Dr. JoAnn Yanez, AANMC executive director, joins KCAA’s NBC LA affiliate On the Brink to discuss Irritable Bowel Syndrome (IBS).
 

Full Transcript of Interview Below.

Topics Include:

  • IBS as a diagnosis of exclusion
  • IBS prevalence and the impact on quality of life
  • IBS symptoms
  • Mind-body holistic approach to IBS treatment
  • And more…

Erin Brinker: Welcome back. I’m Erin Brinker.

Tobin Brinker: And I’m Tobin Brinker.

Erin Brinker: And we are On the Brink, the morning show on KCAA, AM 1050, FM 106.5, and FM 102.3. We are so excited to welcome back to the show Dr. JoAnn Yanez. She is the executive director for the Association of Accredited Naturopathic Medical Colleges, and the chair of the Academic Collaborative for Integrative Health. She also serves on the Integrative Health Policy Consortium Education Committee. Weaving a passion for illness prevention into her professional life, Dr. Yanez’ career has spanned advocacy, academia, patient care, and public health. As AANMC executive director, Dr. Yanez oversees research, advocacy effort, and the joint academic endeavors of the accredited colleges of naturopathic medicine. Additionally, she helps spread awareness of naturopathic medicine as a viable and satisfying career path. Dr. JoAnn Yanez, welcome back to the show.

Dr. Yanez: Good morning, folks. How are you doing?

Erin Brinker: Doing great. The weather is warming up and it’s beautiful outside, so life is good.

Dr. Yanez: I know. I know. Some of the joys of southern California living, especially right now.

Erin Brinker: What is new and exciting at the AANMC before we get to our topic?

Dr. Yanez: Oh gosh, there’s so much going on. We actually have a webinar coming up tomorrow on how to apply to Naturopathic Medical Schools. So, folks are welcome to join that and hear about the steps you need to take as a student. We always have our webinars every month. Coming up, we’ve got ones on cancer. We have a naturopathic doctor and veteran presenting on PTSD in June. So, there are a lot of really great webinars that we have coming up, so I encourage people to check out our events and register if they’re interested.

Erin Brinker: Now, are the webinars archived on the website? So maybe they can’t watch it live, so to speak, but they can get to it later.

Dr. Yanez: Oh no, we record all of the webinars. They’re on our YouTube station, as well as on the website. So, they’re all archived. If there are past ones that people want to take a look at, they can go to the prior event as well and see all of the other webinars we’ve done over the years.

Erin Brinker: Wonderful. Now there’s an issue that is kind of embarrassing, but effects a lot of people. That’s irritable bowel syndrome. I don’t know that … I know people who have gone for treatment and that is with some mixed results. Sometimes it works and sometimes it doesn’t through traditional medicine. Does naturopathic medicine have anything to offer people who are suffering?

Dr. Yanez: You know, it is one of those issues that, like you said, is very embarrassing. People don’t like to talk about problems with the bathroom, but one of the things that is core to naturopathic medicine, as we’ve talked over the years now with coming on your show, is the ND’s ability to get to the root of an issue. We talk about diet and we talk about elimination. I know one of the running jokes when I was in medical school was we talked a lot about poop. It was just one of those things that when you go to a naturopathic doctor, be prepared to talk about poop. They are going to ask you, how many times do you poop? Do you have trouble pooping? What does it look like? What does it smell like? Do you have any other digestive issues, like gas, bloating or indigestion? We’ll make light of it and we’ll make a joke out of it, but your elimination really is a sign, and can be a sign of underlying imbalance in the body. And that is one of the reasons why we ask about it.  I know we’ve talked about libido before as well, and energy and sleep. All of those things, when they’re working well, are signs that our body is in balance, and when they’re not, can give us hints about other things that may be wrong. So, IBS Worldwide has a prevalence of about 10% to 20%. The thing that we’ve recognized is the costs for IBS are upwards of $20 billion annually.

Erin Brinker: Oh my gosh. Wow.

Dr. Yanez: Yes, wow. So, when we’re thinking about the prevalence of this, and not to even mention the quality of life issues, this is a pressing concern for so many. If you are uncomfortable or you don’t know when you’re going to need a bathroom, how do you go out? Years ago when the HIV meds first started to be used, there were horrible GI symptoms. I had patients who got to the point where they were almost incontinent, where they could not control their bowels. How do you leave the house? How do you go out and hang out with friends if you don’t know if you’re going to have an accident? And an accident like that, like you said, can be extremely embarrassing for people. So, that is the sort of thing that if you’re having excessive flatulence or diarrhea or problems with constipation and bloating, you don’t feel good. That is a huge impact on quality of life.

So, with Irritable Bowel Syndrome, it is a diagnosis of exclusion, which means that you have to rule out everything else. So, it’s one of those, ‘well if it’s nothing else, then it’s this’ diagnosis, which isn’t a great. It’s not like that simple, oh we’ve got a blood test for it, we test for it, and oh boom this is what you have. You have to rule out a whole lot of other things. So, many patients will come to naturopathic doctors having long time symptoms of gas, bloating, irregularity with their poop, and really just not feeling right, but not knowing what’s wrong. NDs will dig down. We’ll look at stress, because anxiety can play a role. How many times have you heard, “Oh I’ve got butterflies in my stomach.” Well, that is the connection between your brain and your gastrointestinal symptoms. So, there is a connection between our emotions and our gut.  Oftentimes with kids who are experiencing anxiety, they’ll just say their tummy hurts. They won’t have the words or the connection to say, “I’m nervous about this.” They’ll just complain of tummy pain. So, it really is incumbent upon us to flesh this out further and to find the root cause. Is there a mental emotional component? Is there a food allergy component? Are the foods that you’re eating exacerbating a symptom? Is there an imbalance in the gut flora? So is probiotics something that needs to be taken? Are we not digesting our foods? Do we need to have an old timey naturopathic treatment that’s called digestive bitters? In many cultures, we see that folks will have greens. There’s a reason why we eat salads at the start of a meal, and it’s to … Normally without all of the sweet syrupy salad dressings, salad greens on their own are bitter. That bitterness can stimulate digestive juices. So, there’s a reason why-

Erin Brinker: Interesting.

Dr. Yanez: Oftentimes there’s that green at the beginning of a meal. It was really intended as an appetite stimulant and to stimulate the digestive juices. So, NDs incorporate a lot of different components into assessing and treating patients, not only the mind and the body, but supplementation as well. There’s really a lot that NDs can do for folks that haven’t seen benefit otherwise.

Erin Brinker: Like so many other things, and we’ve talked about this, your standard family physician or general practitioner is so busy that they don’t … You get a pat on the head and say, they say take something over the counter and then you’re on your way. So, the naturopathic doctor really has the time to be able to sit down with the patient and do that history, and really look into what’s bothering the patient.

Dr. Yanez: Yes. Again, it’s a mind-body approach. It’s a holistic approach. The six principles, which I have talked about before, first, do no harm, physician as teacher, treating the cause, treating the whole person and prevention are inherent in how we address each patient, as is the therapeutic order. We start with the basics. Before we go to recommending drugs or surgery or something more invasive, we start with diet. We start with sleep. We start with stress. We start with your environmental factors, your social support, your exercise, all of the basic things that people need to be healthy, and then we go up the ladder in intensity from there. I think it’s a really important approach that addresses things in a gentle way, but also helps patients take responsibility and understand, hey, maybe let’s not just throw a pill at this. Let’s look at the real reason why you’re having this. Now in very serious situations or situations that are more life threatening or really impacting, of course there’s medication, and NDs aren’t going to shy away from that, but in the situations like this, IBS, where there are very strong environmental factors, food factors that help, let’s go there first.

Erin Brinker: Yeah, because that’s Occam’s razor, right. Usually it’s the most obvious solution that is the right one.

Dr. Yanez: Yes. I always like to think of my math teacher. Back in the day when we did long form math, there are a lot of different ways to teach math, and I know Tobin, you teach in the school settings. But my math teacher, and I always remember this phrase, “Find the most elegant solution for that problem.” That was his way of pointing and saying, “Hey sure there are a lot of ways to solve this, but what’s the simplest, easiest and quickest way to get you there?”

Erin Brinker: What a good math teacher. So, this is also the time of year when people graduating from college are really thinking about what they want to do after they graduate from college. Where can they find out more information about naturopathic medical careers?

Dr. Yanez: Well again, our website is a great resource. Tomorrow we have a webinar on finding your way in applying to ND School. That would be a great resource as well. But we’ve got all the different ways that NDs are using their careers. On our website, we’ve got a great video that also explains the different types of career options you can take as an ND. So, lots of good information on our website. Hope that folks check it out.

Erin Brinker: Well, Dr. JoAnn Yanez, it’s always a treat to have you on the air with us. Thank you so much for joining us today.

Dr. Yanez: Thanks. Talk soon!

Erin Brinker: Talk soon. And the website is AANMC.org for the Association of Accredited Naturopathic Medical Colleges.

Dr. Yanez: Thank you, Erin.

Erin Brinker: Thank you so much. It’s now time for a break. I’m Erin Brinker.

Tobin Brinker: And I’m Tobin Brinker.

Erin Brinker: And we are On the Brink, the morning show on KCAA. We will be right back.

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