Tuesday, December 17, 2013

The Microbiome

I am fascinated by the new research and information on the gut microbiome.  These microorganisms (germs, bacteria, microbes) live harmoniously in every part of our body and especially in our gastrointestinal system.  It wasn't even really discovered until the late 1990s and we now know that these microbial communities affect our health in ways we never dreamed.  The human microbiome may play a role in obesity, immune response, diabetes, irritable bowel syndrome, and maybe even anxiety, depression and autism.

Anything that is this new has many possibilities the science is just starting, but there is clearly something very important here.   The Human Microbiome Project  is a NIH initiative with the goal of identifying and characterizing the microorganisms which are found in association with both healthy and diseased humans.  They intend to test how changes in the human microbiome are associated with human health or disease.

A new study published in Nature this week showed that adaptation to the gut microbiome can change in a day.  This is important because dietary changes can have a huge immediate effect on disease.  The researchers showed how immediate changes occur, depending upon subjects eating a plant based or animal based diet.  They fed the volunteers either plant (grains, legumes, fruits and vegies) or animal (meats, cheese, eggs) diets for 5 consecutive days.  They tracked food in the digestive tract, how the subjects felt and bowel movements.

The researchers analyzed 16S ribosomal RNAs to identify microbiome components in fecal samples, which were collected for several days before the dietary changes and each day during the study.
The animal-based diet clearly had a greater effect on the microbiome than the plant-based diet. Even after 1 day, the microbiome of those eating the animal-based diet differed significantly from baseline analyses.

The researchers found fecal bile acid changes in the animal based diet that are associated with liver cancer and Irritable bowel disease. These bile acids change the bile tolerant bacterium that is associated with IBD.

There is no cause-effect found here and the study size was too small to know what is actually occurring.  But the fact that changes could be found in the gut microbiome in such a short amount of time is compelling.  It is simply another potential explanation why diet is so important to health.  And changing our diet can have an immediate effect on our health.


Saturday, December 14, 2013

Answer to Medical Challenge



OK, the answer to yesterday's Image Challenge was #3, Squamous cell carcinoma.

Ninety percent of all mouth cancers are squamous cell cancer.  Factors that increase your risk of mouth cancer are:
  • tobacco use of any type (including smoking, chewing, cigars and pipes)
  • heavy alcohol use
  • Human Papillomavirus (HPV)  (think of Michael Douglas)
Usually surgery is needed to treat squamous cell carcinoma in the oropharynx, along with radiation therapy to eradicate all of the cells.

Wednesday, December 11, 2013

Image Challenge

Back by popular demand is this weeks medical challenge where you get to make the diagnosis. (click on the image for a close up view)

The patient opens his mouth, says "ahhh" and this is what you see.  Is it:

1. Aphthous stomatitis
2.  Pyogenic granuloma
3.  Squamous-cell carcinoma
4.  Syphillis
5.  Traumatic fibroma

Make your diagnosis in the comments section and check back tomorrow for the answer.

Sunday, December 8, 2013

Things Doctors Do (That Normal People don't)


I have been too swamped to blog recently on EverythingHealth, spending lots of time with my physician colleagues (as well as patients).  I realized that doctors are really not normal when it comes to a few things.  Here is a list of things doctors do that normal people don't.  You may have more to add!
  1. Eat standing up, while walking or while charting on patients
  2. Take expired medication (we know that expiration date is phony)
  3. Work hard-core, even when sick
  4. Don't get regular check-ups
  5. Cannot watch doctor TV shows (House is especially intolerable)
  6. Freely discuss body functions at dinner.  Nothing is off limits
  7. Silently diagnose medical conditions on strangers.  No lump or rash goes unnoticed.
  8. Combine vacations with work
  9. When we shake hands, think "Oh, that's a nice vein"
  10. When our child is hemorrhaging, we can fix anything with steri-strips
  11. Seldom use antibiotics on ourselves or family
  12. Listen to lectures and medical information while commuting
  13. Take suitcases full of journals to catch up on when on vacation
  14. Carry stethoscope, and full medical supplies in our trunk because "you never know"
  15. Seldom take vitamins or supplements
I'm sure I'll hear from my nurse and doctor readers, or spouses of medical people if I got something wrong. 

Coffee, Tea and Heart Disease