Discover and read the best of Twitter Threads about #motility

Most recents (9)

I gave a talk on inpatient bowel regimens today for the @YaleMed @YaleIMed residents and students, with additional 💎s on outpatient #constipation. Here are the slides!

💩 💩 💩

#MedTwitter #GITwitter #motility #MedEd @YaleIM_Chiefs @MayoClinicGIHep
Most inpatients require a bowel regimen. Our patients typically have most of the risk factors for #constipation!
#Constipation is more about symptoms than frequency! 🚽

It’s also a *symptom* (like chest pain), so need to figure out what’s causing it and treat accordingly.
Read 20 tweets
Chronic constipation is common and has tremendous impact on quality of life
#Constipation is NOT all about frequency. Ask about 👇
Read 20 tweets
Buckle up! This 🧵 is a deep dive into the #physiology of defecation, the mechanics of pooping! 🧰 🚽 💩

nature.com/articles/s4157…

#medicine #MedEd #science #GITwitter #GI #gut #motility #constipation #IBS
Defecation requires
1. intact #GI tract
2. coordination of many systems: neural (enteric nervous system, modulated by the peripheral somatic, autonomic and the CNS); muscular (smooth and striated); hormonal (endocrine and paracrine); and cognitive (behavioural and psychosocial)
#Constipation is the3⃣rd most common #GI symptom

💰 Annual cost of fecal incontinence and constipation: $1,594 - $7,522
Read 31 tweets
Here are the new @BritSocGastro guidelines for #IBS in @Gut_BMJ! I'll summarize in 🧵 ⬇️⬇️⬇️!

😖💩🦠🧠🥦🍞💊

#GITwitter #GI #gut #braingut #motility #DGBI #FGID #microbiome #probiotics #MedTwitter #MedEd

gut.bmj.com/content/early/…
🧑‍⚕️-😷
Doctor-patient communication
🧑‍⚕️A strong 🧑‍⚕️-😷 relationship is fundamental to the management of #IBS
😷Patients want their 🧑‍⚕️ to ⬆️empathy, support and information about the nature of IBS, diagnosis, and treatment options
DIAGNOSIS
🩸New pt: CBC, CRP or ESR, celiac serology and, if <45 w diarrhea, fecal calprotectin
➕Make POSITIVE diagnosis based on @RomeFoundation criteria
➡️Refer to #GI when: diagnostic doubt, pt w symptoms that are severe or refractory to 1stline tx,or when pt wants specialist
Read 16 tweets
A little late but better late than never! ⌚️ Here's a recap of @AmCollegeGastro Virtual Grand Rounds by @ScottGabbardMD on...... FUNCTIONAL DYSPEPSIA!
🤢🤢🤢

This is a VERY common entity that is underdiagnosed! #MedTwitter take notice!

#GITwitter #GI #gut
DYSPEPSIA = epigastric #pain. (can be associated with any other upper #GI symptom such as epigastric fullness, nausea, vomiting, or heartburn).

Dyspepsia is COMMON, and most cases are FUNCTIONAL (i.e., caused by brain-gut axis dysfunction)!
Like all disorders of gut-brain interactions FD pathophysiology is❌completely understood, but is thought to be complex+multifactorial. Components include
🤢disrupted duodenal barrier
🤢altered duodenal #microbiome
🤢dysmotility
🤢visceral hypersensitivity
🤢psychosocial stress
Read 22 tweets
Let's talk about something common, hard to treat, and often misunderstood: CHRONIC BLOATING AND DISTENSION!

A 🧵 summarizing from the excellent @AGA_CGH article cghjournal.org/article/S1542-…

#GI #GITwitter #motility #IBS #DGBI #FGID #microbiome #health #MedEd
🟢Bloating: subjective sensation of gassiness, trapped💨, or a feeling of pressure or being distended w/o obvious visible distension.

🟢Distension: objective physical manifestation of an⬆️in abdominal girth. Patients commonly say they look like 🎈 or 🤰
Bloating and distension are COMMON

🔴16-31% in the general population

🔴Women > men

🔴66-99% in #IBS

🔴IBS-C > IBS-D

🟢Bloating and distension are distressing to patients and ⬇️quality of life
Read 13 tweets
Recapping @AmCollegeGastro's #VirtualGrandRounds on #IBS! Let's begin!
🟣IBS can be diagnosed with the Rome criteria
🟣Making a positive diagnosis is very helpful to patients, many of whom have gone years without a name for their symptoms
#IBS is heterogeneous, and so are its pathogenesis and pathophysiology.
🟣Identifying underlying factors in patients can help target treatment!

@AmCollegeGastro
Important principles when diagnosing and treating #IBS.

@AmCollegeGastro
Read 34 tweets

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