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Gloria sent me a link to a very interesting research article where a group of researchers dispute the association of PPIs, SSRIs, and statins, with MC. Bearing in mind that some of the top GI specialists in the country have maintained that these drugs are associated with the development of MC, this report is rather controversial, to say the least.
I get the impression that they "overselected" their cohort of MC subjects, (as a result they were only able to come up with 25 subjects that met their criteria). That's pretty clear if we look at the data for diabetes and hypercholesterolemia, for example. Their MC subjects had only one- third or one-fourth of the incidence of diabetes, when compared with the random controls and the diarrhea controls, respectively. The percentage of MC subjects with high cholesterol was on a par with the diarrhea controls, but only about half the percentage of the random controls. Of course, that just validates my claim that cholesterol levels have to come down, when chronic diarrhea is present. The data regarding diabetes is interesting, though. Does that suggest that diabetes is protective of MC? I doubt it, even though their numbers indicate pretty strongly that it is.
More disturbing than that, though, is the fact that their MC cohort showed only one-fourth the incidence of total PPI use, compared with random controls, and only one-third the incidence of PPI use, compared with diarrhea controls. This seems odd, in view of the fact that the incidence of GERD was very similar for all three groups. We all know that PPIs are widely prescribed for GERD, so why weren't the subjects in their MC group using PPIs on a level comparable with the other groups? Did the researcher's selection criteria introduce a bias? Could it be that their MC cohort avoided PPIs because they found that PPIs make their symptoms worse? The authors even pointed out that discrepancy in their write up, but offered no explanation for such a distorted arrangement:
Anyway, be all that as it may, IMO, the biggest problem with the conclusions of the report is the premise on which they were presented. They present the evidence as "odds ratios".It must be noted that we did indeed find a significant decreased association for PPI use and MC compared to random controls which we cannot adequately explain.
Odds ratios? This strikes me as not only convoluted, but totally beside the point.In fact, it doesn't actually matter whether it's more likely, (or less likely), that someone with MC might respond negatively to a given class of drugs, when compared with "random controls", or "diarrhea controls". All that matters is whether or not a given drug triggers the symptoms of MC, and the conclusions of the report do not even address that issue.
As far as the report conclusions are concerned, for all we know, those drugs may cause the same issues in "random controls", and in "diarrhea controls". If that's the case, then a comparison is obviously totally pointless. Since the researchers made no effort to prove that the various drugs do not cause symptoms in "random controls", or in "diarrhea controls", that makes their conclusions totally irrelevant - nothing but smoke and mirrors. IOW, their conclusions are confounded by an invalid assumption, right off the bat, namely that the drugs being considered do not cause adverse symptoms in "random controls" and "diarrhea controls". Obviously, they couldn't prove that, even if they tried, because all we have to do is to look at the labels of the respective drugs to see that they do indeed cause various adverse symptoms, (including diarrhea).
So what did the researchers prove? They proved that the drugs in question cause side effects for a certain percentage of the people who take them, regardless of whether those individuals have MC, or not. So what? We already knew that. Furthermore, our cumulative experience here on the board supports the evidence that those drugs do indeed cause the symptoms of MC, for certain people. If they didn't, then those individuals wouldn't be able to resolve their symptoms, simply be discontinuing the use of the drug. Simpler and more convincing proof probably doesn't exist.
http://www.la-press.com/redirect_file.p ... leType=pdf
As if such a gross error isn't enough, the authors had the gall to specifically dispute the claims of Dr. Pardi and his associates, for claiming that those drugs are associated with MC. Most of you know that I'm not Dr. Pardi's biggest fan, (due to his failure to recognize the importance of food sensitivities in the treatment of MC, and his asinine refusal to acknowledge the legitimacy of Dr. Fines' stool tests for determining food sensitivities), but I have to rally to his defense on this issue, because certain drugs obviously can prevent us from achieving remission of our MC symptoms, if we happen to be sensitive to them.
The bottom line is that this was a very misguided research project, that reached some ridiculous conclusions, because of one or more stupid mistakes in designing the study. I can't help but wonder if anyone in the medical research community will even bother to critically analyze their results, let alone dispute their conclusions. I sometimes wonder how many in the medical research community even give a you-know-what, anymore, as far as accuracy and integrity are concerned.
The report does show a lot of nicely-organized data, and comparisons. Unfortunately, most of it is irrelevant, as far as their conclusions are concerned, and, of course, their conclusions are totally wrong.
Tex
