I'm sorry, what scare tactics did I refer to? I have not referred to any well publicized and likely misleading sources used by the war on drugs - I have not referenced the usual claims of lowering IQ or as a gateway drug even though it is reported in a peer reviewed journal. I specfically avoided such sources because I knew someone would attempt to discredit them. What I have given you is clinical experience (19 years now) of issues that I have encountered with actual patients that I have treated. I have had people so strung out on drugs that they failed to recognize a decline in their health that made their condition worse. I have stuporous individuals who have serious medical derangements that we could not determine from their history (they weren't able to talk or were exhibiting paranoia) or from physical exam (they were so out of it I couldn't get they to react to any exam or they refused to cooperate with the exam) Related reference here. It is still illegal to drive after using marijuana in Colorado and California.

While an increasing number of states are allowing "medical marijuana", there are very few registered patients in most states ( CA being the exception - and not a surprising one). So yes, most people _still get their drugs off the street_. I will grant you on a second read that one reference was more of a scare position. A better article is here, and also a report form Europe on laced drugs here. And, please, a little more evidence than "snopes" here - one discredited mass media report is hardly adequate evidence. Not related to marijuana, but an extremely interesting story occured in the 1980s about poorly synthesized ecstasy that resulted in several very young people developing a Parkinson's like disease because of a mistake made by the "chemist" . This tragedy had a bright spot: it gave neurobiologists a way to create a model of Parkinson's in lab animals that they had been unable to create before that.

Trust me I know about people doing stupid things. I am a trauma surgeon and nearly half of my patients arrive with drug and or alcohol on their toxicology screen. Verified in the literature here But marijuana use still has dangers associated with it, especially when smoked. It has been linked to several lung diseases, here, and here. So again, please stop referring to marijuana as "safe" or "safer". And if you would please give me a reference or two stating how it is safer, peer reviewed if you would, as I have given you plenty of links to such.

This is a very interesting article and they may be on to something, but it is far from the first time Crohn’s disease has been attributed to microbes. They make a good argument, but I don't think that this closes the case yet. They specifically note that this is for "Familial Crohn’s Disease" and not all cases are familial. This was also a study that only looked a 9 family, with an n of 20, so this is not a very large study, and these are likely geographically co-located (but they did not give a lot of data on that). I'll avoid a long history of the disease and just place the gentle reminder that correlation is not causation (and in medicine the level of evidence for proof is often much higher than in other sciences). A lot more research needs to go into this - but investigating the complex relations in the gut biome is probably going to yield some very good insights.

So I'll continue with my standard answer for Crohn's that "we still don't know for sure" - but we're getting closer.

This is not a joke, this is some of the worst advice. Please stop posting uninformed advice that is more harmful than helpful.

Muscle relaxants (of which marijuana is a poor one) are not useful here and are actually contraindicated. This capsule is not hung up on a sphincter, it is likely caught in a stricture and inhibition of peristalsis is not going to help and may make matters worse.

In addition, by consuming marijuana and getting "high" he or she may miss changes in their condition that indicate that they need to get to the hospital emergently (e.g. abdominal pain indicative of intestinal rupture). If they decide to take themselves to the ED, driving while impaired is illegal in all states not to mention just plain dangerous. Once there, again, being under the influence of a psychoactive drugs they may not give a thorough medical history, or it may alter the physical exam findings, possibly leading to a misdiagnosis (even with EMRs - I have seen this happen). Marijuana may also interact with other more useful medications that need to be given leading to further complications. In addition, diagnostic tests may be delayed as they won't be able to properly consent after consuming an substance that alters cognition. In addition, buying drug on the street is very dangerous because you do not know exactly what you are buying (a pharmacology professor of mine proved this in the 80s) - even marijuana can be laced with even more dangerous substances

In short, please don't self-medicate. This is especially true when you have a complex medical condition. Leave the medical advice to someone who is trained and qualified.

And stop claiming that marijuana is harmless. I see too many people land in our ED as a result of this type of self-medication.

This is highly unlikely to work. The problem? You think of the intestine as a linear tube from mouth to colon (then anus), but in reality there are many twists and turns in the intestine (which happens in real time - aka peristalsis). So for any placement of the magnet, you are just as likely to hang it up as to move it along - so doing this yourself won't help - and may actually be harmful if the magnet is strong enough and left in one area too long. That being said....someone has already thought of this. But if you look at the article, it looks like a pretty elaborate setup that likely only exists as a handful centers in the world as this would need to be done in real-time with imaging (looks like a mini CT scanner).

After 12 weeks, the likelihood of this passing on its own is virtually nil, so it will need some help. Double balloon enteroscopy (aka push enteroscopy) can be used if not too far in, and is performed at most university/academic medical centers. Other medical options are descried here. A more aggressive, but not maximally invasive choice would be to bring a surgeon into the mix to do a combination of double balloon enteroscopy and a laparoscopy or just plain old laparoscopy.

Best of luck.

Really? He lost to Douglas Adams by about 15 years......the successor to Deep Thought was the Earth.

Whoosh!

I believe the HHGTTG summed it up best:

The Hitchhiker’s Guide to the Galaxy defines the Federal Communications Commission as “a bunch of mindless jerks who’ll be the first against the wall when the revolution comes,” with a footnote to the effect that the editors would welcome applications from anyone interested in taking over the post of robotics correspondent. Curiously enough, an edition of the Encyclopedia Galactica that had the good fortune to fall through a time warp from a thousand years in the future defined the Federal Communications Commission as “a bunch of mindless jerks who were the first against the wall when the revolution came.”

-- Douglas Adams, The Hitchhiker's Guide to the Galaxy

First, there have been no reported deaths from this infection as per the article, so how exactly is this deadly? Dangerous, potentially deadly? So, please, lets title these articles responsibly. The remainder of this post is not meant to bash the parent, just to define terms and clarify concepts. My opinion is at the end.

The term antibiotic covers both anti-bacterial agents (e.g. penicillin) used against bacteria, and anti-fungals (e.g. fluconaole/Diflucan), and technically, they also refer to anti-virals (e.g. aciclovir), but in the most common use, antibiotics refer to antibacterials, and never to antivirals. There are no medications that treat both bacteria (prokaryotes [no nucleus]), fungus (eukaryotes [true nucleus]) simultaneously; yes, bleach (sodium hypochlorite) can destroy both, but internal use is discouraged [and as referenced in the wikipedia article, your body's neutrophils (a type of white blood cell - cells that fight infection) uses hypochlorous acid as an antimicrobial . So.....yes and no. [sorry that kept getting longer and longer]

Flu con a zole - that's not too hard....Talimogene Laherparepvec...that's hard. :-)

Ummm, no. You can get pretty powerful topical antibiotics and topical antifungals over the counter. Fluconazole is an oral antifungal that still requires a prescription (at least in the US and other "responsible" countries).

It is a common ailment, but it is also a true infection that can be cultured and proven, and usually requires treatment. (I don't want you to poo-poo this aliment :-), pretty miserably for those afflicted), and unless there is a well established relationship between physician and patient, an exam is required (and strongly encouraged to rule out other more dangerous diagnoses).

I see fluconazole resistant candida albicans frequently (reported 7% resistance rate), but I work at a tertiary care referral center, so YMMV. Never been under the illusion that it could not become resistant. Every organism (meaning microbial species) given enough time and opportunity can become resistant to just about anything.....The only thing that microbial organisms will never become resistant to is fire, well heat anyways (shout out to the the post below).

Yes and no...You are quite correct that nystatin is of limited value as it is not systemically absorbed, so for fungemia fungal infections of the blood), it is useless.(sorry, link is likely paywalled for you, my domain is exempt)

There are a few other antifungal agents that are useful, but this bug is showing some concerning resistances. But I think that one of the things pointed out by the original article is that over 75% of these cases were colonizations, not infections. Therefore, the sky is not falling (yet), but increased surveillance on the part of the global healthcare system is warranted. How can you help? Be responsible, please don't demand antibacterials (or antifungals) at the first sign of what is typically a mild viral infection. Why do antibacterials matter? The bacterial colonization of you body is the first line of defense against fungal infections (read the abstract, for a decent in-depth review see this)