Pr Jean-Marc Sabaté: « Functional colopathy must be managed in a better way»

Why this book, what is your anger?

It is a relative feeling of course, and it applies especially to patients who often suffered for long before they find somebody who listens to them and find improvements in their quality of life only after a long journey. I have been considering writing a book which would touch the greatest number of patients, and which would allow me to explain the disease, and at the same time fight some misconceptions. I also wanted to explain the progress made in the understanding of the mechanisms and the current status of available treatments. The digestive tube being, moreover, a fashionable subject, with all the approximations we can imagine, it was necessary to say things with exactness and hindsight.

Why do you investigate an unrecognized disease?

I consider that these patients, with whom I deal with on a daily basis, deserve the same kind of attention as those suffering from recognized inflammatory bowel diseases as Crohn’s disease and ulcerative colitis or cancers, which is far from being the case.

We can talk about an arsenal that targets different mechanisms of which we know the results cannot be applied to all

What are the progress you mention and how do you take care of these patients?

Listening is very important and I propose different scenarios over several months mainly because of waiting times between two appointments, with different strategies that the patient will test successively. If approach # 1 works, we continue, if not, the patient goes on to the next one without having to wait. I am optimistic that we improve the quality of life of 80% of our patients. We can talk about an arsenal that targets different mechanisms of which we know the results are not generalizable, such as diet, the use of dietary supplements including probiotics, some antidepressants, and more generally a thorough educational therapy. The dietary approach of FODMAP gives valuable results, as well as various complementary therapies such as hypnosis and sophrology, all these approaches provide unsurprisingly improvements that vary from one patient to another. Another dimension that we have been able to bring is to offer patients the opportunity to join the patient association we have created, the APSSII, to find listening space and advice from other people suffering just like them.

What do you think of probiotics?

I am extremely surprised when I ask my patients about what probiotics they take because most often they do not know. Marketing is king and there are products without any reliable studies or with positive studies only in animals, and omitting to mention negative results in humans coexist with a few rare products that have actually been studied. I use the metaphor of the car to make it clear that it is necessary to have all the details (brand, engine capacity, fuel …) to understand what we are driving. The same effort must be made to educate patients to make them understand what they take and highlight the probiotics that have serious studies and do not hide mixed results. For functional colopathy, we know that the scenarios that we propose will be diversely favorable and in no case generalizable. The formulation of Prof. De Simone is a product of interest in inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), with less positive evidence in IBS, although favorable effects could be expected for bloating, subject to further the investigation.

More information on the association, and to join: APSSII website
APSSII – Secretariat of Pr Sabaté
Hepato-Gastroenterology Service
Louis-MOURIER Hospital
178 rue des Renouillers
92700 Colombes
Secretariat@apssii.org
07.83.25.82.60