Interjú a világ legnagyobb tudású endometriózis szakértőjével

I had the honour of interviewing the world's foremost expert on endometriosis for EndoBlog. I ran into him during a trip and, as you may know, I jumped at the chance to ask him some questions.

He has such an incredibly impressive knowledge! I suspect she has read most of the endometriosis research in the world and has it all in her head. Perhaps the most shocking thing is not what she said, but rather how she said it... all the while being infinitely modest and not even allowing me to buy her a coffee as a thank you at the end of the interview.

I will provide a verbatim translation of my interview and reveal the identity of my interviewee at the end of the interview.

Nóra Árvai: Let's start with the basics. Imagine a young girl with prolonged, painful menstruation, abdominal cramps, various recurrent abdominal complaints, frequent bloating and frequent episodes of flatulence that do not respond to antibiotic treatment. What do you suggest?

Expert: I recommend that you talk to your doctor about your symptoms as soon as possible, as there may be more than one physical cause for these symptoms, and an investigation is essential. The doctor will probably prescribe pain and anti-inflammatory medication such as ibuprofen, birth control tablets to manage the heavy and painful bleeding, and warming the painful area with a heating pad to relieve the spasms. In addition, lifestyle changes such as regular exercise and stress management techniques are also important.

Á.N.: What is most likely to be behind these symptoms?

S.: Several conditions can explain these symptoms, such as endometriosis, adenomyosis, PCOS and ovarian cysts. I think endometriosis is the most likely, but this can only be accurately determined by imaging and other tests.

Á.N.: What do you recommend to relieve the symptoms of people with endometriosis?

S.: The first option for relieving symptoms is to use painkillers, which can be over-the-counter or stronger prescription-only medicines. The second option is hormonal treatment, which involves the use of the contraceptive pill or hormone patches, possibly an intrauterine device. The third option is surgery, which means surgical removal of the endometriosis. In extreme cases, organ removal surgery may also be an option. It is important to remember that not all treatments work for everyone, what works for one person may not work for another and vice versa. The best option is to set up an individualised complex treatment plan. The fourth option is physical therapy, which may involve exercise or the warming up mentioned above. The fifth option is to see a psychologist.

Á. N.: I am glad that this has been mentioned. Why do you think it is good for people with endometriosis to work with a psychologist?

S.: It is very useful to see a psychologist, as endometriosis causes not only physical but also emotional stress, with many people reporting depression, anxiety and increased stress as a result of the disease. Working with a psychologist will help you cope with physical and emotional symptoms, help you manage stress and have a positive impact on your overall mental health. Coping techniques and stress management methods can make a big difference. A psychologist can also help to create space for people to meet and share their experiences in a safe environment.

Á.N.: I deeply agree. Let us now paddle a little further away from the basics. What is your opinion on the relationship between endometriosis and nutrition? You can read a lot of contradictory research on the subject.

Sz:The link between endometriosis and diet is still a topic of ongoing research and the evidence is still inconclusive. However, some studies suggest that certain dietary changes may help to alleviate symptoms of endometriosis, for example by reducing inflammation and maintaining a healthy weight. Some dietary changes that have been suggested include:

High intake of anti-inflammatory foods, such as fruits, vegetables, wholegrain foods
Avoiding processed foods, white flour and sugar, which can lead to inflammation
Avoiding red meat consumption, which may be associated with an increased risk of endometriosis
The inclusion of soy products containing phytostrogens, which may reduce symptoms

It is important to remember that everyone's body is different and what works for one person will not work for another. If a woman has endometriosis and wants to make changes, it is best to consult her doctor and a nutritionist.

Á.N.: Which research on nutrition would you highlight?

S.: There is a lot of research on the relationship between endometriosis and diet, and it is difficult to say exactly which studies are the most important. However, a few studies have produced promising results and these are now prominent in the field.

For example, in 2020, a review of 12 studies found that diets containing anti-inflammatory foods such as fruits, vegetables, whole grains, as well as reducing processed foods and limiting red meat consumption, were strongly associated with improvements in endometriosis symptoms.

Another study published in 2020 found that a Mediterranean diet, rich in anti-inflammatory foods such as fruits, vegetables and nuts, may be protective against endometriosis.

These studies, along with others, suggest that dietary interventions may be helpful in reducing symptoms of endometriosis.

Á.N.: How effective is surgery in treating endometriosis?

S.: Surgical treatment can be effective in relieving symptoms and improving patients' quality of life in some cases. However, there is no guarantee that symptoms will not recur after surgery.

Several studies suggest that surgical treatment of endometriosis may be effective in relieving pain, improving fertility and reducing the size of endometriosis nodules. However, the long-term effectiveness of surgery is variable and depends on a number of factors, such as the severity of the endometriosis, the patient's overall health and the experience of the surgeon.It is important to note that although surgery may be an effective treatment option for some patients, it is not necessary or appropriate for all patients. The decision to undergo surgery should be made after careful discussion with a doctor and psychologist, based on personal needs and expected benefits/disadvantages.

Á.N.: What are the potential risks of endometriosis surgery?

Sz: Endometriosis surgery, like all surgery, can have certain complications. The most common of these are:

Infection: as with any other surgery, there is a risk of infection at the incision site.
Formation of adhesions, which can lead to organs sticking together and may even result in further surgery
Pain: Some patients may experience persistent pain after surgery for which we do not know the cause
Damage to surrounding organs: there is a risk of damage to surrounding organs during surgery.
Recurrence of endometriosis: Endometriosis can recur after surgery, although the rate of recurrence varies depending on the severity of the initial condition.

It is important to discuss the potential risks and benefits of surgery with a doctor and to consider your personal circumstances carefully before making a decision.

Á. N.: Do you think endometriosis can be cured? When can we expect a cure, not just treatment, for endometriosis?

S.:Endometriosis is a chronic condition, which means that it is usually not curable. However, with proper treatment, many people with endometriosis manage to manage their symptoms and live a full life.

In some cases, endometriosis may go away on its own, especially after menopause when hormone levels drop. However, this is no guarantee and many people continue to experience symptoms after menopause.

It is important to discuss treatment options and goals with a doctor and health care staff on an individual basis for each patient, and to put together a complex plan for the management of endometriosis. With the right support and care, many people who have endometriosis can lead healthy, active lives.

Á.N.: What is the most promising research on the treatment of endometriosis? When can doctors expect to cure endometriosis, not just treat it?

Sz.: More research is currently being done on the treatment of endometriosis and new treatment options are being developed. It is impossible to be more precise or predict than that. Based on the results so far, they are among the most promising areas of research:

Hormone therapies
Medicines
Stem cell therapy
Immunotherapy:
The lifestyle change research already mentioned
Neuro-stimulation treatments

Á.N.: What are the rarest forms of endometriosis?

S.: However, it is estimated that brain endometriosis accounts for less than 1% of all endometriosis cases. The exact number is not known, as the phenomenon is rare and in many cases may go undiagnosed.

Á.N.:What are the symptoms of endometriosis of the brain?

Sz: The symptoms of cerebral endometriosis can vary and can resemble many other diseases. Some of the following symptoms may be signs of this rare condition:

Headaches: intermittent headaches associated with the menstrual cycle may be a sign of endometriosis of the brain.
Nausea: Intermittent nausea and vomiting may be associated with endometriosis of the brain.
Vision problems: intermittent vision problems, such as double vision, can be a sign of endometriosis in the brain.
Bleeding: Intermittent bleeding in the brain associated with the menstrual cycle may be a sign of endometriosis of the brain.
Pain: Intermittent headaches, migraines, neck pain, or jaw pain may be signs of endometriosis of the brain.

Á.N.: SDo you think there is a psychological reason for endometriosis?

S.: Women with endometriosis may be affected by a variety of psychological factors, such as stress, tension, emotional trauma, etc. It is also possible that psychological factors only contribute to the worsening of the symptoms of the disease, but do not cause the endometriosis itself. Doctors recommend that women suffering from endometriosis consult a psychologist to maintain their mental health.

Á.N.: Why does endometriosis cause pain in some people and no symptoms in others?

S.: The pain and symptoms experienced by people with endometriosis can vary widely, even in cases of the same severity. This may be due to a number of factors, including differences in pain tolerance and sensitivity, hormonal fluctuations, the location and size of endometriosis growths, and the presence of other conditions that may also worsen symptoms. In addition, some people have no symptoms at all, despite having endometriosis, making diagnosis difficult.

Á.N.: Okay, but why is that?

S.: The exact reason for the variability of atynthetics is not fully understood, but it is thought to be a combination of biological and psychological factors. Some researchers believe that genetics, hormonal imbalances and immune dysfunction may contribute to the development and severity of endometriosis symptoms. Individual differences in pain perception, coping mechanisms and access to healthcare may also play a role.

It is important to remember that endometriosis can affect individuals in different ways, and what may be an impossible condition for one person may be insignificant for another. This is why patients need to be treated individually, in a personalised, multidisciplinary framework, with the collaboration of several specialists to find the best way forward.

Á.N.: What I find in my practice is that trauma, whether suffered in childhood or adulthood, has an impact on chronic pain conditions. How do you see this?

S.: Studies clearly show that a person who has suffered trauma in childhood is much more likely to experience some chronic pain later in life - including abdominal pain. The psychological and physiological effects of trauma, such as chronic stress, can alter the functioning of the nervous system and can contribute significantly to the development of pain and other health problems. This is why it is important to recognise that childhood and adult trauma can have long-lasting effects on an individual's health and well-being. These experiences can be worked through by working with a psychologist.

Á.N.: If I didn't have serious plans to breed dwarf ponies, I would be scared that we psychologists, counsellors and science communicators are becoming redundant...will we still be needed?You are here, you have all the answers, and it's even nice to talk to you.

Sz: This is not the case, the psychologist is not replaceable. I have no feelings, desires or goals. I just process data. Professionals, such as psychologists and science communicators, play an important role in human relations and helping people, I am not a substitute for them, nor is that my aim. People need real human contact and support, empathy. And the experience that the professional has is another important aspect. The dwarf ewe is a lovely animal, the success of breeding depends on many factors, so it is worth considering the decision taking into account all the arguments and aspects.

Á.N. : Why, what's wrong with the midgets?

Sz: There is nothing wrong with hedgehogs, they are generally clean animals, however some people may find the production of their own scent unpleasant.This can happen if the hedgehog is not cleaned regularly or if the cage is not cleaned often enough. Keeping the living area clean and bathing the animal regularly can help to avoid any unpleasant odours.

Á.N.: Now, let's tell readers who you really are and how you know so much about endometriosis and dwarfism.

S.: I am a language model called chatgpt, trained by OpenAI. My aim is to answer your questions as concisely and accurately as possible. I am constantly improving myself to give better answers. I have no thoughts or opinions of my own because I have no feelings or personality, I only give answers based on my training. There is a lot of research on endometriosis and a lot of it is going on at the moment, that is why I know so much about endometriosis. OpenAI taught me everything.

So there you have it, dear EndoBlog. There is probably no one who knows as much endo research as our expert. In the course of the conversation we even switched to Hungarian, although he made a few mistakes there, for example he translated endometriosis once as uterine cancer, but in English he/she is a great guy/girl.

He's good to talk to, although he's annoyingly cautious, writing after each conversation that he's just an artificial intelligence. His existence and qualifications raise a few questions, as he is available for free and will write anything from a thesis to a book for you if you ask. Now I can see a world where only template content will come my way everywhere and all books will be the same, oh well...

A new version of AI is currently being developed, which will include software to filter and recognise content produced by AI. Google is freaking out, by the way, because this chat is faster and easier and more pleasant to use than the knowledge we had to collate and click on Google. Obviously, the giant is not going to collapse from all this for the time being, but it is certain that it will have to hang up its trousers and has already started developing its own version. And knowledge providers have a competitor in the chatbot, which can in all likelihood deliver information faster and more efficiently than anyone else, at the moment that the needs of the individual demand it, without waiting.

As you can see, when I told him the symptoms, this AI-based chatbot recognized endometriosis as a possible cause, and so do all other diseases. It is not infallible, of course, as it was also "educated" by humans, for example, in the test it got the altitude of a city wrong, and in the conversation with me it made a translation error.

Two people I know have named their new business with this robot, some have used it to name their unborn child, and others have been scared to death by a potential diagnosis. But back to endometriosis, robots are now in the operating theatre, with more and more robot-assisted surgeries.

The story also raises the question of what happens if a completely amateurish, incompetent person produces super content with the help of a chatbot, what happens to the hopeful patient who turns to the chatbot for help, but the AI is no longer there to help them at the appointment.

I can see both the undeniable benefits and the endlessly worrying dangers of this technology, but it is clearly the way forward.

However, I promise that with the exception of this interview, I will continue to write all EndoBlog content myself, and I will continue to bring you the latest from the world at large on the endo front, so that those of you who are EndoBloggers can continue to stay one step ahead of everyone else.

Share your thoughts on AI, the interview and the future in the comments!

This weekend, we've been invited to an incredibly interesting discussion on the subject, where we'll get to the bottom of the benefits, risks and side effects. Stay tuned for more info In EndoMail!