Gastrointestinal

Underlying Causes and Causal Pathways are Largely Unknown (guess the disease)

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Using high-quality population-based cancer registry data until 2017, this study presents contemporary trends in early-onset colorectal cancer incidence across 50 countries and territories, including 12 additional countries (Argentina, Bahrain, Belarus, Chile, Columbia, Ecuador, France [Martinique], Iceland, Kuwait, the USA [Puerto Rico], Qatar, and Uganda) since the last published report on colorectal cancer incidence trends. The findings show that the rising incidence of early-onset colorectal cancer is no longer limited to high-income countries; it now extends to countries and territories in Latin America and the Caribbean (Argentina, Chile, Costa Rica, Ecuador, Martinique, and Puerto Rico), Asia (Israel, Japan, Thailand, and Türkiye), and eastern Europe (Belarus). Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data – https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00600-4/fulltext

Yikes.

Yogurt and CSBMs (Complete Spontaneous Bowel Movements)

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In a randomized controlled trial, the probiotic Bifidobacterium animalis subsp. lactis—used in many probiotic products, including Dannon’s Activia yogurts—did nothing to improve bowel health in people with constipation, according to data from a randomized triple-blind placebo-controlled clinical trial published Wednesday in JAMA Network Open. Popular gut probiotic completely craps out in randomized controlled trial – https://arstechnica.com/health/2024/10/popular-gut-probiotic-completely-craps-out-in-randomized-controlled-trial/

Here’s a lesson in the need to read the original study. I found this statement from the researchers:

The 2 study groups were very similar with respect to baseline characteristics. The participants had a low dietary fiber intake (9 g/d), which is in line with observations by others (11.7 g/d) and well below recommended levels (25.0 g/d).14 This may be a contributing factor to the bowel movement problems experienced by the participants. Eight-Week Supplementation With Bifidobacterium lactis HN019 and Functional Constipation – https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824333

IMO the low dietary fiber intake in this shitting study leads me to think the entire study results were…crappy.

BTW yesterday I had two CSBMs. That’s what I get for eating a bowl of black eye peas http://garyskitchen.net/2022/01/16/vegetarian-badass-black-eyed-peas-2022/ and a baked sweet potato in the same day.

The More Drugs You Take…(fill in the blank)

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This was a retrospective longitudinal cohort study of adults aged 60 years and older.

An increase in polypharmacy severity was significantly associated with a higher likelihood of all-cause hospitalization within 1 year, but not a hospitalization related to IBD. Use of a PIM (potentially inappropriate medication) was also associated with a higher probability of all-cause hospitalization compared with patients without. Hospitalization Risk in Older Adults With IBD Associated With Severe Polypharmacyhttps://www.gastroenterologyadvisor.com/news/hospitalization-risk-in-older-adults-with-ibd-associated-with-severe-polypharmacy/

Photo by Anna Shvets on Pexels.com

Everybody poops, but not every day

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Unsurprisingly, those who reported eating a fiber-rich diet, better hydration, and regular exercise tended to find themselves in the bowel movement Goldilocks zone. Timing is everything: Study finds link between bowel movement frequency and overall health — Institute for Systems Biology. “Timing is everything: Study finds link between bowel movement frequency and overall health.” ScienceDaily. http://www.sciencedaily.com/releases/2024/07/240716122711.htm (accessed July 18, 2024).

I could not resist posting about pooping.

Gut Bacteria May Drive Colorectal Cancer Risk

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The researchers found signs that a high-fat, low-fiber diet may increase inflammation in the gut that prevents it from naturally suppressing tumors. The cells of young people with colorectal cancer also appeared to have aged more quickly — by 15 years on average — than a person’s actual age. That’s unusual, because older people with colorectal cancer don’t have the same boost in cellular aging.

The rate of colorectal cancer among young people has been rising at an alarming rate, according to a 2023 report from the American Cancer Society. In 2019, 1 in 5 colorectal cancer cases were among people younger than 55. That’s up from 1 in 10 in 1995, which means the rate has doubled in less than 30 years. Young People’s Gut Bacteria May Drive Colorectal Cancer Risk – Medscape – June 06, 2024 — https://www.medscape.com/s/viewarticle/young-peoples-gut-bacteria-may-drive-colorectal-cancer-risk-2024a1000amd?src=rss

Yikes.

Gut Bacteria Break Down Cholesterol

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It has been established that the human gut microbiome affects cholesterol levels, and previous research has pointed to microbial enzymes that might be involved. A 2020 study2 identified a bacterial enzyme called ismA that can convert cholesterol into coprostanol, a lipid that is excreted instead of absorbed by the body. People whose gut bacteria made this enzyme had lower cholesterol levels in their blood than did those who did not. This study was published by the same research group — led by gastroenterologist and microbiologist Ramnik Xavier at the Massachusetts General Hospital in Boston — that is responsible for the new finding. Until now, it was not clear which bacteria produced enzymes that metabolize cholesterol.

For the current study, the researchers analysed microbial genomes in stool samples from 1,429 participants in a long-term study of risk factors for cardiovascular disease. The team found many gut-bacteria species, including those in the genus Oscillibacter, that were correlated with lower cholesterol levels. The researchers confirmed their results in participants in two independent studies.

Gut bacteria break down cholesterol — hinting at probiotic treatments – https://www.nature.com/articles/d41586-024-00955-3

Not confirmed in animal models or clinical trials.

But an OTC supplement will arrive on store shelves before any scientific confirmation is achieved.

Diet Until Proven Otherwise

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According to a study published in BMC Medicine, men who ate the most plant-based foods had a 22 percent reduced risk of colon cancer, compared with those who ate the least. Eating a plant-based diet increases consumption of fiber and antioxidants associated with cancer prevention, while simultaneously avoiding the compounds in animal products linked to cancer risk. It has long been known that people who avoid meat are at reduced risk.

The power of nutrition in cancer prevention — https://www.kevinmd.com/2024/02/the-power-of-nutrition-in-cancer-prevention.html

Also schedule that colonoscopy you’ve been putting off.

Undiagnosed Cirrhosis and Hepatic Encephalopathy in Dementia

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The findings of this cohort study suggest that, in a national veterans cohort of patients with dementia, 5% to 10% of the patients have laboratory values suggestive of possible undiagnosed cirrhosis that could implicate HE as a contributor to overall cognitive impairment. Patients in this study with possibly undiagnosed cirrhosis were more likely to be of races other than White, Hispanic, and urban-dwelling, and more likely to have AUD and viral hepatitis. These percentages of affected patients were corroborated with medical records review of 2 separate validation cohorts. In conclusion, FIB-4 should be considered as a screening tool to detect cirrhosis and potential HE in older veterans with dementia. Those with high scores (eg, >2.67) should be considered for further evaluation and treatment.

Undiagnosed Cirrhosis and Hepatic Encephalopathy in a National Cohort of Veterans With Dementia — JAMA Netw Open. 2024;7(1):e2353965. doi:10.1001/jamanetworkopen.2023.53965 — https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814346

Diet Until Proven Otherwise

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Plant foods, high in fiber, can reduce the contact of potential carcinogens with cells lining the digestive tract. The fiber causes food to travel faster through a person’s digestive system. This also reduces intestinal cells’ contact with bile acids, which can promote cancer growth. Fruits, vegetables, whole grains, and legumes also provide phytonutrients and antioxidants, which can help repair damaged cells and reduce cancer risk.

Why poor diets are contributing to a surge in colorectal cancer cases among young people — https://www.kevinmd.com/2023/04/why-poor-diets-are-contributing-to-a-surge-in-colorectal-cancer-cases-among-young-people.html

Life is short and science takes too long.

Change your diet. If you have any changes in your bowel habits, talk to your physician.

IBS – Diet or Medication?

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What are the new findings?

  • In a controlled trial enrolling 470 newly diagnosed primary care IBS patients, a self-management FODMAP-lowering smartphone application was superior to standard medical therapy in alleviating IBS symptoms.
  • The superiority of the diet app was already present at 4 weeks and persisted at 8 and 16 weeks.
  • The diet app had a high acceptability and adherence rate.
Diet or medication in primary care patients with IBS: the DOMINO study – a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute — https://gut.bmj.com/content/71/11/2226?rss=1