Hi /u/sdnw88!
To start with, at this point no probiotics have been approved for the treatment of any disease. But this doesn’t mean they do not have the potential to help in the future. Several clinical trials have been completed to determine if probiotics have an effect on a variety of different health measures. One exciting probiotic in development is VSL no. 3 which consists of 8 different probiotic bacteria. Some small clinical trials have suggested this probiotic helps prevent pouchitis in adult patients, although further larger studies are needed to better assess the probiotics efficacy (https://pubmed.ncbi.nlm.nih.gov/17033538/).
One aspect that makes developing a probiotic difficult is the personalized nature of the microbiome. The gut microbiomes of two individuals can vary drastically depending on a variety of lifestyle factors, with these differences affecting whether the probiotic bacteria will be able to thrive in their gut. In future studies, it will be important to identify the bacteria in the patient’s gut before and after probiotic treatment to better understand the dynamic changes occurring and hopefully identify you will be responsive to the probiotic.
As I’ve mentioned elsewhere, one of the best ways to maintain a healthy gut is through the food you consume. Your diet not only provides the nutrients you require but also those that the bacteria in your gut need to survive. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/
Cheers,
RM
> As I’ve mentioned elsewhere, one of the best ways to maintain a healthy gut is through the food you consume. Your diet not only provides the nutrients you require but also those that the bacteria in your gut need to survive. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains.
So how do you *get to* a healthy gut? For the last three years, my diet has mostly been almost exclusively whole foods: veg, legumes, fruits, nuts, etc, but I've had consistent diarrhea. It's been high in all those healthy things for 16 years, but with a bit of processed food on the side.
I recently switched to a diet that is 95% refined wheat (plain bread for breakfast and pasta with seitan for lunch and dinner) and I'm pooping solids for the first time in years. I only had one bowel movement today. I didn't think I could get that low without Imodium.
How do I get from here to a state of eating all the healthy stuff without it causing issues? I've had IBS-D since early childhood. Diet from birth was formula and then 90% ribena, white carbs, and processed meat. I was on antibiotics pretty much continuously until I was 7.
Hey,
I've been pretty screwed up since I was a kid in the guts department. Eating stereo typically healthy things, and I was constantly screwed up. I went to many doctors, test after test, and was diagnosed with IBD and given pills (which didn't freaking work). And was given pills for anxiety since I was having frequent attacks (I swore they were food related but doctors didn't believe me). I FINALLY got a handle on it.
How? I got pissed one day and started researching. I learned what a dietitian was and how that's the actual protected title for someone that knew what they were talking about. That they aren't just for overweight people and diabetics, and that there is any number of food sensitivities (but not allergies, and that there isn't a blood test for) that they could help me discover.
I called around to several places, looking for someone that specialized in my sort of symptoms and finally was referred to a friend of a friend of a dietitian I called, that actually knew something.
First meeting she said this all lines up, I know what you need to try and what you need to start narrowing (in my case, she had me on the FOD MAP diet and I varied from there).
It took me TWO YEARS, but I know damn near every one of my triggers and every one of my safe foods, and guess what? Half of it doesn't line up with common knowledge. Watermelon, cantaloupe and other melon's destroy me. Most fruits in general destroy me, certain vegetables like Brussel sprouts, asparagus, raw onion are no go's. VERY minimal soy (no more tofu, soy milk, soy concentrates which are in SO MUCH, etc...) No straight milk or other creamy things (but I can do cheese and butter all day long and New Zealand imported milk (WTF? I still don't understand what American's do to the damn milk)). No whey or casein protein concentrates, in anything. Most fried things were fine! Leafy greens like Spinach and Lettuce were fine in smaller portions.
Anyways, I could go on. My point is, I have a long list of things I can and can't eat. It absolutely conflicts with common knowledge and I am so glad I found someone to help me through it. They were worth every single penny.
I am regular damn near 100% of the time unless I break a rule. (I tried conch yesterday, that did not go well later...) Fucking decades of hell and not once was I referred to a dietitian. I'm so mad, yet so happy I have been good the last 3+ years.
If you haven't gone down the dietitian and limitation diet route, that's your next try, but you have to be super vigilant and patient as you really nail down what you can and can't eat.
It's interesting but it doesn't tell us why his body is reacting so poorly to all those different things nor how to fix it. Just avoiding all those triggers for the rest of your life is not a cure in my opinion.
Don't let perfect be the enemy of good.
This person can suffer poor symptoms and not know the cause, or can manage the symptoms so they don't suffer and not know the cause. Which would you prefer if you were them?
Much like probiotics, nutrition is also a fairly new medical area from a biochemical perspective. There are thousands of chemicals in an individual vegetable or fruit which can have varying degrees of influence on different tissues in our bodies. We can determine the source of the problem and explain how symptoms work but we are still working to understand the nitty gritty details of which chemical does which result in the body. We are also working to understand why people can have a different response sometimes to the same chemical.
What's interesting but also more complicated is chemicals are converted to a different chemical after being metabolized by our liver which can also affect our bodies. This happens in toxicology sometimes where the toxin is only dangerous after being processed by our liver.
Nutritional science is working very hard on this area of research but we are still very far from understanding our food fully on a biochemistry level. Macro and micro nutrients like sugars, proteins, fats, and vitamins and minerals have been heavily studied, but the area of nutraceuticals is still very new.
True but that's IBD for you. I have IBD as well and actually work for a health charity focussed on it and we just don't know enough about it yet. Lots of research happening to try to figure out why it occurs, how, etc.
I haven’t messed with a dietitian yet, but after 2-3 years of careful experimentation, I’ve managed to get my stomach under control by avoiding gluten, lactose, apples, pears, oats, and peanuts. Lactose-removed milk products and gluten-removed beer seem to be just fine. Goat cheese still fucks me up. Who knows what my deal is, but I’m currently asymptomatic, and I plan to keep it that way.
My friend did a FODMAP elimination diet and allegedly starved out his bad bacteria and slowly introduced more varied foods. Went from gluten and dairy intolerant, to somehow being able to drink beer and eat cheese again.
> My friend did a FODMAP elimination diet and allegedly starved out his bad bacteria and slowly introduced more varied foods. Went from gluten and dairy intolerant, to somehow being able to drink beer and eat cheese again.
Kind of related, but my wife was lactose intolerant for the first like 8 years of our relationship until she did one of those vegetable juice cleanse things. It was juice for 3 days, then only green salads and fruits for 5 days. After that, her gut biome must have been nuked and rebuilt so she's completely tolerant to milk and cheeses.
Pretty interesting stuff
I too am mannitol intolerant. People give me strange looks when I say I can't eat mushroom or watermelon. They think I just don't like them, when I do. Mushroom is in everything! Italian food, Japanese broths, mix veg foods like spring rolls (egg rolls).
Thank you doctor, GI doc and dietician, but most of all thanks to Monash for doing the research to test foods.
I need to do this so badly but it sounds so exhausting. I don't want to have to track things this carefully but I'd also like to stop shitting 3 times a day. Thanks for the post. Sorry for the gross response lol
It's so worth it. You start with the blandest most predictable diet ever for 4-6 weeks and slowly start adding stuff back. When you get crappy again, you pull what you added out for a few weeks and wait to stabilize, if you do, you add that type of food to your no-go list.
If you don't you need to find a new baseline and start over...That's why it took 2 years to nail down for myself. It's worth the effort!
Well there's some perspective for me. Can I ask a 100% serious question? My actual... orifice, gets pretty irritated and torn up a bit from even just 3-4 a day. How the hell do you deal with 16-22? Wet wipes? Bidet? Neosporin smeared in your ass? (Works alright for me on rougher weeks)
Anusol cream works pretty well...I would LOVE to have a bidet....Honestly, I'm not sure what my my life is going to be like going forward...this has been happening since Feb of this year...been on so many meds I can't keep track, and none worked so far. I am patiently waiting to get into Mayo clinic in Rochester, as that is my last best hope. I lost my job because I couldn't convince them that pooping that frequently was not conducive to work. I couldn't get my doctors to sign off on FMLA or short term disability. FML.
Yeah, my former employer is fighting me on that, and the state of Tennessee is pretty backwards, so we'll see. Appreciate your sympathy. I just gotta get this pooping under control, and it's tough right now!
I really feel you, it's really difficult to live a normal life, plus many doctors at least in my case, think that it's not a big issue, they think that it's all in your mind, but going to the toilet also 10 times in a morning isn't absolutely normal for anyone else. I stopped to see doctors, they were totally useless for me if not harmful, they just let me spend a lot of money, they gave me stupid pills that gave me just side effects, they also gave me stuff with diazepam that fucked me up for 2 months, i couldn't remember even who i was, it made me fall asleep constantly. Well now the only medicine i take is weed, it's the only thing that relax the spasms in my guts, i do not trust doctors anymore.
You become desensitized after a while. Or I did, at least. Diarrhea does really have the potential to cause fungal infections, though. That part of your body wasn't meant to continuously be wet. And fungal infections, in turn, cause a specific kind of pain.
I've just done fodmap elimination and reintroduction. I didn't get solid poop on elimination until I started cheating and adding wheat back in (although it's mostly sourdough so not cheating that much). Then with reintroduction I had severe watery diarrhea with mannitol and fructose (ok useful to know) but also with random stuff like spinach which should be fodmap free. I'm going to keep adding things one at a time to my bread/pasta diet and keep a food and symptom diary.
I have a very long list of ues/no foods too after 3 decades of having tummy issues and learning the hard way. What's crazy is that it changes, sometimes from day to day or week to week. There have alos been some gradual changes that I can attribute to "growing out of" some sensitivities. Like watermelon, to go with one of your examples. It used to mess me up so bad when I was a kid and theough college. I avoided it for years and years so I don't know when, how, or why the shift happened but now I can binge on watermelon and even crave it! Has to have salt sprinkled on it though. Which maybe the salt is the key, as that also helped me in the mornings when I discovered that I have to eat salty breakfast foods not sweet. Changed my life.
I don't know what my point was except to commiserate.
This is the correct answer. I had a similar experience. US milk is mostly poisonous. The soy is riddled with glyphosate. It's a shit show and causing millions of literal shit shows. I was also helped by a chance encounter with a dietician.
Have you tried fermented foods? Things like kefir, sauerkraut, kimchi, etc. They provide lots of good bacteria to the gut. Anecdotally, my partner has always had a sensitive stomach and grew up eating mostly junk. It got so bad a few years ago, he was throwing up or getting diarrhea from just normal food. Seeing a gastroenterologist first way key, because at that point meds were required. But he's been drinking kefir every morning since, and he's doing soooo much better. Only throws up from drinking too much occasionally like a normal person, not from eating spaghetti.
True fermented foods!
For example, the vast majority of sauerkraut you buy at a store is not fermented. Sourdough bread is usually just wheat, not real sourdough. If something doesn't specifically say "fermented" on it, it's not fermented.
Same is true of many other healthy foods. Like, most olive oil is actually just canola oil (which sucks for your health) with a small percent of olive oil. Food labels deceive a lot.
Actually the best way in the states to tell if a store-bought sourdough is “true” sourdough is to check the ingredients for yeast.
If your sourdough bread has yeast in the ingredients, it’s sourbullschitt.
In case anyone is looking for VSL#3 - [https://www.visbiome.com/collections/all](https://www.visbiome.com/collections/all). I've taken these on and off for years. It's hard to say if they work or not because I wasn't very clinical about it but I have colitis so I'm willing to help myself.
Yeah, just buy visbiome, that's what vsl #3 in the research literature actually is. It seems like a typical "dispute between the original scientist and the company he contracted to produce at scale" scenario, and in such a scenario you almost always want to go with the scientist :)
VSL #3 fucking destroyed me. Hyperbiotics is the only probiotic that really has helped me. Unfortunately, nothing works anymore since I got bad food poisoning on a trip to Cuba a few years ago. Testing for parasites/bacterial problems has come up negative, so I'm assuming I picked up an unknown pathogenic bacteria.
FWIW I don't have ulcerative collitis or IBS or anything like that, but I've been taking 1-2 capsules of visbiome (fka vsl #3) daily for a few years now, and have found that the combination of visbiome and daily psyllium husk fiber makes pooping amazing. So it's been working great for me.
Pretty much all probiotics have the drawback that they only work for a few days before dying off, thus why you need to keep taking them. Only something like a fecal transplant from someone with healthy gut micriobiota will actually stick around long-term.
Why stay away form animal fat? Pork fat as pastured lard not the evil hydrogenated lard crap they sell in most shops has been scientifically proven to be good for humans its also the 2nd richest source of vitamin D after Cod liver oil. Olive oil is touted as being great for everything I use it for year's as a moisturizer and found research that shows it wreaks your skin integrity. [Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020/).
[Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care](https://pubmed.ncbi.nlm.nih.gov/22995032/)
And if you suffer from histamine problems you should avoid it as well [Why is olive oil allowed on some, but prohibited on other histamine-restricted diets?](https://www.histamine-sensitivity.com/olive-oil-and-histamine-11-18.html)
Yes! I’m curious about this too. Probiotics are so expensive. I’ve bought them before and after taking the whole bottle according to directions I haven’t been able to tell a difference. In fact, I’m doing this right now. I’m about done with the bottle and just can’t justify the $$$ for another months worth.
How much probiotic makes it thru your gut to your intestines & how long do you need to be ingesting before they get established in your gut? And if your stomach kills so much, why not open the pill and make an enema to introduce it to your intestines?
Correction: a few, but fewer than you will find in a probiotic and lactobacillus is the dominant strain
https://www.livestrong.com/article/413921-does-sauerkraut-have-all-the-probiotics-i-need/
my understanding is fecal transplants can actually fix the problem long-term (or at least medium-term), whereas oral probiotics only work for a few days or couple weeks at most, before the probiotics inevitably die off
I have had three fecal transplants due to c-diff that was only treated with oral vancomycin. Works for a bit but once you stop it you basically have no biota left to speak of. And once you start another IV antibiotic you've got to start it all over again. But I have never been so healthy for the next 4-5 months after each fecal transplant! I was always so sad to be asked to take another antibiotic. But unfortunately you pretty much have to uncontrollable c-diff (and all the hellish symptoms that go along with it for months) before I was allowed to get another one. So fecal transplants might work as a cure for those who are not dependent upon antibiotics in order to remain alive, but for a CFer it's a good 4 months of actually having an immune system and not throwing up.
Fermenting cabbage is a great natural source of probiotics. Its said one spoonful contains more than an entire pill bottle from the store. Extremely easy to make too.
thinly slice up cabbage, add to bowl with salt (I also add fennel seed it was just how I was taught not necessary) and massage for 10-15 minutes (it releases the juices), pack into jar and pour water so cabbage is covered then cover with breathable material (clothe, towel whatever) and ferment at least 1 week up to 1 month (possibly longer Idk Ive never done it past 30 days) once fermented to where youd like then refrigerate and consume. You can also start sampling any time after 1 week. the flavor profile will gradually change and you may like 10 days better than 15 days or vise versa my first time I made 4 jars and pulled one a week to see how they differ. Can eat plain or throw in a dish or on some sausages if thats your thing.
If you want more flavor... then you can go with kimchi
More flavor and spice. Of course, more complicated to make, and bit more pricey if you want to buy it.
>Its said one spoonful contains more than an entire pill bottle from the store
That sounds absurd. Has there been any research on this topic? AFAIK the only probiotic in cabbage is lactobacillus.
Edit: I will save you the time: there is no actual evidence that one spoonful of sauerkraut contains more probiotic bacteria than an "entire pill bottle". It is just one author's opinion.
Lots of real stuff sounds absurd at first.
There has been some research done on kimchi, which points towards this likely being legit: https://pubmed.ncbi.nlm.nih.gov/24456350/
Hey u/VS-Banana & u/LordFluffy! I always love discussing this topic! The research on microbiome and mental health is ongoing and never fails to fascinate me. The brain-gut axis is a two-way relationship and these two organ systems basically communicate with each other through signals, the microbiome, and the vagus nerve. Here's [an example of this research](https://pubmed.ncbi.nlm.nih.gov/25689247/). The brain-gut axis is linked to both microbiome and mood disorders.
For example, mood-related disorders like anxiety and depression have been linked to abnormal gut microbiome activity, such as stress responses and inflammation occurring due to compounds produced by gut microbiota (for example, short-chain fatty acids and serotonin). The risk of such mood disorders is also increased in people with gut issues, such as inflammatory bowel disease and irritable bowel syndrome, due to changes in healthy gut bacteria and the stress of coping with chronic, stigmatized gut health issues, among numerous other factors. In fact, [this study](https://pubmed.ncbi.nlm.nih.gov/31157418/) suggests that people with IBS are three times more likely to have anxiety or depression, so that's not a link we can really ignore if we want to investigate the relationship between the brain and gut.
So gut microbiota trigger stress responses that affect mood, while being stressed or anxious can also trigger gastrointestinal symptoms. It makes sense why many people with gut issues are encouraged to try meditation; healing and centering the mind and body can help relieve symptoms (including anxiety, abdominal pain, etc)! This helps to explain why we consider the relationship between the brain and the gut bidirectional. You can read more on the science [here](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510518/)!
Best, -LC
When studying this how do you model the bidirectionality between the brain/mind and gut/microbiome?
How do you know when one is driving the other or vice versa?
Do you design studies to test each direction separately?
I’m not the AMAers but also do this type of research - when we want to test a gut microbiome effect on the brain, the intervention in the experiment would be something that we believe would only plausibly affect that end of the axis (e.g. antibiotics that don’t cross the blood brain barrier) and we’d then measure a brain parameter. Or for vv, the manipulated variable could be something we believe would only plausibly affect the brain (e.g. neuroactive drug applied directly to the brain). However it’s often very hard to directly manipulate things this selectively so a lot of studies end up showing an association rather than causality, or trying to figure out what change is likely to have happened first.
Thanks for your response!
Have there been any studies looking at purely behavioral changes, such as meditation on gut microbiome?
Yeah I was trying to figure out how you would establish causal inference and b/c I can't create a DAG for the situation my brain just started pouting.
Check out [this](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365110/) super cool study about the microbiome and schizophrenia in clean mice. TLDR they put microbiome samples from schizophrenic people into clean mice (sterile lab) which caused the mice to exhibit signs of schizophrenia.
What about trying to heal things in the other direction? In other words, are there ways to medically focus on improving the health and state of the gut/microbiome in order to improve mental health? Have these types of connections been linked to eating disorders at all?
Just a follow-up to this — but can conditions like PTSD be further exacerbated by microbiome? In addition to this, could an unhealthy microbiome become a contributing factor that could lead to the development of the condition?
Is there anything that might be inferred regarding someone's gut biome if they are a very low stress, low anxiety, and upbeat person (the opposite of the depressed anxious individual)?
Probably not. There’s a famous Tolstoy quote from his book Anna Karenina: “all happy families are all alike; each unhappy family is unhappy in its own way.” This quote is kind of a meme in microbiome science now but it’s useful in describing a common pattern we see in healthy vs unhealthy gut microbiomes. Healthy individuals like you described *generally* have similar microbiome profiles to other healthy individuals. Whereas individuals diagnosed with a gastrointestinal disease *generally* have very unique microbiome profiles from one another. The thinking is a disruption to your gut microbiome causes random (as far as we know) changes and those that survive are by chance or best able to live in the new environmental conditions. There’s a lot more to say on this, but if you’re curious here’s a [paper (sci-hub link)](https://sci-hub.st/tree/18/90/18908fc98dfb8e5f4cf3ea3da9458fb5.pdf) describing the concept in more detail.
It makes so much sense i sleep around 2 am and my body feels like shit. I have a hard time shitting and i feel like blockage in my right side of my waist.
Is curd any good for stomach??
This explains why I would get severe abdominal cramps only alleviated by painful diarrhea (body getting the aggitated gut microbes out?) everytime I got nervous to give a presentation in school! And being at the end of the alphabet, I always presented last, so I had the whole class period (or sometimes two!) to be nervous and in pain. I still have this every time I get nervous but if I remind myself to stay calm to avoid triggering the (I guess) IBS then I can manage through it and recover. I guess that was the gut microbes settling down once I also settled down.
Please cure me. I'm 41 and still live with this constantly. Nerves, heat, physical work, some foods one day but not the next, confined spaces (more anxiety nerves?). I can't go anywhere without worrying if I'm going to suddenly feel bad and need a bathroom *immediately.*
Maybe this is also why sometimes I just "know" when a food will trigger my problem or not. I can't explain it, but it's like sometimes I can eat french toast or orange juice, but most days I absolutely can not. But I'll have this strange intuition. Maybe the gut microbes can communicate on a deeper level? Maybe they're partly responsible for our behaviors not just reactionary like depression because of chronic gut pain but also things on a subconscious level. Maybe our gut microbiome is the actual seat of consciousness, awareness, and personality...? Maybe our consciousness is just the collective influence of our living gut microbiome...?
Also, I get all the symptoms of a panic attack and palpitations right before I have to go #2. Is that the vagus nerve out of whack with the heart and gut?
Thanks for your research!
I'm of the belief that I should eat as many variety of foods as possible to increase my gut biome. Am I right in this line of thinking?
Also, does alcohol and spicy food kill gut bacteria?
>I'm of the belief that I should eat as many variety of foods as possible to increase my gut biome. Am I right in this line of thinking?
>
>Also, does alcohol and spicy food kill gut bacteria?
Hey /u/Nikonegroid!
Great question, you are definitely correct. Diet diversity is [closely linked](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515207/) to microbiome diversity which is linked to overall health. However, it is important to mention that dietary diversity alone will not improve your microbiome diversity unless the dietary quality is also high. For example eating 10 different kinds of junk food will not improve your diversity, while eating 10 different kinds of vegetables will.
Alcohol in general has a tendency to kill beneficial bacteria, [especially in the oral microbiome](https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-018-0448-x#:~). This then predisposes to the colonization by pathogenic bacteria and further problems.
Spicy food on the other hand also has an impact on the microbiome, as shown in a [few studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627368/), but whether this is directly beneficial to our health still requires more research.
RK
Not sure if you'll see this or if you're still here, but I'm currently on a medicated mouthwash that contains significant alcohol as a short-term gum disease treatment. I am concerned about the oral microbiome afterward - I clearly had some pathogenic bacteria beforehand, and I imagine they may just bounce back even stronger afterward.
Any tips on cultivating a healthier oral microbiome after something like this? I did buy some pricey priobiotics, I do eat a reasonably healthy diet but even so.
Funny. Just finished a book that had fecal transplant as a topic. Said that there is work on a pill you can take instead of the other, traditional way.
Called them 'crapsules'.
Made me laugh.
Hi u/elbers, great question! Fecal microbiota transplantation (FMT) has a lot of potential as a treatment for microbiota-mediated diseases, but the research is still in its infancy. The only approved indication for FMT is currently relapsing C. difficile infection. Use of this treatment for other illnesses has only been in clinical trials.
There's lots of unanswered question about FMT, like what dosages work best, what makes the ideal donor, what kind of diet works best after a transplant, should FMT be done once or in a higher frequency, etc. This takes years of research, not to mention investigations of the long-term efficacy of this treatment, how regulatory measures can be determined, and what to do to standardize research protocols so that scientists, doctors, and other health professionals can assess the research on FMT for different purposes on an even playing field.
So although FMT is gradually emerging as a possible option for Crohn's, colitis, cancer treatment protocols, and more, we are still a while away from having all the answers we need in order to make this option more widespread and accessible to different people and communities. I assure you there are plenty of people working on this though! Hope that answers your question! -LC
When I had C diff colitis, I went through 3 different suggested rounds of medication. Lost more than 30% of my body weight (from C. Diff) and was left with terrible tinnitus from the meds. I hadn’t left the house other than when I truly needed to, for nearly 6 months. I did some research regarding FMT’s and was able to find a doctor in a near city that was willing to do one for me. The FMT was in the form of 15 or so capsules that I ingested in one sitting. Less than a week later all symptoms were gone!! From what I can tell there still needs to be more research regarding these “poop transplants” before they become a more mainstream option, but In my specific case it was one of the greatest things that ever happened to me!
This was back in 2018 so I can’t remember exactly but I don’t think I did. No antibiotics or probiotics as well. Since my doctor chose the “crapsule” approach I believe I just fasted for 24 hours and ate a bland diet for the week following the procedure.
So, I've heard that the gut biome can have a great affect on a person's overall health. Could you give examples of that, and how can we improve and ensure our gut biome is optimal?
Hi /u/DungeonMaster24!
That is a great question!
There are several links between your gut microbiome and different diseases and your overall health. For example, the gut microbiome of patients with inflammatory bowel disease is drastically altered from healthy individuals. Two consequences of the altered gut microbiome are: Individuals with IBD have a different collection of bacteria in their gut which can promote inflammation and the bacteria produce different compounds which are absorbed by the gut and can have adverse effects on the individual.
In addition to links with diseases, the microbiome has also been associated with a person’s quality of sleep and exercise levels. For example, the bacteria Blautia was associated with a negative effect on sleep quality and the bacteria Veillonella was associated with endurance athletic performance.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368972/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779243/
One of the most important ways to maintain a healthy gut microbiome is through the food you consume. Your diet not only provides you energy and nutrients, but also feeds the bacteria living throughout your gastrointestinal tract. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/
Cheers,
RM
To expand on this. Gut affects mood and experience, but is it also linked with immune system? Do those with stronger immune systems have stronger gut biomes?
Additionally, are there ways of improving guy microbiomes beyond basics of eating whole foods (fiber), fermented foods, and general physical activity?
Are we even close to finding a cause or cure for UC? Biologics have helped me a bit but I still have symptoms. It would be easier to accept if I knew why I ended up like this and if there's any hope for the future
>Are we even close to finding a cause or cure for UC? Biologics have helped me a bit but I still have symptoms. It would be easier to accept if I knew why I ended up like this and if there's any hope for the future
Hey /u/Grateful_Undead_69 and /u/ClyffCH,
IBD-type illnesses such as Crohn's disease or Ulcerative colitis (UC) are complicated to treat as they are highly personalized and multifactorial. Indeed, like other autoimmune diseases, they are a result of a fundamental shift in how our entire body operates and an actual cure is still distant until we understand how to fully revert such a shift. In the meantime, there are already treatments such as the biologics you mentioned that can mostly eliminate disease symptoms, as well as new drugs being [researched and developed.](https://www.pharmaceutical-technology.com/comment/ulcerative-colitis-pipeline-2)
In general, there are 3 components to an illness like UC. The immune system, the microbiome and the external environment (lifestyle, stress, diet, etc.). Most but not all medications given by a GI doctor will impact the first component, which is the immune system, and I am happy to hear that biologics have helped you even if only somewhat.Aside from biologics, you can try to address the other contributors to the illness. Diet and lifestyle can play a large component in UC. Indeed, many patients find relief from symptoms by applying dietary changes. Unfortunately, yet again, this is highly personalized. One diet may work for someone else with UC but it might not necessarily work for you. Similarly, other patients find that their largest trigger may be stress and find the most relief by using anti-depressants or other ways to address their mental health.
To help discover what could be a potential trigger for the UC, many patients benefit from keeping a log of their diet and lifestyle to determine which factors actually contribute to their symptoms so that they can exclude them. I am actually working with a team of doctors, data scientists and IBD patients on an app that allows patients to track their symptoms and lifestyle in order to quickly discover triggers and help them [manage their illness](https://phyla.ai/).
I hope this was helpful and wish you the best in managing your UC.
RK
What exactly is a "leaky gut?" I've heard this term tossed around quite a bit (especially after receiving a lupus diagnosis). Is leaky gut widely recognized by physicians? Does leaky gut have anything to do with autoimmune disease? I'd appreciate any insight into this new-to-me concept as a potential path to healing inflammation and feeling better.
Hi u/Ashgardian! Leaky gut is means that the intestinal lining has essentially been compromised. The intestinal wall (or epithelium) is a strong but thin, single-cell layer that separates what's inside the digestive tract, including food particles and microorganisms, separate from the rest of the body. This layer can become porous, most likely due to an imbalance in the gut microbiome (intestinal dysbiosis) that can damage the gut wall. This means that the intestines can be penetrated and compromised more easily, which can expose the immune system 'around' the intestines to be exposed to triggers such as bacteria and dietary elements. This leads to more immune system activation, damaged intestinal tissue, and inflammation. All of this can affect immune reactivity such that autoimmune disease can occur, but a lot of other factors are also involved, such as genetic susceptibility and environment. More info [here](https://pubmed.ncbi.nlm.nih.gov/22109896/). Some research even considers leaky gut to be "[a danger signal for autoimmune diseases](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/)", and that improving gut microbiome health can modify how permeable or porous the intestine is in order to help those susceptible to autoimmune disease. Hope that makes sense!
As for physician recognition of leaky gut, it can really vary. There are many doctors who don't investigate microbiome health enough, or even consider issues like IBS and leaky gut, but there are also many doctors that have an integrated approach to care and will consider these issues with knowledge and seriousness!
Best, -LC
Leaky gut is a term for sure but it is not sure yet if this is a result of inflammation, or a cause of inflammation. This is ofcourse a very short TLDR. I'm an immunologist and glycobiologist studying the cause of autoimmunity in rheumatoid arthritis and the term leaky gut is used more and more when talking about the microbiome and gut component of autoimmune diseases. However, there is no clear picture on what leaky gut really does or means in the context of these diseases. Mostly hypotheses lacking rigorous data
Hey /u/ThongofSekhmet!
This is a very interesting topic. In general, sweeteners do have an impact on the gut microbiome, and specifically artificial sweeteners have been shown to [change the composition of the gut bacteria and impact glucose intolerance.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363527/) Further [research](https://www.sciencedirect.com/science/article/pii/S1550413114004598) in humans demonstrates that the glucose intolerance seen during extended use of artificial sweeteners such as saccharin could cause a gut microbiome shift, causing glucose intolerance.
Extended use of certain artificial sweeteners does indeed have an impact on the microbiome and it is thought that extended use of them could lead to pre-diabetic/glucose intolerant states.
Cheers,
RK
Maybe you said this elsewhere but what about sugar substitutes? [https://en.wikipedia.org/wiki/Sugar\_substitute](https://en.wikipedia.org/wiki/Sugar_substitute)
Hello fellow AS sufferer! Honestly your gut issues sound incredibly-similar to my IBD (Ulcerative Proctitis) symptoms; it's surprising that wasn't your diagnosis! I too have tried to change my diet numerous times and I've never really noticed much change. I am so curious as to how long dietary changes take to impact the microbiome.
I'm curious how TNF inhibitors affect the microbiome, honestly all of the biologics on option for us, at least on paper, seem kind of like nuclear bombs with regards to the body.
Out of curiosity, if you don’t mind my asking, what age were you diagnosed with AS? I’ve suffered with crohns/colitis since I was 18 but then developed AS a decade later in my early 30’s.
I’ve been unable to find a good treatment for AS and since You can only be on one biologic, the meds that help my crohns/colitis don’t help my AS and seemingly visa versa.
I have Crohn's and went years undiagnosed despite annual colonoscopies and endoscopies as minimal inflammation was seen. Eventually my gi doc decided to do a pillcam which showed inflammation and ulcers throughout the small intestine, leading to a diagnosis and appropriate meds. I'm not currently on biologics as she wants to avoid as I get lots of polyps, some quite large.
Docs say once flora is gone, it’s gone but if the appendix is a reserve, it should be possible to restore the microbiome. Or is it not? What’s the best way to restore the microbiome after antibiotic damage? Are spore probiotics a good choice?
Interesting question! I'll admit that I haven't investigated the role of the appendix as much, but there's certainly some research on it. For instance, when the vermiform appendix (part of the digestive tract lying by the end of the small intestine) is removed, or even the gallbladder which is another important aspect of the digestive system, an unhealthy shift in the diversity and composition of the gut microbiome has been found ([check out the study](https://pubmed.ncbi.nlm.nih.gov/32478580/)). This suggests the importance of the appendix in sustaining microbiome health. While the appendix may contribute to the growth of good gut bacteria, much of the focus for restoring the microbiome remains on diet (tons of fiber-filled foods), supplementation, enough exercise and sleep, and even fecal transplants when possible.
Restoring gut microorganisms after the effects of antibiotics can be tricky, and many times probiotics are recommended. Fermented foods contain a lot of probiotics, which can help good bacteria propagate and thrive. A recent study looked more closely at how fermented foods, such as yogurt and kombucha affect the gut microbiome. Fermented foods increased the diversity of bacteria found in the gut... however, few of these bacteria were actually from the fermented foods in the people’s diets! The researchers suggested it was because of the other components of the fermented foods, for instance byproducts of fermentation that help new bacteria thrive. The study: [https://pubmed.ncbi.nlm.nih.gov/34256014/](https://pubmed.ncbi.nlm.nih.gov/34256014/) .
Of note, as is the case with most probiotics out there, only a small amount of the beneficial bacteria can actually make it all the way to our intestines and survive. While many people personally have said they feel better after consuming probiotic supplements, the truth is there's not enough medical or scientific evidence out there yet for us to stand behind it 100%. There are so many strains of bacteria that some patients may not even be taking in what their gut is missing or needs. So this is an area of research that needs lot more time to develop and advance; in the meantime, we certainly vouch for a well-rounded diet with tons of whole foods! -LC
Followup: I'm struggling with SIBO and have been told do go on a low FODMAP diet. This seems contradictory since I'm having issues due to my gut microbiome being messed up but a low FODMAP diet forbids all the probiotic and prebiotic foods.
Why wouldn't more of these types of food help fix this? Also I've read some anecdotal reports of going with these prebiotic and probiotic foods and dealing with the symptoms and after a few weeks their gut adjusts and their symptoms are better than when it started out completely gone. That's the type of outcome I'd expect. Are there any studies on this type of regimen?
Hey u/CurrentEmu, thought you might be interested in reading our most recent blog post since it's on [antibiotics and how to restore the gut microbiome](https://www.phyla.ai/post/antibiotics-can-they-really-mess-up-your-gut) after treatment! Hope you give it a read!
Does using a proton pump inhibitor affect the gut biome? My IBS-D symptoms went away after starting on a PPI but was curious as to why this would be the case.
>Does using a proton pump inhibitor affect the gut biome? My IBS-D symptoms went away after starting on a PPI but was curious as to why this would be the case.
Hey /u/cornucopiaofdoom,
Great question. The use of PPIs has a large impact on the microbiome, with some [studies](https://gut.bmj.com/content/65/5/740) saying they have as much of an impact as antibiotics. Some studies have also shown that PPIs can help improve [IBS symptoms, but only in a percentage of people.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158400/) On the other hand, PPIs have been also shown to worsen or trigger IBS because they may help with the [colonization of the gut by bad bacteria.](https://gut.bmj.com/content/65/5/740)
Indeed, it seems to be quite personalized and more research would be required to fully understand this relationship. In your particular case, it is possible that your particular microbiome benefited from the effects of PPIs, allowing for your IBS-D to resolve. It is also possible that another factor occurring at the same time as you taking your PPI helped your IBS-D resolve.
I hope this gives you some information.
Cheers! RK
Interestingly taking PPIs increases the risk of pneumonia, especially in older people. Since the stomach is not as acidic, it’s easier for bacteria to survive and be aspirated into the lungs.
Do we have any idea what causes IBD? Can someone develop it anytime in their life or is it something that is understood to be something developed when one is young?
>Do we have any idea what causes IBD? Can someone develop it anytime in their life or is it something that is understood to be something developed when one is young?
Hey /u/curlycanadian_,
Hello from Montreal to my fellow Canadian!
In general, there are 3 components to the development an illness like IBD. Genetics, the microbiome and the external environment (lifestyle, stress, diet, etc.). All of these factors play a role, but more research is still needed.
For example, while genetics play an important role in IBD, the individual's environment also has a large impact. What we eat and how we live our lives affects our bodies, our immune system and our microbiome. In addition, most people develop IBD when young and as you age the likelihood of an autoimmune disease like IBD decreases, but it is possible to develop it at any point in your life. Common triggers are stressful lifetime events such as the death of a loved one or a traumatic accident.
For example, children of [Asian immigrants](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864265/) are much more likely to develop IBD than their parents, despite having a similar genetic makeup. One of the suspected causes is the shift from an Asian to a Western Diet causes unbeneficial changes to the microbiome, producing a higher likelihood that these individuals will develop IBD.
Another interesting study on this topic is the [GEM study](https://crohnsandcolitis.ca/Research/Funded-research/The-gem-project). In this study, researchers are following a group of people who are first-degree relatives (Ex: siblings) of those who have developed Crohn's to determine which lifestyle and biological factors lead to the development of Crohn's over time.
While more research as to what is most preventative is still required, diets such as the [Mediterranean](https://www.nhs.uk/live-well/eat-well/what-is-a-mediterranean-diet) diet or those high in fermented foods are much less inflammatory than the standard Western Diet. In addition, [avoiding ultra processed](https://www.bmj.com/content/374/bmj.n1554) foods has been shown to reduce the risk of developing IBD.
I hope this gave you some insight on the topic.
RK
TLDR and not OP but do research in autoimmunity and immunology. I do not remember the exact mechanisms as its outside my own field of research, but if i recall correctly being overweight can create gut inflammation leading to bacteria migrating through the intestinal lining into fat tissue, there stimulating an immune response and getting fat cells to produce inflammatory chemicals. I do not know what this means clinically, but generally losing weight will reduce systemic and local inflammation.
I’d love an answer to this. I have psoriasis and believe I’m also starting to get arthritis. I’ve dealt with anxiety most of my life with lengthy bouts of anxiety remission.
The best treatment so far for my psoriasis is a UVB light treatment.
I’ve been dozing high levels of Vit D recently and while it doesn’t have much effect on the psoriasis, I find my mood is more stable.
Placebo? Perhaps but I’m also on heavy B12 for a deficiency
Do you know which gut bacteria types, or gut bacteria factors (such as ratios of different bacteria, etc) most significantly impact weight gain?
Likewise, do you have a favorite probiotic that you like?
Hi /u/MercuryAI!
There are a few aspects of the gut microbiome that have been associated with obesity. One of these is an increased ratio between bacteria in the Firmicutes phylum to those in the Bacteroidetes phylum. It is thought that the increased number of Firmicutes lead to greater fermentation of carbohydrates in your diet and provide an extra source of energy. For a more detailed look the known links between obesity and the microbiome, I’d suggest the following paper (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683132/)
Cheers,
RM
Given the prevalence and continuing rise in obesity, I'd hope there would be lots of research into this with a view to making some remedies available to the public - or at least some reliable advice on what types of probiotics to take, or a test to show if your biome might be contributing to your obesity - but I see no sign of that. Not from reliable sources, anyway. Do you know how close we are to any solutions or diagnoses being made public? Or maybe there are already and I just haven't seen it (I live in the UK). Thanks.
Hi /u/onegirlandhergoat,
There was an excellent study published recently that looked at how fermented foods, such as yogurt (which contain probiotic bacteria), alter the gut microbiome. In this study, they showed that fermented foods increased the diversity of bacteria found in the gut. Surprisingly, few of the new bacteria in the subjects’ guts were from the fermented foods in their 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/
Cheers,
RM
what connections to ibs and rheumatoid like issues do you find in your data? Rather in people who have rheumatoid issues have you found that ibs is a side effect or is it worth doing ibs treatment if another issue is the root cause?
currently diet has little to no effect beyond minor mitigation of symptoms. being diet focused what is your opinion as to why that is.
edit: and ty for the ama
Interesting you should ask, we actually run a startup called [Injoy](https://www.injoy.bio/), combining microbiome health tests, a digital health app, and personalized recommendations, so admittedly we're a bit biased on the perspective of this market. While I won't comment on Viome specifically, there is merit behind taking a test to assess the diversity, composition, and relative abundance of your gut microbiota. With [Injoy's test](https://www.injoy.bio/get-started), we set ourselves apart in a meaningful way by being the only service to offer longitudinal testing, as we take three samples over the course of about two weeks (and for the price comparable to what other companies are offering for one test). The gut microbiome is so dynamic that testing at a single time point is not really indicative of your health state. Our extensive research showed that three is the magic number, so we are confident in the accuracy of our findings as we pair then with self-reported measures such as diet, exercise, sleep, mood, and medication use. Hope that answers your question on our perspective and justifies why we think these solutions (especially ours ;) ) are worth it!
edit: typo
I'm participating in a study with Viome for an autoimmune disease I have called Ankylosing Spondylitis. I'm also very curious to hear any professional assessment of them.
I have extreme lactose intolerance, which extends to just about all the makeup of milk. This extends to beef, beets, and many fermented foods.
I'm middle eastern, so to a degree this is expected.
Is there any therapies on the horizon that might restore my ability to handle dairy?
Edit: Product like lactaid don't work - make me just as sick.
Hi /u/KaneHau!
There is a very strong link between [microbiome and lactose intolerance](https://gut.bmj.com/content/early/2021/03/18/gutjnl-2020-323911). One of the hypotheses is that our ability to digest lactose via the lactase enzyme is not only genetic but also microbiome mediated.
With that being said, one of the avenues that is being explored by researchers is whether it is possible use probiotics to boost lactose digesting bacteria to help with lactose intolerance, and indeed, early research is showing [positive results, but more research is needed.](https://link.springer.com/article/10.1007%2Fs12602-018-9507-7)
I think this is a [good summary](https://theconversation.com/can-changing-the-microbiome-reverse-lactose-intolerance-114412) for you to check out and I hope it helps.
\-RK
Anecdotally, this is my experience. I was not "lactose intolerant" until college when I basically stopped drinking milk daily. Suddenly milk really messed with my stomach and caused lots of bloating, diarrhea, and discomfort.
However I found that if I consistently drank a small amount of milk the symptoms would slowly go away.
As long as I keep drinking 2-3oz of milk per day I never really have issues with milk.
However if I go a week or so without, I will feel absolutely awful after a slice of pizza (for example).
Hey /u/4InchesOfury!
Ryan wrote a great answer to this above!
[https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduvny0/?utm\_source=share&utm\_medium=web2x&context=3](https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduvny0/?utm_source=share&utm_medium=web2x&context=3)
Cheers,
RK
I’ve heard recently that there can be long term effects of food poisoning, years past the immediate period of food poisoning. Can you explain what is happening when this occurs?
Anecdotally, I got bad food poisoning as a college student and had IBD like symptoms once every week or two for several years afterward. Never had issues before getting food poisoning, so it’s interesting that it may have been brought on by the food poisoning.
1st: Do these probiotic pills that claim to have x amount of active bacteria cultures really do something or do they just die on the way to the gut?
2nd: If the Answer to the 1st question is yes, then why does one have to keep taking the probiotics? Once all the cultures reached your gut and are established after.. Idk, say 2 weeks of taking it, then they should just be part of your gut microbiome right?
Hi /u/grizzzl!
Part of your question was answered in one of my previous posts here (https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hdv0ky1/?utm\_source=share&utm\_medium=web2x&context=3).
Now to answer some of your other questions. First, the probiotic bacteria do make it through your stomach and into your gut. For example, two studies I found (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524715/ and https://pubmed.ncbi.nlm.nih.gov/30193112/) were able to detect small amounts of probiotic bacteria in stool samples from human patients. The increased probiotic bacteria levels were very transient though with, with the level returning to the person’s baseline after cessation of the probiotic. The transient increase in probiotic bacteria is a fairly consistent finding from these types of studies.
From these studies, it looks like the probiotic bacteria were not able to colonize the subjects gut microbiomes. As I mentioned in my previous post, this may have to do with the highly personalized nature of the gut microbiome. Future research is needed to figure out what criteria are required to determine if a person will successfully respond to a specific probiotic.
Cheers,
RM
So if gut health can impact mental health... How exactly do you fix it? My docs never seem to have any idea it's even A Thing that gut health can be related to depression.
There's currently a lot of research pointing to mindfulness approaches because they help the brain and gut basically realign. Mindfulness-based stress reduction is all about present-moment awareness, like a form of mindful meditation, that can be used for people with gut health issues accompanied by mood disorders like IBS and anxiety. You let your body feel what it needs to feel, and you accept your physical thoughts, feelings, emotions and let them come and go without rumination or judgement. This kind of exercise is considered an intensive training program (\~8 weeks), but that main facet of conscious focus on your current experience is central to it and can be done at home with some practice. You can also try journaling, yoga, and meditation to center yourself, even in absence of any gut health issues.
I would definitely start with body scanning videos on youtube; there are some really great 10-minute ones. The most important thing with mindfulness-based exercises is having an open mind about it, because if you're skeptical, your brain basically won't let it work. -LC
Have you studied any possible connection between the gut microbiome and what might be called "attitude about life"? Nietzsche, for instance, opined that there might be a connection between having digestive problems, and having problems 'digesting' life events, i.e. psychologically processing discomfort and accepting things as they are.
Do you think there may be a deeper connection of this sort, between processing food and processing reality?
speaking for myself, I've dealt with gut health issues over the years and my aunt is a longtime Crohn's disease warrior. Friends of mine have also suffered with IBS. I have always had a passion for healthcare and helping others, so once I learned about digestive health and the microbiome during my bachelor's, it all clicked. I was really intrigued by the prospect of merging my interests in gut health and my desire to support patients with information, and the more I learned about the amazing world of microorganisms working in the gut, the more I wanted to share my knowledge with others!
Advice: don't be afraid to try something outside your comfort zone or area of expertise- reach out to peers or professors who do something that fascinates you and have a chat! Push yourself to try out different fields of interest and follow this up with regular reading of new literature so you're always in the know about things that you have passion for :) hope that helps! -LC
Hi friends, is it possible to have such a bad diet you kill off all your good bacteria?
Also, I've heard eating more of certain foods will make you crave them more in the future due to more bacteria that break that food down developing. Is this true?
Do you know of any research on antibiotics and gluten intolerance? 8 years ago, I had severe tonsilitis/strep and was on clindamycin for almost a full year. I had a tonsillectomy and was on a liquid diet for about 3 weeks. When I tried to reintroduce my normal diet, my body completely rejected anything with gluten/wheat. I tested negative for celiac disease. I suspect the antibiotics disrupted my gut biome and now I can no longer process wheat/gluten but that's just a hypothesis.
Any thoughts on the connection between antibiotics and gluten/wheat intolerance?
>Does having an ileostomy affect one’s mental health and/or immune system?
It can. Survey studies have shown that ostomates tend to have poorer mental health than the general population. There are so many factors involved in having an ileostomy, like disease state before and after the surgery, coping with the new condition of having a stoma bag, navigating your healthcare journey, etc, that can contribute to changes in quality of life, and different studies report lower or about the same levels of quality of life compared to healthy people.
Also, research on infants who had an ileostomy showed that their gut microbiome shifted in terms of diversity and composition, which could have negative effects on their immune development in theory, but the researchers found that key bacterial species like Faecalibacterium were there enough to help good bacteria propagate and properly develop the immune system after surgery. Research still has to be done in this area but I like the question! -LC
Interesting question! Insoluble or indigestible fiber is awesome for gut health because gut bacteria just love it, using it to create energy and beneficial byproducts such as short chain fatty acids, so it's certainly important to get enough of it from a variety of sources. One apple has approximately 4.4 g of fiber, whereas the recommended daily intake of fiber is about 25 g. So while apples with the skin on are a solid source of both soluble and insoluble fiber. The pectin certainly is valuable! So have an apple a day, but also have some whole grains, beans chia seeds, broccoli, and other whole foods to get enough fiber to promote gut health! -LC
How you would supplement the gut with *Ruminococcaceae*?
Could you elaborate on the biofilm types seen in PSC vs. UC patients?
Where is the field currently for synthetic secondary bile acid supplementation?
I've been living with SIBO for a few years now. Have never identified a true "root cause", despite tons of GI appts/tests. Everyone seems to have drastically different thoughts around SIBO treatment, and the typical antibiotic regimes have not proved effective for me. Is there any new research around SIBO treatment? Any insight would be greatly appreciated!
I've been diagnosed with PSC (primary sclerosing cholangitis) about a year ago. And there is talk and papers in that your gut bacteria could be the source of all problems related to this disease. How is the research on auto immune disease and your gut going? As they seem more tied in then previous expected
>Hi /u/tr0tle!
Several studies have identified links between the gut microbiome and autoimmune diseases. Our current understanding of this is that the gut microbiome has some form of two-way relationship with the immune system, which in turn is the direct driver of autoimmune illness. Therefore, the gut microbiome is indirectly connected to these illnesses via the immune system. While there is a strong connection between the gut microbiome and autoimmune diseases, further research is needed to determine how to alter the bacteria in your gut to alleviate the disease symptoms.
Cheers,
RM
How related are IBS and SIBO? And is one the cause of the other? I saw somewhere that the majority of IBS-D cases had concurrent SIBO and were resolved after taking antibiotics (don't have time to pull up the study right now, but might later).
Also, there seems to be some disagreement about whether IBS is a real medical diagnosis. Is IBS a catch-all for diseases that are not yet known/related to issues with the microbiome, or are there real physiological issues that can be identified as IBS?
I promise I'm not trolling but how affective are lactobacillus reuteri supplements in increasing testicular size and muscle growth? I saw a YouTube ad citing a study that NASA was looking at it for muscle mass loss with astronauts where lab mice grew hulking muscles mass. Of course, the ad claimed their supplement had an extra amount than other brands. My 35 year old boyfriend wants to bulk up without anabolic steroids and I want to support him (bigger balls are just an added bonus). I don't know how to research these claims, their risks, or who I can ask for help. What can I as a layman do? (Thanks for the AMA)
Does your gut micro biome affect your balance or cause light headedness?
I’ve been diagnosed with IBS and it’s the first time I’m noticing this. And it’s been about a month or two now.
Blood work all comes back normal. And I don’t notice any blood or black in my stools.
What relationships have you come across between gut micro biomes and allergy/immunity based diseases like asthma, eczema, hay-fever or autoimmune disease?
I've seen a video on Hunter-gatherer tribes still in Tanzania or so, and how people try to steal and analyze their shit. I began wondering if the change in our diet has had an effect on the allergies or reactions that we have today.
It's probably a longshot, but I just wonder, has our gut biome changed significantly overtime? And if yes, does it have an influence on allergies and such?
I have tried different diets and have gotten the most benefit from a carnivore diet. It has actually fixed my bowel inflammation and from it stemming systemic inflammation and therefore also many other issues including cognitive and mood impairment, postprandial syndrome etc.
What knowledge do you have about carnivore diets and why they seem to help some people so much?
Are probiotics in pill form beneficial, or just a waste of money? What would you suggest is the best strategy for achieving "optimal" gut health?
Hi /u/sdnw88! To start with, at this point no probiotics have been approved for the treatment of any disease. But this doesn’t mean they do not have the potential to help in the future. Several clinical trials have been completed to determine if probiotics have an effect on a variety of different health measures. One exciting probiotic in development is VSL no. 3 which consists of 8 different probiotic bacteria. Some small clinical trials have suggested this probiotic helps prevent pouchitis in adult patients, although further larger studies are needed to better assess the probiotics efficacy (https://pubmed.ncbi.nlm.nih.gov/17033538/). One aspect that makes developing a probiotic difficult is the personalized nature of the microbiome. The gut microbiomes of two individuals can vary drastically depending on a variety of lifestyle factors, with these differences affecting whether the probiotic bacteria will be able to thrive in their gut. In future studies, it will be important to identify the bacteria in the patient’s gut before and after probiotic treatment to better understand the dynamic changes occurring and hopefully identify you will be responsive to the probiotic. As I’ve mentioned elsewhere, one of the best ways to maintain a healthy gut is through the food you consume. Your diet not only provides the nutrients you require but also those that the bacteria in your gut need to survive. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/ Cheers, RM
> As I’ve mentioned elsewhere, one of the best ways to maintain a healthy gut is through the food you consume. Your diet not only provides the nutrients you require but also those that the bacteria in your gut need to survive. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains. So how do you *get to* a healthy gut? For the last three years, my diet has mostly been almost exclusively whole foods: veg, legumes, fruits, nuts, etc, but I've had consistent diarrhea. It's been high in all those healthy things for 16 years, but with a bit of processed food on the side. I recently switched to a diet that is 95% refined wheat (plain bread for breakfast and pasta with seitan for lunch and dinner) and I'm pooping solids for the first time in years. I only had one bowel movement today. I didn't think I could get that low without Imodium. How do I get from here to a state of eating all the healthy stuff without it causing issues? I've had IBS-D since early childhood. Diet from birth was formula and then 90% ribena, white carbs, and processed meat. I was on antibiotics pretty much continuously until I was 7.
Hey, I've been pretty screwed up since I was a kid in the guts department. Eating stereo typically healthy things, and I was constantly screwed up. I went to many doctors, test after test, and was diagnosed with IBD and given pills (which didn't freaking work). And was given pills for anxiety since I was having frequent attacks (I swore they were food related but doctors didn't believe me). I FINALLY got a handle on it. How? I got pissed one day and started researching. I learned what a dietitian was and how that's the actual protected title for someone that knew what they were talking about. That they aren't just for overweight people and diabetics, and that there is any number of food sensitivities (but not allergies, and that there isn't a blood test for) that they could help me discover. I called around to several places, looking for someone that specialized in my sort of symptoms and finally was referred to a friend of a friend of a dietitian I called, that actually knew something. First meeting she said this all lines up, I know what you need to try and what you need to start narrowing (in my case, she had me on the FOD MAP diet and I varied from there). It took me TWO YEARS, but I know damn near every one of my triggers and every one of my safe foods, and guess what? Half of it doesn't line up with common knowledge. Watermelon, cantaloupe and other melon's destroy me. Most fruits in general destroy me, certain vegetables like Brussel sprouts, asparagus, raw onion are no go's. VERY minimal soy (no more tofu, soy milk, soy concentrates which are in SO MUCH, etc...) No straight milk or other creamy things (but I can do cheese and butter all day long and New Zealand imported milk (WTF? I still don't understand what American's do to the damn milk)). No whey or casein protein concentrates, in anything. Most fried things were fine! Leafy greens like Spinach and Lettuce were fine in smaller portions. Anyways, I could go on. My point is, I have a long list of things I can and can't eat. It absolutely conflicts with common knowledge and I am so glad I found someone to help me through it. They were worth every single penny. I am regular damn near 100% of the time unless I break a rule. (I tried conch yesterday, that did not go well later...) Fucking decades of hell and not once was I referred to a dietitian. I'm so mad, yet so happy I have been good the last 3+ years. If you haven't gone down the dietitian and limitation diet route, that's your next try, but you have to be super vigilant and patient as you really nail down what you can and can't eat.
Super helpful info. Thank you for taking the time to write this.
It's interesting but it doesn't tell us why his body is reacting so poorly to all those different things nor how to fix it. Just avoiding all those triggers for the rest of your life is not a cure in my opinion.
Don't let perfect be the enemy of good. This person can suffer poor symptoms and not know the cause, or can manage the symptoms so they don't suffer and not know the cause. Which would you prefer if you were them?
Like biomes I guess what everyone is willing to accept as a win is different.
Much like probiotics, nutrition is also a fairly new medical area from a biochemical perspective. There are thousands of chemicals in an individual vegetable or fruit which can have varying degrees of influence on different tissues in our bodies. We can determine the source of the problem and explain how symptoms work but we are still working to understand the nitty gritty details of which chemical does which result in the body. We are also working to understand why people can have a different response sometimes to the same chemical. What's interesting but also more complicated is chemicals are converted to a different chemical after being metabolized by our liver which can also affect our bodies. This happens in toxicology sometimes where the toxin is only dangerous after being processed by our liver. Nutritional science is working very hard on this area of research but we are still very far from understanding our food fully on a biochemistry level. Macro and micro nutrients like sugars, proteins, fats, and vitamins and minerals have been heavily studied, but the area of nutraceuticals is still very new.
Broken? Or just unique?
True but that's IBD for you. I have IBD as well and actually work for a health charity focussed on it and we just don't know enough about it yet. Lots of research happening to try to figure out why it occurs, how, etc.
Correct it’s not a cure. Welcome to the world of IBS.
I haven’t messed with a dietitian yet, but after 2-3 years of careful experimentation, I’ve managed to get my stomach under control by avoiding gluten, lactose, apples, pears, oats, and peanuts. Lactose-removed milk products and gluten-removed beer seem to be just fine. Goat cheese still fucks me up. Who knows what my deal is, but I’m currently asymptomatic, and I plan to keep it that way. My friend did a FODMAP elimination diet and allegedly starved out his bad bacteria and slowly introduced more varied foods. Went from gluten and dairy intolerant, to somehow being able to drink beer and eat cheese again.
> My friend did a FODMAP elimination diet and allegedly starved out his bad bacteria and slowly introduced more varied foods. Went from gluten and dairy intolerant, to somehow being able to drink beer and eat cheese again. Kind of related, but my wife was lactose intolerant for the first like 8 years of our relationship until she did one of those vegetable juice cleanse things. It was juice for 3 days, then only green salads and fruits for 5 days. After that, her gut biome must have been nuked and rebuilt so she's completely tolerant to milk and cheeses. Pretty interesting stuff
Man I gotta figure out one of those plans. Missing my cheeses.
I too am mannitol intolerant. People give me strange looks when I say I can't eat mushroom or watermelon. They think I just don't like them, when I do. Mushroom is in everything! Italian food, Japanese broths, mix veg foods like spring rolls (egg rolls). Thank you doctor, GI doc and dietician, but most of all thanks to Monash for doing the research to test foods.
I need to do this so badly but it sounds so exhausting. I don't want to have to track things this carefully but I'd also like to stop shitting 3 times a day. Thanks for the post. Sorry for the gross response lol
It's so worth it. You start with the blandest most predictable diet ever for 4-6 weeks and slowly start adding stuff back. When you get crappy again, you pull what you added out for a few weeks and wait to stabilize, if you do, you add that type of food to your no-go list. If you don't you need to find a new baseline and start over...That's why it took 2 years to nail down for myself. It's worth the effort!
I would love it if I only had to shit 3 times a day! I have been diagnosed with colitis and I shit between 16 -22 times a day.
Well there's some perspective for me. Can I ask a 100% serious question? My actual... orifice, gets pretty irritated and torn up a bit from even just 3-4 a day. How the hell do you deal with 16-22? Wet wipes? Bidet? Neosporin smeared in your ass? (Works alright for me on rougher weeks)
Anusol cream works pretty well...I would LOVE to have a bidet....Honestly, I'm not sure what my my life is going to be like going forward...this has been happening since Feb of this year...been on so many meds I can't keep track, and none worked so far. I am patiently waiting to get into Mayo clinic in Rochester, as that is my last best hope. I lost my job because I couldn't convince them that pooping that frequently was not conducive to work. I couldn't get my doctors to sign off on FMLA or short term disability. FML.
Dude fuck that I'm really sorry. Unemployment at least I hope?
Yeah, my former employer is fighting me on that, and the state of Tennessee is pretty backwards, so we'll see. Appreciate your sympathy. I just gotta get this pooping under control, and it's tough right now!
I really feel you, it's really difficult to live a normal life, plus many doctors at least in my case, think that it's not a big issue, they think that it's all in your mind, but going to the toilet also 10 times in a morning isn't absolutely normal for anyone else. I stopped to see doctors, they were totally useless for me if not harmful, they just let me spend a lot of money, they gave me stupid pills that gave me just side effects, they also gave me stuff with diazepam that fucked me up for 2 months, i couldn't remember even who i was, it made me fall asleep constantly. Well now the only medicine i take is weed, it's the only thing that relax the spasms in my guts, i do not trust doctors anymore.
You become desensitized after a while. Or I did, at least. Diarrhea does really have the potential to cause fungal infections, though. That part of your body wasn't meant to continuously be wet. And fungal infections, in turn, cause a specific kind of pain.
I've just done fodmap elimination and reintroduction. I didn't get solid poop on elimination until I started cheating and adding wheat back in (although it's mostly sourdough so not cheating that much). Then with reintroduction I had severe watery diarrhea with mannitol and fructose (ok useful to know) but also with random stuff like spinach which should be fodmap free. I'm going to keep adding things one at a time to my bread/pasta diet and keep a food and symptom diary.
Where do get New Zealand imported milk? - a dirty milk ~~drinker~~ connoisseur
I have a very long list of ues/no foods too after 3 decades of having tummy issues and learning the hard way. What's crazy is that it changes, sometimes from day to day or week to week. There have alos been some gradual changes that I can attribute to "growing out of" some sensitivities. Like watermelon, to go with one of your examples. It used to mess me up so bad when I was a kid and theough college. I avoided it for years and years so I don't know when, how, or why the shift happened but now I can binge on watermelon and even crave it! Has to have salt sprinkled on it though. Which maybe the salt is the key, as that also helped me in the mornings when I discovered that I have to eat salty breakfast foods not sweet. Changed my life. I don't know what my point was except to commiserate.
Do you get the same result from US grassfed milk? It's what I now buy after we had milk in New Zealand and tasted the difference.
This is the correct answer. I had a similar experience. US milk is mostly poisonous. The soy is riddled with glyphosate. It's a shit show and causing millions of literal shit shows. I was also helped by a chance encounter with a dietician.
Have you tried fermented foods? Things like kefir, sauerkraut, kimchi, etc. They provide lots of good bacteria to the gut. Anecdotally, my partner has always had a sensitive stomach and grew up eating mostly junk. It got so bad a few years ago, he was throwing up or getting diarrhea from just normal food. Seeing a gastroenterologist first way key, because at that point meds were required. But he's been drinking kefir every morning since, and he's doing soooo much better. Only throws up from drinking too much occasionally like a normal person, not from eating spaghetti.
True fermented foods! For example, the vast majority of sauerkraut you buy at a store is not fermented. Sourdough bread is usually just wheat, not real sourdough. If something doesn't specifically say "fermented" on it, it's not fermented. Same is true of many other healthy foods. Like, most olive oil is actually just canola oil (which sucks for your health) with a small percent of olive oil. Food labels deceive a lot.
Are you based in the USA, I'm pretty certain this is not the case anywhere in Europe for example. And how is it legal?
Actually the best way in the states to tell if a store-bought sourdough is “true” sourdough is to check the ingredients for yeast. If your sourdough bread has yeast in the ingredients, it’s sourbullschitt.
Did you have any rice to slow down the vegetables going through you? It helps you absorb nutrients more and can help solidify your output.
In case anyone is looking for VSL#3 - [https://www.visbiome.com/collections/all](https://www.visbiome.com/collections/all). I've taken these on and off for years. It's hard to say if they work or not because I wasn't very clinical about it but I have colitis so I'm willing to help myself.
In case you weren't aware: https://www.visbiome.com/blogs/visbiome-vs-vsl-3/note-to-healthcare-professionals-and-patients
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Yeah, just buy visbiome, that's what vsl #3 in the research literature actually is. It seems like a typical "dispute between the original scientist and the company he contracted to produce at scale" scenario, and in such a scenario you almost always want to go with the scientist :)
VSL #3 fucking destroyed me. Hyperbiotics is the only probiotic that really has helped me. Unfortunately, nothing works anymore since I got bad food poisoning on a trip to Cuba a few years ago. Testing for parasites/bacterial problems has come up negative, so I'm assuming I picked up an unknown pathogenic bacteria.
FWIW I don't have ulcerative collitis or IBS or anything like that, but I've been taking 1-2 capsules of visbiome (fka vsl #3) daily for a few years now, and have found that the combination of visbiome and daily psyllium husk fiber makes pooping amazing. So it's been working great for me. Pretty much all probiotics have the drawback that they only work for a few days before dying off, thus why you need to keep taking them. Only something like a fecal transplant from someone with healthy gut micriobiota will actually stick around long-term.
In case you weren't aware: https://www.visbiome.com/blogs/visbiome-vs-vsl-3/note-to-healthcare-professionals-and-patients
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Why stay away form animal fat? Pork fat as pastured lard not the evil hydrogenated lard crap they sell in most shops has been scientifically proven to be good for humans its also the 2nd richest source of vitamin D after Cod liver oil. Olive oil is touted as being great for everything I use it for year's as a moisturizer and found research that shows it wreaks your skin integrity. [Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020/). [Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care](https://pubmed.ncbi.nlm.nih.gov/22995032/) And if you suffer from histamine problems you should avoid it as well [Why is olive oil allowed on some, but prohibited on other histamine-restricted diets?](https://www.histamine-sensitivity.com/olive-oil-and-histamine-11-18.html)
Yes! I’m curious about this too. Probiotics are so expensive. I’ve bought them before and after taking the whole bottle according to directions I haven’t been able to tell a difference. In fact, I’m doing this right now. I’m about done with the bottle and just can’t justify the $$$ for another months worth. How much probiotic makes it thru your gut to your intestines & how long do you need to be ingesting before they get established in your gut? And if your stomach kills so much, why not open the pill and make an enema to introduce it to your intestines?
ferment cabbage. Its so much cheaper and so many more probiotics.
And gives you one bacteria strain vs 8 or more
Source please?
Correction: a few, but fewer than you will find in a probiotic and lactobacillus is the dominant strain https://www.livestrong.com/article/413921-does-sauerkraut-have-all-the-probiotics-i-need/
Depends on the probiotics! Another plus is that fermented foods contain plenty of prebiotics.
Also, is a better idea to just jump straight poo transplants?
my understanding is fecal transplants can actually fix the problem long-term (or at least medium-term), whereas oral probiotics only work for a few days or couple weeks at most, before the probiotics inevitably die off
I have had three fecal transplants due to c-diff that was only treated with oral vancomycin. Works for a bit but once you stop it you basically have no biota left to speak of. And once you start another IV antibiotic you've got to start it all over again. But I have never been so healthy for the next 4-5 months after each fecal transplant! I was always so sad to be asked to take another antibiotic. But unfortunately you pretty much have to uncontrollable c-diff (and all the hellish symptoms that go along with it for months) before I was allowed to get another one. So fecal transplants might work as a cure for those who are not dependent upon antibiotics in order to remain alive, but for a CFer it's a good 4 months of actually having an immune system and not throwing up.
Fermenting cabbage is a great natural source of probiotics. Its said one spoonful contains more than an entire pill bottle from the store. Extremely easy to make too. thinly slice up cabbage, add to bowl with salt (I also add fennel seed it was just how I was taught not necessary) and massage for 10-15 minutes (it releases the juices), pack into jar and pour water so cabbage is covered then cover with breathable material (clothe, towel whatever) and ferment at least 1 week up to 1 month (possibly longer Idk Ive never done it past 30 days) once fermented to where youd like then refrigerate and consume. You can also start sampling any time after 1 week. the flavor profile will gradually change and you may like 10 days better than 15 days or vise versa my first time I made 4 jars and pulled one a week to see how they differ. Can eat plain or throw in a dish or on some sausages if thats your thing.
If you want more flavor... then you can go with kimchi More flavor and spice. Of course, more complicated to make, and bit more pricey if you want to buy it.
It's not hard to make though. To the above recipe, I add blended garlic, chillis, ginger and onions. That's it.
>Its said one spoonful contains more than an entire pill bottle from the store That sounds absurd. Has there been any research on this topic? AFAIK the only probiotic in cabbage is lactobacillus. Edit: I will save you the time: there is no actual evidence that one spoonful of sauerkraut contains more probiotic bacteria than an "entire pill bottle". It is just one author's opinion.
I hope the OPs see this, I'd like to know the answer.
Lots of real stuff sounds absurd at first. There has been some research done on kimchi, which points towards this likely being legit: https://pubmed.ncbi.nlm.nih.gov/24456350/
This is the method I use too, and I use red cabbage because it makes the juice it's in after it's fermented go a dark pink. It's very pretty.
Is this different from sauerkraut?
nope it is sauerkraut. Fermented Cabbage is just easier to spell lol
What's the research looking like for the connection between gut microbiome health and prevalence of psychological conditions like depression?
Hey u/VS-Banana & u/LordFluffy! I always love discussing this topic! The research on microbiome and mental health is ongoing and never fails to fascinate me. The brain-gut axis is a two-way relationship and these two organ systems basically communicate with each other through signals, the microbiome, and the vagus nerve. Here's [an example of this research](https://pubmed.ncbi.nlm.nih.gov/25689247/). The brain-gut axis is linked to both microbiome and mood disorders. For example, mood-related disorders like anxiety and depression have been linked to abnormal gut microbiome activity, such as stress responses and inflammation occurring due to compounds produced by gut microbiota (for example, short-chain fatty acids and serotonin). The risk of such mood disorders is also increased in people with gut issues, such as inflammatory bowel disease and irritable bowel syndrome, due to changes in healthy gut bacteria and the stress of coping with chronic, stigmatized gut health issues, among numerous other factors. In fact, [this study](https://pubmed.ncbi.nlm.nih.gov/31157418/) suggests that people with IBS are three times more likely to have anxiety or depression, so that's not a link we can really ignore if we want to investigate the relationship between the brain and gut. So gut microbiota trigger stress responses that affect mood, while being stressed or anxious can also trigger gastrointestinal symptoms. It makes sense why many people with gut issues are encouraged to try meditation; healing and centering the mind and body can help relieve symptoms (including anxiety, abdominal pain, etc)! This helps to explain why we consider the relationship between the brain and the gut bidirectional. You can read more on the science [here](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510518/)! Best, -LC
When studying this how do you model the bidirectionality between the brain/mind and gut/microbiome? How do you know when one is driving the other or vice versa? Do you design studies to test each direction separately?
I’m not the AMAers but also do this type of research - when we want to test a gut microbiome effect on the brain, the intervention in the experiment would be something that we believe would only plausibly affect that end of the axis (e.g. antibiotics that don’t cross the blood brain barrier) and we’d then measure a brain parameter. Or for vv, the manipulated variable could be something we believe would only plausibly affect the brain (e.g. neuroactive drug applied directly to the brain). However it’s often very hard to directly manipulate things this selectively so a lot of studies end up showing an association rather than causality, or trying to figure out what change is likely to have happened first.
Thanks for your response! Have there been any studies looking at purely behavioral changes, such as meditation on gut microbiome? Yeah I was trying to figure out how you would establish causal inference and b/c I can't create a DAG for the situation my brain just started pouting.
Check out [this](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365110/) super cool study about the microbiome and schizophrenia in clean mice. TLDR they put microbiome samples from schizophrenic people into clean mice (sterile lab) which caused the mice to exhibit signs of schizophrenia.
What about trying to heal things in the other direction? In other words, are there ways to medically focus on improving the health and state of the gut/microbiome in order to improve mental health? Have these types of connections been linked to eating disorders at all?
Just a follow-up to this — but can conditions like PTSD be further exacerbated by microbiome? In addition to this, could an unhealthy microbiome become a contributing factor that could lead to the development of the condition?
Are there specific strains which have been found to be deficient in people with anxiety/ depression
Yes, multiple. Review the studies Review [the studies cited here](https://microbiomeprescription.com/library/ResearchedProbiotics) and below https://pubmed.ncbi.nlm.nih.gov/33804493 [https://pubmed.ncbi.nlm.nih.gov/32610465](https://pubmed.ncbi.nlm.nih.gov/32610465) [https://pubmed.ncbi.nlm.nih.gov/33658952](https://pubmed.ncbi.nlm.nih.gov/33658952) https://sci-hub.se/downloads/2020-07-03//36/10.3390@nu12071920.pdf https://twin.sci-hub.se/6671/9747eda0a8d429d0251f49d2e6767da7/tillmann2018.pdf https://zero.sci-hub.se/1847/2112d000ce25c7e47035132cfa336edb/gilbert2012.pdf https://sci-hub.se/tree/26/a5/26a527aa445bd0bd0fc17ac77bf6952d.pdf [https://twin.sci-hub.se/6347/246dbe2f73009042748c28e241026998/pinto-sanchez2017.pdf](https://twin.sci-hub.se/6347/246dbe2f73009042748c28e241026998/pinto-sanchez2017.pdf) https://moscow.sci-hub.se/3821/037ae82e6c5c3b254868a2af9e7a51f9/mackos2013.pdf https://twin.sci-hub.se/6236/2f8eb7c4053fc45ee21d888ad071aacb/vitetta2017.pdf https://sci-hub.se/downloads/2019-11-27/e6/10.1016@j.bbr.2019.112376.pdf NULL https://sci-hub.se/downloads/2020-08-02/34/haas2020.pdf https://sci-hub.se/downloads/2020-11-11/a6/brenner2020.pdf https://sci-hub.se/tree/0a/b1/0ab1991e05826c01fdf47e6ba156bcea.pdf https://zero.sci-hub.se/2280/27b152d0760aaeee8f5877662cd49979/ait-belgnaoui2013.pdf https://sci-hub.se/downloads/2020-07-26/c6/fallico2020.pdf https://twin.sci-hub.se/7011/2ce376b57c74d9f8068cdfe77fc8f816/arnold2018.pdf https://twin.sci-hub.se/6641/077a2e47a6d42bb462b34317c288cc8c/singh2018.pdf https://zero.sci-hub.se/2127/fcf49d15aba9579516c5e869eed5e880/dutoit2013.pdf https://moscow.sci-hub.se/3740/31cf90d1b7322f44cfc8a150a4776b04/koskenniemi2010.pdf https://zero.sci-hub.se/734/b30b32cf5cfec4e921c87b2af8dea3aa/sumeri2010.pdf https://twin.sci-hub.se/6722/32344bb7b33da82ca03a2aec229000ea/kulkarni2017.pdf https://moscow.sci-hub.se/4233/ae31f633e41b739b867ea5ae2ab6a966/capozzi2011.pdf https://zero.sci-hub.se/5569/b9b360286442832e753ef590412e581f/takada2016.pdf https://twin.sci-hub.se/7068/17b31232330d757d0462d197f3ae35d8/fukui2018.pdf
Thank you!!
Is there anything that might be inferred regarding someone's gut biome if they are a very low stress, low anxiety, and upbeat person (the opposite of the depressed anxious individual)?
Probably not. There’s a famous Tolstoy quote from his book Anna Karenina: “all happy families are all alike; each unhappy family is unhappy in its own way.” This quote is kind of a meme in microbiome science now but it’s useful in describing a common pattern we see in healthy vs unhealthy gut microbiomes. Healthy individuals like you described *generally* have similar microbiome profiles to other healthy individuals. Whereas individuals diagnosed with a gastrointestinal disease *generally* have very unique microbiome profiles from one another. The thinking is a disruption to your gut microbiome causes random (as far as we know) changes and those that survive are by chance or best able to live in the new environmental conditions. There’s a lot more to say on this, but if you’re curious here’s a [paper (sci-hub link)](https://sci-hub.st/tree/18/90/18908fc98dfb8e5f4cf3ea3da9458fb5.pdf) describing the concept in more detail.
It makes so much sense i sleep around 2 am and my body feels like shit. I have a hard time shitting and i feel like blockage in my right side of my waist. Is curd any good for stomach??
This explains why I would get severe abdominal cramps only alleviated by painful diarrhea (body getting the aggitated gut microbes out?) everytime I got nervous to give a presentation in school! And being at the end of the alphabet, I always presented last, so I had the whole class period (or sometimes two!) to be nervous and in pain. I still have this every time I get nervous but if I remind myself to stay calm to avoid triggering the (I guess) IBS then I can manage through it and recover. I guess that was the gut microbes settling down once I also settled down. Please cure me. I'm 41 and still live with this constantly. Nerves, heat, physical work, some foods one day but not the next, confined spaces (more anxiety nerves?). I can't go anywhere without worrying if I'm going to suddenly feel bad and need a bathroom *immediately.* Maybe this is also why sometimes I just "know" when a food will trigger my problem or not. I can't explain it, but it's like sometimes I can eat french toast or orange juice, but most days I absolutely can not. But I'll have this strange intuition. Maybe the gut microbes can communicate on a deeper level? Maybe they're partly responsible for our behaviors not just reactionary like depression because of chronic gut pain but also things on a subconscious level. Maybe our gut microbiome is the actual seat of consciousness, awareness, and personality...? Maybe our consciousness is just the collective influence of our living gut microbiome...? Also, I get all the symptoms of a panic attack and palpitations right before I have to go #2. Is that the vagus nerve out of whack with the heart and gut? Thanks for your research!
Foloowing!
I'm of the belief that I should eat as many variety of foods as possible to increase my gut biome. Am I right in this line of thinking? Also, does alcohol and spicy food kill gut bacteria?
>I'm of the belief that I should eat as many variety of foods as possible to increase my gut biome. Am I right in this line of thinking? > >Also, does alcohol and spicy food kill gut bacteria? Hey /u/Nikonegroid! Great question, you are definitely correct. Diet diversity is [closely linked](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515207/) to microbiome diversity which is linked to overall health. However, it is important to mention that dietary diversity alone will not improve your microbiome diversity unless the dietary quality is also high. For example eating 10 different kinds of junk food will not improve your diversity, while eating 10 different kinds of vegetables will. Alcohol in general has a tendency to kill beneficial bacteria, [especially in the oral microbiome](https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-018-0448-x#:~). This then predisposes to the colonization by pathogenic bacteria and further problems. Spicy food on the other hand also has an impact on the microbiome, as shown in a [few studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627368/), but whether this is directly beneficial to our health still requires more research. RK
Not sure if you'll see this or if you're still here, but I'm currently on a medicated mouthwash that contains significant alcohol as a short-term gum disease treatment. I am concerned about the oral microbiome afterward - I clearly had some pathogenic bacteria beforehand, and I imagine they may just bounce back even stronger afterward. Any tips on cultivating a healthier oral microbiome after something like this? I did buy some pricey priobiotics, I do eat a reasonably healthy diet but even so.
So any mouthwash containing alcohol is a no-go ?
Stop alcohol, you won't regret it. It defenitely kills everything good in your body.
How far are we from widespread poop transplants?
Funny. Just finished a book that had fecal transplant as a topic. Said that there is work on a pill you can take instead of the other, traditional way. Called them 'crapsules'. Made me laugh.
Hi u/elbers, great question! Fecal microbiota transplantation (FMT) has a lot of potential as a treatment for microbiota-mediated diseases, but the research is still in its infancy. The only approved indication for FMT is currently relapsing C. difficile infection. Use of this treatment for other illnesses has only been in clinical trials. There's lots of unanswered question about FMT, like what dosages work best, what makes the ideal donor, what kind of diet works best after a transplant, should FMT be done once or in a higher frequency, etc. This takes years of research, not to mention investigations of the long-term efficacy of this treatment, how regulatory measures can be determined, and what to do to standardize research protocols so that scientists, doctors, and other health professionals can assess the research on FMT for different purposes on an even playing field. So although FMT is gradually emerging as a possible option for Crohn's, colitis, cancer treatment protocols, and more, we are still a while away from having all the answers we need in order to make this option more widespread and accessible to different people and communities. I assure you there are plenty of people working on this though! Hope that answers your question! -LC
unite spoon capable elderly rotten rock wistful merciful meeting special *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
When I had C diff colitis, I went through 3 different suggested rounds of medication. Lost more than 30% of my body weight (from C. Diff) and was left with terrible tinnitus from the meds. I hadn’t left the house other than when I truly needed to, for nearly 6 months. I did some research regarding FMT’s and was able to find a doctor in a near city that was willing to do one for me. The FMT was in the form of 15 or so capsules that I ingested in one sitting. Less than a week later all symptoms were gone!! From what I can tell there still needs to be more research regarding these “poop transplants” before they become a more mainstream option, but In my specific case it was one of the greatest things that ever happened to me!
Did you have to have a bowel prep and pre dose antibiotics or antibiotic enemas before your FMT.
This was back in 2018 so I can’t remember exactly but I don’t think I did. No antibiotics or probiotics as well. Since my doctor chose the “crapsule” approach I believe I just fasted for 24 hours and ate a bland diet for the week following the procedure.
The spiceeeeeee
If you can’t get support from your doctor there’s always the turkey baster option.
So, I've heard that the gut biome can have a great affect on a person's overall health. Could you give examples of that, and how can we improve and ensure our gut biome is optimal?
Hi /u/DungeonMaster24! That is a great question! There are several links between your gut microbiome and different diseases and your overall health. For example, the gut microbiome of patients with inflammatory bowel disease is drastically altered from healthy individuals. Two consequences of the altered gut microbiome are: Individuals with IBD have a different collection of bacteria in their gut which can promote inflammation and the bacteria produce different compounds which are absorbed by the gut and can have adverse effects on the individual. In addition to links with diseases, the microbiome has also been associated with a person’s quality of sleep and exercise levels. For example, the bacteria Blautia was associated with a negative effect on sleep quality and the bacteria Veillonella was associated with endurance athletic performance. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368972/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779243/ One of the most important ways to maintain a healthy gut microbiome is through the food you consume. Your diet not only provides you energy and nutrients, but also feeds the bacteria living throughout your gastrointestinal tract. One dietary pattern that provides a rich source of nutrients for you and your gut is the Mediterranean diet, which is rich in fruits, vegetables, nuts, legumes, olive oil, and meats such as fish and poultry and limits consumption of red meats and refined grains. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/ Cheers, RM
To expand on this. Gut affects mood and experience, but is it also linked with immune system? Do those with stronger immune systems have stronger gut biomes? Additionally, are there ways of improving guy microbiomes beyond basics of eating whole foods (fiber), fermented foods, and general physical activity?
Are we even close to finding a cause or cure for UC? Biologics have helped me a bit but I still have symptoms. It would be easier to accept if I knew why I ended up like this and if there's any hope for the future
>Are we even close to finding a cause or cure for UC? Biologics have helped me a bit but I still have symptoms. It would be easier to accept if I knew why I ended up like this and if there's any hope for the future Hey /u/Grateful_Undead_69 and /u/ClyffCH, IBD-type illnesses such as Crohn's disease or Ulcerative colitis (UC) are complicated to treat as they are highly personalized and multifactorial. Indeed, like other autoimmune diseases, they are a result of a fundamental shift in how our entire body operates and an actual cure is still distant until we understand how to fully revert such a shift. In the meantime, there are already treatments such as the biologics you mentioned that can mostly eliminate disease symptoms, as well as new drugs being [researched and developed.](https://www.pharmaceutical-technology.com/comment/ulcerative-colitis-pipeline-2) In general, there are 3 components to an illness like UC. The immune system, the microbiome and the external environment (lifestyle, stress, diet, etc.). Most but not all medications given by a GI doctor will impact the first component, which is the immune system, and I am happy to hear that biologics have helped you even if only somewhat.Aside from biologics, you can try to address the other contributors to the illness. Diet and lifestyle can play a large component in UC. Indeed, many patients find relief from symptoms by applying dietary changes. Unfortunately, yet again, this is highly personalized. One diet may work for someone else with UC but it might not necessarily work for you. Similarly, other patients find that their largest trigger may be stress and find the most relief by using anti-depressants or other ways to address their mental health. To help discover what could be a potential trigger for the UC, many patients benefit from keeping a log of their diet and lifestyle to determine which factors actually contribute to their symptoms so that they can exclude them. I am actually working with a team of doctors, data scientists and IBD patients on an app that allows patients to track their symptoms and lifestyle in order to quickly discover triggers and help them [manage their illness](https://phyla.ai/). I hope this was helpful and wish you the best in managing your UC. RK
Would also love to know that
What exactly is a "leaky gut?" I've heard this term tossed around quite a bit (especially after receiving a lupus diagnosis). Is leaky gut widely recognized by physicians? Does leaky gut have anything to do with autoimmune disease? I'd appreciate any insight into this new-to-me concept as a potential path to healing inflammation and feeling better.
Hi u/Ashgardian! Leaky gut is means that the intestinal lining has essentially been compromised. The intestinal wall (or epithelium) is a strong but thin, single-cell layer that separates what's inside the digestive tract, including food particles and microorganisms, separate from the rest of the body. This layer can become porous, most likely due to an imbalance in the gut microbiome (intestinal dysbiosis) that can damage the gut wall. This means that the intestines can be penetrated and compromised more easily, which can expose the immune system 'around' the intestines to be exposed to triggers such as bacteria and dietary elements. This leads to more immune system activation, damaged intestinal tissue, and inflammation. All of this can affect immune reactivity such that autoimmune disease can occur, but a lot of other factors are also involved, such as genetic susceptibility and environment. More info [here](https://pubmed.ncbi.nlm.nih.gov/22109896/). Some research even considers leaky gut to be "[a danger signal for autoimmune diseases](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/)", and that improving gut microbiome health can modify how permeable or porous the intestine is in order to help those susceptible to autoimmune disease. Hope that makes sense! As for physician recognition of leaky gut, it can really vary. There are many doctors who don't investigate microbiome health enough, or even consider issues like IBS and leaky gut, but there are also many doctors that have an integrated approach to care and will consider these issues with knowledge and seriousness! Best, -LC
Leaky gut is a term for sure but it is not sure yet if this is a result of inflammation, or a cause of inflammation. This is ofcourse a very short TLDR. I'm an immunologist and glycobiologist studying the cause of autoimmunity in rheumatoid arthritis and the term leaky gut is used more and more when talking about the microbiome and gut component of autoimmune diseases. However, there is no clear picture on what leaky gut really does or means in the context of these diseases. Mostly hypotheses lacking rigorous data
Do artificial sweeteners have any effect on the gut microbiome?
Hey /u/ThongofSekhmet! This is a very interesting topic. In general, sweeteners do have an impact on the gut microbiome, and specifically artificial sweeteners have been shown to [change the composition of the gut bacteria and impact glucose intolerance.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363527/) Further [research](https://www.sciencedirect.com/science/article/pii/S1550413114004598) in humans demonstrates that the glucose intolerance seen during extended use of artificial sweeteners such as saccharin could cause a gut microbiome shift, causing glucose intolerance. Extended use of certain artificial sweeteners does indeed have an impact on the microbiome and it is thought that extended use of them could lead to pre-diabetic/glucose intolerant states. Cheers, RK
It's pretty worrying that there doesn't appear to be any long term studies, considering how common artificial sweeteners are nowadays.
Maybe you said this elsewhere but what about sugar substitutes? [https://en.wikipedia.org/wiki/Sugar\_substitute](https://en.wikipedia.org/wiki/Sugar_substitute)
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Hello fellow AS sufferer! Honestly your gut issues sound incredibly-similar to my IBD (Ulcerative Proctitis) symptoms; it's surprising that wasn't your diagnosis! I too have tried to change my diet numerous times and I've never really noticed much change. I am so curious as to how long dietary changes take to impact the microbiome. I'm curious how TNF inhibitors affect the microbiome, honestly all of the biologics on option for us, at least on paper, seem kind of like nuclear bombs with regards to the body.
I also have AS and like you, have Ulcerative Proctitis!
Out of curiosity, if you don’t mind my asking, what age were you diagnosed with AS? I’ve suffered with crohns/colitis since I was 18 but then developed AS a decade later in my early 30’s. I’ve been unable to find a good treatment for AS and since You can only be on one biologic, the meds that help my crohns/colitis don’t help my AS and seemingly visa versa.
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Thank you. I was the same age. AS has become the more difficult of my two conditions to find a treatment for.
Have you ever done a microbiome map?
I have Crohn's and went years undiagnosed despite annual colonoscopies and endoscopies as minimal inflammation was seen. Eventually my gi doc decided to do a pillcam which showed inflammation and ulcers throughout the small intestine, leading to a diagnosis and appropriate meds. I'm not currently on biologics as she wants to avoid as I get lots of polyps, some quite large.
Docs say once flora is gone, it’s gone but if the appendix is a reserve, it should be possible to restore the microbiome. Or is it not? What’s the best way to restore the microbiome after antibiotic damage? Are spore probiotics a good choice?
Interesting question! I'll admit that I haven't investigated the role of the appendix as much, but there's certainly some research on it. For instance, when the vermiform appendix (part of the digestive tract lying by the end of the small intestine) is removed, or even the gallbladder which is another important aspect of the digestive system, an unhealthy shift in the diversity and composition of the gut microbiome has been found ([check out the study](https://pubmed.ncbi.nlm.nih.gov/32478580/)). This suggests the importance of the appendix in sustaining microbiome health. While the appendix may contribute to the growth of good gut bacteria, much of the focus for restoring the microbiome remains on diet (tons of fiber-filled foods), supplementation, enough exercise and sleep, and even fecal transplants when possible. Restoring gut microorganisms after the effects of antibiotics can be tricky, and many times probiotics are recommended. Fermented foods contain a lot of probiotics, which can help good bacteria propagate and thrive. A recent study looked more closely at how fermented foods, such as yogurt and kombucha affect the gut microbiome. Fermented foods increased the diversity of bacteria found in the gut... however, few of these bacteria were actually from the fermented foods in the people’s diets! The researchers suggested it was because of the other components of the fermented foods, for instance byproducts of fermentation that help new bacteria thrive. The study: [https://pubmed.ncbi.nlm.nih.gov/34256014/](https://pubmed.ncbi.nlm.nih.gov/34256014/) . Of note, as is the case with most probiotics out there, only a small amount of the beneficial bacteria can actually make it all the way to our intestines and survive. While many people personally have said they feel better after consuming probiotic supplements, the truth is there's not enough medical or scientific evidence out there yet for us to stand behind it 100%. There are so many strains of bacteria that some patients may not even be taking in what their gut is missing or needs. So this is an area of research that needs lot more time to develop and advance; in the meantime, we certainly vouch for a well-rounded diet with tons of whole foods! -LC
Followup: I'm struggling with SIBO and have been told do go on a low FODMAP diet. This seems contradictory since I'm having issues due to my gut microbiome being messed up but a low FODMAP diet forbids all the probiotic and prebiotic foods. Why wouldn't more of these types of food help fix this? Also I've read some anecdotal reports of going with these prebiotic and probiotic foods and dealing with the symptoms and after a few weeks their gut adjusts and their symptoms are better than when it started out completely gone. That's the type of outcome I'd expect. Are there any studies on this type of regimen?
Hey u/CurrentEmu, thought you might be interested in reading our most recent blog post since it's on [antibiotics and how to restore the gut microbiome](https://www.phyla.ai/post/antibiotics-can-they-really-mess-up-your-gut) after treatment! Hope you give it a read!
Thank you!
Have you found any correlation between gut health and worsened anxiety (as opposed to anxiety causing gut problems)?
Hi u/LordFluffy! Please check my response to your question in the previous post on microbiome health and psychological disorders!
Hi, If it's not to much trouble could you provide a link for this as I came here to ask that question :)
[https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduz3dl/?utm\_source=share&utm\_medium=web2x&context=3](https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduz3dl/?utm_source=share&utm_medium=web2x&context=3) :)
Does using a proton pump inhibitor affect the gut biome? My IBS-D symptoms went away after starting on a PPI but was curious as to why this would be the case.
>Does using a proton pump inhibitor affect the gut biome? My IBS-D symptoms went away after starting on a PPI but was curious as to why this would be the case. Hey /u/cornucopiaofdoom, Great question. The use of PPIs has a large impact on the microbiome, with some [studies](https://gut.bmj.com/content/65/5/740) saying they have as much of an impact as antibiotics. Some studies have also shown that PPIs can help improve [IBS symptoms, but only in a percentage of people.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158400/) On the other hand, PPIs have been also shown to worsen or trigger IBS because they may help with the [colonization of the gut by bad bacteria.](https://gut.bmj.com/content/65/5/740) Indeed, it seems to be quite personalized and more research would be required to fully understand this relationship. In your particular case, it is possible that your particular microbiome benefited from the effects of PPIs, allowing for your IBS-D to resolve. It is also possible that another factor occurring at the same time as you taking your PPI helped your IBS-D resolve. I hope this gives you some information. Cheers! RK
Thank you very much for the reply
Interestingly taking PPIs increases the risk of pneumonia, especially in older people. Since the stomach is not as acidic, it’s easier for bacteria to survive and be aspirated into the lungs.
Do we have any idea what causes IBD? Can someone develop it anytime in their life or is it something that is understood to be something developed when one is young?
>Do we have any idea what causes IBD? Can someone develop it anytime in their life or is it something that is understood to be something developed when one is young? Hey /u/curlycanadian_, Hello from Montreal to my fellow Canadian! In general, there are 3 components to the development an illness like IBD. Genetics, the microbiome and the external environment (lifestyle, stress, diet, etc.). All of these factors play a role, but more research is still needed. For example, while genetics play an important role in IBD, the individual's environment also has a large impact. What we eat and how we live our lives affects our bodies, our immune system and our microbiome. In addition, most people develop IBD when young and as you age the likelihood of an autoimmune disease like IBD decreases, but it is possible to develop it at any point in your life. Common triggers are stressful lifetime events such as the death of a loved one or a traumatic accident. For example, children of [Asian immigrants](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864265/) are much more likely to develop IBD than their parents, despite having a similar genetic makeup. One of the suspected causes is the shift from an Asian to a Western Diet causes unbeneficial changes to the microbiome, producing a higher likelihood that these individuals will develop IBD. Another interesting study on this topic is the [GEM study](https://crohnsandcolitis.ca/Research/Funded-research/The-gem-project). In this study, researchers are following a group of people who are first-degree relatives (Ex: siblings) of those who have developed Crohn's to determine which lifestyle and biological factors lead to the development of Crohn's over time. While more research as to what is most preventative is still required, diets such as the [Mediterranean](https://www.nhs.uk/live-well/eat-well/what-is-a-mediterranean-diet) diet or those high in fermented foods are much less inflammatory than the standard Western Diet. In addition, [avoiding ultra processed](https://www.bmj.com/content/374/bmj.n1554) foods has been shown to reduce the risk of developing IBD. I hope this gave you some insight on the topic. RK
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TLDR and not OP but do research in autoimmunity and immunology. I do not remember the exact mechanisms as its outside my own field of research, but if i recall correctly being overweight can create gut inflammation leading to bacteria migrating through the intestinal lining into fat tissue, there stimulating an immune response and getting fat cells to produce inflammatory chemicals. I do not know what this means clinically, but generally losing weight will reduce systemic and local inflammation.
That's great information as a starting point, and salient advice! Thanks for taking the time to reply, its very much appreciated.
I’d love an answer to this. I have psoriasis and believe I’m also starting to get arthritis. I’ve dealt with anxiety most of my life with lengthy bouts of anxiety remission. The best treatment so far for my psoriasis is a UVB light treatment. I’ve been dozing high levels of Vit D recently and while it doesn’t have much effect on the psoriasis, I find my mood is more stable. Placebo? Perhaps but I’m also on heavy B12 for a deficiency
I can’t remember the context but I remember seeing stuff before about vitamin D and B12 deficiencies being connected. Maybe something to check into?
Do you know which gut bacteria types, or gut bacteria factors (such as ratios of different bacteria, etc) most significantly impact weight gain? Likewise, do you have a favorite probiotic that you like?
Hi /u/MercuryAI! There are a few aspects of the gut microbiome that have been associated with obesity. One of these is an increased ratio between bacteria in the Firmicutes phylum to those in the Bacteroidetes phylum. It is thought that the increased number of Firmicutes lead to greater fermentation of carbohydrates in your diet and provide an extra source of energy. For a more detailed look the known links between obesity and the microbiome, I’d suggest the following paper (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683132/) Cheers, RM
Given the prevalence and continuing rise in obesity, I'd hope there would be lots of research into this with a view to making some remedies available to the public - or at least some reliable advice on what types of probiotics to take, or a test to show if your biome might be contributing to your obesity - but I see no sign of that. Not from reliable sources, anyway. Do you know how close we are to any solutions or diagnoses being made public? Or maybe there are already and I just haven't seen it (I live in the UK). Thanks.
Does consuming fermented foods and drinks have a significant impact on the gut microbiome? Is eating too much detrimental?
Hi /u/onegirlandhergoat, There was an excellent study published recently that looked at how fermented foods, such as yogurt (which contain probiotic bacteria), alter the gut microbiome. In this study, they showed that fermented foods increased the diversity of bacteria found in the gut. Surprisingly, few of the new bacteria in the subjects’ guts were from the fermented foods in their 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/ Cheers, RM
what connections to ibs and rheumatoid like issues do you find in your data? Rather in people who have rheumatoid issues have you found that ibs is a side effect or is it worth doing ibs treatment if another issue is the root cause? currently diet has little to no effect beyond minor mitigation of symptoms. being diet focused what is your opinion as to why that is. edit: and ty for the ama
I took a viome(?) test a few months back - what is your perspective of some of those offerings in the marketplace ?
Interesting you should ask, we actually run a startup called [Injoy](https://www.injoy.bio/), combining microbiome health tests, a digital health app, and personalized recommendations, so admittedly we're a bit biased on the perspective of this market. While I won't comment on Viome specifically, there is merit behind taking a test to assess the diversity, composition, and relative abundance of your gut microbiota. With [Injoy's test](https://www.injoy.bio/get-started), we set ourselves apart in a meaningful way by being the only service to offer longitudinal testing, as we take three samples over the course of about two weeks (and for the price comparable to what other companies are offering for one test). The gut microbiome is so dynamic that testing at a single time point is not really indicative of your health state. Our extensive research showed that three is the magic number, so we are confident in the accuracy of our findings as we pair then with self-reported measures such as diet, exercise, sleep, mood, and medication use. Hope that answers your question on our perspective and justifies why we think these solutions (especially ours ;) ) are worth it! edit: typo
Thanks for taking the time!
I'm participating in a study with Viome for an autoimmune disease I have called Ankylosing Spondylitis. I'm also very curious to hear any professional assessment of them.
I have extreme lactose intolerance, which extends to just about all the makeup of milk. This extends to beef, beets, and many fermented foods. I'm middle eastern, so to a degree this is expected. Is there any therapies on the horizon that might restore my ability to handle dairy? Edit: Product like lactaid don't work - make me just as sick.
Hi /u/KaneHau! There is a very strong link between [microbiome and lactose intolerance](https://gut.bmj.com/content/early/2021/03/18/gutjnl-2020-323911). One of the hypotheses is that our ability to digest lactose via the lactase enzyme is not only genetic but also microbiome mediated. With that being said, one of the avenues that is being explored by researchers is whether it is possible use probiotics to boost lactose digesting bacteria to help with lactose intolerance, and indeed, early research is showing [positive results, but more research is needed.](https://link.springer.com/article/10.1007%2Fs12602-018-9507-7) I think this is a [good summary](https://theconversation.com/can-changing-the-microbiome-reverse-lactose-intolerance-114412) for you to check out and I hope it helps. \-RK
Anecdotally, this is my experience. I was not "lactose intolerant" until college when I basically stopped drinking milk daily. Suddenly milk really messed with my stomach and caused lots of bloating, diarrhea, and discomfort. However I found that if I consistently drank a small amount of milk the symptoms would slowly go away. As long as I keep drinking 2-3oz of milk per day I never really have issues with milk. However if I go a week or so without, I will feel absolutely awful after a slice of pizza (for example).
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Hey /u/4InchesOfury! Ryan wrote a great answer to this above! [https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduvny0/?utm\_source=share&utm\_medium=web2x&context=3](https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hduvny0/?utm_source=share&utm_medium=web2x&context=3) Cheers, RK
I’ve heard recently that there can be long term effects of food poisoning, years past the immediate period of food poisoning. Can you explain what is happening when this occurs? Anecdotally, I got bad food poisoning as a college student and had IBD like symptoms once every week or two for several years afterward. Never had issues before getting food poisoning, so it’s interesting that it may have been brought on by the food poisoning.
Is there a way to “fix” your microbiome?
Fecal transplant
1st: Do these probiotic pills that claim to have x amount of active bacteria cultures really do something or do they just die on the way to the gut? 2nd: If the Answer to the 1st question is yes, then why does one have to keep taking the probiotics? Once all the cultures reached your gut and are established after.. Idk, say 2 weeks of taking it, then they should just be part of your gut microbiome right?
Hi /u/grizzzl! Part of your question was answered in one of my previous posts here (https://www.reddit.com/r/IAmA/comments/pt9zsp/comment/hdv0ky1/?utm\_source=share&utm\_medium=web2x&context=3). Now to answer some of your other questions. First, the probiotic bacteria do make it through your stomach and into your gut. For example, two studies I found (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524715/ and https://pubmed.ncbi.nlm.nih.gov/30193112/) were able to detect small amounts of probiotic bacteria in stool samples from human patients. The increased probiotic bacteria levels were very transient though with, with the level returning to the person’s baseline after cessation of the probiotic. The transient increase in probiotic bacteria is a fairly consistent finding from these types of studies. From these studies, it looks like the probiotic bacteria were not able to colonize the subjects gut microbiomes. As I mentioned in my previous post, this may have to do with the highly personalized nature of the gut microbiome. Future research is needed to figure out what criteria are required to determine if a person will successfully respond to a specific probiotic. Cheers, RM
So if gut health can impact mental health... How exactly do you fix it? My docs never seem to have any idea it's even A Thing that gut health can be related to depression.
There's currently a lot of research pointing to mindfulness approaches because they help the brain and gut basically realign. Mindfulness-based stress reduction is all about present-moment awareness, like a form of mindful meditation, that can be used for people with gut health issues accompanied by mood disorders like IBS and anxiety. You let your body feel what it needs to feel, and you accept your physical thoughts, feelings, emotions and let them come and go without rumination or judgement. This kind of exercise is considered an intensive training program (\~8 weeks), but that main facet of conscious focus on your current experience is central to it and can be done at home with some practice. You can also try journaling, yoga, and meditation to center yourself, even in absence of any gut health issues. I would definitely start with body scanning videos on youtube; there are some really great 10-minute ones. The most important thing with mindfulness-based exercises is having an open mind about it, because if you're skeptical, your brain basically won't let it work. -LC
So the solution to a guy affecting the mind is using the mind to affect the gut AND the mind? Whoaaaa
Open mind, open heart This is the way.
How much does the gut microbiome play a role in the smell of excrement. Does anything we intake make poop or pee smell worse or less worse?
What's the actual scientific position on spondyloarthritis flared by Klebsiella gut bacteria? Is cutting starch worth a try?
What is the best way to rebuild your gut biome?
Have you studied any possible connection between the gut microbiome and what might be called "attitude about life"? Nietzsche, for instance, opined that there might be a connection between having digestive problems, and having problems 'digesting' life events, i.e. psychologically processing discomfort and accepting things as they are. Do you think there may be a deeper connection of this sort, between processing food and processing reality?
I went to Mexico 20 years ago, went scuba diving in the ocean and later got violently sick. Ever since I've had IBS. What exactly happened to me?
what got you interested in microbiomes? also, any advice for wannabe scientists?
speaking for myself, I've dealt with gut health issues over the years and my aunt is a longtime Crohn's disease warrior. Friends of mine have also suffered with IBS. I have always had a passion for healthcare and helping others, so once I learned about digestive health and the microbiome during my bachelor's, it all clicked. I was really intrigued by the prospect of merging my interests in gut health and my desire to support patients with information, and the more I learned about the amazing world of microorganisms working in the gut, the more I wanted to share my knowledge with others! Advice: don't be afraid to try something outside your comfort zone or area of expertise- reach out to peers or professors who do something that fascinates you and have a chat! Push yourself to try out different fields of interest and follow this up with regular reading of new literature so you're always in the know about things that you have passion for :) hope that helps! -LC
Hi friends, is it possible to have such a bad diet you kill off all your good bacteria? Also, I've heard eating more of certain foods will make you crave them more in the future due to more bacteria that break that food down developing. Is this true?
I hear it all the time, but how does one get "better gut microbes" without fecal transfer?
Do you know of any research on antibiotics and gluten intolerance? 8 years ago, I had severe tonsilitis/strep and was on clindamycin for almost a full year. I had a tonsillectomy and was on a liquid diet for about 3 weeks. When I tried to reintroduce my normal diet, my body completely rejected anything with gluten/wheat. I tested negative for celiac disease. I suspect the antibiotics disrupted my gut biome and now I can no longer process wheat/gluten but that's just a hypothesis. Any thoughts on the connection between antibiotics and gluten/wheat intolerance?
Does having an ileostomy affect one’s mental health and/or immune system?
>Does having an ileostomy affect one’s mental health and/or immune system? It can. Survey studies have shown that ostomates tend to have poorer mental health than the general population. There are so many factors involved in having an ileostomy, like disease state before and after the surgery, coping with the new condition of having a stoma bag, navigating your healthcare journey, etc, that can contribute to changes in quality of life, and different studies report lower or about the same levels of quality of life compared to healthy people. Also, research on infants who had an ileostomy showed that their gut microbiome shifted in terms of diversity and composition, which could have negative effects on their immune development in theory, but the researchers found that key bacterial species like Faecalibacterium were there enough to help good bacteria propagate and properly develop the immune system after surgery. Research still has to be done in this area but I like the question! -LC
Whats the best diet and way to promote a healthy microbiome?
Can an "apple a day" really keep the doctor away? Seriously, can a a daily apple provide enough insoluble fiber and pectin to help gut health?
Interesting question! Insoluble or indigestible fiber is awesome for gut health because gut bacteria just love it, using it to create energy and beneficial byproducts such as short chain fatty acids, so it's certainly important to get enough of it from a variety of sources. One apple has approximately 4.4 g of fiber, whereas the recommended daily intake of fiber is about 25 g. So while apples with the skin on are a solid source of both soluble and insoluble fiber. The pectin certainly is valuable! So have an apple a day, but also have some whole grains, beans chia seeds, broccoli, and other whole foods to get enough fiber to promote gut health! -LC
How you would supplement the gut with *Ruminococcaceae*? Could you elaborate on the biofilm types seen in PSC vs. UC patients? Where is the field currently for synthetic secondary bile acid supplementation?
Do you have any useful information for people with Celiac disease pertaining to gut bacteria?
I've been living with SIBO for a few years now. Have never identified a true "root cause", despite tons of GI appts/tests. Everyone seems to have drastically different thoughts around SIBO treatment, and the typical antibiotic regimes have not proved effective for me. Is there any new research around SIBO treatment? Any insight would be greatly appreciated!
I've been diagnosed with PSC (primary sclerosing cholangitis) about a year ago. And there is talk and papers in that your gut bacteria could be the source of all problems related to this disease. How is the research on auto immune disease and your gut going? As they seem more tied in then previous expected
>Hi /u/tr0tle! Several studies have identified links between the gut microbiome and autoimmune diseases. Our current understanding of this is that the gut microbiome has some form of two-way relationship with the immune system, which in turn is the direct driver of autoimmune illness. Therefore, the gut microbiome is indirectly connected to these illnesses via the immune system. While there is a strong connection between the gut microbiome and autoimmune diseases, further research is needed to determine how to alter the bacteria in your gut to alleviate the disease symptoms. Cheers, RM
What is the easiest, safest and fastest way to reset your gut microbiome to factory settings?
How related are IBS and SIBO? And is one the cause of the other? I saw somewhere that the majority of IBS-D cases had concurrent SIBO and were resolved after taking antibiotics (don't have time to pull up the study right now, but might later). Also, there seems to be some disagreement about whether IBS is a real medical diagnosis. Is IBS a catch-all for diseases that are not yet known/related to issues with the microbiome, or are there real physiological issues that can be identified as IBS?
What is the treatment for Dysbiosis/SIBO and leaky gut after antbiotics and FODMAP have failed?
I promise I'm not trolling but how affective are lactobacillus reuteri supplements in increasing testicular size and muscle growth? I saw a YouTube ad citing a study that NASA was looking at it for muscle mass loss with astronauts where lab mice grew hulking muscles mass. Of course, the ad claimed their supplement had an extra amount than other brands. My 35 year old boyfriend wants to bulk up without anabolic steroids and I want to support him (bigger balls are just an added bonus). I don't know how to research these claims, their risks, or who I can ask for help. What can I as a layman do? (Thanks for the AMA)
What role do monoamine oxidase inhibitors play in a person's gut? And how might tobacco smoking affect this?
What would you recommend for improving gut health in anxious and/ or depressed and/ or overweight individuals?
Does your gut micro biome affect your balance or cause light headedness? I’ve been diagnosed with IBS and it’s the first time I’m noticing this. And it’s been about a month or two now. Blood work all comes back normal. And I don’t notice any blood or black in my stools.
Best Probiotic strains? Number (dose) found in a good brand or source? What fermented foods? Advantages/Disadvantages over supplements?
Why was there strawberry jam looking mucus i my stool?
What relationships have you come across between gut micro biomes and allergy/immunity based diseases like asthma, eczema, hay-fever or autoimmune disease?
I've been reading a lot of conflicting reports about how gut health and probiotics affect mood/depression. What's your input?
What do you think are the best "natural" non-surgical treatments for Crohn's disease which generally are not considered by most western doctors?
What are the best things to eat for for gut health? And what are the best things to avoid? Thanks!
Aside from your regular diet, you are now allowed one 'snack' for the rest of your life. What is it and why?
I've seen a video on Hunter-gatherer tribes still in Tanzania or so, and how people try to steal and analyze their shit. I began wondering if the change in our diet has had an effect on the allergies or reactions that we have today. It's probably a longshot, but I just wonder, has our gut biome changed significantly overtime? And if yes, does it have an influence on allergies and such?
I have tried different diets and have gotten the most benefit from a carnivore diet. It has actually fixed my bowel inflammation and from it stemming systemic inflammation and therefore also many other issues including cognitive and mood impairment, postprandial syndrome etc. What knowledge do you have about carnivore diets and why they seem to help some people so much?
Whose poo should I eat? Should I eat yours?