Hi /u/PeanutSalsa,
Great question. There is definitely a mix of factors driving this increasing frequency of gluten allergies.

One theory is that the increase in the prevalence of gluten allergy is due to changes in the wheat that is grown today.

Another theory is that the increase in gluten allergies is due to the increased consumption of processed foods that contain gluten. For example, we see a much higher level of gluten allergy in Asian immigrants in the west. Before moving to the west, many people's diets consisted of much less gluten. It is therefore possible that the high level of gluten in the Standard American Diet is not compatible with many people's bodies.

Lastly, as with many diseases like cancer and autism, we have simply gotten better at diagnosing things and see them for what they are. So it may not be that there's a growing amount of the allergy, but that we are simply better at detecting it.

Thank you !
RK

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

Thanks for your question u/PeanutSalsa !

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

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

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

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

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

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

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

Hope this helps!

LC

Thanks for the questions! I can give you some more information on your first question regarding the gut microbiome and acne.

The gut microbiome is an important regulator of the body’s immune system. In people with an altered, or dysbiotic, gut microbiome the permeability of the intestinal wall is increased. The increased permeability leads to the release of inflammatory compounds signalling and increase in inflammation throughout the body. This can lead to an increased response to bacteria on the skin and the development of acne. In addition, there can be alterations in the skin microbiome due to transit of bacteria from the gut to the skin, with the altered skin microbiome leading to the development of acne.
-RM

Hi /u/draegs,

Great question. There is some evidence around the probiotic 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.

There is also evidence for other probiotics such as: the De Simone Formulation, Bifidobacterium longum, Clostridium butyricum MIYAIRI. However, keep in mind many of these studies are done on very low amounts of individuals. So it is best to wait for studies with larger amounts of people before we can say for sure that these probiotics prevent pouchitis.

Thank you for tuning in today.

RK

Hi /u/Other_Exercise,

Sorry to hear about your situation, but the fact that you once had something that helps is hopeful!

To start, Asian restaurant soups will often use as base something called "miso" paste, which is a fermented food and can benefit your digestion. In addition, there is preliminary evidence that seaweed can be quite beneficial for the human microbiome.

Other ways to improve your gut microbiome health is again via adding fermented foods, such as kombucha, kefir, yogurt, kimchi, to your diet. Fermented foods contain live, beneficial bacteria that can lead to improvements in your gut microbiome. In addition, they contain a lot of compounds formed through the process of fermentation that are beneficial to you and the bacteria already in your gut.

I hope this helps you start towards better digestion, best of luck !

-RK

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

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

Thanks for the question!

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

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

-RM

Great question u/IndyDude11 !

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

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

Here are some papers if you’re interested!

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

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

LC

Thanks for the question!There's a saying that the gut is your second brain, and I think that's a fitting way to get into the topic of the link between the brain and gut. The brain-gut axis is a two-way highway of communication between these regions of our bodies. This relationship is bidirectional, meaning the activity and functioning of one can affect the other.

Early childhood trauma can lead to a large stress response in these individuals. The stress response can lead to changes in the gut microbiome through stress hormones and inflammation. The bidirectional communication between the gut and the brain means that these early life changes in the gut also affect the brain at a time period critical to its development. In addition, there is some evidence that these alterations can lead to increased risk of developing stress related disorders later in life.

-RM

In case you're not already aware, there is a SIBO subreddit support group r/sibo I believe. Definitely keep a food journal. It takes a while to sort things out but I've noticed there's a link with certain foods and feeling worse. Good luck with things. Oh and if you have insurance issues with them covering Rifaximin as often as you need it (when I first started I needed to be on it for 3 weeks every 2 months for about a year but my insurance only covered twice a year), the drug manufacturer has a program that they'll send you prescriptions direct from them for free. It's a lot of paperwork unfortunately but worth it vs paying out of pocket.

Hey /u/cozyessi,

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

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

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

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

Thank you !

-RK

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

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

-RM

Great question u/emiredlouis !

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

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

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

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

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

Hope this helps!

LC

>I had H Pylori a few years ago and it really went qute bad for me. Ended up needing two blood transfusions etc.
>
>Is there anything I can specifically do myself to mitigate it happening again? It's always a lingering worry at the back of my mind.

Thanks for your question u/stvbles !

Sorry to hear you had such a rough time.

H. Pylori is extremely common with the majority of the world’s population having some in their bodies. In most cases symptoms are rare, but in others ulcers and inflammation can be found.

When it comes to prevention (I had to look this up) there doesn’t seem to be much outside of general hygiene to avoid a recurrent infection. I’ll include some links below from the Mayo and Cleveland Clinics, but the general gist is to make sure you’re using and consuming clean water and washing your hands thoroughly before eating.

I know this probably isn’t the answer you were looking for, but recurring infections tend to be rare; mainly occurring in developing countries and shortly after being ‘cured’ due to incomplete clearance. Due to the fact that you mentioned it has been years since your infection it seems you’re in the clear :)

Hope this helps!

https://www.mayoclinic.org/diseases-conditions/h-pylori/symptoms-causes/syc-20356171

https://www.hopkinsmedicine.org/health/conditions-and-diseases/helicobacter-pylori

LC

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

Thanks for your question u/MasterPainting5098 !

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

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

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

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

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

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

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

LC

Thanks for the question!

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

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

-RM

Thanks for your question u/CatKitKatCat!

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

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

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

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

Another great question!

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

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

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

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

LC

Hey u/Masek_Kiel , thanks for your question!

First and foremost if you’re experiencing chronic digestive problems you should see a medical professional such as your primary care provider or a gastroenterologist.

There are a handful of tests out there that people with digestive problems can take, namely microbiome/stool tests, food intolerance tests, and general blood tests.

Full transparency our startup, Injoy, has a microbiome test we are extremely proud of. We are a group of patients, doctors, and researchers so validation is core to our offering (we have peer reviewed publications and have begun a few clinical studies). Our microbiome test is unique to others because we have you take 3 samples instead of 1 so we can see how your microbiome is changing over time in comparison to your diet and lifestyle (tracked in our app). We also sequence our samples so we can see all the bacteria present as opposed to a few preselected ones which allows us to provide a more personalized report. Here’s a link to one of our example reports.

Other stool tests look for the presence of inflammatory proteins, blood, or parasites.

At-home food intolerance tests are also very common, but commonly leave much to be desired. Mainly due to the fact that they are most applicable to food allergies which mount an IgE response as opposed to food intolerances and sensitivities which do not. In other words, great for detecting a peanut allergy, but less useful for telling you to avoid tomatoes.

General blood panels are the standard type of blood test you do at the doctor’s office and are a great way to understand a wide swath of things such as your hormone levels and lipid levels. This is helpful when it comes to understanding your liver health, cancer risk, and more in addition to how your body is functioning overall.\

Hope this helps!

Thanks for the question!There is evidence that radiation therapy leads to changes in the gut microbiome. One study found a decrease in bacterial diversity and a few specific bacteria in cancer patients following radiation therapy. In addition, another study found that patients who developed diarrhea after radiation had a different microbiome composition prior to beginning treatment. This suggests that some the microbiome may be protective against the development of side effects to radiation.

Several randomized clinical trials have been performed to determine if probiotics prior to radiation can provide the microbiome-mediated protective effects to adverse side effects. The results of these trials are inconsistent due to the use of different probiotic mixtures. In the trials that reported a reduced incidence of diarrhea, the probiotics consisted of Lactobacillus acidophilus, VSL#3 (which consists of 8 different probiotic bacteria), or a combination of Lactobacillus acidophilus with Bifidobacterium bifidum (https://pubmed.ncbi.nlm.nih.gov/25040088/).

-RM

Great question u/PeanutSalsa !

In short, heavy foods can include many hidden ingredients that can make us feel uncomfortable after eating.

For example, many places you might order takeout from probably use cheap oils to cook their food. Commonly soybean oil, sesame oil, and canola oil. These oils are filled with linoleic acid — a polyunsaturated omega-6 fatty acid  — which can cause inflammation in the body.

Additionally, heavy foods normally mean fatty foods. Fat in general requires several steps before it can be broken down in the digestive tract, such as enzymes in saliva, acid in the stomach, and bile. Additionally, different types of fat can impact the speed of contractions occurring along the digestive tract leading to both diarrhea and constipation depending on whether or not contractions are sped up (diarrhea) or slowed down (constipation, bloating…).

Hope this helps!

LC

Thanks for the question!There's a saying that the gut is your second brain, and it is a good way to start thinking about the gut-brain axis. The gut-brain axis refers to the bidirectional communication, meaning the activity and functioning of one can affect the other, between these regions of our bodies.

An unhealthy, or “dysbiotic” as it is referred to in the field, gut microbiome can lead to changes in the communication occurring along the gut-brain axis. A person can develop a dysbiotic microbiome from an unhealthy diet, the development of some diseases, or high amounts of stress, to name a few. One way an unhealthy gut microbiome can lead to the development of headaches and migraines is through increased inflammation. The unhealthy gut microbiome can lead to an increased production of pro-inflammatory compounds in the gut and an increased permeability of the gut lining. The compounds are then able to affect other parts of the body, such as the brain. Many of the pro-inflammatory compounds released have also been implicated in the development of migraines.

To help reduce migraines, you can implement lifestyle changes that are associated with a healthier microbiome state. We gave some suggestions to improve your gut microbiome in another question.

-RM

New york style sure (if you're weird like that)

Neopolitan style hello no!

LC

This is an interesting one, thanks u/fitzsimonsdotdev

The mind and the gut are more closely linked than many people realize. It’s the reason why our mouth waters and our stomach gurgles when we see yummy food or why we might feel the need to throw up when we get nervous or scared.

With this in mind it’s not hard to imagine that fermented foods could boost your sleep. One theory is that inflammation in the body can worsen sleep quality, which can in turn drive further inflammation. A recent article showed that regular consumption of multiple portions of fermented foods daily could substantially reduce inflammation in the body.

Perhaps the anti-inflammatory effects of the fermented foods you're having could be positively impacting your sleep.

What fermented food do you eat? Do you do anything to create variants with different taste or texture?

>Why is monosodium glutamate (MSG) such a trigger of headaches for people?

Hey /u/PeanutSalsa,

MSG, a common food ingredient is a trigger of headaches for some people because it contains an excitatory neurotransmitter (glutamate). This means that it can cause nerves to fire more easily, which can lead to headaches. This effect will vary from person to person.

-RK

Chiming in to say I’m curious to know what you did, if you have the time to give any input :)