What is going on with my digestive system?
January 16, 2021 9:09 AM   Subscribe

I have a gastroenterologist. You are not him. But I hope someone can shed some light on unusual changes that have occurred recently with my gastrointestinal tract. Content warning: Some gross descriptions of my GI function.

Last summer, I suddenly developed some kind of food intolerance. After eating a meal, I would get bloating and very foul flatulence. And my stools became loose. I never had any significant abdominal pain or anything that suggested a medical emergency. Some foods triggered me worse than others. The worst were beans (and related legumes) and certain kinds of fruit. But basically any food could cause the symptoms, though not 100% consistently. Some meals were uneventful.

These symptoms persisted for three months or so. I finally made an appointment with a gastroenterologist, and I was seen by his physician's assistant. She really didn't have much insight, but she ordered two tests: Sensitivity to gluten (came back negative), and a barium swallow (everything looked normal).

I was supposed to return for a follow-up appointment with the physician's assistant, but I canceled it, at least for now. First off, she didn't really inspire me with confidence in her abilities. More importantly, my GI tract went back to normal. I've had no symptoms for two months or more. In fact, my digestion is better than normal now. Even before I experienced these recent problems, eating a serving of beans would consistently give me a moderate amount of flatulence. Now, I can eat a bowl of Mexican chili and have very little gas – much less gas than in the past. It's just bizarre.

I'm trying to puzzle this out. Was there some kind of disturbance in my intestinal flora, and it ended up being resolved via a regrowth of better-than-normal flora? Any advice on what I should do to avoid having this happen again in the future?
posted by alex1965 to Health & Fitness (14 answers total) 3 users marked this as a favorite
Best answer: Yeah, I think you just picked up some kind of intestinal bug that threw things out of whack for awhile. I've had similar things hit me, and my gastro person was equally clueless, and things eventually worked back to normal. Glad things have sorted them out for you! Enjoy the chili!
posted by Thorzdad at 9:34 AM on January 16, 2021

Best answer: All I can suggest is the general advice for gut health: routinely eat naturally* fermented foods (kimchi, sauerkraut, kefir, kombucha, miso, tempeh, probiotic yogurt), and foods with prebiotic fiber (flax seed is probably the easiest to add without much work, but diversity is an important factor in prebiotic/insulin effectiveness).

*This is a real term of distinction - the kind of pickles made in mostly vinegar are not fermented in a way that generates probiotics, but there are plenty of super easy home pickle (generic pickle, not necessarily cucumber) recipes that use a small amount of vinegar only for flavor and acidity and that's fine.

As far as home pickling and fermentation, you can find a million pages and videos about doing this yourself, it's very easy. You don't HAVE to have equipment to do this, but I am using Jillmo lids and weights as I am still pretty new to it myself and I find this pretty foolproof.

I have had a similar experience to you, where something Abruptly Went Wrong and I had months of trouble and then things got better. I suspect this is extremely common but we don't think about it that way and we don't tend to talk to each other about it, and many people never see a doctor about it so there's not very good data.
posted by Lyn Never at 9:47 AM on January 16, 2021 [3 favorites]

Best answer: I agree with Thorsdad, maybe look up the symptoms for giardia and see if they match. Giardia can resolve on its own and it doesn't always show up on a test.
posted by InkaLomax at 10:14 AM on January 16, 2021 [1 favorite]

Speculation: whatever major problem microbiota colonized your digestive system (and have since been kicked out for being a menace) evicted the former colony that had been giving you your prior minor gut issues.
posted by aniola at 10:21 AM on January 16, 2021 [1 favorite]

Here is a good website on fermenting.
posted by aniola at 10:22 AM on January 16, 2021

"Flora" really doesn't do justice to what lives in our guts. It's a jungle in there, and everybody's jungle is different which makes them hard to study, and every now and then something novel will get in there and succeed for a while at the microbiological parallel to land clearing for palm oil. What grows back afterward will often be somewhat different to what came before.
posted by flabdablet at 10:23 AM on January 16, 2021 [1 favorite]

I agree, it sounds to me like you possibly had some sort of gut infection that threw everything off for a bit. I had something similar happen to me a few years ago, but it lasted for much longer. I saw my PCP, a gastro specialist, a naturopath, and a therapist. From my experience and research, I concluded that I had gotten some sort of gut infection (I had been traveling in Spain) and because I was under stress in my personal life, the symptoms just lasted longer for me.

As for advice, one thing that really helped me were butyrate supplements.
posted by Shadow Boxer at 10:30 AM on January 16, 2021

Great advice upthread. I also have very grumpy innards at times. For me stress is also a factor in tummy happiness, as I tend to be very anxious and goodness knows there are lots of things to be anxious about lately. :-/

I take Wellbutrin and it put my digestion out a whack for a while. I added a fiber supplement and that helped me greatly.
posted by dorkydancer at 10:30 AM on January 16, 2021

By the way, the upper digestive tract is a complete torture track for gut microbes, which is why all the effective over-the-counter probiotics are supplied in enterosoluble capsules.

If you want to experiment with your own selection of of live organisms, introducing them via a 5ml syringe (with no needle!) lubricated and slipped in where the sun don't shine is much more effective than swallowing them. Plain unsweetened live-culture yoghurt administered this way has had rapid positive effects on my own gut several times. If you find a mixture that works for you, you'll feel the difference within a day. And there's no need to try to get it in any deeper than a small syringe makes easy. Bacteria are quite mobile once given a start in an environment that isn't actively trying to acid-burn them to death.

Pumpkin provides really useful amounts of dietary fibre. You can add a fair bit of it into a lot of different recipes without altering the taste much, and such alteration as does happen tends to be an improvement.
posted by flabdablet at 10:46 AM on January 16, 2021

nthing that you ate something specific that messed up your gut flora for a while. But if you do want to figure out if you have specific GI triggers you could try a low-FODMAP diet. Monash University has tons of info about how to properly reintroduce foods to test for an intolerance, including recipes and meal plans. (source: this is what my GI doctor sent me when I was considering a low-FODMAP diet, although it turns out my issue was actually SIBO) (it may also turn out that you had SIBO)
posted by capricorn at 10:53 AM on January 16, 2021

Best answer: Last summer, I suddenly developed some kind of food intolerance. After eating a meal, I would get bloating and very foul flatulence.

This sounds like Giardia.

Interesting that you got better after the barium swallow, because Giardia are protozoan, and heavy metals are toxic to protozoans (note that they are particularly hard on the ciliated, which Giardia happen to be).

And there is some evidence barium is toxic to Giardia in the fact that barium swallows tend to suppress positive tests for Giardia beyond the point where any barium is left in the system.

Which might be a clue to something you could do if you have a recurrence and your doctor is similarly baffled, because bismuth also suppresses positive tests for Giardia and is available over the counter in the form of Pepto-Bismol.

That your digestion is better than ever suggests you might have had a little GI overgrowth of other protozoa, and the barium quelled that as well.
posted by jamjam at 11:12 AM on January 16, 2021 [3 favorites]

I am not a doctor, but I am a person who has experienced a full-blown giardia infection. I won't gross you out with precisely what that meant for my gut at the time, but you can Google it and find out for yourself. What you are describing sounds an awful lot like giardia, which as I understand it, has about a 6 week to 2 month duration. It was truly a horrible experience, one that I hope never to repeat. (Incidentally, like Shadow Boxer, I picked my case up in Spain, courtesy of a bus station sandwich.)
posted by pleasant_confusion at 7:41 PM on January 16, 2021

heavy metals are toxic to protozoans

There is ongoing research to find out whether the same applies to viruses.
posted by flabdablet at 10:27 PM on January 16, 2021

Note sufficient heavy metals are also toxic to people, so not recommended for home experimentation/supplementation. (A dose of pepto when your stomach is acting up, sure.) That's always a key challenge in getting from "kills X in a lab" to "is a medicine that treats X".
posted by Lady Li at 8:55 AM on January 17, 2021 [1 favorite]

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