Of course!

Thanks for your question u/CatKitKatCat!

How is it possible that a person can have totally normal colonoscopy results even if they have such severe gut issues?

This is a very frustrating issue that we get asked about all the time.

A colonoscopy is mainly focused on examining the colon for growths (such as polyps), inflammation and other physical abnormalities such as sores. As a result, colonoscopies are great when it comes to detecting things such as colon cancer and in most cases Crohn’s and Colitis (visible inflammation), but are of little value when it comes to something such as IBS. Except when ruling out other conditions of course. In the case of IBS, which is not a single condition but instead a combination of symptoms caused by gastrointestinal dysfunction, it is highly unlikely anything indicating its presence would be seen. This is an issue that is also experienced in the case of celiac disease and some drug side effects.

If a person has ‘absorption issues’ with low vitamin/mineral levels, how does the gut influence that?

Another great question!

Malabsorption of vitamins and minerals is a big concern for those with conditions such as IBD. In the case of Crohn’s, up to 75% of patients might be malnourished. There are a few reasons for this: their intestines are too inflamed to properly absorb nutrients, their microbiome has been impacted so they are unable to produce the necessary vitamins ‘themselves’, and they might simply be eating less due to the medications they’re taking or the symptoms they’re experiencing.

Different vitamins and minerals are also absorbed at different points along the digestive tract. So if a patient’s Crohn’s is primarily localized to their ileum they would have issues absorbing vitamin B12 since this is the only place in the body it can be absorbed.

If you’re curious to learn more, we wrote a blog post to break down how the different areas of the gut are responsible for absorbing different vitamins and minerals! Feel free to check it out!

https://www.injoy.bio/post/nutrition-and-ibd-why-you-could-be-missing-out-on-key-nutrients

LC

Thanks for the question!

One potential explanation is that gas is moving through your intestines along with your stool, but there is more gas being produced than can escape at a given time. Intestinal gas is produced by the fermentation occurring when the bacteria in your gut digest the foods you are giving them. Several different types of food have been associated with increased gas production, including beans, peas, lentils, and cruciferous vegetables. One common characteristic of these foods is the large amount of soluble fiber, which is digested by bacteria in your gut and leads to gas production.

Figuring out which foods trigger an uncomfortable amount of gas for you can be tricky and takes a lot of trial and error. It’s one of the features of our app we’re most proud of! We want to be doing everything we can to help people understand their gut as quickly as possible so they can avoid any GI discomfort in the long run.

-RM

What are tests you would recommend people with digestive problems?

Awesome, thank you for answering!

Speaking by anecdotes, I, seem to have issues with anything store bought/processed gluten. It's not even minor either it's pretty severe reactions. However, if I were to go and buy a bag of whole wheat flour, or even make my own flour from scratch with a blender and use that on recipes to make my own bread and other gluten products, I seem to have 0 issues.

I haven't put my finger on what it could be I check very carefully on labels now and try to make comparisons of products that flare me up although lately I've just eliminated most processed foods from my diet anyways since the recent findings that ultra processed foods is a leading cause of cancer.

Maybe it's the way they process the gluten these days or mixture of cheaper products/oils/ sugars/ flavors comparatively to about ten years ago. Whatever it is, it's in everything now. I have no choice but to avoid anything that isn't whole foods.

Ive heard a month to reset tolerance on LSD and that seems to be anecdotally true

Great question u/IndyDude11 !

For the most part, lactose intolerance comes down to your genes and is not something that can be restarted, but instead supported. Believe it or not, less than half of the global population are able to produce enough lactase into adulthood to comfortably consume dairy regularly.

That being said, there have been some interesting publications that have looked into using probiotics to improve one’s ability to digest lactose and even the use of prebiotics to feed/sustain the lactose digesting bacteria. So there is potential for this being a solution in the future! But for now lactase pills are the best option for those with lactose intolerance.

Here are some papers if you’re interested!

https://pubmed.ncbi.nlm.nih.gov/30332787/

https://link.springer.com/article/10.1007/s12602-018-9507-7

LC

Do you mind if I ask how it ruined your life?

How is it possible that a person can have totally normal colonoscopy results even if they have such severe gut issues?

If a person has ‘absorption issues’ with low vitamin/mineral levels, how does the gut influence that?

Thanks for the question!

Several studies have found altered, or ‘dysbiotic’, gut microbiomes in patients with Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS). A review of these papers found little agreement between them on what the specific changes to the gut microbiome were though. The link between ME/CFS and the gut microbiome is also evident by the improvement in self-reported symptoms after a short course of antibiotics in some patients (https://pubmed.ncbi.nlm.nih.gov/26779319/).

Despite evidence that the gut microbiome is linked with ME/CFS, it is unclear how to improve the disease with microbiome targeted treatments. Some of the treatments being explored include specific probiotics, fecal microbiota transfer (FMT), and dietary interventions. Further research is needed to determine what microbiome targeted treatment can improve these patients microbiome and their symptoms though.

-RM

Great question u/emiredlouis !

Acid reflux, commonly referred to as heartburn, happens when stomach acid makes its way into the esophagus.

This can be triggered by many different things, such as acidic/spicy/fatty foods, certain medications (OTC painkillers), stress and anxiety and more.

So in short, try and take note of the foods you’re eating prior to feeling symptoms of heartburn, try to avoid them, and see if this reduces your discomfort. Just keep in mind that foods are not the only possible culprits.

For most people getting a little heartburn after a large meal is not an issue. It’s when this becomes a chronic issue that you should consider consulting a physician.

I’ll include a great article here from Ceders-Sinai with background on acid reflux and some of the potential triggers that are out there.

Hope this helps!

LC

In a person who isn’t constipated, why does the poop move through but gas stays trapped in both upper and lower gi? I have no trouble with daily BMs, often feel it urgently, but still bubble with gas all around my abdomen. I can’t make sense of why/how the poop moves but gas doesn’t.

I had H Pylori a few years ago and it really went qute bad for me. Ended up needing two blood transfusions etc.

Is there anything I can specifically do myself to mitigate it happening again? It's always a lingering worry at the back of my mind.

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>Is it possible to rebuild the microbiome after taking broad-spectrum antibiotics? Thank you.

Thanks for your question u/MasterPainting5098 !

I get asked all the time about how antibiotics impact the microbiome. Long story short, the science is still evolving on this subject and there’s no magic bullet solution. While there’s lots of discussion going around about using probiotics, fecal microbiota transplants, phage therapy, and other interventions, there’s not enough research or accessibility of these options for us to confidently support them at this time.

That being said, there are a number of things that are known to help healthy bacteria grow, thrive, and populate the gut.

-Try the Mediterranean diet. The variety of foods rich in fibers, vitamins, minerals, omega 3 fatty acids, and more nutrients feed your gut bacteria, helping them survive and produce byproducts needed for healthy digestion.

-Incorporate fermented foods and beverages, such as sauerkraut and kefir, into your diet. Fermented products contain beneficial bacterial species that can help restore the gut microbiota.

-Reduce your sugar and artificial sweetener consumption, as these products can increase inflammation or lead to further imbalance in the gut microbiome.

FYI I took some of these tips from a blog post we wrote where we combine research from ~10 peer-reviewed publications on this topic. Hope you find it useful!

https://www.injoy.bio/post/antibiotics-can-they-really-mess-up-your-gut

LC

My response is to go ahead and prosecute more people over it. Don't let people get away with crime. The people who's prosecutions you're upset over all broke the law.

Once you become lactose intolerant, is there any way to restart the production of lactase?

>Why does stomach inflammation happen in general? And for a person who experiences stomach inflammation from eating certain foods, why does it only happen when that person eats certain foods?

Thanks for your question u/PeanutSalsa !

If you’re referring to gastritis, there are a few reasons this might arise.

In short, gastritis occurs when the balance between the mucosal lining of the stomach and the production of stomach acid begins to fall apart.

This can happen for several reasons such as infection by bacteria or viruses (Helicobacter pylori being a common one), Alcohol/painkiller consumption, and food poisoning, all the way to more autoimmune reasons, such as your immune system destroying the mucus producing cells. Even your lifestyle can cause acute inflammation if you are stressed or struggling with depression.

If you’re more curious about food triggers causing gastrointestinal symptoms…so are we!

As you said in your question, certain foods can trigger symptoms in some but not others. This is mainly due to the muscles within the gastrointestinal tract responding to hormones and other compounds that are released during digestion. The problem is, the gut’s response to foods will differ person to person. For some, eating foods high in dairy can cause diarrhea because they are unable to digest lactose (a type of sugar). For others, dairy might be fine, but they might experience severe GI distress after eating FODMAP foods, such as apples, because they are unable to break down and absorb the sugars that are present.

It’s important to note that triggers aren’t always dietary. Stress can cause GI discomfort as well. Similar to how you might feel like you need to go to the bathroom right before a big meeting.

Identifying food triggers is tricky and takes a lot of trial and error. It’s one of the features of our app we’re most proud of]! We want to be doing everything we can to help people understand their gut as quickly as possible so they can avoid any GI discomfort in the long run.

Hope this helps!

LC

Are you referring to the time he was jailed over donating 10k to his friends campaign? In the history of thr united states, he is the only prosecution of campaign donation being over limit.

Like no arguing, just adult conversation, but when you hear that he's the only person to ever to be punished for it, why doesn't that give a you pause and wonder why the DNC would want to punish him in the form of a 2 teered justice system?

>Do you think drinking kombucha is good for gut health?

Thanks for the question!
Kombucha falls into the category of fermented foods which are foods or beverages produced with live cultures of microbes. Fermented foods contain live, beneficial bacteria that can lead to improvements in your gut microbiome. In addition, they contain a lot of compounds formed through the process of fermentation that are beneficial to you and the bacteria already in your gut (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306734/).
A recent study looked more closely how fermented foods alter a person’s gut microbiome. In this study, they showed that fermented foods increased the diversity of bacteria found in the gut. Diversity is a common measure used to characterize the gut microbiome, and generally the greater the diversity the healthier and more stable the person’s gut microbiome. Interestingly, few of these bacteria were actually from the fermented foods in the people’s diets. The study suggested it was because of the other components of the fermented foods, such as compounds produced during fermentation, that provide a more hospitable environment to new bacteria (https://pubmed.ncbi.nlm.nih.gov/34256014/).

-RM

Hey /u/cozyessi,

I'm happy to hear that the antibiotics helped. SIBO is tricky and still very poorly understood. I'm going to list some recommendations for maintaining a healthy microbiome below:

FoodThe low FODMAP diet has been shown to be effective at helping prevent SIBO recurrence.In general, you can improve your gut microbiome health by adding fermented foods, such as kombucha, kefir, yogurt, kimchi, to your diet. Fermented foods contain live, beneficial bacteria that can lead to improvements in your gut microbiome. In addition, they contain a lot of compounds formed through the process of fermentation that are beneficial to you and the bacteria already in your gut.

However, as a SIBO patient, some of these may worsen your symptoms. The response to diet is highly personalized and I would recommend you try some of these things to see what improves.Lastly, lifestyle aspects have been associated with features of a healthy gut microbiome. Specifically, some studies have identified links between good sleep quality and exercise with positive improvements in the gut microbiome.

It also sounds like fatigue is something that is bothering you. Fatigue can be caused by many different things, so I will give you an answer in the context of the microbiome. Often, when our digestive system is out of balance, we can develop inflammation in our gut, especially in the context of SIBO. This inflammation has been linked with brain fog and fatigue-like symptoms. I would see if there's a link between your digestive symptoms and your fatigue as a first step. As you address your digestive symptoms, your fatigue could improve in parallel.

Thank you !

-RK

>oral microbes to the gut? Namely, P. gingivalis, H. parainfluenzae, and A. actinomycetemcomitans. Are we missing something? Well I know the physicians are missing it but as researchers, why is this often overlooke

Thanks for the question! There have been many papers describing the oral microbiome and its connection with the gut microbiome. As you mentioned, both of these microbiomes are part of the larger digestive donut and it is not surprising that bacteria are able to travel from the oral to gut microbiomes. Similar to the gut microbiome, the oral microbiome has also been shown to be disrupted in patients with Crohn’s disease (https://academic.oup.com/ecco-jcc/advance-article/doi/10.1093/ecco-jcc/jjac063/6577053) and Ulcerative Colitis (https://www.frontiersin.org/articles/10.3389/fped.2020.620254/full). Although it is still unclear whether these changes to the microbiome are causative or a result of the disease. With IBD primarily active in the lower GI tract, it is easy to see why a lot of research has focused on the gut microbiome and the bacterial activity in these regions. As we aim to better understand these diseases, it is important to consider the data in the context of the whole body and how the changes in the oral microbiome coincide with those changes we see in the gut microbiome. -RM

Is it possible to rebuild the microbiome after taking broad-spectrum antibiotics? Thank you.

Have there been any findings linking biome health and chronic fatigue and/or chronic fatigue syndrome (i.e., longer-term post-viral conditions)? And if so, is there any idea what the best solution/treatment plan is for it?