Mark Pimentel MD
@MarkPimentelMD
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Executive Director, @MASTprogram . A program finding solutions to diseases of the human #microbiome such as #SIBO , #IBS , #Metabolicdisorders @CedarsSinai
Los Angeles
Joined May 2014
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Pivot. Our team has spent the last 6 weeks, 16 hours a day, 7 days a week working on
#COVID
. We have developed a device to kill coronavirus with
@MASTprogram
@cedarssinai
hoping to bring to humans in weeks with help of
@SterlingMedDev
and
@BioscienceAytu
.
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Our study is out!
#IBS
has three main microtypes. H2S gas (Desulfovibrio & Fusobacteria) drives diarrhea, H2 producers (E. coli & Klebsiella) driving SIBO type, and Methanobrevibacter (CH4) driving constipation. Forms the basis for new treatments coming.
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The mantra is "when you see something...then think of something...and do something...". We completely shifted gears to
#COVID
and introduce
#healight
. Thanks
@AliRezaieMD
@gym99
@RuchiMathurMD
@GabrielaGSLeite
Chus, Gonzalo, and entire
@MASTprogram
. More updates tomorrow.
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Happy to announce, covering years of work, our new book with
@AliRezaieMD
on the
#microbiome
and
#IBS
/
#SIBO
. Covering many new concepts that we hope will help people and their doctors better understand this condition. On Amazon and coming out April 12!
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#diarrhea
but not just any diarrhea...unpredictable diarrhea.
#Bloating
and uncomfortable distension with most foods. Being told to "live with it". This is what
#IBS
patients experience. "Live with it" is NOT acceptable in 2021!
#IBSAwarenessMonth
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We are retooling our 5 year plan for
#IBS
and
#SIBO
based on data from the
#REIMAGINEstudy
. Now we know who the culprit bugs are. Already have plans for at least two new treatments that should work better. Will post more soon.
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I heard a recent speakers say "IBS is not a disease"... There is a proven derangement of the small bowel
#microbiome
in
#IBS
, There is a blood test that can diagnose
#IBS
. Food poisoning causes a large proportion of
#IBS
. FDA approved drugs can remedy.
#IBS
is a disease!
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E. coli and Klebsiella are the hydrogen producers in
#SIBO
and feed hydrogen to Desulfovibrio and Fusobacterium to produce hydrogen sulfide. More hydrogen sulfide=more
#diarrhea
. We now know this gang of bugs for
#SIBO
as well. Next is
#treatment
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Finally we reveal deep sequencing of the entire small bowel and stool together. The gut microbiome is NOT represented by stool! The longest segment of the gut (20 ft of small bowel) is completely different. Rashin from our
@MASTprogram
is presenting study Sa1912 from REIMAGINE.
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So glad to announce 2 years of effort to publish the first guideline on
#SIBO
. Thanks to my co-authors, the grade authors, and of course
@AmCollegeGastro
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Pedialyte now has sucralose in it! So let me get this straight. A product to help children with diarrhea now has a non-absorbed sugar that causes bloating and maybe diarrhea if you ingest enough. What!?
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At the beginning of 2024 we now have a really good understanding of how IBS develops from food poisoning and CdtB toxin. Just wait till you see how we fix it in this model (study is done and being published now).
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So excited! Our new book is in pre-order and out April 12 (6 days). We decided that all proceeds from sales during launch in April will go to
@WCKitchen
. The book is meant to help
#IBS
and
#SIBO
and the proceeds will help
#ChefsforUkraine
. Its a win-win. Bless
@chefjoseandres
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Enough is enough! 💩This brown soft serve ice cream-like creature is not normal poop. Yours should not look like this. This is what stool and it's emoji should look like. Just saying...
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#SIBO
we now know who you are (Klebsiella and Eschericia). We also now know where you live. We are coming for you with potentially better directed treatments. Looking for patients with diarrhea IBS for clinical trials.
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It is vital that in 2018 we educate beyond the gastroenterologist. Most primary care doctors still think
#IBS
is a psychologically associated condition. They need to know that food poisoning and
#microbiome
changes are important in many cases! Lots of work to do.
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Christensenella and Ruminococcus are the hydrogen producers we now believe fuel
#methane
production in
#IMO
(methane overgrowth of M. smithii). This is a big finding. More methane = more
#constipation
and
#bloating
. We now know the gang of bugs for
#IMO
.
#treatment
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I am grateful for the angels in our midst. We received an important donation/grant today to keep us going in our quest to find therapies for patients with
#SIBO
,
#IBS
and microbiome disorders. Thanks on behalf of
@MASTprogram
@RuchiMathurMD
@AliRezaieMD
Let's get to work!
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Proud to say that the next advances in the small bowel
#microbiome
are accepted at the
@DDW2023
. Our expert microbiome team from
@CedarsSinai
@MASTprogram
will be sharing amazing new discoveries in May!
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Was in Chicago last night and was supposed to speak to 30 primary care physicians and 55 showed up. Great group. Bad news, most still thought
#IBS
was psychologically linked. Good news, they did not think that way after I was done. One day at a time...
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It's officially
#IBSawarenessmonth
and while we have made great strides in finding better ways to diagnose and treat IBS, we are now believing a cure is possible. Let's start this month on a positive note because
#weknowIBS
and we will do everything it takes to get there.
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A lesson for young researchers in medicine. If you put the patient at the center of your focus, you will always be on the right path. It's not about what might treat a disease, it's about what might treat a patient with a disease.
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In 1999, you, the patient, made an impact on my life that changed my goals forever. Telling patients "just live with it" did not compute for me. There had to be better answers and few were looking. Thanks for inspiring me to walk this path for the last 20 years!
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@josh_disbrow
@YouTube
@BioscienceAytu
@RuchiMathurMD
@AliRezaieMD
@MASTprogram
More work to do but we are excited to do it for patients. The world is hurting. Science will determine the right path.
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It's
#IBS
awareness month. This condition affects 45 million people in US and nearly 1 billion worldwide. It's not in your head! We will be sharing some new information throughout the month about this
#microbiome
related condition. Next news...Tuesday!
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This is shocking...the average time for patients to feel confident they have
#IBS
can be as long as 6 years. Colonoscopy, ultrasounds, CT scans, biopsies all negative and many doctors = a lot of $$$ out of pocket. Also the pain and suffering of not knowing. We can do better!
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A low point this week. I heard someone refer to
#IBS
as a “female disease”. After 20 years of trying to root out this notion that women have a psychological flaw that leads to IBS, there are still some who say stuff like this. This needs to stop. More education!!
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If you have 6 people in your life, you know someone suffering with IBS. It's that common! Often they suffer in silence. As we approach
#IBSAwarenessMonth
be mindful of one of the most common conditions affecting all age groups.
#WeknowIBS
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@runPattirun
@josh_disbrow
@YouTube
@BioscienceAytu
@RuchiMathurMD
@AliRezaieMD
@MASTprogram
@CedarsSinai
There are many who want to distort the facts or simply don’t understand. We have already published the dramatic effect of the technology on bacteria at UEGW 2019 (peer review conference). We are publishing the new work and then the scientific community can scrutinize.
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Every day now our lab is one step closer to fully understanding the
#microbiome
basis for
#IBS
and
#SIBO
link. Food poisoning-autoimmunity-neuropathy-SIBO then IBS. Can’t wait till
#DDW19
. So much new stuff to share!
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16
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The
#REIMAGINE
study in our
@MASTprogram
will completely change the way we think about the
#microbiome
. In
#IBS
,
#SIBO
,
#metabolicdisorders
, and even
#autoimmunedisease
. We are weeks away from presenting new data on all these conditions.
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I would like to declare this "love your dietician day" because these people are amazing when it comes to helping you make good decisions. For me its the low fermentation diet for
#SIBO
. Thanks for the hard work you do. You teach me
@robinberlinrd
@GIdietitian
@KateScarlata_RD
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We need a clear diagnosis, better treatments, and more funding for
#IBS
now. It's IBS awareness month and a good time to think about the 1 billion worldwide who suffer from this condition. Get involved.
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This week we are one step closer to beginning the development of two new drugs for
#SIBO
/
#IBS
based on findings from the
#REIMAGINEstudy
. This is why the REIMAGINE study is so important, and will continue to bear fruit in the coming years for patients!
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2/2
5. E. coli and Klebsiella are main
#SIBO
culprits. We now know where they live.
6. New treatment being tested on basis of
#5
7. Validated breath test based on small bowel sequencing
8. Proved that hydrogen is coming from small bowel in
#IBS
/
#SIBO
#IBSAwarenessMonth
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Twenty five studies from around the world pooled and confirm SIBO/IBS connections. Patients win! Next chapter=better treatments. Small Intestinal Bacterial Overgrowth in Irritable Bowel Syn... : American Journal of Gastroenterology
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I want to take this opportunity to thank all those who help make our research into
#SIBO
#IBS
and
#microbiome
possible. Your support is a big part of why we have made such important discoveries the last 3 years. Believe me when I say 2019 will be a big year for patients!
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.
@SepidehMehravar
and
@AliRezaieMD
and our team present a meta-analysis showing
#methane
is associated with
#constipation
and
#IBS
-C. So many studies convincingly proves this. Two new treatments for methane coming. One maybe in January!
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We have quietly waited for this peer reviewed paper to drop. The first-in-human use of UVA to treat critically ill patients with
#COVID19
.
First-in-human trial - daily endotracheal narrow-band UVA therapy in critically ill
#COVID
patients appears to be safe, with a significant reduction in
#SARSCoV2
viral load:
@alirezaieMD
@markpimentelmd
@ruchimathurmd
@gilmelmedmd
@gabrielagsleite
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The small intestine has the surface area of a tennis court! This is where food, vitamins, drugs and anything else gets absorbed into the body. Imagine a thin layer of bacteria spread across this massive surface. What these bugs produce can have an impact on health and disease.
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Food poisoning (acute gastroenteritis) can trigger
#IBS
and lead to
#SIBO
and
#autoimmunity
. Be very careful during the coming holiday season. Thanksgiving to New Years is the highest risk time. Make sure food is properly cooked and hot.
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As promised. Herculean effort by our
@MASTprogram
and
@GabrielaGSLeite
to technically define
#SIBO
. We define the bugs, cutoff, correct media to find SIBO, the right catheter to use, and symptoms! This paper sets stage for treatment.
#microbiome
@AGA_CGH
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On
#WorldIBSDay
I reflect on the more than 50,000 patient encounters in our program over the last decade. This experience teaches me that
#IBSSucks
for patients. While we are working hard everyday to find new tests and treatments, we need to work faster with more resources.
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19
114
Heading to Europe today. Invited talk on role of
#microbiome
in
#IBS
. It’s critical to help these patients and make sure they are respected as a disease, not just a “syndrome”! And IBS is a real microbiome disease.
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Finally! Thanks to the co-editors
@RuchiMathurMD
@barlowgillian
and authors including
@jfcryan
@GabrielaGSLeite
@AliRezaieMD
and many others for contributing to our new text book "Clinical Understanding of the Human Gut Microbiome".
#Amazon
via
@Amazon
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Experience of the week! I am still encountering doctors who just can't seem to understand that
#IBS
is an important disease. Not surprised that patients are frustrated.
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New Study! Specific ultraviolet A light makes tracheal cells activate a mitochondrial antiviral system. The amazing thing is that they seem to tell cells far from the light to do the same. Could this be why we have less viruses in summer? More to come.
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Experience from patient this week. Doctor told patient "there's nothing more I can do..." It's true we don't have all the cures in medicine yet. But, the better response should be "we will never stop trying". However, if you say this...mean it.
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Happy 2023! This will be an exciting year
@MASTprogram
as we work towards the clinical trials of 2-3 drugs from our program for the treatment of the
#microbiome
and other disorders. Patients need better options for these conditions.
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11
109
Amazing. The first evidence-based guideline on
#IBS
acknowledging
#postinfectiousIBS
as well as
#SIBO
and
#IMO
in IBS-D and IBS-C, respectively. They used GRADE methodology to weigh the evidence. Congrats to Dr. Uday Ghoshal and his team.
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108
Flying home from last work trip of 2019. What a year for
@MASTprogram
helping patients with:
1. Launch of SYN-010 trial for
#methane
#SIBO
2. Next gen testing for
#IBS
3. Bugs for
#obesity
emerging
4. Bugs for
#appendicitis
5.
#REIMAGINE
study
and so much more...2020 even better
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April is
#IBSawarenessmonth
. I am grateful for the having the opportunity to treat these patients and for being part of a research effort to help. This is a disease that affects so many. We will be posting facts and events all month.
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When you do a larger trial the truth emerges. Peppermint oil does not appear to work for IBS! Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel Syndrome
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Today I'm reminded of a quote from a recent speaker. "IBS is a disease of hysterical women". NO! This was shocking and sad.
#IBS
is a real DISEASE in part caused by food poisoning and the
#microbiome
. This 2012 piece is dated but tries to address this.
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Why is the 💩 emoji a Bristol Stool 5-6? That’s not normal!
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In 8 days
#IBS
month begins. Think about this
#disease
. Let's empower these patients (not unpower and not umpire them). It's are real disease. My theme for this year is
#notasyndrome
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@MrSarcasimo
@abarnes2012
@AliRezaieMD
@gym99
@RuchiMathurMD
@GabrielaGSLeite
@MASTprogram
We are trying to look at this entirely with these terribly ill patients in our focus. Fast but careful steps. The data will be revealed in the coming days (not months).
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This morning
@GabrielaGSLeite
from our team presents the conclusive evidence for SIBO using deep sequencing in the REIMAGINE study. We now know who's the culprit! Enterobacteriaceae.
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Another patient with positive hydrogen sulfide on breath test today. Great because this gas seems to be quite responsive to treatment and benefits seem to last longer than hydrogen only
#SIBO
. More data to come on this.
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And here we go again. 2022 was another year of disappointment for
#IBS
grant funding. The
#disease
that affects nearly 1 billion people worldwide, received almost no funding last year. Answers are coming slowly for this exact reason.
#notasyndrome
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This is the big one this afternoon at
#DDW2022
. Dr Villanueva and our team have for the first time defined three gut microtypes. Hydrogen, and hydrogen sulfide in diarrhea and methanogens in constipation. But the bugs giving hydrogen for methanogens are different.
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This is the year where new diagnostics and therapeutics for
#SIBO
start to emerge. Our lab has grown to make these things happen. I know it takes time and is frustrating for all those who suffer, but know that we are on the task. Thanks for all the support and stay tuned!
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.
@CedarsSinai
the
@MASTprogram
has reached new heights with discoveries around
#SIBO
and
#IBS
connection. Everything changes this year! New data for treatments and diagnostics will be revealed. Remarkable revelations about the
#microbiome
(
#drugsforbugs
).
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During
#IBSAwarenessMonth
we need to accomplish two more goals.
#IBS
research needs more funding. While more funding=more potential cures, it also means more scientists studying conditions like
#IBS
and
#SIBO
. It also means more doctors who know how to treat
#IBS
patients.
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95
Based on the presentation defining
#SIBO
with deep sequencing this morning, we now know the bugs and have already developed a new way of treating
#SIBO
in
#IBS
@MASTprogram
@CedarsSinai
. Stay tuned in the coming year!
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US News and World Report ranks Cedars-Sinai GI
#2
in the nation. Thanks to all the patients that trust us and help discover new treatments for conditions in
#IBS
#SIBO
#IBD
#microbiome
and so much more. We are humbled.
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These are the people getting the answers for
#IBS
and
#SIBO
@CedarsSinai
. Bridging basic science and clinical research to get the next treatment for IBS based on the microbiome. I am so proud of this amazing team!
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Our paper now in the December issue of
@AmJGastro
. The
@MASTprogram
team has defined three major microtypes in the
#IBS
#microbiome
that correlate to the three gases on
#breathtest
(hydrogen, methane and now hydrogen sulfide as well), and symptoms.
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#IBSawarenessmonth
#IBD
is defined by gut inflammation (causative factor) so companies successfully developed drugs to treat that.
#IBS
is defined only by symptoms so we mostly get drugs to treat symptoms.
To make progress in
#IBS
, we need to move away from just symptoms!
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So proud to be working
@CedarsSinaiMed
now officially the
#2
hospital in the whole country and
#2
in
#gastroenterology
. Hard work, important research innovations, and great leadership focused on keeping the patient in the center of our view.
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Looks like some don't get the point. We need advocacy and funding so these conditions are respected and science/cause-effect work is enabled. No science, no answers...besides the old default answers.
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91
What I learned about
#PCOS
@TheEndoSociety
is that it reminds me of
#IBS
. No one knows why it happens, it affects 10-15% of women, patients often dismissed, the default is to treat anxiety, lots of $ spent. Worse...there are no approved drugs for this. We need to do better.
5
11
90
In a special requested review, we summarize the whole concept of the
#microbiome
and
#IBS
/
#SIBO
. Thanks
@AnthonyLemboMD
for collaboration on this. Look at figure 1
@IBSpatient
. This summarizes 20 years of work.
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