The GP Show11 Maalis 2018

#30 Probiotics with Dr Johan Van Den Bogaerde Gastroenterologist

Surrounded by the familiar beeps and glow of the hospital surgical theatres I had a thoroughly enjoyable chat with scrubs-donned Dr Johan Van Den Bogaerde Gastroenterologist and researcher. We discuss probiotics and the various relevant themes around them. Topics we discuss include: - What are probiotics and some important principles - How do they work? - Evidence for different conditions - IBD, IBS, diarrhoeal disorders, helicobacter pylori, atopic eczema and others - Research bias - Working with real people who are suffering but that don't fit the guidelines = the clinicians dilemma Summary of the POSSIBLE uses: IBD Ulcerative Colitis and Pouchitis - VSL3, E. coli nissle and saccharomyces boulardi may help for remission. No clear evidence for chron's disease IBS - VSL3, bifido infantis - mixed studies, some positive and some only as good as placebo (~50% reduction in pain) Diarrhoeal disorders (antibiotics associated, childrens diarrhoea, c.dif and preventing travellors diarrhoea) = Lacto. rhamnosus, saccharomyces boulardii and Lacto. reuteri may be of assistance e.g. reduce duration of infectious diarrhoea by <1 day Helicobacter pylori - Saccharomyces boulardii and Lacto. reuteri - may reduce side effects to antibiotics and improve eradication rate Atopic eczema - Lacto. rhamonsus and Bifido. lactis reduce rate of atopic eczema in children by 80% if taken by mother during pregnancy and breastfeeding Atopic eczema - not clear, mixed studies as a treatment of atopic eczema Other possible use though studies are limited and early - bacterial vaginosis, major depression disorder, autism spectrum disorder, other CNS disorders, hepatic encephalopathy Doses and duration's vary Risks: Do not use in critically unwell or marked immunosuppression Side effects may include - constipation, flatulence, nausea, rash and others Don't forget the price tag Some of the many references: IBD - https://www.ncbi.nlm.nih.gov/pubmed?term=20517305, https://www.ncbi.nlm.nih.gov/pubmed?term=14684584, https://www.ncbi.nlm.nih.gov/pubmed?term=22161412 IBS - https://www.ncbi.nlm.nih.gov/pubmed/25780308 Diarrhoeal disorders - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748908/ , H pylori - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588086/ Atopic disease pregnancy - https://www.racgp.org.au/your-practice/guidelines/handi/interventions/children/probiotics-in-pregnancy-for-infant-atopic-eczema/ Eczema in children - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828648/

Probiotics and intestinal permeability-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/

CNS disorders = https://www.ncbi.nlm.nih.gov/pubmed/27413138

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#224 Clean Slate Clinic with Dr Chris Davis

Dr Chris Davis is a GP, Co-Founder and CMO of the Clean Slate Clinic, Australia's leading virtual detox and recovery service, and an Addiction Specialist at St Vincent's Hospital, Sydney. He establish...

13 Elo 59min

#223 Premenstrual Dysphoric Disorder (PMDD) with Professor Jayashri Kulkarni

Professor Jayashri Kulkarni is one of Australia's leading psychiatrists and researchers specialising in women's mental health. She is the Director of the HER Centre Australia (Health, Education and Re...

27 Heinä 31min

#222 Perimenopausal Mental Health with Professor Jayashri Kulkarni

7 Heinä 1h 2min

#221 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MECFS) with Dr David Fineberg

Dr David Fineberg is a General Practitioner and PhD candidate at the University of Melbourne whose research focuses on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID. He is...

22 Kesä 1h 16min

#220 Loose Joints, Lax Ligaments, and Liquid Gold: Musculoskeletal Medicine for Hypermobility with Dr Rob Illingworth

Many of us have patients with hypermobility and Ehlers-Danlos syndrome who we work hard to help. As our understanding of these complex multisystem conditions grows, understanding that it doesn't just ...

4 Kesä 1h

#219 Fast Facts in Sexual and Reproductive Health with Dr Sara Whitburn

Dr. Sara Whitburn is the Medical Director of Sexual Health Victoria, Chair of the RACGP Sexual and Reproductive Health Special Interest Group, and a Senior Lecturer in Sexual Health at the University ...

4 Kesä 1h 14min

#218 Workers' Compensation with Greg Spinda

Ever found yourself staring at a workers' compensation or insurance form, pen in hand, quietly wondering what on earth you're supposed to write in half these boxes? You're in good company. Most of us ...

2 Touko 1h 2min

#217 Men's Sexual Health with Dr Sama Balasubramanian

Dr Sama Balasubramanian is a General Practitioner and Sexual Health Physician, Fellow of the Australasian Chapter of Sexual Health Medicine and Fellow of the European Committee of Sexual Medicine. He...

22 Huhti 1h 11min