Moodle at CCNM

This presentation takes a look at the natural agents that are most studied to heal intestinal permeability. We discuss natural agents as well as pharmaceutical that are available for repair. Medications discussed include: Linzess, Amitizia, Trulance, Resolor

This talk will involve a 45 minute case description of a commonly encountered presentation of Small Intestinal Bacterial overgrowth in clinical practice. The presentation will review symptomatology, laboratory work up and breath test interpretation, and treatment approaches, including dietary interventions. We will also explore concepts of dietary expansion, following long-term dietary restriction.

Naturopathic doctors have always stressed the importance of treating the gut, and have used personalized diet to optimize health, botanical and other antimicrobials to treat stealth pathogens, and numerous other interventions to minimize harmful levels of inflammation and otherwise encourage best outcomes. How does the normal microbiome influence the importance and success of these treatments? How can emerging technology help us assess the importance of commensals and “possible pathogens?”

Ayurved is the most ancient science and holistic system of medicine originating from India and gaining popularity throughout the world because of its’ holistic approach, consistent concepts, wide range of preventative measures, practical applicability at any age, place and in any given conditions. Ayurved examines multidisciplinary paradigms of life and teaches mind-full living of life. The inseparable relationship of mind and body, relationship of various parameters of human life with the nature and significance of mind are recognized by Ayurved. Ayurvedic individualistic approach identifies the personalized care, prevention and medication. “Manovikar” is the Ayurvedic terminology for Mental Disorder. This presentation provides a brief overview of Ayurvedic perspective of Classification, and Prevention of Mental Disorders and opens-up multiple avenues to explore learning and applying Ayurved in real life for psychophysical wellness of an individual and community.

The role of the endocannabinoid system in both physiological and pathophysiological function of the gastrointestinal tract is relatively unknown. Pharmacokinetic studies shed light on the metabolism and bioavailability of exogenous cannabinoids. Preclinical and clinical trials continue to explore the utility of using cannabinoids as therapeutic agents for gastrointestinal disorders. This presentation elucidates the key functions of the endocannabinoid system in maintaining gut function. It also summarizes existing evidence for using cannabinoids to treat GI disorders. Pharmaceuticals covered: Cannabidiol, Nabiximols, Dronabinol, Nabilone

Each year more than 2.5million Americans visit the emergency department due to brain injury. This “silent epidemic” which causes disability is often minimized, misdiagnosed or dismissed altogether when in fact it is a major contributing factor for fatigue, cognitive problems, memory difficulty, and mood problems including depression. One of the most important lessons I have learned from brain imaging work over the past 8years is that concussions and more severe brain injuries are a major cause of mental illness in this country. This presentation will discuss the assessment for mild to severe concussion and TBI as well as treatment approaches.

Prevalence and definitions of eating disorders in various populations, including patients with concurrent SIBO diagnoses. Work-ups recommended for eating disorder patients, and treatment strategies. Vyvanse/lisdexamfetamine dimesylate for binge eating disorder. Anti-depressants for appetite increase. And other medications with anorexia as a side effect including: Concerta/methylphedate, Adderall/dextroamphetamine.

An elemental diet is a meal replacement plan that uses a mixture of all essential and nonessential amino acids, fat, simple sugars, electrolytes, trace minerals and vitamins. Components of this mixture are already in their simplest forms so they can be easily assimilated. This presentation will introduce elemental diets and provide information on how and when to use an elemental diet clinically for various gastrointestinal conditions, but primarily for SIBO. This presentation will include a discussion on indications and contraindications, as well as how to transition off of an elemental diet. A brief overview of current research and a couple of short cases demonstrating the use of elemental diets will also be included.

This presentation provides an overview of human genetics and how the intricacies of the human genome are amazing dynamic with delicate intricacies that allow us to adapt to our changing environment; yet also put us at great peril due to epigenetic factors both within our control and external factors that trend towards disruption of homeostasis.  The Clinical impact of stress, pharmaceuticals, environmental pollutants, sleep, etc is also discussed.

It is becoming increasingly clear that SIBO is in some cases due to previous exposure to gastroenteritis. Through a series of interesting studies, it is now understood that this singe food poisoning event can lead to long term changes in the microbiome. The most important of these is the development of antibodies to vinculin. In this presentation, we will update the audience on the latest developments on this topic and how the future is shaping up to treat SIBO and IBS as an autoimmune condition.

This presentation goes through the underlying causes, prognosis of and complications associated with gastroparesis. Management options discussed include herbal, pharmaceutical, dietary, surgical, manual, mind-body and acupuncture treatments. After this lecture, the learner should come away with a greater understanding of the management of gastroparesis in a clinical setting. Pharmaceuticals discussed include erythromycin, azithromycin, domperidone, prucalopride and metoclopramide.

The Human microbiome is a dense network of microbes that live in and on our skin. Their discovery was only beginning to become well known after we were able to identify and see those who didn't require oxygen. Since this development and over the last 10 years of research we’ve not only come to find out who is there, but what they are making. The microbial metabolites may be the future of ecosystem restoration in the gut and if that’s true, then implications for mental health are vast. These metabolites communicate directly with the brain and having impacts on not only brain development, but immune system development. We’ll explore the microbiome, fecal transplant, and a few case studies to exemplify the potential of this 12th organ system.

The role and function of the liver; clinical diagnosis of underlying liver disease. The importance of the intestinal microbiome (IM) on the gut liver axis and the impact of dysbiosis on chronic liver disease. Pathogenesis and causative factors leading to disease progression: gut dysbiosis, bile acid metabolism chronic inflammation , intestinal permeability, and immune system activation. The impact of these factors on development or progression of chronic liver disease with a particular focus on fatty liver disease and cirrhosis/hepatic encephalopathy. Highlighting the role of IM manipulation in a an attempt to reverse or slow down liver disease through diet, use of studied herbals supplements, prebiotics, probiotics and synbiotics and fecal transplantation. Briefly conclude with practical pearls for the naturopathic clinician to fully understand full scope and benefits of adjunctive therapies available to treat their patient’s with chronic liver disease.

A discussion of homeopathic medicines for common health complaints for both mother and baby—including acute postpartum care, breast health, nursing. Safety of homeopathic in infancy and review of frequently used homeopathic medicines for common childhood concerns. Clinical cases and key medicines for the first aid kit.

The presentation will cover what healing means in the clinical environment, how the experience of the patient’s suffering can be support by addressing spiritual distress, providing compassionate presence and offering accompaniment. Clinicians need to be aware of their own inner life or spirituality to be able to provide such care. The concept of a transformational model of care will be discussed.

This is a 60 minute power course orienting everyone into the world of inflammatory bowel disease. We discuss foundational presentation of IBD, pharmaceutical management of IBD and naturopathic treatment options for IBD. Pharmaceuticals discussed:5-ASA drugs like sulfasalazine, mesalamine drugs, prednisone, budesonide, biologic agents like infliximab, ada Infliximab, Adalimumab, Certolizumab pegol, Natalizumab, Vedolizumab and Ustekinumab and immunosupressants like Azathioprine, Mercaptopurine and Methotrexate

Over the past several decades, we have gained immense insight into the world of the human microbiome. The observations made using techniques like Fecal Microbiota Transplant and microbial sequencing are contributing to a new paradigm of what it means to be human. We now know we are not alone in our own bodies. We are a compilation of trillions of microbes and human cells working together as an ecosystem with the bulk of this ecosystem residing in our colon. This ecosystem and the repercussions of its health are now being investigated outside the local GI system. The colonic microbiome is communicating with our brain through neuroimmune, neuroendocrine, and direct sensory input. The bi-directional role this gut-brain axis has on health expands our understanding of what GI and mental health really means.

Gastrointestinal health spans from the mouth to the anus, but rarely the tail end is talked about. During this lecture, we discuss how common GI conditions such as constipation, diarrhea or bloody stools may cause and be causing changes in anorectal health. Intimidated to take a look? We review the rectal examination, as well as prostate exam, to determine if a patient’s anorectal health may be the cause of their IBS. We will also offer both conventional and holistic approaches to help patients achieve immediate relief from their poor anorectal health as well as prevent reoccurrence of disease.

Traditional naltrexone has been used to help patients struggling with addiction to opiates or alcohol. However, for decades we have recognized that at lower dosages, aptly named Low Dose Naltrexone (LDN), we see an entirely different effect on the body. LDN has been shown to have a significant impact on immune function and inflammation. It has been studied and used clinically in Multiple Sclerosis (MS), Crohn’s, Sjogren’s, Hashimoto’s, Lupus, Rheumatoid Arthritis and more. Understanding its mechanisms of action and analyzing literature as well as clinical practice can help practitioners ascertain which patients might benefit from LDN as part of their treatment protocol. There will be a short discussion of adjunctive compounded therapies used in these various conditions, such as biotin and methylcobalamin in MS, topicals for Sjogren’s and thyroid for Hashimoto’s.

Small intestinal bacterial overgrowth (SIBO) is a syndrome in that it has multiple causes. Motility disorders are most often the underlying factors to predispose for the development of SIBO. Postural orthostatic tachycardia syndrome (POTS) leads to an imbalanced autonomic nervous system because excessive sympathetic activity overrides vagal tone. Peristalsis is reduced and SIBO may be promoted. Mast cell activation syndrome (MCAS) is a leading factor in 33% of POTS. It is also conceivable that MCAS could directly impact motility via one of 200 mediators that may reduce neuromuscular activity.  It is important to recognize POTS which has a prevalence of 500,000-1,000,000 in the US. Understanding this disease and the more prevalent MCAS (1 – 17% of the population) is critical to help many patients who otherwise suffer for decades without a diagnosis and/or effective therapy.Specific pharmaceutical medications to be discussed in both the overview and outline: rifaximin and naltrexone.