I had really bad IBS from consuming water on a tropical island in Panama one time and suffered for a few years with even my doctor friend telling me "Damn that sucks, not much you can do except manage". Pretty horrible symptoms until I discovered L. Reuteri. [1] I read that it's been a bacteria that was more commonly found in samples until around the 1950s when people started consuming more garbage processed food and was sold. Simply stated, it changed my life. It emits a substance called Reuterin which inhibits the growth of other more harmful bacterial species. [2] I can't speak personally for suffering on the level of Crohn's disease, but there's positive research out there regarding it. [3] [4]
> Damn that sucks, not much you can do except manage
This has been my entire experience with gastroenterology as a field. Once they rule out cancer there's really not much they can do for you. Meanwhile, I'm waiting for the revolution in our understanding of the microbiome.
I’ve been throwing up for a year straight. Recently it has gotten worse. The only thing that seems to help is weight loss. I just feel like there’s shit in the back of my throat multiple times a day (which I mean, there is) but the only way to clear it to my body’s satisfaction is throwing up. Gastroenterologist took a look and said everything looked fine. Thanks, doc, very helpful.
Not sure why people flagged the guy who said if I smoked a lot of pot it could be causing this. He’s totally right, my doctor did in fact ask me if I smoke a lot of marijuana or anything, as it can cause excessive vomiting. But no, that’s not why in my case at least. If someone could unflag him that’d be cool but I apparently can’t.
My teenager kid is having stomach pain, mostly after eating food. This has been going on for 3-4 years and we have seen 2 different doctors. They have done stool test, endoscopy and colonoscopy. However, everything is clean and they can not find a cause or treatment. So my child keeps taking pain killer almost every day and avoid eating when she is out. Unfortunately, they do not have any idea what might be going on while obviously something is wrong.
Does that happen with all food? Have you tried an elimination diet? Unfortunately chronic conditions like this are an absurd amount of trial and error in many cases.
That’s really unfortunate. I second what other people have recommended about attempting an elimination diet. I went on a ketogenic, minimal processed food diet of foods and it resolved a lot of these issues. I went back to eating like crap and the issues came back with a vengeance.
My philosophy is try what the doctors say and if that doesn’t work it’s time to expand your search space. Like troubleshooting code.
Please only take painkillers continuously under the direction of your doctor. A lot of people don’t realise this, but NSAIDs like ibuprofen and other types like paracetamol / acetaminophen do negatively impact your liver and / or kidneys, especially after repeated use. Always read and adhere to the label of the medication you take.
You should get a gastric-emptying study done. I had similar symptoms and was diagnosed with gastroparesis. Unfortunately, it's one of those "not much we can do" situations, but knowing what the underlying issue was allowed me to find a diet that got me back to a semi-normal life.
I’m not a doctor, and I don’t like to be that person pretending they know anything about other people’s problems, but two things come to mind, both long shots, that may plausibly help with the sensation of something in your throat: Gaviscon and Chloraseptic. Gaviscon (supposedly) reduces reflux by changing the physical properties of the contents of your stomach. Chloraseptic literally numbs your throat.
They’re both available OTC. Read the labels before using :).
Interesting. I was thinking of the mechanics of what's going on and it always feels like there's gunk I can't cough out in the back of my throat. Tried some Mucinex today, going to take it tomorrow morning and see if it prevents my early morning puke (which is mostly dry heaving as there's nothing actually in my stomach). I never ever feel nausea while I'm laying down or sleeping.
I do worry that with Chloraseptic I'm treating the symptom but not identifying and mitigating whatever the cause is, but I might try it to help keep me from throwing up! My wife recommended it the other day but I dismissed her out of hand. I really should listen to her more.
I just recently watched "Diagnosis" on Netflix. One of the cases seems similar. It may not help directly, but it's an all around interesting show, might want to have a look.
I think the vomiting might be a combination of food sensitivities causing problems and allergies. I ate nothing but meat and cheese for a few days (as I know I don’t react to these) and felt much better, but then I tried to stop taking my allergy medications and I started throwing up again.
I’ve lost 80 pounds before doing elimination, then 60 the last time (if I go back to SAD, I gain weight again).
Today I took Mucinex and Flonase and Xyzal, and haven’t thrown up yet. But there’s definitely some sort of food that I’m eating that exacerbates whatever is already happening. Thanks for the advice.
I had horrible sinus headaches and post nasal drip. It bothered me so much when a doctor would prescribe me flonase, just treating the symptom. It was all food, try chicken and rice. I live off meat and dairy now, but dairy can give people mucus so I'd cut it out initially. Also with the meat, avoid deli meats and bacon in the initial tests as they have sodium nitrite, turned out to be a trigger for me. Gluten too. Look at all the FODMAPs. Carnivore diet is a good shotgun approach.
For digestion issues it is usually a FODMAP, gluten, lactose, fructose, legumes. Everyone is different though so I try to not bias things. Chicken and rice, I'd recommend cutting out caffeine and sugar but it's a bit extreme, just mind what you drink for fructose and lactose.
There are actually biologic treatments for Crohn's/UC, not everyone responds but they produce remission which can spare or prolong time to surgery for many.
My life would be significantly less enjoyable without the foods that trigger my GERD. I'll stick with the small, cheap pill that lets me continue to enjoy carbonation, hot drinks, spice, chocolate, acidity, dairy, fried foods
My advice is to go to microbiome experts like Dr Borody, he has a lot more tools to help like fecal transplants and antibiotica for Crohn (long story, look at his videos). Borody is the one who invented the triple antibiotics therapy for the helicobacter pylori.
had the same experience. spent a couple thousand on colonoscopy and when the results were benign and it was "just" IBS, the gastroenterologist basically told me to go fuck myself. And eat more fiber.
So doing a search for "Reuteri" on Amazon, I immediately see several pages worth of supplements, with such helpful reviews as "HELPS DIGESTION. ENLARGES TESTICLES."[0]
How do you separate the trustworthy supplements from the snake oil?
There's one supplier I trust out of Sweden called Biogaia. [1] Look for the keith haring lookalike box art. I don't buy anything off of that website but it's something you can get a couple of weeks supply of from the pharmacy for under 100$.
Amazon is so full of scams, Jeff Bezos really needs to be held to account for that.
At my hospital we prescribe Lactobacillus reuteri for older patients on broad spectrum antibiotics to reduce the risk of C. difficile infection. The brand name used is ProTectis which appears to be exactly the BioGaia product another commenter was describing.
We have actually recently stopped using protectis in this way as the evidence base is too thin to justify the cost, but suffice to say that the Biogaia protectis is sufficiently genuine to be prescribed in UK hospitals.
Just echoing this. I've worked with marketing agencies who use Reddit to post things like this for their clients.
Both of those posts have the OP linking to specific products, with one of the OPs blatantly posting a referral link to a specific product.
Even without the links or mentioning specific products or brands, marketers will post things like this to build up markets, audiences and anticipation for new products, in this case it is a specific species and variant of bacteria.
It's pretty easy to suss out a lot of those accoutns just by looking at profile age and their comments. Sure, sometimes people sell their accounts but it'll be apparent eventually.
Having any sort of active microbiome is probably a good idea and an intended aspect of the human digestive system. I don’t know that this one specifically is better or worse but I would probably consider probiotics a decent idea to try.
The testes thing is… I guess vaguely plausible. I’m bemused everyone in the reviews seems to be confident that this is desirable. It seems like desperate people are just flocking to some study on rats.
Sure, but the parent comment was suggesting a specific bacterium, so I would want to make sure whatever probiotics I'm buying contain it. And normally I would probably just rely on getting them through a trusted vendor (e.g. my neighborhood grocer/pharamcy/health food store), but if I'm forced to shop online to make sure it has this specific thing in it...I want something I can check to vouch for its quality, yeah?
For example, pretty much every bottle of probiotics you buy will claim it contains "Over XX billion CFUs (colony-forming units?) in every pill!" But, are more better? Are they the right kind? Will I get 60 billion CFUs in a pill if I just dehydrate some pond water?
> And normally I would probably just rely on getting them through a trusted vendor (e.g. my neighborhood grocer/pharamcy/health food store), but if I'm forced to shop online to make sure it has this specific thing in it...I want something I can check to vouch for its quality, yeah?
Oddly enough, with the food/supplement I'm most familiar with, kava, the worst quality you can find is in brick and mortar establishments. The trusted vendors are all online-only and dedicated entirely to the one product instead of just trying to stock their shelves with every supplement on the planet.
Well I guess my thought process (however incorrect it might be) is that from a food safety perspective--not necessarily a supplement efficacy perspective--there's a greater bar to pass for the FDA to allow something to sit on the shelf at CVS than to get it from some random vendor on Amazon that might not even reside in the US.
I see. The fact is, the FDA doesn't regulate what's in supplements so it could be grass in those pills whether they come from Utah or Uttar Pradesh.
As for food safety, the standards are the same whether manufactured in the US or outside. The FDA ensures they comply with HARPC and are made in cGMP facilities.
The part titled "THE BEST MILK TO USE" is not good advice. UHT (ultra heat treated milk) is far better to use for yoghurt making than normal milk (I say "normal" for someone from the UK where most milk consumed is pasteurised at lower temperatures to avoid denaturing the milk).
Denaturing is a plus for making a yoghurt, and the high temperature also further removes bacteria that may spoil the yoghurt. It also means you don't need to go through the initial heating portion of most recipes and go straight to the fermentation phase at a lower temperature.
Yes you can make yogurt out of it. Technically speaking, lactobacillus refers to the fact that this bacterium produces lactic acid not that it consumes lactose.
It’s easy to confuse.
I just finished making 2 liters of yogurt with this bacterium this morning.
I took a couple of 40$ boxes of it for a few weeks and ever since, I've had no problems. Pretty great!
I buy a box every now and then since then just to keep it up. It's like the most expensive probiotic on the shelf, but it works.
Oh yeah, and I also stopped consuming crap that goes in the fridge or freezer ready to eat a long long time ago. I think that might have something to do with it. They found that there's certain harmful bacterial species which proliferate in such environments [1]
Also, people who are eating too many pre-made/processed/frozen foods might not be eating enough fresh, organic fruits and vegetables, which are a great source of helpful bacteria and the prebiotic fibers that keep them alive.
Jumping on this, modern refrigeration has helped us, as humans, tremendously in a lot of ways but hurts us too. Your example is a good one, but there's also certain kinds of mold that grow in the fridge on berries that cause weird stomach problems if you don't wash your fruit when you take it out.
Isla Bastimentos. It's in an archipelago that was like a pirate enclave back in the day where they speak a mixture of Spanish, English and French. Very cool place, I go to that region at least once a year actually - But that first one I was pretty naive and did what you shouldn't do, which is consume tap water (even if boiled) on a tropical island.
What's fun to do in that region is waking up early to take one of the speedboats that drops you off on cayes zapatillas, which are these small islands you can walk around in around 20 minutes. Make sure to bring water and wear sunscreen of course, but you get to feel like you're on a treasure island for a day and there's good snorkeling/diving reefs around there as well.
Just once. Drink bottled water when you go to these places. They are tropical islands covered in jungle trees where pumas swim between these islands, it's not that hard to realize why when you think about how water flows in a place where everything is trying to kill. It's terrifying until you realize all nature isn't disney.
On the one hand, it makes total sense to me that childhood antibiotics could mess up your digestive tract immune system. On the other hand:
"Subgroup analysis showed that antibiotic use <18 years old was a risk factor for CD development in the Chinese (adjusted OR 4.80, 95% CI 1.62–12.24; P = 0.005) but not in Australian populations (OR 1.80, 95% CI 0.33–9.95; P = 0.498)."
If it were a robust finding, it would not fall apart on subgroup analysis.
Actually the reverse, we should be skeptical of subgroup analyses, because they are often fishing for results, have issues with multiple comparisons, and are typically underpowered.
The healthcare needs to be completely overhauled. So many doctors are completely ignorant of risks of antibiotics and other meds.
There was a study that found 7% of doctors reported adverse reactions. Some were scared, some didn’t know how, some didn’t have time. Some doctors made no reports in nearly lifetime of practice.
When I was 16-22 I had multiple 6+ months courses of doxycycline for acne. I have seen multiple dermatologist who said nothing can be done about my cystic acne. At some point I was tired of doxy making me feel awful so I researched different skin types and skin care routines. As long as I use a mild soap twice a day, use a moisturizer and don’t touch my skin I get 0 cystic acne but it took weeks to see the results. No doctor ever told me about different types of skin and I was young and dumb. My parents didn’t know any better. And internet wasn’t as popular back then.
Then, I got an adverse reaction to cipro. And 40+ doctors ignored it. Told me it’s all in my head. Told me to seek help for my mental health and depression. Later FDA added warning about permanent nerve damage. I still have to send studies to doctors because they try to tell me I’m wrong, after I had every test under the sun to rule out other causes.
I help admin flouroquinolone toxicity group and every day we get individuals who were given these last resort meds for suspected infection. It is border line medical malpractice. However, I have seen that it is impossible to find a lawyer to take the case and find a physician willing to testify.
There needs to be a better system for tracking allergic reactions and trends. For example, cipro might show no reaction up to 6 months. Then, you snap your Achilles. The doctor won’t tell you it was cipro unless you tell him. It’s fucked and extremely underreported.
I research every prescribed treatment side effects after levofloxacin gave me bilateral achilles tendinitis. In my experience, potential side effects and complications from treatments are never discussed with patients.
I also had the displeasure of suffering from the mental side effects of the antiallergic montelukast, which again were not even mentioned by the doctor despite the serious FDA warning.
Doctors in the USA have no feedback mechanisms to know whether treatments work or not. They’re probably falling back to hunches in marginal cases. Also, if you are discussing treatment options with parents or patients, advising against antibiotics is a losing battle: the parent/patient gets angry whether you are right or wrong. The question of whether antibiotics would be helpful or ineffective means there is asymmetric risk. Even long term risks are unknown on an individual case by case basis.
There is definitely a mix of issues. Some patients expect antibiotics because they paid for the visit.
However, every physician should be able to present patient with different options and risks. It simply is not happening. Some antibiotics carry smaller risks than flouroquinolones as this drug belongs to topoisomare II inhibitors along with chemo drugs. Some reactions we are seeing are much like damage from chemo. However, the action of damage is still very poorly understood. There is some research on mitochondrial dna damage and adducts.
There recently has been talk if flouroquinolone antibiotics could be a potential cancer treatment even.
If I knew I would never touch this antibiotic unless on my death bed.
I live in an Asian country where antibiotics are massively overused. Go to the local pharmacy and tell them you have cold symptoms and you're likely to get 3 different full spectrum antibiotics.
I've asked a few pharmacists about this and the usually say they know it is bad but it is what people expect -- the more pills they get, the more effective they think the treatment will be. If you don't hand out as many pills as the pharmacy down the road then you'll lose customers and go out of business. So it is a race to the bottom tragedy of the commons kind of market failure that can only really be fixed with effective government regulation. Which isn't easy in a developing country, to say the least.
Is this Japan, perchance? Every time we take my kid to a doctor here they seem to reach for antibiotics. Extremely frustrating and the source of some cross-cultural marriage tension.
There are many things wrong with the Swedish system, but what they really managed well is to reduce the amount of prescribed antibiotics.
My partner is a GP and doctors need to justify antibiotic prescriptions ver specifically. It means that Sweden is still using many "old" antibiotics which are not used in most other European countries anymore due to high resistance there.
>The healthcare needs to be completely overhauled. So many doctors are completely ignorant of risks of antibiotics and other meds.
Doctors are well aware by my talks with them. There is unfortunately a large subset of the population that unless prescribed antibiotics feel that they have not been taken care by the doctor. So there is quite a demand.
The problem is how knowledge in managed in our society.
A central authority administering truth to the greater unwashed mass is the popular method.
And it seems to be built into us, to get our truth that way. Truth is what the authority tells us. Contriving truth yourself is generally considered a perversion.
So there's that inertia, keeping the knowledge management system stuck this way.
Maybe high-quality society-wide pervasive knowledge is impossible.
If you were damaged enough for long term side-effects it is likely to an extent an irreversible process, as it trends to be for many diseases.
That's not to say you can't have some recovery and adapt, just that what you were before is never coming back.
I developed diastolic dysfunction and severe sensitivities and food intolerances after Cipro and other antibiotics in 2014. The only way there could be a persistent diastolic dysfunction is if there has been permanent damage to the cells of the heart.
If he has input as to things which helped him I'd love to see, but as far as I understand, if the mechanism is indeed mtdna depletion and mutagenesis from excessive ROS then I don't really see how you actually cure that.
I know that aortic aneurysms is a common side effect.
There is variety of supplements one can take.
There is a physician in Germany Dr. Stefan Piper who published a book on it. He goes over possible therapies. Tendonitis usually gets manageable. Neurological symptoms are the ones that are more difficult to treat.
Some people report success with high dose thiamine, but high dose thiamine has been helpful in fibro and small fiber neuropathy along with alpha lipoic acid. Anti depressants can be also used to manage symptoms.
Some people reported resolution with pirenzepine. There is a drug company putting pirenzepine in a cream to treat nerve damage. That is currently in trials. I think the company is called WinSanTor.
My condition has improved but I still cycle. I’m taking antioxidants and other supplements that support mitochondria.
There is a sticky thread on reddit r/floxies, that discuss some of the supplements used and reasoning behind them.
I was never diagnosed with fluoroquinolone toxicity. Doctors don't really acknowledge it. The best you'd be able to do is a muscle biopsy, if you were able to convince.
With my heart we have echocardiograms from before and after the antibiotics and it went from normal with good parameters to abnormal with questionable parameters. Things like E/A reversal, a large increase in deceleration time, and a significant decrease in mitral valve bloodflow velocities. These are tell-tale signs that your heart is starting to struggle that usually aren't seen until like middle aged diabetics or later on for non-diabetics. But I'm 32, and previously above average fitness.
Likewise the food sensitivity reactions are mostly diagnosis by symptoms. I've had a mild elevation in tryptase during a reaction but everything else has largely been normal.
I used to take supplements but they never really seemed to do much. When I took things I needed because of malnutrition there were improvements but that was about it. Subjectively I would say I felt more energetic while on B complex and L-Carnitine but I eventually developed a sensitivity to those medications, as I do with anything I continually intake, because my immune system's mechanism of tolerance has been disrupted by the antibiotics (and maybe something genetic who knows).
I actually have spoken with a guy who got extremely sick after flouroquinolones and after taking antihistamines for a few weeks he went completely back to normal.
Your tryptase could be a sign of mcas. I would definitely explore if it seems like you are getting an allergic reactions to foods and things.
Antibiotics are actually really more damaging than we realise. Western digestive tracts show significant differences in microbiome that those of people who do not use antibiotics as treatment and some of the lost species are really important. We also have no way to fix it currently, some of the species like Faecalibacterium Prausnitzii are critical to our bodies energy system but can't survive in oxygen, so we have no way to eat it at all, you kill it then its gone likely for good. Others like Limosilactobacillus reuteri stop fungus from inhabiting our small intestine as well as other bacteria but just 5% of us still have some of it as its very susceptible to antibiotics.
We don't know what ideal microbiomes look like, we just know the bulk of people living in the western world have unhealthy ones that are missing key species and we have only scratched the surface of understanding.
People imagine some special mechanism of transfer, but the reality is that we get bacteria from inside and outside of our bodies all over stuff, all the time, and we’re crawling with it. The babies would be introduced to GI tract flora pretty much immediately even if you tried to prevent it (unless you prevent it with antibiotics of course).
I think there is even some evidence that cesarean births have higher risks of some infections because of not being exposed, I even recall that they did some things with babies being born with cesareans because of this.
But the feces is sterile. It's not even feces exactly, it's meconium and doesn't look like feces and doesn't smell at all (it's basically the remains of cells from the intestine and the amniotic fluid the baby swallows).
I have a child who had Crohns. This has been known since antibiotics were invented. All IBS conditions are caused by the wrong gut bacteria - typically c. diff - and the cure rate for fecal bacteriotherapy is about 95% in one shot. It's ludicrous that we're still studying this and acting as though it's such a mystery, while people suffer and die.
You are confusing Crohn's, an inflammatory bowel condition that is life long and can often be disfiguring and requiring surgery with IBS which is completely unrelated, non-inflammatory (if it were then it would not be IBS), with distressing but not usually life limiting sequelae. Do you even know what IBS stands for?
The fact is we do not understand the complete mechanisms of either Crohn's or IBS, but based on their presentation and treatment it is unlikely they are too closely related - and it is likely that IBS is itself due to multiple factors - hence it is a syndrome, not a disease.
Given this, it is hogwash to say all of any kind of condition is caused by one thing. And if there was a cure with 95% effectiveness, I am sure many of the affluent IBS sufferers on this site would have figured it out by now.
> and the cure rate for fecal bacteriotherapy is about 95% in one shot. It's ludicrous that we're still studying this and acting as though it's such a mystery.
Wife is a internal doctor (Switzerland's biggest hospital), and we were very wary about avoiding giving any kind of antibiotics before our kids reached age of 1. Common knowledge among peer doctors is that even single usage before 12 months significantly increases risk of diabetes later in life significantly (and god knows what other nasty side effects).
In some cases they are miracle cure, with some nasty side effects. But general over-prescription even in relatively developed world is ridiculous.
From my less developed and highly corrupt home (Slovakia/Czech republic), I often get news from friends who got prescribed full course of antibiotics on clearly viral infections. General doctors there are mostly on such an abysmal level that self-treatment is sometimes better than their clueless visits. Even for small kids.
Another item are painkillers - I see prescriptions for literally anything, usually heavy doses of paracetamol or ibuprofen but I've seen worse for maladies which don't warrant it. I don't even take those in pharmacies unless I know I have acute inflammation to treat.
My wife is a GP in Slovakia and she has a device for a quick test (CRP) whether you have a bacterial infection in blood or not. So they don’t prescribe antibiotics if the test is negative. And she doesn’t recommend them if not necessary - unfortunately many patients demand them because that’s what they expect to get. But she is maybe an exemption who cares a lot about each patient and invests into better equipment even though you are not really incentivized by the system to do so.
They still do. It's literally insane. Most will prescribe oral for everything even if it's just a cut. Not only will they give antibiotics they won't even tell someone to take a probiotic during treatment. Most doctors I've met over the years just phone it in and don't stay up to date on anything.
It’s partially doctors giving in to the demands of patients who want a prescription for everything. I think it’s a side effect of our expensive healthcare system. People don’t like paying their copay for just a band aid. Or to be told “it’s a virus, get some sleep and drink fluids”. They want to feel like they got something for their money.
Yeah, i remember being prescribed ampicillin and aspirin for every cold, as a child. They didn't care, they only wanted to "do something".
I remember in highschool having a colleague who's overprotective mother was also a germophobe, and was treating her only son with ever increasing doses of antibiotics every winter. By the time we met, pills had no effect(according to them, the hell knows what they meant by "effectiveness"), and he was getting intramuscular ones. The poor people probably never learned that there almost no antivirals, and are doing more harm that good. Antibiotics are thought to be a panacea around here, in eastern Europe.
I have Crohn's and I remember my pediatrician as being very willing to prescribe meds at the drop of a hat. I still remember the oral antibiotics I had as a little kid in the 70s. So this would not surprise me. A lot of the theories I've heard of Crohn's is it happens because modern humans are too clean, germ free and not riddled with parasites, giving the immune system too much free time at which point it starts attacking the gut.
I'm glad this just came up. My ten-year old nephew has been in and out of hospital stays for the past 4 years and was just finally diagnosed with Crohn's and released from a long stay at the hospital this week. They've now got him on a diet that they claim seems to help a bit but I haven't seen it. As a result of having undiagnosed Crohn's for some years he has fallen behind in school, with friends, and so on. If anybody is aware of any support groups, diets, good doctors, or any advice in general for young kids with Crohn's, please post. I may not have time to respond but I'll definitely read through responses. If an email is more appropriate you can send one to qbwkmaz@protonmail.com. Thanks in advance.
In my case, medicine and diet had little effect. And I was in pretty bad shape, i got to the emergency room several times a week with awful abdominal pain, vomiting, constipation. A different doctor adviced me to eat anything I want, but for at least half a year to eat kefir with every meal. That worked. Whenever I feel like my digestive tract is getting funny, i add a few bottles of kefir for a few days.
You have actual Crohn's or IBS? Because your symptoms while distressing don't sound like Crohn's at all. Crohn's is an autoimmune inflammatory condition with actual tissue destruction. People with Crohn's flares don't show up to the ED with constipation, they often show up with profusely bloody diarrhea. Additionally weight loss and anemia. They may likely require admission for high dose steroids. People with Crohn's will often need surgery. What you're describing sounds more like IBS.
A bottle of kefir is unlikely to hurt. However, I am quite skeptical that such a thing has any prophylactic effect once a recurrent process like Crohn's is set in motion - like pissing on a gasoline fire. A bottle of kefir is not going to touch an actual Crohn's flare at all.
There's no good evidence that any specific diets seem to help the chronic course of Crohn's unfortunately, and it's not like no one has looked.
I had chronic tonsillitis as a kid. The doctors treated it with antibiotics until finally after about 3 years they recommended I just get my tonsils out. I got diagnosed with UC about 14 years ago. Also have had psoriasis for years.
I blame both on excessive use of antibiotics as a 5 - 8 yr old.
Hey, me too. Kind of bummed that had to happen. I had a few invasive and unnecessary operations as a kid.
I walked on my tippy toes for example, and lost flexibility in my ankles. Rather than, you know, stretch and exercise my ankles… My Achilles’ tendons were cut and stretched, then I was in casts with my ankles extended for quite a while.
Nothing was really physically wrong, I was just a weird kid.
You may be interested in the book The Keystone Approach by Rebecca Fett. It goes over research into the connection between pediatric strep throat and psoriasis. IIRC(from the book), if you are diagnosed with psoriasis before the age of 40, there is a 90% chance that it happened shortly after a... bad case of strep throat? Tonsillectomy? I forget which. Pretty eye opening book with some good diet-based advice on reducing symptoms of psoriasis, if you are looking for relief.
Since you specifically mention one cure through removal, my data point on Crohns and surgery: Took years for me to finally get a clue about surgery for Crohns in a case as unremittant as mine. My guess at the time was that MDs consider referral to surgery as "medical failure" -- I've seen that term in the literature -- so do not volunteer the option.
Anecdata: Root canal, antibiotics, and first Crohns indications in the span of 10 days for me.
Medical failure in the literature is a jargon term. (Internal) medicine and surgery are traditionally two distinct fields of, er, medicine. So it is just a matter of fact that a disease such as Crohn's that is refractory or resistant to treatment with medicine is a "medical failure" - no spin on it, that's what we call it.
Biases in referral across services is a complicated topic, and there is quite a bit of literature about it over the years. I am not sure about Crohn's/IBD specifically, but it's one of the well known co-management touch-points between surgery and GI, so there might be something written on the subject. There are many complexities at play here, some is definitely due to human factors, but the simple thought of "medical failure" doesn't have much to do with it. The average internists make thousands of consults to surgery every year, so that's really not it, there's much more to it.
Thanks, very helpful. That is one less questionable inference I will carry around.
Speaking of complexities, I'm fairly sure the GI who did not refer me was married -- so he told me I'm 98% sure -- to a pharmaceutical salesperson who sold GI related infusions (and he got me in a perhaps unrelated study). There were other manner-related problems. .. Does not change my profound regard for MDs in general. (Have worked with MD/PhDs, wouldn't be alive without some interventions, very dedicated care, etc.) Be well.
Well when your kid is screaming in pain from an ear infection, I'm not sure I'm going to decline to treat them with antibiotics because of some small future risk of Crohn's disease.
Does the study recommend antibiotics not be used to treat ear infections? I would think the message is that it's even more important not to use antibiotics when they're not needed, not that they shouldn't be used at all
Or even disinfectants instead of antibiotics.
I've been using a few drops of hydrogen peroxide for ear infections forever and it always took care of them.
Why would I want to disturb my entire microbiome for a small local infection?
Topical antibiotics won't penetrate the inner ear. You can use drops for outer ear infections, but if it's on the other side of the ear drum, it needs to be oral antibiotics.
The other side of the ear drum is directly connected to the respiratory system though. It may not be good advice and children probably would hate it, but I am pretty sure that sniffing small drops of hydrogen peroxide solution helped with my ear infections.
Typically if a child has a middle ear infection, the eustachian tube is blocked. Otherwise the pressure from the infection would just drain through the back of the nose.
Do you think you should be writing medical advice?
Ear infections are dangerous. My nurse friend decided she didn’t need to go to a doctor for her ear pain (nurse knows best). A few days later two burst eardrums, blood running from ears. Fixing ear infections without losing hearing ability is a wonder of modern science. Good parents don’t risk their children going deaf.
The answer to bad doctors is not “don’t go to the doctor”.
The answer is to go to a good doctor.
It takes time and effort to find a good doctor. Worth the investment since health risks are very high expected personal costs. Or you are spending X% of your salary on health insurance, so the implication is that you should invest significant time and effort to get a good doctor.
Same with house purchases: treat that like a fucking degree you must learn, otherwise you are just gambling with quality years of your life (the extra years you work to buy a bad decision, the quality of life of the years you spend living on a property).
Either learn doctor and property knowledge (if you have the capacity to do so), or learn how to choose the right people to help you. Anything else is rolling the dice with your life and the lives of those you care for.
You misunderstand a doctor's role in your medical journey. Trying to find the mythical good doctor who will absolve you of any thinking is a path filled with failure. You need to take responsibility yourself and consult with different medical professionals if needed. Hoping to find the one good doctor who will put your interests above themselves and with the ability to battle with the insurance companies on your behalf is going to lead to a poor outcome for yourself.
Either learn doctor and property knowledge (if you have the capacity to do so), or learn how to choose the right people to help you. Anything else is rolling the dice with your life and the lives of those you care for.
That was the last sentence I wrote: I am explicitly saying to learn as much as reasonable and implicitly saying not to blindly trust doctors where possible. You appear to be avoiding answering the points I made and appear to have misunderstood what I wrote.
> ability to battle with the insurance companies
You are assuming I am in the USA: I am not. The USA health system is uniquely broken, and New Zealander’s don’t have the same problems that American’s have.
One of the reasons why antibiotics are somewhat ineffective against ear infections is because the bacteria develop biofilm that makes it difficult for both the immune system and treatments to reach that area.
Xylitol nose spray can help along with a humidifier and rubbing behind the ear to sort of try and disrupt the biofilm colonies.
Anecdotally I've also had great success with a supplement called X-INFX (and I've tried quite a bit including various antibiotics to no avail).
As far as preventative measures, keeping the inner ear dry with a quick dab of toilet paper or a little ear dryer pump goes a long ways.
It also helps if you get an ear cleaner, just in case you have hardened wax. For whatever reason, an ear infection sometimes causes wax to build up inside (which is a like a sticky conveyor belt your body uses to "churn" out debris and pathogens).
I make no judgement about whether or not to use antibiotics since that's not my expertise and I'm not a doctor. I'm just simply offering adjunct treatments that have historically worked for me and others.
I suspect (but have no science to back it up) that it’s a risk factor for many things. I had ear infections more or less constantly in my childhood and were on antibiotics the whole time until they finally stooped working. The end result is that I’m now deaf on one ear. I get why they were prescribed, it stopped the acute pain but no one thought about the long term
OMG, does anyone think that with samples size this small that this study means anything? The effect is barely significant, and the potential confounders could fill a dictionary.
Crohn's et al is important, but this study adds little more than noise.
And that sample size is pretty good considering the low incidence of Crohn's in general and the fact that study participants had to be sought out and recruited.
I’m not familiar with the 'Odds Ratio,' but after reading the Wikipedia page, it seems the number here represents a very weak correlation. Am I mistaken?
There are some other issues with this study that might strain credibility, but yes, I think you are mistaken about the size of the effect being reported.
At low prevalence probabilities, odd ratios are more or less just multipliers on the prevalence probability.
So if there is a 0.1% probability of developing Crohn's without childhood antibiotics, an odds ratio of 3.5 would mean that there is approximately an 0.35% probability of developing Crohn's with childhood antibiotics. That's 100 in 100k vs. 350 in 100k, and in my opinion that's not a small difference.
More generally, an odds ratio is the ratio of the odds of something under two different sets of circumstances.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917019/
[2] https://en.wikipedia.org/wiki/Reuterin
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270012/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468961/