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| | | | | This week |  | How much does your gut health impact your overall health? A lot, doctors say | | | | | | Diabetes Canada stresses it doesn't endorse medical products after ads suggest otherwise | | | | | | Mandating childhood vaccines | | | | |  | Doctors and researchers are looking to see if fecal transplants can be used for hard-to-treat illnesses. (Steven Senne/The Associated Press) | Amina Zafar | You may be hearing a lot about the gut microbiome these days — it's been mentioned everywhere from wellness podcasts to the grocery aisle. Doctors are tapping into it to try and treat some diseases differently.
The gut microbiome is the community of all the bacteria and viruses in our intestines, including friendlier microbes that promote health as well as some foes that can cause illness.
One evolving procedure is the fecal transplant, where a small sample of stool from the colon of a healthy person is given to a recipient for therapeutic purposes. Despite the ick factor, they have been used to treat potentially fatal, recurring bacterial infections for which antibiotics have been less effective.
Now, doctors and researchers are looking to see whether fecal transplants can be used for other hard-to-treat illnesses.
Health Canada approved fecal transplants for recurrent C. difficile infections in 2015. Impacting the colon, these infections lead to diarrhea and, if recurring, dehydration that can wreak havoc on the body. The goal with the transplant is to have the healthy bacteria outcompete the C. difficile and wipe out the stubborn infection.
Overall, for recurrent C. difficile, fecal transplants were significantly more effective, greater than 85 per cent, compared with less than 50 per cent for antibiotics.
Dr. Nikhil Pai, a pediatric gastroenterologist and associate clinical professor at McMaster University in Hamilton, said antibiotics can create a terrible cycle.
"What ends up surviving after this scorched-earth antibiotic regimen are bacteria that cannot only make things worse, but can affect a lot of other things such as just general nutrition and metabolism," Pai said. | | |  | | A human 3D minigut, cross sectioned and immunostained to show mucus (green) inside, epithelial cells (red) and their nuclei (blue). Scientists are studying whether certain microbes that may drive Crohn's and colitis can get through a key mucus layer in the intestines. (Ashley Gilliland/University of British Columbia) | | | In adults, a 2023 review of clinical trials published by the respected Cochrane Library concluded fecal transplants may also help control Crohn's disease and ulcerative colitis, two forms of inflammatory bowel disease that harm the gut when the body's immune system mistakenly attacks itself.
Bruce Vallance, a pediatrics professor at the University of British Columbia, said inflammatory bowel disease is essentially chronic inflammation of the gastrointestinal tract, possibly triggered by the bacteria living in our intestines. It can happen at any age, he said.
"We're trying to figure out whether certain microbes are driving the disease and whether we could target those microbes, deplete them and hopefully remove them from the intestine so there's no longer any trigger for disease."
Building slimy 'mini guts'
Vallance and his team are also studying whether certain microbes that may drive Crohn's and colitis can get through a key mucus layer in the intestines.
To that end, he's been working with doctors at BC Children's Hospital to take fecal samples and biopsies that offer a snapshot of what's going on in the human colon.
Vallance builds "mini guts" — a 3D model of the intestines in the shape of a ball — to study how the microbes function. He's focusing on growing bacteria in the epithelium, or gut lining, which contains proteins with sugars on them that form a slimy coating.
"It doesn't look nice and it doesn't sound nice, but that sticky coating is actually really important in terms of how we interact with our gut microbes," Vallance said.
Another trial focuses on short bowel syndrome in children who have had parts of their small intestine surgically removed. It can cause an excessive build-up of bacteria, leading to abdominal pain, bloating and diarrhea that's traditionally treated with antibiotics.
There have been other unintentional benefits of the fecal transplant. Pai recalled, while at his other position at Children's Hospital of Philadelphia, treating an autistic child who had recurrent C. difficile.
"After their treatment, there were comments from the family that this child was also just showing some real improvements and changes in their behaviour as well as noted by their teachers in school," Pai said. "I don't think it's any surprise that other aspects of him also got better."
Read more on the intentional and unintentional benefits of fecal transplants. | | |  | Joel Snitman, 81, of Thornhill, Ont., has Type 2 diabetes and says he trusted an ad for a blood glucose testing product he saw on Facebook because it had Diabetes Canada's logo. However, Diabetes Canada says it does not endorse any medical health product. (Craig Chivers/CBC) |
Diabetes Canada stresses it doesn't endorse medical products after ads suggest otherwise
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Diabetes Canada says it's received a surge in reports from people who've seen ads for or bought products that use the charity's logos without authorization.
Since January, Diabetes Canada says it's had over 300 calls to its 1-800 line and emails from people reporting misleading advertisements for diabetes products that have the charity's logo.
Diabetes Canada isn't the only organization being affected. Products ranging from purported medications and supplements to devices that claim to be blood glucose monitors are also carrying the logos of Obesity Canada and Health Canada. Some of the groups say they want the ads taken down and social media companies are doing that, but new ads keep appearing.
A class of injectable medications known as GLP-1 agonists, sold in Canada under the brand name Ozempic and Wegovy are approved to treat Type 2 diabetes and obesity, respectively. These drugs need to be administered by doctors and distributed by pharmacists. They are also not endorsed by Diabetes Canada, Obesity Canada or Health Canada.
Some of the misleading ads are for products that doctors say are not effective but mimic the names of these more recognizable medications. These include GLP-1 oral drops, said Laura Syron, the president and CEO of Diabetes Canada.
"They're certainly not endorsed by us," Syron said on Thursday. "We do not endorse any medical health product."
Doctors say it's important for people who live with diabetes to get accurate blood sugar readings. That's why Syron recommends anyone considering changing their medication, trying a new treatment or getting a new monitoring device talk to their health-care provider first.
The organization said some ads falsely claim the organization will also offer patients a subsidy.
Use of logo created sense of trust
Joel Snitman, 81, of Thornhill, Ont., has Type 2 diabetes and checks his blood sugar levels at least once a week. Snitman said he saw a Facebook ad for a product with a photo identifying it as a glucose monitor. He said he trusted it because the ad showed Diabetes Canada's logo.
"This gadget offered to do it without sticking a needle in your finger," Snitman recalled. "I thought I would give it a shot."
The product turned out to be an oximeter, a device used to measure blood oxygen levels, not blood sugar.
Snitman contacted Diabetes Canada, saying he felt he got sucked in by seeing their logo on the ad.
Read more on the misleading ads and what's being done about them.
| | | | | Trending research | | | | Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study | Vaccine | | | | | Leveraging pre-vaccination antibody titres across multiple influenza H3N2 variants to forecast the post-vaccination response| eBioMedicine | | | | | | | THE BIG NUMBER |
69%
| Sixty-nine per cent of Canadian adults polled between May 20 and 23 agreed that childhood vaccinations should be mandatory.
That's up from 55 per cent of respondents last year to the Angus Reid Institute's online survey.
The responses come as Canada is in the midst of the worst measles outbreak since the virus was declared eliminated back in 1998.
Maxwell Smith, a bioethicist and associate professor at Western University's School of Health Studies, says the figure suggests mandating childhood vaccinations is not as divisive as once thought.
"Given what we just experienced with COVID and controversies around vaccine mandates, I think this is why this figure is quite striking," he said.
Read more from CBC Health’s Jennifer Yoon on the poll's findings in provinces experiencing measles outbreaks.
| | | | | Stories we found interesting this week | | | | | | | | | | |  | May 29
How long can I live with advanced prostate cancer?
Former U.S. president Joe Biden's advanced prostate cancer has raised some questions, like how it could have gone undiagnosed for so long, and what the future holds. Dr. Laurence Klotz, chief of urology at Sunnybrook Health Sciences Centre, explains how prostate cancer is diagnosed, why some forms are more aggressive than others, and the extensive array of treatments available.
Play on CBC Listen | | | |  | May 31-June 1
Family doctor who quit teaches the next gen how to stay
After more than 25 years as a family physician, Dr. Fan-Wah Mang closed her practice because she burned out. Now, she’s at Humber River Hospital in Toronto, teaching the next generation of family doctors how to avoid the pitfalls that made her leave.
We also hear from two residents who have put a lot of thought into what they’ll need to be a family physician long term. . Tune in on CBC Listen | | | | Thanks for reading! You can email us any time at secondopinion@cbc.ca with your comments, questions, feedback or ideas.
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