Doctors Just Don't "Get It", Do They

Discussions on the details of treatment programs using either diet, medications, or a combination of the two, can take place here.

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tex
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Doctors Just Don't "Get It", Do They

Post by tex »

Hi All,

Consider the "updated" treatment plan for IBS in this article:

http://www.medpagetoday.com/Gastroenter ... rome/12232

Is it any wonder that they aren't making any progress? Look at this claim from that article:
For example, the group said that extensive testing to rule out colon cancer and inflammatory bowel disease is unwarranted for most younger patients, unless they have "alarm features."
Can you believe that :BSFlag: ?

And this conclusion:
The panel also said there was little evidence to support exclusionary diets to treat IBS, except in patients with demonstrated problems with dairy products
.

They just don't get it, and I'm beginning to wonder if they ever will. :roll: They simply can't comprehend how the food that passes through the digestive system, could somehow affect the way that the GI tract behaves. Well Duh!

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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kate_ce1995
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Post by kate_ce1995 »

For example, the group said that extensive testing to rule out colon cancer and inflammatory bowel disease is unwarranted for most younger patients, unless they have "alarm features."

That one wants to make me run right out to a GI appointment like my PCP wants me to do! NOT!

Ah well.
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Post by starfire »

What we need is a group of GI docs with MC conducting studies......... on themselves.
When the eagles are silent, the parrots begin to jabber"
-- Winston Churchill
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Post by tex »

Now that would probably have some interesting results> :lol:

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Sunshine »

The article says that Rifaximin "has high-quality evidence of reducing global IBS symptoms, especially bloating, with short-term dosing although symptom recurrence is common."

Does this imply that IBS is actually a bacterial infection which this drug treats, but it isn't killing all of them so it reccurs?

(And don't you love it when a medicine used to treat diarrhea has this as side effects?
bloating, gas, stomach pain;
feeling like you need to empty your bowel urgently;
feeling like your bowel is not completely empty;
nausea, vomiting, constipation)
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Post by JLH »

Amitiza (the first drug mentioned in the article) is what was prescribed for DB. Last time I spoke with him he said it wasn't making much of a difference on his C.

Tex, DB said that his report said that biopsies were randomly taken...
(I think that's correct. I'll check again.)
DISCLAIMER: I am not a doctor and don't play one on TV.

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tex
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Post by tex »

Joan wrote:The article says that Rifaximin "has high-quality evidence of reducing global IBS symptoms, especially bloating, with short-term dosing although symptom recurrence is common."

Does this imply that IBS is actually a bacterial infection which this drug treats, but it isn't killing all of them so it reccurs?


Not necessarily. Usually, that antibiotic is most effective against bacteria such as E. coli. It's not effective against bacteria such as Campylobacter, Shigella, or the various Salmonella species, for example.

You have to bear in mind that many/most antibiotics are not "bactericidal", (bactericidals work by actually killing bacteria). Many antibiotics are "bacteriostatic", meaning that they work by stopping bacteria from multiplying.

Each different type of antibiotic affects different bacteria in different ways. For example, an antibiotic might inhibit the ability of a species of bacteria to turn glucose into energy, or its ability to construct or repair its cell wall. When this happens, the bacterium dies instead of reproducing. Typically, bacteriostatic antibiotics achieve those effects by altering the DNA of a bacterium, so that some part of the organism cannot function normally. If a vital component cannot function normally, then the cell either cannot survive, or it cannot reproduce.

If you think about that a bit, the ability to alter the DNA structure of a cell, (i.e., a single-celled organism), is a very powerful tool, and most likely to have rather complex implications. Therefore, like most/all meds, there are almost surely some side effects that go along with most/all of these antibiotics. IOW, there is a very good chance that they also have certain effects on human tissue, that change the way that certain cells behave, and this is possibly the mechanism by which certain antibiotics tend to control D. For example, we have long observed that Ciprofloxacin will stop the D caused by an MC reaction in virtually every case. No one knows exactly how this is accomplished, but it is almost certainly related to some sort of antibiotic-modulated effect on the cellular level. Since the changes are not permanent, obviously, then apparently the temporary changes that occur in human cells due to the influence of the antibiotic, are not due to a DNA modification in human cells.

Note that everything in that last paragraph is just my thoughts on the matter. It's possible that it might be documented somewhere, but I didn't research it - those are just my thoughts. Everything else, above that, though, is documented fact, and common knowledge.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by JLH »

Sunshine, not Joan. "I know nothing" to quote Sgt. Schultz.
DISCLAIMER: I am not a doctor and don't play one on TV.

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Post by Gloria »

Once again Tex, you have "wowed" me with your understanding and explanation of how something works. Thank you for all you provide to this board.

Gloria
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Post by tex »

Sunshine and Joan,

:oops: Sorry about the mixup. I probably got confused by the identical avatars that the system assigned to both of you, and I just noted the username on the last post, without paying attention to the fact that they were written by two different people. Shame on me. :roll: I'll try to pay closer attention to what I'm doing, in the future.

Joan - Sgt. Schultz, of course, knew a hell of a lot more than he would admit, so I'm sure that you do, too. :grin:

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by tex »

Hi Gloria,

:oops: Thank you for the kind words. I believe it was Polly who inspired me to do some research on that topic a couple of years ago, when we were talking about why cipro always seems to stop D, and we were trying to figure out why. I've learned a lot from this board, and from every one here, so it is I who should be thanking all of you.

As always, you're most welcome,
Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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