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Navigating the Festive Feast: Seasonal Challenges for Digestive Health

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The festive season, adorned with twinkling lights and joyous gatherings, graces our tables with an array of delightful treats. However, for those grappling with gastrointestinal conditions, this time of year feast brings forth unique challenges. In this seasonal article, we embark on a journey to explore the impact of food on gastro symptoms and discover the invaluable role of Hydrogen and Methane Breath Testing (HMBT) in managing these challenges.

The Yuletide Culinary Extravaganza: The festive season is synonymous with indulgence, featuring a tapestry of rich, decadent dishes that can trigger gastrointestinal symptoms. From creamy mashed potatoes to buttery desserts, the abundance of high-fat and high-sugar foods poses a challenge for those with sensitive digestive systems.

A Culinary Journey Across the UK of Traditional Delights: Let’s embark on exploring the traditional foods of each country in the United Kingdom, along with some insights into their unique traditions and how these might impact digestive health.

1. England:

  • Traditional Food: Roast Beef and Yorkshire Pudding, Fish and Chips, Full English Breakfast.
  • Tradition: Afternoon Tea, a quintessential English tradition featuring tea, sandwiches, and pastries.
  • Impact on Digestive Health: Some may find the richness of traditional English dishes, especially those high in fat, challenging for digestion.

2. Scotland:

  • Traditional Food: Haggis, Neeps, and Tatties (turnips and potatoes), Scotch Broth.
  • Tradition: Hogmanay, the Scottish New Year’s celebration, often involves festive meals and customs.
  • Impact on Digestive Health: Haggis, a savoury pudding, may contain various ingredients, and individual tolerance can vary.

3. Wales:

  • Traditional Food: Welsh Rarebit, Cawl (a traditional soup), Bara Brith (fruitcake).
  • Tradition: The Eisteddfod, a cultural festival celebrating Welsh arts and literature, includes traditional foods.
  • Impact on Digestive Health: Rich and hearty dishes like Welsh Rarebit may be heavy for some digestive systems.

4. Northern Ireland:

  • Traditional Food: Ulster Fry (similar to Full English Breakfast), Irish Stew, Wheaten Bread.
  • Tradition: The Twelfth, a Protestant celebration, often involves communal meals.
  • Impact on Digestive Health: Traditional Irish Stew with lamb and vegetables is generally well-tolerated.

Ranking in Terms of Impact on Digestive Health: Considering individual digestive tolerance, it’s challenging to provide a definitive ranking. However, generally speaking, traditional dishes in Wales and Northern Ireland might be perceived as somewhat lighter compared to the richer and heartier offerings in England and Scotland.

A Neurological Journey of Pleasure: The seasonal indulgence in festive foods is not merely a matter of tradition; it has a profound neurological impact that contributes to the joy and comfort associated with these culinary choices.

Take, for instance, the rich and hearty fare of Scotland. Traditional dishes like haggis, neeps, and tatties are more than just a feast for the taste buds; they evoke a sense of home and nostalgia. The brain, in response to familiar and comforting flavours, releases neurotransmitters like dopamine and serotonin, creating a pleasurable experience that goes beyond the immediate taste.

In Wales, the emphasis on ingredients like lamb and leeks in dishes such as cawl reflects a connection to the land and local agriculture. Consuming these foods during the festive season triggers a neurological response tied to cultural identity and a deep-rooted sense of community. The brain perceives these flavours as not just sustenance but as a reaffirmation of cultural belonging, fostering a positive emotional response.

Moving to Northern Ireland, the fondness for Ulster Fry during the festive season is a sensory experience that goes beyond the plate. The sizzle of bacon, the aroma of fresh soda bread, and the savoury taste of potato bread collectively stimulate the brain’s reward centres. The anticipation and enjoyment of these familiar flavours release endorphins, creating a sense of happiness.

In England, the Christmas pudding, with its blend of spices, dried fruits, and a gEnerous splash of brandy, is a sensory delight. This traditional dessert engages the brain through olfactory and gustatory stimuli. The combination of festive aromas and complex flavours activates the limbic system, responsible for emotions and memory, contributing to a sensory-rich experience.

Gastro Grumbles – The Impact of Festive Foods:

1. Carbohydrate Overload: As we delve into the heart of traditional seasonal fare, laden with carbohydrates, we encounter a dual challenge for individuals with digestive conditions like lactose intolerance or fructose malabsorption. The digestive system contends with potential issues such as bloating, gas, and abdominal discomfort. Simultaneously, the influx of carbohydrates influences the gut microbiome, serving as a substrate for microbial fermentation. This intricate interaction extends beyond digestion, as the brain’s reward centres respond to indulgence in carb-laden delights, experiencing a temporary boost in mood. The release of neurotransmitters like serotonin contributes to both digestive and neurological experiences, highlighting the interconnectedness of our gut, brain, and microbiome.

2. Fatty Feasts: Roasts, velvety gravies, and decadent desserts take centre stage, not only delighting the palate but also affecting the gut microbiome. Individuals with gallbladder issues or difficulties in fat digestion may experience symptoms like nausea, bloating, and diarrhoea. Fats, acting as substrates for microbial metabolism in the gut, influence the composition of the microbiome. This microbial interplay extends to the brain, triggering the release of dopamine, the pleasure neurotransmitter. The holistic impact on the digestive system, brain, and microbiome underscores the complex web of connections affected by festive fatty feasts.

3. Sugar Rush: Sweet treats, a staple during this time of year, pose a challenge for those with conditions like irritable bowel syndrome (IBS). The surge in sugar intake exacerbates digestive symptoms, causing pain and discomfort while concurrently influencing the gut microbiome. Sugar serves as a substrate for microbial activity, affecting the diversity and balance of gut bacteria. At the neurological level, the brain responds to the sugar rush by releasing endorphins, creating a fleeting sense of happiness. This multifaceted impact on the digestive system, brain, and microbiome highlights the intricate relationship between festive indulgences and the comprehensive well-being of our gut health.

4. Chocolate Delights: Amidst the festive spread, the allure of chocolate takes centre stage, captivating taste buds and contributing to the symphony of seasonal delights. While this beloved treat is a source of joy for many, its impact on digestive health can vary. For individuals with conditions like irritable bowel syndrome (IBS), the richness of chocolate may pose challenges, potentially triggering discomfort and digestive distress. On a neurological level, however, the consumption of chocolate triggers the release of endorphins and serotonin, eliciting feelings of pleasure and contentment. The complex interplay between the digestive system and the brain during the indulgence in chocolate adds a nuanced layer to the festive experience, reminding us that even the smallest treat can have both delightful and varied effects on our well-being.

HMBT: A Gift for Gastrointestinal Health: Enter Hydrogen and Methane Breath Testing, a tool, not so much as part of festive activities or gifts, is used for diagnosing conditions like Small Intestinal Bacterial Overgrowth (SIBO) and carbohydrate malabsorption. During the holiday season, HMBT can offer insights into how our bodies respond to the festive feast.

1. Monitoring Carbohydrate Intolerance: HMBT emerges as a valuable ally in identifying carbohydrate intolerance. Individuals experiencing bloating or discomfort after meals can undergo HMBT to pinpoint specific carbohydrates causing distress, enabling them to make informed dietary choices.

2. Unravelling Fats and Gases: The excessive consumption of fatty foods during the festive season can lead to the production of gases in the gut. HMBT, with its ability to detect hydrogen and methane levels, can assist in understanding the impact of fat-rich meals on digestive processes.

3. Personalised Dietary Guidance: Armed with HMBT results, individuals can collaborate with healthcare professionals to create personalised dietary plans. This empowers them to enjoy the festive season without compromising digestive well-being.

Tips for a Digestive-Friendly Festive Season:

  1. Moderation is Key:

Enjoy the festive spread but in moderation. Limiting portion sizes can help prevent overwhelming the digestive system.

  1. Mindful Eating:

Slow down and savour each bite. Mindful eating not only enhances the dining experience but can also aid digestion.

  1. Choose Wisely:

Opt for dishes that align with your dietary needs. If you have identified specific triggers through HMBT, make conscious choices.

  1. Stay Hydrated:

Adequate water intake supports digestion. Ensure you stay hydrated, especially if your meal is rich in salt or sugar.

Conclusion:

As we gather around the festive table, let’s not forget the importance of digestive health. By understanding the potential impact of festive foods and incorporating tools like HMBT into our wellness strategies, we can make the festive season both joyful and comfortable.

Note: This article is intended for informational purposes only and should not be considered as medical advice. Individuals with specific dietary concerns or health conditions should consult healthcare professionals for personalised guidance.

Battling Winter Wheezes: How Cold Weather Impacts Asthma and the Benefits of FeNO Monitoring

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As we enter the winter months and it becomes cold outside, the air we breathe is dry and the protected fluid in our lungs evaporates. This environmental change triggers the muscles within our lungs to spasm as they work to maintain open airways, resulting in increased tightness and difficulty breathing. While asthma symptoms persist throughout the year, they can escalate during winter, aggravating issues such as chest pain, coughing, shortness of breath, chest tightness, and wheezing1.

Asthma is recognised in part by the variability of symptoms. Indeed, this variability is a key consideration in making the diagnosis of asthma2. Once a diagnosis is confirmed, asthma symptoms can continue to demonstrate variability. This variability may be unpredictable and unexpected due to the natural disease process, or more predictable because of exposure to individual triggers.

Asthma guidelines state that if symptoms worsen, the clinician should check adherence with prescribed medication, check inhaler technique and remove triggers2. This may be overlooked when increasing doses of inhaled medication or prescribing additional medications. It is worth thinking about how this can be done in practice.

Medication adherence can be a tricky subject to bring into the consultation. It is a complex mix of patients’ health beliefs or misjudgement of their condition3,4 and can also be influenced by cultural beliefs5. It is a fascinating subject and worth looking into in more depth to get an understanding of why some people will not take prescribed medication whether it is an intentional decision or a non-intentional action. The attitude and experience of the prescribing clinician can also influence a patient’s decision to adhere to a prescribed medication regimen6.

One of the strategies we tend to use to assess adherence is to look at the prescribing history – has the patient been prescribed adequate treatment (inhaled steroid-containing inhaler) to be taking it regularly as prescribed? Has the patient ordered excessive amounts of rescue medication (Salbutamol or Terbutaline) indicating poor symptom control? The national review of asthma deaths7 found these measures were potential contributors to mortality. Salbutamol overuse is the focus of the global social movement Asthma Right Care8, in part because of the recognised link between the overuse of rescue medication and the increase in asthma mortality and morbidity.

Another approach that can help when assessing adherence with inhaled corticosteroids is to measure fractional exhaled nitric oxide (FeNO). This measures eosinophilic airway inflammation which is a key component of most asthma types. If inhaled corticosteroids are taken regularly using the correct inhaler technique, this inflammation should be controlled unless a dose increase or addition of add-on therapy is required. If the patient is not taking regular treatment or is taking it using a poor technique, the airways will demonstrate this inflammation. If the test is undertaken following a clear explanation of what asthma is, how inhalers work and what the test will measure, the discussion on inhaler use has a good basis to work from – many people with asthma do not understand the disease process and how inhalers work so do not take them regularly. For those who are adherent with medication who can demonstrate good inhaler technique, a raised FeNO level may be an indication of the need to increase or add in medication.

Suboptimal inhaler technique is a common cause of increasing asthma symptoms and poor asthma control, yet is very common9. According to the systematic review published in 2016, only 31% of patients can use an inhaler correctly, and the inhaler technique has not improved over the past 40 years10.

Guidelines emphasize the importance of correct inhaler technique before escalating treatment2, yet many healthcare practitioners are not confident or indeed competent in checking and coaching patients to optimise the use of inhalers. To address this, the UK Inhaler Group have produced a Standards and Competency document11 to guide and encourage appropriate teaching and coaching of inhaler technique.

Checking the correct inhaler technique and assessing adherence with prescribed medication are 2 of the basics to check if a person presents with increasing asthma symptoms (not sudden acute asthma) especially if the person is found with raised FeNO levels.

The third element is to discuss and, where possible, eliminate asthma triggers. Whilst asthma has a natural variability which can often be unexpected and unpredictable, there are more obvious triggers that may be specific to the individual and will be known to increase asthma symptoms. There are a wide range of triggers from seasonal elements – increasing pollens in the spring and through summer, dampness and moulds in autumn, and respiratory infections in the winter – through exposure to perfumes and smoke, pets and animals, and house dust mites and many others besides.

Whilst some of these can also be unpredictable there are elements, especially as we go into winter for example, where a person knows from past experience that a particular season will ‘set them off’. The population with long-term health conditions are offered protection against some respiratory infections with vaccinations but viral infections have been found to cause up to 70% of asthma exacerbations12. So, what can we do to protect our patients with asthma as we move into winter in addition to vaccine administration? During the COVID-19 pandemic where social distancing rules and mask-wearing were mandated, there was a reduction in admissions to hospitals from long-term respiratory conditions but this is not an acceptable strategy in the future.

What we can do is be sure that our patients have the appropriate medication in a device that they can and will use on a regular basis to optimise asthma control leading up to known predictable periods of likely exacerbation. The basis of this must be the patient’s understanding of what asthma is and an understanding of the expected effects of prescribed medication, supported with a personalised asthma action plan that will help patients to know their potential when asthma control is optimal, to recognise deterioration and know how to act and adjust medications safely, when to seek help and from whom.

There are various tools that will help in this patient journey such as placebo inhaler devices to practice and optimise inhaler technique, and diagrams and airway models to improve understanding of asthma. Measurement of lung function using a peak flow meter when a patient, as well as a comparator when a patient has increasing symptoms, is helpful. Measurement of FeNO is a valuable addition to the asthma toolbox to measure airway inflammation which will help the patient better understand what asthma is and how inhaled medication, in particular inhaled steroids, target inflammation. In symptomatic patients, it can open conversations around adherence and inhaler technique, guide step-up and step-down treatment decisions, and work as part of the toolkit to optimise asthma control.

Delve deeper into the impacts of winter and asthma care in our upcoming webinar with Carol Stonham; Battling Winter Wheezes: How Cold Weather Impacts Asthma and the Benefits of FeNO Monitoring, being held on Tuesday 9th January 2024 at 7pm. Learn how FeNO measurements play a pivotal role in monitoring and managing respiratory health during colder months.

References:

  1. Why asthma is worse in winter [Internet]. Temple Health. 2021. [Cited Monday 13th November 2023]. Available from: https://www.templehealth.org/about/blog/why-asthma-worse-in-winter
  2. British Thoracic Society, SIGN. BTS/SIGN Guideline for the management of asthma. Available from https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/ [Last accessed 24.10.2023]
  3. Brandstetter S, Finger T, Fischer W, et al. Differences in medication adherence are associated with beliefs about medicines in asthma and COPD. Clin Transl Allergy. 2017;7(1):1–7. doi: 10.1186/s13601-017-0175-6
  4. Ahmedani BK, Peterson EL, Wells KE, et al. Asthma medication adherence: the role of God and other health locus of control factors. Ann Allergy Asthma Immunol. 2013;110(2):75-79. e2. doi: 10.1016/j.anai.2012.11.006
  5. Kaplan A, Mitchell PD, Cave AJ, et al. Effective asthma management: is it time to let the AIR out of SABA? J Clin Med 9(4):921. doi: 10.3390/jcm904092
  6. van Boven JF, Ryan D, Eakin MN, et al. Enhancing respiratory medication adherence: the role of health care professionals and cost-effectiveness considerations. J Allergy Clin Immunol Pract 4(5):835–846. doi: 10.1016/j.jaip.2016.03.007
  7. National review of asthma deaths. Why asthma still kills (2014). Available from https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills [Last accessed 24.10.2023]
  8. Asthma Right Care (PCRS) available from https://www.pcrs-uk.org/campaign/asthma-right-care [Last accessed 24.10.23]
  9. van der Palen J, Thomas M, Chrystyn H, Sharma RK, van der Valk pd, Goosens M, Wilkinson T, Stonham C, Chauhan AJ, Imber V, Svedsater H, Barnes NC. A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices npj Primary Care Respiratory Medicine volume 26, Article number: 16079 (2016) [last accessed 24.10.2023]
  10. Sanchis J, Gich I, Pedersen S, et al Systematic review of errors in inhaler use: has patient technique improved over time?Chest 2016;150:394-406. doi:10.1016/j.chest.2016.03.041pmid:http://www.ncbi.nlm.nih.gov/pubmed/270607 26
  11. UK Inhaler Group (2016, reviewed 2019) Inhaler Standards and Competency Document. Available from https://www.ukinhalergroup.co.uk/uploads/s4vjR3GZ/InhalerStandardsMASTER.docx 2019V10final.pdf [Last accessed 24.10.2023]
  12. Hammond C, Kurten M, Kennedy JL. Rhinovirus and asthma: A storied history of incompatibility. Curr Allergy Asthma Rep. 2015;15:502.

Local Med-tech Company, Bedfont® Scientific Ltd., Celebrates Double Triumph at the KICC Awards

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Bedfont® scoops the Innovation Award and Export Award at the Kent Invicta Chamber of Commerce Business Awards

Medical device manufacturer, Bedfont®, is elated to announce its recent success in winning two esteemed business awards at the Kent Invicta Chamber of Commerce Business Awards. The annual business awards, which took at Westenhanger Castle on Thursday 23rd of November, bring together the business community showcasing the amazing achievements of a range of businesses and talented individuals throughout Kent.

Bedfont® was delighted to have won Success in International Trade 2023, boasting over 82 distributors worldwide, with exports accounting for 80% of turnover for the past 9 years.

Bedfont® was over the moon to win Innovative Business of the Year 2023, making it the 3rd year in a row – a significant achievement and testament to the innovation that is at the heart of Bedfont®.

Jason Smith, Managing Director at Bedfont®, comments, “We are incredibly honoured to receive not just one, but two prestigious business awards. This achievement reflects the hard work and enthusiasm of the exceptional members of the Bedfont® Family and our dedicated network of Distributors. Each member has played a vital role in our success, and these awards celebrate the collective effort that defines our company culture and core values.”

Bedfont’s mission is to work with the Bedfont® Family and healthcare professionals worldwide to provide cutting-edge breath analysis medical products to the highest standard, through technical innovation and professional business practice. Bedfont’s vision is a world where everyone has access to instant, non-invasive, simple breath testing to aid in medical diagnosis.

England’s Plans for a Smokefree Generation

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Currently, in the UK, it is against the law to sell tobacco products to individuals under the age of 18. In October 2023, the English government introduced a ground-breaking proposal to raise the legal age by one year, each year. The ultimate goal is to make the sale and purchase of cigarettes illegal, gradually phasing out smoking in the country. New Zealand led this initiative in 2021 by annually increasing the legal smoking age for anyone born after 2008. This change made tobacco products less affordable and less accessible for those still permitted to smoke in New Zealand1.

Current statistics

Smoking-related deaths are the UK’s biggest preventable killer, causing 1 in 4 cancer deaths and 64,000 deaths per year in England2. The government’s proposed plan aims to alleviate the pressure, on an already over-burdened National Health Service (NHS), given that nearly one hospital admission per minute is linked to smoking, along with up to 75,000 monthly GP appointments for smoking-related illnesses2.

In 2022, data revealed that across all age groups from 18 to 65+, men were consistently more likely to smoke than women. Notably, individuals aged 25 to 34 had the highest smoking rate, with 19.1% for men and 13.4% for women3. Yet for those who vape daily, the largest group was those aged 16 to 24, constituting 15.4% of daily vapers across the age range from 16 to 60+. This marked a 3.7% increase from 2021 (11.7%)4.

The government’s plan

According to recent statistics, smoking and vaping are predominantly adopted by younger generations and the government’s plans to prevent the next generation from smoking will benefit England ultimately. This would involve removing additional strain, money, and time on the NHS with appointments and hospital admissions caused by smoking, as well as discouraging young people from taking up vaping with future policies in place for flavours and packaging. Additionally, the government’s efforts to restrict disposable vapes aim to mitigate the environmental impact of these products ending up in landfills.

As well as the plans to increase the legal age to smoke, the government has also pledged to fund numerous initiatives aimed at supporting smoking cessation aid. This involves an additional £70 million annually allocated to local stop-smoking services, and a further £45 million spread over two years to introduce the national ‘Swap to Stop’ project. This project aims to provide individuals who are attempting to quit smoking with a free vape kit and behavioural support as another incentive to help England reach the ‘smokefree’ target by reducing adult smoking to 5% or less by 20305. The government is set to intensify its measures on vaping products, introducing additional regulations on flavours and packaging to reduce appeal among children. Although vaping is intended as a resource to help adults quit smoking, the statistics for youth vapers have tripled in the past three years with 20.5% of children aged 11 to 17 years old having tried vaping at least once in 2023, reported by Action on Smoking and Health (ASH). This trend is not unique to the UK, as similar patterns are observed globally, including in Canada and New Zealand6. There are also plans to limit the availability of disposable vapes in the market, aiming to reduce environmental harm by minimising the disposal of these products in landfills. New research has revealed in the UK that 78% of the 138 million disposable vapes sold every year in the UK are being disposed of incorrectly, which means more than two million single-use vapes are thrown away in general waste every week, instead of being recycled correctly7.

Carbon monoxide devices

Bedfont® Scientific Ltd. manufactures the Smokerlyzer® range, measuring carbon monoxide (CO) which consists of the Micro+™, piCObaby™, piCO™, and the homecare CO device the iCOquit®. All the devices measure CO on the breath with instant results to help motivate patients and there are many resources that can help individuals quit smoking. In addition to behavioural support and nicotine replacement therapy (NRT), CO devices have been integrated into stop-smoking programmes for years, used as a bio-verification tool that can identify CO on the breath (produced by incomplete combustion burning of tobacco products) and therefore confirm abstinence from traditional tobacco smoking, in addition to being used as a motivational tool for smokers.

To find out more about how you can support patients with smoking cessation, visit https://www.bedfont.com/smokerlyzer

Read the full research briefing on the government’s smokefree 2030 ambition for England:

https://researchbriefings.files.parliament.uk/documents/CBP-9655/CBP-9655-The-Smokefree-2030-ambition-for-England-Oct-2023.pdf

References:

  1. New Zealand to ban cigarettes for future generations [Internet] BBC News. 2021. [Cited Tuesday 17th October 2023]. Available from: https://www.bbc.co.uk/news/world-asia-59589775
  2. Prime Minister to create ‘smokefree generation’ by ending cigarette sales to those born on or after 1 January 2009 [Internet]. GOV.UK. 2023. [Cited Tuesday 17th October 2023]. Available from: https://www.gov.uk/government/news/prime-minister-to-create-smokefree-generation-by-ending-cigarette-sales-to-those-born-on-or-after-1-January-2009
  3. Adult smoking habits in England [Internet]. Office for National Statistics. 2023. [Cited Friday 20th October 2023]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/datasets/adultsmokinghabitsinengland
  4. E-cigarette use in England [Internet]. Office for National Statistics. 2023. [Cited Friday 20th October 2023]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/datasets/ecigaretteuseinengland
  5. The Smokefree 2030 ambition for England [Internet]. House of Commons Library. 2023. [Cited Friday 20th October 2023]. Available from: https://researchbriefings.files.parliament.uk/documents/CBP-9655/CBP-9655-The-Smokefree-2030-ambition-for-England-Oct-2023.pdf
  6. Creating a smokefree generation and tackling youth vaping: what you need to know [Internet] GOV.UK. 2023. [Cited Friday 20th October 2023]. Available from: https://healthmedia.blog.gov.uk/2023/10/12/creating-a-smokefree-generation-and-tackling-youth-vaping-what-you-need-to-know/
  7. Single use vapes spark surge in blazes as three dumped every second [Internet]. Zurich. 2023. [Cited Friday 20th October 2023]. Available from: https://www.zurich.co.uk/news-and-insight/single-use-vapes-spark-surge-in-blazes-as-three-dumped-every-second#:~:text=Research%20released%20today%20by%20public,thrown%20away%20improperly%20every%20week.

iCOquit® Pilot Study Utilizing Personal Bluetooth® CO Devices for Smoking Cessation During Pregnancy

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In the UK, the National Health Service (NHS) revealed a promising trend in smoking rates among pregnant women during the 2021-2022 period. At the time of birth, the smoking rate hit a historic low of 9.1%, marking a notable drop from the 2019 rate of 10.6%1.

In Somerset, a smoking cessation pregnancy programme called Mums2Be Smokefree had to replace all in-person appointments with telephone support in 2020 due to COVID-19. In 2021, face-to-face appointments were reinstated but the number of sessions had been reduced. This led to the creation of a 12-month pilot study spanning from April 2021 to April 2022, which included the iCOquit® Smokerlyzer®, a personal Bluetooth® carbon monoxide (CO) device manufactured by Bedfont® Scientific Ltd. There were 58 participants, aged 18 to 30 years old, enrolled in the pilot study and each person was issued an iCOquit® device through Mums2Be Smokefree. They were given the device either at 4 weeks (34%) or 12 weeks (66%) into their pregnancy, followed by a semi-structured survey to evaluate the effectiveness of the iCOquit® device from the patient’s perspective.

Study’s finding for iCOquit® and CO testing

Face-to-face CO readings were conducted to validate quit rates, and no discrepancies were reported. At 4 weeks, an impressive 96.55% of participants had successfully quit smoking, and at 12 weeks into the smoking programme, 94.83% of patients had quit smoking.

The implementation of the iCOquit® device not only tracked quit attempts but also significantly minimised the loss of follow-up appointments, with 1.72% at the 12-week mark. The voucher incentive plan for those who quit smoking increased by 828.95% (from 38 to 353 vouchers) from 2020 to 2021. The pilot study resulted in a 26.79% increase in attendance to first appointments with the Mums2Be Smokefree programme. With specific spikes of 15.35% at 4 weeks, and 3.47% at 12 weeks.

Study’s impact on CO testing

The outcomes of the study highlighted the impactful role of iCOquit® in equipping patients with the skills to quit smoking and maintain their journey throughout their pregnancy and post-partum when they were unavailable to meet face-to-face with their smoking practitioner.

Of the participants, half engaged in a brief survey focused on iCOquit®. When asked, “How helpful do you feel the iCOquit® has been to support you not smoking”, respondents expressed a high level of satisfaction, with 55.2% finding iCOquit® very helpful and 41.4% considering it somewhat helpful. When asked, “In what (if any way) did you find the iCOquit® useful to support you not smoking”, 51.72% found the visual results on the phone were supportive of their quit, 31% found the motivation to quit helped them most, 13.8% found the ease of monitoring efficiency at home most helpful, and 3.45% answered goal setting.

The consensus between participants and smoking practitioners on the value of iCOquit® is clear. Providing instant results accessible from anywhere, iCOquit® has not only empowered participants but also streamlined face-to-face appointments with smoking practitioners. The successful integration of iCOquit® into the practices of Mums2Be Smokefree further underscores its significance in enhancing the efficiency and effectiveness of smoking cessation support.

“The combination of the ICOquit® and an advisor (Stop Smoking Practitioner) is what helped me to quit”

(Service user, 2022)

With an easy-to-use, handheld, home CO device, Bedfont® can help users become smoke-free with instant results shown by a motivational traffic light system. The iCOquit® also offers the ability to take a reading anytime, anywhere, allowing a practitioner to offer remote motivation and sustained support. To find out more about how you can support patients with smoking cessation, visit https://www.icoquit.com/

Read the full Evaluation Report here:

https://fabnhsstuff.net/storage/iCO-Monitor-Evaluation-Report-FINAL-12082022-643fa275e1b5d.pdf

References:

  1. NHS helps thousands of pregnant smokers kick the habit [Internet] NHS England. 2022. [Cited Monday 9th September 2023]. Available from: https://www.england.nhs.uk/2022/07/nhs-helps-thousands-of-pregnant-smokers-kick-the-habit/

Reviving Lung Health: How FeNO Testing Can Help Millions Suffering from Lung Conditions

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As winter draws in, the NHS braces for an influx of patients infected with common respiratory viruses. For those with respiratory conditions, such as the 5.4 million asthma sufferers in the UK, the colder months pose an especially daunting threat.1 Constricted airways, breathlessness, and tightness of the chest are typical yet distressing symptoms of asthma, an inflammatory disorder affecting around 9% of the population and capable of increasing vulnerability to respiratory infections.1,2

Beyond the physical and mental strain caused by asthma, a DALY rate of 350 per 100,000 indicates a significant burden of asthma-related disability in the UK population.3 This is reflected in the reported 60,000 hospital admissions and 200,000 bed days for asthma sufferers each year.1 Asthma can also be life-threatening, with asthma attacks claiming the lives of three people each day.1

The human toll of asthma has led to a significant economic burden. This year, the direct cost of asthma in England – encompassing NHS expenses, the impact of greenhouse gas emissions, and patient travel costs – has exceeded £1.2 billion.1 Collectively, lung conditions, including asthma, place an annual £9.6 billion burden on the NHS and exacerbate winter healthcare pressures, as individuals with these conditions are more susceptible to respiratory illnesses and cold weather.1 Asthma has become more than a personal health concern; it is a public health and economic crisis.

Compounding a Crisis: Inadequate Diagnostic Testing Impedes Effective Decision-Making

A report published in 2023 by the British Charity Asthma + Lung UK highlights the concerning state of lung healthcare in England. Despite lung disease being the third leading cause of death, individuals suffering from breathlessness frequently wait years for a formal diagnosis, while others remain undiagnosed or are misdiagnosed.1 One study found that an asthmatic diagnosis could not be established in over 30% of adults who had previously received positive diagnoses.4 The scale of this issue is brought into focus when realizing that an estimated 750,000 people are misdiagnosed as asthmatic in England, and attendant financial repercussions are estimated at £132 million each year.1

The reasons behind these apparent oversights are complex. One contributing factor involves funding restrictions and a lack of accessibility to diagnostic tests, undermining the veracity of primary care diagnoses. As uncovered in a PwC analysis, current deficiencies in testing are estimated to cost England £2.2 billion, primarily due to preventable hospital stays and treatments.5

To recoup some of these costs and alleviate pressure on the NHS, Asthma + Lung UK proposed the following measures. By fully funding diagnostic testing such as FeNO, reinstating nationwide spirometry, and maximizing the potential of community diagnostic centers and primary care for diagnoses, £307 million could be saved, and 273,000 beds could be made available – with over a third of these during the critical winter period. This figure dwarfs the £250 million in emergency funds that the UK government set aside to create 5,000 extra NHS hospital beds for this winter.1

FeNO Testing: Tackling the Burden of Lung Conditions, One Breath at a Time

As one of the three recommendations proposed by Asthma + Lung UK, improving diagnostic testing appears realistically achievable. NICE recommends a single objective test for measuring airway inflammation in the diagnosis of asthma, fractional exhaled nitric oxide (FeNO).6 This test works by measuring nitric oxide, a naturally occurring gas produced by cells lining the airways to help combat inflammation. In individuals with respiratory conditions, especially asthma, there is often increased production of nitric oxide due to localized inflammation. During a FeNO test, the individual breathes into a specialized device, such as the NObreath® by Bedfont Scientific Ltd, which is designed to capture and analyze its nitric oxide content. With extreme sensitivity, the device measures the concentration of nitric oxide in parts per billion. Through reading the output of the device, valuable information about the degree of inflammation in the individual’s airways can be discerned. Higher FeNO levels are indicative of greater airway inflammation, which is often associated with conditions like asthma.5

The NObreath®, developed by Bedfont Scientific Ltd., is a non-invasive FeNO monitor suitable for both adult and child patients. Conforming to ATS & ERS guidelines, the NObreath® works using an easy exhale-only technique and on-screen visual motivation. After a breath sample is collected and analyzed, airway inflammation can be assessed, and responses to treatment can be monitored. Furthermore, a patient interpretation guide streamlines result analysis, enabling healthcare providers to make informed decisions.7

While the NObreath® offers a simple and cost-effective solution to asthma diagnosis, FeNO tests and solutions essential to accurately evaluating lung health remain largely unavailable in primary care.5,7 A comprehensive analysis conducted by the PwC suggests that if FeNO tests were to be made universally accessible to GPs across England, optimization of asthma treatment could save around £100 million.1 Such a finding not only underscores the cost-effectiveness of FeNO testing but emphasizes its potential to enhance patient outcomes by ensuring accurate diagnoses and tailored treatments.

A Nation Blue in the Face: Heeding the Call for Improved Diagnostic Testing

The asthma crisis in England is a multifaceted challenge involving misdiagnoses and financial strain on the NHS. FeNO testing represents a solution that can aid in the accurate diagnosis of lung conditions, such as asthma, and save millions of lives when made widely available to GPs across the country and integrated into primary care. It is crucial that everyone suspected of lung conditions, such as asthma, has access to FeNO tests and that those who undergo testing receive precise diagnoses.

By embracing FeNO testing as a cornerstone of asthma management, we can significantly improve the quality of life for asthma sufferers, reduce healthcare costs, and alleviate the burden on the NHS. The time to act is now for the benefit of patients and the healthcare system nationwide. Contact Bedfont Scientific Ltd. to find out what solutions are available to aid in this journey to more accessible testing.

References and further reading

  1. Saving Your Breath: How Better Lung Health Benefits Us All. (2023). Asthma + Lung UK. Available at: https://www.asthmaandlung.org.uk/saving-your-breath-report
  2. Sharma S, et al. (2022). Vulnerability for Respiratory Infections in Asthma Patients: A Systematic Review. Cureus. http://doi.10.7759/cureus.28839
  3. Nunes C, et al. (2017). Asthma costs and social impact. Asthma Research and Practice. http://doi.10.1186/s40733-016-0029-3
  4. Aaron SD, et al. (2017). Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA. http://doi.10.1001/jama.2016.19627
  5. ‘Abysmal’ lack of testing for lung conditions is forcing GPs to play a ‘guessing game’ with diagnosis. (2023). Asthma + Lung UK. Available at: https://www.asthmaandlung.org.uk/media/press-releases/abysmal-lack-testing-lung-conditions-forcing-gps-play-guessing-game-diagnosis (Accessed on 09 October 2023).
  6. Asthma: diagnosis, monitoring and chronic asthma management. NICE. Available at: https://www.nice.org.uk/guidance/ng80/chapter/Recommendations#objective-tests- for-diagnosing-asthma-in-adults-young-people-and-children-aged-5-and-over (Accessed on 09 October 2023).
  7. Nobreath. Available at: https://www.nobreathfeno.com/us/ (Accessed on 09 October 2023).

Industry expert, Dr. Jafar Jafari, teases new book, The Essential Guide to Hydrogen and Methane Breath Testing, at UEG Week 2023

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Dr Jafar Jafari, Head of Upper GI Physiology Service at Guy’s and St Thomas’, announces new book in the works highlighting the benefits of HMBT

Dr. Jafar Jafari, expert in the field of gastroenterology, is excited to announce the forthcoming release of his groundbreaking book, “The Essential Guide to Hydrogen and Methane Breath Testing.” at one of the largest Gastroenterology congresses in the world, UEG Week 2023.

Gastrointestinal disorders affect millions of individuals globally, impacting their quality of life and often leading to substantial healthcare costs. Dr Jafari’s new book offers “A Modern Approach to Investigating Gastrointestinal Disorders”, shining a light on the transformative potential of Hydrogen Methane Breath testing (HMBT) to aid in the diagnosis and treatment of various gastrointestinal conditions.

In this comprehensive and expertly researched book, Dr. Jafari delves deep into the science behind HMBT, exploring its role in reshaping the way we understand and manage gastrointestinal health. This book will be published in 2024, and will be published in partnership with leading medical device manufacturer, Bedfont® Scientific Ltd.

Jason Smith, Managing Director at Bedfont®, comments, “We are excited to be working with Dr Jafari on the upcoming release of his new book, we believe it will really help healthcare professionals to unlock the potential of HMBT in Gastroenterology.”

Dr. Jafari, explains, “I have the opportunity to share my knowledge and passion for gastrointestinal health with the next generation of healthcare professionals. This book is a culmination of my experiences, insights, and dedication to the field. I hope it serves as a valuable practical resource for those seeking a deeper understanding of hydrogen and methane breath testing, ultimately leading to improved patient care and outcomes.”

While the official book launch is scheduled for 2024, attendees of UEG 2023 will have the opportunity to get a sneak peek at the book’s content and meet the author, Dr. Jafar Jafari. They can also engage in discussions about the book’s content, its implications for the field, and the future of gastroenterology. This year, UEG 2023 takes place on October 14 – 17, at the Bella Center in Copenhagen; Dr. Jafari will be at Bedfont’s stand, C3-70.

Carol Stonham MBE, RN, MSc, Queen’s Nurse, and Policy Lead PCRS joins the Bedfont® Medical Advisory Board

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Esteemed Respiratory Healthcare Expert, Carol Stonham, Joins the Medical Advisory Board for Medtech Company, Bedfont Scientific Ltd.

Bedfont® Scientific Ltd, a leading innovator in breath analysis medical device technology, is proud to announce the addition of Carol Stonham, a highly respected and accredited respiratory healthcare expert, to its esteemed medical board. This appointment further strengthens Bedfont’s commitment to revolutionising respiratory healthcare solutions and delivering cutting-edge products to patients and healthcare professionals.

Carol brings an extensive background in respiratory healthcare and in particular Asthma and FeNO (Fractional Exhaled Nitric Oxide). She has worked in primary care in Gloucestershire for over 26 years. Her role includes running a local FeNO referral service whilst being a CCG Primary Care Nurse Practitioner for Respiratory Care. Her experience extends even further in this clinical field as she is an active member of the PCRS and currently Policy Lead.

Jason Smith, Managing Director at Bedfont®, exclaims, “We are thrilled to welcome Carol to our Medical Advisory Board. Her expertise and dedication to improving respiratory healthcare align perfectly with our vision to foster a world where everyone has access to instant, non-invasive, simple breath testing to aid in medical diagnosis. As Helen Keller said, ‘Alone we can do so little; together we can do so much’. With Carol’s fantastic knowledge and passion for FeNO, we hope to work together to improve asthma management and diagnosis worldwide.”

Carol, adds, “I am delighted to be part of the Bedfont Medical Advisory Board and to collaborate in the advancement of respiratory healthcare. I look forward to working with Bedfont and fellow board members and leveraging my experience to drive innovation in this critical field. I have been passionate about FeNO for a number of years now and my main interest is improving the industry standards and the care we deliver to our patients.”

Bedfont’s mission is to work with the Bedfont Family and healthcare professionals worldwide to provide cutting-edge breath analysis medical products to the highest standard, through technical innovation and professional business practice. The addition of Carol Stonham to its medical board underscores its dedication to delivering excellence in respiratory healthcare.

To learn more about Carol, watch her introduction here: https://www.youtube.com/watch?v=Z_15x3eanM8

Prioritising Lung Health: How FeNO can help to tackle Lung Conditions, the UK’s 3rd Largest Threat

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Harnessing the Power of FeNO Monitoring to Combat Lung Conditions – A Vital Step in Addressing the UK’s Lung Health Crisis

A new report from PwC commissioned by Asthma+Lung UK has highlighted the alarming crisis surrounding Lung Health in the UK. Sarah Woolnough, CEO of Asthma+Lung UK, said lung conditions were the third biggest killer in the UK, with the report finding that due to the lack of testing, such as FeNO monitoring, patients can also be wrongly diagnosed and an estimated 750,000 people in England are misdiagnosed with asthma, costing the NHS an estimated £132 million every year1.

Fractional Exhaled Nitric Oxide (FeNO) is a non-invasive medical test that measures the level of nitric oxide in a person’s breath. It is a pivotal advancement in asthma care, offering precise insights into airway inflammation. By facilitating accurate diagnoses, personalising treatment plans, and enabling ongoing monitoring of asthma control, FeNO empowers healthcare providers to optimise medication use, reduce exacerbations, and enhance patient engagement. This transformative tool not only improves the quality of life for individuals with asthma but also contributes to more effective, cost-efficient healthcare management, ultimately making a profound impact on the battle against this chronic respiratory condition.

Carol Stonham MBE, RN, MSc, Queen’s Nurse, and Policy Lead PCRS, explains, “Making an accuratediagnosis of asthma relies on taking an accurate history and then performing appropriate tests to confirm the diagnosis. Spirometry (a test of lung function) was stopped during the pandemic and hasbeen very slow to restart. FeNO testing provides a valuable piece of the jigsaw to confirm whether a person has asthma (or not). It is a very quick test to perform and most people find it easy to do. The basis of asthma is airway inflammation which is what the FeNO test gives an indication of. It helps confirm a diagnosis quickly and easily and helps the patient better understand their condition and how inhalers work to treat the condition. It helps clinicians make the correct diagnosis in a timely way and get the person onto the correct treatment pathway avoiding unnecessary hospital admission and life-threatening asthma attacks.”

Jason Smith, Managing Director at Bedfont Scientific, comments, “As a leading manufacturer of breath analysis medical devices, we understand the pivotal role that innovation plays in enhancing patient care and healthcare efficiency. FeNO testing is a prime example of such innovation. We remain committed to advancing respiratory care and hope that in working towards our mission to make healthcare more accessible, our NObreath® FeNO monitor can help make a positive impact on the lives of individuals living with asthma.”

Livio Gagliardi, Acting Managing Director at Intermedical, adds, “As the official UK distributor for NObreath®, we understand the significance of accessibility and affordability. We take pride in offering a flexible three-year rental plan for the NObreath® FeNO device. Our aim is to support practices and Primary Care Networks, regardless of their size or testing volume, in ensuring equal access to FeNO testing for their patients. We are well aware of the financial constraints faced by healthcare providers and patients alike.”“What sets us apart is our democratic cost per test pricing policy. We do not penalise smaller practices; instead, we maintain a low fixed cost per test, regardless of the volume of tests conductedper year. This means that even the smallest practices can benefit from our cost-effective solution. Our rental program for the NObreath® FeNO device serves as a crucial link, as we actively strive to narrow the gap and make advanced respiratory care accessible to everyone.”

The full report can be found here: https://www.asthmaandlung.org.uk/saving-your-breath

To contact Intermedical, please call 01732 522444 or email sales@intermedical.co.uk

References

  1. Asthma+Lung UK. Saving Your Breath: How Better Lung Health Benefits Us All. September 2023. Available from: https://www.asthmaandlung.org.uk/saving-your-breath-report

World Lung Day – 25th September 2023

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Access to prevention and treatment for all. Leave no one behind:

Organised by the Forum of International Respiratory Societies (FIRS) since 2016, World Lung Day is a time for everyone to take a look at what we can do individually and as a society, to work toward clean air and healthy lungs for all. Asthma is closely related to World Lung Day because it is one of the major lung health conditions that the day seeks to address.

Under-diagnosis of asthma

In 2019, asthma affected an estimated 262 million people worldwide1 and led to 455,000 deaths globally2. A study completed by Nolte et al. in 2006 involved 10,877 participants aged 14-44 years old, 11% (1,149) of whom had previously reported asthma symptoms. After further assessment provided by Global Initiative for Asthma (GINA) recommendations, 43% (493) of the 11% were diagnosed with asthma, of which a further 50% (246) had not been diagnosed before3.

When asthma remains undiagnosed or receives inadequate treatment, it can lead to stress, anxiety, or depression, as well as lung infections, hindered growth and delayed puberty in children. Additionally, it can escalate to critical asthma attacks that can be life-threatening4.

FeNO testing and asthma:

The use of FeNO testing, in conjunction with a comprehensive clinical history and additional examinations, contributes to more efficient asthma diagnosis and enhances patient care. Furthermore, it enables the monitoring of patients’ responses to asthma interventions.

FeNO testing can be completed within seconds and provides nearly instantaneous results, compared to traditional testing like spirometry with a bronchodilator test. Thereby ensuring a larger number of individuals receive appropriate treatment for their specific conditions, leading to reduced medication wastage5. In England, a two-year programme from 2021-2023 showed an estimated 58,000 people with newly diagnosed asthma received faster treatment, after more than 1,200 FeNO devices entered primary care6, highlighting the impact FeNO testing can have on asthma care.

Visit https://www.nobreathfeno.com to find out how you can support your patients with FeNO monitoring, with the NObreath® from Bedfont® Scientific Ltd.

References:

  1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, and Abdollahi M. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204-1222. DOI: 10.1016/S0140-6736(20)30925-9.
  2. Asthma [Internet] World Health Organization. 2023. [Cited 24th August 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma
  3. Nolte H, Nepper-Christensen S, and Backer V. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respiratory medicine. 2006;100(2):354-362. PMID: 16005621. DOI: 10.1016/j.rmed.2005.05.012
  4. The Global Asthma Report 2018 [Internet]. 2018. [Cited 25th August 2023]. Available from: http://globalasthmareport.org/2018/index.html
  5. Improving access to FeNO testing in primary care [Internet]. 2023. [Cited 25th August 2023]. Available from: https://www.ahsnnetwork.com/programmes/respiratory-disease/bettering-access-to-feno-testing-in-primary-care/
  6. New report shows impact of FeNO national programme on asthma care in England [Internet] Primary Care Respiratory Society. 2023. [Cited 24th August 2023]. Available from: https://www.pcrs-uk.org/news/new-report-shows-impact-feno-national-programme-asthma-care-england#:~:text=During%20the%20two%2Dyear%20programme,in%20primary%20care%20in%20England.
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