Trial By Error: CBT and Irritable Bowel Syndrome

https://twitter.com/user/status/1386734188972453892


Guidelines

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

https://gut.bmj.com/content/early/2021/04/27/gutjnl-2021-324598

 

Treating Irritable Bowel Syndrome (IBS) w/ Dr. Emeran Mayer | MGC. Ep. 31
June 10, 2021
Welcome back to the Mind Gut Conversation! Join Dr. Mayer in Ep. 31 of The Mind Gut Conversation featuring himself as the guest! Being interviewed by Mahana Therapeutics' Jana Hoffman, Dr. Mayer discusses Irritable Bowel Syndrome & science-backed ways of treating IBS. Disclaimer: Dr. Mayer is on the Scientific Board of Advisors for Mahana Therapeutics Follow Dr. Mayer: https://linktr.ee/emayer

https://www.listennotes.com/podcasts/the-mind-gut-conversation-emeran-mayer-YhcMnBjG0Ab/

 

Thanks @Sly Saint, you are supplying me with lots of holiday listening and viewing!

 

Is it just me?

1st we had the BPS lot busily citing their own work....in their own work.

Now we have this person being interviewed in his own podcast?

How soon beforw we let schoolkids mark their own homework?

 

Actually a friend of mine who teaches in state secondary quite regularly gets pupils to mark each others' work, during a lesson, where she goes through the items she was expecting to see. I am sure she would not be taken in by someone getting much higher or lower marks than usual. Not so good for all the tests they have been doing for teacher assessed grades for GCSE's this year. I think she was hoping to be able to retire last summer.

 

Marking each other's work is a different kettle of fish, I think.

Occasionally, we did that when I was a schoolgirl. In my final year a teacher who had never taught us before took over our maths class. I wish I'd had her as a teacher sooner!

We broke up into workgroups and marked each others work and had to explain to each other where we'd gone wrong. We all really learned from the experience. Not just maths - we learned to be fair but also be thorough. Someone being nice for the sake of it meant a lesson wasn't learned, and of course if I marked your work today, sooner or later you'd be marking mine.

Being all at the same level with no one in authority meant the work was assessed purely on it's merits.

Very different than each individual marking their own work.

 

Trial By Error: Did the IBS Trial Really Show that Web-Based CBT Offered Significant Clinical Effectiveness?

https://www.virology.ws/2021/06/24/...-significant-clinical-effectiveness/#comments

 

I hadn't come across this. it's an infomercial i guess

 

Mahana Therapeutics gears up to launch IBS treatment app with $61M series B | FierceBiotech, 2021-08-11

[...]
As Mahana has begun rolling out its digital treatment program to the masses and accelerated its work to apply cognitive behavioral therapy to other long-term health conditions, it hasn’t been without its fair share of critics.

Despite votes of confidence in the form of both FDA and CE mark clearances for Mahana IBS, the program has come under fire from those who take issue with its classification as a digital therapeutic.

One such critic, David Tuller, a journalist and public health expert, has argued in a series of blog posts that the app shouldn’t be marketed as a therapeutic technology, noting that it has only been proven to alleviate some symptoms of IBS, rather than completely curing the condition, and that the clinical trial data suggests those benefits drop significantly within a year of using the program.

https://www.fiercebiotech.com/medte...s-up-to-launch-ibs-treatment-app-61m-series-b

@dave30th

 

The floodgates have clearly been opened as apparently the FDA has approved an ACT app for fibromyalgia, with some people in the NHS trying to capitalize on this and bring it to the UK ASAP. Lots of been said of the FDA's controversial approval of an apparently useless Alzheimer's drug but this is just as bad, it's filling the space with junk, which we know prevents useful things from being worked on. I have no idea what they are doing approving blatant quackery like this.

It's roughly the same crap as the CBT for IBS app, along with infomercial-level news coverage. @dave30th.

https://www.thesun.co.uk/health/15919446/hope-millions-fibromyalgia-treatment-green-light/

 

"Although it doesn’t target the actual pain, people who have used ACT have reported an improvement in their quality of life."

exactly the same as the research for IBS, or at least that was what Trudie Chalder claimed (ie improved QOL)

 

re-tweeted by Rona Moss-Morris

https://twitter.com/user/status/1519352344856698880


also

https://twitter.com/user/status/1519195911188094976

 

@Sly Saint

In the second twitter link in post #212 what does RoB mean?

 

Presume it is risk of bias.

 

Thanks.

 

in case anyone is wondering why I posted the above see an earlier post #209
Mahana Therapeutics gears up to launch IBS treatment app with $61M series B | FierceBiotech, 2021-08-11
also see the other threads on Mahana Therapeutics; Rona Moss-Morris has shares in the company and it is her and TCs questionable research (see David Tullers write ups) that 'provide the evidence' for the therapys 'effectiveness'.
It is also being implemented by the NHS.

 

https://twitter.com/user/status/1610286243535007750

(re-tweeted by RMM)

article includes:

https://www.theguardian.com/lifeand...t-stress-does-to-your-body-and-how-to-beat-it

 

THat's a laugh isn't it. 'Illness is not a business opportunity' being retweeted

I think it really is vital that somehow the sums get done on how much money this area is taking in research (which includes the cost of those salaried who spend all their research time on this stuff), treament, conferences and so on

The shocking thing is that for all their selling the idea that 'treating stress might be a good thing' (under what they are actually saying which is 'instead of looking into or treating for anything else' which is the real part of the message/agenda) why is it that noone ever asks or says - where is the bit where you focus on 'do your treatments even help stress?'.

It is such a charade. Why does noone even stop and say 'but even if you were just treating stressed people, isn't the discussion and question really what is the best help'

it is what i call a switch-and-bait because the 'treatments' that mightn't be logical or effective or kind and could indeed hinder and harm people psychologically (noone really is doing that research about whether telling people something will cure it when it doesn't or suggesting it is their problem and no changes to the situation when the situation is the cause is harmful - when 'old psychology' would say treat the situation, remove the hot iron, is this being used as an excuse to not remove the hot iron?).

And yet they are selling it under some banner that doesn't relate to anything they've proven - who is going to disagree with 'reducing stress might help most things' or 'stigma against mental health is bad' -yet noone checks what the people saying it are doing, and assuming what someone 'liking' their tweet thinks they are agreeing with isn't actually the opposite of what these people are actually up to, or not useful, or preventing something even more important from being provided

Who would say no to providing cancer patients with stress relief if they imagine it is more relaxing surroundings, help with things surrounding the illness that can be stressful without support to make them straightforward, options of things many like and can choose from like massage or candles or whatnot. It would be a very different answer if someone suggested replacing biomedical treatment with 'CBT' (all 'CBT' is not the same thing, it's a delivery mechanism) telling them to reframe their symptoms and not pay attention to their body signals or that whether their life is stressful or they have too many demands is a matter of how they are perceiving that etc. or is their responsibility to do something about it. EDIT: Here laypersons only require logic and empathy not 'research' to realise this isn't common sense, nor psychology but its para-version

To me the fact that discussions never get to the question of whether something actually helps the person - the bit where these people everyone likes on the pretence of caring so much about them gets to have their voice and input about whether it did help their body - talks over them, puts words in their mouth etc IS the stigma, IS bigotry, IS the issue of other people telling them their reality. And that stigma is hiding under banners for anti-stigma and people pretending they are helping. It's shockingly harmful psychologically and physically (as it affects their health)

 

The way they talk about it is so freaking weird, so much woo about imaginary fears and other nonsense. I've rarely seen people so out of touch with reality, it's right up there with the worst quacks. Like it was written by alien machines who don't know anything about human experience.

And besides being fully generic, it's all missing one key definition: what even is "stress"? It's used willy-nilly to mean anything bad or that people don't like. The word has lost all meaning and the way it's used is recklessly irresponsible.