DIGESTIVE & GUT HEALTH
THE LATEST NEWS FROM DIGESTIVE DISEASE WEEK (DDW) IN SAN DIEGO
Each year, Gastroenterologists and digestive health experts from around the world, get together for a week of symposiums on --- you guessed it --- digestive and gut health. Being the curious bird that I am, I took a peek at what was on the agenda for Digestive Disorders Week (DDW). After looking at blog posts about numerous presenters and the meetings they were leading, two things stuck out to me. Number one was that there is a great divide in the way that the medical community thinks about health and disease when compared to the alternative medical community (stick around to see what I mean). Number two, the divide seems to be shrinking as mainstream medicine is actually discussing topics that just ten short years ago would have been branded as quackeristic voodoo.
- CELIAC DISEASE / GLUTEN SENSITIVITY: This symposium, led by Dr. Peter Gibson (Professor / Director of Gastroenterology) of Melbourne, Australia, discussed an interesting study of 6,600 Celiacs. What researchers discovered was that, "diseases such as hypertension, coronary artery disease and diabetes type 2 are all significantly less common in people with celiac disease, although the reasons are uncertain." Uncertain, yes --- but I have a theory. The people who are actually diagnosed and realize they have Celiac Disease typically (but not always) go on a GLUTEN FREE DIET. This almost always leads to significant improvements in the way they feel, a reduction of any number of NEUROLOGICAL SYMPTOMS, they may be having, as well as dramatically diminished SYSTEMIC INFLAMMATION. Although some of these people continue their poor dietary habits by simply substituting the highly processed grains they were eating (think wheat / GLUTEN here) for HIGHLY PROCESSED GLUTEN FREE grain-based products, many do not. Those that don't frequently gravitate toward LOW CARB or PALEO-LIKE approaches. Following some of these links reveals that eating in this manner is consistent with fewer cases of Diabetes, HIGH BLOOD PRESSURE, HYPER CHOLESTEROLEMIA, HEART DISEASE, etc, etc. Probably not the only reason, but too big to fail to mention. One more thing; do not think that just because you do not have Celiac, that Gluten can't be a problem for you (HERE).
- INFLAMMATION AND CANCER: There are several things that we know for sure. We know that Inflammation is intimately related to a wide array of diseases, including Cancer (HERE). Furthermore, we know that Inflammation is intimately linked to SCAR TISSUE / FIBROSIS as well. The kicker is that these two are in turn, intimately related to each other (HERE). To continue, we know that Americans are probably as "inflamed" as any society in history (HERE). The cherry on top is that there are all sorts of natural things to be done to solve this problem --- one of the most important of which is consuming an ANTI-INFLAMMATORY DIET. As far as I could tell, this meeting (the Gastroenterology Research Group's Spring Symposium called Inflammation in Cancer: Friend or Foe?) did not concern itself with these sorts of things. Instead, it focused on new treatments, most of which revolved around a host of NEW CANCER VACCINES.
- INFLAMMATION AND CANCER PART II: Dr. Alessandro Fichera of the University of Washington in Seattle moderated a session led by various experts from around the world, who talked about the relationships of various forms of "itis" (inflammation) to various forms of Cancer. For instance, although this is somewhat oversimplified, the dealt with the fact that hepatitis (inflammation of the liver) has a propensity to turn into liver cancer. Pancreatitis (inflammation of the pancreas) has a propensity to turn into PANCREATIC CANCER. IBD (COLITIS) has a propensity to turn into colon cancer as well.
- INFLAMMATION AND CANCER PART III: Although Colon Cancer has shown slight decreases over the past several years in older folks (attributed mostly to COLONOSCOPIES), the under-50 crowd has seen a significant spike in this third most common of cancers. The speaker said of this phenomenon, "It's critical that we reverse this trend so that we are able to reduce, and hopefully eliminate it in all populations, regardless of age". The problem is, he is not really talking here about "reducing" the rates of Cancer. He is essentially talking about detecting more cases of Cancer, which, as I have shown you in the past, is the very reason that the terms "OVERDIAGNOSIS & OVERTREATMENT" have become part of the vernacular of the American public.
- THE COCHRANE COLLABORATION'S RECOMMENDATIONS FOR DIAGNOSING AND TREATING INFLAMMATORY BOWEL DISEASE: As I've shown you time and time again, THE COCHRANE GROUP is the gold standard for evidence-based medical reviews. In this meeting, they looked at and discussed IBD, which comes mainly in two forms --- something called Crohn's Disease and Ulcerative Colitis (they could have mentioned IBS here, which is now recognized as an AUTOIMMUNE DISEASE as well). Listen to this quote from Dr. Nilesh Chande, of Western University in London, Canada. "It is not clear why the prevalence of IBD has been increasing over recent generations, but the hygiene hypothesis is gaining credence. Children are being born and raised in much more hygienic environments today than they were in the 1950s and earlier. The relatively clean environment means they are exposed to fewer pathogens, parasites and allergens when they are young. As a result, the immune system has less opportunity to learn to regulate its response over multiple exposures and is more likely to overreact to particularly bothersome antigens. Asthma, IBD and other allergic conditions are probably worse as a result of the clean environments kids are growing up in these days. Kids that grow up playing in the sandbox, eating dirt and surrounded by pets don’t usually grow up with these allergic kinds of problems. We may not be able to do much to prevent IBD, but there are ways we can help patients to manage their symptoms." Managing symptoms. The problem with this approach is that it never deals with underlying causes, and always involves heavy doses of IMMUNOSUPPRESSIVE DRUGS. For more information on the Hygiene Hypothesis, HERE and HERE are good starting points. Bottom line, research is starting to reveal that as a society, we are in many ways too clean --- both inside and out (HERE).
- THE MICROBIOME REALLY IS IMPORTANT: Even though peer-review reveals that the single hottest area of medical research pertains to GUT HEALTH and the MICROBIOME, I don't see much changing when it comes to doctors in practice prescribing things that destroy them; chiefly ANTIBIOTICS and ANTIBIOTIC-LIKE drugs. DDW had symposiums on probiotics for C. DIFF INFECTIONS, as well as Dr. Dean Yimlamai, MD, PhD, presenting on the relationship between the Microbiome and pediatric liver disease. He stated, "Infant intestinal microbiome is shaped by delivery — vaginal or Cesarean section — and diet — exclusively breast milk or some amount of formula. As in adults, nutrition modifies the pediatric microbiota, which in turn can affect overall metabolism and susceptibility to disease, including liver disease." His co-presenter, Dr. Daniel H. Leung of Baylor (Professor of Pediatrics) raised the question of the impact of the microbiome on certain aspects of digestion. "The infant gut is relatively naïve [immature / undeveloped].... Knowing that the gut microbiota does not establish an adult profile for at least the first two to three years of life, it will be interesting to hear what our speakers have to say about important changes and early exposures in childhood that may have prognostic indications for subsequent liver disease." He's talking her about the Hygiene Hypothesis. Even though it's the elephant in the room that was certainly not addressed during any of these seminars, this is the very reason there is an undeniable link between Autism and poor Gut Health (HERE). For more on the benefits of vaginal deliveries and breast feeding, HERE and HERE are the respective links.
- THE MICROBIOME REALLY IS IMPORTANT PART II: In another symposium, Dr. Rob Knight (Ph.D from Princeton, Professor in the Department of Pediatrics, and founder of the American Gut Project) of University of California San Diego talked about the importance of the Microbiome as it relates to diagnosing and solving diseases via testing for the VARIOUS FORMS OF DYSBIOSIS found in fecal samples. He admits in a YouTube Video interview (a preview of his symposium) that, "ten years ago people thought it was crazy to try and connect gut markers to obesity." If you follow my site, you know I probably have at least a dozen articles on the subject --- maybe more. It's no longer crazy. He went on to talk about other diseases connected to the Microbiome --- Liver Disease, DIABETES, RHEUMATOID ARTHRITIS, MULTIPLE SCLEROSIS, DEPRESSION, and yes; Autism, along with several others. The thing I found disappointing was his recommendation for the public to temper their enthusiasm for the Microbiome; especially since he did not mention the hottest topic in this hottest field of study --- FMT.
- THE RELATIONSHIP BETWEEN NUTRITION AND GI DISEASES: Despite the fact that there should be many such symposiums during DDW, it's a start. Head of Pediatric Gastroenterology at University of Tennessee in Memphis, Dr. Mark Corkins, writes, "Food once played a dual role, aiding in both nutritional and disease therapy. Pharmaceutical therapies have since eclipsed nutritional therapy, but a growing body of clinical evidence and observational studies suggest that food can be used to treat a variety of gastrointestinal disorders." He then mentions that there aren't great tests for determining which nutrients to prescribe. Professor of Medicine at Chicago University, Dr. Carol Semrad, complains that not only are there "no biomarkers for our most poorly understood disease entities in GI" --- namely IBS, but that, "nutritional trials are complex because there are so many variables to control." She is correct on the second count. This is why Dr. David Seaman has repeatedly told us that MONOTHERAPIES ARE INEFFECTIVE. In her defense, she compares the effectiveness of certain drugs to the effectiveness of proper nutrition. She also happens to be the only speaker I have seen in this symposium who discussed FECAL MICROBIOTA TRANSPLANTS. This seminar was desperately needed because research has revealed that most doctors know so little about nutrition (HERE).
- OBESITY INTERVENTION: If you've followed my posts on OBESITY, you are aware of just how serious this epidemic really is. Dr. Andres Acosta is an MD / Ph.D who happens to be a professor at the Mayo Clinic. He makes the statement, "We should never stop managing obesity." Sounds good on the surface, but we've heard this all before (HERE and HERE). However, he does not appear to be a drugs-first kind of doctor. "All of our patients should start with diet and activity changes,” Dr. Acosta said. “All of our other interventions — drugs, endoscopy, bariatric surgery — are acute tools. Lifestyle changes are what is going to work in the long run." The cool thing about Obesity is that if people will just take care of their health, their weight will take care of itself (HERE and HERE are examples).
One of the most surprising things about this meeting of some of the best gastroenterological minds on the planet is that as far as I could tell, no one addressed hot topics such as PPI'S (heartburn / Acid Reflux drugs) or INCREASED INTESTINAL PERMEABILITY (Leaky Gut Syndrome). Beyond that, it seems like at least part of the medical community is getting at least a glimpse of the BIG IDEA as it pertains to health. If you are one of the numerous people struggling with Chronic Pain or Chronic Illnesses, take just a moment to look at THIS POST that consolidates many of the concepts we talked about today.
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