The Shift in Dementia Care from Control to Connection
PodcastDX
Today we’re continuing our Medicine in Transition theme with a topic that is deeply personal, professionally important, and long overdue. This episode is titled “The Shift of Dementia Care: From Control to Connection.” But we’re not doing this one alone. We’re joined by a special guest, Jennifer Stoner.Jennie is a retired professor from Aurora University in Aurora, Illinois, where she taught in recreation administration and therapeutic recreation, helping train future professionals to design meaningful, person‑centered programs for older adults and...
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Cancer Care in Transition
PodcastDX
In this week’s episode, “Cancer Care in Transition: Precision Medicine, Immunotherapy, and Patient Choice,” we look at how cancer treatment is changing at the exact moment when patients are trying to move from crisis mode into something like a new normal. Precision medicine now uses a person’s genes, tumor markers, and even lifestyle to match them with targeted drugs or immunotherapies instead of one‑size‑fits‑all chemo, while immuno‑oncology has created a growing group of survivors living with long‑term effects and unique follow‑up needs. At the same time, shared...
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The Dark Side of Patient Advocacy on Social Media
PodcastDX
The dark side of advocacy is that the same social media platforms that help health advocates reach millions can also expose them to relentless trolls, coordinated pile‑ons, and even threats to their safety and careers. Studies of physicians and public‑health advocates show that a large share—sometimes more than half—have been personally attacked online for speaking about vaccines, gun violence, or other health issues, facing abuse that targets not just their ideas but also their gender, race, disability, or identity. What starts as “just comments” can quickly escalate into doxxing,...
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Various Types of Dementia
PodcastDX
Various Types of Dementia This week on PodcastDX, we’re stepping into the complex world of dementia—not as a single diagnosis, but as a family of conditions that affect memory, thinking, behavior, and independence in different ways. We’ll introduce the most common types of dementia, including Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia, where more than one process—often Alzheimer’s plus vascular changes—are happening in the brain at the same time. We’ll also touch on less common causes, such as dementia related to...
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Rethinking DX: A Digital DSM and the Roots of Mental Health
PodcastDX
“Rethinking DX: A Digital DSM” looks at how the Diagnostic and Statistical Manual of Mental Disorders (DSM) quietly shapes almost every part of mental health care—from who gets a diagnosis and insurance coverage to how people understand their own symptoms and identities. In this conversation, Lita and Jean Marie unpack what the DSM actually is, why the current DSM‑5‑TR matters, and how a future, fully digital “DSM‑6” could function as a living document that updates more quickly, links to decision‑support tools, and better integrates real‑world data from electronic health...
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The Next Decade in Medicine
PodcastDX
Over the next decade, medicine won’t just add new gadgets—it will change what it feels like to be a patient. In this episode of PodcastDX, we explore how AI as a clinical co‑pilot, stem cells and regenerative medicine, genomics and precision care, wearables, and hospital‑at‑home models could reshape everyday care. We talk about the promise of earlier detection and more personalized treatment, the risks around bias, privacy, and hype, and why equity and shared decision‑making must stay at the center as technology races ahead. Most of all, we ask how patients and caregivers can be...
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Patients as Partners: Shared Decision Making in Medicine
PodcastDX
This week we are discussing the rise of a new type of health care where the patients play a vital role in their medical care. Patients as partners in care are at the heart of shared decision making (SDM), a model where clinicians and patients deliberately work together to choose tests and treatments that fit both best evidence and the patient’s values and life context. What shared decision making means SDM is a collaborative process in which clinicians contribute clinical expertise while patients contribute their goals, preferences, and lived experience. Core...
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End of Life in Transition: Earlier Palliative Care, Better Conversations
PodcastDX
At a time when modern medicine is allowing people to enjoy longer, fuller lives, mortality is not always a chief concern. But when a serious illness occurs, the topic becomes unavoidable. This became especially clear during the early days of the COVID-19 pandemic when hospitals were overrun with patients, many with grim prognoses. “The pandemic gave all of us a sense that life can be short and there’s the very real possibility of dying,” says , director of the Palliative Care Program at Yale New Haven Hospital. “It opened the door for us to talk more about death and have a...
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Is Mental Health Care Changing Fast Enough
PodcastDX
This week we discuss the current status of Mental Health Care. Mental health care is changing, but most experts argue it is not changing fast enough relative to the need, especially on access, equity, and workforce. Where change is too slow Unmet need is huge. In the U.S., millions with a diagnosable condition still receive no treatment each year; a recent national report notes that many adults with mental illness remain uninsured or unable to access care. Global workforce shortages. Nearly 50% of the world’s population lives in countries with fewer...
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Rehabilitation Reimagined: Technology, Therapy and Independence
PodcastDX
The integration of Artificial Intelligence (AI) into post-injury rehabilitation is transforming recovery paradigms by enabling personalized, adaptive, and efficient rehabilitation pathways tailored to individual patient needs. This podcast reviews the current advances in AI applications that facilitate assessment, monitoring, and optimization of rehabilitation programs following injuries. Through machine learning algorithms, wearable sensors, and predictive analytics, AI enhances the precision of therapy plans, tracks patient progress in real-time, and predicts recovery trajectories. The...
info_outlineThis week we will discuss Bile acid malabsorption (BAM), a gastrointestinal disease. It’s a common cause of chronic diarrhea. When bile acids aren’t properly absorbed in your intestines, they build up, upsetting the chemical balance inside. Excess bile acids trigger your colon to secrete extra water, leading to watery stools.
What are bile acids?
Bile is a substance your liver makes while filtering your blood. Your liver sorts waste products, such as toxins, dead blood cells and excess cholesterol into bile. Bile acids come from synthesizing these products together. The different acids in bile help to stabilize the lipids in the mix and keep them in a liquid form.
Your liver sends bile through your bile ducts to your small intestine to help with digestion. Bile acids in your small intestine help break down fats for absorption. When that work is done, they are supposed to be reabsorbed themselves, returning to your circulation and then your liver to be recycled into bile again.
What is malabsorption?
Malabsorption is any failure of your intestines to absorb all of the chemicals they’re meant to. Malabsorption can be a problem with your intestines themselves, or it may result from a chemical imbalance. For example, you may have too much or too little of a certain chemical for your intestines to absorb.
Who does bile acid malabsorption affect?
BAM has been historically underdiagnosed due to a lack of accessible ways to test for it. But studies now show that at least 30% of those diagnosed with functional diarrhea disorders may have BAM. Functional disorders are those that have no apparent cause and are likely to go undetected during a medical examination, such as irritable bowel syndrome (IBS).
BAM is seen in people with conditions such as:
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Diarrhea that persists after a bacterial infection.
It can also happen in people who receive certain medical treatments including:
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Surgical bypass or resection of the ileum, the last section of the small intestine.
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Gallbladder removal (cholecystectomy).
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Radiation therapy, especially in the abdominal-pelvic region.
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Metformin, a treatment for type 2 diabetes.
What are the symptoms of bile acid malabsorption?
Typical symptoms include:
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Watery diarrhea.
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Painful stomach cramps.
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Urgency and difficulty holding bowel movements in.
Some people also have:
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Steatorrhea (fatty stools.)
Long-term symptoms can include:
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Weight gain.
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Weight loss.
About half of people have constant symptoms, and the other half only report occasional symptoms.
What causes bile acid diarrhea?
The symptoms of bile acid malabsorption — primarily, bile acid diarrhea, or BAD — result from the buildup of bile acids in your colon, where food waste turns to poop. Normally, 95% of the bile acids in your small intestine are reabsorbed in the last segment (the ileum) before passing on to your colon.
When too many are left over, however, they pass into your large intestine with the rest of the waste. Bile acids in your colon irritate the mucous lining, triggering it to secrete extra fluid and speeding up the muscle contractions that move poop along. This causes frequent, urgent diarrhea and cramping.
What causes bile acid malabsorption?
What causes bile acids to build up in your intestines is another question.
Researchers have classified the possible causes of BAM into four different types. Sometimes they classify BAM as either primary or secondary.
Primary BAM is caused by your liver overproducing bile acids (types 2 and 4.)
Secondary BAM is caused by damage to your small intestine due to disease, surgery or radiation treatment (types 1 and 3.)
Type 1 BAM is caused by a problem with your ileum itself. This is considered true malabsorption, because the problem begins at absorption stage of the bile acid cycle. You may have type 1 BAM if you’ve had the last part of your small intestine surgically removed, altered or bypassed to treat another condition. Certain diseases, such as Crohn’s disease, and treatments such as radiation therapy can also damage the ileum. Significant damage impairs its ability to absorb.
Type 2 BAM has sometimes been called “idiopathic,” which means that it happens spontaneously or for unknown reasons. However, current research suggests that it's a problem with the chemical signaling between your intestines and your liver. This signaling is what normally regulates your bile acid cycle (enterohepatic circulation.) Chemicals in your blood signal when your liver should produce and deliver more bile acids and when it’s time to stop, reabsorb and recycle them. But with type 2 BAM, your liver doesn't get the memo to stop. So, it keeps sending bile acids — too many for your ileum to absorb.
Type 3 BAM is caused by gastrointestinal diseases that can affect your ileum along with other parts of your digestive system. These include celiac disease, chronic pancreatitis and small intestinal bacterial overgrowth (SIBO).
Type 4 BAM is caused by excessive bile acid production as a side effect of taking Metformin.