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Medscape
3 days ago
- Health
- Medscape
Can Mind-Body Therapies Improve GI Outcomes?
A growing body of research shows that complementary and alternative medicine (CAM) can help treat certain gastrointestinal disorders. With up to 44% of people with diagnosed gastrointestinal (GI) disorders using CAM, chances are most gastroenterologists — whether they know it or not — are seeing patients who take products or engage in practices that fall under its umbrella. Gerard Mullin, MD Many gastroenterologists are unfamiliar with CAM because it isn't widely taught in medical school. 'Some doctors even discourage the use of CAM because they've never heard of a given intervention,' said Gerard Mullin, MD, associate professor of medicine and director of the Johns Hopkins GI Clinical Laboratory, Johns Hopkins University School of Medicine, Baltimore, Maryland. Unfortunately, many patients aren't telling their doctors about their CAM use because they're afraid of being judged, Mullin said. Patients also may not disclose their CAM use because they don't realize it's important to share with their physician or their doctor simply hasn't asked them about it. But CAM's popularity makes it important for gastroenterologists to be educated about what their patients may be using, the risks and benefits of various CAM products and practices, and the evidence base that might or might not support their use. Gastroenterologists also may want to incorporate CAM into their practices to offer what's known as integrative gastroenterology. Many arguments support this approach, Mullin, editor of the book Integrative Gastroenterology , told Medscape Medical News . Digestive disease rates are very high and are increasing, he noted. 'The escalating prevalence of obesity, anxiety, depression, stress, consumption of ultraprocessed foods, and food-borne illnesses contribute to a digestive disease epidemic,' Mullin told Medscape Medical News . 'Adopting an integrative model can contribute to more effective prevention and treatment of these conditions.' CAM comprises an array of different modalities and approaches, from oral products to mind-body practices and alternative styles of medicine. This article cannot provide an exhaustive analysis of all CAM interventions for GI conditions, but it reviews several evidence-based approaches for common disorders. Why CAM? David Hass, MD, associate clinical professor with the Division of Digestive Diseases at Yale University, New Haven, Connecticut, became interested in integrative medicine because he treated many patients who came to him after consultations with other physicians for troublesome symptoms of disorders of the gut-brain interaction, also known as functional gastrointestinal disorders. David Hass, MD 'These patients can be difficult to treat,' he said. 'Many have undergone multiple studies and scans and tried multiple medications. I wanted to be helpful and explore what else might be out there for them that may not be traditional or mainstream but is evidence-based.' CAM is appealing to patients because these approaches often provide a sense of control of their bodies and health and because they offer an alternative when conventional approaches fail to alleviate symptoms or provide a cure, said Hass, a partner at the Physicians Alliance of Connecticut in Hamden and coauthor of a review article on CAM for functional GI disorders. Interventions once considered alternative have attracted more research attention and become more accepted in the conventional medical community, Nitin Ahuja, MD, associate professor of clinical medicine (gastroenterology) at Perelman School of Medicine, University of Pennsylvania, Philadelphia, told Medscape Medical News . Nitin Ahuja, MD For example, L-glutamine therapy has been found to alleviate symptoms in postinfectious irritable bowel syndrome (IBS) with diarrhea and intestinal hyperpermeability. Until relatively recently, the concept of intestinal permeability or 'leaky gut' had been 'discussed mostly in alternative health spaces.' But an increasing body of evidence now supports the legitimacy of the diagnosis in certain GI conditions. Similarly, mind-body medicine was once categorized as alternative medicine. But interventions such as cognitive-behavioral therapy and mindfulness-based approaches are gaining traction in conventional circles and amassing evidence of its efficacy. 'Additionally, while a substantial gap remains between anecdotal and empirical understandings of some of the approaches previous considered 'alternative,' they also raise thought-provoking mechanistic hypotheses and invitations for further research,' said Ahuja, who is also director of the Program in Neurogastroenterology and Motility, Division of Gastroenterology and Hepatology, University of Pennsylvania, and author of a review article critically appraising popular remedies for esophageal symptoms. Dietary Supplements Several herbal products have been shown as effective for GI conditions. For example, ginger has been found to be generally safe and useful in treating nausea and vomiting. However, it can inhibit platelet aggregation and potentially be mutagenic, so it should be used cautiously in patients already taking antiplatelet therapy and in pregnant women. Vitamin B 6 (pyridoxine) has been shown to be helpful with nausea during pregnancy. For functional dyspepsia, peppermint and caraway have been researched extensively. In a number of studies, both agents have yielded statistically significant improvements in bloating and epigastric pain compared to placebo. Several herbal products can protect the stomach and esophagus in the setting of gastritis and when a patient is transitioning off proton pump inhibitors (PPIs). Zinc carnosine and glutamine can protect the gastrointestinal lining, repair damaged cells, stabilize gut mucosa, and decrease inflammation. Glutamine may play a role in supporting the gut microbiome and gut mucosal wall integrity and in modulating inflammatory responses. Steve Irsfeld, RPh Other nutrients that help decrease inflammation and restore the mucosal lining include apple pectin, marshmallow root, slippery elm bark, licorice root, and okra, Steve Irsfeld, RPh, owner and pharmacist in charge at Irsfeld Pharmacy, Dickinson, North Dakota, told Medscape Medical News . Irsfeld recommends curcumin, which has anti-inflammatory properties in the gut, and bovine colostrum. He told Medscape Medical News that he believes histamine 2 blockers and PPIs are overprescribed for heartburn and gastroesophageal reflux disease (GERD). 'They're designed to suppress stomach acid, but they're being prescribed without verifying that hyperacidity is actually present,' he said. 'We wouldn't prescribe antihypertensives or statin drugs, for example, without checking the patient's blood pressure or cholesterol, but we administer PPIs without ascertaining stomach acid levels merely on the assumption that if the patient has symptoms or visible inflammation, the acid levels must be elevated.' Prolonged use of PPIs can have adverse effects, including infections, impaired nutrient absorption, dementia, kidney disease, hypergastrinemia, and a rebound effect upon discontinuation. Studies have found that the herbal preparation STW-5 (Iberogast) can improve symptoms of epigastric pain and GERD, Hass noted. The product contains bitter candytuft, chamomile, peppermint, caraway, licorice root, lemon balm leaves, celandine, angelica root, and milk thistle. To promote colon health, Irsfeld recommends probiotics. 'We're now able to recommend highly targeted probiotic strains,' he said. For example, Saccharomyces boulardii has been shown to be helpful in counterbalancing the effects of antibiotics on the gut microbiota during antibiotic therapy. After antibiotic discontinuation, the patient can transition to a different probiotic. Acupuncture and Traditional Chinese Medicine Acupuncture, the application of small needles or pressure to specific points in the body, is rooted in traditional Chinese medicine, in which health is regarded as stemming from the alignment of qi, or 'vital energy.' Its practitioners aim to remove blockages or reduce excesses in qi, which flows through specific channels in the body, known as meridians. Shi-Hong Loh, MD 'In acupuncture, there are meridians that govern the GI system,' Shi-Hong Loh, MD, of Dao Sheng Acupuncture, Hoboken and Hackensack, New Jersey, told Medscape Medical News . 'Meridians are typically not tied to Western concepts of anatomy or neurology. The points we use are often related to the parasympathetic nervous system, with nerve distribution from areas in the thoracic and lumbar spine. That type of nerve innervation is from the spinal area and controls abdominal and intestinal function.' Acupuncture is highly personalized, Loh said. 'Everything is specific to the condition and the individual, and the interpretation of each practitioner.' Manual and electroacupuncture have shown utility for patients with GI conditions, including functional GI disorders, constipation, GERD, inflammatory bowel disease, ileus, acute pancreatitis, and gastroparesis. A recent systematic review of 10 randomized controlled functional MRI trials comparing acupuncture to sham acupuncture, moxibustion, placement on a waiting list, or medication found that acupuncture improved GI symptoms and psychological status in patients with functional gastrointestinal disorders and regulated functional connectivity and activity in brain regions associated with visceral sensation, pain regulation, and emotion. Loh said that in addition to acupuncture, he often recommends Chinese herbs and encourages patients to identify whether their eating patterns affect their conditions. 'When I see a patient with GI symptoms, such as IBS, I know the symptoms are often related to diet, so I don't depend on acupuncture alone. I look at the whole picture,' he said. Loh advises patients with upper GI symptoms to 'pay attention to their eating habits, daily behavior, and activities. Do they eat too much or too fast? Do they lie down soon after eating? Do they eat a lot of greasy foods? Are they taking in enough fiber?' Acupuncture can play an important role for patients who don't respond to conventional treatments, Loh said. 'It's reasonable for the gastroenterologist or internist to refer these patients to an experienced, knowledgeable, licensed acupuncturist,' he said. The Mind-Body Connection Stress is an established driver of many GI conditions. Loh described a patient with ulcerative colitis and an extremely high-stress job whose symptoms abated whenever he went on vacation. 'I've noticed the same pattern in other patients, too,' he said. Loh often targets acupuncture points that 'calm the spirit and ease anxiety, as well as those directly addressing the intestinal symptoms.' In addition, he often recommends psychotherapy — especially cognitive-behavioral therapy (CBT), which has been shown to be effective for a number of GI conditions, such as IBS. A review of nine studies encompassing more than 600 patients with gastroduodenal disorders of the gut-brain interaction found that CBT effectively improved GI symptoms and psychological outcomes. 'There have been an impressive number of studies demonstrating that CBT is effective in improving symptoms of IBS when compared to usual medical care, antidepressants, placebo, antispasmodic agents, or support therapies,' Loh said. One meta-analysis found a number needed to treat of 3 for treatment with CBT, which is 'tremendously beneficial,' Hass noted. The placebo effect may play a role, he said, 'but if I can help people get better with a placebo, I have no problem with that.' Other evidence-based mind-body approaches include gut-directed hypnotherapy, meditation, mindfulness-based therapies, guided imagery, and yoga. A systematic review of six randomized controlled trials found evidence that in patients with IBS, yoga can decrease bowel symptoms, disease severity, and anxiety, as well as improve physical functioning and quality of life. Like CBT, hypnotherapy and mindfulness-based stress reduction 'aim to reduce overactivity to stressors and to improve maladaptive coping behaviors,' said Hass, who has been trained in hypnotherapy. 'Particularly for anxiety-provoked symptoms due to catastrophizing, CBT would be the modality of choice.' Hypnotherapy and mindfulness meditation have been found effective in several GI cancers, as well as Crohn's disease and ulcerative colitis, Hass noted. Some research has shown that mind-body approaches can decrease tumor necrosis factor alpha — a cytokine involved in inflammatory bowel disease — and other inflammatory markers. Gastroenterologists may wish to consider incorporating these evidence-based therapies into their treatment regimens for GI disorders, especially functional bowel diseases, Hass said. Using these interventions in conjunction with standard medical therapies 'may alleviate symptoms more quickly than when medical therapies alone are used,' he added. Ahuja, Hass, Loh, and Mullin reported no relevant financial relationships. Irsfeld reported being an unpaid member of the scientific board for NutriDyn, which manufactures Dynamic GI Integrity.
Yahoo
4 days ago
- General
- Yahoo
Chinese students anxious, angry over Rubio visa revocations vow
Chinese students are expressing anxiety after Secretary of State Marco Rubio said Wednesday that the Trump administration would begin to 'aggressively revoke visas' from scholars within the demographic. This is a 'new version of Chinese Exclusion Act,' Linqin, a Chinese student at Johns Hopkins, told The Associated Press. He asked the outlet to identify him only by first name out of fear of retaliation. The 143-year-old law was used to issue an absolute 10-year ban on Chinese laborers immigrating to the U.S. and certain provisions within the law remained in place until 1943 — when U.S. officials capped the yearly limit of Chinese immigrants at 105. Students studying abroad from Asia have voiced their concerns that similar confines will be put in place. China is the second-largest country of origin for international students in the U.S., behind only India. Last year, the group accounted for roughly a quarter of all foreign students in the U.S. as reported by the AP. 'The U.S. decision to revoke Chinese student visas is fully unjustified. It uses ideology and national security as pretext,' Foreign Ministry spokesperson Mao Ning said Thursday. 'It seriously hurts the lawful rights and interests of international students from China and disrupts people-to-people exchanges between the two countries.' 'China firmly opposes it and has protested to the U.S. over the decision,' she added. Beijing's officials have called the move 'politically motivated' and 'discriminatory' while some of the country's top institutions say the move could drive an increase in enrollment from domestic talent. 'Having fewer international exchanges is definitely not good for America's development,' Zhang Qi, a postdoctoral fellow in Beijing told the AP. 'This could be a positive change for China's development,' he continued. 'More talented individuals may choose to stay at Tsinghua or Peking University, or with the Chinese Academy of Sciences and other top institutions in China, which would benefit the development of domestic science and technology.' In April, following President Trump's 'Liberation Day' tariff announcement, Chinese leaders issued a travel advisory for citizens studying in the U.S. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Arab News
4 days ago
- General
- Arab News
Chinese students anxious and angry after Rubio vows to revoke visas
HONG KONG: Chinese students studying in the US are scrambling to figure out their futures after US Secretary of State Marco Rubio announced Wednesday that some students would have their visas revoked. The US will begin revoking the visas of some Chinese students, including those studying in 'critical fields,' and 'those with connections to the Chinese Communist Party,' according to the announcement. China is the second-largest country of origin for international students in the United States, behind only India. In the 2023-2024 school year, more than 270,000 international students were from China, making up roughly a quarter of all foreign students in the US This is a 'new version of Chinese Exclusion Act,' said Linqin, a Chinese student at Johns Hopkins University, who asked to be identified only by his first name out of fear of retaliation. He was referring to a 19th-century law that prohibited Chinese from immigrating to the US and banned Chinese people already in the US from getting citizenship. He said Wednesday was the first time he thought about leaving the US after spending one third of his life here. Chinese international students are point of tension between US and China China's Foreign Ministry spokesperson, Mao Ning, called the US decision unreasonable. 'Such a politicized and discriminatory action lays bare the US lie that it upholds the so-called freedom and openness,' she said Thursday, adding that China has lodged a protest with the US The issue of Chinese students studying overseas has long been a point of tension in the bilateral relationship. During Trump's first term, in 2019, China's Ministry of Education warned students about visa issues in the US, with rising rejection rates and shortening of visas. Last year, the Chinese Foreign Ministry protested that a number of Chinese students have been unfairly interrogated and sent home upon arrival at US airports. Chinese state media has long hyped gun violence in the US and violent protests during the pandemic, and portrayed the US as a dangerous place that wasn't safe for its citizens. The tense bilateral relationship has also meant that some Chinese students are opting to study in the UK or other countries over the US after the pandemic. Zou Renge, a 27-year-old public policy master's student at the University of Chicago, said she had planned to take some time off and work in humanitarian aid programs abroad after graduating at the end of this year. But now, she will refrain from leaving the US and will look for jobs in the meantime. 'In a very uncertain environment, I'll try my best to find myself a solution,' she said. Hong Kong seeks to draw in talent amid uncertainty Some were eager to capitalize on the uncertainty facing international students in the US Hong Kong's leader John Lee told lawmakers on Thursday that the city would welcome any students who have been discriminated against by American policies to study in the city. 'The students who face unfair treatment can come from different countries beyond the US I think this is an opportunity for Hong Kong,' he said. 'We will work with our universities to provide the best support and assistance.' That followed a widely shared post by the Hong Kong University of Science and Technology (HKUST) inviting Harvard students to 'continue their academic pursuits' there after Trump said he would revoke the university's ability to accept international students. Hong Kong, a former British colony that returned to China in 1997, is a popular destination for mainland Chinese students to pursue their university degrees because of its international image and relative freedoms. The city launched a new visa scheme in 2022 to counter the exodus of expatriates and local professionals that occurred after Beijing imposed a national security law to quell dissent and during the COVID-19 pandemic. Multiple Hong Kong universities including the Chinese University of Hong Kong, HKUST, and City University of Hong Kong said they would streamline or facilitate applications for international students coming from top universities in the US Will Kwong, managing director at Hong Kong's AAS Education Consultancy, said his company was helping students with offers from American universities to apply to other institutions, predominantly in Britain and Australia, so that they had alternative choices. US was known for diversity and this will hurt it, students say 'Having fewer international exchanges is definitely not good for America's development,' said Zhang Qi, a postdoctoral fellow in Beijing. 'This could be a positive change for China's development. More talented individuals may choose to stay at Tsinghua or Peking University, or with the Chinese Academy of Sciences and other top institutions in China, which would benefit the development of domestic science and technology.' For many, there is little they can do as they now wait for the fallout from the move. Chen, an incoming Chinese student at Purdue University who only gave his last name out of concern for retaliation by the Trump administration, has been waiting anxiously for his visa approval. But he was also angry. Currently in China, he said this was the exact opposite of what he thought the US stood for. 'I was expecting freedom and tolerance. The US was known for its diversity which allows international students to fit in, but it is a pity to see such kind of change,' he said.
The Hill
4 days ago
- Business
- The Hill
Chinese students anxious, angry over Rubio visa revocations vow
Chinese students are expressing anxiety after Secretary of State Marco Rubio said Wednesday that the Trump administration would begin to 'aggressively revoke visas' from scholars within the demographic. This is a 'new version of Chinese Exclusion Act,' Linqin, a Chinese student at Johns Hopkins, told the Associated Press. He asked the outlet to identify him only by first name out of fear of retaliation. The 143-year-old law was used to issue an absolute 10-year ban on Chinese laborers immigrating to the U.S. and certain provisions within the law remained in place until 1943 — when U.S. officials capped the yearly limit of Chinese immigrants at 105. Students studying abroad from Asia have voiced their concerns that similar confines will be put in place. China is the second-largest country of origin for international students in the U.S., behind only India. Last year, the group accounted for roughly a quarter of all foreign students in the U.S. as reported by the AP. 'The U.S. decision to revoke Chinese student visas is fully unjustified. It uses ideology and national security as pretext,' Foreign Ministry spokesperson Mao Ning said Thursday. 'It seriously hurts the lawful rights and interests of international students from China and disrupts people-to-people exchanges between the two countries.' 'China firmly opposes it and has protested to the U.S. over the decision.,' she added. Beijing's officials have called the move 'politically motivated' and 'discriminatory' while some of the country's top institutions say the move could drive an increase in enrollment from domestic talent. 'Having fewer international exchanges is definitely not good for America's development,' said Zhang Qi, a postdoctoral fellow in Beijing told the AP. 'This could be a positive change for China's development,' he continued. 'More talented individuals may choose to stay at Tsinghua or Peking University, or with the Chinese Academy of Sciences and other top institutions in China, which would benefit the development of domestic science and technology.' In April, following President Trump's 'Liberation Day' tariff announcement, Chinese leaders issued a travel advisory for citizens studying in the U.S.
Yahoo
4 days ago
- Business
- Yahoo
US cancels over $700 mln funding for Moderna bird flu vaccine
STORY: Bird flu is spreading through U.S. poultry flocks and cattle herds. It's infected 70 people in the country over the past year, mostly farm workers. But drug maker Moderna says the Trump administration has cancelled funding for development of a vaccine. The firm was originally awarded $590 million by the Biden administration to advance work on the treatment. That was on top of an earlier $176 million from the U.S. Department of Health and Human Services. Now Moderna says the funding has been withdrawn. An HHS spokesperson said a review showed the project did not meet standards required for federal investment. But a medical expert at Johns Hopkins University said the government was discarding what could have been an effective and fast tool to combat the disease. U.S. Health Secretary Robert F. Kennedy has questioned the use of vaccines. He drew criticism earlier in the year after suggesting poultry farmers should let bird flu spread, to allow the study of chickens that stayed immune. Moderna now says it will seek alternative ways to develop and manufacture the vaccine. It has been banking on revenue from new shots to make up for waning post-pandemic demand for its COVID inoculations. Bird flu has also been detected in other countries, including Brazil - the world's top exporter of chickens. This week, officials there said they were investigating a possible new case on a commercial farm. Error while retrieving data Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data Error while retrieving data
