Month: October 2014
Research in real time
This past week, I was reminded of the problem of fraud in medical research when the British courts ruled that the mother of a child with autism had lied about her child’s symptoms. The woman was a supporter of Dr. Andrew Wakefield, the British doctor who published studies connecting the Measles Mumps and Rubella – MMR – vaccine to autism based on “data” he made up.
Published medical studies, especially randomized controlled trials, remain the most reliable way for doctors to make treatment decisions. But, in addition to fraud, there are many other problems with medical research studies including the fact that they cost a lot of money to perform and take a long time to complete. An even bigger problem is that research studies have not been done for most of the questions that doctors and patients want answered. And even if there is a relevant published study, the people in the study may be very different from you.
FODMAPs
A few weeks ago, I was asked if I knew anything about the low FODMAP diet as a treatment for inflammatory bowel disease (IBD). I was sure this was yet another fad diet (or that the name was misspelled – seemed like FOD should be FOOD, right?) .
Imagine my surprise when I found detailed information about the diet and its use in treating irritable bowel syndrome (IBS) on the Stanford Health Care website. Irritable bowel syndrome is a chronic condition that causes abdominal pain, bloating, gas, diarrhea and other symptoms in the gut. It turns out that FODMAP is an acronym for Fermentable Oligosaccharide, Disaccharide, Monosaccharides and Polyol. All of these substances are found in certain foods and are types of carbohydrates. Researchers in Australia found that these carbohydrates are not well absorbed by the small intestine in people with IBS. As a result, the substances stay in the gut rather than being used by the body and they pull water into the gut. The FODMAPs can also be fermented by the bacteria in the gut which produces gas. All of this can lead to a bloating feeling, pain and other symptoms.
Food stories
Personal stories are very powerful.
Not just in magazines about celebrities but also in healthcare. In fact, there is a Department of Narrative Medicine at Columbia University (and at other universities) and several medical journals have created sections devoted to patient stories including the “Narrative Matters” column of Health Affairs.
I’ve written a lot about my fascination with food – how it affects inflammation, the psychology behind what we eat, how the food we eat affects the important bacteria in our gut (the microbiome) and more. I began wondering if food stories could be just as important as patient stories.