Trying to figure out what’s happening with my unhappy digestive system
March 19, 2022 11:32 PM Subscribe
For a few months now, I’ve been struggling with some digestive issues. I’ve been unable to sort it myself, so made an appointment with a dietician. Had to wait 5 weeks for the appointment, then 2 hours before she cancelled due to illness. Fair enough! But looks like I have to wait another 5-6 weeks to be seen and I would like to figure out the best way to utilise that time so I have more data to work with when I see her. Vaguely gross details within.
Initially I decided not to change anything in what I’m currently eating because I felt like I could just keep a food diary and wait for her input. But I really don’t feel good most days, and I am not wanting to spend another 5 weeks feeling like this. I feel like there must be something I can do to at least troubleshoot or gain more understanding of what is happening in my gut.
In August of last year, my city went into an extremely locked down lockdown due to Omicron entering the country. I was performing research for my dissertation at the time, so I basically transitioned from being pretty active and eating a mostly fine diet to sitting at my desk, barely getting any exercise and eating like absolute shit almost every day. This went on for 3 or 4 months. Over this time I definitely put on a fair amount of weight (I’d ballpark about 8 kg).
I emerged from this stressful time determined to up my exercise and improve my diet. I had a very good go at both and have been pretty successful. However, I seem to have been left with some mild but very persistent digestive issues that don’t seem obviously tied to anything.
The general symptom lowdown:
- I get mild to moderate bloating and distention in my lower abdomen almost every night. It doesn’t happen during the day and seems to happen regardless of what I ate that day. It happens post-dinner but not immediately after
- it’s typically gone by morning, though sometimes I am still a little bit gassy on my walk to work
- definitely quite farty while it’s happening. Gas is typically not bad-smelling, but occasionally is. Not often though
- bowel motions are definitely on the constipated end of the Bristol Stool scale but are frequent (it’s common for me to poop multiple times a day, even before my issues started). My water intake doesn’t seem to affect how constipated I get
- doesn’t seem to be tied to gluten or dairy, specifically
- no burping
- no notable pain. I feel the pressure of it and it’s not exactly comfortable but I wouldn’t say I get wind pains or cramps as such.
- weirdly seems to happen more the ‘healthier’ I eat. If I have a day eating high fat/high sugar/very processed takeways etc. I often feel relatively good in the evening, and I tend not to have constipation the next day
My diet is mainly comprised of veggies, eggs, chicken, soft cheeses, rice, pasta, bananas, plain unsweetened yoghurt, low sugar granola/museli, tomato-based sauces, and random dinner simmer sauces from the supermarket. Bread is a part of my diet sometimes, but I don’t keep it in the house. Will 100% admit to drinking a glass or two of sugar-free soda most days and acknowledge I’ll probably have to give this up, but I’ve done this for years so it’s not new behaviour. The gas still happens regardless of soda intake.
My assumption is that because I essentially lived on sugar for months that I’ve fucked up my gut microflora. I thought if I continued to focus on veggies and protein and cut way down on sugar, over time it would get better. It has not. I have not tried a probiotic yet because I’m aware a lot of them are a waste of time so was waiting to get a recommendation from the dietician. Am definitely willing to go this route, though.
I’ve considered trying a low FODMAP elimination diet. I know doctors and dieticians hate it when you go off and do this shit by yourself but I think I’m educated enough about food (have a food sci and micro degree) and aware enough of my body after paying uncomfortably close attention to it for months now that it would be manageable.
Though I know it's a very obvious solution, I haven't tried going to a GP. I went from being a student to moving to a new city, so I don't have one yet. And from past experiences, I've found GPs aren't real great at stuff that is digestion related. Figured I'd see what a dietician had to say and would agree to see a doctor if they thought it was the better route.
Any ideas on what I could try? Thanks so much.
Initially I decided not to change anything in what I’m currently eating because I felt like I could just keep a food diary and wait for her input. But I really don’t feel good most days, and I am not wanting to spend another 5 weeks feeling like this. I feel like there must be something I can do to at least troubleshoot or gain more understanding of what is happening in my gut.
In August of last year, my city went into an extremely locked down lockdown due to Omicron entering the country. I was performing research for my dissertation at the time, so I basically transitioned from being pretty active and eating a mostly fine diet to sitting at my desk, barely getting any exercise and eating like absolute shit almost every day. This went on for 3 or 4 months. Over this time I definitely put on a fair amount of weight (I’d ballpark about 8 kg).
I emerged from this stressful time determined to up my exercise and improve my diet. I had a very good go at both and have been pretty successful. However, I seem to have been left with some mild but very persistent digestive issues that don’t seem obviously tied to anything.
The general symptom lowdown:
- I get mild to moderate bloating and distention in my lower abdomen almost every night. It doesn’t happen during the day and seems to happen regardless of what I ate that day. It happens post-dinner but not immediately after
- it’s typically gone by morning, though sometimes I am still a little bit gassy on my walk to work
- definitely quite farty while it’s happening. Gas is typically not bad-smelling, but occasionally is. Not often though
- bowel motions are definitely on the constipated end of the Bristol Stool scale but are frequent (it’s common for me to poop multiple times a day, even before my issues started). My water intake doesn’t seem to affect how constipated I get
- doesn’t seem to be tied to gluten or dairy, specifically
- no burping
- no notable pain. I feel the pressure of it and it’s not exactly comfortable but I wouldn’t say I get wind pains or cramps as such.
- weirdly seems to happen more the ‘healthier’ I eat. If I have a day eating high fat/high sugar/very processed takeways etc. I often feel relatively good in the evening, and I tend not to have constipation the next day
My diet is mainly comprised of veggies, eggs, chicken, soft cheeses, rice, pasta, bananas, plain unsweetened yoghurt, low sugar granola/museli, tomato-based sauces, and random dinner simmer sauces from the supermarket. Bread is a part of my diet sometimes, but I don’t keep it in the house. Will 100% admit to drinking a glass or two of sugar-free soda most days and acknowledge I’ll probably have to give this up, but I’ve done this for years so it’s not new behaviour. The gas still happens regardless of soda intake.
My assumption is that because I essentially lived on sugar for months that I’ve fucked up my gut microflora. I thought if I continued to focus on veggies and protein and cut way down on sugar, over time it would get better. It has not. I have not tried a probiotic yet because I’m aware a lot of them are a waste of time so was waiting to get a recommendation from the dietician. Am definitely willing to go this route, though.
I’ve considered trying a low FODMAP elimination diet. I know doctors and dieticians hate it when you go off and do this shit by yourself but I think I’m educated enough about food (have a food sci and micro degree) and aware enough of my body after paying uncomfortably close attention to it for months now that it would be manageable.
Though I know it's a very obvious solution, I haven't tried going to a GP. I went from being a student to moving to a new city, so I don't have one yet. And from past experiences, I've found GPs aren't real great at stuff that is digestion related. Figured I'd see what a dietician had to say and would agree to see a doctor if they thought it was the better route.
Any ideas on what I could try? Thanks so much.
Oh! It could also be that you are eating overly quickly or overly much on the healthier food days than the high calorie days, because you still need that energy boost and it can be much slower when you are not eating something front loaded with simple carbs and energy. I was starving hungry while eating constantly pre diagnosis for a bit and I would just consume my meals at speed and then feel awful afterwards. I don't know if adding some snacks spaced through the day and seeing if eating slower helps might make a difference?
posted by MarianHalcombe at 12:54 AM on March 20, 2022
posted by MarianHalcombe at 12:54 AM on March 20, 2022
I'm not a doctor, but if it's something like colitis or Crohn's, then there may not be much you can do (vis a vis diet and exercise) without the help of a medication. I say that based on my own experience (caveat: data point of one). Your symptoms sound similar to what I experienced before I was diagnosed. I hope you find a solution soon.
posted by johnxlibris at 1:24 AM on March 20, 2022 [2 favorites]
posted by johnxlibris at 1:24 AM on March 20, 2022 [2 favorites]
I am not a fear monger, but I am a survivor. If you have female reproductive organs you could ask your doctor for a CA125 test. For me, bloating turned out to be a symptom of ovarian cancer. There are no one-stop-shop definitive tests, but a CA125 blood test will report if general markers are raised.
posted by Thella at 1:28 AM on March 20, 2022 [5 favorites]
posted by Thella at 1:28 AM on March 20, 2022 [5 favorites]
Response by poster: Thanks everyone for the suggestions so far, there is some interesting stuff in here that I can definitely work into my troubleshooting.
I probably should have mentioned, I am a cis-woman in my late 30s so stuff like ovarian cancer would potentially be applicable to me. I think I'll prioritise getting GP recommendations from friends and workmates just in case I need to pursue this.
posted by BeeJiddy at 1:35 AM on March 20, 2022 [2 favorites]
I probably should have mentioned, I am a cis-woman in my late 30s so stuff like ovarian cancer would potentially be applicable to me. I think I'll prioritise getting GP recommendations from friends and workmates just in case I need to pursue this.
posted by BeeJiddy at 1:35 AM on March 20, 2022 [2 favorites]
From the many anecdotes from my extended family, I feel like any dietician who wouldn’t first want to see some test results of the sort you would get from a GP is not worth paying attention to or paying for. You are right to prioritize finding a doctor. You may also in the interim have various ways to get things like bloodwork done depending on your insurance and local labs and different kinds of telehealth services.
I did read your question and think that it sounds like you might be having trouble with the increased fiber during your “healthy” eating days. (Healthy is in scare quotes because I really dislike using that kind of moralizing language around specific foods.) I would suggest trying to make your fiber intake more consistent by finding a supplement or shortcut kind of item to have on your other days, so your system acclimates to it. Go very slow though, don’t just start having like three fiber meal bars or anything.
posted by Mizu at 2:25 AM on March 20, 2022 [1 favorite]
I did read your question and think that it sounds like you might be having trouble with the increased fiber during your “healthy” eating days. (Healthy is in scare quotes because I really dislike using that kind of moralizing language around specific foods.) I would suggest trying to make your fiber intake more consistent by finding a supplement or shortcut kind of item to have on your other days, so your system acclimates to it. Go very slow though, don’t just start having like three fiber meal bars or anything.
posted by Mizu at 2:25 AM on March 20, 2022 [1 favorite]
It doesn't sound like your diet is particularly problematic, so I'm not sure a dietician would help. I agree that GP would be the first step--ovarian cancer was my first concern, followed by some sort of inflammatory bowel disease. If their tests are inconclusive, then maybe a gastroenterologist. And then a dietician, if the GP or GI thinks a diet change might help.
posted by hydropsyche at 4:58 AM on March 20, 2022 [2 favorites]
posted by hydropsyche at 4:58 AM on March 20, 2022 [2 favorites]
I had somewhat similar issues, though some of my symptoms were different. I saw a physician assistant (PA) who recommended taking oral probiotics. I ended up using Physician's Choice 60 Billion Probiotic and Culturelle. My digestive problems resolved within about three months. It's hard for me to know whether the probiotics helped or not. The PA didn't seem knowledgeable and wasn't really helpful with regard to diagnosing the root cause of the problem. Also, I think a gastroenterologist would be better than a dietician in this case.
posted by alex1965 at 5:30 AM on March 20, 2022
posted by alex1965 at 5:30 AM on March 20, 2022
I'd do a three day water fast, and break it with two heaped dessertspoons of psyllium husk stirred thoroughly into a cup of full fat live culture yoghurt.
I've been eating only one day in four on average for the last six months, and those three day fasts are always enough to clear out pretty much all of what was already in my gut. The first bowel motion after breakfast happens pretty urgently about an hour after eating, and is always recognizably composed mostly of whatever I ate to break the fast.
That used to be an unpleasantly dramatic and almost entirely liquid affair until I worked out that I could send a big bolus of properly wetted psyllium husk through as an advance guard, half an hour before eating anything else. Now it's fine every time. And if I use yoghurt instead of water to wet the husk, not only is it not disgustingly slimy to eat but it preloads my gut with useful amounts of good bacteria too.
The bacterial cultures in yoghurt don't usually survive well in the acid environment of the stomach, but after a three day fast my stomach doesn't seem to want to do much at all with its first meal before waving it straight on through the checkpoint. I've certainly seen great improvements in gut behaviour on the rest of breakfast day since switching from psyllium husk and water to psyllium husk and yoghurt as the very first thing I eat.
Even if you're not willing to try clearing the decks beforehand with a longish fast, one daily dessertspoon of psyllium husk thoroughly stirred into at least a cup of something almost entirely liquid, preferably before the rest of breakfast, will probably help you. It's the best all-round poo improver I've ever found.
posted by flabdablet at 5:30 AM on March 20, 2022 [3 favorites]
I've been eating only one day in four on average for the last six months, and those three day fasts are always enough to clear out pretty much all of what was already in my gut. The first bowel motion after breakfast happens pretty urgently about an hour after eating, and is always recognizably composed mostly of whatever I ate to break the fast.
That used to be an unpleasantly dramatic and almost entirely liquid affair until I worked out that I could send a big bolus of properly wetted psyllium husk through as an advance guard, half an hour before eating anything else. Now it's fine every time. And if I use yoghurt instead of water to wet the husk, not only is it not disgustingly slimy to eat but it preloads my gut with useful amounts of good bacteria too.
The bacterial cultures in yoghurt don't usually survive well in the acid environment of the stomach, but after a three day fast my stomach doesn't seem to want to do much at all with its first meal before waving it straight on through the checkpoint. I've certainly seen great improvements in gut behaviour on the rest of breakfast day since switching from psyllium husk and water to psyllium husk and yoghurt as the very first thing I eat.
Even if you're not willing to try clearing the decks beforehand with a longish fast, one daily dessertspoon of psyllium husk thoroughly stirred into at least a cup of something almost entirely liquid, preferably before the rest of breakfast, will probably help you. It's the best all-round poo improver I've ever found.
posted by flabdablet at 5:30 AM on March 20, 2022 [3 favorites]
After reading this article, I changed my diet a lot to fit in with the recommendations in it. It has really helped a lot. Unfortunately, if your problem is with your gut micro biome, it can take a long time to get back to a healthy enough situation that you can "sin" sometimes, don't ask me how I know.
Also, start slowly, don't go from 10 grams of fiber to 30 in one week.
I’ve done this for years so it’s not new behaviour
You can go on with mildly unhealthy habits for years and years if your baseline was good. And then suddenly you can't at all. I think the late 30's is quite typically when the system begins to protest, it happened to me and a lot of my friends.
posted by mumimor at 6:37 AM on March 20, 2022
Also, start slowly, don't go from 10 grams of fiber to 30 in one week.
I’ve done this for years so it’s not new behaviour
You can go on with mildly unhealthy habits for years and years if your baseline was good. And then suddenly you can't at all. I think the late 30's is quite typically when the system begins to protest, it happened to me and a lot of my friends.
posted by mumimor at 6:37 AM on March 20, 2022
As a small test, you might try eliminating the diet soda (artificial sweeteners are high on the Low FODMAP list of things to avoid). Even switching to a cane-sugar based soda (like Mexican Coke or some of the smaller brands) will be a pretty quick indicator of whether those sweeteners are the issue.
posted by mollymillions at 8:35 AM on March 20, 2022
posted by mollymillions at 8:35 AM on March 20, 2022
Sorry you're having these issues, it sucks and it can take a while to get a proper diagnosis and treatment and if they don't find anything specific like celiac disease then it can take a lot of trial and error to find what works for you to alleviate symptoms.
For years I had horrible IBS of the constipation kind, with awful abdominal distension and gas that wouldn't pass so I ballooned up and couldn't go to the bathroom and that in turn caused nausea and lack of appetite for days, it would flare up routinely and then I'd get some respite but it was exhausting. The gas could be so bad a couple of times I had such pain in my guts I had to go to the ER in fear something was ruptured, but they just gave me Buscopan and that only helped short term. I went to see both GP kind of doctors and gastroenterologists, did a lot of tests, they ruled out celiac disease, lactose intolerance, inflammatory bowel diseases but from stool tests it did turn out my gut flora was all messed up (no wonder because I had to take a lot of general antibiotics repeatedly in the space of a few years, for other issues).
Here's what worked for me:
- a few repeated cycles of a specific antibiotic which is given mainly for SIBO (bacterial overgrowth of the small intestine) but which many doctors have started using also for general IBS because it seems to regulate the intestinal flora by targeting the bad bacteria and leaving the good ones alone, it's called rifaximin. I did a lot of my own research and read a lot of clinical trials abstracts and such, if you go to Google scholar and search for rifaximin IBS you can have fun there's just so much that's been published about it
- probiotics, but that's definitely a trial and error thing, one of the most effective for me was a basic one that is usually given for traveller's diarrhea paradoxically, not for constipation, but I guess it does regulate the gut bacteria so it did work for me too. It's called saccharomyces boulardii. Again if you wanna have fun Google scholar "saccharomyces boulardii irritable bowel". I also saw improvements with other probiotics that were a mix of different strands.
- no fiber! Fiber of any kind would only exacerbate my symptoms, especially the gas, and it really didn't help with constipation in fact made it worse. My gut bacteria were so out of balance that fiber was like adding fuel to the fire. In my extensive googling around I came across both the Fodmap diet and the "low fermentation diet" for SIBO which has been prescribed by specialists at Cedars-Sinai and that worked really really well for me
- antidepressants! Actually had to take those anyway because I developed severe depression, but those cleared up all my GI symptoms better than anything else. No more gas, no more constipation, now I can eat pretty much anything and also have some fiber without any issues, i guess like me my gut bacteria are happier too, go figure.
Tl,dr: until you see a doctor, try the low fermentation diet protocol from cedars-sinai, it's easier than FODMAP and totally worth a try in my experience; also try probiotics like saccharomices boulardii and/or probiotic mixes; when you see a doctor, make sure they prescribe tests for celiac and lactose intolerance and IBD, and then mention treatment for SIBO with rifaximin and see what they think. Antidepressants are sometimes prescribed even just for IBS because they seem to also act on the brain-gut connection so if nothing else helps you could mention that too...
Best of luck!! Please let us know if you try anything and see any improvements, hope you do!
posted by bitteschoen at 8:36 AM on March 20, 2022 [3 favorites]
For years I had horrible IBS of the constipation kind, with awful abdominal distension and gas that wouldn't pass so I ballooned up and couldn't go to the bathroom and that in turn caused nausea and lack of appetite for days, it would flare up routinely and then I'd get some respite but it was exhausting. The gas could be so bad a couple of times I had such pain in my guts I had to go to the ER in fear something was ruptured, but they just gave me Buscopan and that only helped short term. I went to see both GP kind of doctors and gastroenterologists, did a lot of tests, they ruled out celiac disease, lactose intolerance, inflammatory bowel diseases but from stool tests it did turn out my gut flora was all messed up (no wonder because I had to take a lot of general antibiotics repeatedly in the space of a few years, for other issues).
Here's what worked for me:
- a few repeated cycles of a specific antibiotic which is given mainly for SIBO (bacterial overgrowth of the small intestine) but which many doctors have started using also for general IBS because it seems to regulate the intestinal flora by targeting the bad bacteria and leaving the good ones alone, it's called rifaximin. I did a lot of my own research and read a lot of clinical trials abstracts and such, if you go to Google scholar and search for rifaximin IBS you can have fun there's just so much that's been published about it
- probiotics, but that's definitely a trial and error thing, one of the most effective for me was a basic one that is usually given for traveller's diarrhea paradoxically, not for constipation, but I guess it does regulate the gut bacteria so it did work for me too. It's called saccharomyces boulardii. Again if you wanna have fun Google scholar "saccharomyces boulardii irritable bowel". I also saw improvements with other probiotics that were a mix of different strands.
- no fiber! Fiber of any kind would only exacerbate my symptoms, especially the gas, and it really didn't help with constipation in fact made it worse. My gut bacteria were so out of balance that fiber was like adding fuel to the fire. In my extensive googling around I came across both the Fodmap diet and the "low fermentation diet" for SIBO which has been prescribed by specialists at Cedars-Sinai and that worked really really well for me
- antidepressants! Actually had to take those anyway because I developed severe depression, but those cleared up all my GI symptoms better than anything else. No more gas, no more constipation, now I can eat pretty much anything and also have some fiber without any issues, i guess like me my gut bacteria are happier too, go figure.
Tl,dr: until you see a doctor, try the low fermentation diet protocol from cedars-sinai, it's easier than FODMAP and totally worth a try in my experience; also try probiotics like saccharomices boulardii and/or probiotic mixes; when you see a doctor, make sure they prescribe tests for celiac and lactose intolerance and IBD, and then mention treatment for SIBO with rifaximin and see what they think. Antidepressants are sometimes prescribed even just for IBS because they seem to also act on the brain-gut connection so if nothing else helps you could mention that too...
Best of luck!! Please let us know if you try anything and see any improvements, hope you do!
posted by bitteschoen at 8:36 AM on March 20, 2022 [3 favorites]
broad spectrum digestive enzyme supplements
warm water with lemon juice or with apple cider vinegar before a meal or when feeling bloated
herbal teas for digestion (ginger, peppermint) or fermented beverages (kefir, kombucha) to replace the diet soda
eating slowly and mindfully, chewing thoroughly
psyllium husk is a game changer, but start small and ramp up slowly
posted by Former Congressional Representative Lenny Lemming at 9:19 AM on March 20, 2022
warm water with lemon juice or with apple cider vinegar before a meal or when feeling bloated
herbal teas for digestion (ginger, peppermint) or fermented beverages (kefir, kombucha) to replace the diet soda
eating slowly and mindfully, chewing thoroughly
psyllium husk is a game changer, but start small and ramp up slowly
posted by Former Congressional Representative Lenny Lemming at 9:19 AM on March 20, 2022
How often do you eat tomato? Is it worse on the days you do? It took me ages to figure out that nightshades were a bad scene for my guts, so if you're eating a lot of tomatoes, eggplants, etc try cutting them and see if anything changes.
posted by Grim Fridge at 9:22 AM on March 20, 2022
posted by Grim Fridge at 9:22 AM on March 20, 2022
I'd talk to my MD (Source: various digestive ailments which were helped me with medication. She also gave me two sheets: one what to eat when flaring up, and one what to eat when stable.)
posted by intrepid_simpleton at 9:30 AM on March 20, 2022
posted by intrepid_simpleton at 9:30 AM on March 20, 2022
I'd ask them to reschedule more promptly since they canceled.
In 5 weeks, you could do a trial of either no gluten or no dairy. It's very common for adults to lose their ability to digest lactose as they get older. The ability to digest dairy is more an exception than the rule, globally. Another option is to add probiotic/ prebiotic foods like kimchi or fresh sauerkraut. Dietary changes can take weeks to show results.
posted by theora55 at 2:21 PM on March 20, 2022
In 5 weeks, you could do a trial of either no gluten or no dairy. It's very common for adults to lose their ability to digest lactose as they get older. The ability to digest dairy is more an exception than the rule, globally. Another option is to add probiotic/ prebiotic foods like kimchi or fresh sauerkraut. Dietary changes can take weeks to show results.
posted by theora55 at 2:21 PM on March 20, 2022
Probiotics aren’t usually too expensive, and it seems like it can’t hurt to try one a day for a month or so.
posted by bluedaisy at 10:31 PM on March 20, 2022
posted by bluedaisy at 10:31 PM on March 20, 2022
Response by poster: Thanks again, everyone. Seems like first port of call should be a doctor to get a few tests ordered, and talk to them about fibre supplements or probiotics while I am there. Will try to incorporate some of the easier things listed here (e.g. eating smaller meals more frequently) and will consider the more complex depending on how that goes.
posted by BeeJiddy at 12:31 AM on March 21, 2022
posted by BeeJiddy at 12:31 AM on March 21, 2022
The times you eat fast food and don't have the symptoms, are you drinking diet sodas or full-sugar sodas? Intolerances to sugar substitutes are a thing, and can cause gut issues.
(Other than that, I'd also throw my hat in with the commenter who suggested more fiber because in my experience most gut things are significantly improved with the addition of more fiber.)
posted by telophase at 8:53 AM on March 21, 2022
(Other than that, I'd also throw my hat in with the commenter who suggested more fiber because in my experience most gut things are significantly improved with the addition of more fiber.)
posted by telophase at 8:53 AM on March 21, 2022
Sorry you are going through this.
+1 eliminate artificial sweeteners.
A couple of things I don’t see mentioned:
Imtermittent fasting: There is some thought that SIBO and other dysbiosis are exacerbated, or even caused, by the system never having a chance to catch up. Like a conveyer belt going too fast for the line workers. Fasting need not be a super dramatic thing; an 8 or 10 hour eating window, ended with a high protein first meal, can bring the benefit of giving each sector of digestion time to be good and finished before you start again.
Microbiome sequencing: If you are in the U.S., you can obtain a gene report of your gut without a doctor’s order, if you are willing to collect a sample. I used Thorne, because I wanted the pathogen panel it included, but there are others. It takes your results and compares it to the results of the Human Microbiome project, which collected a data as to what was present in a healthy gut. I found it useful because, as others have mentioned, probiotics are scattershot right now. Turns out, what I was deficient in can’t be acquired in supplements; but it makes some suggestions as to other ways to encourage the good bacteria. It also put my mind at ease about some things my GP was right about, but not offering any empirical proof to back up his pronouncements.
Good luck sorting this out!
posted by Rube R. Nekker at 9:48 AM on March 21, 2022
+1 eliminate artificial sweeteners.
A couple of things I don’t see mentioned:
Imtermittent fasting: There is some thought that SIBO and other dysbiosis are exacerbated, or even caused, by the system never having a chance to catch up. Like a conveyer belt going too fast for the line workers. Fasting need not be a super dramatic thing; an 8 or 10 hour eating window, ended with a high protein first meal, can bring the benefit of giving each sector of digestion time to be good and finished before you start again.
Microbiome sequencing: If you are in the U.S., you can obtain a gene report of your gut without a doctor’s order, if you are willing to collect a sample. I used Thorne, because I wanted the pathogen panel it included, but there are others. It takes your results and compares it to the results of the Human Microbiome project, which collected a data as to what was present in a healthy gut. I found it useful because, as others have mentioned, probiotics are scattershot right now. Turns out, what I was deficient in can’t be acquired in supplements; but it makes some suggestions as to other ways to encourage the good bacteria. It also put my mind at ease about some things my GP was right about, but not offering any empirical proof to back up his pronouncements.
Good luck sorting this out!
posted by Rube R. Nekker at 9:48 AM on March 21, 2022
It's not my primary field, but I have collected and analyzed human gut microbiome data for a course and once in a while I check in on the literature.
Your gut microbiome is driven by your diet. It will typically adapt to a new diet over the course of a couple weeks or so. The sequences you get from a sample are a selection of your microbiome - rarer bacteria may not show up but they are generally there and ready to multiply once you start eating stuff they're good at digesting. The dietary axes that make the biggest difference in your gut microbiome are typically how much grain vs. meat you eat, and how much alcohol you drink.
There is not generally a good tie between "you have these bacterial taxa" and gut function, it's reductive to say that someone is missing something or that there is a prototypical healthy gut. If you want to have the gut microbiome of a hunter-gatherer, time to start eating what, when, and how much a hunter-gatherer eats. Eating any consistent diet should help you have a stable population of bacteria that are adapted to digest what you eat. There are rare cases where people have really disrupted their gut microbiome during illness and need a fecal transplant to recolonize the gut. This doesn't sound like what OP has going on.
A reason to be careful about cutting foods out of your diet for weeks is that your microbiome adjusts to that absence, and when you start eating e.g. gluten again, your digestion will be upset. Be aware of this effect if you start trying elimination diets.
Anxiety can affect digestion, and that's something that's increased for most folks since the pandemic started. Exercise and a host of other lifestyle factors can also affect digestion. I wouldn't start with "attempt to control a complex assemblage of bacteria that are rapidly multiplying, swapping genes with each other, and dying."
posted by momus_window at 1:04 PM on March 21, 2022 [4 favorites]
Your gut microbiome is driven by your diet. It will typically adapt to a new diet over the course of a couple weeks or so. The sequences you get from a sample are a selection of your microbiome - rarer bacteria may not show up but they are generally there and ready to multiply once you start eating stuff they're good at digesting. The dietary axes that make the biggest difference in your gut microbiome are typically how much grain vs. meat you eat, and how much alcohol you drink.
There is not generally a good tie between "you have these bacterial taxa" and gut function, it's reductive to say that someone is missing something or that there is a prototypical healthy gut. If you want to have the gut microbiome of a hunter-gatherer, time to start eating what, when, and how much a hunter-gatherer eats. Eating any consistent diet should help you have a stable population of bacteria that are adapted to digest what you eat. There are rare cases where people have really disrupted their gut microbiome during illness and need a fecal transplant to recolonize the gut. This doesn't sound like what OP has going on.
A reason to be careful about cutting foods out of your diet for weeks is that your microbiome adjusts to that absence, and when you start eating e.g. gluten again, your digestion will be upset. Be aware of this effect if you start trying elimination diets.
Anxiety can affect digestion, and that's something that's increased for most folks since the pandemic started. Exercise and a host of other lifestyle factors can also affect digestion. I wouldn't start with "attempt to control a complex assemblage of bacteria that are rapidly multiplying, swapping genes with each other, and dying."
posted by momus_window at 1:04 PM on March 21, 2022 [4 favorites]
Please get your gallbladder checked out, there is a quick scan they can do for gallstones and this sound like the start of that before a lot more pain and suffering come.
posted by meepmeow at 6:50 PM on March 21, 2022
posted by meepmeow at 6:50 PM on March 21, 2022
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posted by MarianHalcombe at 12:48 AM on March 20, 2022 [2 favorites]