consult their physician. Over the past three years our 1-800-HRT-BURN hotline has had over 750,000 callers -- about 2 million free heartburn brochures and 375,000 free heartburn videos have been distributed.

The conclusions from the New England Journal article about: 1) greater frequency and/or severity and/or duration of symptoms corresponding to increased risk of serious consequences (whether Barrett's esophagus or adenocarcinoma); and 2) the possible benefits of endoscopic surveillance, confirm the College's observations, as do the observations in Drs. Cohen and Parkman's editorial that patients with severe symptoms of chronic reflux require special attention, and that gastroesophageal reflux needs to be identified as a chronic disorder requiring ongoing observation and therapy. Healing of esophagitis and complete symptom relief are appropriate goals of therapy. The College is also very interested by apparent links to gastroesophageal reflux disease and chronic untreated heartburn with asthma and chronic cough.

Information packages are available for physicians, consumers and the media either through our 1-800-HRT-BURN hotline (consumer information) or by contacting the College at 4900 B South 31st Street, Arlington VA 22206 fax: 703-931-4520.

SOURCE American College of Gastroenterology

The lead article in the current issue of the New England Journal of Medicine sounds a wakeup call to millions of Americans who suffer from the gnawing pain of a common digestive disorder known as gastroesophageal reflux disease (GERD), which is characterized by recurrent heartburn.

GERD is a serious condition that occurs when stomach acid regurgitates into the esophagus. The American College of Gastroenterology estimates that 60 million Americans suffer from GERD at least once per month. Watch streaming video comments from Dr. Andrew Dannenberg, director, New York Presbyterian Hospital Cancer Prevention Center-Cornell, who offers advice on treating and managing GERD at http://www.newstream.com/99-106.shtml

Keywords: Health Medical Medicine Heartburn GERD Research

For other online audio and video, please visit http://www.newstream.com

CONTACT:

Medialink, New York

GASTROGARD is the First and Only Product Approved to Improve and Heal Equine

Stomach Ulcers and Prevent Their Recurrence -

ISELIN, N.J., March 18 /PRNewswire/ -- Merial, a Merck (NYSE: MRK) and Rhone-Poulenc (NYSE: RP) company, announced today that it has received clearance from the U.S. Food and Drug Administration (FDA) to market GASTROGARD(TM) (omeprazole) Paste, the first and only prescription medication approved by the FDA to heal and prevent the recurrence of stomach ulcers in horses. Omeprazole is the same active ingredient found in PRILOSEC(R) the world's leading anti-ulcer medication for humans.

"Only recently, with advances in diagnostic testing, has the seriousness of Equine Gastric Ulcer Syndrome (EGUS) been understood and until now, there was no approved medicine specifically designed for treating ulcers in horses," said Dr. Frank Andrews, associate professor and section chief, Large Animal Medicine, University of Tennessee College of Veterinary Medicine, Knoxville, Tenn. "GASTROGARD is an important new drug because it is the first medication that has been proven to heal stomach ulcers and, just as significantly, can prevent them from recurring even while the horse is still in training. This drug will have a significant impact on the equine industry."

GASTROGARD was granted accelerated review by the FDA because the molecule was new to veterinary medicine and had potential therapeutic value for an important, often serious condition. EGUS may affect as many as 1.8 million U.S. performance horses. Recent studies have shown that EGUS affects up to 93 percent of racehorses, almost 60 percent of other performance horses and up to 57 percent of foals (horses under the age of one year). GASTROGARD will be available from veterinarians in two weeks.

Like People, Horses Get Ulcers, Too

As with human ulcers, stomach acid appears to be the main cause of horse ulcers. Excess acid can eat through the protective lining and damage the stomach. Among the most noticeable signs of ulcers are decreased appetite, colic, poor hair coat, poor body condition and poor performance. In foals, clinical signs may include grinding of teeth, colic, intermittent nursing, decreased appetite and weakness.

Feeding practices, training and trailering, competing, and even hospitalization can contribute to ulcer formation in horses. Intensity of training may also contribute to ulcer formation. "Helicobacter pylori," bacteria that are a factor in the development of human ulcers, have not been isolated from horse stomachs and are not currently considered to be a cause of horse ulcers.

"Gastric ulcers are very common in adult horses as well as foals. Symptoms of ulcers are often not apparent because our patients can't talk to tell us they are uncomfortable," said Dr. Michael J. Murray, associate professor and Adelaide C. Riggs Chair in Equine Medicine, Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, Va. "In most cases, foals and horses exhibit signs of ulcers in ways that can be missed or misunderstood, and an owner or trainer may not recognize that there is a problem unless the horse shows overt signs of colic."

GASTROGARD Contains Same Ingredient as PRILOSEC, the No. 1 Anti-Ulcer Drug

for Humans

The active ingredient in GASTROGARD is omeprazole -- the same compound as in PRILOSEC(R) (marketed as LOSEC(R) outside the US) -- the world's No. 1 anti-ulcer medication for humans and the No. 1 selling prescription drug in the world.

"In the past, many different medications used to treat heartburn and stomach ulcers in humans have been used by veterinarians to treat horses," said Dr. Nicholas Vatistas, department of veterinary surgical and radiological sciences, University of California, Davis, Calif. "This is a common and accepted practice. Unfortunately, many of these medications had variable results, even at high doses, and had no recommended dose or administration schedule proven through controlled research studies. Often, treatment required that the horse be removed from training."

None of these medications have been evaluated or approved for use in horses by the FDA, and their safety in horses has not been assessed.

GASTROGARD Safely Heals and Prevents Recurrence of Ulcers in Horses

Clinical field trials showed that daily use of GASTROGARD for four weeks effectively healed or reduced the severity of gastric ulcers in 99 percent of treated horses. The product was tested for both safety and efficacy in major multicenter studies at more than 15 trial sites involving more than 300 horses of more than nine different breeds. GASTROGARD is the only medication to meet FDA standards for the treatment of equine stomach ulcers.

"In clinical trials, GASTROGARD allowed horses to remain in active training during treatment," explained Andrews, one of the lead researchers of the studies. "This will be of greatest benefit in treating ulcers in racehorses and other equine athletes, such as show jumpers and three-day event horses, because valuable conditioning will not be lost through lay-up." (Lay-up is a break in training or rest period.)

GASTROGARD provides superior acid suppression because it effectively shuts down acid production in the stomach, giving the ulcer time to heal. The stomach cells contain several acid-stimulating receptors. When any of these receptors are activated, they send a message to acid pumps (enzyme systems) to secrete acid into the stomach. GASTROGARD works by disabling the acid pumps so when receptors send the message to produce acid, the acid pumps are unable to respond.

GASTROGARD has been proven safe, with adult horses in clinical trials experiencing no drug-related health problems, even when the product was administered at 10 times the recommended dose. It also can be used safely in foals as young as 4 weeks old and in breeding stallions.

"GASTROGARD is one of the most rigorously and extensively tested drugs in equine medicine," said Kevin Schultz, vice president of research and development at Merial. "All the horses whose health and performance are diminished by ulcers will now benefit from the only medication proven to heal and prevent gastric ulcers."

Merial: Making the Vital Difference

Merial is the world's leading animal-health company dedicated to the research, development, manufacture and delivery of innovative pharmaceuticals and vaccines for use by veterinarians, food-animal producers and pet owners to improve the health, well-being and performance of all animal species. The company is also market leader in the development and production of poultry breeding stock. With its worldwide headquarters in London, Merial employs around 6,500 people and operates in more than 150 countries. Total 1998 sales were US$1.76 billion. Merial is jointly owned by Merck and Co., Inc., and Rhone-Poulenc S.A.

For more information on GASTROGARD and Equine Gastric Ulcer Syndrome, please visit the Websites http://www.gastrogard.com and http://www.egus.org, or call toll-free, 877-GASTROGARD -- 877-427-8764.

Full prescribing information available at www.gastrogard.com.

SOURCE Merial Limited

8. Clif Bars Go Kosher; Also Dairy-free and Sulfur-free     Top^

BERKELEY, Calif.--(BUSINESS WIRE)--March 12, 1999--All 10 flavors of Clif Bar(R) have been certified as kosher by the Orthodox Union, exciting news for millions of consumers who prefer kosher foods for quality, religious or dietary reasons.

Clif Bars, a leading brand of all-natural energy bars, will reach retail shelves with a kosher seal this summer.

In addition, every Clif Bar sold will now be dairy-free, with soy-based chips replacing dairy-based chips in the Carrot Cake and Cookies `n Cream flavors. Apricot Clif Bar will soon contain only sulfur-free apricots, an important change for people allergic to sulfites (sulfur compounds). Dairy-free Clif Bars are in stores now; sulfur-free Apricot Clif Bars should arrive at retail outlets this summer.

Clif Bar Inc., a top producer of all-natural energy foods, announced these product innovations today at Natural Products Expo West in Anaheim, Calif. The company also introduced LUNA(TM), a delicious, whole nutrition bar designed especially for women. LUNA's retail debut is scheduled for this summer.

"Our consumers asked and we listened," said Clif Bar Inc. co-founder Gary Erickson, in explaining the new improvements to Clif Bars. "That's one of our hallmarks, along with a respect for -- and sensitivity to -- the many lifestyles and preferences in this country."

Consumer interest in kosher foods has been growing dramatically. Kosher food sales exceed $3.25 billion annually, and an estimated 9 million consumers will purchase kosher foods annually by the year 2000. The Orthodox Union, kosher certifier of Clif Bars, is the largest, oldest and most recognized label in kosher certification.

Millions of Americans cannot consume milk because they are lactose intolerant or suffer from milk allergies -- making foods that are dairy-free essential to their daily lives. In addition, vegans exclude animal products from their diets.

Sulfites, which are present in most dried fruits, can trigger allergic reactions in sensitive individuals, including people with asthma.

Headquartered in Berkeley, Calif., Clif Bar Inc. was founded on the principle of promoting healthy snacks without highly processed ingredients. The result is Clif Bar, a great-tasting, all-natural energy bar. Today, Clif Bar Inc. is a leading producer of all-natural energy foods and ranked as one of the fastest-growing private companies in America by Inc. magazine. Clif Bar Inc.'s ethic of social responsibility includes an active community service program and extensive annual support for hundreds of charities and charitable events.

CONTACT:

Clif Bar Inc.

Dean Mayer, 510/558-7855