Prebiotics (oligosaccharides) induce a more healthful flora; probiotics are not routinely recommended due to case reports of central line infections, though these likely occurred through direct line contamination rather than translocation.
Metronidazole is the wrong choice for bacterial overgrowth because it has limited spectrum, knocks off anaerobes, and facilitates aerobic overgrowth; 2/3 of bloodstream infections were seen in patients on prophylactic Flagyl.
Donor breast milk is less advantageous than maternal breast milk because it is usually from mothers 10-14 months postpartum, has lower caloric density and protein, and freezing may inactivate trophic factors.
Cholestyramine in effective doses will bind nutrients, fat-soluble vitamins, and fats, with risk of hyperchloremic acidosis and bezoars; homeopathic doses may improve stool appearance but not reduce volume.
Since developing a mature multidisciplinary intestinal rehabilitation program, internal transplant candidates have declined by 75%, and intestinal transplants are almost non-existent.
epidemiologicalSince developing a mature multidisciplinary intestinal rehabilitation program, internal transplant candidates have declined by 75%, and intestinal transplants are almost non-existent.↗
▶Ep 2 · 1:02:40
clinicalDonor breast milk is less advantageous than maternal breast milk because it is usually from mothers 10-14 months postpartum, has lower caloric density and protein, and freezing may inactivate trophic factors.↗
▶Ep 2 · 1:11:51
epidemiologicalAbout 60% of patients weaned off TPN have deficiencies in one micronutrient or another.↗
▶Ep 2 · 1:23:28
quoteThe older I get, and I'm pretty old, the more I recommend prebiotics and the less I recommend antibiotics.↗
▶Ep 2 · 1:23:28
opinionPrebiotics (oligosaccharides) induce a more healthful flora; probiotics are not routinely recommended due to case reports of central line infections, though these likely occurred through direct line contamination rather than translocation.↗
▶Ep 2 · 1:24:14
quoteWe need to discourage putrefactive bacteria such as E. coli, Klebsiella, and the like, and we want to encourage the anaerobes.↗
▶Ep 2 · 1:30:10
clinicalMetronidazole is the wrong choice for bacterial overgrowth because it has limited spectrum, knocks off anaerobes, and facilitates aerobic overgrowth; 2/3 of bloodstream infections were seen in patients on prophylactic Flagyl.↗
▶Ep 2 · 1:32:11
quoteMetronidazole is absolutely the wrong choice. It has a limited spectrum. It knocks off your anaerobes and facilitates the growth of aerobes.↗
▶Ep 2 · 1:32:27
opinionIf using antibiotics for bacterial overgrowth, selective decontamination with non-absorbable aminoglycosides (tobramycin) and colistin may be preferable to metronidazole.↗
▶Ep 2 · 1:46:00
clinicalCholestyramine in effective doses will bind nutrients, fat-soluble vitamins, and fats, with risk of hyperchloremic acidosis and bezoars; homeopathic doses may improve stool appearance but not reduce volume.↗
▶Ep 2 · 1:49:38
clinicalIn infants, only pancreatic proteases are present in adult quantities; amylases appear between 6-12 months and lipase reaches adult levels by end of first year.↗
epidemiologicalSince developing a mature multidisciplinary intestinal rehabilitation program, internal transplant candidates have declined by 75%, and intestinal transplants are almost non-existent.↗
▶Ep 2 · 1:02:40
clinicalDonor breast milk is less advantageous than maternal breast milk because it is usually from mothers 10-14 months postpartum, has lower caloric density and protein, and freezing may inactivate trophic factors.↗
▶Ep 2 · 1:11:51
epidemiologicalAbout 60% of patients weaned off TPN have deficiencies in one micronutrient or another.↗
▶Ep 2 · 1:23:28
quoteThe older I get, and I'm pretty old, the more I recommend prebiotics and the less I recommend antibiotics.↗
▶Ep 2 · 1:23:28
opinionPrebiotics (oligosaccharides) induce a more healthful flora; probiotics are not routinely recommended due to case reports of central line infections, though these likely occurred through direct line contamination rather than translocation.↗
▶Ep 2 · 1:24:14
quoteWe need to discourage putrefactive bacteria such as E. coli, Klebsiella, and the like, and we want to encourage the anaerobes.↗
▶Ep 2 · 1:30:10
clinicalMetronidazole is the wrong choice for bacterial overgrowth because it has limited spectrum, knocks off anaerobes, and facilitates aerobic overgrowth; 2/3 of bloodstream infections were seen in patients on prophylactic Flagyl.↗
▶Ep 2 · 1:32:11
quoteMetronidazole is absolutely the wrong choice. It has a limited spectrum. It knocks off your anaerobes and facilitates the growth of aerobes.↗
▶Ep 2 · 1:32:27
opinionIf using antibiotics for bacterial overgrowth, selective decontamination with non-absorbable aminoglycosides (tobramycin) and colistin may be preferable to metronidazole.↗
▶Ep 2 · 1:46:00
clinicalCholestyramine in effective doses will bind nutrients, fat-soluble vitamins, and fats, with risk of hyperchloremic acidosis and bezoars; homeopathic doses may improve stool appearance but not reduce volume.↗
▶Ep 2 · 1:49:38
clinicalIn infants, only pancreatic proteases are present in adult quantities; amylases appear between 6-12 months and lipase reaches adult levels by end of first year.↗
Sam's statements about Intestinal Failure11 statements
epidemiologicalSince developing a mature multidisciplinary intestinal rehabilitation program, internal transplant candidates have declined by 75%, and intestinal transplants are almost non-existent.↗
▶Ep 1 · 1:02:40
clinicalDonor breast milk is less advantageous than maternal breast milk because it is usually from mothers 10-14 months postpartum, has lower caloric density and protein, and freezing may inactivate trophic factors.↗
▶Ep 1 · 1:11:51
epidemiologicalAbout 60% of patients weaned off TPN have deficiencies in one micronutrient or another.↗
▶Ep 1 · 1:23:28
opinionPrebiotics (oligosaccharides) induce a more healthful flora; probiotics are not routinely recommended due to case reports of central line infections, though these likely occurred through direct line contamination rather than translocation.↗
▶Ep 1 · 1:23:28
quoteThe older I get, and I'm pretty old, the more I recommend prebiotics and the less I recommend antibiotics.↗
▶Ep 1 · 1:24:14
quoteWe need to discourage putrefactive bacteria such as E. coli, Klebsiella, and the like, and we want to encourage the anaerobes.↗
▶Ep 1 · 1:30:10
clinicalMetronidazole is the wrong choice for bacterial overgrowth because it has limited spectrum, knocks off anaerobes, and facilitates aerobic overgrowth; 2/3 of bloodstream infections were seen in patients on prophylactic Flagyl.↗
▶Ep 1 · 1:32:11
quoteMetronidazole is absolutely the wrong choice. It has a limited spectrum. It knocks off your anaerobes and facilitates the growth of aerobes.↗
▶Ep 1 · 1:32:27
opinionIf using antibiotics for bacterial overgrowth, selective decontamination with non-absorbable aminoglycosides (tobramycin) and colistin may be preferable to metronidazole.↗
▶Ep 1 · 1:46:00
clinicalCholestyramine in effective doses will bind nutrients, fat-soluble vitamins, and fats, with risk of hyperchloremic acidosis and bezoars; homeopathic doses may improve stool appearance but not reduce volume.↗
▶Ep 1 · 1:49:38
clinicalIn infants, only pancreatic proteases are present in adult quantities; amylases appear between 6-12 months and lipase reaches adult levels by end of first year.↗
Sam's statements about Intestinal Rehab11 statements
epidemiologicalSince developing a mature multidisciplinary intestinal rehabilitation program, internal transplant candidates have declined by 75%, and intestinal transplants are almost non-existent.↗
▶Ep 8 · 1:02:40
clinicalDonor breast milk is less advantageous than maternal breast milk because it is usually from mothers 10-14 months postpartum, has lower caloric density and protein, and freezing may inactivate trophic factors.↗
▶Ep 8 · 1:11:51
epidemiologicalAbout 60% of patients weaned off TPN have deficiencies in one micronutrient or another.↗
▶Ep 8 · 1:23:28
quoteThe older I get, and I'm pretty old, the more I recommend prebiotics and the less I recommend antibiotics.↗
▶Ep 8 · 1:23:28
opinionPrebiotics (oligosaccharides) induce a more healthful flora; probiotics are not routinely recommended due to case reports of central line infections, though these likely occurred through direct line contamination rather than translocation.↗
▶Ep 8 · 1:24:14
quoteWe need to discourage putrefactive bacteria such as E. coli, Klebsiella, and the like, and we want to encourage the anaerobes.↗
▶Ep 8 · 1:30:10
clinicalMetronidazole is the wrong choice for bacterial overgrowth because it has limited spectrum, knocks off anaerobes, and facilitates aerobic overgrowth; 2/3 of bloodstream infections were seen in patients on prophylactic Flagyl.↗
▶Ep 8 · 1:32:11
quoteMetronidazole is absolutely the wrong choice. It has a limited spectrum. It knocks off your anaerobes and facilitates the growth of aerobes.↗
▶Ep 8 · 1:32:27
opinionIf using antibiotics for bacterial overgrowth, selective decontamination with non-absorbable aminoglycosides (tobramycin) and colistin may be preferable to metronidazole.↗
▶Ep 8 · 1:46:00
clinicalCholestyramine in effective doses will bind nutrients, fat-soluble vitamins, and fats, with risk of hyperchloremic acidosis and bezoars; homeopathic doses may improve stool appearance but not reduce volume.↗
▶Ep 8 · 1:49:38
clinicalIn infants, only pancreatic proteases are present in adult quantities; amylases appear between 6-12 months and lipase reaches adult levels by end of first year.↗
Summaries Sam gave as host
· 8 summaries
Recaps of other experts' statements, not Sam's own clinical position.
Summaries Sam gave as host · Gastroschisis2 summaries
host summarySam Kocoshis summarizing the discussion: In a classic French study by Jolie, adults with short bowel syndrome had 60% absorption with ad lib feeding, 85% with continuous drip feeds, and 75% with half calories by mouth plus overnight drip feeds.↗
▶Ep 2 · 1:54:00
host summarySam Kocoshis summarizing the discussion: GLP-2 analog can reduce fecal output such that TPN can be reduced by about 20% in 60-70% of adult patients, and totally emancipate about 20% from TPN in extension studies.↗
Summaries Sam gave as host · Gastroschisis2 summaries
host summarySam Kocoshis summarizing the discussion: In a classic French study by Jolie, adults with short bowel syndrome had 60% absorption with ad lib feeding, 85% with continuous drip feeds, and 75% with half calories by mouth plus overnight drip feeds.↗
▶Ep 2 · 1:54:00
host summarySam Kocoshis summarizing the discussion: GLP-2 analog can reduce fecal output such that TPN can be reduced by about 20% in 60-70% of adult patients, and totally emancipate about 20% from TPN in extension studies.↗
Summaries Sam gave as host · Intestinal Failure2 summaries
host summarySam Kocoshis summarizing the discussion: In a classic French study by Jolie, adults with short bowel syndrome had 60% absorption with ad lib feeding, 85% with continuous drip feeds, and 75% with half calories by mouth plus overnight drip feeds.↗
▶Ep 1 · 1:54:00
host summarySam Kocoshis summarizing the discussion: GLP-2 analog can reduce fecal output such that TPN can be reduced by about 20% in 60-70% of adult patients, and totally emancipate about 20% from TPN in extension studies.↗
Summaries Sam gave as host · Intestinal Rehab2 summaries
host summarySam Kocoshis summarizing the discussion: In a classic French study by Jolie, adults with short bowel syndrome had 60% absorption with ad lib feeding, 85% with continuous drip feeds, and 75% with half calories by mouth plus overnight drip feeds.↗
▶Ep 8 · 1:54:00
host summarySam Kocoshis summarizing the discussion: GLP-2 analog can reduce fecal output such that TPN can be reduced by about 20% in 60-70% of adult patients, and totally emancipate about 20% from TPN in extension studies.↗
