Aw, Nuts! By: Sasha Klemawesch, MD

Aw, Nuts! By: Sasha Klemawesch, MD

Conventional wisdom for decades has been to avoid nuts and seeds if you have diverticulosis; however official Gastroenterology literature now says otherwise. Actually, it has for some time, but old habits die hard, and anecdotal rumors still heavily cloud the discussion both in the medical community and among lay people. While it’s not surprising that patients’ impressions may be skewed by rampant Reddit forums on the subject, doctors should be aware of the change in recs, seeing that literally hundreds…

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Tincture of Time By: Sasha Klemawesh, MD

Tincture of Time By: Sasha Klemawesh, MD

In the preceding article I mentioned how antibiotics became accepted as standard treatment for diverticulitis; doctors considered which pathogenic bacteria would typically invade the gut, and drew a logical conclusion that if the colon was infected, then Cipro/Flagyl would treat it. The practice had staying power because patients seemed to get better while on said treatment. However, like many other entities commonly “treated” with antibiotics, it is not the antibiotic that is making the patient better, it is so-called Tincture…

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O O O….Oh no! By: Sasha Klemawesch, MD

O O O….Oh no! By: Sasha Klemawesch, MD

If you are a non-streaming luddite like me who still watches cable, then I’m sure you could not only sing the Ozempic jingle on command, but probably do the Jardiance-Lady’s dance as well. There’s been so much hype around the novel diabetic agents, I thought it worth discussing some of their downsides, since otherwise mainly what you hear are social media-ites & bravo-lebrities lauding them as quick & easy weight loss hacks. While it’s true (especially for the Ozempics/Mounjaro’s of…

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Mushroom Misery

Mushroom Misery

Shiitake dermatitis is a big price to pay for the joy of shiitake mushrooms.  The dermatitis consists of intense itching that occurs shortly after ingesting raw or undercooked shiitake mushrooms.  Characteristic of the rash are raised, red streaks which is also called “flagellate erythema” because it literally looks like the sequela of being whipped.  Other than this characteristic appearance, the dietary history is the cue to diagnosis.     It responds quickly to oral antihistamines and/or steroids.  It is prevented by adequate…

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Supplements or Not 

Supplements or Not 

The Journal of the American Medical Association recently published a study done by scientists in Cambridge, Mass.  This group did refined chemical analysis on 60 different health supplements.  Their findings were very disconcerting.  Just 11 percent of the products contained an accurate amount of the key ingredients listed on the label.  Forty percent had none of the indicated ingredients.  Forty Five percent had inaccurate amounts varying from .02 percent of the amount listed to 334 percent of the amount listed….

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Thymus

Thymus

Scientists at Mass General Hospital in Boston recently published findings on 1,150 adult patients in their hospital who underwent thymectomy (removal of the thymus gland).  The thymus gland is a bit of a mysterious organ found in our chest that is most active in early childhood.  It is located in the chest between the lungs and just above the heart.  In infants the gland is large and completely covers the front of the heart.  Until this recent study scientists have…

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Chronic PPI Use and Asthma

Chronic PPI Use and Asthma

New research shows that prolonged use of proton pump inhibitors (PPI’s) can increase the risk for developing asthma.  PPI’s are the “drugs of choice” for esophageal reflux, gastritis and gastric ulcers.  But their long-term use impacts the gut microbiome which in turn can cause immune dysregulation.  It is this “tilting” of immune function that increases the risk for asthma.  Prolonged use of PPI’s by women during pregnancy also increases the risk for their child to develop asthma.  One strategy to…

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Cross Reactive Epitopes & Food Allergy

Cross Reactive Epitopes & Food Allergy

A recent article in the Journal of Allergy and Clinical Immunology provided an update on our understanding of cross reactivity.  First by way of definition an epitope is a discreet (usually small) portion of a molecule that is the binding target of an antibody.  In the case of allergic problems, the antibody is IgE.  By way of example think of distinguishing features that help you identify a car:  the Mercedes Star and the Dodge Ram.  Allergy is directed at this…

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Dear Dr. K;

Dear Dr. K;

I’ve seen you and multiple other doctors for what has been called unexplained chronic cough.  Now I’ve read about the new drug Gefapixant.  Do you think I’m a candidate? My answer is a qualified yes. But before I continue my answer let me first give a summary of your own situation that might be of help to other kindred spirits.  Your cough is called “unexplained” because despite our best efforts the medical specialists you’ve seen have failed to find a…

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Dear Dr. K;  I read something that indicated chronic sinusitis can predispose to stroke.  It scared me.  Is it true? 

Dear Dr. K;  I read something that indicated chronic sinusitis can predispose to stroke.  It scared me.  Is it true? 

The short answer to your question is yes. But, the best answer to your question is maybe.  First of all, it is important to know that vascular problems in general whether due to blockage from plaque or due to a clot have inflammation as a common denominator.  Whether you’re talking about a coronary artery or a carotid artery or an intracranial artery its arterial inflammation that sets the stage for the problem.  By way of example, its arterial inflammation that…

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