Gastrointestinal & Microbiome Health

gut health microbiome

Here at Boucher, we would like to proudly acknowledge that NUNM, a non-profit, natural health science private university based in Portland, OR, is BINM’s active partner in continuing education development and delivery.

View our complete collection of online conferences here

Gastroenterology Conference 2019

Acute Cholecystitis: How To Save a Gallbladder From Surgical Removal

Presenter: Mona Morstein, ND, DHANP

Cost: $49 CAD

CE Hours: 1.0 hour

Gallstones are very common among patients and cause biliary colic and/or cholecystitis, leading to 300,000 cholecystectomies a year. Naturopathic medicine is a valuable tool in healing gallstone problems and even reducing/eradicating gallstones. Dr. Morstein presents comprehensive information on gallstones, the signs and symptoms of them, and gives specific clinical details on how to treat them. She presents two successful cases with U/S verification of her treatments.


The Ethics of Prescribing a Gluten Free Diet

Presenter: Lisa Shaver, ND, LAc

Cost: $49 CAD

CE Hours: 1.0 hour

The gluten-free diet is a frequent staple in a practitioner’s list of modalities to use for a myriad of conditions. “Try a gluten-free diet” or “go gluten-free” has become a common phrase heard even between friends and neighbors, nutritionists and bloggers. However, a gluten-free diet (GFD) is a medical prescription for celiac disease. When prescribing a GFD prior to thoroughly testing for celiac disease, a practitioner is unwittingly denying that patient a chance at revealing the root cause of symptoms and a life-long/permanent systems-damaging inflammatory autoimmune process with grave associated repercussions. We wouldn’t ask a non-type 1 diabetic to “try insulin” – it’s inappropriate. As conscientious practitioners, the medical community needs to be diagnosing celiac disease appropriately, or thoroughly ruling it out, prior to prescribing a GFD. Dr. Shaver presents the top reasons why prescribing a GFD is unethical in the absence of first performing thorough testing for celiac disease, from high risks of developing other unidentified autoimmune diseases to repercussions amid an entire family tree, to increase risks for cancers in celiacs who continue undiagnosed.


Microscopic Colitis

Presenter: Steven Sandberg-Lewis, ND

Cost: $69 CAD

CE Hours: 1.5 hours

Lymphocytic colitis (LC) and collagenous colitis (CC) are two causes of chronic non-bloody diarrhea, and are coupled under the diagnosis of microscopic colitis (MC). These are inflammatory diseases of the colon which have no gross changes and are identified by histology alone. Dr. Sandberg-Lewis has treated a significant number of cases of MC. In this presentation he defines these conditions, explains their known etiology, risk factors and pathophysiology and focuses in more detail on the most effective standard and Naturopathic treatment and management strategies. Pharmacology is included in this discussion (drug causes of MC, dosages and tapering strategies for prescription medicines and some off label approaches.) Indeterminate colitis is also discussed – that condition that falls between Crohn’s colitis and ulcerative colitis. Even with the eclectic approach of NDs, knowing the definitive diagnosis for inflammatory bowel disease holds importance and allows you to focus your treatment toward more proven options rather than guessing. What do you do when there is no definitive diagnosis? Sandberg-Lewis attempts to demystify this – discussing his approach in these situations.


Gastroparesis: An Integrative Approach

Presenter: Lela Altman, ND, LAc, EAMP

Cost: $49 CAD

CE Hours: 1.0 hour

This presentation goes through the underlying causes, prognosis of and complications associated with gastroparesis. Management options discussed include herbal, pharmaceutical, dietary, surgical, manual, mind-body and acupuncture treatments. After this lecture, the learner should come away with a greater understanding of the management of gastroparesis in a clinical setting. Pharmaceuticals discussed include erythromycin, azithromycin, domperidone, prucalopride and metoclopramide.


Hormones and Their Effect on Digestion

Presenter: Debbie Rice, ND

Cost: $49 CAD

CE Hours: 1.0 hour

Overall objectives and goals for this presentation are to discuss sex hormones and adrenal hormones, production, and the overall effect of these hormones on digestion and Gastrointestinal function. Estrogen has been shown to have significant effects on the gastrointestinal microbiome, including estrobolome, which is necessary for estrogen metabolism in the gut. Estrobolome influences beta-glucaronidase and its influence on gut health, as well as estrogen’s effect on inflammation, mucosal barriers, and immune function. Gut microbiome imbalances and estrogen levels are a highly complex and intertwined system affecting other components of health including immune function, cardiovascular risk, obesity, and other metabolic pathologies. Progesterone has been found to highly influence the time for bowel emptying and movement through the bowels, especially related to the luteal phase of the menstrual cycle. Adrenal hormones such as cortisol and DHEA are influenced by gut microbiome imbalance and gut inflammation. Cortisol can be anti-inflammatory with regard to IBS pathologies in certain instances. Too much cortisol can dampen appropriate enzyme release and appropriate anti-inflammatory response. DHEA levels are an integral component of immune and anti-inflammatory support of overall digestion and GI function.


Unveiling the Intersection of Gut, Brain, and Hormones

Presenter: Corina Dunlap, ND, MS

Cost: $49 CAD

CE Hours: 1.0 hour

There is an important link between gastrointestinal function, brain, hormones, and health. Why do some women feel bloated or have stool changes with fluctuations in their menstrual cycle? What about PMS, including symptoms such as anxiety and depression, all coinciding with gastrointestinal health? In the past decade, there have been huge advancements in the research on this topic. Now we see a relationship between the gut microbiome, our mood, and our memory. We see a higher percentage of people with IBS or other bowel problems suffering from depression and anxiety. We see gut inflammation impacting a whole range of issues from pain, sleep, and libido to mental health. We see probiotic therapy used in place of some anti-depressants with equal success. We’ve found evidence of direct communication from gut to brain, a type of neural superhighway. This presentation attempts to connect some of these dots in order to shed light on how this intersection may impact our approach to case management.


IBD Bootcamp

Presenter: Ilana Gurevich, ND, LAc

Cost: $49 CAD

CE Hours: 1.0 hour

This is a 60 minute power course orienting everyone into the world of inflammatory bowel disease. We discuss foundational presentation of IBD, pharmaceutical management of IBD and naturopathic treatment options for IBD. Pharmaceuticals discussed:
5-ASA drugs like sulfasalazine, mesalamine drugs, prednisone, budesonide, biologic agents like infliximab, ada Infliximab, Adalimumab, Certolizumab pegol, Natalizumab, Vedolizumab and Ustekinumab and immunosupressants like Azathioprine, Mercaptopurine and Methotrexate.


Outlet Dysfunction Constipation: Diagnosis & Treatment Considerations

Presenter: Sabrina Kimball, ND, LAc, EAMP

Cost: $69 CAD

CE Hours: 1.5 hours

Outlet dysfunction constipation is commonly overlooked cause of chronic constipation. This group of conditions is often a consequence of poor coordination of colonic, abdominal, pelvic and rectal musculature resulting in ineffective or incomplete expulsion of stool during defecation. This can be caused by weak colonic contractions, rectal hyposensitivity, rectal outlet obstruction, poor lower abdominal muscle recruitment, increased ano-rectal muscle tone or anismus. It is estimated that about 50% of those with outlet dysfunction constipation also suffer from slow transit constipation. Outlet dysfunction constipation should be evaluated first in-office with a detailed history and physical examination. Further evaluation by a pelvic floor physical therapist or GI motility specialist is often warranted. Dr. Kimball discusses when to refer and common treatment approaches performed by specialists. Treatment of outlet dysfunction constipation requires a coordinated and personalized approach to treatment to achieve resolution. As part of this presentation, Dr. Kimball reviews the application of behavioral modifications, dietary modifications, physical therapy, nutritional supplements, pharmaceuticals and biofeedback therapy to address outlet dysfunction constipation disorders. Also discussed is the use of osmotic laxatives, stool softeners, enemas, colonic secretogogues: linclotide and lubiprostone, muscle relaxants: tizanidine and cyclobenzaprine, and botulinum toxin injection.


Is Your Tail Talking?: Clinical Approaches to Common Anorectal Disorders

Presenter: Crane Holmes, ND

Cost: $49 CAD

CE Hours: 1.0 hour

Gastrointestinal health spans from the mouth to the anus, but rarely the tail end is talked about. During this lecture, we discuss how common GI conditions such as constipation, diarrhea or bloody stools may cause and be causing changes in anorectal health. Intimidated to take a look? We review the rectal examination, as well as prostate exam, to determine if a patient’s anorectal health may be the cause of their IBS. We will also offer both conventional and holistic approaches to help patients achieve immediate relief from their poor anorectal health as well as prevent reoccurrence of disease.


Individualizing Botanical Medicines for Patients with IBD

Presenter: Crane Holmes, ND

Cost: $49 CAD

CE Hours: 1.0 hour


The Gut-Brain Axis: Emerging Science of the Microbiome’s Role

Presenters: Andrea Mcbeth, ND, and Heather Zwickey, PhD

Cost: $69 CAD

CE Hours: 1.5 hours

Over the past several decades, we have gained immense insight into the world of the human microbiome. The observations made using techniques like Fecal Microbiota Transplant and microbial sequencing are contributing to a new paradigm of what it means to be human. We now know we are not alone in our own bodies. We are a compilation of trillions of microbes and human cells working together as an ecosystem with the bulk of this ecosystem residing in our colon. This ecosystem and the repercussions of its health are now being investigated outside the local GI system. The colonic microbiome is communicating with our brain through neuroimmune, neuroendocrine, and direct sensory input. The bi-directional role this gut-brain axis has on health expands our understanding of what GI and mental health really means.


All Presentations under Gastroenterology Conference 2019

Multiple Presenters

Cost: $499 CAD

CE Hours: 12.5 hours


Register for Gastroenterology Conference 2019

 

 

Gastroenterology Conference 2018

Non-Celiac Gluten Sensitivity

Presenter: Lisa Shaver, ND, LAc

Cost: $69 CAD

CE Hours: 1.5 hours

In your practice, 6% of your patients, or more, have Non-Celiac Gluten Sensitivity (NCGS). Confused the difference between NCGS, non-celiac wheat sensitivity, gluten allergy, wheat food sensitivity, wheat allergy and celiac disease? Dr Shaver discusses diagnosis and reviews the research about this relatively new condition, named in 2011. There are important ethical issues to discuss with your patient prior to prescribing any of the current gluten-free diets (Keto, Paleo, Low Fodmap, Anti-Inflammatory, Wahls, etc.) if one has not thoroughly tested for NCGS and celiac disease.


Gastrointestinal Infections: Considerations and Treatment

Presenter: Anne Hill, ND

Cost: $69 CAD

CE Hours: 1.5 hours

This lecture discusses common gastrointestinal bacterial and parasitic infections and gives guidance for diagnosis and treatment. Also discussed is the importance of eradication of these infections as a key primary approach to reversing metabolic endotoxemia and establishing optimal gastrointentinal health. Prescriptive medications as well as herbal and nutraceutical treatments are discussed as well. Pharmaceuticals discussed include: Pyrantal Pamoate, Nitazoxanide, Praziquantel, Albendazole, Mebendazole, Tinidazole, Ivermectin, Iodoquinol.


Sterol Biome

Presenter: Steven Sandberg-Lewis, ND

Cost: $69 CAD

CE Hours: 1.5 hours

The liver synthesizes and secretes hydrophilic primary bile acids, processed in the small and large bowel by the microbiota. These enter the enterohepatic circulation and join the bile acid pool. These bile acids are hormones that regulate their own synthesis and transport as well as regulating lipid, glucose, lipoprotein and energy metabolism as well as inflammation. Dr. Sandberg-Lewis reviews the biochemistry and physiology of these processes and discuss the use of botanicals, nutrition and prescription medication to aid the activity of this essential “endocrine organ”.


Research Updates in IBS

Presenter: Joshua Goldenberg, ND

Cost: $69 CAD

CE Hours: 1.5 hours

This presentation reviews the latest update from the Bastyr research group and affiliated international naturopathic researchers focused on whole systems naturopathic approaches to irritable bowel syndrome (IBS). Specifically, one of only a few expert consensus panels on naturopathic medicine was completed recently – The Expert Consensus for Naturopathic Approaches to IBS. A shocking 42 items of consensus were agreed upon leading to a real possibility of an external valid randomized trial of Naturopathic Approaches to IBS in the future. Our progress on the largest international observational study of naturopathic medicine to-date (the IRCNAC-IBS study) and the consortium supporting it – the first ever, international research consortium of naturopathic academic clinics – will be reviewed. Additionally, we discuss findings from the first fully naturopathically designed and executed Cochrane Review – Biofeedback to Treat IBS.


“Gut Healing” Protocols

Presenter: Ilana Gurevich, ND, LAc

Cost: $49 CAD

CE Hours: 1.0 hour

This presentation takes a look at the natural agents that are most studied to heal intestinal permeability. We discuss natural agents as well as pharmaceutical that are available for repair. Medications discussed include: Linzess, Amitizia, Trulance, Resolor.


Assessing the Microbiome in Gastrointestinal Health

Presenter: Mark Davis, ND

Cost: $49 CAD

CE Hours: 1.0 hour

Naturopathic doctors have always stressed the importance of treating the gut, and have used personalized diet to optimize health, botanical and other antimicrobials to treat stealth pathogens, and numerous other interventions to minimize harmful levels of inflammation and otherwise encourage best outcomes. How does the normal microbiome influence the importance and success of these treatments? How can emerging technology help us assess the importance of commensals and “possible pathogens?”


Updates in CRC Screening Guidelines

Presenter: Eliot Edwards, ND, FABNO

Cost: $29 CAD

CE Hours: 0.5 hour

Colon cancer is the 3rd most common type of cancer in both men and women in the US. Naturopathic Physicians in a general medicine practice will inevitably see patients who have been diagnosed with colon cancer, or have a strong family history and thus risk factors for developing cancer. What is the role of the ND for these patients? Dr. Edwards provides an update on the most recent screening guidelines from the American Cancer Society which were changed in May 2018. Also a review of the more recent published research on integrative oncology for colon cancer is covered.


Cannabinoids as Mediators of GI Function

Presenter: Jamie Corroon, ND, MPH

Cost: $49 CAD

CE Hours: 1.0 hour

The role of the endocannabinoid system in both physiological and pathophysiological function of the gastrointestinal tract is relatively unknown. Pharmacokinetic studies shed light on the metabolism and bioavailability of exogenous cannabinoids. Preclinical and clinical trials continue to explore the utility of using cannabinoids as therapeutic agents for gastrointestinal disorders. This presentation elucidates the key functions of the endocannabinoid system in maintaining gut function. It also summarizes existing evidence for using cannabinoids to treat GI disorders. Pharmaceuticals covered: Cannabidiol, Nabiximols, Dronabinol, Nabilone.


Treat the Gut: Approaching Pediatric Constipation

Presenter: Caitlin O’Connor, ND

Cost: $69 CAD

CE Hours: 1.5 hours

Functional constipation is the most common reason for a GI referral in the pediatric population. Naturopathic medicine offers an extremely effective approach for treating these children that goes far beyond the routine laxative prescription. This presentation covers how to properly diagnose and treat constipation in this population and how to fill your toolkit with clinically applicable, evidence-based modalities that you can immediately put into practice. This presentation also covers both pharmaceutical and non-pharmaceutical approaches to management. Polyethylene glycol, magnesium oxide and sennosides are reviewed.


Visceral Hypersensitivity: Causes, Consequences, and Therapeutic Approaches

Presenter: Megan Taylor, ND

Cost: $69 CAD

CE Hours: 1.5 hours

Visceral hypersensitivity occurs in up to a third of patients with IBS and Functional Dyspepsia, two of the most common functional gastrointestinal disorders presenting to naturopathic practices. This condition is often overlooked and rarely discussed in clinical context, yet can complicate presentation and often leaves patients with continued symptoms despite “normal” work-up. This presentation reviews the proposed causes of visceral hypersensitivity, its relationship to IBS and FGID, and various treatment approaches, including review of research on pharmaceutical, botanical, manual, and psychological interventions. Review of pharmaceuticals to include classes of SSRI, TCA, 5HT3 antagonists, 5HT4 agonists, GABAnergic agents, as well as Ketotifen & Naltrexone (low dose).


All Presentations under Gastroenterology Conference 2018

Multiple Presenters

Cost: $499 CAD

CE Hours: 12 hours


Register for Gastroenterology Conference 2018

 

 

SIBO Symposium 2018

Exploring the Intersection between Eating disorders and SIBO/IBS

Presenters: Megan Taylor, ND & Sara Hopkins, ND, LAc

Cost: $69 CAD

CE Hours: 1.5 hours

Disordered eating behaviors can have a profound impact on digestive physiology, resulting in changes to motility, anatomy, digestive secretions, immunologic status, and microbial balance. These changes often lead individuals with eating disorders to develop any number of functional gastrointestinal disorders (FGID), with some studies estimating a 98% prevalence of FGID in patients with an eating disorder (Boyd, et al. 2005). And to make matter more complex, the symptoms of the eating disorder itself can often be indistinguishable from the symptoms of these gastrointestinal disorders, making it difficult for clinicians to identify appropriate treatment strategies. This overlap can present challenges in the setting of a functional GI practice, and poses some difficult questions. How do we appropriately screen for and recognize patients who have eating disorders? How do we ensure that our interventions do not cause harm to these patients? Do we consider dietary modification or other cornerstones of digestive health treatments in this patient population? This presentation will explore these questions, as well as provide useful tools for clinical evaluation, management, and appropriate referrals for patients with disordered eating behavior and diagnosable eating disorders.


Evolving Story of Autoimmunity in the Development of SIBO

Presenter: Mark Pimentel, MD, FRCP(C)

Cost: $49 CAD

CE Hours: 1.0 hour

It is becoming increasingly clear that SIBO is in some cases due to previous exposure to gastroenteritis. Through a series of interesting studies, it is now understood that this singe food poisoning event can lead to long term changes in the microbiome. The most important of these is the development of antibodies to vinculin. In this presentation, we will update the audience on the latest developments on this topic and how the future is shaping up to treat SIBO and IBS as an autoimmune condition.


Ehlers-Danlos Syndrome, Joint Hypermobility, POTS

Presenter: Alena Guggenheim, ND

Cost: $49 CAD

CE Hours: 1.0 hour

Ehlers-Danlos and generalized joint hypermobility syndromes are common genetic connective tissues disorders that can present in a heterogenous pattern. This talk will discuss the subtypes of EDS, common comorbidities, red flag symptoms that indicate possible CNS involvement and a treatment approach to improving outcomes. We will also over a common co-morbidity, postural orthostatic tachycardia syndrome that can impact gastrointestinal motility and predispose patients to developing small intestinal bacterial overgrowth. We will discuss lifestyle and pharmaceutical approaches to treatment for POTS. The following medications will be discussed: Florinef, midodrine, beta-blockers, IV saline, low dose naltrexone, mestinon, and Corlanor.


Mast Cell Activation Syndrome

Presenter: Leonard B. Weinstock, MD

Cost: $49 CAD

CE Hours: 1.0 hour

Small intestinal bacterial overgrowth (SIBO) is a syndrome in that it has multiple causes. Motility disorders are most often the underlying factors to predispose for the development of SIBO. Postural orthostatic tachycardia syndrome (POTS) leads to an imbalanced autonomic nervous system because excessive sympathetic activity overrides vagal tone. Peristalsis is reduced and SIBO may be promoted. Mast cell activation syndrome (MCAS) is a leading factor in 33% of POTS. It is also conceivable that MCAS could directly impact motility via one of 200 mediators that may reduce neuromuscular activity. It is important to recognize POTS which has a prevalence of 500,000-1,000,000 in the US. Understanding this disease and the more prevalent MCAS (1 – 17% of the population) is critical to help many patients who otherwise suffer for decades without a diagnosis and/or effective therapy. 

Specific pharmaceutical medications to be discussed in both the overview and outline: rifaximin and naltrexone.


The Importance of Gas Type in SIBO

Presenter: Mark Pimentel, M.D., FRCP(C)

Cost: $29 CAD

CE Hours: 0.5 hour

In the last decade, the understanding of clinical breath testing in the evaluation of SIBO has evolved. We have come to know that methane on breath testing is highly associated with constipation and requires a different approach to treatment. Hydrogen on the other hand is not related to any specific symptom. The missing gas has been hydrogen sulfide and this gas is of great importance to the symptom diarrhea. Not having this gas in the breath test profile leaves a missing piece of the puzzle out. In this presentation we will examine the interaction of all three gases and the importance they play in the evolving microbiome story of SIBO. Rifaximin will be discussed which is FDA approved, neomycin a drug not yet approved for SIBO and SYN-010 which is not yet approved by FDA for methane.


SIBO and the Thyroid: A Significant Relationship

Presenter: Gary Weiner, N.D., L.Ac.

Cost: $49 CAD

CE Hours: 1.0 hour

In continuing the discussion of the principle of treating underlying causes of SIBO rather than simply focusing therapy on reduction of bacterial overgrowth, we cannot overlook the thyroid gland’s role in motility. Evidence has emerged for thyroid disorders as one of SIBO’s etiologies. This presentation explores SIBO’s intersections with dysthyroidsm, and points to implications in developing effective treatment plans and strategies for prevention of recurrence. The presentation will include a brief overview of thyroid prescribing, both clinically and sub-clinically, including use of Levothyroxin, Tri-iodothyronine, dessicated Thyroid USP, and compound prescribing.


Pelvic Inflammatory Processes Part I: Endometriosis, Adenomyosis and Dysmenorrhea

Presenters: Lara Williams, MD, FACOG and Stefani Hayes ND, LAc

Cost: $89 CAD

CE Hours: 2.0 hours

The conditions of endometriosis, adenomyosis, and dysmenorrhea and their treatments have many consequences on the body. We will discuss how traditional management not only affects the pelvic inflammatory processes themselves but how it also impacts other inflammatory processes in the body, including SIBO. We will also show how pelvic inflammatory processes can have similar symptoms to SIBO. Pharmaceuticals to be discussed include: OCPs, Lupron, NSAIDS (including ponstel), Mirena IUD, Progestins (including norethindrone and Depo Provera), and Narcotics (including oxycodone and hydrocodone).

Pelvic Inflammatory Processes Part 2: PID, TOA and Ectopic Pregnancy – An Integrative Exploration

Presenters: Lara Williams, MD, FACOG and Stefani Hayes ND, LAc

Cost: $89 CAD

CE Hours: 2.0 hours

Pelvic inflammatory disease (PID), Tubo-Ovarian Abcesses (TOA) and ectopic pregnancy can have numerous negative effects on the body. We will discuss how traditional management not only affects these pelvic inflammatory processes but also how it impacts other inflammatory processes, including SIBO. We will expound on current theories regarding the possible etiologies of numerous pelvic inflammatory processes and how this impacts our understanding of other inflammatory processes, including SIBO. Pharmaceuticals to be discussed include: antibiotics such as azithromycin, Doxycycline, Ceftriaxone, Gentamicin and Flagyl as well as methotrexate.


The Parasite/SIBO Connection

Presenters: Ilana Gurevich ND, LAc

Cost: $49 CAD

CE Hours: 1.0 hours

This is a discussion of the connection between how both SIBO and parasitic infections affect the Microbiome and how one is often misdiagnosed as another. This will be a deeper look on how we currently understand how parasitic infections change the microbiome presentation and how patients will often suffer from and be diagnosed with one but the underlying cause is the other one. Alinia is briefly discussed as a use for treatment of parasitic infections.


Diabetic Enteropathy and SIBO

Presenters: Steven Sandberg-Lewis ND, DHANP

Cost: $49 CAD

CE Hours: 1.0 hours

This presentation will explain how metabolic syndrome, prediabetes and frank diabetes become key underlying causes for SIBO and other GI disorders. The influences of lipopolysaccharides from overgrown flora, autonomic neuropathy, hepatic insulin resistance, effects of hyperglycemia and the hypothalamic-pituitary-adrenal axis on upper GI transit. SS-L will use example cases to show his approach to diabetes treatment and management. Pharmaceuticals to be discussed include: Metformin, berberine, allicin, oregano, ginger and neem will be discussed with regards to diabetes, insulin resistance and SIBO.


All Presentations under SIBO Symposium 2018

Multiple Presenters

Cost: $499 CAD

CE Hours: 12 hours


Register for SIBO Symposium 2018