Disorders of gut–brain interaction, eating disorders and gastroparesis: a call for coordinated care and guidelines on nutrition support 2024 Kellar+

[Andy]

Untangling the complex interplay between eating disorders, gut–brain disorders and motility disorders is challenging. Nationally and internationally, there has been a concerning increase in patients receiving artificial nutrition that may be unnecessary.1 This places patients at risk of iatrogenic harm and results in considerable economic burden to health services. There is a clear need for high quality research to guide care, but in its absence, now more than ever, we require a national treatment consensus to support clinicians working in this field. This article aims to highlight the current status, knowledge, and service limitations in treating this difficult cohort of patients, and make recommendations on future strategies within Australia to move forward for better patient outcomes.

Open access, https://onlinelibrary.wiley.com/doi/10.5694/mja2.52537

 

[rvallee]

So, it's a complete and total mess, as bad and filled with tropes and nonsense as any other chronic illness problem that medicine doesn't understand, including a now mandatory mention of interoception. And they are still betting everything they have at roulette on yellow. Always the same bet. Never even on the board.

You can read the fanatical obsession, the need, for this psychwoowoo to be true. They can't imagine anything else. This is why they have nothing. And they still can't imagine anything different. No, clearly it's the patients who are wrong and the TikToks and other stuff and vibes that make it hard to get the patients to accept things contrary to our experience. I guess before that it was video games, maybe magazines, or bicycles. Who knows, really?

Which all really adds up to the simple fact that where technology does not give answers, medicine has made zero meaningful progress in the last century. Without technology giving them answers, they have nothing at all. Only woo. Only bust. But they can't imagine the possibility of being wrong, so they remain entirely useless at best, harmful at worst.

 

[bobbler]

So, it's a complete and total mess, as bad and filled with tropes and nonsense as any other chronic illness problem that medicine doesn't understand, including a now mandatory mention of interoception. And they are still betting everything they have at roulette on yellow. Always the same bet. Never even on the board.

You can read the fanatical obsession, the need, for this psychwoowoo to be true. They can't imagine anything else. This is why they have nothing. And they still can't imagine anything different. No, clearly it's the patients who are wrong and the TikToks and other stuff and vibes that make it hard to get the patients to accept things contrary to our experience. I guess before that it was video games, maybe magazines, or bicycles. Who knows, really?

Which all really adds up to the simple fact that where technology does not give answers, medicine has made zero meaningful progress in the last century. Without technology giving them answers, they have nothing at all. Only woo. Only bust. But they can't imagine the possibility of being wrong, so they remain entirely useless at best, harmful at worst.

Could you find the bit where they actually explained what this gut-brain disorder is and how it would be treated - it seems like it’s either code and the treatment is just non treatment or another pseudo term for hypochondria or they think they are above actually having anything

I suspect bith and it is so full of sophistry in style of writing I assume it’s a manifesto - another one slyly written to warn about THOSE persons

to fish people out and deprive them being taken seriously based on no serious reason and just either assuming everyone is this or by whether you gut tells you or bias to demographics

oh and it seems a big old whinge about whether all should be sent to eating disorder clinics first because if they go to gastro they get a different diagnosis

the thing is that this is such a serious area in results for the patient and not actually a game for the staff and I guess there is some sort of personal frustration here based on assumption I frankly can’t believe the level of discussion these papers get away with - it’s not even hidden from me it’s a content free whinge underneath it all ?

 

[Jonathan Edwards]

This looks like an echo of the proposals put out by people like Peter Paine in the UK.

The question has to be why anyone should be receiving unnecessary feeding support. If such a situation exists it is almost certain that it is due to memes created by the same physicians who bemoan the consequences.

 

[rvallee]

Could you find the bit where they actually explained what this gut-brain disorder is and how it would be treated - it seems like it’s either code and the treatment is just non treatment or another pseudo term for hypochondria or they think they are above actually having anything

I have never seen such an explanation, despite sifting through hundreds of papers mentioning this. It's always hand-wavy "bidirectional" relationship, the rest is left to the imagination of the reader. Basically just another way of saying a biopsychosocial complex interaction of this and that requiring multidisciplinary something or another. All on the basis that they don't know. Here they seem especially focused on eating disorders.

Honestly the section on treatment is just some hand-way mess that makes it clear it's all arbitrary and ineffective, unless maybe if it's an eating disorder, but they're making it clear that they can't tell the difference and it's all framed in the usual "imagine a world" marketingspeech where if you just imagine they could treat this, they could treat it.

There is a clear need for nationwide dedicated multidisciplinary services, ideally embedded within community eating disorder programs, incorporating consultation–liaison psychiatry, eating disorder clinicians (psychiatry, psychology, dietetics), gastroenterology and surgical specialties.

Basically they don't know, have run out of ideas a long time ago, but if you could imagine that they could do something, maybe send money their way so they can burn it doing nothing. I guess.

 

[bobbler]

I have never seen such an explanation, despite sifting through hundreds of papers mentioning this. It's always hand-wavy "bidirectional" relationship, the rest is left to the imagination of the reader. Basically just another way of saying a biopsychosocial complex interaction of this and that requiring multidisciplinary something or another. All on the basis that they don't know. Here they seem especially focused on eating disorders.

Honestly the section on treatment is just some hand-way mess that makes it clear it's all arbitrary and ineffective, unless maybe if it's an eating disorder, but they're making it clear that they can't tell the difference and it's all framed in the usual "imagine a world" marketingspeech where if you just imagine they could treat this, they could treat it.

Basically they don't know, have run out of ideas a long time ago, but if you could imagine that they could do something, maybe send money their way so they can burn it doing nothing. I guess.

So a sales pitch for give us all yee patients and then it doesn’t matter how far you search in the article lifting up every newspaper and blanket to check underneath the part where there are good medical reasons and they prove it’s because they have something to offer all these patients seems to never be there

it’s shocking really

we might get exhausted cognitively but those reading it who are doctors and commissioners shouldn’t and I’d expect they should be approaching any film flam paper with a metaphorical highlighter looking fir the bit that says ‘this is what we will do/offer’ and ‘thus is why it’s useful and who it works for vs doesnt’ and ‘these are the facts’

but they don’t even state any sort of evidence or anything to confirm the idea people are getting tubes they don’t need isn’t just a lie / presumption

that in itself should surely be a massive commission-level investigation and debate

not a hand wave