Rush to the Seymour

Sport for Jove is one of the most successful independent theatre companies in Sydney right now. This production only reaffirms its important place in the theatre scene. The current production ‘Of Mice And Men’ at the Seymour Centre is based on the beautiful book by John Steinbeck, and is a stunning production.

The ensemble cast, led by the charismatic Anthony Gooley and Andrew Henry as Lenny, is ideally cast, and every detail in this production is appealing. The characters are revealed through engaging dialogue and the action is utterly convincing.

Good acting is central to any production and the cast are all excellent. The crucial role of the cognitively impaired Lenny is portrayed to perfection by Andrew Henry. I have seen him perform in several plays in the last twelve months and he is a rare actor who can completely change his persona, his facial expressions and even his vocal tone to suit the role. The virtuosity of this performance demands attendance- book immediately because the season is short and bookings have been heavy for the rest of the dates.

The basics of Gut Pathology

Many patients come to see me with undiagnosed gut issues.

The cardinal gut symptoms are abdominal pain, diarrhoea, constipation and bloating. Reflux/dyspepsia and excessive wind are also common problems.

Most of my patients have already attended other doctors, and serious conditions such as coeliac disease, ulcerative collitis, Crohn’s disease and even bowel cancer have been excluded, so I will not discuss the integrative management of these conditions in this blog.

My work is therefore largely functional gut disorders- which simply means that a gastroscopy/colonoscopy does not show anything abnormal. These patients are often told that there is ‘nothing wrong’ with them in spite of debilitating symptoms. There are actually three main categories of problems which my patients have- parasitic infection, dysbiosis, and digestive problems. These issues can co-exist.

Parasites are usually protozoal and cause the spectrum of gut symptoms. Parasitic infection was dismissed as a cause of gut symptoms until quite recently, and it is vital that the G.P. order a stool test which specifies  PCR analysis, rather than a simple culture of the stool, or the pick up rate is very low. If a parasite is detected, I always eradicate it before focusing on other gut pathology, since it is not possible to correct dysbiosis or repair permeability whilst the parasite is inhabiting he gut wall. Parasites are not easy to eradicate, and the antibiotics used conventionally have a very poor clearance rate and are the most devastating to the healthy gut flora. Integrative doctors utilise antibiotics that are well known and utilised overseas but do not have a big enough market here for drug companies to brand and market them. When the parasite has been cleared, 70% of patients find that their symptoms are significantly improved.

In the absence of a parasite most patients have digestive problems or dysbiosis. Digestive problems can be generalised or specific and can often be elicited from history Alternatively, formal testing with a range of breath tests can quantify enzyme deficiencies. The cornerstone of treatment is  dietary manipulation with enzyme supplementation as appropriate.

Dysbiosis is a surprising common condition which simply means an imbalance in the bacterial constituency of the gut. Due to the work of a microbiologist in Melbourne,Henry Butt, who has been studying the gut for decades and always has ten PhD students working for him, we know a great deal about the range and numbers of bacteria which should inhabit the bowel. Too many or little of any of these will create various gut symptoms. The diagnosis of ‘irritable Bowel’ has often be given erroneously to people who have dybiosis. I send stool samples to Melbourne for analysis and then a precise programme of prebiotics, probiotics and antibiotics can be prescribed to establish a new balance . The results from this are excellent, and whilst the success can be quantified with repeat analysis, it is often not required because the symptomatic relief speaks for itself.

Gut permeability or ‘Leaky Gut’ is another diagnosis only recently accepted by mainstream medicine. Leaky gut usually occurs because of injury to the gut wall- but sometimes my patients have suffered from symptoms for a long time and the original insult has been forgotten. There are very effective regimens to reduce this problem. Not only do these patients have significantly reduced symptoms, but they also reduce the risk of future illness, such as autoimmune disease, due to exposure to toxic substances from the gut.

I am very grateful to have so many tools to help patients with gut symptoms, many of whom have been dismissed by local G.Ps. The results are extremely satisfying.

Men at the Old Fitz…another winner..make it a double

The latest play at The Old Fitz is another excellent play which is performed flawlessly. Three men interact in a room…is the end of the world near?We are not sure what is happening in the outside world for most of the play but the final, surprising last scene brings it all together brilliantly. The play focuses on the vulnerabilities of younger men, but does so in an engaging and highly entertaining way. The characters are all flawed but likeable because the actors are so charismatic. Ben O’toole, Sean Hawkins ( a recent best actor award winner in ‘Howie the Rookie’) and Jamie Timony are all wonderful; surprisingly no-one is upstaged. The female character , played by Cheree Cassidy is quite mysterious and up to the measure of the other cast members. The set is very imaginative as I have come to expect from Red Line Productions. See this play…you will leave feeling invigorated!

For a really memorable night of theatre, stay at the Old Fitz and see the late show- it starts at 9:00pm, so a snack at the bistro will take care of the intermission. The late show is a beautiful play called The Ishmael Club and focuses on a friendship between two well known Australian artists, Norman Lindsay and Will Dyson.It is actually very informative from an art history perspective as a bonus! The stand out performances are from Richard Hilliar as Dyson and Amy Scott-Smith as his wife Ruby, who has a particularly rich vocal tone which adds grandeur to all her roles.

The two plays were not conceived as a double bill, but make a very well balanced night out at the theatre.