Acorn Gastroenterology

12/09/2025

GLP-1 Receptor Agonists: The Game-Changer in Metabolic and Renal Medicine

Introduction
Glucagon-like peptide-1 (GLP-1) receptor agonists have evolved from niche diabetes treatments to multi-indication powerhouses. In 2025, their clinical relevance spans type 2 diabetes, obesity, chronic kidney disease (CKD), cardiovascular risk reduction, and even obstructive sleep apnea. With expanding FDA approvals and robust clinical data, GLP-1 RAs are reshaping chronic disease management.

🧬 What Are GLP-1 Receptor Agonists?
GLP-1 RAs mimic the endogenous incretin hormone GLP-1, which enhances insulin secretion, suppresses glucagon, slows gastric emptying, and promotes satiety. These effects translate into:

Improved glycemic control

Sustained weight loss

Cardiovascular and renal protection

Popular Agents:
Drug Name Brand Name Indications (2025)
Semaglutide Ozempic, Wegovy

Tirzepatide Zepbound
Exenatide Byetta

🚀 Latest Approvals and Expanding Indications
Semaglutide (Ozempic): Approved to reduce CKD progression and cardiovascular mortality in T2DM patients

Wegovy: Awaiting FDA decision for metabolic dysfunction-associated steatohepatitis (MASH)

Zepbound: First GLP-1 agent approved for obstructive sleep apnea

💡 Emerging Benefits
Cancer Risk Reduction: GLP-1 RA use linked to lower risks of endometrial, ovarian, and meningioma cancers in obese adults

Environmental Impact: Reduced greenhouse gas emissions due to fewer hospitalizations and lower calorie consumption among heart failure patients

Muscle Mass Preservation: ProGo®, a consumer GLP-1/GIP agonist, protects lean muscle via myostatin and Activin A inhibition

⚠️ Clinical Considerations
While GLP-1 RAs offer transformative benefits, they’re not without challenges:

Gastrointestinal Side Effects: Nausea, vomiting, and early satiety are common, especially in CKD patients

Lean Mass Loss: Up to 50% of weight loss may be lean muscle, raising concerns in sarcopenic or protein-restricted populations

Adherence Issues: Real-world data shows high discontinuation rates due to cost, side effects, or unmet expectations

📈 Market Outlook
The GLP-1 market is projected to exceed $100 billion globally by 2027, driven by:

Expanding indications

Oral formulations in development

Consumer health applications (e.g., ProGo®)

Conclusion
GLP-1 receptor agonists are no longer just antidiabetic agents—they’re central to a new era of metabolic, renal, and cardiovascular care. As research deepens and indications broaden, clinicians must balance efficacy with personalized care strategies to maximize outcomes.

13/08/2025

益生元、益生菌与后生元 Prebiotic, Probiotic, Postbiotic：它们的区别与肠道健康的重要性

引言
我们的肠道中生活着数万亿微生物，它们影响着消化、免疫，甚至情绪。为了维持这些有益菌群的平衡，有三个关键角色非常重要：益生元、益生菌 和 后生元。虽然它们的名字相似，但在维持健康消化系统方面，它们各自承担着不同的功能。

1. 什么是益生菌 (Probiotic) ？
益生菌是活的有益细菌，能够帮助维持肠道菌群的健康平衡。

作用：
- 在使用抗生素后恢复肠道菌群
- 改善消化和营养吸收
- 增强免疫功能

最佳来源：

- 含活性菌的酸奶
- 克非尔（Kefir）
- 泡菜（Kimchi）
- 德国酸菜（Sauerkraut）
- 含乳酸杆菌、双歧杆菌等的益生菌补充剂

2. 什么是益生元(Prebiotic)？

益生元是不可被人体消化的膳食纤维，它们为肠道中的有益细菌提供食物。

作用：

- 相当于益生菌的“肥料”
- 促进有益菌的生长
- 支持健康的消化与排便

最佳来源：

大蒜, 洋葱, 芦笋, 香蕉
全谷类（燕麦、大麦）

3. 什么是后生元 (PostBiotic) ？
后生元是益生菌消耗益生元后产生的具有生物活性的物质，包括短链脂肪酸、肽类、酶等。

作用：

- 减少肠道炎症
- 强化肠道屏障
- 调节免疫系统

来源：
后生元主要在我们摄入益生元和益生菌食物后，由体内自然产生。一些补充剂现在也直接提供后生元成分。

4. 益生元、益生菌与后生元如何协同作用
肠道健康就像一个三步链式反应：

益生元 为有益菌提供养分
益生菌 得到滋养并繁殖
后生元 产生并发挥健康功效

5. 平衡肠道生态系统的健康好处
改善消化和营养吸收

增强免疫力
减轻肠易激综合征（IBS）症状
可能改善情绪与心理健康

13/08/2025

A gastroscopy (also called an upper endoscopy) is a simple, minimally invasive procedure that allows your doctor to look inside your oesophagus, stomach, and the first part of your small intestine. But how do you know when you really need one? Knowing the right time for a gastroscopy can help detect digestive problems early, prevent complications, and give you peace of mind.

Common Reasons You May Need a Gastroscopy
1. Persistent Upper Abdominal Pain
If you have ongoing pain or discomfort in the upper abdomen that lasts more than a few weeks, a gastroscopy can help identify causes such as gastritis, ulcers, or inflammation.

2. Chronic Heartburn or Acid Reflux
Long-term gastroesophageal reflux disease (GERD) can damage the oesophagus lining. Gastroscopy helps assess the severity and detect conditions like Barrett’s oesophagus.

3. Unexplained Nausea and Vomiting
Frequent, unexplained vomiting or nausea can be linked to stomach ulcers, blockages, or inflammation — all visible via gastroscopy.

4. Difficulty Swallowing (Dysphagia)
If swallowing feels painful or food gets stuck, a gastroscopy can help identify narrowing, growths, or inflammation in the oesophagus.

5. Signs of Gastrointestinal Bleeding
Black stools, vomiting blood, or unexplained anaemia could be due to ulcers, erosions, or tumours — urgent gastroscopy is recommended.

Preventive and Screening Reasons
Family history of stomach cancer

Monitoring polyps or Barrett’s oesophagus

Follow-up after treatment for ulcers or tumours

Even without severe symptoms, people with high-risk factors may need regular gastroscopy screenings.

What Happens During a Gastroscopy?
A thin, flexible tube with a camera is passed through the mouth to inspect the digestive tract. The procedure usually takes less than 15 minutes, often with sedation for comfort.

Why Early Gastroscopy Matters
Delaying the test could allow ulcers, cancers, or other problems to progress silently. Early diagnosis means better treatment outcomes and peace of mind.

Key Takeaway
If you have persistent digestive symptoms, unexplained weight loss, blood in stool/vomit, or difficulty swallowing, see a gastroenterologist promptly. They can advise whether a gastroscopy is necessary for diagnosis or screening.

07/08/2025

It’s in the news now,
More people under age 50 has been diagnosed with colorectal cancer.
There has been increase numbers of screening for people age 45-49, leading to early cancer detection and better outcome.

22/02/2024

《賽普沙辛 (Ciprofloxacin) 导致神经线衰歇 》

賽普沙辛 (Ciprofloxacin) 是一种常用于治疗尿道炎，肠道感染， 肺部感染等疾病。 一些病人因对青霉素敏感所以只能利用賽普沙辛治疗感染。

话说一个英国妇女因尿道炎吃了这抗生素导致全身神经线故障。
这情况很罕见， 在医学研究报告， 在一百多万病人中 ，大约 有0.00024% 病人 ， 也大约是 1万个人里两个患上某程度的神经线问题。
其中的症状包括：
手脚麻痹， 乏力， 疼痛
情况可能马上发生， 或高达30天内

我本人有个病人曾经有过这样的状况，因为他是运动员，出院前我特别提醒他 有关这药的罕有副作用。
还好停了药后就好了。但是医药研究显示有些病人病情可能会留下后遗症。

小心为妙

Talia Smith, 44, from Norwood, Massachusetts, was left in excruciating pain and unable to walk after she was prescribed a common antibiotic for a UTI and had extreme, rare side effects.