John Damianos, M.D. Profile picture
Aug 26, 2021 30 tweets 20 min read Read on X
Thank you so much to @DrPraegers for having me to discuss the effects of plant-based diets on the #gut #microbiome! Here are my slides for all to see! 😃

🍅🥑🧅🍑🥦🍒🫑🍊🌶️🍎🍆🍊🫒🍓🥒🍉🥗🥝🦠

#medicine #medtwitter #diet #nutrition #GITwitter #GI #guthealth #health
Just as we do things for heart health and brain health, our #microbiome is an organ of its own (the size of a 🥭), so we need to take care of it!
The #microbiome affects almost all organ systems!
Long term dietary patterns are important contributors to the composition of the #microbiome
Dysbiosis contributes to the development and maintenance of many chronic diseases
The Western diet induces metabolic endotoxemia which stimulates the perpetuation of inflammation
The microbiota can activate pro- and anti-inflammatory metabolites via specific metabolites based on components of the #diet
Like in life, #diversity is good for the #microbiome!
Prebiotic fiber makes our friendly bugs happy and ultimately suppresses inflammation!
Two examples of downstream effects of SCFAs from fiber (gut-brain axis and immune system)
Specific plant foods support the good guys in specific ways. This is another reason why dietary diversity is good!
Associating bugs with health and disease states, and how diet manipulates this
High intake of animal protein adversely impacts the #microbiome and damages the gut epithelial barrier
High fat diet ▶️ systemic inflammation 🔥
TMAO and CVD
Switching to a vegan diet dramatically ⬇️ TMAO levels
Processed foods can promote inflammation, which is why we advise #IBD patients to minimize or avoid!
Here's my prescription for a #microbiome friendly #diet and some bonus ways to support our friendly bugs!

#GITwitter #GI #health #nutrition #guthealth

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More from @john_damianosMD

Mar 14
A master class on prokinetics from @NGMJournal! Here is a summary! 🧵👇

⚡️🎈〽️🪠🫀💩🚄🧠✳️🗯️💊📰🚽🔌🧪💡🧲📊🔎

#MedTwitter #GITwitter #motility #pharmacology

onlinelibrary.wiley.com/doi/full/10.11…
Image
Pyridostigmine & neostigmine
⚡️cholinesterase inhibitors
🧠pyrido should not cross the blood-brain barrier
🚽evidence in chronic idiopathic constipation and acute colonic pseudo-obstruction
🫄pregnancy class C; excreted in breastmilk
🫀cholinergic side effects, esp bradycardia Image
Acotiamide
⚡️inhibits cholinesterase and enhances ACh release via muscarinic receptors
🎈enhances gastric emptying and accommodation
🔥NERD & FD
🫄no safety data
💊side effects: nausea, abdominal distension, constipation Image
Read 20 tweets
Dec 15, 2022
I gave a talk on inpatient bowel regimens today for the @YaleMed @YaleIMed residents and students, with additional 💎s on outpatient #constipation. Here are the slides!

💩 💩 💩

#MedTwitter #GITwitter #motility #MedEd @YaleIM_Chiefs @MayoClinicGIHep
Most inpatients require a bowel regimen. Our patients typically have most of the risk factors for #constipation!
#Constipation is more about symptoms than frequency! 🚽

It’s also a *symptom* (like chest pain), so need to figure out what’s causing it and treat accordingly.
Read 20 tweets
Dec 13, 2022
💨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
🦠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
Read 15 tweets
Oct 23, 2022
Summarizing our learning at #ACG2022 today! 🧑‍🎓

@tinahamd @AmCollegeGastro #MedTwitter #GITwitter
💎 GI bleeding🩸
💎#IBD
Read 8 tweets
Oct 23, 2022
Management of benign anorectal disorders with #AdilBharucha

#MedTwitter #GITwitter #ACG2022 Image
🔑Have patient complete symptom questionnaire to get a more detailed picture of their symptoms Image
🔑Digital rectal examination Image
Read 17 tweets
Oct 23, 2022
Chronic constipation is common and has tremendous impact on quality of life
#Constipation is NOT all about frequency. Ask about 👇
Read 20 tweets

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