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

27 Aug
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

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
Read 43 tweets
10 Aug
Buckle up! This 🧵 is a deep dive into the #physiology of defecation, the mechanics of pooping! 🧰 🚽 💩

nature.com/articles/s4157…

#medicine #MedEd #science #GITwitter #GI #gut #motility #constipation #IBS
Defecation requires
1. intact #GI tract
2. coordination of many systems: neural (enteric nervous system, modulated by the peripheral somatic, autonomic and the CNS); muscular (smooth and striated); hormonal (endocrine and paracrine); and cognitive (behavioural and psychosocial)
#Constipation is the3⃣rd most common #GI symptom

💰 Annual cost of fecal incontinence and constipation: $1,594 - $7,522
Read 31 tweets
26 Apr
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/…
🧑‍⚕️-😷
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
Read 16 tweets
6 Apr
Foods in our #diet can alter the pro-inflammatory vs anti-inflammatory milieu of the intestinal #microbiome.

See 🧵 below for the findings!

🥬🍑🍅🍠🥚🍎🧀🍆🫒🫓🍇🥦🥑🥥🥯🌶️🧄🥖

#GITwitter #GI #gut #nutrition

gut.bmj.com/content/early/…
🥖 🥜 🐠 🌰
Breads, legumes, fish and nuts⬇️several pro-inflammatory pathways:
🫓⬇️pathogenic growth factors & endotoxins
🫓⬇️ pathogenic E. coli, Bacteroides fragilis, parabacerioides
🫓⬆️ammonia detoxification pathway
🌰🐟 🍑🥦
Nuts, oily fish, fruit, vegetables & cereals ⬆️short-chain fatty acid producers
🫑⬆️Faecalibacterium prausnitzii, roseburia hominis, and more

Bacteria ferment fiber and pectins to acetate and butyrate.

SCFAs have anti-inflammatory effects on the mucosa!
Read 20 tweets
8 Mar
A little late but better late than never! ⌚️ Here's a recap of @AmCollegeGastro Virtual Grand Rounds by @ScottGabbardMD on...... FUNCTIONAL DYSPEPSIA!
🤢🤢🤢

This is a VERY common entity that is underdiagnosed! #MedTwitter take notice!

#GITwitter #GI #gut
DYSPEPSIA = epigastric #pain. (can be associated with any other upper #GI symptom such as epigastric fullness, nausea, vomiting, or heartburn).

Dyspepsia is COMMON, and most cases are FUNCTIONAL (i.e., caused by brain-gut axis dysfunction)!
Like all disorders of gut-brain interactions FD pathophysiology is❌completely understood, but is thought to be complex+multifactorial. Components include
🤢disrupted duodenal barrier
🤢altered duodenal #microbiome
🤢dysmotility
🤢visceral hypersensitivity
🤢psychosocial stress
Read 22 tweets
28 Feb
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
🟢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 🤰
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
Read 13 tweets

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