What might be the cause for the emerging inflammatory bowel disease in Saudi outpatients?
Bibliographic record
Abstract
Sir, I read with great interest the study by Al-Mofarreh and Al-Mofleh regarding the emerging inflammatory bowel disease (IBD) in Saudi Arabia.[1] It shows that there was none or only one patient of Crohn's disease (CD) during 1993-2000, but the number increased to three or four cases during 2001-2003 and then jumped to 174 cases in 2009. In contrast, there is not much change in the incidence of ulcerative colitis (UC), suggesting that the observed increase in CD is unlikely to be just due to increased awareness of IBD in the society or increased referral of patients to the clinic. There would be an urgent need to find out the cause of this dramatic increase since the early 2000s. In the last decade, a series of findings made me suspect that dietary chemicals like saccharin and sucralose may have played an important causative role in IBD through their inhibition of gut bacteria and the resultant impaired inactivation of digestive proteases and excessive damage of the mucus layer and the underlying gut tissue. This eventually led me to publish a paper in 2012 with a unified hypothesis on the etiology of IBD,[2] in which I included some evidences collected at that time, such as the remarkable increase of IBD in Alberta of Canada since the early 1990s, in Brisbane of Australia since the middle 1990s, in North California of the United States since the late 1990s, and in southeastern Norway since the middle 2000s, shortly after the approval of sucralose in Canada in 1991, in Australia in 1993, in the United States in 1998, and by the European Union in 2004. After the publication of that paper, more evidences are accumulating, such as the recent study showing a remarkable increase of pediatric IBD, also mainly CD, in Singapore since the beginning of this new millennium,[3] which happened again shortly after the approval of sucralose in Singapore in 1998. As Saudi Arabia approved sucralose around 2000, I recommend checking out the possible link between sucralose and the recent emergence of IBD in this country.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".