Free Online Webinar for IBS, Functional GI Disorders with Dr. Drossman, “Achieving Effective Patient-Provider Communication” on April 24, 2017

April 17, 2017

The American College of Gastroenterology has announced that for IBS Awareness Month, it will be sponsoring a free online webinar presented by Douglas Drossman, MD, MACG  and one of his patients, Katie Errico on “Achieving Effective Patient-Provider Communication.” The webinar will take place on Monday, April 24, 2017 from 8:00-9:00 p.m. Eastern time. The webinar is designed specifically for people with irritable bowel syndrome and/or other functional gastrointestinal disorders.

Dr. Drossman, a leading, internationally-known expert on IBS, functional gastrointestinal disorders, doctor-patient relationships and the biopsychosocial approach to medical care, is President of the Drossman Center for the Education and Practice of Biospsychosocial Care, President of the Rome Foundation, Professor Emeritus of Medicine and Psychiatry at the University of North Carolina at Chapel Hill, retired co-director of the University of North Carolina Center for Functional GI and Motility Disorders and a longtime board member of the International Foundation for Functional Gastrointestinal Disorders,  along with many other pivotal roles in the development of the field of functional gastrointestinal disorders like IBS over his 40+ year career.

To participate in the webinar, please use the link to register. You will need to provide ACG with your full name and email address so that instructions for accessing the webinar on the scheduled date can be sent to you. It is open to anyone in any geographical location who has Internet access fast enough to handle streaming video, audio and chat technology. You will be able to ask questions after the presentation. Please keep in mind that Dr. Drossman cannot diagnose or treat anyone over the Internet, and depending on the number of participants and questions, he and Ms. Errico may or may not be able to get to every question.

“Achieving Effective Patient-Provider Communication” online webinar with Dr. Drossman, April 24, 2017

This is a tremendous and rare opportunity, especially for people with IBS or their loved ones to hear from and communicate directly with one of the world authorities and pioneers in the research, education and treatment of IBS. IBS Impact thanks ACG for making this webinar possible. We also thank Dr. Drossman for taking time out of his busy schedule to make himself available to the general public, and for his long decades of commitment to making functional gastrointestinal disorders like IBS a serious field of medical research and to supporting and treating many who live with these complex conditions.

 

 


Free Online Webinar for IBS with Dr. Drossman, “How to Make the Most of Your Doctor Visit” on April 16, 2015

April 4, 2015

The American College of Gastroenterology, the Rome Foundation, and the International Foundation for Functional Gastrointestinal Disorders (IFFGD) have announced that for IBS Awareness Month, they will be sponsoring a free online webinar presented by Douglas Drossman, MD, MACG on “How to Make the Most of Your Doctor Visit.” The webinar will take place on Thursday, April 16, 2015 from 8:00-9:00 p.m. Eastern time. The webinar is designed for people with irritable bowel syndrome and family members, but health care professionals are also welcome to attend.

Dr. Drossman, a leading, internationally-known expert on IBS, functional gastrointestinal disorders, doctor-patient relationships and the biopsychosocial approach to medical care, is President of the Drossman Center for the Education and Practice of Biospsychosocial Care, President of the Rome Foundation, Professor Emeritus of Medicine and Psychiatry at the University of North Carolina at Chapel Hill, and retired co-director of the University of North Carolina Center for Functional GI and Motility Disorders, along with many other pivotal roles in the development of the field of functional gastrointestinal disorders like IBS over his 40+ year career.

Dr. Drossman will take questions of general interest at the end of his presentation, or they can be emailed in advance through the American College of Gastroenterology at jgaulin@gi.org. Further details are available at the link below. To participate in the webinar, please use the link to register. You will need to provide ACG with your full name and email address so that instructions for accessing the webinar on the scheduled date can be sent to you. It is open to anyone in any geographical location who has Internet access fast enough to handle streaming video, audio and chat technology.

“How to Make the Most of Your Doctor Visit” Webinar with Dr. Drossman, April 16, 2015

This is a tremendous and unique opportunity, especially for people with IBS or their loved ones to hear from and communicate directly with one of the world authorities and pioneers in the research, education and treatment of IBS. IBS Impact thanks ACG, the Rome Foundation and IFFGD for making this webinar possible. We also thank Dr. Drossman for taking time out of his busy schedule to make himself available to the general public, and for his long decades of commitment to making functional gastrointestinal disorders like IBS a serious field of medical research and to supporting and treating many who live with these complex conditions.

 

 


American College of Gastroenterology Issues 2014 Evidence-Based Review on Irritable Bowel Syndrome (IBS) Management

August 10, 2014

This past week, on August 5, the American College of Gastroenterology Task Force on Functional Bowel Disorders, publicly released the 2014 ACG evidence-based systematic review on the management of irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC), also known as functional constipation. The last such review was in 2009. The updated review was issued as a monograph supplement to the August 2014 issue of The American Journal of Gastroenterology. The full 25 page text in PDF format is accessible at the above link.

The task force included eight leading expert clinicians and researchers of functional gastrointestinal disorders from various academic research centers in the United States and Canada. The chair was Eamonn Quigley, MD, FRCP, FACG of Houston, Methodist Hospital and Weill Cornell Medical College. Other members were Brian Lacy, MD, PhD, FACG, of Dartmouth Hitchcock Medical Center, Anthony Lembo, MD of Harvard Medical School and Beth Israel Deaconess Medical Center, Paul Moayyedi, BSc, MB, ChB, PhD, MPH, FRCP (London), FRCPC, FACG of McMaster University Medical Centre, Yuri Saito, MD, MPH of the Mayo Clinic, Rochester, Lawrence Schiller, MD, FACG of Baylor University Medical Center, Edy Soffer, MD, FACG of the Keck School of Medicine, University of Southern California, and Brennan Spiegel, MD, MSHS of the UCLA School of Medicine. According to a press release sent directly to IBS Impact by the ACG media contact, “Dr. Moayeddi conducted the systematic reviews with support from Alexander C. Ford, MD, ChB, MD [sic], FRCP, and carried out the technical analyses of the data independent of the Task Force.” (page 2)

The task force sought to systematically examine and evaluate available research literature on a wide variety of conventional and complementary treatment interventions, both existing and relatively new, that are commonly used for IBS. These included but were not restricted to diet, probiotics, the non-absorbable antibiotic rifaximin (brand name Xifaxan), antidepressants, antispasmodics, peppermint oil, bulking agents and laxatives, including loperamide (Immodium), the 5-HT3 receptor antagonist alosetron (Lotronex for severe IBS-D, available under FDA-restricted distribution only because of past serious safety concerns), the 5-HT4 serotonin receptor agonist tegaserod (Zelnorm for IBS-C, no longer available in the United States because of past serious safety concerns), the chloride channel activator lubiprostone (Amitiza), psychological therapies such as hypnotherapy and biofeedback, herbal preparations, and acupuncture. The task force used preset criteria in selecting reliable studies to review and used meta-analyses when appropriate. The quality of evidence for the effectiveness of each type of treatment was graded, again using standard scales. The full report also notes instances of possible bias or other study limitations. The task force’s revised recommendations are based on the quality of evidence and other considerations like risks and costs and possible patient preferences.

Some of the notable conclusions of the task force follow:

Elimination diets may be helpful to some people with IBS, but the overall reliability of available evidence is “very low,”(page 56 of monograph, page 5 of PDF). The low-FODMAP approach specifically is considered to “show promise” but in need of more research to determine more precisely how or why it may work. (page 58 of monograph, page 7 of PDF.)  For those with IBS whom increasing fiber intake helps, the evidence is stronger for psyllium (soluble fiber) than for bran (insoluble fiber).  Probiotics can moderately improve global symptoms, bloating and flatulence in IBS for some people, but relatively few strains have been specifically studied for IBS, and it is not possible at this time to target specific individuals they may help or specific strains to recommend. Prebiotics and synbiotics do not have sufficient evidence of effectiveness.  Rifaximin has moderate evidence of effectiveness for diarrhea-predominant IBS, but the task force expresses concern about potential long-term antibiotic resistance, uncertainty about long-term effectiveness, and the relatively high expense of this treatment to patients. Linaclotide (Linzess in the United States; Constella in Europe) and lubriprostone (Amitiza) garner strong recommendations from the task force for use in constipation-predominant IBS. This is particularly of interest, since the vast majority of treatment types reviewed, even many long considered to be traditional, established approaches to IBS, have received “weak” recommendation (page 56 of monograph, page 5 of PDF). Also, the review concludes that there is increased evidence than in previous years to support antidepressants and psychological therapies as effective for IBS, however, the report notes that antidepressants tend to have various side effects that some people with IBS may not be willing or able to tolerate, and the dearth of mental health professionals knowledgeable about and experienced in psychological therapies for IBS is a barrier to widespread use of psychological treatments.

The task force emphasizes that although IBS research is quickly increasing and evolving, the vast majority of available treatments continue to be aimed at an individual’s predominant Rome criteria symptom, not on the global symptoms of IBS as a whole, and only a small subset of people with IBS tend to be helped by any given intervention. It is important to work with one’s personal physician and other health care providers to determine the appropriate management options for one’s own situation and preferences.

IBS Impact appreciates the work of the task force and ACG’s willingness to make this review readily available to the functional GI community, professionals and affected individuals alike. Although ACG’s recommendations for IBS management are not drastically changed from five years ago when the last review was published, it is clear that the field is moving incrementally forward. Periodic peer review is important to the scientific process and future advances, and the availability of this document provides a comprehensive summary and guidance to professionals providing health care to people with IBS and to interested people with IBS in the most current standards of care for IBS in the United States. When so many people with IBS, families and professionals continue to receive outdated or inaccurate information about basic aspects of IBS, an evidence-based document is an important tool in education and management of IBS.


Evidence-Based Guidelines and Resources for Irritable Bowel Syndrome (IBS)

April 27, 2012

A large part of being credible and effective self-advocates as people with IBS and family members is being well-informed ourselves as to what IBS is and is not and what reputable scientific research currently says about treatment options and other topics related to IBS. Functional gastrointestinal disorders like IBS, as well as many non-GI symptoms or disorders that commonly overlap with IBS, are generally not as well understood and often not as effectively treated as conditions with less complex and more obvious abnormalities. People with IBS, including many involved in IBS Impact, have had the experience of finding numerous conventional and complementary interventions to provide inadequate relief and, for months or years at a time, may be left largely to find our own way, because every person with IBS has a different experience, and even the most knowledgeable and well-meaning professionals do not have quick or easy answers. We understand on a very personal level the desperation that moderate or severe IBS can prompt during the worst phases to find anything or anyone that might help. This impulse toward self-advocacy and self-preservation can be a positive thing, but can also have negative consequences if not approached in an informed way.

Those who become active in the IBS community eventually become aware that as far as IBS is concerned, almost everybody has an opinion, whether it’s our peers with IBS, professionals in the field, books, articles, websites or support forums, our family and friends or colleagues, and the general public– and many of these opinions and experiences conflict with each other. How do we separate potentially useful information and resources from the myths, misconceptions, outdated data, or outright quacks selling supposed miracle cures? The science of IBS has a long way to go, but it has advanced quite a bit in the past couple of decades. Physicians and other health care providers who received the majority of their training some time ago, or people with IBS who have lived with the symptoms for many years simply may not be aware of newer developments. For example, as noted in this blog’s October 9, 2011 post, recent research at UCLA shows that large percentages of health care providers in local communities are not aware that international functional GI experts  no longer consider IBS a diagnosis of exclusion that requires numerous tests of every person with apparent IBS symptoms. That’s why education and awareness of all involved parties: people with IBS, our loved ones, health care providers and the general public are all important.

For IBS Awareness Month, two organizations have been highlighting online tools they offer that may be of use to people with IBS and those who support us. The IBS Network in the United Kingdom has newly launched an online, interactive self care plan that can be used by IBS Network members to track symptoms, learn about treatments through audio, video, case histories and exercises, and design a individual plan for self-management.  The American College of Gastroenterology has also called attention to its online IBS treatment matrix, first made available in 2009, that discusses commonly used treatment interventions that the user indicates. It also mentions other possible options for one to discuss with one’s own physician.

The matrix is based on a comprehensive, evidence-based review by the ACG in 2009 of common conventional and complementary treatments, and the strength or weakness of current scientific evidence for their effectiveness. The full, published report is linked above. For blog readers from the U.K, the British Society of Gastroenterology issued guidelines for IBS management in 2007 and the National Health Service’s National Institute for Health and Clinical Excellence released its own in 2008. The Gastroenterological Society of Australia professional guidelines on IBS, as last revised in 2006, are linked here.  To IBS Impact’s knowledge, there is no similar, publicly available, comprehensive official statement by the Canadian Association of Gastroenterology in regard to IBS. However,  its associated Canadian Digestive Health Foundation discusses the diagnosis and treatment process on this page. The New Zealand Society of Gastroenterology and the Irish Society of Gastroenterology, unfortunately, do not appear to have professional guidelines or consensus reports on IBS at this time.

IBS Impact is a grassroots group focused on awareness and advocacy and encouraging informed decisions by people with IBS and their family members. Please consult qualified health care professionals for advice on individual medical treatment concerns.  Many more original articles and links to reputable sources of information on IBS can be found on the IBS Impact main website.


Continuing Conversations with the Media about IBS

November 6, 2011

The American College of Gastroenterology recently held its 2011 annual meeting, distributing various media releases on the newest findings in the field. One IBS-specific topic, a Mayo Clinic study on the relationship of cumulative trauma or stress on the development of IBS, has generated particular interest from the mainstream national media in the past week or so, prompting coverage  by Forbes, Fox News, Time  and USA Today, among others.

Any major research insights from a respected medical center like the Mayo Clinic are welcome, as is quality coverage from news sources outside of IBS websites or small health care publications.  For those who are interested in public awareness and advocacy for IBS, these occasions are an opportunity waiting to be taken.

Extensive, national coverage in mainstream media doesn’t come along often. It is usually prompted by  a well publicized research finding like this one or, earlier this year, Cedars Sinai’s work on the antibiotic Rifaximin, which is still considered a controversial potential treatment for small intestine bacterial overgrowth (SIBO) or IBS-D. Smaller regional and local sources, such as this report from the Pueblo Chieftain, a southern Colorado newspaper, appear more likely to run stories with basic information about IBS. Although this example mentions possible interventions at length, and refers to IFFGD, such stories frequently are not as detailed as this one, may have errors or may not offer any resources for further information. Outside the IBS community, veterans’ organizations and websites following the legislative process, public awareness of the new VA regulations making IBS and other functional GI disorders presumptively service-connected disabilities for Gulf War veterans or  HR 2239, the Functional Gastrointestinal and Motility Disorders Research Enhancement Act, is scant.

Most media stories on any subject tend to die down quickly, but as self-advocates, readers of this blog can continue the conversation with the media and others who follow it. This task is made easier by the Internet age. Sometimes family and friends may forward a relevant article to people with IBS in an attempt to be helpful. If the sender is receptive, proactive self-advocates can use this as a starting point for discussing our own experiences with IBS and educating others. What is good about the content, and what is not so good? Does the treatment or research being discussed seem to correlate with our individual experiences or not? Even if no one sends such an article, people with IBS can send articles to others themselves. We can write emails or letters to editors or use the comment sections on media websites to explain our reactions.

Working with the media to highlight our issues and needs doesn’t necessarily mean granting a personal interview. Sometimes it is very simple outreach. A few years ago, the IBS Impact founder encountered  an online article riddled with factual errors, including confusion of irritable bowel syndrome and inflammatory bowel disease. A brief, polite email including a few links to correct information, was all it took to have the article promptly removed.  The IBS Impact website and blog usually get some hits from intelligently left comments and links left periodically on media articles. For more extensive awareness efforts, IFFGD has several Reporter’s Guides that can be downloaded by anyone and passed along to a journalist.

By making other readers and journalists aware, through our presence, that the community of people affected by IBS is huge and diverse—that there are different perspectives and experiences, successes and failures with different interventions— makes it clear to others that IBS, of all conditions, cannot be reduced to the sound bite of the day. The more we, as a community, are willing to do this, the better those without IBS will understand the complexities many of us with IBS  face physically, educationally, professionally and socially, and be more likely to support our efforts toward meaningful, productive change.

For original articles of interest to  those without IBS, see IBS Impact’s family and friends page on the main website. For more on telling others about IBS, see the September 18 blog post.