abdominal pain (a different reason)

[JLH]

http://www.ivanhoe.com/channels/p_chann ... ryid=24615

(Dr. Liu recommended Dr. Fine's genetic testing for MC.)

[Gabes-Apg]

i like the comment -

"They're labeled as being crazy this is all in your mind, or they're labeled as anorexic or they have an eating disorder,” Dr. Liu explained. “That's a very common thing."

mmmmm sounds a bit familiar in the pre diagnosis stage for us!

[tex]

The scene:

A classroom containing a couple dozen wannabe GI specialists, on their last day of formal coursework.

As he looks around the room, and peers into the glazed eyes of the half-asleep group, the aging Prof makes his final, sage, remark:

PROFESSOR OLDGUARD

And remember - you're experts now, so whenever you don't have a clue what's wrong with a patient, for Pete's sake, don't admit it - that sounds unprofessional. Just tell 'em it's all in their head. Considering what you'll be charging them for your advice, they can't afford to argue with you.

Maybe we should write a comedy screenplay, instead of a book.

Tex

[Joefnh]

Chapter 4 scene 6: Commentator States: "The scary part is that after a while most of the docs begin to believe the lie..."


--Joe

[Gabes-Apg]

Chapter 7 scene 1 - the doctor looks at Polly's colonscopy biopsy results and exclaims "its a miracle!"

"if you didnt take drugs then it must be a miracle that you are cured" he refuses to acknowledge that good health could be the resultant of diet and relaxation management......

[Joefnh]

I love it...

--Joe

[Bifcus16]

Not sure the GI's would accept a miracle.

How about:

"Obviously the earlier test results showing MC were just incorrect."

Lyn

[Joefnh]

I'm not sure that they would recognize it anyway

--Joe

[tex]

There would be no reason for them to acknowledge the validity of that report. "Everyone" knows that MC resolves spontaneouosly, in about 3 years:

CONCLUSIONS: Lymphocytic colitis is characterised by a benign course with resolution of diarrhoea and normalisation of histology in over 80% of patients within 38 months.

http://www.ncbi.nlm.nih.gov/pubmed/9824342

The same type of research conclusions can be found for collagenous colitis, as well. Either the medical profession's view of microscopic colitis is totally corrupt and confused, or the vast majority of us who are members of this board, are obviously anomalies, or paradoxes, or we pretend to be affected by the disease longer than 3 years simply because we are hypochondriacs. Are they screwed up, or we are? I don't believe we need a poll, to answer that one. The implications, though, mean that as a group, they are not likely to place any value in anything we might say or do.

Tex

[Joefnh]

I'll mark it on my calendar then.... Lets see I will be feeling well by June 2013



--Joe

[tex]

Joe,

It should be sooner than that, shouldn't it? Remission should occur within 38 months from the time that the symptoms begin, because once the symptoms present, the disease has already developed, and therefore should be diagnosable. Remember - treatment is not even necessary, according to the article:

Considering the benign course of the disease, the potential benefit of any drug treatment should be carefully weighed against its potential side effects.

You may have been in remission for several years already, based on their science, and you just didn't realize it.

I love their logic - as if any patient should be content to just put up with 38 months of uncontrollable diarrhea, because, (according to them), everything will be AOK after that.

Tex

[Rosie]

Tex, I was curious about why that paper showed results that are so much in variance to our collective experience. The entire article, not just the abstract, is available, and I read it over. I was especially curious as to how they selected patients for the study. They weren't very clear about how the selection of patients was made, but it appears that they might have had serious "selection bias", as they appear to have chosen patients with sudden onset of diarrhea, which we know often stems from non-diet causes, such as certain medications, and often goes into remission once the drug is stopped. They apparently didn't want patients who already had been struggling with D for many years...... it would no doubt interfere with their statistics, since they only looked at 27 patients.

Our patients with lymphocytic colitis had a sudden onset of diarrhoea, an observation also made in patients with collagenous colitis.

Also, they noted that a number of their patients had been on NSAIDs and antibiotics. One was also diagnosed with CD too.

One patient was known to have coeliac disease. Five patients took non-steroidal antiinflammatory drugs (NSAIDs) on a regular basis, three of them low dose acetylsalicylic acid for cardiovascular reasons. One patient was receiving ranitidine.

Also, they only did the follow-up histology with a signoidoscopy, not colonoscopy. Here is what they said:

Accordingly index biopsy specimens were usually obtained from the ascending colon, whereas all follow up samples were taken from the sigmoid colon. However, we do not believe that this explains the difference in intraepithelial lymphocyte counts between index and follow up biopsy samples, as lymphocytic colitis usually affects the entire colon. Thus the intraepithelial lymphocyte count is quite similar between the various segments of the large bowel. Therefore biopsy samples from the sigmoid colon may be considered to be representative of the entire colon.

And 20% of the patients still weren't in remission after the 38 months. I guess too bad for them.....since MC runs a benign course.

It's just bad science, and the rest of us suffer for it........

Rosie

[Joefnh]

Well Tex I'm glad I'm in remission... Unfortunately my body didn't get the memo.




--Joe

[tex]

Rosie,

I did look up the full text article, before I posted that, but unlike you, I started reading at the last paragraph, and saw that it was virtually identical to the conclusions stated in the abstract, except that they listed 40 months, instead of 38, (strangely enough), as the "magic" number. When I noticed that the "summary" paragraph didn't contain any more detail than what was stated in the abstract, I thought, "Why bother?", and I stopped reading.

Obviously, I should have read the rest of it, because you're right, it definitely appears that they "judiciously" selected their cohort of subjects for the study, in order to assure the results that they "wanted". I believe it is indeed true that most cases of MC that are initially caused by medications, will promptly resolve, if the medications are discontinued. We have several members who found that to be true for them.

And there is no way that the BS about the biopsy samples from the sigmoid colon being representative of the entire colon, is true. It might have some correlation, based on a correction factor, but it is not directly comparable, in most cases. The IL count is virtually always higher in the ascending colon, and MC presents in random patches, not as a uniform distribution. That research team must have been composed of liars and thieves, to use such unscrupulous tactics.

For years, I've wondered how in the world they could come up with those results, but I never read the full text of the article, because every time I looked it up, I couldn't get past that last paragraph. Many thanks for clearing up that mystery. You're a thorough researcher.

Tex

[JoAnn]

Thanks Joan (and Tex) for all the research you do and post for us to read. This particular article is the exact thinking I ran into when I was first diagnosed. That's why it took me 4 months before I found you people. My gi acted like it was no big deal, asacol would heal me in no time, it would eventually burn itself out, blah, blah, blah. Four months later I was worse than ever. I wish some famous, wealthy person would get this so we could be heard. JoAnn