Discover and read the best of Twitter Threads about #gastropsych
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@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 7/12 #MondayNightIBD
MultiD Rx of #IBS in #IBD
🩺target predominant symptom(s)- pain, diarrhea, constipation, bloating
🌱supplements: peppermint oil, #probiotics
🥑diet: ⬇️FODMAP, Mediterranean
💊antibiotics, panc enzymes, neuromodulators, secretagogues
🧠CBT, hypnotherapy
MultiD Rx of #IBS in #IBD
🩺target predominant symptom(s)- pain, diarrhea, constipation, bloating
🌱supplements: peppermint oil, #probiotics
🥑diet: ⬇️FODMAP, Mediterranean
💊antibiotics, panc enzymes, neuromodulators, secretagogues
🧠CBT, hypnotherapy
@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 8/12 #MondayNightIBD
#SIBO is common in #IBD, especially
👩🦰F>M
🔥CD>UC
✂️prior surgeries
📿strictures
🧪⬇️albumin
🦥⬇️transit times
Testing (🌬️or🦠) and treating improves symptoms & outcomes!
Treatment
⛽️hydrogen▶️rifaximin
🐄methane▶️rifaximin+neomycin
🩺See ACG guidelines!
#SIBO is common in #IBD, especially
👩🦰F>M
🔥CD>UC
✂️prior surgeries
📿strictures
🧪⬇️albumin
🦥⬇️transit times
Testing (🌬️or🦠) and treating improves symptoms & outcomes!
Treatment
⛽️hydrogen▶️rifaximin
🐄methane▶️rifaximin+neomycin
🩺See ACG guidelines!
@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 9/12 #MondayNightIBD
Anxiety, depression, & #PTSD are very common in #IBD and are associated with worse disease outcomes, ⬆️🏥utilization, & ⬇️quality of life.
🔍screen for ψ disorders
💊neuromodulators can treat IBD/IBS and ψ symptoms
🧠CBT, GDH
🤝refer to #GastroPsych
Anxiety, depression, & #PTSD are very common in #IBD and are associated with worse disease outcomes, ⬆️🏥utilization, & ⬇️quality of life.
🔍screen for ψ disorders
💊neuromodulators can treat IBD/IBS and ψ symptoms
🧠CBT, GDH
🤝refer to #GastroPsych
@MondayNightIBD @DCharabaty 1/12
📣#GITwitter #IBDTwitter
Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD
🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?
Check out our review📜
practicalgastro.com/2022/05/18/rec…
#NeuroGI #GastroPsych #DGBI
📣#GITwitter #IBDTwitter
Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD
🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?
Check out our review📜
practicalgastro.com/2022/05/18/rec…
#NeuroGI #GastroPsych #DGBI
@MondayNightIBD @DCharabaty @john_damianosMD 2/12 #MondayNightIBD #B2B
👩🏼⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!
It’s important bc:
👨👩👧👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics
👩🏼⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!
It’s important bc:
👨👩👧👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics
@MondayNightIBD @DCharabaty @john_damianosMD @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak 3/12 #MondayNightIBD Persistent/New GI Sx in #IBD
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!
2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea
3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!
2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea
3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep
Here are the new @BritSocGastro guidelines for #IBS in @Gut_BMJ! I'll summarize in 🧵 ⬇️⬇️⬇️!
😖💩🦠🧠🥦🍞💊
#GITwitter #GI #gut #braingut #motility #DGBI #FGID #microbiome #probiotics #MedTwitter #MedEd
gut.bmj.com/content/early/…
😖💩🦠🧠🥦🍞💊
#GITwitter #GI #gut #braingut #motility #DGBI #FGID #microbiome #probiotics #MedTwitter #MedEd
gut.bmj.com/content/early/…
🧑⚕️-😷
Doctor-patient communication
🧑⚕️A strong 🧑⚕️-😷 relationship is fundamental to the management of #IBS
😷Patients want their 🧑⚕️ to ⬆️empathy, support and information about the nature of IBS, diagnosis, and treatment options
Doctor-patient communication
🧑⚕️A strong 🧑⚕️-😷 relationship is fundamental to the management of #IBS
😷Patients want their 🧑⚕️ to ⬆️empathy, support and information about the nature of IBS, diagnosis, and treatment options
DIAGNOSIS
🩸New pt: CBC, CRP or ESR, celiac serology and, if <45 w diarrhea, fecal calprotectin
➕Make POSITIVE diagnosis based on @RomeFoundation criteria
➡️Refer to #GI when: diagnostic doubt, pt w symptoms that are severe or refractory to 1stline tx,or when pt wants specialist
🩸New pt: CBC, CRP or ESR, celiac serology and, if <45 w diarrhea, fecal calprotectin
➕Make POSITIVE diagnosis based on @RomeFoundation criteria
➡️Refer to #GI when: diagnostic doubt, pt w symptoms that are severe or refractory to 1stline tx,or when pt wants specialist
