Progress is being made with GI Docs

[Polly]

Good Morning!

Had an appt. with my GI doc yesterday. I have always liked her - she is traditionally trained (John Hopkins) but open to alternative ideas. She has always been interested in whatever I tell her about the relationship of MC and food. She said that the latest thinking in the workup of prolonged diarrhea is to perform the usual (routine) tests first (ova and parasites, colonoscopy, etc.) but then......before moving on to more sophisticated tests, a food elimination trial should be recommended - first with the "big 4" (gluten, dairy, soy, eggs) and then with other likely offenders. How about that? She is seeing many cases now where the D improves with diet alone. Of course, we are not surprised! But she is surprised how many patients do not want to try food elimination and demand medication instead. We know this only too well too!

I asked if anything new had been discovered related to gut microbia. She said that we still don't know much about how to evaluate/treat them but mentioned that the naturopaths are doing much of the work in this area and that one of these days, she thinks traditional medicine and naturopaths will together come up with the answers. We can only hope! LOL.

She mentioned an interesting patient on whom she had diagnosed ulcerative colitis. The patient decided to go for naturopathic treatment. He used a particular probiotic (I think it was something like a "morgana morgana") and some kind of special tea. Anyway, he was cured! He wanted a repeat colonoscopy to prove it, and my GI doc did it and found all to be normal. Now, of course, we know that spontaneous cures do happen, and only time will tell in this case. My point here is that MY GI doc worked in sync with the naturopathic doc to provide care.

Polly
_________________
Blessed are they who can laugh at themselves, for they shall never cease to be amused.

[JLH]

[Lilja]

Good Morning!

But she is surprised how many patients do not want to try food elimination and demand medication instead. We know this only too well too!

Polly
_________________
Blessed are they who can laugh at themselves, for they shall never cease to be amused.

Hi,

One of the hardest things for me to understand, is how people react when they ask how I have recovered (well it's a bit too early to say, but I hope and *touch wood*), and I answer "through a restricted diet".

Some just don't comment on it and switch subject, some seem to not believe me and stare at me with an empty look, and some get defensive and say "You probably would have recovered no matter what". But, the nearest friends who themselves struggle with different health issues get angry, as if I had adviced them to do the same!

I will never stop to wonder about these "denial" reactions.

Lilia

[JFR]

Good Morning!

But she is surprised how many patients do not want to try food elimination and demand medication instead. We know this only too well too!

Polly
_________________
Blessed are they who can laugh at themselves, for they shall never cease to be amused.

Hi,

One of the hardest things for me to understand, is how people react when they ask how I have recovered (well it's a bit too early to say, but I hope and *touch wood*), and I answer "through a restricted diet".

Some just don't comment on it and switch subject, some seem to not believe me and stare at me with an empty look, and some get defensive and say "You probably would have recovered no matter what". But, the nearest friends who themselves struggle with different health issues get angry, as if I had adviced them to do the same!

I will never stop to wonder about these "denial" reactions.

Lilia

I have a friend with RA. She got very angry when her sister suggested she try eliminating gluten. Her response was that she had a serious disease and dietary solutions would not work for her. Serious diseases need serious medicine in her estimation. I have kept my mouth shut, figuring it would not do any good and only make her angry. As far as I can tell she has never tried to change her diet. She takes one of the heavy hitter immune suppressants. I know she has tried out a lot of them. It's really kind of sad.

I wish more doctors would get on board and become interested in the relationship between diet and IBD's but it's nice to know that some have.

Jean

[tex]

Polly,

That's great news of course. They're definitely making progress (now if only they would wake up and endorse the stool tests offered by EnteroLab, so that patients wouldn't have to blindly follow a broad elimination diet). As you know, patients are far less likely to cheat on a diet if they have lab test results in hand on which to base their diet restrictions. But I'm puzzled over this remark:

She said that the latest thinking in the workup of prolonged diarrhea is to perform the usual (routine) tests first (ova and parasites, colonoscopy, etc.) but then......before moving on to more sophisticated tests, a food elimination trial should be recommended - first with the "big 4" (gluten, dairy, soy, eggs) and then with other likely offenders.

If a colonoscopy is done, then presumably a diagnosis (of MC, or another IBD) would result (at least in a significant number of cases). In that situation, no further tests should be necessary. So do they recommend an elimination diet to newly-diagnosed IBD patients (or at least MC patients) prior to recommending a medication, or does this policy only apply to patients who remain undiagnosed after a colonoscopy? It appears that it only applies to undiagnosed cases.

And how does this relate to their (GI specialists) long-standing policy of absolutely insisting that celiac patients must have an official celiac diagnosis before trying a GF diet. Is that ridiculous policy going to finally fall by the wayside, or will celiacs continue to be punished in the name of "medical correctness" (the medical version of "political correctness")? LOL.

Love,
Tex