Linaclotide is Safe and Effective for Chronic Constipation

Chronic constipation affects about one in six people in the U.S. and is a problem that primary care doctors hear about very frequently. Symptoms include infrequent bowel movements, hard stools, straining, abdominal bloating and discomfort, and a sense of incomplete evacuation. It’s not a dangerous problem, but it causes plenty of misery for lots of people. Though doctors have a few remedies for chronic constipation (which I’ll list at the end of this post) they are only temporarily and modestly ...
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More Than Half of Americans Take Dietary Supplements

Did you know that the Centers for Disease Control has something called the National Nutrition Monitoring System? And apparently it’s a good thing too, since who else would monitor the nation’s nutrition? This week the intrepid bunch at the National Nutrition Monitoring System released a report detailing how many of us use dietary supplements and which ones we use. (The link to the report is below, but be warned. It’s not scintillating.) The report’s major finding is that for the first time over...
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Eat Right for Your Belt Size, Not Your Blood Type

Every couple of months I get asked this same question. “Doc, what’s my blood type?” I load my “why you don’t need to know your blood type” speech from my cerebrum and press replay, trying to add a little spontaneous variation for authenticity. “Actually, I’ve never checked it.” “I thought you check everything.” “Nobody checks everything. There are thousands of different available blood tests. Most of them would be completely useless to you.” “Well doc, could you check my blood type?” “I’m...
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News Flash: Diabetes is Not Good

Type 2 diabetes mellitus has long been known to increase the risk of stroke, heart attack, kidney disease, and eye disease. In the US diabetes is the leading cause of kidney failure requiring dialysis and one of the leading causes of blindness. Diabetes is also increasing in prevalence as people become more overweight. A study in this week’s New England Journal of Medicine attempted to quantify the risk of premature death associated with diabetes. The results were dramatic, and attracted much m...
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Evidence Mounts in favor of Weight Loss Surgery

Readers who have been following my posts for a few years know that weight-loss surgery is amassing an impressive body of scientific evidence supporting its effectiveness and safety. (Links to my previous posts about weight loss surgery are below.) This week, two studies in the Archives of Surgery attempted to compare the different kinds of weight loss surgery. An LA Times article (link below) has a clear explanation of the different kinds of surgery and summarizes the findings of the studies. T...
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This Isn’t Your Father’s Heart Disease

What’s the most common cause of death among American women? Breast cancer? Accidents? Suicide after watching too many Lifetime Channel specials? Nope. Heart attacks kill more women than any other cause—same as men. A generation ago heart disease was mistakenly thought of as an exclusively male disease, but patients and physicians have learned that preventing and treating heart disease is critical in women too. This week the American Heart Association published their updated recommendations for ...
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Rattled by Rickets Resurgence

Rickets is a childhood bone disease caused by severe vitamin D deficiency. It causes bone pain, weak bones and bone deformities in growing children. In the 1920s the link between rickets and vitamin D was discovered and within a couple of decades rickets largely disappeared from the developed world. Until now. A flurry of articles in the media this week (links below) reports a resurgence of rickets in England, Scotland and Ireland. One hospital in Southampton is reported to have treated 40 chi...
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The Most Recent Celebrity Vitamin: D

Every now and then some vitamin or dietary supplement becomes all the rage.  A couple of generations ago vitamin C was the miracle drug that could prevent all diseases, despite lots of evidence to the contrary.  Lots of my patients still take it for colds, demonstrating its persistent mythology.  Vitamin B12 became the wonder-drug a few decades ago, leading to a whole generation of patients getting monthly injections for reasons that remain scientifically mysterious.  And many lesser stars can b...
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Thank You

Thank you for all the feedback you’ve given me about my posts.  You let me know that I’m not just writing to myself. Thank you for all the links to interesting articles you send me.  You help keep me informed and give me great ideas for posts. Thank you for praising Jaymes, our receptionist, Nancy, our medical assistant, and Angela, our biller, when they help you.  They’re very good at what they do and I couldn’t do what I do without them. Thank you for understanding my unusual practice model...
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