Discover and read the best of Twitter Threads about #sibo
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🔺SIBO proviene del inglés, “Small intestinal bacterial overgrowthes”, y se trata de un sindrome muy, pero muy particular, producido por el crecimiento exagerado de bacterias en el intestino delgado. Qué sucede exactamente...
#Sigue
👇🏼
#Sigue
👇🏼
🔺Como todos sabemos, el tracto digestivo está integrado por la boca, el esófago, el estómago, el intestino delgado, intestino grueso, recto y ano.
#Sigue 👇🏼
#Sigue 👇🏼
Diet, gas, and the #microbiome 💨
#MedTwitter #GITwitter #diet #nutrition #IBS #SIBO
sciencedirect.com/science/articl…
#MedTwitter #GITwitter #diet #nutrition #IBS #SIBO
sciencedirect.com/science/articl…
💨The gut microbiota generates ~0.2L–1.5L of gas per day
💨>99%: hydrogen (H2), carbon dioxide (CO2), & methane (CH4)– *odorless*
💨foul smell of gas from <1%: sulfur–containing gases hydrogen sulfide (H2S), methanethiol (CH3SH), dimethyl sulfide [(CH3)2S] + volatile compounds
💨>99%: hydrogen (H2), carbon dioxide (CO2), & methane (CH4)– *odorless*
💨foul smell of gas from <1%: sulfur–containing gases hydrogen sulfide (H2S), methanethiol (CH3SH), dimethyl sulfide [(CH3)2S] + volatile compounds
🦠bacteria in the colon ferment substrates that are not digested or absorbed in the upper GI tract (e.g. carbohydrates, proteins, fats)
🦠produce short-chain fatty acids, branched-chain fatty acids, ammonia, N-nitro compounds, phenolic and indolic compounds, and various gases
🦠produce short-chain fatty acids, branched-chain fatty acids, ammonia, N-nitro compounds, phenolic and indolic compounds, and various gases
🧵 Thread zum Thema #GI #gastrointestinale Probleme im Zuge von #LongCovid
Viele #longcovid (und auch #mecfs) Betroffene berichten von anhaltenden Verdauungsproblemen wie Durchfall - #Diarrhoea nach der Infektion.
Auch ich habe seit 11 Monaten eine gestörte Verdauung …
1/17
Viele #longcovid (und auch #mecfs) Betroffene berichten von anhaltenden Verdauungsproblemen wie Durchfall - #Diarrhoea nach der Infektion.
Auch ich habe seit 11 Monaten eine gestörte Verdauung …
1/17
6 Monate nach der Infektion wurde es immer schlimmer, unverdaute Substanzen im Stuhl, anhaltender Wasser- und Kräfteentziehender Durchfall.
Ich lies eine #Mikrobiomanalyse einer Stuhlprobe durchführen. (Kosten: 130€)
2/17
Ich lies eine #Mikrobiomanalyse einer Stuhlprobe durchführen. (Kosten: 130€)
2/17
Mit folgenden auffälligen Ergebnissen:
1. #leakygut, … heißt mein Darm ist löchrig und Stoffe die eigentlich ausgeschieden in die Toilette gehören, landen leider auch im Blut, woraufhin leider auch das Immunsystem wie zb #Mastzellen reagieren können.
3/17
1. #leakygut, … heißt mein Darm ist löchrig und Stoffe die eigentlich ausgeschieden in die Toilette gehören, landen leider auch im Blut, woraufhin leider auch das Immunsystem wie zb #Mastzellen reagieren können.
3/17
@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
🌬️ Breath testing for #SIBO: everything you need to know! 🎈 😮💨 💩 🦠 🐄 📈
#MedTwitter #medicine #science #GITwitter #GI #microbiome #IBS #diet #nutrition
cghjournal.org/article/S1542-…
#MedTwitter #medicine #science #GITwitter #GI #microbiome #IBS #diet #nutrition
cghjournal.org/article/S1542-…
To kick things off: how do you diagnose #SIBO?
#SIBO is a disorder characterized by excessive colonization of the small intestine by organisms usually found in the colon, especially Gram-negative bacteria.
(NB: the more we learn, it seems the *type* of bacteria is more important than the *number!*)
(NB: the more we learn, it seems the *type* of bacteria is more important than the *number!*)
While we're beginning to understand more and more about the #microbiome, research on the #mycobiome (fungi 🍄) is in its infancy. Here is my summary of 🔑 points from @aeprobio's seminar on the latest research on fungi and the gut!
#GITwitter
#GITwitter
Bacteria in the #gut outnumber fungi as a class, but at the individual species level can occur in the same numbers.
Most #gut fungi belong to Ascomycota or Basidiomycota
I was harmed by #CBT/GET not bc I was forced into the torture (aka #MEcfs) Clinics but bc lack of education meant #NHS Dx me w/ Depression as cause of #PEM, #BrainFog & debilitating #Fatigue and was then traumatised by #Psychiatrists who told me I was to blame 1/
I was a happy, successful, yoga pant wearing, posh gym attending, green juice drinking, extroverted Californian forced to undergo #CBT w/ stern British #Psychiatrists. I wasn’t Depressed until I met them, temporarily saved by acceptance into @BerkeleyHaas MBS program 2/
MBA life is hectic, exhilarating & inspiring. In remittance, I love people & Academics so got involved in everything. For 2nd year, I got a position teaching undergrad Business. An income meant I moved into nicer apartment, flew business clothes to NYC for Reuters internship 3/
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
Let's talk about something common, hard to treat, and often misunderstood: CHRONIC BLOATING AND DISTENSION!
A 🧵 summarizing from the excellent @AGA_CGH article cghjournal.org/article/S1542-…
#GI #GITwitter #motility #IBS #DGBI #FGID #microbiome #health #MedEd
A 🧵 summarizing from the excellent @AGA_CGH article cghjournal.org/article/S1542-…
#GI #GITwitter #motility #IBS #DGBI #FGID #microbiome #health #MedEd
🟢Bloating: subjective sensation of gassiness, trapped💨, or a feeling of pressure or being distended w/o obvious visible distension.
🟢Distension: objective physical manifestation of an⬆️in abdominal girth. Patients commonly say they look like 🎈 or 🤰
🟢Distension: objective physical manifestation of an⬆️in abdominal girth. Patients commonly say they look like 🎈 or 🤰
Bloating and distension are COMMON
🔴16-31% in the general population
🔴Women > men
🔴66-99% in #IBS
🔴IBS-C > IBS-D
🟢Bloating and distension are distressing to patients and ⬇️quality of life
🔴16-31% in the general population
🔴Women > men
🔴66-99% in #IBS
🔴IBS-C > IBS-D
🟢Bloating and distension are distressing to patients and ⬇️quality of life
#Hydronomastics is the study of #hydronyms, the proper names of bodies of water.
It's a branch of #toponomastics, the study of #toponyms (the proper names of places), which in turn is a branch of #onomastics, the study of #orthonyms (proper names).
French / Luxembourghish sign:
It's a branch of #toponomastics, the study of #toponyms (the proper names of places), which in turn is a branch of #onomastics, the study of #orthonyms (proper names).
French / Luxembourghish sign:
#Hydronym and #hydronomastics both derive from Ancient #Greek ὕδωρ / húdōr (water) + ὄνομα / ónoma (name).
#Hydronyms tend to outlast other #toponyms, even when new #languages and cultures displace earlier ones.
#England, #EastAnglia, #Essex, and #Sussex are named for the #Angles and #Saxons; but #Trent, #Ouse, #Thames, #Severn, and #Avon are older #Celtic and #RomanoBritish names.
#England, #EastAnglia, #Essex, and #Sussex are named for the #Angles and #Saxons; but #Trent, #Ouse, #Thames, #Severn, and #Avon are older #Celtic and #RomanoBritish names.
I don’t know how to get the word out about this. I am concerned about #MECFS patients who are a) having craniocervical fusions b) in Europe and c) are not actively engaged in patient groups on Facebook. [1]
My primary concern is that a significant proportion of patients who have fusions experience an initial improvement, but then have worsening symptoms roughly 5-7 months after surgery.[2]
In many cases, this is due to the “unmasking” of tethered cord syndrome, a condition many patients with craniocervical instability have. [3] me-pedia.org/wiki/Tethered_…
thread
Remarkable @bmj_latest @BMJCaseReports report documenting the extreme lengths a bedbound patient went through to get a diagnosis of #POTS, #MCAS, #SIBO and #tachycardia
read her story here
#MedEd #MedTwitter @MayoClinic
casereports.bmj.com/content/2018/b…
Remarkable @bmj_latest @BMJCaseReports report documenting the extreme lengths a bedbound patient went through to get a diagnosis of #POTS, #MCAS, #SIBO and #tachycardia
read her story here
#MedEd #MedTwitter @MayoClinic
casereports.bmj.com/content/2018/b…
2. After suffering for 16 years, seeing 19 docs with repeated misdiagnosis:
Her cardiologist couldnt diagnose #POTS
Her gastroenterologist couldnt diagnose #SIBO
Her immunologist couldnt diagnose #MCAS
Her neurologist referred her to a #psychiatrist!
casereports.bmj.com/content/2018/b…
Her cardiologist couldnt diagnose #POTS
Her gastroenterologist couldnt diagnose #SIBO
Her immunologist couldnt diagnose #MCAS
Her neurologist referred her to a #psychiatrist!
casereports.bmj.com/content/2018/b…
3. Patient: the "neurologist was out of ideas and suggested I get a psych evaluation, which I declined"
the patient <referred herself> to @MayoClinic
#SickNotWeak #chronicillness #chronicpain #MedEd #medtwitter
casereports.bmj.com/content/2018/b…
the patient <referred herself> to @MayoClinic
#SickNotWeak #chronicillness #chronicpain #MedEd #medtwitter
casereports.bmj.com/content/2018/b…
Penyebab sakit #gerd (Gastro-Esophageal Reflux Disease) atau naiknya asam lambung ke kerongkongan utamanya dikarenakan oleh #sibo (Small Intestines Bacterial Overgrowth) bagiaman hubungannya? A THREAD...
Saya akan ahare sebab GERD yang bersumber dari penelitian profesor mikrobiologi Norm Robillard), asam lambung yang naik ke kerongkongan itu kalau menurut medis konvensional adalah melemahnya katup/klep antara lambung dan kerongkongan. Tapi apakah sumber utamanya sakit #gerd ini?
1. Jadi sumber utama terjadi reflux adalah dari dorongan gas. Gas ini hasil fermentasi bakteri di usus kecil bawah lambung (kalau gas hasil fermentasi bakteri di usus besar keluar ke belakang jadinya kentut). Jadi sebab utamanya adalah SIBO (Small Intestines Bacterial Overgrowth)
