PodcastDX
This week we discuss vectors in a hotter world. Vector-borne diseases, which are transmitted by hematophagous arthropods such as mosquitoes, ticks, and sandflies, pose a significant burden on global public health. These diseases disproportionately affect populations in tropical and subtropical regions, where environmental conditions favor the survival and proliferation of vectors. Given that vectors are ectothermic organisms, their life cycles, reproduction, survival rates, and geographic distribution are heavily influenced by climate variables such as temperature, rainfall, and...
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This week we discuss the basics about a topic several of our guests have spoken about- Ehlers Danlos Syndrome or EDS. Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls. Connective tissue is a complex mixture of proteins and other substances that provide strength and elasticity to the underlying structures in your body. The Ehlers-Danlos syndromes received and this is what we now know: EDS are heritable connective tissue disorders affecting the quality of collagen in every...
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This week we discuss "Food is Medicine". The concept of "food is medicine" refers to the idea that certain foods and dietary patterns can play a significant role in promoting health, preventing disease, and managing chronic conditions. This concept is based on the notion that food is not only a source of energy and nutrients but also a powerful tool for influencing our physiological and biochemical processes. Access to affordable, nutritious food is crucial for good health, yet many Americans, particularly in under-resourced communities, face barriers. The result? A...
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Our guest today is Evelyn Gamble. Evelyn is a dedicated healthcare worker and passionate heart disease advocate. With a deep commitment to improving health outcomes, Evelyn uses her personal and professional experiences to raise awareness about heart health, particularly for young adults. As a strong voice for change, she aims to inspire others to take proactive steps in managing their heart health and to advocate for better care and resources for those affected by heart disease. Definition: A heart arrhythmia, also known as a cardiac arrhythmia, is an abnormal rhythm...
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This week's episode we will discuss the resurgence of TB/ Tuberculosis. TB is a treatable and curable disease. Active, drug-susceptible TB disease is treated with a standard 6-month course of 4 antimicrobial drugs that are provided with information and support to the patient by a health worker or trained volunteer. Without such support, treatment adherence is more difficult. Since 2000, an estimated 66 million lives were saved through TB diagnosis and treatment. A total of 1.5 million people died from TB in 2020 (including 214 000 people with HIV). Worldwide, TB is the 13th leading...
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Our guest today is a Physical Therapist that specializes in Sciatica. Dean Volk, MPT, and owner of Sciatica Relief Now, has spent over 33 years revolutionizing sciatica treatment. After owning three successful clinics and a cash concierge practice and working with professional athletes, Volk transitioned to a virtual model in 2018, turning this side hustle into a full-time operation in 2021. Now based in Santa Monica, CA, Dean and his team of coaches provide virtual consultations and coaching to clients worldwide, helping them live their lives to the fullest. The cornerstone of Sciatica...
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In this episode we will discuss Myasthenia Gravis, an Autoimmune Disease affecting the neuromuscular system of the body with Tasha White, Director of a new Non-profit organization called My Walk with MG located in St. Louis, MO. Myasthenia gravis is a chronic neuromuscular disease that causes weakness in the voluntary muscles. Voluntary muscles include muscles that connect to a person’s bones, muscles in the face, throat, and diaphragm. They contract to move the arms and legs and are essential for breathing, swallowing and facial movements. Myasthenia gravis is an autoimmune...
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This week we discuss blood clots A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a necessary process that can excessive blood loss when you have a cut, for example. Thrombosis is when a blood clot and reduces blood flow. There are two types: Arterial thrombosis occurs when a blood clot forms in an artery. Venous thrombosis occurs when a blood clot forms in a vein. When a clot forms inside one of your veins, it may dissolve on its own. However, sometimes a clot doesn’t dissolve on its own, or part of it...
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This week we discuss hearing loss. A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 20 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe or profound. It can affect one ear or both ears and leads to difficulty in hearing conversational speech or loud sounds. Hard of hearing refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as...
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In this episode we will discuss food safety at the holidays. From prep to serving there are important tips to remember to ensure a toxin free meal for everyone! Parties, family dinners, and other gatherings where food is served are all part of the holiday cheer. But the joy can change to misery if food makes you or others ill. Typical symptoms of foodborne illness, also known as food poisoning, are vomiting, diarrhea, and flu-like symptoms, which can start anywhere from hours to days after contaminated food or drinks are consumed. The symptoms usually are not long-lasting in healthy...
info_outlineThis week we will discuss the most common type of Ehlers-Danlos syndrome – the hypermobile type (hEDS, formerly also described as EDS type III or joint hypermobility syndrome), this is the type that most commonly presents to gastroenterology services.
As connective tissue is present throughout the body, many different structures around the body including the digestive tract can be affected by EDS. Connective tissue is present in the digestive tract and is essential to the passive mechanical movements needed to complete digestion. It has been suggested that any abnormalities in the connective tissues in the digestive tract are likely to alter the way in which it moves, which could contribute to the range of symptoms experienced by people with hEDS. Connective tissue is also present around the nerves of the digestive tract and abnormalities of this can potentially make the gut more sensitive. It is important to remember that whilst differences in the digestive tract function are likely to be present in hEDS, as yet diagnostic biomarkers have not been identified and more research is needed to better understand the nature and impact of connective tissue within the digestive system, particularly in the other subtypes of EDS.
The digestive tract starts at the mouth, and ends at the anus. Many aspects of the digestive tract can potentially be affected, including both the upper digestive tract (oesophagus, stomach and duodenum) as well as the lower digestive tract (small intestine, large intestine, colon and rectum). We frequently see patients who mainly have symptoms related to either the upper or the lower digestive tract only, and some research studies have found that a significant proportion of people with hEDS experience some kind of gastrointestinal symptoms.
What sort of gut problems can occur?
The type, frequency and severity of digestive symptoms can vary greatly from person to person as everyone with hEDS is different. The most frequently reported problems affecting the upper digestive tract are acid reflux and chronic/recurrent indigestion with pain or discomfort and early fullness after meals. The lower digestive tract can present problems such as constipation, abdominal pain, bloating, diarrhoea and a feeling of general abdominal discomfort. Nausea and vomiting can occur alongside any of the symptoms described above.
Delayed gastric emptying / dysmotility
The term dysmotility is often used to describe abnormal movements (e.g. sluggish movements or spasm) of the gut. Some hEDS sufferers can have a sluggish stomach, which means that there is a delay in the emptying of stomach contents into the small bowel, and this is often referred to as delayed gastric emptying. Delayed gastric emptying can range in severity from mild to severe, with the most severe form called gastroparesis (paresis = paralysis). A portion of hEDS sufferers do have delayed gastric emptying, however only a few will be severe enough to be diagnosed with gastroparesis. Patients with a lot of bloating and/or fullness after meals or nausea and vomiting can be tested for delayed gastric emptying, but it is important to note that so far a link between hEDS and gastroparesis has not been categorically established.
In other patients increased sensitivity of the stomach may be a more common problem. Both dysmotility and increased sensitivity of the stomach can be associated with symptoms such as acid or bile reflux, bloating, early fullness during meals/extended fullness after meals and nausea.
Heartburn / reflux
There is some preliminary research that suggests that people with hEDS are slightly more likely to have a small hiatus hernia at the lower end of the oesophagus. This means that the upper end of the stomach slips into the chest cavity through a small hole (hiatus) in the diaphragm (the large muscle that separates the chest cavity from the abdominal cavity). This is quite a common finding and is usually not dangerous, but it can mean that the muscle that closes to stop food or liquid contents of the stomach from escaping back up into the oesophagus is somewhat inefficient, resulting in the acid reflux and/or heartburn symptoms, and this is called gastroesophageal reflux disease (GERD or GORD). However, it is also possible to experience reflux and/or heartburn symptoms without having a hiatus hernia. These symptoms can be associated with dysmotility, increased sensitivity of the oesophagus, or be experienced in isolation with none of these underlying causes.
Bloating
Abdominal bloating is a common symptom in people with hEDS, and although the underlying causes are not fully understood, it is thought that dysmotility may be a contributing factor. Overgrowth of bacteria of the small bowel can occur if there is stagnation within the bowel (i.e. constipation) and this can lead to excessive fermentation of food leading to production of gas, which can also be associated with bloating. A link between hEDS and bacterial overgrowth has not been categorically established and further research is required.
Constipation
Chronic constipation in adults is a common and debilitating problem and it is estimated that around 12 to 19% of the general population experience this, with females and the older population being more prone. Constipation is also common in patients with EDS and it is thought that a sluggish colon and difficulty with evacuation of the bowel are key causes. However there are often many factors inter-linked which can contribute to constipation such as diet, metabolic (hormone) or neurological (nerve) conditions, side effects of prescription medications, particularly opioid-based painkillers, or physical disorders such as prolapse of the bowel.
Rectal and genital prolapse are recognised as potential problems for some people with hEDS, and can be a factor contributing to constipation. Prolapse of the rectum means that the lining (mucosa) of the rectum (called a partial prolapse) or the entire rectal wall (called a complete prolapse) protrudes into the rectum, which interferes with the ability for a stool to be passed. Prolapses of the rectum usually occur during bowel movements, and then recede, but more advanced rectal prolapses can occur upon standing as well. However, in most cases prolapses tend to be small and do not require any active interventions. If a significant prolapse is diagnosed upon testing, and it is thought to be contributing to your gastrointestinal problems, your physician will refer you to a surgeon.
Functional gastrointestinal disorders
Sometimes people with hEDS who have symptoms such as reflux, heartburn, constipation or nausea may not have an identifiable cause of their symptoms on any medical testing and these patients are then given a diagnosis of functional gastrointestinal disorder (FGID). Patients who have symptoms with no underlying cause found account for more than a third of new referrals to gastrointestinal specialists, and so this is a common occurrence. A preliminary study amongst patients who were referred to a specialist because no cause of their symptoms could be found, demonstrated that over a third of those patients met the criteria for joint hypermobility and many of them had previously received a diagnosis of irritable bowel syndrome (IBS) or functional dyspepsia. IBS is the most common example of a FGID, and is characterized by recurrent abdominal pain and frequent changes in bowel habits. Functional dyspepsia is another type of FGID and relates to symptoms of upper abdominal pain, fullness, nausea and bloating, frequently following meals.