Gases, Prebiotics, Probiotics and Irritable Bowel Syndrome

Image via Wikipedia

This is an un-sanitary topic. Yet, for those who have an illness as irritable bowel syndrome (IBS) is a life quality issue. For the same level of colonic distension, pain and discomfort is worse for people suffering from IBS.

Lately, I started reading on prebiotics and probiotics. This led me to read on our gut microbiota. Some consider our gut micorbiota an organ. Yes, an organ that we did not learn about while in medical school.(Gibson 2004)
Above picture is for the 1908 Noble prize in medicine winner Ilya Ilych Mechnikov who started the interest in the gut microbiotia and its connection to health.
Gut microbiota is the bacteria and other micro-organisms living in our gut. Number of their cells is 10 times our cells. They are not all parasitic or pathogenic, rather most are symbiotic. They feed off of use and offer many health benefits. They even feed us. They produce short chain fatty acids that our enterocytes feed on. (Bixquert Jiménez 2009) This is an area of active research and most of the benefits are shown on animal models. For a handful of reasons (big corporations is one) I don’t see this science advancing fast enough. Having said this, there are studies on humans showing some benefits in certain disease entities.

Integrative Thinking for Preventive Medicine

It is time for a new paradigm in preventive therapy. RCTs and meta-analyses are not suited for complex interventions as primary prevention. For primary prevention we need to eat well, exercise regularly, and sleep well. I do not believe that family physicians are trained enough in these areas. More, I do not believe that the science in these areas has reached where it is supposed to be.

It is a shame that over 70 years after the death of Dr. Alexis Carrel his observation holds true till today:

Medicine is far from having decreased human sufferings as much as it endeavors to make us believe. Indeed, the number of deaths from infectious diseases has greatly diminished. But we still must die in much larger proportion from degenerative diseases.

Roger Martin the dean of Toronto’s Rotman School of Business has a suggestion that I think is worth trying in medicine. You can find his suggestion in his book ‘The Opposable Mind: How Successful Leaders Win Through Integrative Thinking’

1. Have a good stance. A stance is how we think of the word, and what we value. Thinking high of RCTs can be thought of as a stance. Refusing to accept any reductionist science to guide preventive medicine is another stance. Always being open to different ideas is another stance.

2. Use abductive reasoning along with adductive and inductive reasoning. You may need to read the book to understand abductive reasoning. My understanding is to use our current knowledge to come we with new and imaginative solutions. Abductive reasoning is imagining the possible.

Therapeutics Education Collaboration: a Must Listen to Podcast for Any Family Physician

If you are family physicians you must listen to the therapeutics education collaboration podcast. This podcast in excellent to perfect on all dimensions:
The presented information, the show notes, the style and the audio qualtiy. Superingly, many podcast don't even come close to this quality.

The two primary hosts are a pharmacist Prof. James McCormack and family physicians Dr. Michael Allan.
I will leave you with this you-tube video for Prof. James McCormack