Podcasts about Gastroenterology

In our fourth Summer School episode this season, hosts Dr. Amber Hildreth and Dr. Jordan Whatley have taken highlights from past episodes on liver disease and put them into a special episode full of clinical pearls.Former expert guests Dr. Bill Balistreri, Dr. Jorge Bezerra, Dr. Saul Karpen, Dr. Dennis Black, Dr. Amy Taylor and Dr. Rohit Kohli cover neonatal cholestasis, biliary atresia, PSC, AIH, and MASLD.Our Bowel Sounds Summer School series will include four episodes each summer on big topics in our field, artisanally crafted for the ears of learners of all stages from the young student to the seasoned attending.Learning Objectives:Understand the evaluation of neonatal cholestasisReview the natural history of PSCReview the diagnosis and management of AIHUnderstand the diagnostic evaluation and management of MASLD.Featured episodes:1. Bill Balistreri- Neonatal Cholestasis2. Jorge Bezerra- Advances in Biliary Atresia3. Saul Karpen- Updates in Biliary Atresia4. Dennis Black- Primary Sclerosing Cholangitis5. Amy Taylor- Autoimmune Hepatitis Management6. Rohit Kohli- Fatty Liver DiseaseAdditional Links:1. Guideline for the Evaluation of Cholestatic Infants2. AASLD PSC Guidelines3. AASLD AIH GuidelinesSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

One camp says your reflux is too much stomach acid. The other says it's too little. Dr. Ken Brown says both camps are arguing over the wrong control knob.In this solo episode, the board-certified gastroenterologist makes the case that reflux was never an acid problem - it's a containment problem. Acid belongs in the stomach, and the real question nobody asks is why it left in the first place.Dr. Brown walks through the mechanics: the stomach as a one-way muscular pump, the lower esophageal sphincter as a nightclub bouncer who's started letting people back out the front door, the "acid puddle" that pools when the stomach won't empty, and the inflammation cycle that weakens the valve and keeps the whole thing self-sustaining. He looks at what 37 years of proton pump inhibitors have actually delivered - eight-plus drugs, an 83% rise in documented GERD, and a side effect list that includes bone, B12, magnesium, and kidney concerns - and points out that PPIs don't improve gastric emptying, don't reduce abdominal pressure, and don't strengthen the sphincter.He also tells his own story: 30 years of reflux, a four-centimeter hiatal hernia, grade C esophagitis, every natural remedy on the shelf, and the eight-year project to build something that addressed the mechanism instead of the symptom - the four-polyphenol Re:Flux formula and the clinical trial behind it, recently published in the Open Journal of Gastroenterology.In this episode:- Why the "too much vs. too little acid" debate misses the mechanism- How your stomach actually works as a one-way cycling pump- Transient lower esophageal sphincter relaxations, explained without the jargon- The acid puddle, and why gastric sleeve and GLP-1 patients get it- What stomach acid is genuinely for (B12, minerals, pathogen defense)- The three questions to ask instead of "how much acid?"- What PPIs do well, and what they were never designed to do- The HAND polyphenols and the trial resultsChapters: 0:00 The wrong debate · 2:45 Two camps · 4:15 37 years of PPIs · 7:48 The one-way pump · 12:39 The acid puddle · 14:18 Why the valve opens · 17:15 Why you need acid · 18:59 Three better questions · 21:08 What PPIs can't do · 23:07 Dr. Brown's own 30 years · 26:20 Building the formula · 28:40 Trial results · 33:45 Acid is not the villainEducational content only - not medical advice. Never stop a prescription medication without talking to your physician first.Learn more: regardingyourgut.com · kbmdhealth.com · @kbmdhealthBrought to you by Atrantil Pro.

When you decide to grab a bite to eat, do you think about how to feed your gut microbes? Most of us don't. Even if we did, their only means of stating their preferences is somewhat after the fact. Do you end up feeling less than well? Perhaps the denizens of your gut aren't happy. In this episode, we consider how to support your microbiota and whether that can reduce the inflammation that seems to accompany modern life. At The People's Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, August 15, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can't listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on August 17, 2026. Feed Your Gut Right to Fight Inflammation Dr. Will Bulsiewicz is a gastroenterologist who urges all of us to focus on a healthful fiber-rich plant-strong diet to maintain our microbiome in good shape. He has described his own evolution from a busy medical student relying heavily on processed food products to a whole-food plant-based enthusiast. Eating a wide variety of plants is one of the easiest ways to make sure we are getting the nutrients our gut microbes need. Why are the trillions of microbes in our large intestine so important? Dr. Bulsiewicz (aka Dr. B.) shares the story of a patient who was overwhelmed by a serious C. diff infection. A course of clindamycin for a skin infection had decimated her normal microbiome and left an open field for C. diff to flourish. Instead of treating her with surgery and even more potent antibiotics, Dr. B. and his colleagues utilized a fecal transplant. She got poop from a healthy person into her colon and left the hospital a few days later in good health herself. What Is the Link Between the Microbiome and the Immune System? Inflammation is one of the primary signs that the immune system has gone into action to fight off a perceived foe. There is a close relationship between the gut microbes, the gut barrier and the cells of the immune system. Between 70 and 80 percent of immune system cells are present in the gut (Nutrients, March 9, 2021).  There is just one layer of cells in the gut barrier, firmly attached to each other through tight junctions. If those tight junctions break down, pathogens and toxins can get from the gut into the bloodstream and activate the immune system into creating inflammation Medicines That Harm the Intestinal Barrier Diets that are high in salt have a negative impact on the integrity of the intestinal barrier (Nutrients, Nov. 25, 2025). In fact, a diet high in salt can reduce the number of Lactobacilli in the gut by 90%. This also affects the permeability of the gut barrier, which can contribute to auto-immune conditions. When we asked about inflammatory bowel disorders such as Crohn disease or ulcerative colitis, Dr. B. told us he thinks it's a mistake to classify them as auto-immune conditions. Instead, he suggests we should consider these conditions as due to the immune system rejecting the microbiome. Some of them might be initiated and perpetuated by failures in the gut barrier that allow certain organisms or their toxins into systemic circulation. A number of medications can also harm it, most notably the nonsteroidal anti-inflammatory drugs (NSAIDs). Agents like ibuprofen, naproxen, celecoxib and meloxicam may disrupt the tight junctions that keep the intestinal barrier intact (Gastroenterology, Feb. 2018).  In some cases, they may also upset the balance of microbes. Four Keys to an Anti-Inflammatory Diet There are several different dietary patterns that allow you to feed your gut and fight inflammation. Good evidence supports a DASH diet, a Mediterranean diet, pescatarian, flexitarian, vegetarian and some vegan diets. We asked Dr. B. to summarize the four features healthful eating patterns share. They include adequate fiber, plenty of polyphenols, healthy fat and fermented foods (think of sauerkraut or kimchi). Fiber and Flatulence One drawback of a high-fiber diet is that when microbes in the colon ferment the fiber we can't digest, they produce gases. It has to go somewhere, or it will cause sensations of cramping and bloating. Consequently, fiber is often associated with flatulence. Dr. B. suggests that there may be more gas, and it may be loud, but it shouldn't be stinky. Smelly farts are born of sulfur, which is more common in a diet containing garlic, onions, crucifers like broccoli or cabbage, fish, eggs or meat. Plant-Powered Plus We wondered what might be included in the “plus” category when you feed your gut and fight inflammation. Dr. B. offers a few things that you might not expect in a book about diet, but they are related to reducing inflammation. One is to go outside early in the day, every day, to get your circadian rhythm in sync. Another is to maintain your emotional connections with family and friends. Still another, just as important, is to nurture your spiritual core. This Week’s Guest Dr. Will Bulsiewicz describes how a plant-powered diet can fight inflammation Will Bulsiewicz, MD, is a New York Times bestselling author, award-winning gastroenterologist and internationally recognized health expert. Dr. Bulsiewicz directs the Gut & Microbiome Center for Excellence, a physician-led executive medicine and telemedicine practice based in Mount Pleasant, SC. Dr. Bulsiewicz is the author of several books, including his latest book, Plant Powered Plus: Activate the Power of Your Gut to Tame Inflammation and Reclaim Your Health. His website is https://theguthealthmd.com/books/ The People's Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you). Listen to the Podcast The podcast of this program will be available Monday, August 17, 2026, after broadcast on Aug. 15. In this week's podcast, you get to peek into Dr. B's shopping cart. Are you buying the same vegetables he does? We also get insights on his favorite recipes for grains like farro. And we discuss the effect of coffee on the gut microbes. If you want to feed your gut to encourage certain microbes, remember that consistency is crucial. You can't eat a specific food once and expect it to make a difference. But consuming it several times a week will ultimately add up. We also discuss antidotes for flatulence, if you are interested in that. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Send us Fan MailA colonoscopy that comes back normal can feel like relief, until your body keeps proving something is wrong. We sit down with Dr. Matthew J. Simpson, a family medicine physician in North Carolina, to unpack how he lived with Crohn's disease symptoms for years without a clear diagnosis, and why a perianal fistula finally forced the medical system to see the full picture. If you've ever been told your labs look fine while you're dealing with bleeding, urgency, fatigue, or weight loss, you'll hear your reality reflected back with empathy and precision. We talk about what it's like to chase answers while living outside a major medical hub: limited local gastroenterology options, slow referral pipelines, insurance approvals, and fragmented care between GI, colorectal surgery, and imaging. Matthew walks us through the flex sig, MRI findings, and the moment he realized he needed an IBD specialty clinic and an academic medical center approach. His story is a clear reminder that “not unreasonable” care can still be the wrong pace when your health is sliding. Then we get practical. Matthew explains perianal fistulas in plain language, what a fistulotomy does (and does not do), and why healing often requires treating the underlying Crohn's inflammation. We also dig into shared decision making for Crohn's medications, including how he weighed biologic options, risk communication, and the added complexity of carrying a BRCA2 gene mutation. Along the way, we challenge overreliance on single tests like fecal calprotectin and zoom out to the bigger point: algorithms are helpful, but they are not your lived experience. If this conversation helps you feel less alone, please subscribe, share it with someone navigating IBD, and leave a review so more people can find the show.Links: What is anorectal manometry?- Cleveland ClinicFistulotomy- Cleveland ClinicLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

Coeliac disease is often viewed as a straightforward gastrointestinal condition, but its presentation, diagnosis and long-term management can be far more complex than many clinicians appreciate.In this episode of the RCP Medicine Podcast Dr. Dushen Murugiah, Consultant Gastroenterologist and Trust Lead for Nutrition at Royal Surrey County Hospital NHS Foundation Trust, joins Dr Abhishek Ray to explore the modern approach to coeliac disease.Together they discuss classical and non-classical presentations, the challenges of diagnosing an often under-recognised condition, the role of serology and small bowel biopsy, and the importance of considering celiac disease in patients presenting with unexplained anaemia, nutritional deficiencies and other extraintestinal manifestations. The conversation also explores refractory celiac disease, practical challenges associated with lifelong gluten avoidance, and promising future therapies currently under investigation.This episode offers practical, evidence-informed insights for physicians, trainees and healthcare professionals involved in the assessment and management of patients with suspected or confirmed coeliac disease.  Explore our CPD portfolio by your career stageEducation and professional developmentLeadership CPDTeach the teacherEducational supervisorSix-step programme RCP Social MediaInstagramLinkedInFacebookBlueskyMusic Ep 50 onward - Bensound.com  Ep 1 - 49 'Impressive Deals' - Nicolai Heidlas Any adverts within this podcast may use computer generated voices

Naturopathic gastroenterologist Mark Davis, ND (FABNG), discusses his work in fecal microbiota transplantation (FMT), research, and integrative approaches to GI disease. Davis explains FMT history, screening criteria, delivery methods, how it differs from probiotics, and why it is highly effective for recurrent C. difficile (about a 90% durable cure), while noting FDA-approved products (Rebyota, Vowst) and off-label applications. He describes IRB-approved studies on naturopathic care for IBS and ulcerative colitis and a blinded project comparing consistency across 15–20 stool microbiome labs. The conversation covers evidence for diet in IBS/IBD (including SCD and a semi-vegetarian diet), low-FODMAP as a temporary tool, breath testing and relapse in SIBO, helminthic therapy options and legality, targeted probiotics (Saccharomyces boulardii, Akkermansia, soil-based species), enema therapies, indigo naturalis benefits and risks, saffron evidence for mood, telemedicine practice, and a crowdfunding platform for clinical trials.

Dr. Hoffman continues is conversation with naturopathic gastroenterologist Mark Davis, ND (FABNG).

As cyclosporiasis infections increase across the U.S., an expert from Children's Health discusses clinical guidance for community providers and how to recognize infections in children.  Learn more about Dr. Most.

Four inflammatory bowel disease (IBD) experts explore case-based strategies for optimizing advanced IBD therapy and long-term disease management early in real-world practice. They discuss practical approaches for implementing treat-to-target via strategic treatment sequencing, therapeutic drug monitoring, and maintenance approaches while supporting individualized, evidence-based care for patients with IBD. Presenters Jessica R. Allegretti, MD, MPH, FACG, AGAF Medical Director, Infusion Services Director, Crohn's and Colitis Center Director of Clinical Research Director, Fecal Microbiota Transplant Program Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Boston, Massachusetts Jordan E. Axelrad, MD, MPH, AGAF, FACG, FCCF Co-Director, Inflammatory Bowel Disease Center at NYU Langone Health Associate Professor of Medicine Division of Gastroenterology and Hepatology NYU Grossman School of Medicine New York, New York Russell D. Cohen, MD, FACG, AGAF Professor of Medicine, Pritzker School of Medicine Co-Director, Digestive Diseases Center Clinical Director, Inflammatory Bowel Disease Center Co-Director, Advanced IBD Fellowship Program The University of Chicago Medicine Chicago, Illinois Amy Stewart, MSN, FNP-C Lead Advanced Practice Provider Capital Digestive Care Washington, DC Link to full program: https://bit.ly/4wvm7l4 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In our second Summer School episode this season, hosts Dr. Jason Silverman and Dr. Temara Hajjat have taken highlights from past episodes on nutrition and put them into a special episode full of clinical pearls.Former expert guests Dr. Charlie Vanderpool, Dr. Mark Corkins, Dr. Praveen Goday, Dr. Maria Mascarenhas, Dr. Ruba Abdelhadi, Dr. Bruno Chumpitazi and Kirsten Jones, and Dr. Eytan Wine cover a range of topics from early life nutrition and development, to picky eating and specialized diets.Our Bowel Sounds Summer School series will include four episodes each summer on big topics in our field, artisanally crafted for the ears of learners of all stages from the young student to the seasoned attending.Learning Objectives:Understand the importance of functional components of human milk and other early life influences on growth and development.Review an approach to the evaluation and management of the picky eater.Review the indications and evidence for specialized diets in the context of gastrointestinal disorders.Featured Episodes:Charlie Vanderpool - Functional Components in Infant NutritionMark Corkins - Early Life Nutrition and Impact on Childhood DevelopmentPraveen Goday - The Picky EaterRuba Abdelhadi - Enteral Nutrition and Feeding Tubes 101Eytan Wine - Nutrition, IBD, and the Crohn's Disease Exclusion DietBruno Chumpitazi & Kirsten Jones - Using the Low-FODMAP Diet for Children with IBSMaria Mascarenhas - Culinary MedicineAdditional links:Lisa Richardson - Ins and Outs of Infant FormulasKatie Larson-Nath - Faltering WeightNutrition Pearls PodcastSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

In this episode, we spoke with Dr. Tatyana Kushner, Associate Professor of Medicine in the Department of Gastroenterology at Weill Cornell Medicine in New York. Dr. Kushner discusses hepatitis B treatment during pregnancy, including when antiviral therapy is recommended to help prevent mother-to-child transmission, and the importance of continuing hepatitis B care and treatment after pregnancy to support long-term liver health.Support the showOur website: www.hepb.orgSupport B Heppy!Social Media: Instagram - Twitter - Facebook

In this episode of Better Edge podcast, Rajesh N. Keswani, MD, explores major advances within the Northwestern Medicine Pancreas Program, including standardized pancreatitis care and findings from key trials. He also highlights progress in high‑risk pancreatic cancer surveillance and the expanding use of AI to enhance early detection and diagnostic accuracy.

Send us Fan MailThe fastest way to improve IBD outcomes is not always a new drug. Sometimes it's a better system and a team that can actually reach you before you end up in crisis. We're joined by Dr. Corey Siegel, a renowned gastroenterologist and IBD specialist at Dartmouth Hitchcock Medical Center, to unpack what “high-quality inflammatory bowel disease care” looks like when you measure it, stress-test it, and rebuild it around real patient needs.We talk through IBD Qorus, the Crohn's and Colitis Foundation quality improvement program that defines key standards for Crohn's disease and ulcerative colitis care and then tracks whether clinics meet them. That leads to a practical, patient-first goal: keeping people out of the emergency department by creating urgent clinic access, proactively supporting high-risk patients, and using better visit workflows that start with the patient's top concern. These aren't flashy changes, but they reduce prednisone use, unnecessary CT scans, opioid exposure, and the emotional toll of feeling unheard.Then we zoom out to rural healthcare and specialty access. Dr. Siegel explains RADIUS, a telemedicine “hub-and-spoke” model where community practices connect patients early to a full multidisciplinary IBD team, including behavioral health, nutrition, pharmacy support, and nursing coordination. We also get real about treat-to-target, why symptoms can mislead, and how insurance barriers like prior authorization and step therapy can delay the right biologic or advanced therapy for months.If you want smarter, more human IBD care and concrete ideas you can advocate for, hit play now. After you listen, subscribe, share with a friend, and leave a review so more patients can find these conversations.Links: Dr. Siegel's podcast- Digesting: The Latest in IBD- apple podcastsSpotify optionInformation on IBD Qorus- Crohn's & Colitis Foundation Information about the BRIDGe GroupLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

Co-hosts Ryan Piansky, a patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Dr. Claire Beveridge about EoE and dysphagia. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, research on eosinophilic esophagitis (EoE) and dysphagia.   [1:24] Holly introduces and welcomes today's guest, Dr. Claire Beveridge, a gastroenterologist at the Cleveland Clinic. Dr. Beveridge heads the EoE Adult Clinic and the Transition from Pediatric to Adult EoE Clinic.   [1:36] Holly, a speech pathologist, says she is very excited to dive into the research Dr. Beveridge did with EoE and dysphagia. Holly asks Dr. Beveridge to share some of her background.   [1:48] Dr. Beveridge was recruited to the Cleveland Clinic about five years ago to head the EoE Center. She loves the work they have done there.   [1:57] Dr. Beveridge says it's been nice to center everything on their EoE patients and have multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and more. It's been a great experience.   [2:15] Dr. Beveridge says the other thing they are really proud of is having a Transition Clinic. It can be tough for patients to transition from pediatric to adult care.   [2:23] Dr. Beveridge says this is something she was inspired to do when she was finishing her training at the University of Pennsylvania, where they had been doing some of that. It was really important to her when she joined Cleveland Clinic.   [2:34] Dr. Beveridge, with her Co-director, Dr. Sophia Patel, helps patients transition from pediatric to adult care.   [2:41] Holly speaks of the challenge of transitioning from pediatric care at a multidisciplinary clinic to adult care.   [3:08] Dr. Beveridge says you can't do any training at Northwestern without loving the esophagus. She did her residency there, got exposed to esophagology, and got to know Dr. Gonsalves and Dr. Hirano really well.   [3:33] Drs. Gonsalves and Hirano are really big names in EoE. Dr. Beveridge was fascinated by the disease. She loved the patients and wanted to help them and make them feel better. It's a burgeoning field.   [3:48] Dr. Beveridge says that it's only in the last few years that we have had FDA-approved medications for it, and that we have been jerry-rigging asthma medications to treat our patients.   [4:03] Dr. Beveridge says it's really exciting to see the treatment options we can offer.   [4:10] Ryan says it's exciting to see how EoE management has changed.   [4:16] Ryan says we see so many patients who are untreated or poorly treated for years, who have restructuring of their esophagus and present with dysphagia, or have strictures and rings leading to food impactions; the long-term effects of untreated EoE.   [4:34] Ryan says it's exciting that now we do have better treatment options for people, right off the bat.   [4:43] Dr. Beveridge conducted some research on EoE and dysphagia and presented a poster at the 2024 Digestive Diseases Week.   [4:51] The poster was titled, "Esophageal Luminal Diameter is Associated with Dysphagia and Eosinophilic Esophagitis: Implications for Endoscopic Dilation Therapy."   [5:11] Dr. Beveridge says dysphagia means issues with swallowing. It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen.   [5:31] Dr. Beveridge says patients who have had EoE for a long time become accustomed to how they swallow. Things a patient may think are normal, like needing water and taking a sip after each bite, are learned accommodating behaviors.   [5:58] Dr. Beveridge says accommodating behaviors are that you're needing to imbibe extra water, you're modifying how you're eating, extra chewing, avoiding pills, avoiding other certain foods, and things like that that can be modifying factors.   [6:19] So, difficulty with swallowing, things getting stuck, slowly moving down, but also keeping in mind some of those modifying behaviors that we may end up using.   [7:23] Dr. Beveridge says her motivation was seeing patients in her clinic who were having persistent symptoms, and getting them into histological remission. The goal of treating your EoE is to get the eosinophils less than 15; close to zero is great.   [7:45] Dr. Beveridge says we have patients who, despite doing their endoscopies and taking biopsies, things look fine; they're still having issues with swallowing. Why is that the case?   [7:58] Dr. Beveridge says in a different research paper she had done, looking at some of the predictors for that, one of them was fibrostenosis. There are also other things that can contribute, like esophageal hypervigilance and a fear of swallowing.   [8:21] If a patient has had a food impaction, it's going to be scary to try to swallow again. Some of it is behavioral, but some of it is structural. At what luminal diameter (the size of the esophagus) is that causing a clinical problem for patients?   [8:45] A normal esophagus is 20 to 24 mm in diameter. Traditionally, around 14 to 16 mm in diameter has been when we say that patients get symptoms or they're feeling the issues with swallowing.   [9:03] Dr. Beveridge says a lot of those studies have never been done specifically for EoE patients.   [9:08] Dr. Beveridge wanted to know, if we exclude cancer, if we exclude acid reflux, and all of these other things, and just look at our EoE patients, what size of the esophagus are we looking at?   [9:20] Dr. Beveridge explained they specifically looked at patients whose histology was under control and then compared those who continued to experience symptoms with those who did not. The goal was to determine the histologic threshold at which patients begin to experience dysphagia.    [9:54] Dr. Beveridge says they saw this threshold at 16 mm (1.6 cm). That's still quite the difference from a normal esophagus of 20 to 24.   [10:08] Dr. Beveridge says our esophagus can definitely handle being smaller, but then, once you get to that 16 mm, for a lot of patients, it really does cause that feeling of things getting stuck or slowly moving down.   [10:20] Holly says what's cool about the retrospective data Dr. Beveridge looked at, and the parameters she placed in the research, is that when a patient goes in for an endoscopy, the doctor can measure and say maybe this is why dysphagia is going on.   [10:48] Holly finds that adult patients with food impactions are scared to eat the same food again. She loves having this data to share with patients and say, let's look at what your esophagus measures at. Let's do a smaller bite. Let's add a dip and liquid.   [11:12] Holly says data can push so much progress. Holly, having multiple chronic illnesses, loves when doctors can say, this is going to be safe. This is the mode that we're going to go with.   [11:30] Dr. Beveridge says in the retrospective study, they were looking at stuff that had already been done. We decided from here to assess patients more prospectively. All of this was based on chart review from when the note said symptoms or no symptoms.   [11:53] Dr. Beveridge says when she started this EoE clinic at the Cleveland Clinic, part of it was to standardize better how we were collecting data from patients to understand their symptoms.   [12:07] Dr. Beveridge has a standardized questionnaire for patients to understand if they are having heartburn and difficulty with swallowing, so she can know that at each point of their endoscopy.   [12:18] Dr. Beveridge says it will be nice, hopefully in the future, when she can give a little more detail and depth in terms of assessing this more prospectively and seeing if that same number holds up or if she needs to tweak it a little bit.   [12:34] Holly thinks it's fascinating. Numbers give us so much information, to know if my mm is this versus this, the next time, or during allergy season or not.   [12:53] Ryan says it's cool that you're able to look back at existing patient records and identify this information. Now we have that 16 mm number in mind to say maybe this is where we'll start to see increased risk of dysphagia in these patients.   [13:28] Dr. Beveridge says, how we had to do it retrospectively was based on the endoscopist estimating what the size is. Gastroenterologists recognize they're not always the best at estimating the size of the esophagus.   [13:50] Dr. Beveridge says, if your endoscope could not pass through, or it was snugly passing through, you know the diameter of the endoscope. If a dilation was done, at what size dilation do we start to see a disruption?   [14:19] Dr. Beveridge says, the goal of a dilation is to get a disruption because there's scar tissue we want to break open. A patient might think disruption means a perforation or something more scary, but that is the goal. We want to break open that scar tissue.   [14:42] Dr. Beveridge says, once we see that scar tissue break open a little bit, then we can estimate what the diameter is, based on the size dilator we used.   [15:10] Dr. Beveridge says for adults, we use a standard adult upper endoscope, and that's about 13 mm. The ones we use for kids are about 6 mm.   [15:35] Dr. Beveridge says the adult endoscope is around 13 mm, and it's around 14 to 16 mm when we start to see the symptoms.   [16:07] Dr. Beveridge says there are two main types of dilation that we do. One is the Savary dilator or wire-guided dilator, a long dilator that stretches the entire esophagus, from the mouth down to the stomach.   [17:20] Dr. Beveridge says another way of doing it is while you have the endoscope in, you thread a catheter. At the end of the endoscope, there's a balloon. You fill the balloon with saline up to different sizes. Typically, they go up by 3 mm, so 12 to 15 mm.   [18:01] Dr. Beveridge says the catheter balloon dilator is good for discrete strictures because the balloon isn't going to do the entire esophagus; it's just going to do one area of the esophagus, and you're watching it the whole time.   [18:19] For the wire dilator, you remove the scope. You're not able to see, so it's important to assess ahead of time how narrow things are, so you start at a safe dilation. You go in each time to see if there's starting to be disruption, and then you can do more.   [18:44] Holly asks if a gastroenterologist doing an upper endoscopy with sedation sees that it's tight, would the gastroenterologist automatically do a dilation? Or, can a patient with dysphagia symptoms request to have a dilation?   [19:28] Dr. Beveridge says, right before an endoscopy, she discusses it with the patient and gets consent. She asks, even if their symptoms are good, but in the endoscopy she sees a narrowing where she would recommend a dilation, if they're OK with that.   [20:05] Dr. Beveridge says, if they're having issues with swallowing, often she will ask if they're OK with her doing a dilation. If she sees a narrowing, she can focus on that area and dilate it.   [20:19] Dr. Beveridge says not everywhere in the esophagus can we see as well. The very beginning of the esophagus is challenging to see and challenging to evaluate on imaging.   [20:32] Dr. Beveridge talks about empiric dilation. You don't see a narrowing, but you want to rule it out, so you do a dilation at a safe size, like 16 or 18 mm, to make sure you're not missing something up high.   [20:58] Dr. Beveridge says she always talks about that with her patients. Most say, go ahead. Some patients definitely want dilation; other patients say no, they really don't.   [21:12] Dr. Beveridge then asks the patient if there's real narrowing that may cause a food impaction, would they want dilation then, or hold off for another day?   [21:30] Dr. Beveridge never wants to do something the patient is not comfortable with. She also doesn't want them to need another endoscopy unnecessarily, if she can avoid that for them in the moment.   [21:46] Dr. Beveridge mentions the BougieCap used in Europe. It's a cap you put at the end of the endoscope. You use your endoscope as the dilator. You watch the whole time. It is hard plastic that causes a nice dilation. We may see it come to the U.S.   [22:37] Dr. Beveridge speaks of the FLIP catheter, which is a catheter with a balloon that doesn't cause dilation but distends and helps measure the diameter.   [23:33] Holly asks if Dr. Beveridge gives tips to patients on how to prepare for dilation and the recovery process.   [23:49] Dr. Beveridge had an upper endoscopy. She says there's nothing like experience to understand it better. She didn't have a dilation, but the biopsies caused discomfort.    [24:21] Dr. Beveridge says a lot of her patients have been through upper endoscopies, so they know how it feels. She warns them that the biopsies and dilation can cause discomfort.   [24:33] What's challenging is that everyone is different. Some patients are going to be more hypersensitive to it, and other patients are going to say they felt nothing and they were fine.   [24:46] Dr. Beveridge says some patients need to modify their diet for a few days to avoid significant chest pain. You never want someone to have to go to the ER for significant chest pain when it will just heal over time, and there's no perforation.   [25:12] Dr. Beveridge says other patients will be like her, eating chips and pretzels and saying they're fine. Dr. Beveridge typically has them start with liquids, nothing too hot or too cold, and advance as tolerated.   [25:28] Dr. Beveridge says patients can always use TylenolⓇ and over-the-counter numbing agents. You'll still have patients who will get significant discomfort. For the most part, starting with liquids has worked for Dr. Beveridge's patients.   [25:44] Holly recommends over-the-counter when her patients call, after she talks to their GI. Holly says after she has an endoscopy, she starts on liquids and shakes. On day three, she's fine. Holly says individualized care is amazing. We all are different.   [26:14] In the pediatric setting, the parents get the counseling, and they have not had sedation, but on the adult side, you're talking with the patient, who had sedation. Sometimes they don't remember.   [26:40] Dr. Beveridge says when possible, she waits for family members to come back and tells them they're going to have to "be the memory" because the patient probably won't remember this conversation.   [26:55] If a patient says no, they don't want them to come back and hear about it, always respect that. But Dr. Beveridge always tells them, you may not remember what we say.   [27:30] Ryan asks about data on how many times someone may need dilations. Dr. Beveridge says it comes down to the patient, but the biggest issue can be uncontrolled inflammation.   [27:44] Dr. Beveridge says if a patient's EoE is not controlled, inflammation leads to continued scarring down. That's why we talk about dilation as being an adjunctive measure, but not a treatment for EoE. It doesn't do anything for the inflammation.   [28:03] Dr. Beveridge says she has patients who ask why she can't just do a dilation every now and then. Dr. Beveridge considers dilation to be safe when needed, but if you can avoid it, that would be nicer for everyone.   [28:21] Dr. Beveridge says there's no great data on whether you only need one, or whether you're going to need 10, but one big theme is just: have we gotten your inflammation under control? That's also true for other conditions, such as acid reflux.   [28:45] Holly wasn't diagnosed until she was in her mid-twenties, and she had several upper endoscopies as a teenager and college student to dilate her, to help the situation.   [29:17] Holly says she had to get more endoscopies to figure out her weird food triggers that are not typical for everybody, so even if she's treated, she still has inflammation. That's why she had so many upper endoscopies.   [29:30] Ryan talks about underlying issues causing inflammation. Dilation is not treating those underlying causes. It's just helping with one symptom of this dysphagia, by expanding the esophagus.   [29:50] Ryan asks, What changes in symptoms should patients expect after the dilation? Dr. Beveridge says, ideally, if there's been a stricture, you're going to start to feel like your swallowing is better. You can get pills and food down better.   [30:07] Dr. Beveridge says, immediately post-dilation, sometimes people feel a little bit worse. Everything you swallow may be uncomfortable for you. But if it's been a successful dilation, hopefully, you're going to feel that things are going down better.   [30:40] Holly says she is so grateful that Dr. Beveridge looked into this, and hopefully, there will be a new protocol in the future. Holly asks what other key takeaways from this research may interest Dr. Beveridge in researching something further.   [31:02] Dr. Beveridge says, making sure that we're not missing scar tissue is big and important. One thing that we're trying to look at with our Pediatric GI colleagues is what threshold we should be looking at for the pediatric patient population.   [31:19] Dr. Beveridge says a pediatric patient's esophagus is a different size than an adult patient's. Understandably, we are more cautious when doing a dilation in the pediatric patient population than we are with adults.   [31:34] Dr. Beveridge may recommend empiric dilation for an adult but will feel more cautious about that with pediatric patients than with adult patients. Understanding what that threshold should be for the pediatrics is going to be really interesting.   [31:57] Dr. Beveridge says the diameter threshold we discussed is going to be important to know about, but everyone is different. You may have a diameter of 14 mm, you feel fine, and you don't want a dilation; you can accommodate OK. That's reasonable.   [32:15] Dr. Beveridge says she has had patients who get up to 18 mm, and that helps them, but they need a little bit more. If someone needs more of a dilation, we do that. Yes, have a threshold to assess, but always assess for what's personal for your patient.   [33:04] Dr. Beveridge says not just to assess the luminal diameter, but a thing that is helpful for gastroenterologists to know will be if there are other factors at play. As in her study of dysphagia predictors, anxiety, depression, and hypervigilance can play roles.   [33:37] Dr. Beveridge has patients who have to have a critical narrowing for them to finally feel an issue. Other patients, if they have the slightest of narrowing, are feeling something. Some patients are just more vigilant of what's happening in their esophagus.   [34:07] Dr. Beveridge says there's definitely a role for asking if your anxiety is under control. If there's feedback in the nerves, should we ask your GI Psychologist to be involved in terms of CBT for your esophagus? Take a look at everything.   [34:27] Dr. Beveridge says another part of the study they looked at was: are there different thresholds of eosinophils that we should be looking at? Is it just less than 15, or do some patients need it to be lower? Less than six? Less than 10?   [34:43] Dr. Beveridge says look at it as a whole for your patient.   [34:53] Dr. Beveridge says next, she will be working on a very long-term project: Can we identify a non-invasive method of screening a patient, diagnosing a patient for EoE, or monitoring a response to therapy?   [35:13] Dr. Beveridge has looked at transnasal endoscopy, which is put into this category of minimally invasive. It's still invasive; you're putting a scope through someone's nose, but it doesn't require sedation, which is a nice thing for some patients.   [35:29] There's the EnteroTrack, which started in Colorado. A patient swallows a string, and it stays in their esophagus for an hour, and we look at the proteins to see if things are active or not active.   [35:45] Dr. Beveridge is also looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE?   [36:01] It's assessing about 100 different compounds, not looking at one in particular, but how the whole thing looks. What signature is there, based on looking at all the compounds?   [36:15] Dr. Beveridge presented some of that data at DDW and has a grant from the ACG to look at this and assess patients with and without EoE.   [36:33] Dr. Beveridge says further, doing longitudinal data of looking at patients once they've gotten into remission on treatment and seeing, do we then see a signature change?   [36:47] Dr. Beveridge says no one is under any illusion that endoscopies are going away. They will always be part of what we do in gastroenterology, but there are limitations: sedation, a full day away from work, nothing by mouth, and a driver, etc.   [37:04] If there are alternatives to help supplement that, it would be nice. One of the barriers for patients doing diet elimination is the number of endoscopies that are required. If there's a way to assess by breath if a food is a trigger, that would be good.   [37:32] Dr. Beveridge says that's the big thing she's looking at, but it will take years. It's not going to be a quick, easy one, but it's very interesting to take a look at.   [37:45] Holly speaks of how much treatment has changed since she was diagnosed. She has done all the scopes. She says this sounds amazing. She loves that people like Dr. Beveridge are thinking of how to make testing less invasive and more comfortable.   [38:12] Dr. Beveridge says another thing she is excited about is the transition of care. She recently did a survey and is analyzing the data to assess what the barrier is from the physician perspective in terms of helping our patients transition.   [38:40] Dr. Beveridge is also looking at doing a nice multi-center consensus to help this as well, led by Dr. Sophia Patel and Dr. Emily McGowan, who are fantastic in the EoE world, looking to see how we can make this better for our patients.   [38:58] Ryan says, with so much interesting work coming up, we'll have to have you back to chat about some of these additional projects. Everyone is super interested in less invasive stuff and better treatment pathways. Transition of care is an important part of that.   [39:11] Ryan appreciates Dr. Beveridge for joining the conversation and hopes to have her back on another episode so we can learn more about EoE and these different future research endeavors.   [39:20] For our listeners who would like to learn more about EoE today, you can visit apfed.org/EoE and check out the links in the show notes below. [39:27] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder, available at apfed.org/specialist.   [39:36] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [39:46] If you have personally been impacted by eosinophilic disorders and are interested in sharing your experience, please check out apfed.org/shareyourstory.   [39:55] Ryan thanks Dr. Beveridge for joining us. This was a fun conversation and really insightful. Holly thanks APFED's Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.orgapfed.org/specialist apfed.org/connections Claire Beveridge, MD Cleveland Clinic Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, GSK, Sanofi, Regeneron, and Takeda.   Tweetables (Edited):   "I have loved the work that we've done [at the Cleveland Clinic]. It's been really nice to center everything on our EoE patients and have nice multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and everyone." — Claire Beveridge, MD   "It's a little crazy to think that it's only in the last few years that we have had FDA-approved medications for [EoE], and that we have been jerry-rigging asthma medications to treat our patients." — Claire Beveridge, MD   "On the whole, dysphagia means issues with swallowing. … It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen." — Claire Beveridge, MD   "The goal of a dilation is to get a disruption because there's scar tissue we want to break open." — Claire Beveridge, MD   "I am looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE?" — Claire Beveridge, MD   Guest Bio: Claire Beveridge, MD, is a Staff Member in the Department of Gastroenterology and Hepatology and heads the Eosinophilic Esophagitis (EoE) adult clinic as well as the transition pediatric to adult EoE clinic. Dr. Beveridge's specialty interests include: EoE, Achalasia, Barrett's esophagus, GERD, esophageal swallowing disorders, and esophageal motility disorders.

Roughly half of the average American's daily calories now come from ultra-processed foods — and cutting them out changes how you feel faster than you'd expect. Nurse Doza breaks down five shifts that show up within weeks: steadier blood sugar and energy, a healing gut, lower inflammation, clearer thinking, and hunger hormones that finally reset. Learn what really separates processed from ultra-processed food, and why just two weeks of whole food can change everything. Featured Product: Boost by MSW Nutrition When you're riding the ultra-processed blood-sugar roller coaster, energy is the first casualty — the mid-afternoon crash, the brain fog, the reach for the next quick fix. Boost is the multivitamin you can actually feel: 2,500 mcg of methylated B12, a full multivitamin plus B-complex, electrolytes, and plant-based antioxidants including S-acetyl-L-glutathione. Clean, slow-release energy from one stick in water — no added sugar, no crash — so real food finally has a fair shot at steadying you out.

Send us Fan MailAn MRI, a phone call, and four words nobody wants to hear: “You have a perforated bowel.” Zach Koscuik was on the road to a comedy gig when Crohn's disease forced yet another hard pivot, adding to a 25-year history that includes perianal Crohn's, fistulas, abscesses, emergency surgeries, biologics, and three ileocolonic resections. We talk with him about what it's like to grow up sick, manage the stigma that makes people minimize inflammatory bowel disease, and keep showing up to school, work, and life when your body is always negotiating the nearest bathroom.Then the story takes a turn into the world of clinical trials and high-stakes medicine. Zach explains how severe disease and short bowel complications pushed his team toward an autologous stem cell transplant, a process that essentially wipes out and restarts the immune system. We get specific about the testing, chemo, isolation, and the surreal experience of being treated on a cancer floor without having cancer, plus the very real impact of insurance decisions that kept him hospitalized for 43 days.The payoff lands with the kind of news IBD patients barely let themselves hope for: a one-year follow-up colonoscopy that comes back completely clean. We also keep it honest about what remains, including motility issues, joint pain, and the mental aftershocks of medical trauma. Zach closes with a simple challenge for the Crohn's and colitis community: practice equal empathy, because two people can share a diagnosis and live totally different realities. If this conversation hits home, subscribe, share the episode with a friend, and leave a review so more people living with IBD can find it.Links: Find Zach on InstagramInformation on the stem cell trial that Zach didStem Cell Therapy clinical trial site- Clinicaltrials.govLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

Understanding how values and communication styles differ across cultures is key to succeeding internationally. That’s why training in cross-cultural communication has become commonplace in the international business world. In this session, we’ll look at 6 dimensions of cross-cultural communication and their application to medical scenarios.

SPONSORED BY NURP Nurp is algorithmic trading designed specifically for busy professionals who don't have time to watch markets. Check out start.nurp.com/doctors  to learn more. --- What do heavy metal screams, UFC on the White House lawn, AI-generated Menopause Barbie, and colonoscopy cocktails have in common? Somehow... they're all part of this week's Doc Tales with Cocktails. Drs. Tim and May Hindmarsh take listeners on another unpredictable ride through music, medicine, culture, and internet absurdity. From discovering the incredible vocal talent of Spiritbox's Courtney LaPlante to debating why humans are fascinated by violence, the conversation bounces between hilarious stories and surprisingly thoughtful observations. They also react to the viral AI-generated Menopause Barbie, discuss the ever-changing world of colonoscopy prep (including the unforgettable Piña Colonata), and preview next week's conversation about the internet's latest manscaping craze. As always, expect laughs, strong opinions, medical insight, and plenty of cocktails.   In This Episode Discovering the incredible vocal range of Spiritbox vocalist Courtney LaPlante Why harsh metal vocals are far more technical than most people realize The UFC event on the White House lawn and the internet's reaction A discussion about violence, sports, patriotism, and culture AI-generated "Menopause Barbie" goes viral Colonoscopy prep horror stories—and the hilarious Piña Colonata cocktail Why every gastroenterologist seems to recommend a different bowel prep Preview of next week's "manscaping" discussion   Resources & Mentions Spiritbox Evanescence Courtney LaPlante Jenna McCarthy (Substack) Anne Marie McQueen Hot Flash Inc. Orme Water   Subscribe If you enjoy honest conversations about medicine, culture, health, and everything in between, be sure to subscribe, leave a review, and share the show with someone who appreciates keeping life BS Free. Follow BS Free MD for new episodes every week. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Gut Check: Philip Okafor, MD, on Health Care Disparities in Gastroenterology by Gastroenterology Learning Network

This episode explains the updated screening guidelines and why starting colorectal cancer screening at age 45 can save lives. Dr. Mamta Mehta, MD, MPH, a Board Certified Gastroenterologist with Eisenhower Health, breaks down the evidence behind the change and what it means for average-risk adults.You'll hear clear guidance on screening age 45, colonoscopy vs other screening tests, the importance of early detection, and how screening prevents colorectal cancer by finding and removing polyps. Keywords: colonoscopy, colorectal cancer screening, screening guidelines, screening age 45, early detection, colon polyps. Learn more and schedule a consultation 

Send us Fan MailA ninth inning ballpark burger. Days of relentless diarrhea. Then blood. John Capodilupo's ulcerative colitis diagnosis didn't arrive slowly, it hit like a truck, and it sent him into a crash course on what living with IBD really demands. We talk through the early fear and uncertainty, the 28-day hospitalization, and the chaos of juggling treatment while also battling infections like C. difficile and CMV colitis. John also shares his experience with fecal microbiota transplant (FMT) for recurrent C. diff and why the microbiome still feels like one of the biggest unsolved stories in gut health.From there, we connect the dots between health data and better decisions. John helped build Whoop, the wearable built around continuous physiological tracking like heart rate variability and sleep, and he explains what longitudinal data can reveal about stress, recovery, and early warning signs. We dig into how sleep disruption and subtle body signals can show up before you're sure whether you're flaring or just paying the price for Taco Bell.Then we get into Throne, the smart toilet monitoring system John now co-leads as Chief Product Officer. Throne clips onto the toilet and uses computer vision and sensors to track stool and urine trends passively, aiming to reduce guesswork, improve symptom recall, and open the door to research like flare prediction, medication durability, and future screening signals such as blood detection for colon cancer. We also cover the “real life” questions: multi-user households, cleaning, cost, and a privacy approach built around de-identified data and opt-in research.If you're curious about ulcerative colitis, Crohn's, IBD tracking, gut health technology, or the future of smart toilets, listen now then subscribe, share with a friend, and leave a review.Links: Throne's websiteFun article about the founding of ThroneBuy Throne for $50 off!  or use code ListenToYourGutLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

Learn simple, realistic ways to support digestion without following a restrictive diet. Dr. Mohammad Abdallah, a gastroenterologist at UM Charles Regional Medical Group in LaPlata, explains fiber, hydration, meal timing, trigger foods and when digestive symptoms may need medical care.  For more information about Dr. Abdallah

Edward Ryan is the director of global infectious diseases at Massachusetts General Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E.T. Ryan, F. Qadri, and J.A. Lynch. Global Cholera-Control Efforts — Progress and Remaining Challenges. N Engl J Med 2026;394:2177-2180.

If you've tried medications, diet changes, fiber supplements, or other therapies for IBS-C and still aren't feeling better, you're not alone. Many people with irritable bowel syndrome with constipation (IBS-C) feel frustrated when symptoms persist despite treatment. But when treatments don't work, it may be time to take a closer look at what's really going on. In this episode of the Gastro Girl Podcast, Jacqueline Gaulin sits down with Dr. William D. Chey, world-renowned gastroenterologist  at the University of Michigan and President of the American College of Gastroenterology, to discuss what patients should do when IBS-C treatments fail. Dr. Chey explains why some patients continue to struggle, what conditions may be overlooked, and how to work with your healthcare provider to develop a more effective plan. In this episode, you'll learn: ✅ Why IBS-C treatments may not always work as expected ✅ When it's time to rethink your diagnosis ✅ The role of pelvic floor dysfunction and other overlooked conditions ✅ Questions to ask your healthcare provider ✅ How to take the next step toward better symptom control ✅ Why you don't have to settle for ongoing symptoms Whether you're newly diagnosed or have been living with IBS-C for years, this episode offers practical insights to help you move forward with confidence. Learn more at GastroGirl.com. This episode is sponsored by Ardelyx.  

Send us Fan MailSara Herring lived with stomach pain so long she thought it was just life, then at 21 she finally got the word that changed everything: Crohn's disease. Sara joins us for a raw, funny, and unexpectedly tender conversation about what it's like to be dismissed as a kid, spend months chasing negative tests, and reach the point where you're writing goodbye letters because you're not sure you'll make it. Sara walks us through the turning points of her IBD journey, from the relief of being believed to years of medication trial and error that end in a surgery she never expected. We talk about how chronic abdominal pain can become so “normal” you don't even notice the ways you're bending, bracing, and shrinking your life around it, and why learning to describe pain can be a powerful tool for self-advocacy with doctors. Then we shift into the practice that helped her reclaim her life: a bucket list book that's part scrapbook, part journal, part proof that small moments matter. We dig into presence over perfection, creativity, therapy, boundaries with social media, and the complicated truth about remission, including the guilt that can come with feeling better while others are still in the fight. If you're searching for Crohn's disease support, IBD mental health tools, or hope that doesn't ignore reality, this one's for you. Subscribe for more real talk, share this with someone who needs it, and please leave a rating and review so more people in the IBD community can find us.Let's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

If you've been feeling exhausted, tired, bloated, anxious, in pain, or just not like yourself, you need to hear today's episode. Today, Mel sits down with one of the most respected medical researchers in the world, gastroenterologist Dr. Brennan Spiegel, to uncover the overlooked, invisible force that's having a shocking impact on your energy, strength, gut health, mood, and every single cell in your body – even how fast your body ages.   Whether you're dealing with fatigue, back pain, swelling, digestion issues, or a heaviness in your body that you can't shake, Dr. Spiegel says these are all signs you shouldn't ignore.   Dr. Spiegel is a gastroenterologist and the director of Health Services Research at Cedars-Sinai Medical Center in Los Angeles, one of the leading medical centers in the United States. He is also a professor of medicine and public health at UCLA.  He trained at Cedars-Sinai and UCLA, and is a pioneering researcher in the areas of gut health, the usage of AI in medicine, and tools that help patients with pain, anxiety, and chronic illness.  He's the founding editor of the Journal of Medical Extended Reality and he served as Editor-in-Chief of the American Journal of Gastroenterology.  Dr. Spiegel has published more than 300 peer-reviewed scientific papers, his research has been cited 30,000 times, and he is the author of Pull: How Gravity Shapes Your Body, Steadies the Mind, and Guides Our Health. What Dr. Spiegel reveals will challenge the way you think about your body and, more importantly, give you a completely new, practical way to start feeling better immediately. And it may give you the words and the insight you've been missing to help your aging parents and other loved ones finally start feeling better, too.   By the end of this episode, you'll understand: -Why a “bendy” pinky might be a clue to what's going on in your gut -10 foods that boost serotonin production in your body -The most effective treatment for IBS - and it's probably not what you've tried -A quick way to notice how the force of gravity is showing up in your body -How to make yourself taller in just a few minutes -Why standing on one leg is linked to a longer life -How a weighted vest can change your posture almost immediately -A surprising reason rollercoasters feel unbearable for some people -What “gravity management” looks like in real life  -One small habit that can improve how your body handles gravity Dr. Spiegel says the powerful, invisible force shaping every moment of your life is one you can learn to work with – and he'll show you how.   This is one of those conversations that will change how you see your body, your health, and what it means to be fully alive. For more resources related to today's episode, click here for the podcast episode page:     If you liked the episode, check out this one next: Change Your Body & Your Life in 1 Month: 4 Small Habits That Actually Work.   Connect with Mel:     Order Mel's new product, Pure Genius Protein Get Mel's newsletter, packed with tools, coaching, and inspiration. Get Mel's #1 bestselling book, The Let Them Theory Watch the episodes on YouTube Follow Mel on Instagram  The Mel Robbins Podcast Instagram Mel's TikTok  Subscribe to SiriusXM Podcasts+ to listen to new episodes ad-free Disclaimer Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Kofi Clarke, Chief of Gastroenterology and Hepatology at Penn State Health Milton S. Hershey Medical Center, joins The Spark to discuss celiac disease and a new clinic designed to provide comprehensive care for patients throughout the region.In White Care: The Impact of Race on American Infrastructure, Prof. Cotten Seiler argues that the decline of U.S. infrastructure isn't just about cost—it's about race. He explores how, beginning in the mid-20th century, many white Americans withdrew support from public systems once their benefits expanded to include Black and Brown communities. From schools and public parks to transportation and healthcare, Seiler connects disinvestment and “white flight” to the deterioration of shared resources nationwide, including in Pennsylvania cities. This conversation reframes infrastructure as a reflection of who society chooses to care for—and who it doesn't.

Welcome to this week's Midlife Minute. Today, I'm focusing on all the questions I received about gallbladder health, including HRT-provoking symptoms, supplements that improve gallbladder health, and evidence-based food interventions. IN THIS EPISODE, YOU WILL LEARN: Why the risk of gallstones and gallbladder inflammation increases during the menopause transition How estrogen and progesterone HRT have different effects on gallbladder functioning The differences in risk between transdermal and oral HRT How the progesterone in HRT can cause gallbladder issues in some women What TUDCA is, and how it supports gallbladder health The value of TUDCA for women who have had their gallbladders removed How various nutrients and supplements support bile flow and gallbladder health What can contribute to gallstone formation Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Gallbladder Research: Cabrera D, Arab JP, Arrese M. UDCA, NorUDCA, and TUDCA in liver diseases: a review of their mechanisms of action and clinical applications. Seminars in Liver Disease. 2019;39(4):397–404. doi:10.1055/s-0039-1696799  Vang S, Longley K, Steer CJ, Low WC. The unexpected uses of urso- and tauroursodeoxycholic acid in the treatment of non-liver diseases. Global Advances in Health and Medicine. 2014;3(3):58–69. doi:10.7453/gahmj.2014.017  Bai M, Yang L, Liao H, et al. Tauroursodeoxycholic acid improves nonalcoholic fatty liver disease by regulating gut microbiota and bile acid metabolism. Journal of Agricultural and Food Chemistry. 2024;72(41):22655–22668. doi:10.1021/acs.jafc.4c04630  Simon JA, Hudes ES. Relation of serum ascorbic acid to serum vitamin B12, serum ferritin, and kidney stones in US adults. *Archives of Internal Medicine.*1999;159(6):619–624. doi:10.1001/archinte.159.6.619  Walcher T, Haenle MM, Kron M, et al. Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population. BMC Gastroenterology. 2009;9:74. doi:10.1186/1471-230X-9-74  Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Long-term intake of dietary fiber and decreased risk of cholecystectomy in women. American Journal of Gastroenterology. 2004;99(7):1364–1370. doi:10.1111/j.1572-0241.2004.30281.x  Leitzmann MF, Stampfer MJ, Willett WC, Spiegelman D, Colditz GA, Giovannucci EL. Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterology. 2002;123(6):1823–1830. doi:10.1053/gast.2002.37085  Moerman CJ, Smeets FW, Kromhout D. Dietary risk factors for clinically diagnosed gallstones in middle-aged men — a 25-year follow-up study. Annals of Epidemiology. 1994;4(3):248–254. doi:10.1016/1047-2797(94)90099-x Association between dietary magnesium intake and gallstones: the mediating role of atherogenic index of plasma. Lipids in Health and Disease. 2024;23(1):82. doi:10.1186/s12944-024-02074-4  Pitt HA, Doty JE, Murphy MM, Schwarz MB. Progesterone alters biliary flow dynamics. Annals of Surgery. 1999;229(2):205–209. doi:10.1097/00000658-199902000-00008

We sit down with Jim Doyle to explore the timeless art of bonsai. With over 53 years of experience as part of the Susquehanna Bonsai Club, Jim shares the origins and cultural significance of bonsai, along with practical insights into how to care for these living works of art. From shaping techniques to long-term maintenance, he offers a fascinating look into the patience, creativity, and dedication behind bonsai cultivation—revealing why this ancient practice continues to inspire generations today.then,In this medical update, we highlight the launch of a new Celiac Clinic at Penn State Health Milton S. Hershey Medical Center, designed to provide the region's most comprehensive care for patients living with celiac disease. Dr. Kofi Clarke, Chief of Gastroenterology and Hepatology, discusses the clinic's multidisciplinary approach, advanced diagnostic tools, and personalized treatment plans aimed at improving patient outcomes. This episode explores how expanded resources and expert care are transforming the way celiac disease is managed in Central Pennsylvania.

In this episode, Dr. Ruscio breaks down the surprising gut and systemic benefits of NAC (N-acetylcysteine), including how it may help break down biofilms, support SIBO and H. pylori treatment, improve gut lining repair, boost nutrient absorption, and support glutathione, mitochondria, and brain health. You'll also learn when sustained-release NAC may be useful, how to dose NAC properly, and what side effects or cautions to keep in mind.   ✅ Start healing with us! Learn more about our virtual clinic:  https://drruscio.com/virtual-clinic/  

Join us for an “In The Know” special edition where our experts discuss our Cystic Fibrosis Foundation-accredited program that is co-directed by a pediatric pulmonologist and a pediatric gastroenterologist, enabling our team of experts to provide all the services a child needs in one location. Learn more about our Cystic Fibrosis Program. 

Inflammatory bowel disease (IBD) is a debilitating, lifelong condition that changes how people plan their entire lives. In this episode, KT Park, Global Head of Gastroenterology and Hepatology, and Seppi Lin, Head of OMNI Early Clinical Development, explore the complex biology behind IBD. They discuss the role of genetics, the gut microbiome, and an individual's environment, as well as the exciting future of "immune reset" therapies that could offer hope for people with IBD. Read the full text transcript at www.gene.com/stories/the-abcs-of-ibd

Deirdre Tobias is an associate professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. D.K. Tobias and F.B. Hu. The 2025–2030 Dietary Guidelines for Americans — Progress, Pitfalls, and the Path Forward. N Engl J Med 2026;394:1969-1971.

Send us Fan MailFive years post J-pouch surgery sounds like a finish line, but our bodies do not read the brochure. We're together in person for a live catch-up with our favorite recurring guest and IBD Registered Dietitian, Stacey Collins, and we get real about what changes with time and what still blindsides you when you live with a J-Pouch after IBD.We talk through the wins that matter most day to day: more capacity, less urgency, and the quiet joy of doing normal things without panic, like waiting in line, taking long road trips, hiking, skiing, and traveling. Then we dig into the stuff patients whisper about but rarely get warned about, especially gas pain. We break down what it feels like, why it can block emptying, what actually helps (yes, including “toilet yoga”), and why travel, altitude, fasting, dehydration, carbonation, and food additives can make symptoms spike.We also cover the scary gray zones: when symptoms feel like a Crohn's flare but turn out to be SIBO, why antibiotics may be part of J-pouch life, and how to rebuild the gut microbiome afterward with food you can tolerate. Finally, we get blunt about the “surgery is curative” myth, the need for ongoing monitoring (iron deficiency anemia, B12, folate, fatigue), and what better post-op care should look like, including pelvic floor physical therapy and honest expectations at 3, 6, and 12 months.If you found this helpful, subscribe, share it with someone who needs it, and leave a review. What's one thing you wish your care team had told you before surgery?Links: Stacey's website- sign up for her waiting list, find resourcesStacey's additives guideStacey's oral rehydration guideInfo about SIBO- Mayo ClinicInfo about the ENIGMA Study- National Institutes of Health Info about the ENGIBMA Study from Stacey's websiteLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

In this episode, Lin Chang, MD, and Jan Tack, MD, PhD, discuss the history and evolution of Rome criteria, developing guidelines for multifactorial disorders in Rome V and more. ·       Lin Chang, MD, and Jan Tack, MD, PhD 1:04 ·       How has the Rome Foundation evolved over the last ten years? 4:26 ·       What are the Rome criteria, and why should clinicians care about them? 7:20 ·       How did these guidelines become the Rome criteria? 10:32 ·       What is the timeline of developing these criteria? 12:35 ·       Can you tell us about how the Rome Foundation got to the name "DGBI", and why it makes sense for multifactorial conditions? 22:22 ·       What are the highlights and most important changes from Rome V?  26:38 ·       How will this information be disseminated so clinicians can learn about it? 34:22 ·       What lessons did you learn from the Rome V process? 37:40 ·       What's next for the Rome Foundation? 40:04 Lin Chang, MD, is professor of medicine and vice chief of the Vatche and Tamar Manoukian Division of Digestive Diseases at David Geffen School of Medicine at UCLA. Jan Tack, MD, PhD, is president of the Rome Foundation. He also serves as professor of medicine at KU Leuven and chief of the division of gastroenterology and hepatology at Leuven University Hospitals. We'd love to hear from you! Send your comments/questions to guttalkpodcast@healio.com. Follow us on X @HealioGastro @sameerkberry @umfoodoc. Disclosures: Chey and Tack report no financial disclosures. Chang reports consulting roles with Ardelyx, Atmo, Eli Lilly & Co., FoodMarble, GSK, Ironwood Pharmaceuticals and Ono Pharmaceutical; speaking fees from Bausch Health; research grants from AnX Robotica and Ironwood; serving on the Rome Foundation Board of Directors; and having unvested stock options with FoodMarble, ModifyHealth, PICO Health and Trellus Health. Reference: ·        Drossman DA, et al. Gastroenterology. 2026;doi:10.1053.j.gastro.2026.02.014.

Did you know one third of IBS-D cases could be triggered by bile acids in the large intestine? This week's interview is with Prof Bu'Hussain Hayee and helps explain all you need to know:What is bile acid diarrhoea?The effect of diets on bile acidsAsking your GP about whether this could be causing your IBS-DProfessor HayeeProfessor Hayee has been a Consultant Gastroenterologist at King's College Hospital since 2011. He has held Lead roles for the Inflammatory Bowel Disease service and endoscopy Training Lead and is now the Director for the Division of Liver, Gastroenterology and Endoscopy. He served as Director for the London Endoscopy Academy (2021-23) and is a member of the British Society of Gastroenterology Council, and a Fellow of the American Society of Gastrointestinal Endoscopy. He maintains an active role in basic science, endoscopic and clinical research as well as teaching internationally. His PhD, awarded in 2010, focussed on the gut immune system and Crohn's disease and he maintains an interest in gut health and immunity, treating people with a variety of long-term digestive problems through NHS and private practice.Buy my book - Inside Knowledge for people with IBS & SIBO (find it on Amazon)Get free weekly IBS & SIBO emails - https://mailchi.mp/goodnessme-nutrition.com/h6acndd1bsWork with me3 month Gut Reset - https://www.goodnessme-nutrition.com/consultations/Ready for your gut reset?

Editor's Choice:  Optimization of methylated DNA markers to rule out endometrial cancer in patients with abnormal uterine bleedingEditorial: Tampon-based methylated DNA testing for endometrial cancer: Promising innovation, but prudence before practiceHosted by: Charles N. Landen Jr., MD; University of Virginia Charlottesville, VA, USAFeaturing: Jamie N. Bakkum-Gamez, MD; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USAJohn B. Kisiel, MD; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAJoy M. Davis MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USACheck out more content on the journal's homepage  at https://www.gynecologiconcology-online.net

Send us Fan MailThe word “surgery” can feel like a threat when you're young and already worn down by Crohn's disease. Michael Morgan, author of *The Secret Life of Crohn's*, joins us to talk about being diagnosed at age 10, cycling through medications, and living with the kind of urgency that forces you to plan every minute around toilets, school schedules, and the fear of being noticed. We get into the part people don't always see: the constant anxiety, the shrinking world, and how much mental energy IBD can steal long before anyone calls it mental health.Michael also shares what it was like to hear ostomy surgery discussed as a teenager, the misconceptions that fueled his fear, and the moment he realized life on the other side could be bigger than the life he was trying to protect. We talk about the adjustment period, confidence building, and why so many people with ostomies describe freedom and relief once their disease is under better control.From there, we dig into practical realities: asking schools for accommodations, using tools that make bathroom access easier, staying on top of Crohn's management even after major surgery, and navigating rare symptoms like inflammatory disease in the mouth. And yes, we go deep on travel with an ostomy, including packing supplies, hostel bathrooms, and the small “tricks” that make big adventures possible.If you're facing a big treatment decision, supporting a child with IBD, or trying to make your world bigger again, this conversation will meet you where you are. Subscribe, leave a review, and share this with someone who needs a little more hope and a lot more real talk.Links: More of Michael's Story- Crohn's & Colitis UKOrder Michael's bookArticle about Michael and his book- Hackney CitizenTraveling with an ostomy- United Ostomy AssociationLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

What is cultural distress? It is a negative response rooted in a cultural conflict where the patient lacks control over their situation. It results in more physiologic effects on the body resulting in allostatic overload. To prevent this, healthcare practitioners must use strategies such as cultural humility to help patients navigate healthcare. Come find the best ways to deliver culturally sensitive care in any setting.

As I have said many times before, some podcast ideas come from REAL clinic encounters. In this episode, Dr Hanna V, our dedicated PGY1 on our call team, and I will answer TWO real questions which arose just today on morning rounds, on our service: 1. Does NORMOTENSIVE HELLP still need Mag Sulfate? And 2. Does an indwelling foley s/p iatrogenic bladder injury at CS require prophylactic antibiotic coverage for urinary infection? Yep: It's a BOGO sale on today's podcast- Buy ONE GET ONE! Listen in for details.1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222.Obstetrics and Gynecology. 2020. Committee on Practice Bulletins—ObstetricsGuideline2. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T.SR. Corticosteroids for HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) Syndrome in Pregnancy.The Cochrane Database of Systematic Reviews. 2010. 3. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA.Liver Disease in Pregnancy. Lancet. 2010. Review4. Rimaitis K, Grauslyte L, Zavackiene A, et al.Observational. Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre. International Journal of Environmental Research and Public Health. 20195. Reau N, Munoz SJ, Schiano T.Guideline Liver Disease During Pregnancy.The American Journal of Gastroenterology. 2022. 6. ACG Clinical Guideline: Liver Disease and Pregnancy.The American Journal of Gastroenterology. 2016. Tran TT, Ahn J, Reau NS.7. ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstetrics and Gynecology. 2018. Committee on Practice Bulletins—Gynecology Guideline8. Niels Johnsen, Hunter Wessells, Krystal Archer-Arroyo, et al. Best Practices Guidelines Management of Gentiunrinary Injuries.American College of Surgeons (2025). 20259. Fletke KJ, Jeong DH, Herrera AV . Urinary Catheter Management. American Family Physician. 2024..

In this episode of Talk Nerdy, Cara is joined by neurogastroenterologist, and instructor of medicine at Harvard Medical School, Dr. Trisha Pasricha. They discuss her new book, You've Been Pooping All Wrong: How to Make Your Bowel Movements a Joy. Follow Trisha: @trishapasrichamd

In this episode of Bowel Sounds, hosts Drs. Amber Hildreth and Jennifer Lee talk to Dr. Elizabeth Rand, a pediatric gastroenterologist in the Division of Gastroenterology, Hepatology and Nutrition at Children's Hospital of Philadelphia (CHOP), Medical Director of CHOP's Liver Transplant Program, Director of the Gastroenterology Fellowship Program and Director of the Advanced Transplant Hepatology Program. We talk everything about Fontan Associated Liver Disease (FALD), from diagnosis to management and future research opportunities in the field. Learning objectivesDescribe the pathophysiology of FALDUnderstand the management challenges in patients with FALDExplore the unanswered questions about FALD to help guide future research priorities Links:Single-cell multiomics guided mechanistic understanding of Fontan-associated liver diseaseSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

A long-term patient of Palmerston North Hospital's gastroenterology department is concerned about the care he'll receive when the last permanent doctor leaves next month. Over recent years the service, which focuses on patients suffering from problems with their digestive systems, has struggled to attract specialists to work there. One left on Friday, and the other finishes in June. Temporary and locum doctors will fill the gaps, although Health NZ says it's sent out offers of employment to new recruits. Jimmy Ellingham reports.

Send us Fan MailMedical care can be doing everything “right” and you can still feel wrecked, anxious, and trapped in a never-ending cycle of symptoms, appointments, and fear. That gap is where GI psychology lives, and it's why we wanted Dr. Anna Katherine “AK” Black. AK is a licensed clinical health psychologist at GI Psychology, with a focus on gut-brain therapies, trauma-informed care, and medical fatigue in chronic illness.We get into what clinical hypnosis actually is (no stage tricks, no mind control) and why gut-directed hypnotherapy has decades of research behind it for GI conditions. AK explains the gut-brain connection in plain language, including how stress can hijack the system, how visceral hypersensitivity turns the volume up on sensations, and why you can't just tell your gut to “calm down” with conscious thoughts alone. We also talk about how fear and pain overlap, and why techniques that shift the nervous system toward parasympathetic regulation can change real physical symptoms.Then we name the thing so many people feel but rarely hear described: medical fatigue. If you've ever canceled yet another appointment, struggled to keep up with meds and procedures, or felt judged as “noncompliant,” this conversation puts words to that burnout and offers practical next steps. We also cover trauma-informed care, what providers can do with better language and screening, and why integrated teams work best. AK shares resources and explains the Crohn's & Colitis Foundation partnership group that combines community with skills like CBT and hypnosis.Subscribe for more real talk about living with IBD, share this with someone who needs it, and please leave a rating and review so more people can find the show. What part of the gut-brain story hit closest to home?Links: Join the IBD Psychotherapy GroupInfo on Gut-Directed HypnotherapyLet's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

How Therapists Can Help Clients With IBS, Chronic Nausea, and Gut-Brain Disorders: An Interview with Dr. Ali Navidi, PsyD Curt and Katie talk with Dr. Ali Navidi, PsyD about disorders of gut-brain interaction, including IBS, chronic nausea, and other GI conditions that therapists may see more often than they realize. They explore how the gut-brain axis works, which clients may be more likely to struggle with these concerns, how therapists can stay within scope, and why specialized behavioral health treatment can directly improve symptoms rather than only helping clients cope with them. About Our GuestDr. Ali Navidi, PsyD is a licensed clinical psychologist and co-founder of GI Psychology, a national telehealth practice specializing in the treatment of gastrointestinal (GI) disorders and chronic pain. In addition to providing patient care, Dr. Navidi oversees clinical training and outreach initiatives at the practice. He has presented on GI disorders and chronic pain to organizations across the country, including the American College of Gastroenterology, UNC School of Medicine, George Mason University, Georgetown University (Grand Rounds), INOVA, as well as through podcasts, television appearances, and multiple State Academies of Nutrition and Dietetics. Key Takeaways Therapists are in a strong position to notice GI issues, especially in clients with anxiety, trauma histories, autism, or eating disorders. Disorders of gut-brain interaction are not just “in someone's head.” The pain and symptoms are real, even when there is no visible structural problem. Therapists should encourage appropriate medical evaluation and collaborate with gastroenterologists rather than trying to diagnose IBS or other GI disorders on their own. Specialized CBT and clinical hypnosis can directly treat gut-brain disorders, not just the anxiety that surrounds them. Dr. Navidi, PsyD describes a treatment model focused on hypervigilance, catastrophizing, and visceral hypersensitivity. When diet questions come up, therapists should be cautious and refer to GI-focused dietitians when appropriate. Therapists should also be careful about overconfident claims related to the microbiome, SIBO, and other popular gut-health conversations. For full show notes and the transcript for this episode, visit mtsgpodcast.com. Join the Modern Therapist Community Linktree: https://linktr.ee/therapyreimagined Patreon: https://www.patreon.com/c/mtsgpodcast Podcast Homepage: mtsgpodcast.com Facebook Group: https://www.facebook.com/groups/therapyreimagined Modern Therapist's Survival Guide Creative Credits Voice Over by DW McCann: https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano: https://groomsymusic.com/

Today, we're diving into autoimmunity—what it actually is, why it happens, and how ultra-processed foods may be contributing to the problem. Autoimmune disease is often misunderstood. Some will tell you diet has nothing to do with it. Others claim diet is the cure. The truth is more nuanced—and that's exactly what we explore in this episode. You'll learn: What autoimmunity really is (and why it's a case of mistaken identity) How inflammation and the immune system interact The critical role of gut health and the microbiome How ultra-processed foods disrupt intestinal integrity and immune signaling Why stress and hyper-palatable foods create a harmful cycle A practical experiment you can try to see how diet impacts your own biomarkers This isn't about selling supplements or pushing extremes. It's about understanding the science so you can make informed decisions about your health. As always, this episode is backed by scientific literature. Full citations are included below, with abbreviated versions available on shorter clips. If you're dealing with autoimmune symptoms—or just want to better understand how food impacts your immune system—this episode is for you.   Full citation list: Hall KD, et al. “Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake.” Cell Metabolism, 2019.     Supports the formulation argument: UPF intake increased spontaneous calorie intake and weight gain even with diets matched for presented calories, sugar, fiber, sodium, and macronutrients. This is your anchor for “hyper-palatability and formulation change physiology, not just psychology.”   Narula N, et al. “Association of Ultra-Processed Food Intake With Risk of Inflammatory Bowel Disease: Prospective Cohort Study.” BMJ, 2021.     Best human disease-level citation for the episode. Supports the claim that higher UPF intake is associated with greater IBD risk, making the gut-immune link clinically meaningful rather than purely theoretical.   Chassaing B, et al. “Randomized Controlled-Feeding Study of Dietary Emulsifier Carboxymethylcellulose Reveals Detrimental Impacts on the Gut Microbiota and Metabolome.” Gastroenterology, 2022.     Best emulsifier paper for human translation. Supports the claim that CMC can perturb the microbiota and metabolome and may contribute to barrier-hostile gut ecology in susceptible individuals.   Daniel N, et al. “Human Intestinal Microbiome Determines Individualized Responses to Dietary Emulsifier Carboxymethylcellulose.” Cellular and Molecular Gastroenterology and Hepatology, 2024.     Useful nuance paper. Supports the point that emulsifier sensitivity is not identical across all people and that host-microbiome context matters.   Shil A, et al. “Artificial Sweeteners Disrupt Tight Junctions and Barrier Function in the Intestinal Epithelium Through Activation of the Sweet Taste Receptor T1R3.” Nutrients, 2020.     Best citation for the “sugar-free does not mean barrier-neutral” point. Supports direct epithelial barrier effects of common artificial sweeteners in experimental models.   Peng L, et al. “Butyrate Enhances the Intestinal Barrier by Facilitating Tight Junction Assembly via Activation of AMP-Activated Protein Kinase in Caco-2 Cell Monolayers.” Journal of Nutrition, 2009.     Classic mechanistic citation for butyrate. Supports the claim that loss of fermentable fiber and reduced butyrate production can weaken barrier function.   Kumar KP, et al. “The Interplay Between the Microbiota, Diet and T Regulatory Cells in Maintaining Intestinal Homeostasis.” Frontiers in Microbiology, 2023.     Useful for the tolerance language. Supports the argument that diet and microbial metabolites shape Treg biology and mucosal tolerance.   Haase S, et al. “Sodium Chloride Triggers Th17 Mediated Autoimmunity.” Frontiers in Immunology, 2019.     Key citation for high salt and autoimmune-prone immune skewing. Supports the claim that excess salt can promote pathogenic Th17 biology relevant to autoimmune disease.   Wilck N, et al. “Salt-Responsive Gut Commensal Modulates TH17 Axis and Disease.” Nature, 2017.     Strong bridge between salt, microbiome, and Th17 signaling. Supports the point that salt is not just a blood pressure story; it is also an immune-story.   Vitales-Noyola M, et al. “Analysis of Sodium Chloride Intake and Treg/Th17 Lymphocytes in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus.” Journal of Immunology Research, 2018.     Helpful human-facing citation for salt and immune skewing in autoimmune populations. Use cautiously, but it strengthens translation from theory to autoimmune terrain.   Phuong-Nguyen K, et al. “Advanced Glycation End-Products and Their Effects on Gut Health.” Nutrients, 2023.     Good review for the AGE section. Supports the argument that AGE-rich processed foods may worsen oxidative stress, microbiota balance, and barrier function.   Chen Y, et al. “Dietary Advanced Glycation End-Products Elicit Toxicological Effects by Disrupting Gut Microbiota and Increasing Colon Permeability in Rats.” Journal of Toxicology and Environmental Health, 2021.     Useful mechanistic support for the processing-chemistry section. Reinforces the claim that dietary AGEs can alter microbial ecology and increase permeability.   Monteiro CA, et al. “Ultra-Processed Foods: What They Are and How to Identify Them.” Public Health Nutrition, 2019.   Dr. Brendan McCarthy is the founder and Chief Medical Officer of Protea Medical Center in Arizona. With over two decades of experience, he's helped thousands of patients navigate hormonal imbalances using bioidentical HRT, nutrition, and root-cause medicine. He's also taught and mentored other physicians on integrative approaches to hormone therapy, weight loss, fertility, and more. If you're ready to take your health seriously, this podcast is a great place to start.  

In this episode of Bowel Sounds, hosts Dr. Peter Lu and Dr. Jason Silverman talk to Dr. Leonel Rodriguez, Chief of Pediatric Gastroenterology and Professor of Pediatrics at Yale Medicine. We discuss the rising number of children presenting to us with the inability to belch and the relatively new diagnosis of retrograde cricopharyngeal dysfunction (R-CPD).Learning objectivesRecognize the presenting symptoms of retrograde cricopharyngeal dysfunction (R-CPD) and its potential overlap with disorders of gut-brain interaction.Understand the evaluation of a child with an inability to belch and the utility of esophageal manometry.Review the management of R-CPD, including the potential role of less invasive treatment options prior to cricopharyngeal Botox injection.Send us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Most people think you need to poo every day to be healthy. You don't. In this episode, we explain how to tell if your poo is normal, the warning signs you shouldn't ignore, and the gut mistake you may be making on the toilet every day.  Dr Trisha Pasricha, a leading Harvard gastroenterologist, a columnist for the Washington Post and author of the book You've Been Pooping All Wrong, explains how your poo, gut health, and disease risk are linked, and when you should see a doctor. Dr Pasricha guides us through why frequency, colour, and consistency all matter, and why there is no single “normal.” You'll learn how to spot changes that could signal disease, including early warning signs linked to cancer and long-term brain health. You'll hear simple advice you can use straight away. This includes how to recognise your normal pattern, what changes to look out for, and how to avoid the common toilet habit that may affect your gut. Are you looking at your poo every day? And, if not, what might you notice if you did?

Identification of pancreatic cystic lesions has become increasingly common due to improved resolution and increased utilization of cross-sectional imaging. However, there are many types of pancreatic cysts, each with varying degrees of malignant potential. In this episode from the HPB team at Behind the Knife, listen in as we discuss the clinical presentation, diagnostic work-up, and management strategies for various pancreatic cysts: Pseudocysts, Serous Cystadenomas, Mucinous Cystic Neoplasms, and IPMNs, amongst others. HostsAnish J. Jain MD (@anishjayjain) is a current PGY4 General Surgery resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.Jon M. Harrison MD is a Hepatobiliary & Pancreatic (HPB) surgeon at the Massachusetts General Hospital in Boston, MA and a former HPB Surgery fellow at Stanford University. Learning Objectives·      Develop an understanding of the clinical presentation, diagnostic work-up, and treatment of benign pancreatic cysts·      Develop an understanding of the clinical presentation, diagnostic work-up, and treatment of pre-malignant pancreatic cysts·      Develop an understanding of when surveillance is appropriate for management of pancreatic cysts, and the criteria involved in making that determination·      Develop an understanding of the prognostic utility of PancSeq for IPMNsReferences: Paniccia A, Polanco PM, Boone BA, et al. Prospective, Multi-Institutional, Real-Time Next-Generation Sequencing of Pancreatic Cyst Fluid Reveals Diverse Genomic Alterations That Improve the Clinical Management of Pancreatic Cysts. Gastroenterology. 2023 Jan;164(1):117-133.e7.PubMed Link: https://pubmed.ncbi.nlm.nih.gov/36209796/ Ohtsuka T, Fernandez-Del Castillo C, Furukawa T, et al. International evidence-based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas. Pancreatology. 2024 Mar;24(2):255-270.PubMed Link: https://pubmed.ncbi.nlm.nih.gov/38182527/ Zelga P, Hernandez-Barco YG, Qadan M, et al. Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. J Am Coll Surg. 2022 Jun 1;234(6):1021-1030.PubMed Link: https://pubmed.ncbi.nlm.nih.gov/35703792/ Ciprani D, Weniger M, Qadan M, et al. Risk of malignancy in small pancreatic cysts decreases over time. Pancreatology. 2020 Sep;20(6):1213-1217.PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32819844/ ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this episode, we break down a major factor in treating SIBO and preventing recurrence: biofilm disruption. You'll learn how to identify the telltale signs of biofilms, the steps to our proven treatment protocol, and discover the dietary and supplement strategies that support lasting gut recovery. Our approach is backed by our recently published study, Biofilm Disruption Enhances Antimicrobial Therapy for Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth. Read the full findings here:https://pubmed.ncbi.nlm.nih.gov/41394228/.    If you've struggled with recurring SIBO and felt like nothing works, this episode will guide you to effective solutions.