"Answer to IBS is in the mind" - media coverage of new Chalder/Moss-Morris trial

Here fruit slices ( pastry squares with a kind of current " jam" in the middle) are referred to a fly cemetery s.

 

I'm coming to the conclusion that they are all in fact, mince pies, for people who can't be bothered with having jars of mincemeat lying around. The variation is simply down to various regions cooking preferences and the needs, and ability, of the cook at the time.

I very nearly bought the raisins today but the bag was 500g, which is ten times, literally, what I needed. So I didn't. What am I supposed to do with 450g of raisins. I don't eat raisins, I prefer sultanas, at least they can be eaten with nuts if it's needed to use them up.

I'd only end up eating the stuff anyway as I no longer have anyone to pass stuff onto.

The quest to cook the perfect garibaldi has been abandoned, at least for now, due to the likelihood of producing garibaldi - that makes perfect sense if you knew how I 'master' recipes.

 

The phenomenon I am thinking of is quite specific to cooked cheese. So it occurs with halloumi, fried panier, and Swiss käserschnitte (wine soaked bread covered in melted cheese baked in the oven - a sort of supercharged Welsh rarebit). I think it must be related to casein breakdown in some way. I can eat a ton of reblochon or vacherin mont d'or without any ill effects!

 

OH made the Garibaldi biccies yesterday. Unfortunately we had a complicated phone call at the critical moment of removing them from the oven. So they're a little bit overdone, but still edible. He thinks he'll do them again, next time he'll make them thinner and might even remember to do the egg finish.

 

Well casein is supposed to be slightly slower to digest than whey proteins by design (whey is particularly fast).

Denatured casein (via cheesemaking) will be slower to digest than native but that’s what happens to milk in the stomach anyway. I suppose the additional heating prior to digestion may make the casein even more clumpy/slower to digest? However it is quite a simple protein and our digestive system is kind of designed for them so this is a bit of a mystery? Longer chain peptides hanging around for longer??? Why this would be worse than some grilled chicken I’m not sure. Perhaps it’s the combination with the high fat meaning there is a lot of stuff to digest all at once. Casein will interact with fat in its native form so perhaps the double denatured (my own made up term) makes the fat less accessible for lipase action later in the small intestine? (just a punt)

I suspect heating may possibly have an effect but it is probably also a factor of high calorific/nutrient loading as well.

http://milkgenomics.org/article/dairy-protein-digestion-life-slow-lane/

https://academic.oup.com/ajcn/article/97/6/1161/4576777

 

I believe both of these types of cheese are typically made from unpasteurised milk which might be relevant...

 

If CBT is the "answer" for cases of IBS does that mean that we can expect colon cancer to become far more prominent in the "causes of death" statistics in future? And what about diverticular disease leading to perforations, followed by sepsis that then leads to death?

 

Sure, but by the time this is understood either everyone involved will have retired or real medical researchers will have made the whole BPS nonsense obsolete so whatever, no harm done to anyone's career.

The kind of crap on which BPS is built can survive in the fringes for a while but now that they're attempting to mainstream it, reality will inevitably assert itself and it will be relatively short-lived. Not without impairing progress and causing harm to millions but they can't see that for now with their sparkled glasses.

Much of this will change once medicine starts getting serious about the importance of data and has the ability to do back-propagation, to trace back numerous misdiagnoses of complications that should have been caught but were instead dismissed and sent to psychotherapy.

 

I really wish I had your optimism.

Edit : Sorry that sounds nasty, and it wasn't my intention. I'm simply not an optimist when it comes to anything medical.

 

If you read this whole Twitter thread it turns out that IAPT is working out roughly how you might expect it to i.e. extremely badly!

https://twitter.com/user/status/1108013061225484288

 

I'm surprised that the makers of Buscopan (often prescribed for IBS/available otc for about £3.50 for 20) haven't launched a 'counter attack' on this research. From a cost-effective point of view for the NHS I would have thought that v.s c£750 for a course of CBT it would be a no brainer(?)

 

Well, short-lived is definitely relative. Certainly not for us. It's just so catastrophically dumb that it will collapse on itself, but over years, not decades. Mostly because ideologues over-promised something they can't deliver. The failure will be fiscal, not about the human consequences.

 

We've seen this somewhere, haven't we?
https://twitter.com/user/status/1119322605167624192

 

Dr Hazel Everitt is also involved in this trial:

The Atlantis study:
Amitriptyline at Low-dose and Titrated for Irritable Bowel Syndrome as Second-line Treatment: A Double-blind Placebo-controlled Trial

Duration: Start date 1st September 2018 - End date July 2022

https://www.southampton.ac.uk/medicine/academic_units/projects/atlantis.page?

 

And what if the pain is an important warning sign of developing malignancy or inflammatory disease?

 

Ah, this may even go further into the past. Sir Hugh Swynford, husband of Katherine Swynford who later married John of Gaunt, Duke of Lancaster (whose children were the Tudor ancestors), suffered from dysentery, and it seems in the following years he had several more "attacks" that might be called IBS today, including food intolerances, spontaneous diarrhoea etc. He didn't die of it though, he was poisened.

 

In my experience Ami doesn't 'relieve' pain - it's not a painkiller.

It can however make you less concerned about the pain, make it easier to ignore. It's a sedative, at least for me.

This is not the same thing as relieving the pain.

It concerns me greatly that people prescribing it, and writing about it, don't seem to know that.

 

Are we sure that the whole poisoned thing wasn't just a cover cause of dead coz they didn't want to put IBS on the death certificate?

A hell of a lot of people have died of dysentery, but they were mainly commoners, possibly, even then, it was unacceptable for the upper classes to die of something that was considered to be an all in the mind thing that only commers got or died from? Sort of undermines the whole 'we are in charge coz god loves usand put us here' thing if those people also die from the same things as serfs.

Whereas poisoning was an acceptable, and expected, way to die for the ruling classes at the time.

 

But Sir Hugh Swynford wasn't very popular, so dishonoring him wouldn't have been a problem. (And he only was a low knight.)

History seems to agree he was poisened. Speculation is about why he was poisened, and one probable reason might be to free his wife for the duke who was in love with her.