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Hypotheses in Medicine

In the practice of medicine, physicians often have to make recommendations based on their own prior experience, or on the experience of their colleagues. Often, these "expert opinions" are based on shaky scientific facts and evidence. It is not easy for a physician to admit ignorance. In an attempt to transmit a sense of confidence, the physician may be misinterpreted to be arrogant, particularly when unconventional ideas, alternative or complementary approaches are encountered. These may often be brushed aside as unscientific “myths”. At times, the physician may appear to adopt an adversarial stance when confronted with an unconventional hypothesis, or a different approach to treatment than the orthodox.

Exploring Unconventional Ideas

At the UW Division of Gastroenterology, we believe that it is important to keep an open mind. The evolution of science and medicine is punctuated with the careful cross examination of many seemingly far-fetched hypotheses. We believe that there is a treasure of important information and discoveries hidden in these unproven hypotheses. They should be vigorously examined, challenged, verified or rejected by scientific facts. They must be processed with rigor so that hypotheses, such as represented by alternative or complementary medicine, can be translated to scientific discovery and clinical application.

The GI Tract, A Delicate Ecologica Environment

Although housed within the body’s abdominal cavity, the gastrointestinal tract and its organs are actually in constant contact with the outside environment, with both ends of the tubular structure opening to the exterior. The surface area of the gastrointestinal tract, when spread out, is as much as several tennis courts! The surface of the intestines is constantly interacting with the external environment, including food with its many dietary constituents, foreign antigens, chemicals, and toxins. The intestinal cells process a phenomenal array of molecules, and are responsible for the body’s nutritional physiology, energy balance, micronutrients regulation, antigen processing, and immunologic responses. The gut and the liver comprise the most important synthetic organ in the body. Exogenous chemicals (dietary items, food antigens, environmental toxins), and endogenous chemicals (breakdown products of cell metabolism, bacterial products from the intestine) are detoxified by the liver, and some are liberated into the systemic circulation where it can reach the kidneys and the brain and other organs. These chemicals and antigens can profoundly alter our immunologic response or neurologic function. As a main gatekeeper to regulate the balance of energy, micronutrients, food and environmental antigens and toxins, the gastrointestinal tract is the most important protector of the body from external insults. The gastrointestinal tract also lives in harmony with billions of microbes, achieving a delicate ecologic environment and harmony within our bodies.

Unraveling Medical "Myths" with Scientific Discpline

Understanding the structure and function of the gastrointestinal system holds the keys to the secrets of a number of perplexing neurologic and immunologic disorders; and provides a rational scientific understanding of some alternative or complementary treatment approaches. We believe that there is much to learn from these medical "myths", and that they should be unraveled only with rigorous scientific discipline.

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