Transcript generated automatically by AI and may contain errors.
Chapter 1: What are the biomarkers linked to irritable bowel syndrome?
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I'm Peter Martin, host of The Economy Stupid, where we find economics in relationships. She only wants a man if he's really, really good. In the Reserve Bank board. I knew, I knew. Everybody on the board knew recession was coming. And in food.
It's about the cup of diesels required through the life cycle to get that chicken patty on your burger.
The Economy Stupid. Search for The Economy Stupid on ABC Listen or wherever you get your podcasts. How settled is your tummy?
How settled?
Now, I'm a GP who's going to touch wood as I answer this because I know we could be tempting fate here.
Yeah.
Pretty good. But I am someone who, if I'm worried, my brain talks to my tummy. This is how I explain it to my children.
Well, it's true. There's a lot of crosstalk between your brain and your abdomen and so on. I don't want to get into too much detail. Please. Mine is up and down, I have to say, and always has been since I was a kid. But I think probably that brain-bowel connection is important. But whether that's actually what's going on in people with irritable bowel syndrome is a matter of debate.
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Chapter 2: How does the brain-gut connection affect IBS symptoms?
So to really control human papillomavirus, you've got to immunise boys as well. But there are benefits for boys.
And just to link it again, just to really make the connection, Norman, HPV is what causes most cervical cancers too. So initially it was girls. Some countries still only vaccinate girls. But really, as you say, the benefit is in vaccinating everybody.
And it appears now that everybody yields benefit because what this study found is that in the group who were vaccinated, there was a 46% lower risk of these HPV-related cancers.
Which is interesting because it really only went to the age of 26 because HPV immunization hasn't gone on for that long. But it was hundreds of thousands of boys who'd been immunized versus a two million control group. So it was really what you would call a case control study and showed that even with the small numbers at that age, you still saw a significant effect.
But the authors did say that they need longer term data because a lot of this stuff has a very long tail in terms of HPV exposure and then it's sitting around there for years and causing, you know, the cells to change. So this is wonderful and I think this really makes the case for vaccinating boys and girls, but that some more longer term data would be even better.
So guess what topic we're going to talk about next.
We don't have a sound.
No one's written in. We do have a sound. We do. It's been normal and determined. I'm looking through the glass at James, our producer, and he's iffy about it. I think it's a good sound myself.
Are you going to do it every time or is it being played? You're going to do it every time. Okay.
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Chapter 3: What challenges exist in diagnosing irritable bowel syndrome?
So 21 biosimilars have actually been approved by the Therapeutic Goods Administration as of last month.
Would we know any of them? Do we know a name?
Well, etanercept, for example, for rheumatoid arthritis, that has several biosimilars. Rituximab, which is used in lymphoma amongst other things, that has a few biosimilars. Tends to be drugs that are coming out of patent and they produce these biosimilars. Now, for a generic to come on the market, they've just got to prove that the drug is the identical chemical drug.
For biosimilars, they do actually have to prove equivalence in a clinical trial. They don't have to show cure rates in the phase three, but they actually had to show equivalence. But there's still a fair amount of resistance amongst specialists and non-GP specialists in cancer and rheumatology and so on to use biosimilars and get used to them because they're not the same drug.
And so what Sandoz is doing, self-interestedly, is trying to get a discussion going about this. But potentially, it could save the country quite a lot of money if these biosimilars are just as effective. But you'll find a fair bit of skepticism amongst some specialists about this.
And it could make the drug company a lot of money. There's a reason for the push.
I'm just, you know... Of course, that is absolutely right. Okay. And some of these mainstream companies are producing their own biosimilars, so Pfizer, Sandoz and others. So there's a lot of money here. They may not be saving quite as much as they could, but it's an interesting issue.
On ABC Radio National, you're with The Health Report. Irritable bowel syndrome is very common, Norman. You've kind of declared that perhaps you have it on air. We're building your medical history.
Can you hear my tummy rumbling?
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Chapter 4: How can fecal calprotectin help in diagnosing IBS?
There's significant quality of life impacts of having IBS. And to then be told that there's nothing biologically wrong with you is quite invalidating and quite stressful. And so I think the real point, the today impact of this work is that it does show that there are immune system changes happening
that we can detect, that we can measure, that show that IBS patients are different to healthy controls. And yeah, absolutely, there's plenty of further work that could be done in terms of implementing the signature for diagnosis, but we're really just adding to that body of work. A significant proportion of our population we know have IBS.
We know people live with crippling abdominal pain and changes in their bowel habits. And I'd really implore you to go and talk to your GP about it because there are things they can do to kind of firstly make sure it's not something more sinister, but also to try and make suggestions to help you improve your quality of life.
Dr. Grace Burns from the Centre for Research Excellence in Digestive Health at the University of Newcastle.
You're with The Health Report on ABC Radio National.
Norman, we've talked quite a bit about bowel cancer on the health report, particularly about increasing bowel cancer rates in younger people, not many people actually engaging in the bowel cancer screening program, despite it being very effective.
There's a study that's been published involving researchers from the University of Melbourne, University of Sydney, and it's looking at people presenting in general practice with symptoms that could be bowel cancer and And there's not very consistent investigation. There's big variations and it's a little bit concerning because are people being missed and do we need clearer guidelines?
We are joined now on the health report by Dr Shaoqi Li, who is a research fellow in the Cancer in Primary Care team at the University of Melbourne and also an author on the study. Thank you for joining us.
Thank you so much, Priya.
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Chapter 5: What variations exist in bowel cancer investigations across Australia?
I'm a believer, and I think people should be on it, but we'll have this conversation as we go forward. But as an example of what it can do, we've got Christine Kwong on the line. Christine is a nurse, and you'll hear a little bit about her health journey in a moment. She's also involved in the digital health industry herself, so you could argue that she, like me, is a believer. Hi, Christine.
Hi, Norman. Hi, Priya.
You had diverticulitis, you were in hospital and you had a CT scan for your diverticulitis. And it showed that it was good news for your diverticulitis, but there was one thing missing when it got back to your GP.
I got a phone call from the specialist to say, you know, the diverticulitis is fine, just continue on the oral antibiotics and the usual, like, you know, if the pain gets worse or I don't feel any better, go back to the hospital. In about the week later, for some reason, and I'm a bit like Priya, initially when my health record came out, I didn't want to share my information.
So I don't know if I forgot to opt out or what happened, but I'm kind of grateful that I now have got the My Health Record in there. And for what, as Norman mentioned, I do work in digital health space. So we have been looking at how quickly, you know, your records can come through.
So instead of Instagram, you troll through My Health Record. Is that what happened? Yeah.
Yeah, I do. Well, I kind of look through and, you know, I have some other things and, you know, the regular health checks have been passed, you know, the age of 45. So, you know, being a nurse, you've got to practice what you preach as well. So, doing all the screening and everything.
Your CT scan was in there. What did you find when you went in and had a look at it?
So it did report that my diverticulus is fine. And because of the abdomen, it did look at, you know, my liver and everything else. But it did have on the report that there was a six millimeter lesion on my right breast. And if concerned, should get further ultrasound. So it wasn't usually in like the bright bold or anything like that.
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Chapter 6: How does socioeconomic status impact bowel cancer investigations?
It's still PDFs, believe it or not, not searchable documents and be able to move around easily through that. There's no hospital information. You just wonder how common a story like Christine's actually is, given how clunky this My Health app is, despite we've spent maybe half a billion dollars on it.
That's a great question, Norman. And I'm happy to kind of unpack that a little bit. So the 1-800-Medicare app is actually the patient's version, the way that they access their My Health Record. So if we think about the app separate to what the doctors see, so the app is, you know, what we're really excited about in terms of
patients, you know, have now accessed, well, there's 18,000 of them accessing every week. There's obviously a million downloads.
And if you actually have used it and I have it myself and my kids have it, it is one of the most user-friendly apps that, you know, I have ever seen a government come out with, to be honest, in terms of, you know, being able to... You've actually done something right for a change, haven't you? It's amazing. And I am not someone that's easily impressed with apps.
And I have to say this one, I literally opened it this morning, was just showing it to my physio and was just wowing her with things like the timelines and the scripts and all the Medicare information in there and the results. So I think from a patient side, they have really won at the moment in terms of having a great user-friendly app on their end.
I think for the doctor side, and you're 100% right, like it has historically been a bit of a difficult user interface. It's been a bit clunky to access things that we wanted to access, but there is work now underway to improve that. So we're going through a modernisation of actually making the doctor side of the My Health Record much more user-friendly and
You know, moving away from PDFs and moving away from multiple clicks to go in and out and really having that, as you said, searchable functionality.
Amandeep, just to jump in, like I think it's wonderful, A, kind of having this integration because it does feel very siloed. And I also think it's wonderful for patients to have access to information. And we just spoke to Christine. Christine has high health literacy, is a nurse, has picked up this finding on the CT scan and followed it up with her GP.
If people don't have clinical knowledge and they've got access to all their results on this app, which is really user-friendly, but the clinician is sitting in the room and I can't see the result... and the patient doesn't detect it, is there still a really big failure in communication between healthcare systems? And does My Health Record or the app really fix that?
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Chapter 7: What role does My Health Record play in patient care?
But it is a once-off thing. But if you have trouble, ring our helpline because we'd love to help you. I would say your GP may not be able to help you. I've had some patients ask me and we've gone, well, we actually need to, you know, spend a bit of time doing this. So, but, you know.
The GP's too busy on the fax machine.
Yes, on the fax machine. Or navigating the record on the other end, the clunky record. So definitely ring our helpline.
Amandeep, thank you very much for joining us.
Thank you so much for having me.
Dr. Amandeep Hansra, who's Chief Clinical Advisor for the Australian Digital Health Agency. And the app is called the 1800 Medicare app.
On ABC Radio National, you're with The Health Report.
So what's in the mailbag this week?
So Andrew has written in in response to a comment that you said about having your appendix removed.
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Chapter 8: How can patients ensure effective communication with their GPs?
I'm away and Belinda Smith is going to be your co-host. And I'm looking forward to hearing how the two of you misbehave.
Oh, it's going to be wonderful. Everyone should tune in.
See you next time.
See you then.
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