Agent Reach Reddit search outputs
ingested: 2026-06-29 backend: opencli reddit (Agent Reach active backend)
Query: ulcerative colitis remission success story what helped
- id: 1pmjezk
title: I Analyse Your Stool for a Living (and I Have UC). Let’s Talk Calprotectin.
subreddit: r/IBD
author: Chris-flow
score: 116
comments: 36
url: https://www.reddit.com/r/IBD/comments/1pmjezk/i_analyse_your_stool_for_a_living_and_i_have_uc/
created_utc: 1765732692
selftext: "# All about Faecal Calprotectin:\n\nOh Faecal Calprotectin, how many colonoscopies you have potentially avoided. You have my thanks.\n\nLet’s talk about this test, first identified in the early 1990’s, but only widely adopted in the NHS years later. (I could write an entire post on NHS bureaucracy… unless you prove a test saves a load of money, it doesn’t get adopted.)\n\nFast forward to 2015–2018, and this test finally became routine. It’s now an essential tool for monitoring disease, treatment response, and helping diagnose IBD.\_*(Not perfect for everyone, more on that later.)*\n\nIt’s often difficult to distinguish between\_**IBS**\_and\_**IBD**. That leads to unnecessary colonoscopies (hello money-saving!). Calprotectin allows doctors to tell the two apart quickly and safely.\n\nIf you were diagnosed before this test existed (like me in 2013), it often meant being poked, prodded, and having the C-word thrown in. Faecal calprotectin would have smoothed that journey massively. That’s why it’s one of my favourite tests and a genuine success story for the NHS and for IBD care.\n\n# Indications for Testing\n\n* Marker for acute inflammation,\n* Estimation of gastrointestinal inflammation degree,\n* Parameter for monitoring Crohn’s disease, ulcerative colitis or the patient’s status after removal of polyps,\n* Discrimination between patients with inflammatory bowel disease (acute Crohn’s disease and ulcerative colitis) and irritable bowel syndrome without the need for colonoscopy.\n\n# What is Faecal Calprotectin?\n\nCalprotectin is a\_**calcium/zinc-binding protein complex**\_released by\_**neutrophils**\_(the most abundant type of white blood cell) acting as part of the innate/first responder immune response.\n\nNeutrophils release calprotectin anywhere in the body where inflammation occurs, but\_**only gut inflammation causes it to appear in stool**, which is why this test works.\n\n[Neutrophils \\(the big pink ones, red cells behind them\\) - always like the ones that look like smiley faces.](https://preview.redd.it/74vyi2i8d77g1.jpg?width=2000&format=pjpg&auto=webp&s=b66ae8b2be87c86be27749ee0b2017713efddcb7)\n\n# What Does Calprotectin\_Do? Why Do Neutrophils Release It?\n\n**1.It’s an antimicrobial weapon.**\n\nCalprotectin binds the metal ions\_**zinc**\_and\_**manganese**, which bacteria and fungi need to grow.\n\n*Rathan than directly attacking them, it starves them. A strategy known as “****nutritional immunity.****”*\n\n\n\n**2. It amplifies and regulates inflammation**\n\nThis is part of why IBD becomes a problem. The double edged sword of any auto-immune condition.\n\nCalprotectin acts as a distress signal called\_**DAMP**\_(Damage-Associated Molecular Pattern). It binds to immune receptors like\_**TLR4**\_and\_**RAGE**, triggering cells to release inflammatory messengers called\_**cytokines**\_(IL-1β, IL-6, TNF-α). These cytokines are a focus of much research in regards to IBD.\n\n*In infection this keeps you alive. In IBD, the system misfires and becomes chronic.*\n\n\n\n**3. It helps neutrophils survive in hostile environments**\n\nInflamed tissues are acidic, hot (think fevers), and filled with reactive chemicals. Calprotectin helps neutrophils stabilise themselves so they can keep fighting.\n\n\n\n**Summary:** Calprotectin isn’t “just something we measure”, it’s a powerful tool the immune system uses. We just take advantage of the fact it calprotectin in the stool is a measurable protein directly proportional to the inflammation in the gut.\n\n# How We Run Faecal Calprotectin in the Lab\n\nSend me some poo.\n\nWe don’t need much (actually 15mg, which is pea sized).\n\nDon’t get it contaminated with toilet water! (My preferred method is to put lots of toilet roll in the bowl first to catch it).\n\nBlood and mucus is ok in sample, dont aim for it, don’t avoid it. The idea here is to get a good representative sample of the overall stool. Like a mini poo :)\n\nThe sample is stable for 3 days at room temperature, but we prefer to receive it the same day.\_We store it at 2–8°C and test it within 48 hours.\n\n**If frozen at –20°C**, it’s stable for 12 months. Though freezing can sometimes cause a slight artificial increase, because neutrophils may burst and release more calprotectin. Your lab/doctor will likely take this into consideration when interpreting results so it isn’t an issue.\n\n\n\n# The ELISA Method (How the Test Actually Works)\n\n**1.**\_**Your sample, along with standards and controls (these are known results we use to make sure the result is correct), is added to a test plate.**\_The plate is already coated with special antibodies that specifically capture calprotectin.\n\n**2. If calprotectin is present, it sticks to the plate.**This happens during the first incubation step.\n\n**3. A second antibody is added that attaches to the captured calprotectin.**This second antibody has an\_**enzyme**\_attached to it. So now you have a “sandwich”: Antibody — Calprotectin — Enzyme-linked Antibody.\n\n**4. A colour-forming solution is added.**The enzyme reacts with this solution (called\_**TMB**), turning it\_**blue**, and then\_**yellow**\_when the reaction is stopped.\n\n**5. The strength of the yellow colour reflects how much calprotectin is in your sample.**A stronger colour = more calprotectin, a weaker colour = less calprotectin\n\n**6. A calibration curve is used to calculate your exact result.**The machine compares your sample to known standards and produces a real number (e.g.,\_**75 µg/g**,\_**500 µg/g**, etc.)\n\n*This is why it’s such a reliable, quantitative test for inflammation.*\n\n[Faecal Calprotectin ELISA reagents. Boxes and boxes of these line our cold room!](https://preview.redd.it/6egf0qehd77g1.jpg?width=2000&format=pjpg&auto=webp&s=ff8b2e214022267de2fd02b47a2fb91e598f0f94)\n\nhttps://preview.redd.it/tneqpeehd77g1.jpg?width=2000&format=pjpg&auto=webp&s=950a66bf6cc06b23955ca61266255669ef0947bb\n\n\n\n\n\nhttps://preview.redd.it/4xgdmabjd77g1.jpg?width=2000&format=pjpg&auto=webp&s=f002988cd913cfd2a9eb2d8f993deec6a32752d6\n\n[We use an automated analyser called the DYNEX® DS2 ELISA system. It’s not the most complicated analyser, or the biggest, but this baby will set you back around £100,000 if you want one!](https://preview.redd.it/qru16cbjd77g1.jpg?width=2000&format=pjpg&auto=webp&s=7d3b5912418fe940faadff382438342ed1ae505c)\n\n[If you think your poo smells, imagine 100 other people just like us. So yeah, we use a fume cupboard to pull that smell away from our nostrils and into the lovely fresh Manchester air.\_](https://preview.redd.it/euud0flkd77g1.jpg?width=2000&format=pjpg&auto=webp&s=b714f1242746f352f6562ef9b1cc84f2b266b619)\n\n# Result Interpretation:\n\n>\n\nEach lab may establish their own reference ranges based on their local population. As confusing as that sounds, there may be small differences. Also, these reference ranges are based on the test kit: Manual — IDK® Calprotectin (MRP8/14). Widely used within the NHS UK.\n\n\n\n# Reference Ranges for Faecal Calprotectin in ADULTS (>12 years old):\n\n**Konikoff MR & Denson LA (2006) Inflamm Bowel Dis 12:524–534 doi:10.1097/00054725-200606000-00013**\n\n**Important:**Make sure you check the units your lab is reporting in, and convert if required!\n\n* The median value in healthy adults is 25µ/g (mg/kg)\n* Samples with a calprotectin concentration\_**< 50 µg/g**\_are regarded as negative.\n* Samples with a calprotectin concentration\_**between 50 µg/g and 100 µg/g**\_are regarded as borderline positive. We recommend repeating the measurement at a later time point in order to confirm the result.\n* Samples with a calprotectin concentration\_**> 100 µg/g**\_are regarded as positive.\n\n**Note:**\_Many confounding factors can cause increased levels of faecal calprotectin in the absence of IBD or IBD in a quiescent disease phase, e.g. use of NSAIDs (non-steroidal anti-inflammatory drugs), any intercurrent gastrointestinal infection, and the presence of malignancies. These factors should be considered in the interpretation of the test results and therapy of IBD.\n\n\_\n\n# Normal Ranges for Faecal Calprotectin in Paediatrics (0 - 12 years Old)\n\n**Hestvik E et al. (2011) BMC Pediatrics 11:9 doi:10.1186/1471-2431-11-9**\n\n**Method:**\_302 apparently healthy children, age 0–12 years, in Kampala, Uganda, were tested for faecal calprotectin concentration.\n\n**Table 1: Faecal calprotectin concentration in apparently healthy children by age.** \n95% confidence interval (95% CI) is indicated in brackets.\n\n|**Age**|**Number (%)**|**Median calprotectin \\[µg/g\\] (95% CI)**|\n|:-|:-|:-|\n|0–3 months|14 (4.6%)|345 (195–621)|\n|3–6 months|13 (4.3%)|278 (85–988)|\n|6–12 months|27 (8.9%)|183 (109–418)|\n|1–4 years|89 (29.5%)|75 (53–119)|\n|4–12 years|159 (52.6%)|28 (25–35)|\n\n\n\n# Normal Ranges for Faecal Calprotectin in Paediatrics (4 - 17 years Old)\n\n**Fagerberg UL et al. (2003) J Pediatr Gastroenterol Nutr 37:468–472**\n\n**Method:**\_117 healthy children age 4–17 years were tested for faecal calprotectin concentration.\n\n**Table 2: Faecal calprotectin concentration in healthy children by age.**\n\n|**Age**|**Number**|**Median faecal calprotectin \\[µg/g\\]**|\n|:-|:-|:-|\n|4–6 years|27|28.2|\n|7–10 years|30|13.5|\n|11–14 years|27|9.9|\n|15–17 years|33|14.6|\n\n**Conclusion:**\_The suggested cut-off level for adults (< 50 µg/g) can be used for children aged 4–17 years.\n\n\n\n# FAQ’s:\n\n**1. Is there a test better than a Faecal Calprotectin?**\n\nYes there is: The excretion of Indium-111-labelled neutrophilic granulocytes has been suggested as the “gold standard” of disease activity in inflammatory bowel disease. However, measuring 111-indium-labelled granulocytes is very costly (patient’s hospitalisation, analysis and disposal of isotopic material) and is connected with radioactive exposition of the patients. For this reason, a repeated application to children and pregnant women is not recommended.\n\nFor the NHS - this isn’t available - and frankly, wouldn’t be needed in 99% of cases in my opinion.\n\n\n\n**2. Does a high faecal calprotectin always mean IBD?**\n\n**No.**\n\nCalprotectin rises whenever neutrophils enter the gut – and that can happen for several reasons:\n\n* Gastroenteritis (viral or bacterial)\n* Food poisoning\n* NSAIDs (ibuprofen, naproxen)\n* Coeliac disease\n* Diverticulitis\n* Post-polypectomy\n* GI bleeding\n* After intense exercise\n\nA single elevated result\_**does not equal IBD**. Doctors look at the full clinical picture, this will include symptoms, trends and repeat tests.\n\n\_\n\n**3. Can IBS raise faecal calprotectin?**\n\n**No.**\n\nIBS\_**does not**\_cause inflammation, so calprotectin stays normal.\n\n\_\n\n**4. How quickly does calprotectin respond to treatment?**\n\nUsually\_**2–8 weeks**, depending on:\n\n* Steroids → fast drop\n* Biologics → slower but steady\n* Mesalazine → moderate drop\n* Antibiotics → varies\n\nRegular tests help us so much. It’s hard to make conclusions on one sample alone, but repeating (as annoying as it is) is so important. Trends are crucial for good interpretation.\n\n\_\n\n**5. What are the best practices for stool collection?**\n\n**Pea sized**\_amount.\_**Good representation**\_of the overall stool (think mini poo).\_**Don’t aim for blood and mucus**, but don’t avoid it either.\_**Same day collection**\_is best at room temp, but freezing may be required logistically.\_**Don’t contaminate it**with water!\n\n\n\n**6. Is faecal calprotectin raised in cancer? Is colonoscopy the only way to know?**\n\nI’m always careful discussing cancer because it’s easy for fear to take over, so please trust your doctor’s interpretation here.\n\nWhen interpreting patients results,\_**this is where medical experience really plays.**\_It’s hard to explain how we develop this almost sixth sense. When you interpret these results all day long, subtle differences in the overall picture (I can't stress this enough, the whole story of the patient is considered) can be glaringly obvious to the professional that a colonoscopy must be performed urgently. We will highlight it with a phone call, the doctor will also recognise it.\n\nThere is overlap in colorectal cancers and IBD symptoms. There’s no hard or fast rules I can put into a clear table. Plus, if IBD isn’t in remission all that cell repair puts you more at risk of developing cancer. Hence, the 5 year colonoscopies (don't miss your next one!)\n\nIf we look at faecal calprotectin alone, it is simply a\_**marker of inflammation**, not cancer itself. Calprotectin\_**can**\_be elevated in colorectal cancer or polyps, but that’s because these conditions provoke\_**local inflammation**, not because calprotectin is a cancer signal. It rises because neutrophils release calprotectin in response to irritation in the gut, and that irritation can come from many causes.\n\nIn fact, levels in cancer are often\_**much lower**\_than what we see in active IBD, and cancer is far less common than infections, IBS/IBD overlap, or benign inflammatory conditions.\n\nSo while cancer can raise calprotectin, a high result\_**does not**\_mean cancer - it simply tells us that inflammation is present and needs investigating.\n\nDoctors will interpret the\_**full clinical picture**\_based on:\n\n* **Symptoms**\_(e.g., persistent change in bowel habit, weight loss, blood mixed in stool, low haemoglobin/anaemia, usually in people over 40–50)\n* **Lots of blood tests**and the relationship between them can give clues \n* And if there is any concern, a\_**colonoscopy**with histological interpretation is the definitive test. This is also the reason regular colonoscopies once diagnosed with IBD is VERY important.\n\n**Bottom line:** Calprotectin alone can’t indicate if it's cancer or IBD. However, in combination with other tests and symptoms it may highlight the urgency of performing a colonoscopy (which will give you all the answers).\n\nIf there is one thing I would advise, is,\_**you know your body.**\_All the tests in the world won’t beat a colonoscopy. If you want, it's your right to demand a colonoscopy - that will give you a definitive answer.\n\n**7. Why do I need a colonoscopy if I can just test faecal calprotectin?**\n\nIn short, you can’t beat a colonoscopy. It's the ‘gold standard test’. Faecal Cal has its place in differentiating between IBS and IBD, monitoring IBD disease progression and response to treatment. However, as healthcare professionals it's our job to rule things out. A colonoscopy will give you a much more definitive answer than any non-invasive, in-vitro sample.\n\n**8. Does a negative Calprotectin = no inflammation?**\n\nLot’s of people have asked me this: I have all the symptoms of a flare, but my results appear normal. Why?\n\nI really tried hard to find an answer for this (it's quite common!). It’s possible to get a false negative for example, say you diluted it with toilet water, maybe that particular stool sample wasn’t collected correctly, lab errors, very early flare activity. But\_**if it’s been repeated**\_and your bloods (I.E. CRP) are all negative as well, these are my thoughts and reasoning why:\n\n**1. Proctitis (rectal only):**\_probably the biggest reason may be that inflammation is right at the end of the bowel, the stool may pass\_**above**\_the inflamed area before calprotectin has a chance to mix through it.\n\nMine started as proctitis (it's since spread up a little bit). My CRP and FC (faecal calprotectin where always low, but a colonoscopy diagnosed it. When it spread up a little bit, suddenly FC was high, my CRP was relatively\n\n**2. IBS overlay:**\_a colonoscopy would show active inflammation and prove me wrong. However it may be that the symptoms are overlapping whilst in IBD remission. IBS won’t have blood, but other than that, the symptoms can be fairly similar!\n\n**3. CRP non-responders:**\_This is certainly a known thing, and not anything to worry about. 20 - 30% of patients can be non-responders. Causes can be genetic, and seem to be more common in UC than Crohn's.\n\n*Lewis JD (2011) Gastroenterology 140:1817–1826 doi:10.1053/j.gastro.2010.11.058*\n\n*D’Haens G et al. (2012) Inflamm Bowel Dis 18:2218–2224 doi:10.1002/ibd.22917*\n\nSo unfortunately, that was the best I could find or think of - it just happens to some patients. To be honest, if your results are normal, it isn’t saying you don’t have IBD or invalidating your symptoms. It's saying your body is doing a fairly good job handling it. That’s a good thing!\n\n\_\n\n**9. Do you get used to testing poo?**\n\nYup! I only added this bit to get one point across.\_**Don't ever be embarrassed.**\n\nAside from our duty to remain professional, you really do get de-sensitised to it. Its just poo. I mean, obviously im going to wear gloves/PPE and use a fume cupboard. But if you think i haven't seen worse than yours, i have.\_**It doesn't bother us, and it shouldn't bother you.**\_\n\n\n\n\_\n\n**Thanks for reading,**I really hope it's useful and interesting. It’s a long one, took me a long time to write, but honestly Faecal Cal deserves it!\_\n\nIt will never replace a colonoscopy when needed, but it serves a really important part of our\_repertoire\_of diagnostic tools for IBD. I'm incredibly grateful for the NHS providing it as a service from a personal and professional perspective.\_\n\nYou keep sending. I’ll keep testing.\n\nOriginal article found at: [https://www.ib3discreet.com/blogs/main-just-for-fun/i-analyse-your-stool-for-a-living-and-i-have-uc-let-s-talk-calprotectin](https://www.ib3discreet.com/blogs/main-just-for-fun/i-analyse-your-stool-for-a-living-and-i-have-uc-let-s-talk-calprotectin)\n\nTake care, and all the best on your IBD journey.\n\nChris\_\n\n[](https://www.ib3discreet.com/blogs/main-just-for-fun/why-ib3-packaging-had-to-be-different)"
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- id: 1td43lr
title: Can’t Get Into Remission no matter what
subreddit: r/UlcerativeColitis
author: monsterabug
score: 10
comments: 17
url: https://www.reddit.com/r/UlcerativeColitis/comments/1td43lr/cant_get_into_remission_no_matter_what/
created_utc: 1778777666
selftext: >-
I (25F) have been diagnosed with Ulcerative Colitis since I was 5 years old. When I first got diagnosed with it I
was in the pediatric ICU getting multiple blood transfusions due to the blood loss. My timeline since then (that I
can remember) has been:
\- 5-10yo: remicade and 6MP
\- 10-17yo: remission-no meds
\- 18yo: Humira for about 6 months then no meds
\- 19yo: got sepsis and hospitalized for flare in January, started remicade then developed psoriasis so doctor
changed me to entivyo in April
\- 19-24yo: entivyo until February 2025 (lost insurance)
\- 02/25-09/25: no meds
\- 09/25-11/25: entivyo, hospitalized for flare in November
\- 01/26: started rinvoq (pre authorization took months)
For each hospitalization I had iv solumedrol that transitioned to Prednisone orally. For everytime I started a new
biologic medication I took a bridge dose of prednisone or Budesonide. I also have a steroid enema that is suppose to
help with inflammation. However steroids don’t seem to work for me anymore.
Since being on Rinvoq it has been hell. I got norovirus about a month and a half into rinvoq and my liver levels
were 3x the limit so I had to stop the medication until my liver levels came back down. After restarting rinvoq
about 1-2 weeks in I got sick again and had to stop the medication. Then restarted rinvoq and got ecoli and had to
stop again. I just started rinvoq back up a couple days ago but it seems like everytime I step foot outside I get
sick. My doctor wants me to keep trying rinvoq but I just feel like it compromised my immune system too much.
Lifestyle wise I don’t really go out much, I don’t drink, I don’t eat gluten, I don’t eat lactose, I don’t eat a lot
of fiber, I pretty much follow the diet to a T that the dietitian in the hospital put me on. I also only work a
couple days a month due to my disease (doctors won’t let me work more) and try my best to keep stress down.
My symptoms right now include 10-12 stools a day sometimes bloody sometimes not, intense pain upper and lower GI
daily, urgency/incontinence, and extreme fatigue. I have to wear a diaper anytime I go out. I also wake up at 4 am
almost everyday to go to the bathroom. I can’t get more than 4 hours of sleep at a time. I normally wake up 2 times
throughout the night to go.
My labs as of yesterday are: low sodium, low potassium, high eosinophil, high sed rate, high crp
Stool sample negative
At this point I don’t know what to do. I looked up clinical trials in my area and most of them I’m not eligible for
due to my medication history. I asked my doctors about surgery but because I’m “young and haven’t had a baby yet”
they don’t want me to do the surgery. I’m in between surgery and starting a new medication but I’m tired of the
constant trial and error. I am 25 years old and living like an elderly person. I want to experience life in my 20s
but have to spend most my time in pain and around a bathroom. Please if anyone has a success story or advice on
what to do please let me know. I’m really at a loss at this point.
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- id: 1txh77j
title: newsflash week 23.2026
subreddit: r/UlcerativeColitis
author: achchi
score: 7
comments: 1
url: https://www.reddit.com/r/UlcerativeColitis/comments/1txh77j/newsflash_week_232026/
created_utc: 1780655842
selftext: >-
Welcome back to this week's newsflash
1. We are excited to announce that we are expected to host an AMA with u/WebMD on June 15, 2026. Further details
about this upcoming event will follow soon. do you want to know
[more](https://www.reddit.com/r/UlcerativeColitis/s/csNpL3Ioym)?
2. Recent regulatory developments and phase 3 data are highlighting the rapid pace of innovation across the
gastroenterology specialty. Several new treatment options and trial results for UC and IBD were announced recently.
do you want to know [more](https://www.hcplive.com/view/6-gastroenterology-headlines-you-missed-in-may-2026)?
3. A recent analysis explores whether obefazimod can recover from the cancer cases observed in its UC maintenance
data. Experts are weighing the drug efficacy against these safety concerns to predict its future in IBD treatment.
do you want to know [more](https://firstwordpharma.com/story/7523486?hl=de-DE)?
4. A prospective study in the UEG Journal introduces triple healing as a newly assessed therapeutic target
associated with sustained remission in UC. This involves achieving histological healing combined with intact
intestinal permeability. do you want to know
[more](https://www.morningstar.com/news/business-wire/20260603812206/mauna-kea-technologies-announces-new-publication-in-the-ueg-journal-identifying-triple-healing-a-cellvizio-assessed-therapeutic-target-associated-with-sustained-remission-in-ulcerative-colitis?hl=de-DE)?
5. A comprehensive atlas comprising 2.2 million cells is shedding light on how genes drive the risk of developing
IBD. This massive research effort provides deeper insights into the chronic inflammation characterizing both Crohn
disease and UC. do you want to know
[more](https://medicalxpress.com/news/2026-06-million-cell-atlas-reveals-genes.html)?
6. Treating UC with two biologic medications or combining a biologic with a small molecule drug is becoming
increasingly common. This dual therapy approach often called stacking may offer new hope for patients struggling to
manage their IBD symptoms. do you want to know
[more](https://www.everydayhealth.com/digestive-health/ulcerative-colitis-is-stacking-biologics-safe/?hl=de-DE)?
8. The present and future of monitoring IBD heavily rely on endoscopic and histologic improvements to reduce
hospitalizations. Proper tracking of these metrics translates into significantly better long-term outcomes for
patients with UC. do you want to know
[more](https://www.docwirenews.com/post/the-present-and-future-of-monitoring-inflammatory-bowel-disease)?
9. An increasing number of young adults in their 20s and 30s are being diagnosed with IBD due to immense academic
and work stress. Factors like westernized eating habits and sleep deprivation are further exacerbating UC in this
demographic. do you want to know [more](https://www.mk.co.kr/en/it/12057807?hl=de-DE)?
10. An experimental oral drug for UC has successfully met the main goal of its late-stage trial by showing
significant placebo-adjusted clinical remission. This development could potentially prompt takeover interest in the
company developing the IBD treatment. do you want to know
[more](https://www.reuters.com/business/healthcare-pharmaceuticals/abivaxs-inflammatory-bowel-drug-meets-main-goal-late-stage-trial-2026-06-01/)?
11. While a crucial study showed an experimental UC drug helped patients achieve their treatment goals there are
concerns regarding its safety profile. Investors are closely monitoring how these trial results will impact the
overall IBD therapy landscape. do you want to know
[more](https://www.investors.com/news/technology/abivax-stock-ulcerative-colitis-treatment-2/)?
12. Despite achieving what some analysts described as best-in-disease efficacy for UC the safety worries are
clouding the landmark immune drug results. A handful of malignancies reported among treatment recipients
overshadowed the positive remission rates for IBD patients. do you want to know
[more](https://www.biopharmadive.com/news/abivax-obefazimod-abtect-ulcerative-colitis-results-cancer/821685/?hl=de-DE)?
That's it for this week. Stay safe.
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- id: 1tbhtzq
title: Serving with Crohn's?
subreddit: r/peacecorps
author: tempaccount207914
score: 1
comments: 4
url: https://www.reddit.com/r/peacecorps/comments/1tbhtzq/serving_with_crohns/
created_utc: 1778627148
selftext: >-
Is anyone currently serving with Crohn's disease/Ulcerative Colitis/IBD? I have been in remission for a few years
now and I am on a normal prescription pill. I can eat what I want (spicy food and all), do what I want, and I forget
that I have Crohn's most days...but the government really doesn't give a shit about that from experience. I've been
denied from the military and tons of federal jobs...I feel like every door I've tried was closed on me over
something I didn't ask to be afflicted with.
I was so excited to join the Peace Corps after learning more about it, since I've naturally just worked in positions
where I help people without thinking about. Naturally, whenever I'm interested in something, I get shot down, so of
course I've just discovered an old PC document from 2009 saying Crohn's is "unable to be accommodated".
I have absolutely no mental health problems and have never seen a psychiatrist. I had absolutely zero problems
during COVID lockdown, so the "isolation" thing they seem to worry about is a non issue for me. It seems this one
stupid diagnosis is ruining my life every step of the way.
Anybody have any success stories? It seems this sub is filled to the brim with hellish stories of people getting
denied because their calcium was too high or because they saw a psychiatrist once when they were a kid. Is it really
that bad? Because if it is, I'm screwed.
I've traveled to developing countries before and not gotten sick. Is this something I can bring up to support my
case? Are they medically strict for certain countries (i.e. African) and more lax for others (i.e. European)?
Thanks in advance.
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- id: 1jjutw4
title: Doctors Told Him He Was Going to Die. Then A.I. Saved His Life.
subreddit: r/longform
author: SunAdvanced7940
score: 315
comments: 5
url: https://www.reddit.com/r/longform/comments/1jjutw4/doctors_told_him_he_was_going_to_die_then_ai/
created_utc: 1742937933
selftext: >-
A little over a year ago, Joseph Coates was told there was only one thing left to decide. Did he want to die at
home, or in the hospital?
Coates, then 37 and living in Renton, Wash., was barely conscious. For months, he had been battling a rare blood
disorder called POEMS syndrome, which had left him with numb hands and feet, an enlarged heart and failing kidneys.
Every few days, doctors needed to drain liters of fluid from his abdomen. He became too sick to receive a stem cell
transplant — one of the only treatments that could have put him into remission.
“I gave up,” he said. “I just thought the end was inevitable.”
But Coates’s girlfriend, Tara Theobald, wasn’t ready to quit. So she sent an email begging for help to a doctor in
Philadelphia named David Fajgenbaum, whom the couple met a year earlier at a rare disease summit.
By the next morning, Dr. Fajgenbaum had replied, suggesting an unconventional combination of chemotherapy,
immunotherapy and steroids previously untested as a treatment for Coates’s disorder.
Within a week, Coates was responding to treatment. In four months, he was healthy enough for a stem cell transplant.
Today, he’s in remission.
The lifesaving drug regimen wasn’t thought up by the doctor, or any person. It had been spit out by an artificial
intelligence model.
In labs around the world, scientists are using A.I. to search among existing medicines for treatments that work for
rare diseases. Drug repurposing, as it’s called, is not new, but the use of machine learning is speeding up the
process — and could expand the treatment possibilities for people with rare diseases and few options.
Thanks to versions of the technology developed by Dr. Fajgenbaum’s team at the University of Pennsylvania and
elsewhere, drugs are being quickly repurposed for conditions including rare and aggressive cancers, fatal
inflammatory disorders and complex neurological conditions. And often, they’re working.
The handful of success stories so far have led researchers to ask the question: How many other cures are hiding in
plain sight?
There is a “treasure trove of medicine that could be used for so many other diseases. We just didn’t have a
systematic way of looking at it,” said Donald C. Lo, the former head of therapeutic development at the National
Center for Advancing Translational Sciences and a scientific lead at Remedi4All, a group focused on drug
repurposing. “It’s essentially almost silly not to try this, because these drugs are already approved. You can
already buy them at the pharmacy.”
The National Institutes of Health defines rare diseases as those which affect fewer than 200,000 people in the
United States. But there are thousands of rare diseases, which altogether affect tens of millions of Americans and
hundreds of millions of people around the world.
And yet, more than 90 percent of rare diseases have no approved treatments, and pharmaceutical giants don’t commit
many resources to try to find them. There isn’t typically much money to be made developing a new drug for a small
number of patients, said Christine Colvis, who heads drug development partnership programs at NCATS.
That’s what makes drug repurposing such “an enticing alternative” route to finding treatments for rare diseases,
said Dr. Marinka Zitnik, an associate professor at Harvard Medical School who studies computer science applications
in medical research. Dr. Zitnik’s Harvard lab has built another A.I. model for drug repurposing.
“Other laboratory discovery techniques have already put drug repurposing on the map,” Dr. Lo said. “A.I. just puts
rocket boosters on that.”
Finding Clues in Old Research Repurposing is fairly common in pharmaceuticals: Minoxidil, developed as a blood
pressure medication, has been repurposed to treat hair loss. Viagra, originally marketed to treat a cardiac
condition, is now used as an erectile dysfunction drug. Semaglutide, a diabetes drug, has become best known for its
ability to help people lose weight.
The first time Dr. Fajgenbaum repurposed a drug, it was in an attempt to save his own life. At 25, while in medical
school, he was diagnosed with a rare subtype of a disorder called Castleman disease, which led to an immune system
reaction that landed him in the intensive care unit.
There is no one way to treat Castleman disease, and some people don’t respond to any of the available treatments.
Dr. Fajgenbaum was among them. Between hospitalizations and rounds of chemo that temporarily helped, Dr. Fajgenbaum
spent weeks running tests on his own blood, poring over medical literature and trying unconventional treatments.
“I had this really clear realization that I didn’t have a billion dollars and 10 years to create some new drug from
scratch,” he said.
The drug that saved Dr. Fajgenbaum’s life was a generic medication called sirolimus, typically given to kidney
donation recipients to prevent rejection. The medication has kept his Castleman disease in remission for more than a
decade.
Dr. Fajgenbaum went on to become a professor at the University of Pennsylvania, and began seeking out other drugs
with unknown uses. Existing research, he realized, was full of overlooked clues about potential links between drugs
and the diseases they could treat, he said. “If they’re just in the published literature, shouldn’t someone be
looking for these all day, every day?”
His lab had some early successes, including finding that a novel cancer drug helped another Castleman patient. But
the process was laborious, requiring his team to examine “one drug and one disease at a time,” he said. Dr.
Fajgenbaum decided he needed to speed up the project. In 2022, he established a nonprofit called Every Cure, aimed
at using machine learning to compare thousands of drugs and diseases all at once.
Work similar to Every Cure’s is taking place in other labs around the world, including at Penn State and Stanford
University, as well as in Japan and China.
In Birmingham, Ala., an A.I. model suggested a 19-year-old patient debilitated by chronic vomiting try isopropyl
alcohol, inhaled through the nose. “Essentially we ran a query that said, ‘Show us every proposed treatment there
has ever been in the history of medicine for nausea,’” said Matt Might, a professor at University of Alabama at
Birmingham who leads the institute that developed the model.
The alcohol “popped to the top of our list,” Dr. Might said, and “it worked instantly.”
The model developed by Dr. Might’s institute has successfully predicted other treatments, too: Amphetamines
typically used to treat A.D.H.D. relieved periodic paralysis in children with a rare genetic disorder. A Parkinson’s
drug helped patients with a neurological condition move and speak. A common blood pressure medicine called
guanfacine drastically improved the mobility of a pediatric patient with a different neurological condition.
Many drugs do more than one thing, Dr. Might said. Their additional features sometimes get characterized as side
effects. “If you comb through enough drugs, you eventually find the side effect you’re looking for,” he said, “and
then that becomes the main effect.”
At the University of Pennsylvania, Dr. Fajgenbaum’s platform compares roughly 4,000 drugs against 18,500 diseases.
For each disease, pharmaceuticals get a score based on the likelihood of efficacy. Once the predictions are made, a
team of researchers combs through them to find promising ideas, then performs lab tests or connects with doctors
willing to try the drugs on patients.
Elsewhere, pharmaceutical companies are using A.I. to discover entirely new drugs, a pursuit that has the potential
to streamline an enterprise already worth billions. But drug repurposing is not likely to prove lucrative for any
one party. Many drug patents expire after a few decades, which means there is little incentive for drug companies to
seek out additional uses for them, said Aiden Hollis, a professor of economics at the University of Calgary with a
focus on medical commerce.
Once a drug becomes one of the thousands of generics approved by the Food and Drug Administration, it typically
faces stiff competition, driving down the price.
“If you use A.I. to come up with a new drug, you can make lots and lots of money off that new drug. If you use A.I.
to find a new use for an old, inexpensive drug, no one makes any money off of it,” Dr. Fajgenbaum said.
To fund the venture, Every Cure received more than $100 million in commitments last year from TED’s Audacious
Project and the Advanced Research Projects Agency for Health, an agency within the federal health department
dedicated to supporting potential research breakthroughs. Dr. Fajgenbaum said that Every Cure will use the money, in
part, to fund clinical trials of repurposed drugs.
“This is one example of A.I. that we don’t have to fear, that we can be really excited about,” said Dr. Grant
Mitchell, another Every Cure co-founder and a medical school classmate of Dr. Fajgenbaum. “This one’s going to help
a lot of people.”
‘Someone Had to Be The First to Try’ Dr. Luke Chen was skeptical when Dr. Fajgenbaum’s model suggested he treat a
patient with Castleman disease using adalimumab, a medication typically used to treat arthritis, Crohn’s disease and
ulcerative colitis.
“I didn’t think it was going to work, because it’s kind of a wimpy drug,” said Dr. Chen, a hematologist and
professor at Dalhousie University and the University of British Columbia.
But the patient had already undergone chemotherapy and a bone-marrow transplant and had tried drugs including the
one that saved Dr. Fajgenbaum’s life. Nothing worked, and he was entering hospice.
“We had basically given up, but I put in a last call to David,” Dr. Chen said.
With no other options, Dr. Chen gave the patient the adalimumab. In a matter of weeks, the patient was in remission.
The case was recently the subject of a paper in The New England Journal of Medicine.
No model is infallible, Dr. Zitnik said. A.I. can sometimes make predictions “based on evidence that isn’t
sufficiently strong.”
Dr. Colvis said ranking potential treatments by likelihood of success can also prove difficult. Such issues make
physician oversight crucial. Sometimes, a doctor will determine that a treatment suggestion is too risky to try, she
said. “But then there are instances where they will see something and say, ‘OK, this looks like it’s reasonable,’”
Dr. Colvis added.
When Dr. Fajgenbaum first suggested that Dr. Wayne Gao, a hematologist and oncologist in Washington State, try a
novel treatment on one of his patients, Dr. Gao had doubts.
The patient was Coates, the Washington man headed for hospice, and the aggressive drug combination suggested by Dr.
Fajgenbaum’s model seemed “a little bit crazy,” Dr. Gao said. In fact, he worried that the treatment might kill
Coates faster.
But Coates was a young man, and there were no other treatments to consider. And so, Dr. Gao said, “someone had to be
the first to try.”
Last month, just over a year after his brush with death, Coates and his girlfriend visited Dr. Fajgenbaum in
Philadelphia to thank him for his help. A smiling Coates was the picture of health; he had put on muscle since the
last time he met the doctor.
Coates had tweaked his ankle that morning while working out. But otherwise, he said, he felt “just fine.”
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gallery_urls: []
- id: 1qsg4rd
title: Success stories
subreddit: r/UlcerativeColitis
author: MikeLorenzen
score: 3
comments: 4
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qsg4rd/success_stories/
created_utc: 1769897958
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Hi everyone,
I’m hoping to hear some success stories from people with Ulcerative Colitis who eventually found a medication that
truly worked for them.
A bit about my journey: I’ve been living with UC ffor about a year now,it’s been a constant cycle of flares and
medication changes, trying to find something that actually works long term.
I started with mesalamine (Asacol), which helped somewhat but never got me into full remission. Because flares kept
returning with bleeding, I had to rely on prednisolone on and off — effective short term, but not sustainable.
After that, I moved on to biologic treatment with adalimumab (Hyrimoz / Humira). It worked really well for a few
months, but over time I lost response, and my symptoms gradually came back.
I’m now on Jyselca (filgotinib). I’m still early in this treatment, but so far it doesn’t seem to be working the way
we hoped.
I’d really appreciate hearing from anyone who:
\- Lost response to a medication but eventually found one that worked
\- Went through multiple biologics or JAK inhibitors before reaching remission
\- Took a while before a treatment truly kicked in
What finally worked for you, and how long did it take before you felt stable again?
Thanks in advance🙏
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- id: wt8lp2
title: SIBO - My Journey and Data - planned treatment
subreddit: r/SIBO
author: rt312410
score: 137
comments: 61
url: https://www.reddit.com/r/SIBO/comments/wt8lp2/sibo_my_journey_and_data_planned_treatment/
created_utc: 1661006145
selftext: >-
Synopsis – Treating Sibo is not an exact science. Below is a practical approach, with instructions and dosage, to
try to introduce you to the basics of sibo and hopefully cure your sibo, using comparative data from other users
that have cured their disease. This user has not cured themselves. Posting despite not being cured in hope that all
this research will help someone else in their journey while I go through mine. This is not a completed journey
**Sibo and Me**
Before you start reading this. I just want to say, there is no one size fits all. If anyone tells you just “do this”
or “do that,” they are full of crap. Sibo is too much of a variation for it to be that simple. Each person has
different underlying cause and each person has different bacteria makeup for their sibo. Because so many people
don’t post their exact symptoms, root cause, treatment plans (success and failed) with dosages and length of time
and sibo specific bacteria imbalance (no one has that anyways) (not to be confused with the hydrogen, IMO and
Hydrogen sulfide classifications) it is really hard to determine what will work for each person and to compare why
something works for one and not another. In addition, there is a difference between cured and remission. Some people
claim they are cured and then say they had the symptoms return a year later.
Required note: “I am not a Dr.” But to be honest, I have met a lot of Drs and many of them are not qualified to give
advice and many give wrong advice. You are all responsible to do your own research and never take what someone tells
you as absolute truth.
2022.09.15 Final note: I am not fully treated and am currently between phase 3 and 4
**My Background**
36 male. Weight 165lbs (now 155lbs). Relatively healthy, runner, OCR racer
Condition: Hydrogen positive sibo, Methane Negative. Started July 2021. Symptoms started after second Covid
vaccine. Current known diseases: Prior: Osteoporosis (had since 20s) New: EPI pancreas (Take Zenpep 1200), Hashimoto
Hypothyroidism (Take levothyroxine), Hydrogen SIBO.
Symptoms: Weariness (no longer running), excessive burping, (Kill your spouse smelly farting on bad days), muscle
aches, 15 small duodenal ulcers (treated), sour stomach, occasional headache (assumed histamine intolerance
developed from sibo) Not present: diarrhea, constipation, bowel movements have stayed normal at one a day
Diet: for the most part I eat what I want. I know many have severe restrictions and I’m just not that. My sibo
remains consistent on most food. Only things I avoid 100% is soy and garlic. Breakfast is consistent daily. Cubed
potatoes, kielbasa cubed and eggs put together skillet style. Lunch and dinner vary. I avoid eating out at
restaurants that use sauces or soups. 2022.09.15 I now to intermittent fasting.
Testing:
All bloodwork comes back normal, no deficiencies or low levels, negative for c-diff, ulcerative colitis, Crohns,
Celiac
I’ve had CT scans, Gastric emptying scans, Ultrasounds and 2 upper endoscopies. All showing nothing. Did not have
colonoscopy due to consistent bowel movements.
Drs seen: 6 GI, 2 PCP. 1 Endo, 1 Rheum, 1 Naturopath (unofficial)
Recommend getting to know your family’s medical history. It can have insights if there is a history of autoimmune
disorders.
Here is my theory for how I got sibo based on my research. Covid vaccine triggered latent autoimmune gene.
Autoimmune disorder Hashimoto created. Hashimoto damages Thyroid. Damaged Thyroid stop producing normal TSH levels
and damages MMC. SIBO begins to form and creates symptoms and ulcers. Drs find ulcers and treat with PPI. PPI
reduces acid and SIBO really takes off. SIBO creates damage and EPI begins to form.
**Approach to Success (In process and unconfirmed)**
This data was gathered by cross referencing YouTube channels, Reddit, multiple websites, Cedar Sanai, books and
Facebook groups. I looked at many cases of cured people and compared to others looking for commonalities (Hydrogen
cases only). What follows is a plan I put together based on those cured individuals correlations in treatment.
Again, please do not take this as “THE CURE”. This disease is expensive even with insurance and I don’t want you all
spending money needlessly because you only read this. This plan is the bare minimum approach I could put together
based on the data I found. I have included costs as I have incurred so you can be aware prior to starting a
treatment. All costs are out of pocket
**Baseline SIBO**
1. Take trio smart breath test to determine which sibo you have. Hydrogen, Methane (IMO) Hydrogen Sulfide. Cost $290
(make sure Dr orders or test includes Lactulose for test)
2. Take IBS smart blood test to determine if you have certain antibodies (physician required to order) (if positive,
treatment may need to be different) (not researched) Cost $199, I was billed $220. This test requires you go to a
blood draw location to collect the sample. Cost $50
3. Get full nutritional assessment for deficiencies (Dr bloodwork) Cost Varies
4. Alternative testing. FoodMarble Aire 1 or 2. 1 is Hydrogen only, 2 does Hydrogen and Methane. You can get a
lactulose prescription (cost $15) and test with that or just test with everything you eat. (I have the Aire 1, wish
I bought the Aire 2, even though I was methane negative just to monitor. Love this device and I log breaths almost
hourly and when I wake up in the middle of the night. Really helped me figure out foods that made me worse and how
well intermittent fasting affected treatment)
5. (2022.09.30) Get a full stool sample. Some people do one that looks at different bacteria levels. I did one that
looked for variations and parasites. I don’t know which approach is better. I took a simple one at my primary care
and it ruled out some basics. TI am scheduled to take the Doctors Data: CSA +P Comprehensive Stool Analysis +
Parasitology (a three day collection test)
Recommend 1 upper endoscopy (have them take cultures looking for candida). Colonoscopy if GI recommends (typically
for constipated patients). Avoid taking PPI’s.
Find a Functional Medicine Dr or good naturopath
Your diet has to change for now. Complete sibo diet or low fodmap to determine major triggers. Work with function,
ND or GI Dr. Diet typically means little to no snacking, big meals 3-4. Intermittent fasting while avoiding
fermentable foods.
**Determine underlying cause(s) and TREAT underlying cause(s) (Incomplete list)**
1. Hashimoto (Hypothyroidism)
2. H Pylori
3. SIFO/SIYO (Candida)
4. B12 or iron deficiencies
5. C-Diff
6. Food intolerance tests (gluten)
7. IBS (D-M-C)
8. Crohn’s
9. Parasites
10. Histamine Intolerance
11. PPI use
12. Mold Disease
13. Bile acid malabsorption
14. EPI
15. Low stomach acid
16. Low good flora
17. Heavy metals
18. Anxiety and Stress
19. Ileocecal valve syndrome
20. Vegus nerve disorders (research at home exercises)
21. Estrogen dominance
22. Lyme/EBV
23. Endometriosis
24. Fibroids
25. Post surgical adhesions
26. Psychological issues - trauma (C-PTSD), PTSD, anxiety, depression and others.
27. Other Unknowns
Typical Autoimmune question: Chicken or the Egg. Sibo can cause autoimmune – autoimmune can causes sibo
User: shereadsinbed
“SIBO=damage to gut lining= leaky gut=food particles escaping into blood stream=body sees them as intruders= chronic
immune reaction=autoimmune disease
And/or Autoimmune disorder= motility issues= SIBO”
**Sibo Treatment**
Three Phase approach once treated underlying cause. Order of phases can vary from person to person. Phase 2 is not
recommended as first phase. Phase 3 is the cheapest of each phase.
**Phase 1**
2 weeks antibiotics (40% effective) (Cedar-Sinai) (I personally believe this number is inflated)
Xifaxan for hydrogen (Some studies show adding Augmentin)
Xifaxan, neomycin, bismuth (Pepto Bismal will work) for methane (IMO)
Hydrogen sulfide (Sorry I don’t have any in depth research on this. Likely treat like IMO)
Either treatment take a Biofilm disrupters: Couple options- 30 minutes before food. (Some take this before every
meal) (Some take this exclusively for a month before taking antibiotics)
1. NAC (N-Acetyl-L-Cysteine) 600-1000mg- Biofilm disrupter (considered phase 1)
2. Priority One - Biofilm Phase 2 (Phase 2 is stronger, some only need phase 1, hospitals have stronger than phase 2
used post surgery)
Recommend antifungal (Diflucan) with either as fungus can grow while bacteria die
Diet: Dr Pimentel Recommend eating a high fodmap diet while on xifaxan. (There is mixed results on this approach,
I’m not sold on the idea that feeding the bacteria brings them out more for the antibiotic to kill. Either it is
protected by a biofilm or it is not.)
(During and end of phase 1 felt no change in Symptoms) (took this treatment 3 times over the course of a year. No
change with any round.
**Phase 2**
2-3 weeks strictly elemental diet (gives body rest) (80% effective) (Cedar-Sinai) My own research from people’s
posting does not support that data. I don’t believe this fixes sibo but that it is an important step to healing your
gut. Allows parts of your body to rest like you would an overworked muscles. It is designed to be sipped slowly.
Best practices seem to show to have a chilled drink or with ice. Make 1 to 2 scoop beverage 6-12 ounces, add more
water if needed. Use a straw to sip over an hour. (The straw helped me not gulp it) Make a glass every 2 hours. Try
to consume min 10 Scoops a day (1500 calories). Cost $800-$1500 2-3weeks (prescription required, still not covered
by insurance)
[https://sibosurvivor.com/elemental-diet-for-sibo/](https://sibosurvivor.com/elemental-diet-for-sibo/)
(There are some out there that say elemental diet cured them. They typically did 3 weeks. More often than not I see
this in YouTube channels and then I listen carefully. Many say they started herbal supplements after the elemental
diet and “then” they started feeling better)
Antifungal needed. Elemental diet feeds thrush significantly due to sugars. Brush teeth after EVERY meal, find
antifungal mouthwash
(During and at end of phase 2 the only change I felt was no bad farting and less headaches. I did however feel like
all the joy in my life was sucked out while on this diet. Again, my research results indicate this doesn’t fix sibo
but helps your body rest on your way to fixing sibo) (Please do your own research)
Ending Phase 2 treatment: Low fodmap diet/Elemental diet blend. Don’t just switch back to food. Make a 1 meal a day
transition. Recommend not fatty meat only the first week. (Some of you will have no issue transitioning back to
food and others will be really hard)
**Phase 3**
Medications: Start on low dosage (below listed is final dosage)
Biofilm disrupters: Couple options- 30 minutes before food. (Some take this before every meal) – Reference Phase 1
for options
Herbal protocol: 4 weeks herbal antibiotics (three choices below). Some users say take only twice a day. To be
consumed with food unless notated otherwise. Recommend pill boxes to keep track of what you have taken when. Diet:
Dr Weitz recommends low fodmap with on herbal antibiotics
1. FC Cidal (2 caps 3 times day), Dysbiocide (2 caps 3 times day) and ADP Oregano (200mg 30min before meals)
[https://digestivewarrior.com/](https://digestivewarrior.com/) 2 bottles of 120 fc, 2 bottles 120 days, 3-4 bottles
120 adp Cost$400-$500
2. Candibactin BR (2 caps 3 times day) and AR (2 caps 3 times day) and Oregano (200mg 30min before meals)
Amazon (costs not calculated) (Not taken by this user)
3. Berberine Complex (2-3caps 3x day), Neem Plus(1 cap 3x day) and ADP Oregano (200mg 30min before meals)
Amazon (costs not calculated) (Not taken by this user) (usually taken by methane positive users)
(I CANNOT STATE THIS ENOUGH. NOT ENOUGH RESEARCH OUT THERE ON HOW THESE HERBALS AFFECT YOUR LIVER) Blood tests for
you’re a/g ratio and Globulin are very important when taking these. I don’t see any studies showing they will damage
your liver but it can’t be understated that supplements have the potential to do so. I don’t want you to cure sibo
and end up needing a liver replacement in the process.
I believe the effectiveness of each herbal antibiotic depends on which overgrowth you have: **Escherichia coli,
Enterococcus spp., Klebsiella pneumonia, Proteus mirabilis or unknown others.** Since previously noted we don’t have
that info, it is harder to recommend which one of the 3 options to start with. This makes me sad as I know a lot of
users are doling out money they don’t have on approaches that may not work. I have not researched if anyone has
determined a correlation and since most user treatment is done unscientifically and without a control, it will
likely be years or decades until that is fully locked down. If after finishing 4 weeks with no change, try switching
to another option. Keep daily journal of dosage, length of time and results. (Be mindful of supplements if you have
liver issues) (Foodmarble Aire 1&2 is a great tool for keeping track of food and results)
I’ve found another plan that matches the above with a few tweaks. Uses same drugs but different dosage, and
alternates meds. I like this plan as it seems to give your liver a break and ended up being the one I followed. Plan
is 6 weeks as opposed to 4. Link below.
[https://f.hubspotusercontent10.net/hubfs/4004166/Articles%20and%20Abstracts/SIBO%20Protocol.pdf](https://f.hubspotusercontent10.net/hubfs/4004166/Articles%20and%20Abstracts/SIBO%20Protocol.pdf)
While on this plan, heartburn increased, farting decreased, took less naps during the day, ran a few times,
headaches stayed away for the most part. Burping remained consistent. (I completed one round of herbal antibiotics
without much change. I am switching back to regular antibiotics and a different Prokenetic. (2022.09.11) finished
neomycin, 4 days let of xifaxin, headaches returning, heartburn is down, feeling shitty on a daily basis)
(2022.09.15 My energy is not what is was while on the herbals)
If you are taking a supplement and you start to feel really bad then you have to make the hard decision of continue
or quit. Feeling like crap could mean your body is rejecting the medicine or it could mean the sibo bacteria is in
die off (herxheimer reaction) which is good. No one can confirm which is which and I get nervous when I see users
tell someone to quit or continue. I recommend you get a functional Dr for any approach you take to review your plan
and how it aligns with your current conditions. They will be able to better direct you when to continue or quit.
Many people are asking for advice off of a few words posted and that isn’t wise.
For those with concerns of leaky gut. 2 options
L-Glutamine 850 mg per capsule – Amino acids can work to protect the mucous membrane of the esophagus and intestines
(2022.09.15 will begin taking this soon)
Tributin X – I took this one. 1 pill per meal to start. Move up to 3 per meal. (Didn’t change anything for me.)
[https://healthygut.com/product/tributyrin-x/](https://healthygut.com/product/tributyrin-x/)
**Supplement Support post Phase 3**
Motility agent for MMC (Prokenetic) to keep gut moving and keep sibo from repopulating. Recommended after herbal
antibiotics unless currently constipated.(reason given is you don’t want the antibiotic moving too quickly through
your system) Use for minimum of 6 months after completing phase 3. Examples: Prescription: Motegrity (side effects
suicide, depression), Low dose erythromycin 50mg nightly (most big pharmacies wont’ have it, has to be compounded by
pharmacist and insurance won’t cover Cost $50 per month). Non Prescription: SIBO MMC, Motilpro, Antrantil,
Integrative Therapeutics Motility Activator
I took Integrative Therapeutics Motility Activator 2 times a day and LDE 1 at night.
2022.09. Switched from LDE and Therapeutics to Motilpro
MMC description below and why it isn’t the same as your bowel movements
**Jordan J**
“So. . .the MMC is a series of self-cleansing waves that passes through the stomach and small intestine \*in the
absence of food\*. It's not the same thing as peristalsis which moves food through your system. Stool consistency is
determined not by the MMC but by the colon, whose job it is to remove water from what you've eaten as it passes
through. So, folks with D can still have MMC issues. Since the more we look into the MMC the more it seems as though
it's involved in the majority of SIBO cases, and it's not obvious who has MMC issues without special testing,
doctors are recommending prokinetics to most or all SIBO patients, at least for use for several months
post-antibiotics, to reduce the chance of relapse.”
[https://agutsygirl.com/2019/04/26/a-gutsy-girls-master-guide-to-prokinetics/](https://agutsygirl.com/2019/04/26/a-gutsy-girls-master-guide-to-prokinetics/)
**Additional Supplements**
Some people will need additional supplements, depending on their root cause.
Ox bile to bind bile acid (I have not taken)
Betaine HCL to produce stomach acid (Thorne most recommended) (I have not taken) Some Dr’s recommend bitters over
HCL as they stimulate natural acid production. Bitters Extra by Vitanica is one product but I believe it has to be
prescribed.
Digestive Enzymes (I do take but is prescription for my EPI, ZENPEP $17,000 monthly) (Did not change any of my
symptoms by itself) (Not sure it is really doing anything frankly) (If insurance didn’t pay for it, I wouldn’t take
it)
Allicin (Typically taken by Methane Dominate users as anti-microbial) (I have not taken)
**Complete**
After completing phase 1-3 if your sibo remains, it is possible you have yet to discover all the underlying causes.
Doesn’t mean you haven’t, just a possibility. Sibo is very complex and requires a unique combination approach
tailored specifically to you and can only be discovered through trial and error. You can still be bloated and sibo
free. Testing is required to know if sibo is gone but gut damage can remain and take months to restore to normal.
**Last resort (Phase 4?)**
Find a location that will do a fecal transplant (FMT) (pill form). Dr used to be able to treat sibo this way before
2014 when regulations changed. FDA now only allows for C-diff in the US with insurance. Screw you FDA! I did find a
company in California that will do it sans insurance. Cost min $5k and the initial consult is $400. Link below. (I
did my initial consult and the Dr ordered a stool test which was another $400. He also prescribed different
supplements to take in the meantime. I don’t post cost to be discouraging. I don’t want people to have to guess.)
[https://www.puretyclinic.com/fecal-transplant-fmt-santa-barbara](https://www.puretyclinic.com/fecal-transplant-fmt-santa-barbara)
Success study on FMT Link
[https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01630-x](https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01630-x)
Important note from other user: Dr Pimentel determines this to be ineffective. Reminder his studies are around
patients with food poisoning as root cause. Either way, FMT is definitely understudied in application beyond c diff
and expensive.
**Diet**
(2022.09.14) I don’t speak a lot on diet because this disease is vastly different for everyone and what foods make
their symptoms worse. You may read it’s okay to eat this or that so you do and it makes you so sick. Then you are
frustrated and I know you are already frustrated because who else reads this far if they aren’t already at their
wits end. Each person must trial and error what foods work for them. A general rule of thumb around diet is low
fodmap and intermittent fasting. For me I stop eating at 7pm and won’t eat until after 9am. If I follow this, I
generally feel better. If I wake up at midnight and snack, I feel it in the morning.
**Final Notes**
I’m sure people reading this have read or heard of many other options, supplements and approaches. I am not
discounting those options, I just did not find a commonality when reviewing personal stories of cured individuals.
Brands may vary as well.
One consensus was stay away from prebiotics and probiotics, except (Saccharomyces Boulardii) and only with limited
use. Some report that even this strain has variations and you can end up with the wrong one. (I have not done that
much research into it)
I am wary of any Dr that just promotes their stuff, natural or prescription, any admin that says they have the cure,
or any plan that promotes pre or probiotics. I immediately run from anyone that says they were “cured” but you have
to DM them for their method.
Stay away from any form of acid suppressor (PPI). I know for many with heartburn, this is a very tempting go to
(myself included). 100% show this will make your sibo worse and it did mine. (Suggestions given to me but I haven’t
tried: Apple cider vinegar I glass of water (morning), charcoal tablets, GasX. More research should be done by the
user before taking these to ensure they are not just another form of acid suppression)
Please get out there and read everything you can. Even if it has conflicting info. Glean from others what passes the
smell test and figure out what works for you. Don’t stop reading an article because it has conflicting info. There
may be a nugget in there that leads you down another path. There are not short cuts or quick fix pills.
Please note that links are for reference only. I have ZERO association with any of the sites and if you find
something cheaper elsewhere, buy it elsewhere. Just be careful to know what you are buying. I have not posted links
to any site I have not bought from personally.
**Items to explore:**
LDN Low dose Naltrexone for autoimmune disorders 0.5- 4.5mg dose. For people with inflammation and autoimmune
disorders. Dosage varies significantly from person to person. Seems highly unregulated even though it requires a
prescription.
[https://ldnresearchtrust.org/what-is-low-dose-naltrexone-ldn](https://ldnresearchtrust.org/what-is-low-dose-naltrexone-ldn)
[https://www.youtube.com/watch?v=z0p0ykSzy9o&ab\_channel=LDNscience](https://www.youtube.com/watch?v=z0p0ykSzy9o&ab_channel=LDNscience)
If you have questions, I will answer what I can. I will not give you definitive yes or no on items I have not
researched.
See follow up links in below post
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- id: 1qsncr7
title: 'The Gut Microbiome: The Hidden Organ Controlling Your Health, Disease, and Life'
subreddit: r/POSITIVE_LIFES
author: Muneershah
score: 1
comments: 0
url: https://www.reddit.com/r/POSITIVE_LIFES/comments/1qsncr7/the_gut_microbiome_the_hidden_organ_controlling/
created_utc: 1769916749
selftext: "The Organ You Didn’t Know You Had\nInside your intestines right now, there’s an entire world you can’t see.\n100 trillion microorganisms—bacteria, fungi, viruses—living, eating, reproducing, and communicating with each other and with your cells.\nThis isn’t an infection. This isn’t a disease.\nThis is your gut microbiome, and it’s as essential to your survival as your heart, lungs, or brain.\nIn fact,\_you have more bacterial cells in your body than human cells\_(by a ratio of about 1.3 to 1). Your gut bacteria collectively weigh\_2-5 pounds—about as much as your brain.\nAnd just like your brain,\_your gut microbiome controls far more than you ever imagined.\nHere’s what shocked me when I started researching this: Scientists are now finding connections between gut bacteria and:\nDiabetes and obesity\nHigh blood pressure and heart disease\nCancer\_(colon, liver, breast)\nDepression and anxiety\nAlzheimer’s and Parkinson’s\nAutoimmune diseases\_(rheumatoid arthritis, lupus, MS)\nSkin conditions\_(acne, eczema, psoriasis)\nAnd yes, even hair loss\nThe question isn’t “Is your gut microbiome important?” The question is “Is there anything in your body it\_doesn’t\_affect?”\nAnd here’s the terrifying part:\_We’re destroying our gut microbiomes at an unprecedented rate.\nAntibiotics. Processed food. Stress. Lack of sleep. Pesticides. Chlorinated water.\nEvery day, modern life attacks the bacterial ecosystem that keeps you alive.\nThis article will show you exactly what your gut microbiome does, how it’s linked to virtually every disease, how we’re damaging it, and—most importantly—what you can do to protect and restore it.\nPart 1: What Is the Gut Microbiome? (And Why Should You Care?)\nThe Basics: Your Personal Bacterial Zoo\nThe gut microbiome\_refers to the trillions of microorganisms living primarily in your large intestine.\nKey numbers:\n100 trillion\_organisms (bacteria, archaea, fungi, viruses)\n1,000+ different species\_of bacteria\nCollectively weighs 2-5 pounds\nContains 3.3 million genes\_(150 times more than human DNA)\nThink of it like a rainforest: diverse, interconnected, constantly changing, and critical to the health of the entire ecosystem (your body).\nWhat Does It Actually Do?\nYour gut microbiome is not passive. It’s an active, metabolically busy organ that:\n1. Digests Food You Can’t\nYour body can’t break down fiber, resistant starch, and many complex carbohydrates.\_Your gut bacteria do it for you, producing:\nShort-chain fatty acids (SCFAs): Fuel for colon cells, anti-inflammatory compounds (butyrate, acetate, propionate)\nVitamins: B vitamins (B12, biotin, folate) and vitamin K\nEnergy: SCFAs provide\_10% of your daily caloric needs\n2. Trains and Regulates Your Immune System\n70-80% of your immune system is in your gut, and your microbiome trains it:\nTeaches immune cells to distinguish “good” from “bad”\nProduces antimicrobial peptides that kill pathogens\nRegulates inflammation throughout your entire body\nWithout a healthy microbiome, your immune system either overreacts (autoimmune disease) or underreacts (infections).\n3. Produces Neurotransmitters and Hormones\nYour gut bacteria make:\nSerotonin: 90% of your body’s serotonin is made in the gut\nGABA: Calming neurotransmitter\nDopamine: Motivation and reward\nNorepinephrine: Stress response\nThis is why gut health affects mood, anxiety, and even conditions like depression and Parkinson’s.\n4. Protects the Gut Barrier\nA healthy microbiome strengthens the intestinal lining, preventing:\nLeaky gut: When the intestinal barrier becomes permeable\nToxin entry: Bacterial toxins entering bloodstream (endotoxemia)\nChronic inflammation: The root cause of many diseases\n5. Regulates Metabolism\nGut bacteria influence:\nHow efficiently you extract calories from food\nFat storage and distribution\nBlood sugar regulation\nCholesterol metabolism\nThis is why gut dysbiosis (imbalanced microbiome) is linked to obesity and metabolic syndrome.\nPart 2: The Disease Connections—Can Gut Health Be Linked to Everything?\nThe Honest Answer: Not Everything, But More Than We Ever Imagined\nHere’s what the science actually shows (as of 2026):\nDiseases with STRONG Evidence of Gut Microbiome Connection\n1. Metabolic Diseases\nType 2 Diabetes:\nStudy (Nature, 2012): Diabetics have significantly different gut bacteria than healthy people\nMechanism: Gut dysbiosis causes chronic low-grade inflammation, insulin resistance\nEvidence: Fecal transplant from lean donors improves insulin sensitivity in obese diabetics\nObesity:\nStudy (Cell, 2014): Obese mice given fecal transplants from lean mice lose weight\nMechanism: Certain bacteria extract more calories from food; dysbiosis affects fat storage hormones (leptin, ghrelin)\nHuman data: Obese people have less bacterial diversity and higher Firmicutes/Bacteroidetes ratio\n2. Cardiovascular Disease\nHigh Blood Pressure (Hypertension):\nStudy (Circulation Research, 2019): Gut bacteria produce metabolites (short-chain fatty acids) that lower blood pressure\nMechanism: Gut dysbiosis causes inflammation and affects blood vessel function\nEvidence: Hypertensive rats given probiotics show reduced blood pressure\nHeart Disease:\nStudy (Nature Medicine, 2013): Gut bacteria convert choline and carnitine (from red meat) into TMAO—a compound strongly linked to heart disease\nMechanism: TMAO promotes atherosclerosis (artery plaque buildup)\nEvidence: High TMAO levels predict heart attack and stroke risk\n3. Gastrointestinal Diseases\nInflammatory Bowel Disease (IBD):\nCrohn’s Disease and Ulcerative Colitis: Strongly linked to gut dysbiosis\nEvidence: Fecal transplants show promise in treating IBD\nIrritable Bowel Syndrome (IBS):\nEvidence: Altered gut bacteria found in 70-80% of IBS patients\nTreatment: Low-FODMAP diet and probiotics help many patients\nColorectal Cancer:\nStudy (Cell Host & Microbe, 2014): Specific bacteria (Fusobacterium nucleatum) found in high concentrations in colon tumors\nMechanism: Chronic inflammation from dysbiosis promotes cancer\n4. Brain and Mental Health (The Gut-Brain Axis)\nDepression and Anxiety:\nStudy (Psychopharmacology, 2016): Probiotic supplementation reduced depression scores\nMechanism: Gut bacteria produce neurotransmitters; dysbiosis causes chronic inflammation affecting the brain\nParkinson’s Disease:\nStudy (Movement Disorders, 2017): Parkinson’s patients have distinct gut bacteria patterns\nMechanism: Alpha-synuclein (the protein that damages Parkinson’s brains) may originate in the gut and travel to the brain via the vagus nerve\nAlzheimer’s Disease:\nEmerging evidence: Gut dysbiosis linked to neuroinflammation and amyloid-beta accumulation\nStill being researched: Causal link not yet proven\n5. Autoimmune Diseases\nRheumatoid Arthritis:\nStudy (Genome Medicine, 2013): RA patients have higher Prevotella copri bacteria\nMechanism: Gut barrier breakdown allows bacterial fragments into bloodstream, triggering immune response\nMultiple Sclerosis (MS):\nStudy (PNAS, 2017): MS patients have depleted beneficial bacteria\nMechanism: Gut dysbiosis affects immune regulation\nType 1 Diabetes:\nEvidence: Gut bacteria differences appear before diabetes develops\nMechanism: Gut permeability triggers autoimmune attack on pancreatic cells\nDiseases with EMERGING Evidence (Promising but Not Proven)\nCancer (Various Types):\nLiver cancer: Linked to gut dysbiosis and endotoxemia\nBreast cancer: Gut bacteria metabolize estrogen; imbalance may affect risk\nStill researching: Direct causal links being studied\nHair Loss:\nLimited evidence: Some research suggests gut inflammation affects hair follicles\nMechanism unclear: Possibly through systemic inflammation or nutrient malabsorption\nHonest assessment: This connection is speculative; more research needed\nSkin Conditions:\nAcne, eczema, psoriasis: Gut-skin axis exists; dysbiosis linked to skin inflammation\nEvidence: Some studies show probiotics improve skin conditions\nThe Big Picture: Is Everything Connected to Gut Health?\nThe honest truth:\n✅ Strong evidence: Metabolic diseases, cardiovascular issues, IBD, IBS, colorectal cancer, mental health, some autoimmune diseases\n🔬 Emerging evidence: Other cancers, Alzheimer’s, Parkinson’s, skin conditions\n❓ Speculative: Hair loss, some other conditions\nThe key insight: Chronic inflammation is the link. Gut dysbiosis causes chronic low-grade inflammation, and\_chronic inflammation is the root cause of most modern diseases.\nSo while the gut microbiome isn’t directly causing everything, it’s a major player in the inflammatory processes that lead to most diseases.\nPart 3: How We’re Destroying Our Gut Microbiomes\nThe Modern Assault on Gut Health\nOur ancestors had more diverse gut microbiomes than we do.\_Studies of isolated hunter-gatherer populations (Hadza tribe, Yanomami) show\_30-40% more bacterial diversity\_than Western populations.\nWhy? Because modern life systematically destroys gut bacteria.\n1. Antibiotic Overuse: The Nuclear Option\nThe problem:\nAntibiotics don’t discriminate—they kill good bacteria along with bad.\nThe evidence:\nSingle course of antibiotics: Reduces gut diversity by\_25-50%\nRecovery time: Some bacteria never return; diversity may stay lower for\_years\nStudy (Nature, 2016): Children given antibiotics in first year of life have higher obesity and asthma rates\nThe real-world impact:\nCase Study: Sarah’s Story\nSarah, 34, had a UTI and took a 7-day course of ciprofloxacin (common antibiotic). Within weeks:\nDeveloped chronic diarrhea\nGained 15 pounds despite no diet change\nStarted experiencing anxiety attacks for the first time\nWhat happened: The antibiotic wiped out beneficial bacteria. Opportunistic bacteria (like Clostridium difficile) overgrew, causing symptoms.\nRecovery: Took 6 months of probiotic supplementation and dietary changes to restore balance.\nHow common is this?\n10-30% of people\_taking antibiotics develop antibiotic-associated diarrhea\nC. difficile infections: 500,000/year in the U.S., often after antibiotic use\nWhat you should do:\nOnly take antibiotics when absolutely necessary\_(bacterial infections, not viral)\nTake probiotics during and after\_antibiotic courses\nEat fermented foods\_to help restore diversity\n2. The Western Diet: Feeding the Wrong Bacteria\nWhat damages gut bacteria:\nHighly processed foods:\nEmulsifiers\_(found in ice cream, sauces): Damage gut lining, cause inflammation\nArtificial sweeteners: Kill beneficial bacteria, promote glucose intolerance\nPreservatives: Antimicrobial by design—they kill bacteria in food\_and\_in your gut\nLow fiber intake:\nAverage Western diet: 10-15g fiber/day\nRecommended: 25-30g/day\nHunter-gatherers: 80-120g/day\nWhy it matters: Fiber is food for beneficial bacteria. Without it, they starve and are replaced by harmful strains.\nHigh sugar and refined carbs:\nFeed inflammatory bacteria\nPromote fungal overgrowth (Candida)\nCause blood sugar spikes that damage gut lining\nRed meat (in excess):\nGut bacteria convert carnitine → TMAO (linked to heart disease)\nHigh-fat diets reduce beneficial bacteria\n3. Chronic Stress: The Invisible Gut Killer\nThe gut-brain axis works both ways: Your brain affects your gut, and stress destroys gut bacteria.\nThe evidence:\nStudy (Brain, Behavior, and Immunity, 2011): Students taking exams showed reduced beneficial bacteria during high-stress periods\nMechanism: Stress hormones (cortisol) alter gut pH, reduce blood flow to intestines, weaken gut barrier\nReal-world example:\nJohn’s Experience:\nJohn, 42, high-stress corporate job:\nDeveloped IBS symptoms (bloating, diarrhea, cramps)\nNo food allergies or infections found\nDiagnosis: Stress-induced gut dysbiosis\nTreatment:\nMeditation and yoga (reduced stress hormones)\nGut-healing diet\nResult: Symptoms resolved in 3 months\nWhy this happens: The gut has its own nervous system (enteric nervous system) with more neurons than the spinal cord. Stress directly disrupts gut function.\n4. Lack of Sleep: Circadian Disruption\nYour gut bacteria have circadian rhythms.\nThe evidence:\nStudy (Cell, 2014): Gut bacteria populations fluctuate on a 24-hour cycle\nSleep deprivation disrupts this rhythm, causing dysbiosis\nShift workers\_have less bacterial diversity and higher obesity rates\nThe mechanism:\nDisrupted circadian rhythm → hormonal changes → altered gut environment → bacterial imbalance\n5. Environmental Toxins\nPesticides (Glyphosate/Roundup):\nStudy (Environmental Sciences Europe, 2013): Glyphosate acts as an antibiotic, killing beneficial gut bacteria\nFound in: Most non-organic grains, beans, produce\nChlorinated Water:\nChlorine kills bacteria—that’s its purpose\nDrinking chlorinated tap water\_may reduce gut diversity (limited studies, needs more research)\nHeavy metals (mercury, lead):\nToxic to beneficial bacteria\nFound in some fish, old plumbing, contaminated water\n6. Excessive Hygiene (The Hygiene Hypothesis)\nIronic but true: Being\_too\_clean may harm your microbiome.\nThe evidence:\nChildren raised on farms have\_more diverse microbiomes\_and lower allergy/asthma rates\nOveruse of antibacterial soaps\_may reduce skin and gut bacteria diversity\nThe balance: Good hygiene prevents infections, but extreme sterility prevents beneficial bacterial exposure.\nPart 4: What Current Research Shows (And Where It’s Heading)\nBreakthrough #1: Fecal Microbiota Transplant (FMT)\nWhat it is: Transplanting stool from a healthy donor into a sick patient to restore gut bacteria.\nSuccess stories:\nC. difficile infection: 90% cure rate (vs. 20-30% with antibiotics)\nUlcerative colitis: 24-44% remission rates in studies\nAutism spectrum disorders: Early trials show behavioral improvements in some children\nFuture potential:\nTrials underway for obesity, diabetes, MS, Parkinson’s, depression\nOral capsule FMT\_(less invasive than colonoscopy) showing promise\nBreakthrough #2: Personalized Microbiome Analysis\nCompanies now offer gut microbiome testing\_(Viome, uBiome successors, etc.):\nAnalyzes your bacteria composition\nIdentifies imbalances\nProvides dietary recommendations\nLimitation: Science is still figuring out what an “ideal” microbiome looks like—it varies by individual.\nBreakthrough #3: Psychobiotics (Bacteria That Affect Mood)\nDefinition: Probiotics specifically targeting mental health.\nEvidence:\nLactobacillus rhamnosus: Reduced anxiety in animal studies\nBifidobacterium longum: Improved stress response in humans\nStudy (Gastroenterology, 2017): Probiotic blend reduced depression scores\nThe future: “Prescription” probiotics for mental health conditions.\nBreakthrough #4: Cancer Treatment Enhancement\nGroundbreaking discovery: Gut bacteria affect cancer immunotherapy effectiveness.\nStudy (Science, 2015): Patients with diverse gut bacteria responded\_better to immunotherapy drugs\_(anti-PD-1 treatment).\nImplication: Improving gut health before cancer treatment may improve outcomes.\nWhere Research Is Heading\nNext 5-10 years, expect:\nMicrobiome-based diagnostics: Gut bacteria analysis to predict disease risk\nTargeted probiotic therapies: Specific bacterial strains for specific conditions\nMicrobiome-friendly drug design: Medications that don’t damage gut bacteria\nDietary precision: Personalized nutrition based on your microbiome\nThe challenge: The microbiome is incredibly complex—1000+ species, trillions of interactions. We’ve only scratched the surface.\nPart 5: How to Improve Your Gut Microbiome (Evidence-Based Strategies)\nThe 5 Pillars of Gut Health\n1. Eat More Fiber (The #1 Factor)\nWhy it works: Fiber feeds beneficial bacteria, producing anti-inflammatory SCFAs.\nBest sources:\nVegetables: Broccoli, Brussels sprouts, artichokes, onions, garlic\nLegumes: Beans, lentils, chickpeas (resistant starch)\nWhole grains: Oats, barley, quinoa\nFruits: Berries, apples (with skin), bananas (especially green/resistant starch)\nNuts and seeds: Flaxseeds, chia seeds, almonds\nTarget: 25-30g fiber/day minimum (work up gradually to avoid bloating)\n2. Incorporate Fermented Foods (Live Cultures)\nWhy it works: Provides live beneficial bacteria and supports diversity.\nBest options:\nYogurt\_(unsweetened, with live cultures)\nKefir\_(fermented milk, higher bacterial diversity than yogurt)\nSauerkraut\_(unpasteurized)\nKimchi\_(Korean fermented vegetables)\nKombucha\_(fermented tea)\nMiso and tempeh\_(fermented soy)\nHow much: 1-2 servings daily\n3. Consider Probiotic Supplements (With Caveats)\nEvidence:\nHelpful for: Post-antibiotic recovery, IBS, some cases of diarrhea\nLimited evidence for: General health in healthy people\nBest strains (research-backed):\nLactobacillus rhamnosus GG: Diarrhea, IBS\nBifidobacterium longum: Stress, anxiety\nSaccharomyces boulardii: C. difficile prevention, traveler’s diarrhea\nDosage: 10-20 billion CFU/day\nQuality matters: Choose refrigerated, multi-strain probiotics from reputable brands.\nHonesty check: Probiotics are helpful but not magic. Diet and lifestyle matter more.\n4. Eat Prebiotic Foods (Food for Bacteria)\nPrebiotics\_are specific fibers that beneficial bacteria love.\nBest sources:\nGarlic and onions\nLeeks and asparagus\nJerusalem artichokes\nChicory root\nDandelion greens\nBananas (slightly green)\n5. Reduce Gut-Damaging Factors\nMinimize:\nUnnecessary antibiotics: Only when truly needed\nProcessed foods: Especially those with emulsifiers, artificial sweeteners\nExcess alcohol: Damages gut lining and kills beneficial bacteria\nChronic stress: Practice stress management (meditation, exercise, therapy)\nNSAIDs (ibuprofen, aspirin): Long-term use damages gut lining\nLifestyle Factors\nSleep:\nAim for 7-9 hours\_consistently\nMaintain regular sleep schedule\nExercise:\nAerobic exercise\_increases bacterial diversity\nStudy (Gut, 2018): Rugby players had more diverse microbiomes than sedentary controls\nAim for: 30-60 minutes moderate exercise, most days\nStress Management:\nMeditation, yoga, breathing exercises\nReduces cortisol\_→ healthier gut environment\nAvoid Over-Sanitizing:\nRegular soap is fine; antibacterial soap unnecessary\nExposure to nature\_(gardening, hiking) increases bacterial diversity\nOwning pets\_(dogs especially) increases microbiome diversity\nSample Gut-Healing Day\nBreakfast:\nGreek yogurt with berries, chia seeds, and walnuts\nGreen tea\nLunch:\nMixed greens salad with chickpeas, sauerkraut, avocado, olive oil\nApple with almond butter\nSnack:\nKefir smoothie with banana and flaxseeds\nDinner:\nGrilled salmon\nRoasted Brussels sprouts and garlic\nQuinoa\nFermented kimchi on the side\nEvening:\nHerbal tea (chamomile, ginger)\nFiber count: \\~35-40g\_Probiotic sources: Yogurt, sauerkraut, kefir, kimchi\_Prebiotic sources: Garlic, onions, banana, chickpeas\nFrequently Asked Questions (FAQ)\nQ: Can improving gut health cure all diseases?\nA:\_No, and beware anyone claiming it can.\_However, gut health is a\_major factor\_in many chronic diseases. Improving your microbiome can reduce inflammation, improve immune function, and lower disease risk—but it’s not a miracle cure. Genetics, environment, lifestyle, and medical treatment all matter.\_Think of gut health as foundational, like sleep or exercise—essential but not sufficient alone.\nQ: How long does it take to improve gut microbiome?\nA:\_It depends on the damage:\nDietary changes: Beneficial shifts in 1-4 weeks\nPost-antibiotic recovery: 6 months to 2 years for full diversity restoration\nChronic dysbiosis: May take 6-12 months of consistent effort\nStudy (Cell Host & Microbe, 2013): Microbiome composition can change within\_24 hours\_of diet change, but lasting diversity takes longer\nKey: Consistency matters more than speed.\nQ: Are expensive probiotic supplements necessary?\nA:\_No.\_Food sources (yogurt, kefir, sauerkraut, kimchi) are often more effective\_because they provide broader bacterial diversity and come with prebiotics (fiber). Supplements are helpful in specific cases (post-antibiotics, IBS, traveling), but\_most people get more benefit from eating fermented foods and fiber-rich diets. If you do supplement, choose quality brands (refrigerated, multi-strain, 10-20 billion CFU), but don’t rely on them exclusively.\nQ: Can antibiotics permanently damage my gut?\nA:\_Some damage can be long-lasting, but not necessarily permanent.\_Studies show:\nShort-term antibiotics: Usually recover in 6-12 months with proper diet\nRepeated courses: May cause\_persistent diversity loss\_(some species never return)\nEarly childhood antibiotics: Linked to long-term metabolic changes\nThe good news: Active restoration (fiber, fermented foods, probiotics) can rebuild gut health over time.\_The bad news: Some rare bacterial species may be lost forever.\_Best practice: Avoid unnecessary antibiotics, but don’t avoid them when medically necessary (bacterial infections).\nQ: Is the gut microbiome really linked to mental health?\nA:\_Yes, with strong evidence.\_The\_gut-brain axis\_is well-established:\n90% of serotonin\_is produced in the gut\nGut bacteria produce\_GABA, dopamine, and other neurotransmitters\nVagus nerve\_connects gut to brain directly\nInflammation from gut dysbiosis\_affects brain function\nStudies show:\nProbiotics reduce depression/anxiety symptoms in some people\nFecal transplants in animals change behavior\nParkinson’s may originate in the gut\nHonest assessment: Gut health is\_one factor\_in mental health, not the only one. Therapy, medication, lifestyle, and genetics also matter. But\_improving gut health can improve mood\_for many people.\nQ: Can gut health affect hair loss?\nA:\_Limited and indirect evidence.\_Possible mechanisms:\nNutrient malabsorption: If gut dysbiosis impairs absorption of iron, biotin, zinc (needed for hair growth)\nChronic inflammation: Systemic inflammation may affect hair follicles\nAutoimmune connection: Some autoimmune hair loss (alopecia areata) may be linked to gut dysbiosis\nHonest answer: This connection is\_speculative. If you’re experiencing hair loss, see a doctor to rule out thyroid issues, nutrient deficiencies, hormonal imbalances. Improving gut health\_may\_help indirectly, but it’s not a proven hair loss treatment.\nQ: Should I get my gut microbiome tested?\nA:\_It can be informative but isn’t necessary for most people.\_Testing services (Viome, Thorne, etc.) analyze your bacteria composition, but:\nScience doesn’t yet know\_what the “ideal” microbiome looks like (it varies by person)\nRecommendations are often generic\_(eat more fiber, fermented foods—which you should do anyway)\nCost: $99-$299 for tests\nWho might benefit:\nPeople with chronic digestive issues (IBS, IBD)\nThose tracking recovery from specific conditions\nPeople curious about their health data\nFor most people: Following evidence-based gut health practices (fiber, fermented foods, reduce stress, sleep well) is more cost-effective than testing.\nQ: Can you “reset” your gut microbiome?\nA:\_Not exactly, but you can significantly improve it.\_Fecal transplants (FMT) are the closest thing to a “reset,” but they’re only medically available for serious conditions (C. difficile infections). For most people:\nDietary overhaul\_creates major shifts in 1-4 weeks\nEliminating gut-damaging factors\_(processed food, excess alcohol, chronic stress) allows recovery\nConsistency over time\_is key—temporary changes yield temporary results\nThink of it less like a “reset” and more like “rehabilitation”—gradual improvement with sustained effort.\nConclusion: Your Gut Is Talking—Are You Listening?\nHere’s what I want you to understand:\nYour gut microbiome is not some trendy health fad. It’s not pseudoscience. It’s not a magic cure for everything.\nIt’s a fundamental part of your biology\_that modern science is only beginning to understand.\nThe evidence is clear:\nYour gut bacteria regulate your immune system\nThey produce neurotransmitters that affect your mood\nThey control inflammation that drives most chronic diseases\nThey influence your weight, blood sugar, and heart health\nThey may even affect conditions we never imagined—from Parkinson’s to cancer\nAnd we’re destroying them.\nEvery unnecessary antibiotic. Every meal of processed food. Every sleepless night. Every day of chronic stress.\nWe’re waging war on the bacteria that keep us alive.\nBut here’s the hope:\_Your gut microbiome is resilient. It wants to heal. It just needs the right conditions.\nYou don’t need expensive supplements or complicated protocols.\nYou need:\nFiber\_(vegetables, fruits, whole grains, legumes)\nFermented foods\_(yogurt, kefir, sauerkraut, kimchi)\nLess processed food\nAdequate sleep\nStress management\nAntibiotics only when necessary\nThat’s it. Simple, but not easy in our modern world.\nThe research is ongoing.\_In 10 years, we’ll know far more about which bacteria do what, how to target specific conditions, and how to personalize gut health interventions.\nBut you don’t have to wait for perfect knowledge.\nThe fundamentals are clear now:\nTake care of your gut, and your gut will take care of you.\nYour microbiome is listening to every choice you make.\_Feed it well. Treat it well. Protect it from unnecessary damage.\nBecause inside your intestines, trillions of organisms are working to keep you healthy, happy, and alive.\nThe least you can do is not kill them.\nDisclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals before making changes to your health regimen, especially if you have existing medical conditions or are taking medications To read more, you can go here. positivelifes .com"
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url_overridden_by_dest: https://i.redd.it/24tiq294zsgg1.jpeg
preview_image_url: https://preview.redd.it/24tiq294zsgg1.jpeg?auto=webp&s=3ac3479e134afab67a8d1c704e6189a35745824f
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- id: 1ntg6gn
title: Hope
subreddit: r/Gastroparesis
author: itmedjondjon
score: 3
comments: 6
url: https://www.reddit.com/r/Gastroparesis/comments/1ntg6gn/hope/
created_utc: 1759147511
selftext: >-
Hi guys,
I'm honestly scared of posting this because we all know how unpredictable this disease is. I'm scared it will come
back more forceful than ever, because that used to happen in the past. I know that most of us have periods of time
where we don’t feel as sick and where we can eat normally or almost normally. So I’m not sure I can call this a
success story — but I hope it’s a success story in the making.
I’ve had gastroparesis for almost two years now, and it started after a stomach bug or some kind of virus. After
that illness, I just never recovered. At first, I gave myself some time to heal, thinking it would just pass, but
after six months (maybe a little longer), I started visiting doctors. None of them knew what was wrong. They just
ran tests to rule out other illnesses, and as soon as they saw it wasn’t anything “serious” like colitis, ulcers, or
cancer, they basically gave up on me.
We don’t even have a proper gastroparesis test in my country. They just gave me some prokinetics (domperidone) and
it didn’t do anything. The doctors kept telling me it was stress, IBS, that I’d get better because I’m young, and
basically brushed it off. I was devastated.
The disease literally made me suicidal. I couldn’t eat. Even when I was hungry, I knew what was waiting after a
meal: pain, gas, bloating, burping, nausea. I learned little tricks — how to sit after meals, how much I could eat,
which foods I absolutely couldn’t touch, how long I had to stay upright, how to sleep without lying down. I never
wanted to “learn” those things. My depression came back hard, I felt hopeless, and I convinced myself this was going
to be my forever.
I tried different meds. Metoclopramide (which I could get OTC) helped a little, but not enough. I tried
prucalopride, which was hard to get and expensive. It worked like magic… for three days. Then nothing. I lost hope
again. Out of desperation, I started looking at meds not available here. I found levosulpiride and ordered it
online. I don’t recommend doing that, but I was desperate. I started taking 75mg/day in divided doses, then
eventually went down to 50mg in the morning.
The effects weren’t instant, but after a while, things started changing. First the nausea disappeared and my
appetite came back. Then the bloating got better, then the burping, until it all slowly faded. Now, I eat
everything. I eat big meals — like the kind of portions I haven’t been able to eat since before I got sick. I even
eat foods that usually bloat people or are tough to digest, like red meat (lots of it), beans, mushrooms, and even
oatmeal. I eat a lot of raw fruits again, which I couldn’t touch since I got sick — and I missed them so much.
I still have symptoms around my period (gas, bloating, some burping), but my “bad” days now look like what my “good”
days used to be. I’ve been pretty stable for two months, which hasn’t happened in a long time.
For the last month, I’ve even been able to have big meals and lie down right after — even nap in a flat position —
without food coming back up, nausea, or pain. Sometimes I wake up with a bit of gas, but it’s nothing compared to
before. I really got my life back. I’m not in constant pain. I’m not scared of food anymore. It feels incredible.
I know gastroparesis can have remission periods, and maybe that’s what’s happening, but if this medication has
helped push me into remission, I’m so grateful. I just hope this is part of a longer healing journey, and maybe in a
year or two I’ll be able to get off meds completely and live normally again.
If you have any questions, feel free to comment or message me. I’ll try to reply. For anyone wondering: I first
ordered the meds online, and later stocked up in Turkey while visiting a friend. If you need more info, I can share
details.
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- id: 1n819rh
title: newsflash week 34.2025
subreddit: r/UlcerativeColitis
author: achchi
score: 18
comments: 3
url: https://www.reddit.com/r/UlcerativeColitis/comments/1n819rh/newsflash_week_342025/
created_utc: 1756962053
selftext: >-
Welcome back to this week's newsflash
1. A JAK inhibitor, Tofacitinib, may be a viable option for patients with UC who have failed multiple biologic
therapies, according to a new French study. This offers hope for a difficult-to-treat patient group. Do you want to
know [more](https://www.medpagetoday.com/gastroenterology/inflammatoryboweldisease/117115)?
2. Eli Lilly is initiating a new study for Mirikizumab, a promising step for treating pediatric patients with UC.
The study will evaluate the drug's effectiveness and safety in this younger population. Do you want to know
[more](https://www.tipranks.com/news/company-announcements/eli-lillys-mirikizumab-study-a-promising-step-for-pediatric-ulcerative-colitis-treatment)?
3. Are treatment goals for UC ambitious enough? Some experts are now questioning if aiming for just being
symptom-free is the right target, suggesting a shift towards complete mucosal healing. Do you want to know
[more](https://www.healthcentral.com/news/ulcerative-colitis/should-we-be-moving-the-target-for-uc-treatment)?
4. Researchers have developed novel probiotic-drug conjugates. This new approach achieves synchronized,
site-specific probiotic colonization and drug release, offering a targeted new therapy for UC. Do you want to know
[more](https://pubs.acs.org/doi/full/10.1021/jacs.5c08094)?
5. A new experimental drug, tulisokibart, is showing great promise for Crohn's disease and is also being tested for
UC. This could be a new treatment avenue for both major types of IBD. Do you want to know
[more](https://www.healthcentral.com/news/crohns-disease/this-experimental-drug-put-crohns-disease-into-remission)?
6. Palisade Bio has reported positive outcomes from its Phase Ib study for a new UC treatment. The company also
released encouraging pharmacokinetic data for the colon tissue. Do you want to know
[more](https://www.clinicaltrialsarena.com/news/palisade-ulcerative-colitis-study/)?
7. New hope for children with IBD may come from off-label drug use. A recent report highlights how existing
medications are being repurposed to treat pediatric Crohn's disease and UC. Do you want to know
[more](https://www.newswise.com/articles/off-label-on-target-new-hope-for-children-with-inflammatory-bowel-disease)?
8. The supernatant of the probiotic Saccharomyces boulardii CNCM I-745 has been shown to improve gut barrier
function. The findings support a novel mechanism that could benefit patients with UC. Do you want to know
[more](https://www.google.com/search?q=https://www.researchgate.net/publication/394349132_Saccharomyces_boulardii_CNCM_I-745_Supernatant_Improves_Markers_of_Gut_Barrier_Function_and_Inflammatory_Response_in_Small_Intestinal_Organoids%253F_tp%253DeyJjb250ZXh0Ijp7InBhZ2UiOiJqb3VybmFsIiwicHJldmlvdXNQYWdlIjpudWxsLCJzdWJQYWdlIjoib3ZlcnZpZXcifX0)?
9. A novel PDE4 inhibitor, PALI-2108, has achieved a 100% clinical response rate in a Phase 1b trial for UC. This
promising result comes from Palisade Bio. Do you want to know
[more](https://www.stocktitan.net/news/PALI/palisade-bio-reports-100-clinical-response-in-phase-1b-ulcerative-ztg28dzvcq6o.html)?
10. A more flexible biologics option is now available for IBD patients. This could improve the quality of life for
people with UC and Crohn's disease. Do you want to know
[more](https://www.thestar.com.my/lifestyle/health/2025/08/07/more-flexible-biologics-option-for-ibd-patients-now-available)?
11. A new study investigated the long-term outcomes for UC patients receiving Golimumab. The research focused on
colectomy and neoplasia rates in this patient group. Do you want to know
[more](https://www.researchgate.net/publication/394197831_Colectomy_and_Neoplasia_Outcomes_of_Patients_With_Ulcerative_Colitis_Receiving_Golimumab_A_Post-Authorisation_Safety_Study_Using_the_Spanish_ENEIDA_Registry)?
12. Polpharma Biologics and Fresenius Kabi have signed a licensing agreement for a proposed vedolizumab biosimilar.
This could lead to a more affordable treatment option for patients with UC and Crohn's disease. Do you want to know
[more](https://financialpost.com/pmn/business-wire-news-releases-pmn/polpharma-biologics-and-fresenius-kabi-sign-licensing-agreement-for-proposed-vedolizumab-biosimilar-pb016)?
13. The global incidence of IBD is rising sharply. New research from the University of Chicago charts the
significant increase in both UC and Crohn's disease worldwide. Do you want to know
[more](https://news.uchicago.edu/story/new-research-charts-sharp-global-rise-irritable-bowel-disease)?
14. Researchers have identified genes associated with ferroptosis, a form of cell death, in UC. This discovery could
lead to new therapeutic targets for the disease. Do you want to know
[more](https://www.researchgate.net/publication/394091320_Identification_of_differentially_expressed_genes_associated_with_ferroptosis_in_ulcerative_colitis)?
15. A study in *Nature* reveals that blocking the enzyme argininosuccinate synthetase 1 can alleviate UC. The
research combined metabolomics and proteomics to uncover this new therapeutic pathway. Do you want to know
[more](https://www.nature.com/articles/s41467-025-62217-8)?
16. Dr. Falk Pharma is teaming up with Allianthera to develop a new treatment for UC. The strategic partnership will
focus on a novel AhR agonist. Do you want to know
[more](https://finance.yahoo.com/news/dr-falk-pharma-allianthera-suzhou-081000042.html)?
17. A new study has found that preexisting UC increases the risk of immune-related colitis in cancer patients. This
finding is critical for managing patients with both IBD and gastrointestinal cancers undergoing immunotherapy. Do
you want to know [more](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1627680/full)?
18. Researchers have developed a colon-targeted oral nanosystem. This innovative approach can disrupt the
inflammatory loop in enteric glia to treat IBD. Do you want to know
[more](https://pubs.acs.org/doi/full/10.1021/acsnano.5c05032)?
19. French biotech Abivax has announced dazzling results from its Phase III trials for its oral UC drug, obefazimod.
The successful data has prompted a significant new stock offering. Do you want to know
[more](https://www.genengnews.com/topics/drug-discovery/stockwatch-abivax-shares-leap-on-phase-iii-ulcerative-colitis-data-747-5m-offering/)?
20. Physical activity trends among adults with IBD are a topic of a new study. Researchers are looking into exercise
guidelines for individuals with the condition. Do you want to know
[more](https://www.google.com/search?q=https://www.physiciansweekly.com/physical-activity-trends-in-adults-with-ibd/)?
21. Louise Thompson has been praised for proudly displaying her stoma bag. Her openness helps to raise awareness and
reduce the stigma associated with IBD and stomas. Do you want to know
[more](https://www.dailymail.co.uk/tvshowbiz/article-14945459/Louise-Thompson-proudly-displays-stoma-bag-yellow-bikini-admits-feels-people-staring-urges-people-kind.html)?
22. An article from the Mayo Clinic Press provides a clear overview of IBD. It explains the differences between
Crohn's disease and UC. Do you want to know
[more](https://mcpress.mayoclinic.org/healthygut/what-is-ibd-inflammatory-bowel-disease/)?
23. It can be difficult to know what to say to someone with UC. An article from Everyday Health offers advice on how
to be supportive and avoid common pitfalls. Do you want to know
[more](https://www.everydayhealth.com/digestive-health/things-not-to-say-to-someone-with-ulcerative-colitis/)?
24. A healthy plant-based diet has been linked with a reduced risk of IBD. A new study found a lower incidence of UC
and Crohn's disease in those who ate more fruits and vegetables. Do you want to know
[more](https://www.news-medical.net/news/20250709/Healthy-plant-based-diet-ilinked-with-reduced-risk-of-inflammatory-bowel-disease.aspx)?
That's it for this week. Stay safe!
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- id: 1nbfdg8
title: Little bit of morning inspiration. IBD doesn't need to hold us back.
subreddit: r/IBD
author: Chris-flow
score: 10
comments: 1
url: https://www.reddit.com/r/IBD/comments/1nbfdg8/little_bit_of_morning_inspiration_ibd_doesnt_need/
created_utc: 1757309390
selftext: "At times, I need a little inspiration that this doesn't need to hold us back, if they did it, so can we. Here are 6 successful people with IBD (Crohn's or UC).\n\n**6 is my favourite**\_\n\nhttps://preview.redd.it/mho3f4ovmvnf1.png?width=1200&format=png&auto=webp&s=7c4ced93328e693b7b85da410470f18255c9465c\n\n# 1. Chuck Lorre - creator of The Big Bang Theory + Two and a Half Men (and many more):\n\n“*I was fortunate enough to get an anesthetic-free colonoscopy in front of a classroom of medical students, and I have often thought of that as great preparation for a lifetime in television.*”\n\nDiagnosed in his early 20’s when he says he was “*too poor to go to a doctor*” has meant he is a big supporter of free healthcare in the US. Close to needing a colonoscopy he says “*an angel came into my life and put me on a nutrition program and I somehow went into remission.”*\n\nChuck is known for his ‘vanity cards’ which flash at the end of every episode. In 2015 he talked about his ulcerative colitis at the end of:\n\n1. Apr 20th, 2015 Mike & Molly se05ep18 'No Kay Morale'\n2. Apr 16th, 2015 Mom se02ep20 'Sick Popes and a Red Ferrari'\n3. Apr 16th, 2015 The Big Bang Theory se08ep21 'The Communication Deterioration'\n\nSee his vanity cards here:\_[https://chucklorre.com/?q=ulcerative%20colitis](https://chucklorre.com/?q=ulcerative%20colitis)\n\nhttps://preview.redd.it/g7n06f0xmvnf1.png?width=1200&format=png&auto=webp&s=c583b1b25b36a8180705fb980e34a3adc5df6d57\n\n# 2. Nick Mowbray — Zuru Toys Co-Founder\n\n*‘You either win or you learn — you never lose.’*\n\nThis one has always inspired me. Nick Mowbray built a billion-dollar company while fighting Crohn’s disease—and today still leads 8,500 employees around the world.\n\n*‘Most people see my success, but don’t realise the years of sacrifice on the way.’*\_From sleeping in bushes to washing in public bathrooms, his early journey mirrors that of many founders.\n\nExtreme stress, poor diet, and five years of ignored symptoms cost him his weight, his hair, and almost his life. But after three surgeries to rebuild his intestines, what could have been a fatal blow became a catalyst for reinvention—shaping his optimism, empathy, and relentless drive. Proof that resilience is built in the fire.\n\nhttps://preview.redd.it/j5pmvbtymvnf1.png?width=1200&format=png&auto=webp&s=aba621cf9c6e98e8bca70e43701a28515ed7db11\n\n# 3. Heath Slocum — Pro Golfer & Survivor (Ulcerative Colitis)\n\n*‘I don’t let my ulcerative colitis stop me from winning—and I encourage you to not let IBD stop you from winning too.’*\n\nAt just 23, Heath Slocum had finally reached his dream—competing on the PGA Tour and even winning—only to be stopped in his tracks by ulcerative colitis at the height of his game.\_\n\nThe early treatments offered some relief, but it wasn't until a specialist adjusted his medication that Slocum began to turn the corner.\_\n\nThat breakthrough brought him back—from 18 months off the course, he rebounded to win 4 PGA tours, underlining a vital lesson many in the IBD community understand:\_**don’t give up until you find the treatment that works.**\n\nhttps://preview.redd.it/xepie4ezmvnf1.png?width=1200&format=png&auto=webp&s=6a7a73bc191c39683c9954a09541ef9d933b9a3a\n\n# 4. Pete Davidson - Saturday Night Live, King of Staten Island, and stand-up\n\n‘I work really f—ing hard and I need weed in order to do that. I’m sick, I have Crohn’s… so it sucks.’\n\nCrohn's and IBD is a complex disease. One treatment works for one person but not the other. Some are stress triggered, some are diet triggered, some require the right medication or all the above.\_\n\nAt times the condition left him exhausted, in pain, and unable to eat. He has been refreshingly candid about how he manages his symptoms, often with medical cannabis. I don't see that talked about all that much. It isn’t for everyone, but it’s clearly worked for him. (Cannabis and IBD is a post in itself - which i am writing currently).\n\n*‘There’s something wrong with me for sure… but Crohn’s keeps me skinny, so I guess that’s a plus.’*\_\n\nHe’s also riffed on the\_**urgency of bathrooms**\_during sets, turning it into material about awkward moments on dates or in public spaces.\n\nComedy is such a healthy way to manage the mental side of this disease. His ‘I make fun of it first, it loses power’ mentality is a lesson for anyone.\n\nhttps://preview.redd.it/tvti9d60nvnf1.png?width=1200&format=png&auto=webp&s=0f43b469c654bc97b975818609f2b9b7739fbc52\n\n# 5. Mike McCready - lead guitarist of Pearl Jam\n\n*‘Crohn’s disease doesn’t define me. It is just a part of me. Music, love, family, and friends define me.’*\n\nMike McCready, lead guitarist of Pearl Jam, has lived with Crohn’s disease for decades and admits that for years he carried shame and fear, often suffering in silence. Touring life meant being doubled over in pain on buses, in airports, and even running off stage mid-show.\_\n\nOver time, he found that coping wasn’t just about medication and diet, but also about connection.\_*“Crohn’s disease doesn’t define me. It is just a part of me. Music, love, family, and friends define me,”*\_he wrote.\_\n\nOpening up about his illness proved transformative:\_*“I know how hard it is to talk about this disease. But I’ve learned that sharing my story not only helps me, it can help others. You are not alone.”*\_By combining medical treatment with openness and advocacy, McCready shows how talking about IBD can be as powerful a tool as any prescription.\n\nMike wrote a great piece on the Huff Post -\_**“My Life With Crohn’s Disease”**\_(2013) ([https://www.huffpost.com/entry/crohns-colitis-week\\_b\\_2259921).\_](https://www.huffpost.com/entry/crohns-colitis-week_b_2259921).%C2%A0)\n\nhttps://preview.redd.it/qfdb7fv0nvnf1.png?width=1200&format=png&auto=webp&s=2b10b954381b6d7a453d4a2cc13efd1d42b1359f\n\n# 6. You - the most important.\n\nIBD is brutal. It’s complex, unfair, and lifelong — and accepting that can feel overwhelming.\n\nBut your diagnosis isn’t the end. It’s the beginning of learning that there’s still so much life after IBD. Success looks different for everyone: maybe it’s just making it to the shops today, being the best parent you can be while managing fatigue, winning five PGA Tour titles, or building a billion-dollar business.\n\nThese stories prove it’s possible. But remember — health comes first. No success matters if you can’t enjoy it.\n\nAnd if there’s one lesson every success story shares, it’s this:\_**never give up.**\_They didn’t — and they came out the other side."
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- id: 1c2j06f
title: 'Complete Proctocolectomy w Ileostomy '
subreddit: r/ostomy
author: gaycatmom23
score: 17
comments: 26
url: https://www.reddit.com/r/ostomy/comments/1c2j06f/complete_proctocolectomy_w_ileostomy/
created_utc: 1712952730
selftext: >-
Hello! Been lurking for a few weeks here after finding out my (f24) ulcerative colitis has reached the point that my
colon is a 1/4 of the size it should be, showing dysplasia, and beyond repair, so it’s time to yeet it! I was
diagnosed with UC at 15 and have remained pretty medication resistant (except for 2020-march 2023, when I went into
complete remission with no medication??? idk what was going on there). They told me I’d have my colon removed before
I was 20, so at least I got 4 bonus years, I guess lol. I’m scheduled for May 6th.
I opted for the permanent ileostomy because I am terrified of surgery in general and the idea that I could ever have
to deal with incontinence (or the thought that there’s still precancerous cells in my rectum…..) is just too much.
If I’m doing all of this, it better all be out!
I’m terrified of the surgery itself, I’m so scared of anesthesia and *6 hours* of surgery, but really looking
forward to the rest of my life without shitting myself.
I guess I’m just looking for support and positive outcomes- I love hearing and all success stories. This reddit has
been so incredibly helpful so far just to look through, I’m so happy to have found it.
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- id: 1luhopc
title: I think I need help
subreddit: r/UlcerativeColitis
author: lejumo
score: 3
comments: 0
url: https://www.reddit.com/r/UlcerativeColitis/comments/1luhopc/i_think_i_need_help/
created_utc: 1751956821
selftext: >
Hello everyone, I hope you’re getting good today. Well, I think it’s my first post and it will be a bit long to
expose to you my story.
So I have had ulcerative colitis since July 2022 according to the first symptoms but with one year to wait before
the diagnosis. This year was very horrible because I started my first year of health study (called PASS because I’m
in France) so it was recognised to be very painful physically and emotionally. During this year I kept secret my
symptoms (blood on stools, abdominal pain, great tiredness and frequent emergencies to go to the toilet). It
resulted in an intensification of the symptoms and a great loneliness as I didn’t talk to anyone, even my own family
and close friends. The second part of the year was pretty bad with in one part I miserably felt my year and I, for
the first time, talked of my symptoms with my doctor who thought and diagnosed some haemorrhoids (with all
treatments like laxative and steroids suppository). My symptoms became largely worse at the point I wasn’t able to
get up out of my bed with the pain (the only times I woke were only to go to the toilet to evacuate a lot of blood
and pretty often). I waited until the 6th July 2023 to be taken by my father to the hospital were they find I was in
pretty bad state and after the night and a sigmoïdoscopy, I was diagnosed with a UC with all the rectum and the
colon touched, and accompanied with an acute severe colitis and a start of toxic megacolon. Thankfully I was rapidly
recovering and got out one week later. I was treated with prednisolone for the acute inflammation and after a week
and before living, the medical team did the infusion of infliximab (Rémicade at the time) which it will has become
my treatment by default.
And now we are in July 2025 and yes things seem to be getting better…
Yes, I succeeded in reintegrating the PASS with a derogation thanks to the UC (finally the only good part of the
disease) and I succeeded in integrating the pharmacist university (it was my objective a few years ago so it was a
big success for me 🥳).
Nevertheless, I think it’s the only good thing that appears to my mind to this day.
Last year I was pretty well known for my disease and to support a lot of fellow students in the medical years, I
have gotten a good reputation but… something was off with that.
I was feeling lonely because my help was very virtual and meeting up with the real people was very uncommon so… yes
I was often lonely with my pc and my cat. But I didn’t see through this everything else unlike my disease were I
hadn’t any clinical symptoms (YEEEEEAAAAAH) but I wasn’t, and still today, I not in a state of complete remission
(my calprotectine is always high, last time it was at 261 and I must go bellow 250) but it was find just stressful.
I followed a diet that my parents saw on the Internet. It seemed pretty good I first but was very restrictive (good
when you are in a flare-up, but the worst diet when you have no symptoms and when everything is fine when you eat
everything). I have this chance to eat all I want with no consequences but this diet was very painful to my mood.
It’s become a bit worrisome this year. Last summer I underwent a colonoscopy where we found that my transverse colon
was still in an inflammatory state. Yes, all that was left was alright, unlike this part. Understand that it was for
me a real mace punch to the face when I saw the results. My gastroenterologist chose to add to my infliximab one per
month in infusion, with 125mg of Azathioprine every day for one year. I rejected one time this treatment once
because I didn’t see the need to use this treatment with my current condition and with my results that were good
(except for the calprotectin) but with the colonoscopy, yes I resigned myself and chose it. I was very immuno
depressed and with my studies, my professors limited some practical works when they came to the need to manipulate
microorganisms such bacteria or mushrooms such Aspergillus Niger. So my year was a bit modified with this condition
and I was very frustrated to do nothing during these times. Thankfully my faculty has helped me to have a
modification of my courses to ease my life. To start I was feeling a bit disturbed to have these modifications with
my current conditions but in case of a new flare-up (I hope so bad to never happen) it will be very helpful. Plus
they gave me the coordinates of a specialist of the UC in my city who explores an innovative approach to treat the
UC and Crohn's.
Today it’s this gastroenterologist I follow and yes, I admit he is very strong on this subject and helps me. Thanks
to him, he proved that azathioprine is… ineffective in UC and switched the Infliximab infusion to subcutaneous
injection and HELL THIS IS SOOOO GOOOD 🥳.
Now I “rapidly” share the story (sorry for the book I threw on this post), now I will attack the reason for this
subject.
Like I said earlier, I’m feeling a bit off since last year. I saw I don’t talk anymore with everyone in my faculty,
unlike in Discord or Messenger or Instagram, I’m also no longer very confident when I’m talking to someone (that was
a speciality of mine before). But now I’m feeling very alone. I dodged all parties and meetings with everyone, I
stayed the vast majority of the day in my room with my cat and I don’t have pleasure in what I do. Before, I wasn’t
like this, so maybe it’s just that I got the habit of being alone… but it’s painful. Recently I argued with my
family about why I didn’t go to the gala for my promotion. I said to them they block me from seeing anyone but they
responded I never talked to them I want to socialise (I live still with my parents with the disease it’s better to
have support and also they live near some forests where I like to spend time). And yes I saw they were alright, I
didn’t make an effort to see anyone, I grumble sometimes to be alone but I do nothing to arrange the situation.
Furthermore, today I didn’t consider that I have close friends and it’s very painful to realise this. Yes, I have my
parents, my sisters, my niece and my cat (and thankfully I think), but I feel the need to socialise and talk,
sometimes, online, that does not replace this need I have. I’ve also noted I often feel tired, I sleep pretty badly,
I often have a bad mood (melancholic and I can cry alone just by earring a certain music or by reading something a
bit sad). I also have some difficulty concentrating, I often multitask and it is very bad when I must work for an
exam (but thank goodness I did two good semesters). I noted my memory wasn’t very good, I forgot sometimes a few
things but things that I would never forget usually (I had a good memory, but that was before and the first time I
saw some signs of my brain going in the last year). I also have a changing mood, I noted I’m becoming very irritated
for all and nothing, and it’s getting worse over time. I remember in April bursting into my great sister's after an
argument with my mother and I was out of control when I saw her taking a cigarette (I hate so bad when someone vapes
in front of me). But it was such anger that I made my sister cry and I didn’t understand why I had done this. I
never did something like this before, I felt so bad after that even today, I have the fear to do something like this
to someone else now. Thankfully since then, I’ve stayed calm but I have always had this anger and I feel I have some
issues controlling it. On this day I saw something was becoming off with me.
I have much more issues like when I’m talking to someone in front of me of my disease a flood of tears flow down my
eye, when with my group in the faculty we tested the hypnosis, I was the only to have the worst experience at the
ending with the hypnotist saying at the end I’m the perfect case of someone which is near a broke (thanks man I
didn’t see I was taking the water a few years ago), etc…
Recently and with a mood a little bit better I've begun to think that something has broken since the UC. My mood and
my physical state aren’t very good and I feel I must find out what's going on to solve this problem before it gets
even worse over time. I have read many times that with this disease, the brain-gut axis becomes very disturbed with
some anxiety and depressive disorders, even in remission. I searched for a year for what was going on but a few days
ago I remembered all of these little details, I concluded that in the rare case of my life, I will need help. In the
last year, some people said to me to maybe see a psychologist but I refused every time. Maybe I will do the first
step in that way. Also, I write this post in a part to expose a bit of my story, glad if I can help someone with the
same issue not to don’t feel alone, but also to help me keep in the light all these elements. I know too well how I
worked and I know when something is wrong, I will dodge this like the final boss of a soul like and put a large
amount of thought and put this problem far away in my mind. I made the mistake when the first sign of UC started,
only to make a selection that was lost in advance. I don’t want to make the same mistake again, I swear it to
myself, my family, my friends and every person I will work with and the people I will help during my career. I will
contact very soon a doctor I met at my university to have a first advice of the situation ( I prefer talking to some
people that doesn’t know me to have a clear idea of what’s going on and to have the most objective response) and I
will talked to all these elements with my gastroenterologist the 29 July. I want to know what's going on and
especially, delete the doubt about a depressive disorder, or confirm it.
Hope I wasn’t too confusing with my story, stay strong and stay tuned if you want some news when they arrive.
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- id: 1j8xqg3
title: A Natural Approach to Gut Health
subreddit: r/Exsplore
author: exsplore
score: 2
comments: 0
url: https://www.reddit.com/r/Exsplore/comments/1j8xqg3/a_natural_approach_to_gut_health/
created_utc: 1741717540
selftext: "# What is GutMellow?\n\n[GutMellow](https://gutmellow.com/) is a holistic gut-healing program designed to help individuals struggling with colon inflammation, digestive issues, and chronic gut-related conditions. It offers a structured approach that combines dietary modifications, lifestyle adjustments, and evidence-based natural remedies to support long-term gut health and remission from conditions like [Crohn’s disease](https://my.clevelandclinic.org/health/diseases/9357-crohns-disease), colitis, and IBS.\n\nUnlike conventional treatments that often rely on medications to suppress symptoms, [GutMellow](https://gutmellow.com/) focuses on\_**addressing the root cause**\_of inflammation and digestive distress. By eliminating trigger foods, incorporating gut-nourishing nutrients, and optimizing digestion, GutMellow aims to restore gut balance and support overall well-being.\n\n# Who is GutMellow For?\n\n[GutMellow](https://gutmellow.com/) is for anyone who:\n\n* Struggles with chronic gut issues like\_IBD (Crohn’s, ulcerative colitis), [IBS](https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016), leaky gut, SIBO, or acid reflux\n* Experiences\_colon inflammation, bloating, discomfort, or irregular digestion\n* Has tried conventional medications but still suffers from symptoms\n* Wants a\_natural, food-based approach\_to healing their gut\n* Is looking for\_long-term remission\_instead of just symptom management\n* Wants a clear, step-by-step method backed by personal experience and research\n\n# The GutMellow Healing Method\n\nThe [GutMellow](https://gutmellow.com/) method is built around four core principles:\n\n# 1.\_Eliminating Triggers\n\nMany gut issues stem from\_inflammatory and hard-to-digest foods\_that cause irritation, gut lining damage, and immune system overreaction. GutMellow recommends cutting out\_processed foods, seed oils, refined sugars, gluten, dairy, alcohol, caffeine, and artificial additives, all of which can contribute to gut inflammation and imbalance.\n\n# 2.\_Nourishing the Gut\n\nOnce triggers are removed, the next step is replenishing the gut with nutrient-dense, healing foods. The [GutMellow](https://gutmellow.com/) diet emphasizes:\n\n* **Grass-fed meats and wild-caught fish**\_for essential amino acids\n* **Healthy fats**\_like olive oil, coconut oil, and avocado oil for gut-lining repair\n* **Bone broth and collagen**\_for healing and sealing the gut lining\n* **Low-starch vegetables**\_for fiber and essential micronutrients\n\n# 3.\_Optimizing Digestion\n\nPoor digestion can lead to undigested food particles, bloating, and [gut dysbiosis](https://my.clevelandclinic.org/health/diseases/dysbiosis). GutMellow encourages digestive support through:\n\n* **Hydration with mineral-rich water**\_to support digestion and detoxification\n* **Intermittent fasting or meal spacing**\_to give the gut time to rest and repair\n* **Mindful eating practices**\_to improve digestion and reduce stress-related gut symptoms\n\n# 4.\_Lifestyle & Stress Management\n\nGut health is deeply connected to\_**stress levels, sleep, and movement**. Chronic stress and lack of sleep can trigger inflammation and weaken the gut barrier. GutMellow incorporates:\n\n* **Daily movement**\_(walking, yoga, light exercise) to improve circulation and digestion\n* **Stress-reducing techniques**\_like meditation, deep breathing, and cold therapy\n* **Prioritizing sleep**\_to allow for gut repair and immune regulation\n\n# How Does GutMellow Work?\n\nGutMellow is available as a\_**comprehensive gut-healing roadmap**, guiding users through each phase of healing with:\n\n* A\_detailed meal plan\_with recipes tailored for gut health\n* A\_list of foods to eat and avoid\_for reducing inflammation\n* Supplement recommendations to support healing\n* Step-by-step guidance\_to track progress and make adjustments\n* Community support and expert insights for ongoing motivation\n\n# The Science Behind GutMellow\n\n[GutMellow](https://gutmellow.com/) isn’t just based on anecdotal experience, it aligns with\_scientific research\_on gut healing, microbiome balance, and inflammation reduction. Studies show that an\_anti-inflammatory diet, paired with\_gut-rebuilding nutrients, can significantly improve symptoms of IBD, IBS, and other digestive disorders.\n\nFor example:\n\n* Bone broth\_contains gelatin and amino acids that help\_repair the gut lining\n* Fermented foods\_introduce beneficial bacteria that promote microbiome diversity\n* Omega-3 fatty acids\_from wild-caught fish help\_reduce intestinal inflammation\n* Eliminating gluten and dairy\_has been shown to benefit individuals with\_autoimmune gut issues\n\n# Why Choose GutMellow Over Other Gut-Healing Programs?\n\nThere are many gut health programs available, but [GutMellow](http://gutmellow.com) stands out because it is: \n\n✔\_Designed by someone who has successfully healed their own gut\_\n\n✔\_Focused on food as medicine rather than quick-fix supplements\_\n\n✔\_Comprehensive, guiding users step-by-step through the healing process\_\n\n✔\_Backed by science and personal success stories\_\n\n✔\_Flexible and customizable to individual needs\n\n# How to Get Started with GutMellow\n\nIf you’re ready to take control of your gut health and eliminate [colon inflammation](https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315) naturally,\_**GutMellow offers an easy way to begin your healing journey**.\n\n✔\_Sign up for the GutMellow Remission Roadmap\_\n\n✔\_Follow the structured plan and meal recommendations\_\n\n✔\_Join the GutMellow community for support\_\n\n✔\_Experience real, long-lasting relief from gut inflammation\n\nYour gut can heal. GutMellow is here to show you how.\n\n👉\_**Get started today and take the first step toward a healthier, inflammation-free gut!**\n\n[https://gutmellow.com/](https://gutmellow.com/) "
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- id: 1bc26nk
title: >-
$SLS - Why Sellas Life Sciences is the MOST INTERESTING microcap in the world... and how it WILL squeeze like a lime
into your Dos Equis.
subreddit: r/sellaslifesciences
author: FckMyStudentLoans
score: 42
comments: 11
url: https://www.reddit.com/r/sellaslifesciences/comments/1bc26nk/sls_why_sellas_life_sciences_is_the_most/
created_utc: 1710160706
selftext: >-
While this will be FAR from a scientifically deep dive, my objective here was to bring together many DDs and bits of
info in order to create a comprehensive look at why Sellas is the most interesting microcap in the world.
Now that I have your attention, please bear with me while we dig the fuck in.
# THE SUMMARY
SELLAS Life Sciences Group, Inc. is a late-stage clinical biopharmaceutical company. The Company is focused on the
development of novel therapeutics for a range of cancer indications. The Company's product candidates,
galinpepimut-S (GPS), a peptide immunotherapy directed against the Wilms tumor 1 (WT1), antigen, and SLS009, a
selective small molecule cyclin-dependent kinase 9 (CDK9), inhibitor. GPS is a cancer immunotherapeutic agent
licensed from Memorial Sloan Kettering Cancer Center (MSK), that targets the WT1 protein, which is present in an
array of tumor types. GPS has potential as a monotherapy or in combination with other immunotherapeutic agents to
address a broad spectrum of hematologic malignancies and solid tumor indications. The Company is developing SLS009,
which is licensed from GenFleet Therapeutics (Shanghai), Inc., for all therapeutic and diagnostic uses in the world
outside of Greater China.
# THE BASICS
Market Cap: **53.25M**
Institutional Ownership: **14.59%**
Shares Outstanding: **42.26M**
Float: **41.88M**
Short Float: **9.28%**
Short Interest: **3.89M**
Avg. Analyst 12-mo Target Price: $**6.83 (542% increase)**
**$SLS ALSO JUST FULLY REGAINED COMPLIANCE WITH NASDAQ BY MEETING THE MARKETCAP MINIMUM AND SATISFYING THE $1 CLOSE
RULE THIS PAST FRIDAY.**
# RECENT NEWS/ACTIVITY
[Recent Breakthroughs by Sellas Life Sciences: Advancements in Cancer Treatment and FDA
Designations](https://www.reddit.com/r/sellaslifesciences/comments/1avqkb6/recent_breakthroughs_by_sellas_life_sciences/)
( [u/Jadatrade](https://www.reddit.com/user/Jadatrade/) )
Sellas Life Sciences, has been in the spotlight due to several significant developments in its clinical development
programs. Here's a summary of the latest news about the company:
1. **SLS009 Data Presentation**: Sellas Life Sciences announced it will present Phase 1 data for SLS009, a treatment
for acute myeloid leukemia, at the 2024 European School of Haematology (ESH) Conference scheduled from March 1-3,
2024, in Stockholm, Sweden. These data come from a dose-escalation study in patients with acute myeloid leukemia
[oai\_citation:1,SELLAS Life Sciences to Present SLS009 Phase 1 Data from Acute Myeloid Leukemia Patients at the
2024 European School of Haematology (ESH)
Conference](https://finance.yahoo.com/news/sellas-life-sciences-present-sls009-134500235.html).
2. **FDA Orphan Drug Designation for SLS009**: The FDA granted orphan drug designation to SLS009 for the treatment
of peripheral T-cell lymphomas on December 21, 2023. This designation followed promising results from a Phase 1
study, which demonstrated a 36.4% clinical response rate in treated patients, higher than the standard care response
rate of 25.8%. Orphan drug designation offers benefits such as drug development assistance, tax credits, and FDA fee
exemptions [oai\_citation:2, SELLAS Receives FDA Orphan Drug Designation for SLS009 for Treatment of Peripheral
T-cell Lymphomas, Sellas Life Sciences
](https://www.sellaslifesciences.com/investors/news/News-Details/2023/SELLAS-Receives-FDA-Orphan-Drug-Designation-for-SLS009-for-Treatment-of-Peripheral-T-cell-Lymphomas/default.aspx).
3. **Positive Results for Lung Cancer Treatment**: Sellas also released Phase 1 data for its lead clinical
candidate, galinpepimut-S (GPS), in combination with Bristol Myers Squibb's nivolumab, in patients with malignant
pleural mesothelioma who were refractory or relapsed after at least one line of standard therapy. The results showed
improvements in survival rates [oai\_citation:3,SELLAS Life Sciences Group, Inc. (SLS) Latest Stock News & Headlines
- Yahoo Finance](https://finance.yahoo.com/quote/SLS/news/).
These developments reflect Sellas Life Sciences' progress in the field of innovative cancer therapies and could have
significant implications for patients with these serious conditions. The orphan drug designation and positive phase
1 study data suggest that Sellas is successfully advancing its development pipeline and could offer new hope for
cancer treatments.
​
# THE PIPELINE
I won't pretend to be a scientist, doctor, or medical professional of any kind. In fact, I really need to look into
getting healthcare. But that's a story for another time. So what I will do is paraphrase the key components of what
Sellas is doing, and then link to some of the more thorough and intellectual DD's that I read leading up to my
investment.
Currently, Sellas is developing numerous drugs spread across Phase 1, 2, and 3 in terms of progress. For the sake of
brevity, we are going to key in on the most prominent and pertinent to our investment... the ones that we will
receive updates on this quarter (briefly touching on the ones for next quarter as well).
# 1Q 2024 DATA CATALYSTS
* ***Interim analysis of the Phase 3 REGAL trial of GPS in AML***
“REGAL study is for patients in second or beyond second remission and just to remind these patients have an
extremely poor outcome because **the median survival is in the order of 5 to 7 months.**.. the majority of
hematologist prefers to use as BAT the combination Aza/Ven which is a toxic combination and its administration is
associated with negative consequences that I briefly mentioned before' And again...'GPS administration is very
easy... “ - Dr. Tsirigotis
**“ I am not allowed to give you much more detail about the efficacy because of the confidentiality agreement**, but
I can say to you and I would like to thank Sellas, because I have enrolled personally more than 10 patients into
this trial and I can say to you that GPS is an extremely safe drug and I did not see any systemic toxicity...our GPS
patients have an excellent quality of life..**.l strongly believe that GPS will reach the primary end point of this
study,** but please allow me not to give anymore other details to you and finally I just want to say to you that
if..., which I strongly believe and I eagerly await for the results, but if... and I believe so...if the GPS shows
the expected survival advantage then you can imagine that it will revolutionize the field of AML treatment because
then we have to anticipate that this drug will be used for cr1 and post stem cell." - Dr. Tsirigotis
​
* ***Topline data from Phase 2a SLS009 Relapsed/Refractory AML***
Again, I am not a science guy. So PLEASE read through this as a MUCH smarter investor put together a ton of insight
and value about what is happening with SLS009.
[Is GFH/SLS009 a Miracle AML Cure? It sure is shaping up to
be.](https://www.reddit.com/r/sellaslifesciences/comments/17qr3dk/is_gfhsls009_a_miracle_aml_cure_it_sure_is/) (
u/Run4theRoses2 )
[Venetoclax with Decitabine or Azacitidine in Relapsed or Refractory Acute Myeloid
Leukemia](https://www.reddit.com/r/sellaslifesciences/comments/1az1fvk/venetoclax_with_decitabine_or_azacitidine_in/)
( [u/Gabri71](https://www.reddit.com/user/Gabri71/) )
# 2Q 2024 DATA CATALYSTS
* ***Additional data from Phase 2a SLS009 Relapsed/Refractory AML***
* ***Topline data from the Phase 1b/2 study of SLS009 in PTCL***
https://preview.redd.it/jllpxcnl2pnc1.png?width=2502&format=png&auto=webp&s=413c9b610ace3032d7cfe25d5691576145664224
# Potential Merger/Buyout Breadcrumbs
Stacy Yeung was promoted to VP, Associate General Counsel & Head of Compliance in January 2024.
From today's press release... "In line with the Company’s commitment to maintaining operational excellence, SELLAS
is engaging the expertise of a seasoned commercial consultant with a proven track record of success, including
launching Venetoclax. Stacy Yeung, recently promoted to Vice President, Associate General Counsel, and Head of
Compliance, with 20 years of relevant experience will lead the Company’s legal and compliance functions."
In her last role with Arena Pharmaceuticals she helped lead their acquisition by Pfizer.
https://preview.redd.it/jsyd63624pnc1.png?width=2316&format=png&auto=webp&s=e509edfe797d45aa3405a17600a206c7c69f5776
Pfizer completed their acquisition of Arena on March 11, 2022 for $100 per share ($6.7 billion total).
"Arena has previously indicated that it expected the results of the Phase 3 ELEVATE-UC trial of etrasimod in
ulcerative colitis during the first quarter of 2022."
Arena was gearing up to release their Phase 3 results before the end of 1Q 2022, but they were acquired by Pfizer
beforehand.
[https://www.pfizer.com/news/press-release/press-release-detail/pfizer-completes-acquisition-arena-pharmaceuticals](https://www.pfizer.com/news/press-release/press-release-detail/pfizer-completes-acquisition-arena-pharmaceuticals)
[Mergers & Acquisitions up 29% for biotech this
year.](https://finance.yahoo.com/video/m-dramatically-picks-2024-expect-163133466.html)
# THE SHORT STORY
This is my favorite part (because I'm not sciency but I fuckin love the adrenaline of a short squeeze).
Sellas is a prime candidate for a massive short squeeze due to a number of factors.
1. They have CRITICALLY important catalysts that are dropping this quarter (by EOM). These are "make or break" (for
the most part) for Sellas and will determine whether the company is on a straight shot for ATH and massive revenue,
or another round of dilution/funding.
2. Shorts have been beating this stock down for YEARS. Literally years. I started watching this back in 2020/2021
when it had some really interesting short action (a \~$2/$3 to \~$16 move).
3. Massive amounts of money are pouring into biotech/pharma companies so far this year. If you look to some of the
companies with successful catalysts, the runs have been monumental ($VKTX, $IOVA, and more)
4. Average daily short volume saw a significant increase into the end of last year and early this year.
Approximately \~10% of the float is short... with a 3.5 short ratio.
https://preview.redd.it/1rsp59pd7pnc1.png?width=1298&format=png&auto=webp&s=b89349ba09ab9d34fe43843d852f8c8d69762c28
https://preview.redd.it/zs6yhsg58pnc1.png?width=1276&format=png&auto=webp&s=8928a35e6d95b47a1d7f02d077c386782dc6156f
# DD SHOUTOUTS
I want to give a big shoutout to the following users who posted DD leading to my investment in $SLS, sharing
tremendously valuable and exciting information about Sellas. PLEASE go ahead and comment more information and let me
know of any corrections/edits/additions I can make to improve this for new investors! Here we go In no particular
order...
[u/Jadatrade](https://www.reddit.com/user/Jadatrade/)
u/Run4theRoses2
[u/Gabri71](https://www.reddit.com/user/Gabri71/)
# Why is it interesting & what's the move?
**With 10% of the float short, 3.5 short ratio (3.5 days for all short shares to cover based on avg volume), and
about 5+ years worth of work/data being released this quarter (plus more in 2Q), I believe that this play is about
to see MASSIVE amounts of volume from both retail and institutional investors.**
**Sellas is a $50m marketcap company, that is on the brink of becoming the standard of care in a $5+ billion
market... (after many years of SP brutality).**
**With volume before the data and then positive news when it comes out, $SLS is going to take off and set all time
highs, and be far from it's current marketcap for good.**
**For all of these reasons, and because i'm a bit of a degenerate, I've loaded a SIZEABLE position just about $1
avg.**
**Best of luck to all this week and the weeks ahead.**
**Let's make some fuckin money.**
​
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis constipation psyllium kiwi proctitis
- id: 1njyl7g
title: AITA for buying my niece 2 pairs of glasses and letting her get contacts
subreddit: r/BestofRedditorUpdates
author: LucyAriaRose
score: 3634
comments: 353
url: https://www.reddit.com/r/BestofRedditorUpdates/comments/1njyl7g/aita_for_buying_my_niece_2_pairs_of_glasses_and/
created_utc: 1758168864
selftext: "**I am NOT the Original Poster. That is** [Ok\\_Barracuda\\_5060](https://www.reddit.com/user/Ok_Barracuda_5060/)**.** She posted in r/AmItheAsshole and r/AskDocs\n\nThanks to u/BakingGiraffeBakes for the rec\n\n# Do NOT Comment on Original Posts. Latest update is 7 days old.\n\n**Trigger Warning:** >!child abuse/neglect!<\n\n**Mood Spoiler:** >!positive ending!<\n\n**Original** [Post](https://www.reddit.com/r/AmItheAsshole/comments/1n5v72p/aita_for_buying_my_niece_2_pairs_of_glasses_and/)**: September 1, 2025**\n\nI have a 12 year old niece, Haley. Haley lives with her dad, stepmom, and 4 younger step siblings (2 boys 2 girls, don’t know the exact ages but they seem to be between 5 and 10). Her mom passed when she was 3.\n\nHaley’s dad and stepmom are not well off. They live in a 3 bedroom house so Haley shares a room with her stepsisters. The kids get 1 pair of shoes, reuse school supplies until they’re falling apart, and if their clothes still fit they don’t get new school clothes.\n\nI am doing a lot better but I refuse to help him with money because if I give him money with the direct instructions to get Haley some decent shoes or a nice jacket I expect the money to be used on Haley, not split between all 5 kids. He also dislikes me because he blames me for cps investigating him and his wife for leaving the kids home alone every day. Haley stays with me after school and sleeps over a few nights a week because I won’t drop her off if theres not an adult present and I told her not to get on the bus under any circumstances so they can’t tell her I wanted her to take the bus home that day.\n\nHaley and 2 of her step siblings needed glasses. Nobody was able to take Haley for her eye exam and to get the glasses so they asked me to take her and gave me $100 with the instructions to get the cheapest pair we can find.\n\nI was driving Haley to the eye doctor and she told me she really wanted contacts but her dad said no. I talked to the receptionist and they were able to get her in for a contact fitting that day. After her contact appointment we checked out the glasses and she found 2 pairs that she really liked so I told her to get both. I took her back after school a few days later and picked up a few boxes of contacts.\n\nHer new glasses came in a few days ago and she loves them but her dad is furious about the glasses, then he found out about the contacts (I guess Haley was keeping them in her backpack and never told him about it) so he told her she gets to keep one pair of glasses and everything else has to stay at my house because he’s sick of me and Haley rubbing her stuff in her step siblings faces.\n\nHaley responded by packing most of her stuff and walking to my house. Now she’s refusing to go home.\n\nCPS came for another investigation and was told by the kids that Haley doesn’t live there anymore, which is not helping my BIL’s case. Now my bil wants me to make Haley come back and stop spoiling her so she won’t rub it in her siblings faces anymore (her rubbing it in their faces means she put both pairs of glasses on her dresser but it wasn’t fair because the other kids could see it).\n\nAITA for getting her contacts and 2 pairs of glasses\n\n***Some of OOP's Comments:***\n\nCommenter: INFO:\n\n1. How much did the $100 cover? Did you pay for any overage?\_\n2. Who is going to be paying for the contacts moving forward? You?\_\n\n>**OOP:** I ended up paying out of pocket for everything and told Haley to give the money back to her dad. He tends to have a “I paid for it so I can take it away” attitude so I didn’t want him to have any justification to take away one of her pairs of glasses. He confirmed that he got the money back. I will pay for her contacts.\n\nCommenter: NTA You had good intentions but unfortunately, unless you are willing to become Haley's guardian, you should abide by BIL's rules, which means that Haley has to keep stuff away from her stepsisters at your house.\n\n>**OOP:** I am willing. I’m just waiting to see how this CPS investigation plays out.\n\nCommenter: \\[...\\] Also assuming that since Haley’s dad is your BIL, that it was your sister that passed away. Keep being there for Haley. It sounds as if her parents are leaving the kids home alone that she is expected to take care of them.\n\n>**OOP:** Haley doesn’t care for her step siblings because I pick her up from school and told her dad I will not drop her off unless there’s an adult present and because she knows to walk or ride her bike to my house if they leave on weekends.\n\n*Some more information:*\n\n>Haley’s mom is my sister. The fact that the kids are left home alone is the main reason for the CPS visit. Nobody watches the kids when Haley’s not there. \nI got her daily contacts so she doesn’t have to worry about cleaning them. She wears them and throws them away. She has drops in her backpack and at my house.\n\nCommenter: NTA sounds like you should also file for full custody.\n\n>**OOP:** They won’t give it to me willingly and they’re in the middle of a CPS investigation at the moment so it would make officially getting custody tricky. CPS is aware that she’s currently staying with me and that she was previously sleeping over 3-4 days a week, was here every day after school, and came over most weekends to avoid being home alone with 4 young children.\n\n*Step siblings vs half-siblings:*\n\n>I believe they’re all step siblings. I think the youngest is 5 and they’ve been married for 4 years. \nI did call CPS but I was not the only person that called. They leave the kids home alone from when the bus drops them off until sometimes after 10.\n\nCommenter (downvoted): \\[...\\] She's gone to your house, which she can't do. And are you telling her she needs to go back to her parents? What do you say to her about her dad, her step mom and her step siblings?\n\nYou seem to be working against them.\n\n>**OOP:** I haven’t told her she needs to go back to her dad’s house and her dad hasn’t come back to try to pick her up. I briefly spoke to CPS and they know that she’s staying with me and don’t have a problem with it.\n\n*To a deleted commenter:*\n\n>I’m allowed to have a favorite. One of them is my niece. The other 4 are my sister’s husband’s new wife’s kids. That’s not remotely the same.\n\n*To people saying she's too young for contacts:*\n\n>A 12 year old is able to handle contacts. We were told in the office that a lot of kids start wearing them around middle school. \n*To another commenter:* \nShe knows no shower or swimming while wearing her contacts.\n\n*More on CPS and being placed with OOP:*\n\n>We’re at a point where removal is likely to happen, just not immediately. The parents were told they had 6 months to get their shit together. They were given a list of things to complete and were connected with services to help. So far nothing’s happened and they have a little over a month left.\n\n**Side** [Post](https://www.reddit.com/r/AskDocs/comments/1n6p09y/what_is_wrong_with_my_nieces_stomach/)**: September 2, 2025 (Next Day)**\n\n**Title:** What is wrong with my niece’s stomach\n\nMy niece is 12 years old. She’s pretty tiny (4’8, 75 pounds) and has ADHD and type 1 diabetes.\n\nFor the past month and a half or so she’s constantly complaining about her stomach hurting, her appetite’s decreased, she’s more tired than usual, she either has diarrhea or she’s constipated, and when she has to go to the bathroom she really has to go.\n\nWe’ve been to the doctor 3 times. They did an ultrasound on her stomach which showed inflammation around her large intestine. Then she did blood tests and stool tests.\n\nShe tested negative for every virus and infection\n\nESR: 32\n\nCRP: 1.4\n\nWBC: 11.5\n\nRed blood cell count: 3.8\n\nHgb: 10.2\n\nHematocrit: 38.7\n\nMCV: 92\n\nRDW, RBC: 11.7\n\nPlatelets: 472\n\nStool calprotectin: 640\n\nThe doctor said it’s probably IBS and that she may be getting her period, which could be triggering it or making it worse but I just have a feeling that something’s wrong. She’s staying home from school again today because she just doesn’t feel good and Tylenol isn’t helping. I don’t know what to do at this point.\n\nEdit: we’re officially adding vomiting as a symptom\n\n**Update to Side** [Post](https://www.reddit.com/r/AskDocs/comments/1nckopu/update_what_is_wrong_with_my_nieces_stomach/)**: September 9, 2025 (1 week later)**\n\nWe’ve been in the hospital since Saturday. My niece got a colonoscopy on Monday and they said she has moderate-severe ulcerative colitis across her entire large intestine. They gave her a blood transfusion, now they’re starting her on a steroid, and when she starts to respond to the steroids they’ll put her on something that can be used longer term.\n\n**Update** [Post](https://www.reddit.com/r/AmItheAsshole/comments/1near81/update_aita_for_buying_my_niece_2_pairs_of/)**: September 11, 2025 (10 days from OG post)**\n\nHaley has been in the hospital since Saturday for either ulcerative colitis or Chrons. Her health insurance pretty much only lets her go to the county hospital and medical centers and even this is going to get expensive.\n\nOn top of Haley’s stomach situation, she also has type 1 diabetes and adhd (the adhd is currently not being treated). We live 20 minutes away from one of the best children’s hospitals in the country for both GI and diabetes. They also have a great psych department and adhd clinic. This would be covered under my insurance. 35 minutes in the other direction is another world renowned children’s hospital that I would be able to send her to.\n\nI sat Haley’s dad down the other day and showed him how much I was paying each month for Haley between her health insurance premiums, her insulin, monitor, and pump, her EpiPens, doctors appointments, etc. and told him that I refuse to continue to pay out the ass for her to receive medical care that is subpar at best when, if I was her guardian, she would get some of the best care possible for less than what I’m paying now.\n\nAfter a long discussion and a lot of back and forth, he agreed to give me guardianship of Haley. We started the process yesterday. She will live with me but will see her dad every other weekend and holiday.\n\nWe talked to Haley about it today. She is very excited to officially live with me.\n\n***Some of OOP's Comments:***\n\n*To a removed commenter:*\n\n>She doesn’t consider me a hero. Once we get back to normal she’s going to start hating me again for making her stay with a babysitter or for packing her a healthy lunch instead of getting her McDonald’s like her friends mom.\n\nCommenter: 🌈 Parenthood🌈\n\nDislike, but care, in the short term will always equal health and respect in the long term. Keep it up, auntie!\n\n>**OOP:** I like to say she secretly tolerates me.\n\nCommenter (downvoted but I liked OOP's response): Ok. So you are using your wealth to take guardianship. You didn't need to do this in order to proffer the better treatment. You made him choose between having legal guardianship and better care. If there were changes you wanted to facilitate you could have and still has the responsibility not to mention legal power of decision making up to him. And I less you had a real reason to want him to relinquish it.... I think this is either half baked rage bait or being written by the other party\n\n>**OOP:** I did. \nIf I get guardianship I’m able to put Haley on my insurance. Putting Haley on my insurance gives her access to world class medical care for less than what I’m currently paying. \nSpeaking of me paying for medical care, I already pay for Haley’s health insurance premiums, her insulin, her glucose monitors and insulin pumps, her glasses and contacts, doctor copays, labs, and everything else that comes up. \nAdditionally, I contribute towards her father’s mortgage, I occasionally help with utilities, I’ve sent grocery gift cards to the house before. This man is not able to provide for his daughter and I was sick of paying this much for her to still not be adequately cared for so I sat him down, showed him all that I was doing, and told him to do it himself and take care of his kid or give her to me or let me do it. I’m not going to pay for subpar healthcare, inadequate nutrition, cramped living spaces, etc. anymore.\n\n**Editor's note:** Marked as concluded because OOP will have guardianship of Haley."
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- id: 1txrnev
title: Your Month, Your Sickness.
subreddit: r/Take1Leave1
author: Som-ka-Ras
score: 593
comments: 725
url: https://www.reddit.com/r/Take1Leave1/comments/1txrnev/your_month_your_sickness/
created_utc: 1780680667
selftext: ''
post_hint: ''
url_overridden_by_dest: https://www.reddit.com/gallery/1txrnev
preview_image_url: ''
gallery_urls:
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- >-
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- >-
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- >-
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- id: 1adbnrq
title: What should I name this painting
subreddit: r/acrylicpainting
author: CommissionContent199
score: 3941
comments: 2742
url: https://www.reddit.com/r/acrylicpainting/comments/1adbnrq/what_should_i_name_this_painting/
created_utc: 1706472323
selftext: >-
This is the first time I tried to paint my partner’s nude. I have been worried about not conveying him correctly.
But I think I did a fairly good job here.
Now that it’s mostly finished, I am wondering if I should hang it upside down. The weight distribution can also
makes it interesting.
Either way, please help me name this painting
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- id: 1uax7pt
title: '[oc] - the fluids'
subreddit: r/lgbt
author: Sampetra
score: 2546
comments: 70
url: https://www.reddit.com/r/lgbt/comments/1uax7pt/oc_the_fluids/
created_utc: 1781963630
selftext: >-
Rarely do I get the opportunity to have another comic artist looking over my shoulder while I’m working, but for a
brief moment Luz saw what I was making and said something to the effect of… “Alex, what the fuck?” (continued in
comments)
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- id: 1s2anzo
title: Is constipation still Ulcerative colitis?
subreddit: r/UlcerativeColitis
author: Farma-C
score: 10
comments: 25
url: https://www.reddit.com/r/UlcerativeColitis/comments/1s2anzo/is_constipation_still_ulcerative_colitis/
created_utc: 1774350263
selftext: >-
So ive recently joined this sub-reddit and I see most people with UC seem to suffer with diarrhea.
I was diagnosed with UC in October after a colonoscopy. I was having alot of mucus in my stools and I was always
rushing to the toilet but it was mostly mucus coming out.
One of the main themes throughout this has been constipation and lately more mucus and blood.
I do have bouts where I need to rush to the toilet and cant control myself.
I was wondering if being constipated alot is still a main sign of UC? Or maybe something else?
post_hint: ''
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- id: 1ke5tw7
title: Any positive ulcerative proctitis/colitis stories?
subreddit: r/UlcerativeColitis
author: anonymousposter987
score: 16
comments: 47
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ke5tw7/any_positive_ulcerative_proctitiscolitis_stories/
created_utc: 1746313997
selftext: >-
Hi! All I ever see on here are UC horror stories - debilitating cases, severe progression, hospitalizations,
surgeries, etc. However, when I read the data, it sounds like the majority of people are able to manage their
symptoms, find medications that keep them in remission, and live a normal(ish) life. I’d love to hear some stories
like this on here.
My husband has ulcerative proctitis. He was diagnosed 5 years ago. He has had 2 colonoscopies since diagnosis and it
has not progressed. He manages his UP with oral mesalamine. He flares up about once or twice a year. His primary
symptom in an active flare is blood in his stool - nothing more. He takes a mesalamine suppository at the start of a
flare and it knocks in out in a couple of days. He has had about 2 flares that were a little more intense (diarrhea
2-3 times a day, bloodier stool than usual, lasts 2-3 weeks). These both occurred during times of extremely high
stress for our family. But colonoscopies after each showed no progression (still just UP). Of course, it would be
great if he could get in complete remission with no flares. He reacts well to the suppositories so I think the plan
is to be on both oral and suppository mesalamine daily going forward.
But either way, I’m curious if it’s possible that his UP will stay UP and stay mild. It doesn’t impact his day to
day life all that much except for the toll it takes on his mental health. He reads these horror stories and is so
worried that he will end up that way. Of course, we know it’s possible, but I feel like he has a pretty good chance
of being ok. His is only proctitis, his symptoms are mild, he responds well to medication, and he hasn’t progressed
in over 5 years. It could potentially stay this way forever, right?
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- id: 1s1tzik
title: Ulcerative colitis constipation?
subreddit: r/UlcerativeColitis
author: Due_Item7574
score: 7
comments: 5
url: https://www.reddit.com/r/UlcerativeColitis/comments/1s1tzik/ulcerative_colitis_constipation/
created_utc: 1774300794
selftext: >-
Im wondering if anyone has had a similar experience..
I (33F) was diagnosed with UC in 2019. I went through a very rough couple of years, but thanks to infliximab and
lifestyle management i have been in remission for 4 years.
However recently ive been having some strange bowel symptoms which im unsure are related to uc or not.
Around 2 months ago, I started noticing my stools were round and hard (arpund the size of a ping pong ball, so not
small). Nothing changed in my diet or exercise, albeit ive had an extra bit of life stress.
Im extremely bloated, and have put on weight which I dont think is linked to food intake or less exercise.
Ive had my bloods done recently and nothing was noted. Its not painful to poop, but definitely feels like im never
done, even when theres no more coming.
Has anyone experienced this? And if so what helps??
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- id: 1t20wmk
title: I've seen enough I am quitting all sources of caffiene for good tomorrow
subreddit: r/Biohacking
author: Radiant_Eggplant9588
score: 251
comments: 394
url: https://www.reddit.com/r/Biohacking/comments/1t20wmk/ive_seen_enough_i_am_quitting_all_sources_of/
created_utc: 1777753834
selftext: ''
post_hint: image
url_overridden_by_dest: https://i.redd.it/tdmgxrzuasyg1.png
preview_image_url: https://preview.redd.it/tdmgxrzuasyg1.png?auto=webp&s=a2107d117d977d2e61f1efeb9765cd025b73031d
gallery_urls: []
- id: bujy3a
title: I made a comprehensive guide for those of you lurkers who suffer from extreme constipation
subreddit: r/ibs
author: Nightmare_Tonic
score: 3030
comments: 845
url: https://www.reddit.com/r/ibs/comments/bujy3a/i_made_a_comprehensive_guide_for_those_of_you/
created_utc: 1559162769
selftext: >-
**I now maintain an updated and more user-friendly version of this guide at /r/ConstipationAdvice.**
I've seen that many of you have chronic constipation but you do not understand why you have it, and your general
practitioner doctors either don't think you have an issue or don't know what to do.
I know how you feel. I know what it's like to not even feel like a human being because you can't go to the bathroom
like everyone else. It is frustrating and depressing, and not something you can just go around telling people.
I hope this guide helps you a ton.
**BECOME A DETECTIVE**
Keep this in mind as you proceed: your disorder is a puzzle. All you have to do is solve it. You can do it, if you
have a great deal of patience, persistence, and commitment. Become your own investigator. Figure out your digestive
cycle and your body's language. Listen to your body. Keep notes - I'm talking handwritten or typed notes, anything
that will help you make a paper trail.
**Women:** I have left a special note for you at the bottom regarding the additional problems you face when dealing
with doctors. Please read it.
----------------------
**WHY I MADE THIS GUIDE**
I'm a (mostly) healthy, physically active 31-year-old male. I have spent years seeing doctors, reading studies,
accosting and interrogating medical professionals and pharmacists, calling pharmaceutical companies, and generally
being an interrogator to anyone who has information that could help improve my life. This post is the aggregation of
my conclusions and recommendations.
In 2012 I got constipated. I grabbed an OTC laxative and was fine after that. But then the constipation happened
again a few months later. It became more frequent, going from once a month to once a week, to every day. As of 2016,
I was completely unable to eliminate without the use of pharmaceutical drugs.
It took seven years for doctors to figure out what was wrong with me. I made this post because I want to help some
of you turn my 7-year journey into a 7-month journey.
Print this guide out and keep it with you. I've done all the heavy lifting for you. I did all of these myself, and
now I want to help you. You will spend money on all of this, but it will change your life. You will be glad you did
it.
----------------------
**QUESTIONS FOR YOU**
If you suffer from severe chronic constipation, you need to answer the following questions, write them down, and
bring them to your doctor:
* Do you have the urge to go, but you cannot? Or do you have zero urge to go? (this is the most important question)
* Do you have alternating diarrhea and constipation, or just constipation?
* Do you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety (getting full really early into
a meal)?
* Have you had this issue since childhood, or did it begin in teen years/adulthood/after a major life event
(surgery? divorce? car accident? mauled by bears?)
* Did you in the past or do you currently take any medications that could damage your intestines? The acne drug
Accutane/Sotret/Claravis/many other names (isotretinoin) has been linked to serious conditions of the digestive
tract. I am absolutely convinced that my large intestine was destroyed by this drug. Antibiotics are also a major
culprit in ruining the small intestine microbiome and causing diarrhea/constipation disorders. Antidepressants can
ruin the serotonin balance in the gut as well.
* Did you suffer sexual abuse as a child? There is a high degree of correlation between childhood sexual abuse and
adult constipation disorders. Meaning, a lot of people with chronic constipation disorders in adulthood experienced
trauma when they were young. This sort of thing must be investigated by *both your doctor and a therapist in
coordination*. Do some Googling on this topic if you believe this might be your issue.
**If you have the urge but cannot go**, you very likely have [Pelvic Floor
Dysfunction](https://en.wikipedia.org/wiki/Pelvic_floor_dysfunction), especially if you are a woman who has had
children. Other indicators of PDF are pain during sex and incontinence. Sorry, but your test is the [anorectal
manometry](https://motilitysociety.org/wp-content/uploads/2016/11/Anorectal-Manometry-Patient-Information-8-5-2005.pdf)
- have fun! It can sometimes be treated. Alternatively, you might have a bowel obstruction or a tumor. Your doctor
must test for these.
**If you have zero urge to go to the bathroom**, you very likely have a nerve or muscle disorder of the large
intestine. These are called [motility
disorders](https://www.columbiadoctors.org/childrens-health/condition/gastrointestinal-gi-motility-disorder#:~:text=GI%20motility%20disorders%20are%20digestive,food%20through%20the%20digest%20system.).
This is what I have. The most common are Slow-Transit Constipation, Chronic Idiopathic Constipation, and the dreaded
Colonic Inertia. Both are extremely frustrating and difficult to treat. It is especially likely that you've got one
of these conditions if you have no associated pain or any other symptoms. Your current gastroenterologist likely
specializes in IBS; tell him you want a **motility specialist** or a **neurogastroenterologist**.
**If you have constipation sometimes and diarrhea sometimes**, you very likely have IBS-C or a rare form of colitis,
or a combination of issues. You may have a nervous condition. Outside chance you have Crohn's Disease. You must be
checked for intestinal ulcers/irritation/inflammation, and also for food intolerances and allergies. A buddy of mine
had "IBS" for many years, but then later discovered he was allergic to tuna, shellfish, pistachios, and fructose.
**If you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety**, you very likely have
[general gastroparesis](https://en.wikipedia.org/wiki/Gastroparesis), where your entire GI tract is sluggish. I'm
sorry to say that this is very difficult to treat and a horrible disease. You must see a neurogastroenterologist,
AKA a gastroenterologist who specializes in motility disorders, and you must also see a neurologist to test for
autonomic neuropathy. You need a prokinetic motility drug like cisapride, domperidone, prucalopride, etc. Don't go
on cisapride unless you have excellent heart health and make sure the doctor keeps an eye on your heart at all
times.
**If you have experienced constipation since childhood**, you might have [Hirschsprung's
disease](https://en.wikipedia.org/wiki/Hirschsprung%27s_disease) and you need a neurogastroenterologist (a special
type of gastroenterologist who studies nerves and motility) to diagnose it by taking a [Full-Thickness
Biopsy](https://www.karger.com/Article/Fulltext/486390). This is a major surgery and you should try to exhaust all
other options first. The Full-Thickness Biopsy comes with its own potentially serious side effects.
**If you took heavy medications that could possibly have caused your issue**, first write out a timeline of events
and try to remember exactly when you took the medication and when your issues started. Write down the progression of
symptoms and severity. Bring it with you to your doctor appointments. Correlation does not imply causation, but you
are a detective now and you need to follow every lead.
You need to *insist* to your GP that you want to see a **gastroenterologist** (a specialist of your digestive tract,
from your mouth to your anus). You need to advocate strongly for yourself because nobody else is going to do it for
you. You have to be aggressive in your appointment-making, follow-ups, call-backs, consultations, and arguing with
your insurance company about getting your specialty medications covered.
You have to do it yourself. You have to fight. If you don't, you will suffer alone. Nobody is going to save you but
you. It's time to get smart and tough about your condition.
------------------------
**THE FIVE FUNDAMENTAL TRUTHS**
You are embarking on a journey to improve your health and to discover the cause of your digestive issues. Rather
than force you to stumble upon these facts yourself, I'm just going to lay them out for you:
1. Your general practitioner (AKA "family doctor") does not know anything about your condition. He is not an expert
in diseases of the large intestine. With a few exceptions, he is a gatekeeper for the experts that actually can help
you. He will only refer you to these experts after you complete a few basic tests. Do them quickly.
2. The specialist your GP refers you to is also probably not an expert in your condition. Once you arrive at the
specialist's office, ask him what his specific expertise is. It took me a year to realize that my specialist was an
expert in *liver cancer*. Womp womp. Your disorder is likely in your large intestine, and your specialist may have
spent the years of his fellowship removing nodules from the esophagus. **Ask him who he knows that is an expert in
motility disorders, and if he doesn't know anyone, tell him to find one and send you there.**
3. You have to elbow your way through the medical system like a Muay Thai fighter if you want to get anywhere. Make
your GP give you a referral to a specialist. Make that specialist refer you to the *right* specialist. Make *that*
specialist order a bunch of tests. Then make him lay out a treatment plan for you.
4. Your insurance is going to act like all of your tests and prescriptions are "experimental." Experimental is
insurance-code for "F*ck you, we aren't paying for this." The magic spell to banish this bullshit is the phrase
"medically necessary," and only your specialist has the power to utter it. Make sure he does, on all of your
prescriptions and test orders.
5. Your digestion operates in a cycle - just like your sleep cycle. Pay attention to it, listen to it, memorize it.
Know the foods your body hates, know what throws your cycle off, know what improves it. Most importantly, once you
have the cycle memorized, track its rhythm over a long period of time. After a year or two, you may notice some
changes to the cycle. This information is key.
-------------------
**TESTS YOU PROBABLY NEED**
First, work your way through the following tests with your general practitioner:
1. *Standard blood panel* to check for any really wacky levels/deficiencies
2. *Celiac blood panel* to eliminate the small possibility that you have Celiac
3. *Fecal blood test*. Blood = tumors, ulcers, or perforations
Then, once you have a referral to a gastroenterologist, have him perform the following tests:
4. *Extensive stool cultures*: look for rare parasites. Small chance you have
[SIBO](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/), very small chance you have
[SIFO](https://www.ncbi.nlm.nih.gov/pubmed/25786900), very very small chance you have a [Clostridium
infection](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391391/) that paralyzes the bowels. Ask the doctor to
ensure Clostridia are tested for.
5. *Extensive thyroid panel* (sometimes hypothyroidism causes gastroparesis / slow gut transit. This one's an EASY
FIX; pray you have this one). You want a full workup, not the standard one.
6. *SITZ Marker Study*: The lab will not know what this is or why you're doing it. Follow the doctor's instructions
carefully. Do not take laxatives during this study (it lasts a week) because the point is to identify which specific
part of your large intestine is broken (ascending, transverse, descending, rectum). If you accelerate transit by
taking laxatives, you will give the lab a false result and it will screw up your treatment.
7. *Endoscopy with small bowel aspirate and biopsy; and colonoscopy with biopsy*: If you're under 30 your doctor
will fight you on this. He is an obstacle. Defeat him. Also, specify that you want two types of biopsies performed:
a normal biopsy of the small intestine to check for Celiac and Crohn's, and an eosinophilia biopsy to check for
allergies. They won't do this unless you specifically request it. Don't screw up the pre-op prep, no matter how
hungry you get. If your condition is severe enough, ask about the Full-Thickness Biopsy which tests for ganglionic
nerve density / Hirschsprung's disease. This is a very serious surgery and I urge you to get a second opinion before
having it done.
8. *Anorectal manometry and MR Defacography:* The anorectal manometry is critically important for people with severe
constipation disorders. It really sucks to get it done, but do it.
The AM / MRD test suite is sometimes described as a "motility workup" and it can only be performed at highly
specialized GI clinics. You will need to pressure your doctor to help you find one, tell him to contact your
insurance company and declare these tests *medically necessary*. This is a battery of humiliating tests to determine
if you have PFD or another nerve-related motility disorder. If you have a good sense of humor and are capable of
relaxing in embarrassing situations, it'll be easy.
9. *CT Scan with contrast*: This is the one where you drink the radioactive dye and lay down inside a space ship.
The point is to find tumors, divurticula, obstructions, etc. Ask the radiologist what s/he sees. Sometimes they'll
slip up and tell you. They can't say "You don't have cancer" (that's for your doctor to determine) but they can say
"I don't see any tumors."
**Risks:** Some redditors have expressed disagreement with the CT scan's former position on this list (it was higher
up), citing the patient's exposure to radiation as dangerous. They argue a CT scan should only be performed after a
colonoscopy. To be clear, a CT scan exposes you to much more radiation than a regular X-ray, but only about 1 in
2000 people develop cancer as a result of a CT scan, and that cancer generally occurs late in life. The reality is,
the purpose of the scan is to help diagnose and treat a condition that is debilitating and potentially dangerous to
you *right now*, and you are weighing that benefit against the potential prospect of cancer later in life. Talk with
your doctor about the risks vs benefits. Ask him/her if you should do it before or after a colonoscopy.
You will have a diagnosis after these tests.
**If none of these tests result in a clear diagnosis:** see my comment
[here](https://www.reddit.com/r/ibs/comments/bujy3a/i_made_a_comprehensive_guide_for_those_of_you/f7m3wkp/) for next
steps.
-----------------
**TREATMENTS AND MEDICATIONS**
**Disclaimer: I am not a doctor. Make sure to clear each of these with your doctor before proceeding. Do not gamble
with your own health.**
Cycle through these home remedies and request these medications from your doctor, in roughly the following order:
* Do all the **stupid fiber crap** just so you can tell your doctor to shut up about it. Fiber does not help people
with motility disorders (people like you, probably). It will not help you - unless you have a lack of the
*Prevotella* bacterium in your gut microbiome. Increasing your roughage intake and eating a plant-based diet will
increase your *Prevotella* count, and might alleviate your condition. If the extra fiber constipates you more, move
on.
* Cut out all **dairy** immediately for a month. Dairy is delicious and makes live worth living, but it is
disgusting and terrible for you. Almond milk, almond milk ice cream, rice milk, dark chocolate...get used to it.
* Cut out all **gluten** for a month and stick to it. Wheat is insanely hard to digest for almost all people and it
causes nothing but problems for people with bowel disorders. Even if your Celiac panel comes back negative, you
still might have Non-Celiac Gluten Sensitivity, which is still being researched but quite prominent. Many people
immediately see results after cutting gluten. But look out - the shit's in BBQ sauce, soy sauce, it's in the air,
it's in the water, it's in your pillow, it's *everywhere*. It's as if the USDA has an agreement with US farmers to
sprinkle wheat in literally every f*cking food product.
* Try the [FODMAP diet](https://www.healthline.com/nutrition/low-fodmap-diet) and stick to it. Eliminate all
potential dietary causes of your constipation, then reintroduce them one at a time to identify the culprit. For 90%
of you, diet has nothing to do with your constipation. You have a nerve disorder. As a rule of thumb, grains are all
difficult to digest and should be avoided, but I've found that potato and corn are easiest, rice is a bit harder,
and wheat and oat are the worst. No idea about quinoa. I strongly recommend sweet potato as a healthy filler
replacement for breads. It doesn't even need butter!
* Try a few high-quality **probiotics**. People with intestinal motility disorders have different gut microbiota
than normal people, but scientists aren't sure which is the cause and which is the result. A [2015
study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288092/) showed that *Bifidobacterium*, *Lactobacillus*, and
*Prevotella* are significantly reduced in people with functional constipation disorders, and their *clostridia*
counts were higher. (*Clostridia* is bad and requires antibiotics. You can determine if you have this by asking your
doctor for a Clostridia-specific stool culture test.) Try [Visbiome](https://www.visbiome.com/), VSL#3 if you can
find/afford it. Also, try one of [these](https://www.bustle.com/p/the-3-best-probiotics-for-constipation-17940859).
You want enteric-coated capsules that are not broken down by your stomach acid so they make it to your intestines.
* **Miralax (polyethylene glycol)** is your first line of defense. It's a chemically inert (non-reactive) substance
that you mix in water and chug. It's an osmotic laxative, meaning it does not stimulate the nerves/muscles in the
intestines. It draws water into the bowel and flushes you out. It works slowly; it might take several days to work.
The mainstream medical consensus is that polyethylene glycol is extraordinarily safe and can be used in babies, the
elderly, etc. It can be used for years and years. However, there is some evidence now that it's bad for the
environment and probably not as good for people as we thought. I'm ignorant of chemistry, but polyethylene sure
sounds like plastic to me.
* If you need fast relief, go to a health food store with a supplement section and buy a bottle of **Magnesium
Citrate powder**. It must be citrate, and it must be powder. Mix 450mg (usually a heaping teaspoon) into a tall
glass of water and chug it as fast as you can. Do this on an empty stomach in the morning before breakfast. If your
disorder is mild, you will have to take a dump *immediately*. Don't get in the car to go to work for a little bit.
MagCit is extremely safe and effective. Doctors prescribe it to old people for years and years with no side effects.
But if you have renal disorders (kidney problems) talk to your doctor before trying this.
I find that MagCit works best for me right before bed. I have to wake up in the middle of the night to pee out all
the water I chugged, but in the morning, I generally am able to empty. By the way, MagCit is also an osmotic
laxative.
* **Cayenne pepper capsules** have been used in combination with magnesium citrate with great success in some
people. The pepper stimulates peristalsis in the large intestine, and the magnesium draws water to the large
intestine. Combined, they propel your gut's contents along. These capsules can be obtained at any health food store
with a supplement section; you can get them and magnesium citrate in the same store usually. Be warned, some people
report a mild burning sensation both in their esophagus and their rectum (basically like when you eat some really
spicy food and it gives you the runs). The regimen I've read that works best is a heaping teaspoon of magnesium
citrate in a large glass of water, chased with 1 or 2 Cayenne capsules before bed produces a BM the next morning.
Start with a low dose. When you buy the capsules, they'll have a heat rating, usually between 40,000 - 90,000 HU.
* Request **Lactulose** from your pharmacy. It's basically a sugar that helps with bowel transit. Didn't work for
me, but it works for some.
* **Docusate** is an OTC stool softener that makes me nauseous and does nothing else, but maybe it'll work for you.
MagCit beats its brains out.
* **Bisacodyl** is your go-to OTC stimulant laxative. In the US it's known as Dulcolax, but there are off-brand
boxes that are cheaper and similarly effective. Use this carefully. It can exhaust the muscles in your intestines,
so while you get relief one day, the next two days you're in a refractory period where constipation starts up again.
Use 10mg 2x per week if you have insanely bad constipation like me. Don't exceed twice per week. Use 5mg if you're
underweight. Safe to use with MagCit. I like using it in the morning on an empty stomach and I'll skip breakfast
that day. The more food you have in your digestive tract, the longer it takes. Empty stomach = 2-4 hours, full =
8-12. Long-term use is frowned upon but there's no actual evidence whatsoever that it causes a problem. Read the
case studies if you don't believe me.
* **L-Arginine** is an over-the-counter supplement available at health food stores. It is used by athletes to
increase cardiovascular health, but it has a magic side effect: diarrhea! Why? Because it breaks down into nitric
oxide synthase, which regulates bowel transit time, and researchers recently discovered is [deficient in people with
motility disorders](https://bit.ly/2WuGrCV). See [this
conversation](https://www.ibsgroup.org/forums/topic/352542-unexpected-cure-slow-transit-colonic-inertia/#entry1449238)
for more details. Also, taking this supplement with a small amount of baking soda might increase its effect,
according to some athletes who experienced intense diarrhea after doing so (they like baking soda because it reduces
acid production / muscle soreness). Oral dosages vary from 2-6 grams but some people go higher. Be careful and talk
to your doctor first. L-arginine is also available in suppository form and there is good evidence to believe these
are safer and much more effective.
* **Amitiza (lubiprostone, prescription):** Your doctor might prescribe this first. It's an expensive prescription
osmotic laxative. It causes nausea in a lot of people and it didn't work for me, but it's a godsend for some. Try
it. Take with a great deal of water. DO NOT TAKE AMITIZA WITH LINZESS, MIRALAX, OR MAGCIT BECAUSE THEY'RE ALL
OSMOTICS (or behave like osmotics).
* **Linzess / (linaclotide, prescription, "Constella" in Canada):** This is the most powerful prescription "osmotic"
(it's actually a Guanylate cyclase-C agonist) in the world, and it will make your ass explode the first time you
take it. It comes in strengths of 72mcg (that's micrograms), 145, and 290. I have a lot to say about this medication
so read carefully. Also, if you've tried Linzess and it didn't work, please read my [how to make Linzess work
guide](https://www.inspire.com/groups/agmd-gi-motility/discussion/guide-why-linzess-fails-and-how-to-make-it-work-again/).
First of all, it has a mild prokinetic effect (meaning it stimulates your nerves) in addition to its osmotic effect.
This is a good thing. Amitiza does not have this.
Your digestion is on a schedule. Some of you go every day. Some every other day. Some once a week. Whatever your
normal clockwork is, this medication will sometimes work and sometimes not, depending on how much fecal obstruction
there is in your intestine on the day. There were times when 290mcg did absolutely nothing for me, and other times
145 made me run wide-eyed to the bathroom fifteen times in thirty minutes. You will figure out how to make this
medication work after a lot of trial and error. Don't just dismiss it the moment it doesn't work.
I'm of the mind that no human being should ever take 290mcg and it has got to cause long-term damage to the
intestines, but all my specialists disagree. They prescribe this dose to women quite frequently for some reason.
Linzess has a penchant for working very well for a few weeks, and then ceasing to work at all. Keep it refrigerated
(there's a rumor that it goes bad if it gets warm, but pharmacists will not confirm this). Take it with a large
glass of water and stay super hydrated all day. Water is key; it cannot work if you don't drink a ton of water with
it. If this medication dehydrates you (it will), grab a bunch of those vitamin/mineral powder packets from the
health food store and chug one or two a day. If you get bad headaches/migraines/weak pulse/sweats/nausea, you need
to just quit the medication and talk to your doctor. Ask him to reduce the dosage.
Although the prescription for Linzess is once daily, I find it works best for me taken twice per week with another
medicine like Motegrity (Prucalopride) or Bisacodyl. I take it on an empty stomach in the morning and don't eat
anything until it starts kicking in (which is quite fast...usually under two hours).
LINZESS HAS A [BLACK BOX WARNING](https://en.wikipedia.org/wiki/Boxed_warning) against its usage in persons under
18. It is extremely dangerous to children. If you don't hydrate enough on a regular basis, it is also dangerous to
you. It is illegal to give it to your kids. **If you don't have a gallbladder, mention this to your doctor before
taking Linzess. I once heard that's an issue, but I can't find a source online. DO NOT TAKE LINZESS WITH AMITIZA,
MIRALAX, OR MAGCIT BECAUSE THEY'RE ALL OSMOTICS (or behave like them).**
* **Motegrity (prucalopride, prescription):** This is a brand new drug, the first in its class, and it's a 5-HT4
agonist. It works similar to some antidepressants, by targeting specific serotonin receptors in your intestines.
Except Motegrity is a highly specific agonist, meaning it has a narrower range of side effects and typically won't
affect your mood. This drug actually works for me, it worked immediately, it still works. Zero side effects. I take
it in the morning on an empty stomach, although it can be taken without regard to food.
Most doctors in the US don't even know about Motegrity so ask them to look it up. It's brand new, meaning it's
expensive. But don't worry. *All* of these drugs are insanely expensive. As far as I can tell it is safe to take
with osmotics like Linzess but I have not confirmed this with a doctor. In my reading, I see no relevant
contraindications between the two.
There is a warning in the box that some people committed suicide or experienced suicidal ideation while
participating in clinical studies for Motegrity. There is no statistically significant relationship established
here, but the company is by law required to make this information public. Frankly, Motegrity has zero side effects
on me, and I expect these people killed themselves or thought about it simply because constipation disorders are
f*cking horrible and make you depressed.
If you live in the UK, Europe, or Canada, your doctor will know this medication as Resolor or Resotran.
* **Zelnorm/Zelmac (tegaserod, prescription):** This drug is similar to Motegrity (insofar that it is also a 5-HT4
agonist). It is older than Motegrity, and considered less safe because it interacts with receptors in a less
specified way; there is some evidence that it interacts with cardiac receptors. In plain English this means it
*might* be responsible for causing strokes and heart attacks in some patients. The evidence is debatable. 0.11% of
people who used Zelnorm in a study experienced cardiac events, compared to 0.01% who took the placebo. That's 13 out
of 11,500 people. The drug is available in the US only to women, although your doctor can order it
"off-prescription" if he deems you low risk. Basically don't try this drug if you are overweight or have any notable
cardiac family history.
* **Trulance (plecanatide, prescription):** This is the main competitor of Linzess (linaclotide) and has a smaller
side effect profile. It appears to work pretty well if osmotics work for you, but I haven't tried it. It also has a
mild prokinetic effect (meaning it stimulates the nerves in your intestines). I assume, like Linzess, it is also
dangerous to children. Give it a try.
* **Mestinon (pyridostigmine, prescription):** This is where it gets weird. Mestinon is a drug that treats
myasthenia gravis, which is a nerve disorder similar to MS. But, it can be used to treat constipation in some cases.
It's an acetylcholinesterase inhibitor, meaning it *increases* your body's levels of acetylcholine. This is a
neurotransmitter that is partly responsible for telling your intestines to squeeze. Most doctors will be hesitant to
put you on it, but you can give it a try if all else fails. It has a strange side effect profile and causes
fainting/blood pressure drops in some people. I never tried it.
An interesting story...there is a woman who did a bit of basement chemistry and figured out that she could spike her
acetylcholine levels by literally sticking a nicotine patch on her stomach below the belly button. It caused her
bowels to empty after a week of constipation. She then invented [Parasym
Plus](https://secure.vagusnervesupport.com/products/parasym-plus%E2%84%A2), a supplement that allegedly does the
same thing. I bought this and I cannot figure out if it actually worked. Maybe it did a little.
There are many acetylcholinesterase-inhibiting drugs on the market. Prostigmin (neostigmine) is one of them. Ask
your doctor if he thinks it's a good idea. He'll say it isn't. But if all else fails...
* **Lexapro (escitalopram oxalate, prescription), or any related SSRI antidepressant:** Antidepressants are now
being used to treat constipation. Some clever fellow figured out that the majority of serotonin (the mood-regulating
neurotransmitter) is manufactured in your intestine, not your brain, and that antidepressants were giving people
diarrhea for some reason. I haven't tried Lexapro but it's next on my list and my doctor likes it because of its
small side effect profile relative to other antidepressants. This drug has a wider side effect profile than related
constipation meds like Motegrity/Tegaserod, meaning you could have mood swings or drops/spikes in energy, etc.
Despite our overwhelmingly negative public opinion about antidepressants, they are rather safe* and effective for
many people. It's just that they're over-prescribed. A low dose does help some people normalize bowel function
without causing mood/personality changes.
*edit: A redditor linked me to [this article](https://rxisk.org/bladder-and-bowel-problems-after-antidepressants/)
explaining that some SSRIs can cause long-term GI problems. The comments are worth reading. As with all
pharmaceutical drugs, you are weighing your current problem versus the potential side effects of its treatment. Talk
to your doctor about the risks and do your own research. Talk to friends and family members who have taken SSRIs.
* **Erythromycin:** This is an OTC (I believe) antibiotic with a very odd side effect: it speeds up gastric emptying
and gut motility. Hooray! The case studies are kind of back and forth on its efficacy for constipation, but some
doctors swear by it. The problem is that it's an antibiotic.
Here's the thing about antibiotics. They should not be overused or used unnecessarily. They can *seriously
devastate* your gut flora and cause SIBO and worsen your condition. On the other hand, your condition could have
already been caused by antibiotics, or by a pathogen that will killed with antibiotics. Proceed with extreme
caution.
* **Colchicine:** This is an anti-inflammatory derivative of the autumn crocus plant. In large doses it's highly
toxic, but in small doses it's used to treat Gout. However, [a recent
study](https://www.ncbi.nlm.nih.gov/pubmed/19705134) determined that it's an effective treatment for Slow Transit
Constipation / Colonic Inertia (basically any constipation disorder that does **not** involve physical blockage like
tumors, obstructions, etc). I haven't tried this but my specialist claims it is quite safe in low doses and he would
be happy for me to try it out.
* **For those of you who are diagnosed with slow-transit constipation / colonic inertia:** [Here is a master
list](https://www.inspire.com/groups/agmd-gi-motility/discussion/masterlist-of-remedies-for-colonic-inertia-slow-transit-constipation/)
of treatments.
---------
**MY PERSONAL REGIMEN:**
Some of you have asked about my specific medication regimen. After several years of trial and error, I have found
regimens that basically make my life normal again. **Please note** how the regimen evolves over time! Intestinal
diseases typically are very transient and change over the years. What works for you now might not work in a while:
2012 - 2014: Senna laxative once per week
2016: Bisacodyl and Miralax twice per week
2017: Magnesium citrate 450mg each morning before breakfast
2019:
* 2mg Motegrity (prucalopride) daily in morning
* 145mcg Linzess (linaclotide) every other day in morning
* 450mg Magnesium citrate before bed
-----------
**EXERCISE**
Of all the treatments I've tried, exercise is near the top on the list of effectiveness. Exercise is a conduit for
getting all of that stress and potential energy out of your body and away from your guts.
Get a standing desk at work (a good company will accept a doctor's note and buy one for you). Stand for half the
day, intermittently. Go on jogs in the morning and walks in the evening. Get to the gym and get your knees above
your waist - stairmaster, yoga, squats, etc. Just MOVE MOVE MOVE. By doing so you are stimulating the vagus nerve
and increasing motility. You will literally shake the poop out.
If you live an incredibly sedentary life, you will suffer much more.
---------------------------
**SURGERY FOR EXTREME CASES**
Please visit my updated guide at /r/ConstipationAdvice for new guidance on these surgeries.
* For those of you diagnosed with CI, you might be considered for the [TAR IA
surgery](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180598/), (total abdominal colectomy with ileorectal
anastomosis). This is the laproscopic removal of your entire large intestine and the attachment of your small
intestine to your rectum. The nice thing about this surgery is that you still get to go to the bathroom normally,
except you have mostly diarrhea for the rest of your life (because your large intestine is the thing that turns
diarrhea into solid stool by absorbing water).
* The other option is one of many variants of the colectomy (resection or removal of the large intestine) with
colostomy or ileostomy. These are both [ostomies](https://en.wikipedia.org/wiki/Stoma_(medicine), which is the
surgical creation of a hole in your lower abdomen. A medical bag is affixed to that hole, and your small intestine
drains into it instead of down into your rectum. This is a much bigger life change, but from the people I've talked
to, it's surprisingly not that big a deal.
If you are interested in these surgeries you will have to have a great number of conversations with many doctors and
jump through a lot of hoops.
--------------------
**A NOTE FOR WOMEN AND TEENAGERS**
The feedback I get from most **women** is that their (male) doctors are extremely dismissive and incredulous about
the woman's constipation issues. Doctors are going to act like you are crazy and hormonal. They're going to tell you
to just eat some fiber and take some miralax and bugger off. You have to be strong, confident, and knowledgeable of
your situation. Do not take no for an answer. Inform your doctor that you are *past* the standard constipation
treatments and this is an ongoing problem that reduces your quality of life and warrants the attention of a
specialist.
It helps if you appear to know what you are talking about. Learn about your [digestive
anatomy](https://en.wikipedia.org/wiki/Gastrointestinal_tract) and understand the difference between your small and
large intestine. Understand the [constituent parts of the large
intestine](https://en.wikipedia.org/wiki/Large_intestine) (ascending, descending, sigmoid, transverse, rectum, etc).
This will help you communicate to your doctor more efficiently and it will help you better understand his/her
findings. If you show your doctor you've done your homework, it is very likely he/she will take you more seriously.
Everything I just said applies to **teenagers**. The additional problem facing you is that you have an extra
gatekeeper: your parents, and the fact that you rely on their insurance. You need to have a level-headed
conversation with them about your situation, however embarrassing that may be, and convince them that **they need to
be advocates for you, not obstacles to you.** Getting them on your side now will benefit you greatly when the doctor
questions the seriousness of your complaint.
----------------------
**A FEW FINAL NOTES**
* Read. You aren't going to effectively communicate or convince your doctor of anything unless you have some
introductory knowledge of your body. Learn about your [digestive
anatomy](https://en.wikipedia.org/wiki/Gastrointestinal_tract) and understand the difference between your small and
large intestine. Simply knowing this information will help you come up with questions about what could be causing
your issue.
* Save yourself the remarkable headache and get physical and digital copies of the results of every single test you
have performed, even simple blood tests. When you inevitably get transferred to a different specialist, having this
stack of files will make your life so much easier.
* Your insurance company is going to fight you on some of these medications. Tell your doctor to tell your insurance
it is an *urgent medical necessity* that they cover this medication. They will fold.
* DO NOT GIVE UP. Write down your next steps. Follow up on calls, appointments, etc. I keep lists of all my medical
to-do's and I cross them off line-by-line. It gives me a great sense of accomplishment and control over this whole
situation.
* Relax and get your mind off your condition. This is hard. But there is absolutely a psychological component to
your condition. For some people, it's *entirely* psychological (this is called Chronic Idiopathic Constipation or
Functional Constipation). **People who suffered sexual abuse in childhood often develop constipation disorders in
adulthood.** Google this and investigate it with your doctor!
I go on long nature walks with my headphones. This is how I unwind. Some people do Ju Jitsu. Some people do music.
Spend time with family and engage in your hobbies. This will absolutely help, especially if your condition is
idiopathic in nature.
* Intractable constipation is often the result of extreme stress. Have a serious brainstorm about whether you need
to quit your high-stress job. Are you in an abusive relationship? GET THE FUCK OUT OF IT. Can you afford a week-long
spiritual retreat where you take a vow of silence and eat a vegetarian diet and sit in a garden with a pen and
paper? DO IT. Now is the time to try all the weird stuff.
* Cry whenever you have to; don't bottle anything up.
* Talk to other sufferers about it. Reach out and get involved in a community. Support is everything.
-------------------
Your enemy has a name. You very likely have a [motility disorder](https://www.iffgd.org/motility-disorders.html). It
can be caused by an underlying nerve disorder, blood vessel disorder, mechanical muscle failure, neurotransmitter
imbalance, hormone imbalance, or bacterial imbalance. Once you get your diagnosis, you will not feel so confused and
lost about how to treat it.
post_hint: ''
url_overridden_by_dest: ''
preview_image_url: ''
gallery_urls: []
- id: 1pgiush
title: Ulcerative colitis/proctitis
subreddit: r/UlcerativeColitis
author: Chris-0130
score: 4
comments: 8
url: https://www.reddit.com/r/UlcerativeColitis/comments/1pgiush/ulcerative_colitisproctitis/
created_utc: 1765115558
selftext: >-
Hello all,
Im newly diagnosed and trying to get a handle on things. Anyone else have not only the lower left abdominal pain but
also intense pelvic pain? I try to stay close to the AIP diet and I do yoga regularly. I’m on 4.8mg mez. It’s just
puzzling how I seem to do all of the right things but still have such intense pain. Any words of wisdom?
post_hint: ''
url_overridden_by_dest: ''
preview_image_url: ''
gallery_urls: []
- id: 1k3pq9w
title: Ulcerative Proctitis w/ Constipation
subreddit: r/UlcerativeColitis
author: No_Shame5462
score: 6
comments: 27
url: https://www.reddit.com/r/UlcerativeColitis/comments/1k3pq9w/ulcerative_proctitis_w_constipation/
created_utc: 1745164692
selftext: |-
Hello all :)
I was recently diagnosed with ulcerative proctitis and it’s been absolutely debilitating. My insides ache constantly, and I can’t eat a lot without feeling like I’m gonna explode, but I can’t NOT eat without intense aching pain, along with other painful symptoms. Not fun.
Anywho, I was wondering if anyone else has this or general UC that struggles with constipation instead of diarrhea? To my knowledge, I am constipated because the rectum portion of my colon is so inflamed that nothing can pass, but I have the urge to go constantly with no luck. Does anyone know how I could attack this? Thanks :)
post_hint: ''
url_overridden_by_dest: ''
preview_image_url: ''
gallery_urls: []
- id: 1l9h5iv
title: Can Ulcerative Colitis turn to Ulcerative Proctitis
subreddit: r/UlcerativeColitis
author: brkz323
score: 2
comments: 20
url: https://www.reddit.com/r/UlcerativeColitis/comments/1l9h5iv/can_ulcerative_colitis_turn_to_ulcerative/
created_utc: 1749716697
selftext: >-
Hi, just wanted some opinion. My new GI doctor said that I do not require routine colonoscopies because I have
ulcerative proctitis not ulcerative colitis.
However my last GI doctor said (after my first colonoscopy) that I had very mild patchy/focal active inflammation at
the cecum and ascending colon, indicating I had UC. I guess my second colonoscopy showed I just had mild
inflammation just at the rectum.
Since, my inflammation seemed to have isolated itself to the rectum does this mean I really do only have ulcerative
proctitis? I know I could ask my new GI doctor but she was so quick and not very helpful.
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- id: 1m5hetj
title: Ulcerative colitis (proctitis)
subreddit: r/UlcerativeColitis
author: AvisCantus
score: 2
comments: 15
url: https://www.reddit.com/r/UlcerativeColitis/comments/1m5hetj/ulcerative_colitis_proctitis/
created_utc: 1753100451
selftext: >
So I’m not doing good mentally.
I was diagnosed in late January/ early February. I had blood strips in my stool and weird consistency than my usual.
I went to a colon rectal surgeon because my doc thought it might be a hemorrhoid but ended up mild UC at the
Proctitis.
I was given Mesalamine suppositories and I was good for awhile. Poop was not all the way solid sometimes but no
blood.
But on July 5th when I had diarrhea and the feeling I still have to go. I waited a bit but the feeling in my gut
never got back to normal but I stopped having diarrhea. Though my poop was softer and thinner. I was given two pills
of mesalamine (roughly two weeks ago) but because my anxiety got me really messed up after July 5th I went to see a
GI this time and he gave me 4 mesalamine pills (which I started on July 18th). Sometimes I feel a little bit of pain
around my upper abdomen on the left side, which makes me worried it might be pancreatitis (because I heard that can
happen).
I’m scared that mesalamine will not work or it stopped working. I mean I still don’t have blood but I think I’m
feeling some cramping (which is new-ish to me).
I’m scared that this is the start of failing all medication until I get a stoma bag. I’ve read how a lot of
medication fails after awhile and many people are changing meds constantly. I’m feeling helpless because I just
wanted mesalamine to work for a long time before I had to switch but it seems like it’s going to happen. I haven’t
been eating much too because I’m scared of having to see more soft poop which tells me I’m still not better. I’m
just so done but I know my symptoms are not at all bad compared to many of you. So I’m just extremely scared.
I have a list of reason for the flare:
- I’m working at a camp during summer heat
- more hours of work and less hours of rest
- anxiety related to starting grad school this coming fall
- maybe over eating that one time during 4th of July
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- id: 1h8a6kt
title: Psyllium vs mesalamine to maintain remission in ulcerative colitis
subreddit: r/UlcerativeColitis
author: Automatic_East_9083
score: 0
comments: 27
url: https://www.reddit.com/r/UlcerativeColitis/comments/1h8a6kt/psyllium_vs_mesalamine_to_maintain_remission_in/
created_utc: 1733515015
selftext: "After doing the rounds of everything perfect - healthy eating, drinking enough water, exercise and ideal weight... I decided to give Psyllium a try, ever so low an amount and cautiously. Things are finally moving digestively. The constipation for me is the main trigger. Food intolerances come in second: Milk and coffee are the other two. Be the flare up be from a back up digestively, or that of my foolishly overindulging with dairy, what follows next is a cycle which ends up with constipation. That constipation can trigger yet another flareup and there was no way around it until Psyllium powder.\n\nIt's important to note that the Psyllium I use is not the type that has additives. I use the capsules which do not have added Maltodextrin (MDX) or artificial sweeteners. MDX contributes to suppression of intestinal anti-microbial defense mechanisms and may be an environmental priming factor for the development of chronic inflammatory disease. ( [https://pmc.ncbi.nlm.nih.gov/articles/PMC4084946/](https://pmc.ncbi.nlm.nih.gov/articles/PMC4084946/) )\n\nI am having good results using Psyllium. I am not going to even touch Mesalamine. Mesalamine can cause a serious reaction called\_**mesalamine-induced acute intolerance syndrome**. The symptoms can be confusing because they look like ulcerative colitis. Tell your doctor if you're taking mesalamine and you have: Stomach pain or cramps.\n\nBefore trying the Psyllium, my digestive tract was not moving along food, despite my being physically active, eating healthy and being ideal weight.\n\nStudies state that Psyllium powder might be as effective as mesalamine to maintain remission in ulcerative colitis. [https://pubmed.ncbi.nlm.nih.gov/10022641/](https://pubmed.ncbi.nlm.nih.gov/10022641/)\n\nThose suffering from a host of IBS etc symptoms, wouldn't even be able to distinguish the side effects of mesalamine. \n\nYet, many here are saying that before going on Psyllium which is over the counter item, should not be taken for more than 7 days. That really isn't so... It's more of a legal disclaimer. They simply want to have people check in with their Dr before doing anything longterm. The side effects of Mesalamine are much more pronounced.\n\n"
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- id: 1nvhgyv
title: '[Article] Syphilitic Proctitis Mimicking Ulcerative Colitis'
subreddit: r/Scholar
author: Online-Doctor
score: 1
comments: 3
url: https://www.reddit.com/r/Scholar/comments/1nvhgyv/article_syphilitic_proctitis_mimicking_ulcerative/
created_utc: 1759345859
selftext: >-
[https://www.cghjournal.org/article/S1542-3565](https://www.cghjournal.org/article/S1542-3565)(25)00849-3/abstract?dgcid=raven\_jbs\_aip\_email
DOI: 10.1016/j.cgh.2025.09.024
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis RDLA Pravda STS remission
- id: 1m3pp8n
title: Remission is Possible - What I Learned After 20 Years with Ulcerative Colitis
subreddit: r/UlcerativeColitis
author: LaCremerie
score: 266
comments: 102
url: https://www.reddit.com/r/UlcerativeColitis/comments/1m3pp8n/remission_is_possible_what_i_learned_after_20/
created_utc: 1752908118
selftext: >
I’ve had ulcerative colitis since I was 24—I'm now 44—and I’ve been in remission for the past 10 years. I was
initially prescribed Salofalk (Mesalazine), but it didn’t work for me. These days, I manage my UC with
Imuran(Azathioprine) an immunosuppressant, a restricted diet, and regular exercise.
A bit of backstory: when I was first diagnosed, I had just started my career as a city bus operator. Needless to
say, it was a nightmare. I often experienced urgency while driving a packed bus, and there were more than a few
close calls where I nearly soiled myself on the job. It was humiliating, stressful, and physically exhausting.
I’ve dealt with the full range of UC symptoms, such as severe bleeding, drastic weight loss, and multiple hospital
stays. Things really changed for me when I started having kids. That gave me a bigger reason to get better, not just
for myself but for them. One way I managed UC at work was by using the washroom at every possible opportunity, even
when I didn’t feel the urge.
So, I began tracking everything, what I ate and how I felt afterward. I kept a detailed log of symptoms ranging from
mild to severe: abdominal cramping, black or foul-smelling stool, excess gas (farting / burping), urgency, blood in
the stool, and how often I was going to the washroom (which used to be 4 to 10 times a day). Alongside that, I
logged exactly what I was eating each day.
I used a trial-and-error method, starting by eating freely, then removing foods one by one to see which ones
triggered flare-ups. If you want to try something similar, you could either start this way or take a stricter
approach: stick to only ‘safe’ foods first, and gradually reintroduce others to identify your triggers.
For me, foods high in potassium seemed to be a problem, bananas, avocados, and salmon all triggered symptoms. Dairy
was another major issue: milk, yogurt, cheese, ice cream, and cream cheese were all off-limits. Fried foods, heavily
spiced meals or specific spices, beer, and alcohol also made the list. But keep in mind: your list might look
completely different, which is why personal tracking is so important.
To this day, I’m still on an immunosuppressant (Imuran), which is definitely keeping my condition in check, but
combining that with a disciplined diet and exercise routine has kept me in remission. If you feel like you’ve tried
everything and nothing's working, this might be a path worth exploring.
Be patient, it’s a slow, frustrating process, and you might not see instant results. Some foods that trigger
symptoms can take a while to show their effects, which is why the symptom log is so important. Even something subtle
like excessive gas or foul-smelling stool can be a clue that your gut isn’t agreeing with something you're eating.
Now at 44, with four beautiful kids, still working my city job, and able to take vacations and road trips whenever
and wherever I choose, I’m truly grateful I never gave up on myself. UC tried to control my life, but I took that
control back. It wasn’t easy, and it won’t be perfect, but healing is possible. Stay curious, stay determined, and
don’t lose hope. You’ve got this.
Wishing you strength, healing, and all the best on your journey.
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- id: 1qq3qb2
title: How I put my Ulcerative Colitis into long-term remission (personal experience)
subreddit: r/UlcerativeColitis
author: charming-devil
score: 7
comments: 74
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qq3qb2/how_i_put_my_ulcerative_colitis_into_longterm/
created_utc: 1769677793
selftext: >-
I was diagnosed with Ulcerative Colitis (UC) in 2012. From 2012 to 2017, I dealt with flare-ups and depended on
medication. Since 2018, I’ve been completely symptom-free and eventually stopped taking medication under my own
judgment. I’ve now been in remission for several years.
This is not medical advice just my personal experience with what worked for me.
What I changed:
1) Diet and exercise
I cleaned up my diet and made a journal, after lots of trial and error I ate selected food that didn't made my flare
up worse, also made regular exercise a habit. Nothing extreme just consistent healthy eating and staying active.
This alone made a noticeable difference in my energy, digestion, and overall inflammation.
2) Supplements
My regular stack:
Multivitamin
Probiotic
Omega-3
ZMA
Vitamin D3 + K2
During my active UC days, I took these daily. Now I take them about 3-4 times a week or on alternate days.
3) Intermittent fasting (major factor for me)
I do 24-48 hour fasts once or twice a week.
Originally, I started fasting simply because eating and digestion felt uncomfortable during UC. Over time, I noticed
that fasting significantly improved my symptoms. I believe it helped my gut rest and may have supported healing and
better gut flora balance.
Fasting was the biggest turning point for me.
I’ve been symptom-free since 2018 with no medications and normal daily life. UC may not be “curable” in general, but
in my case, lifestyle changes especially fasting, diet, and consistency put it into long-term remission.
Again, this is just my experience. Everyone’s UC is different, and what worked for me may not work for others. I’m
sharing this in case it helps someone explore lifestyle changes alongside medical care.
Edit 1 - Again this is not a medical advice. THIS IS WHAT I DID WHICH WORKED FOR ME. I didn't stop my medication
suddenly, when I was in remission I gradually decreased the dose to see how the body was reacting. When I felt
healthy I stopped completely.
Edit 2 - people asking me about my diet , after lots of trial and error I found steam and boiled food without any
condiments didn't make my UC worse. I mostly ate boiled chicken and eggs rice and sauteed veggies. Bcz of UC i even
suffered from urticaria so I really had to eat plain food which doesn't make my body release histamine. After I
would feel better i would introduce some food in my diet to see how I was reacting and it went like that. The key is
to keep a food journal, take your meds, take food ( prebiotic probiotic) that will heal your gut flora
Edit 3 - Read Read Read , read as much as you can, educate yourself about the subject, about a healthier lifestyle
and diets. It's an auto immune disease and unfortunately can happen to people living a healthy and active lifestyle
however with modern sciences and meds you can definitely live with it or even cure it. Don't stop your meds. Consult
your doc. I stopped gradually over a period of 3-4 months lower doses over time.
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- id: 1uhefg8
title: Ulcerative Colitis -remission with Antibiotics (personal story)
subreddit: r/UlcerativeColitis
author: OskarWasTaken
score: 6
comments: 18
url: https://www.reddit.com/r/UlcerativeColitis/comments/1uhefg8/ulcerative_colitis_remission_with_antibiotics/
created_utc: 1782595545
selftext: >-
I developed ulcerative colitis in December 2024. I came out with all the usual symptoms, and some unusual symptoms.
The usual symptoms were urgency, blood, loose stools. I was going 15-20 times a day.
The unusual symptoms were rashes, fatigue which was extremely terrible, dry skin.
I had months of hospital visits, hospitalisations, medicines that didn’t work, steroids that didn’t work and left
long lasting effects on my bones, and still nothing that really helped solve my issues to a degree that I could have
a normal life.
I had turned my attention to alternative ways to treat my colitis in the form of pro biotics, I took many of them. I
had met with the owner of a health shop for the pro biotics and more, he sussed out from my rash and previous
illnesses before December 2024, which I had a fever with rash in the summer of 24’ , and he suggested I may have
Lyme disease.
I had testing with the NHS, which came back Negative, however I found with research that with certain strains it
would give back false negatives a lot of the time, and NHS testing alone is not reliable.
I had private testing done separate tests, separate of the NHS, and it was positive.
Still terribly ill, but marginally better, I went to Ireland for treatment as the NHS refused to give me
antibiotics.
I had 3 days of antibiotics with Dr Jack Lambert in Dublin and I was a different person, symptoms subsidised and I
was really good.
I had a few months of going up and down but now with new sets of antibiotics, it’s a new me, I am just really so
much better.
I left out alot of details, but I expect this post won’t be too popular, most people here are going to dislike that
I achieved remission with antibiotics and dislike I didn’t use conventional methods but hey, if you’re here in good
faith I’ll answer any questions .
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- id: 1pnaqau
title: Ulcerative colitis remission
subreddit: r/UlcerativeColitis
author: Layan_k
score: 28
comments: 29
url: https://www.reddit.com/r/UlcerativeColitis/comments/1pnaqau/ulcerative_colitis_remission/
created_utc: 1765813789
selftext: |
Since diagnosis, this is the first time my remission has lasted more than a month.
I’ve been in remission for about 3 months with no bleeding.
From your experience
How long did your remission last?
Did symptoms return suddenly or gradually?Was the flare worse or similar?
Looking for real experiences.
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- id: 1tlox82
title: 'Ulcerative colitis, gut health and remission: Kylie’s naturopathic IBD journey'
subreddit: r/colitisunfiltered
author: colitis-unfiltered
score: 0
comments: 0
url: https://www.reddit.com/r/colitisunfiltered/comments/1tlox82/ulcerative_colitis_gut_health_and_remission/
created_utc: 1779562606
selftext: >-
🎙 In episode 19 of the Colitis Unfiltered podcast, I speak with Kylie, who was diagnosed with ulcerative colitis at
35 after suddenly experiencing urgency, bleeding, and symptoms she immediately knew were not normal. What started
shortly before her daughter’s first birthday quickly turned into a confusing diagnosis, unanswered questions, and
years of feeling alone in a system that never seemed to fully listen.
🤱🏻 Diagnosed while raising three young children, Kylie talks about navigating steroids, failed medications, and
the emotional toll of constantly being stuck on the toilet while trying to be present as a mom. Frustrated by a lack
of answers, she eventually turned to a gut health naturopath, changing her diet, treating underlying gut issues, and
ultimately reaching remission after years of trial and error.
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gallery_urls: []
- id: 1ssqrcg
title: >-
[Article] Sequential JAK Inhibitor Switching in Ulcerative Colitis Patients Maintaining Remission: A Multicenter
Experience
subreddit: r/Scholar
author: Online-Doctor
score: 1
comments: 3
url: https://www.reddit.com/r/Scholar/comments/1ssqrcg/article_sequential_jak_inhibitor_switching_in/
created_utc: 1776875856
selftext: Article link：[https://doi.org/10.1159/000552136](https://doi.org/10.1159/000552136)
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- id: wv4qlx
title: >-
After being diagnosed last year for Severe Ulcerative Colitis and a 2 week Hospital Stay, 1 Year Later I have
Achieved Remission from Inflectra and Lasting on Entyvio. Fast forward to today and I'm cleared to continue my dream
of being a Commercial Pilot.
subreddit: r/UlcerativeColitis
author: Grouchy-Western-5757
score: 301
comments: 56
url: https://www.reddit.com/r/UlcerativeColitis/comments/wv4qlx/after_being_diagnosed_last_year_for_severe/
created_utc: 1661201300
selftext: ''
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- id: 1o4yyg6
title: Novel Oral Drug Obefazimod Sustains Ulcerative Colitis Remission in Over 52% of Patients for Two Years
subreddit: r/UlcerativeColitis
author: Helioscience
score: 172
comments: 4
url: https://www.reddit.com/r/UlcerativeColitis/comments/1o4yyg6/novel_oral_drug_obefazimod_sustains_ulcerative/
created_utc: 1760298939
selftext: "[A long-term, 96-week study](https://www.my-openhealth.com/insights/438-novel-oral-drug-obefazimod-sustains-ulcerative)\_demonstrates that obefazimod, a first-in-class oral therapy, provides durable clinical and endoscopic remission for patients with moderate-to-severe ulcerative colitis (UC). Data from the Ph3 studies were recently released but the publication is not yet out. Summarized here are the published data thus far with responses in biologic experienced/refractory patients and side effect profiles.\n\nI usually post on scientific data across medicine, happy to share IBD content if it's deemed helpful. I have no affiliation of any kind to the drug. "
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gallery_urls: []
- id: 1s451h9
title: >-
Pancolonic mast cell elevation correlates with IBS-like symptoms in ulcerative colitis patients achieving combined
endoscopic and histologic remission: a retrospective case–control study
subreddit: r/IBSResearch
author: jmct16
score: 14
comments: 1
url: https://www.reddit.com/r/IBSResearch/comments/1s451h9/pancolonic_mast_cell_elevation_correlates_with/
created_utc: 1774525130
selftext: "[https://www.sciencedirect.com/science/article/pii/S2772736X26000174](https://www.sciencedirect.com/science/article/pii/S2772736X26000174)\n\n# Highlights\n\n* • IBS-like symptoms in ulcerative colitis patients following endoscopic and histologic remission correlate with elevated mucosal mast cells.\n* • In these patients mast cell elevation occurs throughout the colon and is independent of the duration of remission.\n* • Elevated mucosal mast cell density discriminates symptomatic from asymptomatic patients.\n* • Mast cells may be a potential therapeutic target for symptom-directed therapy.\n\n \nAbstract\n\nApproximately 30% of patients with ulcerative colitis (UC) who achieve endoscopic and histologic remission after biologic therapy continue to report persistent irritable bowel syndrome (IBS)-like lower gastrointestinal symptoms. We hypothesized that mucosal mast cells, which have been implicated in IBS pathophysiology, might play a role. We conducted a retrospective case–control study using systematic random sampling of cases from an institutional database. UC patients with a Mayo endoscopic score of 0 and absent mucosal neutrophils were identified through a consecutive review of electronic medical records in chronological order. Symptom status was determined by contemporaneous clinical documentation within two weeks of colonoscopy. The first twelve symptomatic patients meeting all eligibility criteria were matched by age, sex, disease duration, and therapy to twelve asymptomatic controls. Ninety-six colonic biopsies were reviewed histologically and stained for CD117 to quantify mast cell density. Mucosal mast cell density was significantly higher in symptomatic patients compared with asymptomatic controls (54.9\_±\_11.5 vs. 40.2\_±\_13.2 cells per high-power field; P\_=\_0.0007). It was observed consistently across colonic segments and was uncorrelated with duration of remission (range, 0–208\_months). Receiver operating characteristic analysis demonstrated good discrimination between symptomatic and asymptomatic patients (AUC\_=\_0.875). Pancolonic mucosal mast cell density is associated with persistent IBS-like symptoms in UC patients who achieved endoscopic and histologic remission, suggesting a durable potential target for IBS-like symptom-directed therapy."
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- id: 1jo8nak
title: >-
After months on Zepbound (through an online provider), a Nurse Practitioner refused to renew my prescription this
morning because of an ancient diagnosis of ulcerative colitis (in remission for 30 years).
subreddit: r/Zepbound
author: SkitSkat1999
score: 13
comments: 36
url: https://www.reddit.com/r/Zepbound/comments/1jo8nak/after_months_on_zepbound_through_an_online/
created_utc: 1743441724
selftext: >-
I’m kind of reeling from this. I signed up with an online provider called Everlywell in August 2024. A nurse
practitioner prescribed Zepbound, and I’ve been taking it since September and have lost 40 pounds. It’s even covered
by my insurance. I’ve had no nausea and no other symptoms — other than weight loss — from the Zepbound. And the UC
remains in remission. (I haven’t had a flare-up since 1994.)
I’ve seen an Everlywell nurse practitioner or a doctor at least once a month since August of last year.
This morning, I had the usual monthly check-in to have the rx refilled, and a different nurse practitioner refused,
telling me that Zepbound is contraindicated for UC, and I should never have been prescribed Zepbound. I pointed out
that these other medical professionals under contract to Everlywell have had no problem prescribing this, and I’ve
been honest with all of them about both the diagnosis and the remission. And it’s been in their records the entire
time.
After she formally put in writing that they wouldn’t refill the prescription — with a suggestions that I talk to a
dietician — I asked that Everlywell provide a second opinion. At this point, they just haven’t responded.
Ngl, I’m really angry — and scared about losing all the progress I‘ve made.
Has anyone dealt with having a Zepbound prescription pulled like this?
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- id: 1sb4jvu
title: Retatrutide for ulcerative colitis remission?
subreddit: r/RetatrutideWomen
author: HouseAway3681
score: 1
comments: 0
url: https://www.reddit.com/r/RetatrutideWomen/comments/1sb4jvu/retatrutide_for_ulcerative_colitis_remission/
created_utc: 1775193245
selftext: ''
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preview_image_url: ''
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- id: 1rkqudi
title: >-
[Article] Network Meta-Analysis: Histologic and Histo-Endoscopic Improvement and Remission With Advanced Therapy in
Ulcerative Colitis
subreddit: r/Scholar
author: VacAlbina
score: 1
comments: 3
url: https://www.reddit.com/r/Scholar/comments/1rkqudi/article_network_metaanalysis_histologic_and/
created_utc: 1772643601
selftext: |+
[https://onlinelibrary.wiley.com/doi/10.1111/apt.18315](https://onlinelibrary.wiley.com/doi/10.1111/apt.18315)
doi: [10.1111/apt.18315](https://doi.org/10.1111/apt.18315)
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- id: 1bgxcfq
title: >-
Coconut Water Induces Clinical Remission in Mild to Moderate Ulcerative Colitis: Double-blind Placebo-controlled
Trial
subreddit: r/UlcerativeColitis
author: Relative_Double_2178
score: 55
comments: 58
url: https://www.reddit.com/r/UlcerativeColitis/comments/1bgxcfq/coconut_water_induces_clinical_remission_in_mild/
created_utc: 1710681560
selftext: ''
post_hint: ''
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preview_image_url: ''
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- id: 1r2zbnd
title: >-
[Article] Appendicectomy versus switching to a JAK inhibitor in inducing remission in patients with active
ulcerative colitis after biologic therapy failure (COSTA): 1-year results of a multicentre, prospective, cohort
study
subreddit: r/Scholar
author: Online-Doctor
score: 3
comments: 3
url: https://www.reddit.com/r/Scholar/comments/1r2zbnd/article_appendicectomy_versus_switching_to_a_jak/
created_utc: 1770916660
selftext: >-
10.1016/S2468-1253(25)00291-2
[https://www.thelancet.com/journals/langas/article/PIIS2468-1253(25)00291-2/abstract](https://www.thelancet.com/journals/langas/article/PIIS2468-1253(25)00291-2/abstract)
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- id: 1tyt4hl
title: >-
Fecal transplants are quietly becoming a last resort for kids with cancer, autism, and failing guts, and the early
results are hard to ignore
subreddit: r/microbiomenews
author: Technical_savoir
score: 996
comments: 64
url: https://www.reddit.com/r/microbiomenews/comments/1tyt4hl/fecal_transplants_are_quietly_becoming_a_last/
created_utc: 1780780684
selftext: >-
Link to Study
Restoring Microbial Balance: Clinical Applications, Challenges, and Future Directions of Fecal Microbiota
Transplantation in Pediatric Disorders
https://www.mdpi.com/2076-2607/14/6/1241
The Core Issue
A gut microbiome (the trillions of microbes living in your digestive tract) that gets knocked out of balance can
cause serious problems in children, especially kids already dealing with cancer, organ transplants, or developmental
conditions. Antibiotics, chemotherapy, and disease itself can wipe out the good bacteria, leaving the door open for
dangerous infections and worse outcomes.
The Finding
Fecal microbiota transplantation (FMT), which means transferring healthy donor stool into a sick patient to rebuild
their gut community, is well-established for one specific thing in kids: beating back recurrent C. difficile
infections after antibiotics have failed. A single FMT procedure clears the infection about 81% of the time, and a
second round pushes that closer to 90%. Beyond C. difficile, the research is promising but still early, covering
inflammatory bowel disease, autism spectrum disorder, and drug-resistant bacteria.
Why It Matters
Kids with leukemia, those who just had a stem cell transplant, and children on heavy immunosuppressants are among
the most vulnerable to gut collapse, and they have the fewest safe treatment options. FMT could help reconstitute
their microbiome, potentially reducing transplant rejection complications and improving survival. For children with
autism, one open-label study found meaningful improvements in both gut and behavioral symptoms after a modified FMT
protocol, though that result needs much larger trials before anyone draws firm conclusions.
Limitations of Study
Almost all the pediatric data comes from small, single-center studies or case series, not large randomized trials.
Pediatric oncology patients are routinely excluded from rigorous trials, so the field is stitching together evidence
from adult data and anecdotal reports. Long-term safety, especially in immunocompromised children, is still largely
unknown, and FMT protocols vary wildly across studies, making it hard to compare results.
Conflicting Interests
Current clinical guidelines from NASPGHAN and ESPGHAN recommend against routine FMT in immunocompromised children
outside of established C. difficile indications, citing the limited data and real risk of transmitting infections
through donor material.
Interesting Statistics
• Single FMT clears recurrent C. difficile in about 81% of pediatric cases; a second procedure brings success closer
to 90%
• In adult ulcerative colitis data (which pediatric guidelines currently borrow from), FMT achieves remission in
roughly 37% of patients versus 18% in controls
• Among four pediatric oncology patients with recurrent C. difficile tracked in one series, two resolved after one
FMT and one required six separate procedures
• C. difficile rates are notably higher in children with cancer, IBD, and recent organ transplants
• Reduced microbial diversity during the peri-transplant (around the time of transplant) period in pediatric
leukemia patients is linked to greater risk of graft-versus-host disease and worse survival
• The systematic review pulled from 113 publications covering trials through December 2025
TL;DR
Poop transplants reliably cure recurrent gut infections in kids at a nearly 90% rate, but using them for cancer
patients, autism, and IBD is still early-stage science that needs real randomized trials before it becomes standard
care.
post_hint: ''
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis LDN remission
- id: wt8lp2
title: SIBO - My Journey and Data - planned treatment
subreddit: r/SIBO
author: rt312410
score: 140
comments: 61
url: https://www.reddit.com/r/SIBO/comments/wt8lp2/sibo_my_journey_and_data_planned_treatment/
created_utc: 1661006145
selftext: >-
Synopsis – Treating Sibo is not an exact science. Below is a practical approach, with instructions and dosage, to
try to introduce you to the basics of sibo and hopefully cure your sibo, using comparative data from other users
that have cured their disease. This user has not cured themselves. Posting despite not being cured in hope that all
this research will help someone else in their journey while I go through mine. This is not a completed journey
**Sibo and Me**
Before you start reading this. I just want to say, there is no one size fits all. If anyone tells you just “do this”
or “do that,” they are full of crap. Sibo is too much of a variation for it to be that simple. Each person has
different underlying cause and each person has different bacteria makeup for their sibo. Because so many people
don’t post their exact symptoms, root cause, treatment plans (success and failed) with dosages and length of time
and sibo specific bacteria imbalance (no one has that anyways) (not to be confused with the hydrogen, IMO and
Hydrogen sulfide classifications) it is really hard to determine what will work for each person and to compare why
something works for one and not another. In addition, there is a difference between cured and remission. Some people
claim they are cured and then say they had the symptoms return a year later.
Required note: “I am not a Dr.” But to be honest, I have met a lot of Drs and many of them are not qualified to give
advice and many give wrong advice. You are all responsible to do your own research and never take what someone tells
you as absolute truth.
2022.09.15 Final note: I am not fully treated and am currently between phase 3 and 4
**My Background**
36 male. Weight 165lbs (now 155lbs). Relatively healthy, runner, OCR racer
Condition: Hydrogen positive sibo, Methane Negative. Started July 2021. Symptoms started after second Covid
vaccine. Current known diseases: Prior: Osteoporosis (had since 20s) New: EPI pancreas (Take Zenpep 1200), Hashimoto
Hypothyroidism (Take levothyroxine), Hydrogen SIBO.
Symptoms: Weariness (no longer running), excessive burping, (Kill your spouse smelly farting on bad days), muscle
aches, 15 small duodenal ulcers (treated), sour stomach, occasional headache (assumed histamine intolerance
developed from sibo) Not present: diarrhea, constipation, bowel movements have stayed normal at one a day
Diet: for the most part I eat what I want. I know many have severe restrictions and I’m just not that. My sibo
remains consistent on most food. Only things I avoid 100% is soy and garlic. Breakfast is consistent daily. Cubed
potatoes, kielbasa cubed and eggs put together skillet style. Lunch and dinner vary. I avoid eating out at
restaurants that use sauces or soups. 2022.09.15 I now to intermittent fasting.
Testing:
All bloodwork comes back normal, no deficiencies or low levels, negative for c-diff, ulcerative colitis, Crohns,
Celiac
I’ve had CT scans, Gastric emptying scans, Ultrasounds and 2 upper endoscopies. All showing nothing. Did not have
colonoscopy due to consistent bowel movements.
Drs seen: 6 GI, 2 PCP. 1 Endo, 1 Rheum, 1 Naturopath (unofficial)
Recommend getting to know your family’s medical history. It can have insights if there is a history of autoimmune
disorders.
Here is my theory for how I got sibo based on my research. Covid vaccine triggered latent autoimmune gene.
Autoimmune disorder Hashimoto created. Hashimoto damages Thyroid. Damaged Thyroid stop producing normal TSH levels
and damages MMC. SIBO begins to form and creates symptoms and ulcers. Drs find ulcers and treat with PPI. PPI
reduces acid and SIBO really takes off. SIBO creates damage and EPI begins to form.
**Approach to Success (In process and unconfirmed)**
This data was gathered by cross referencing YouTube channels, Reddit, multiple websites, Cedar Sanai, books and
Facebook groups. I looked at many cases of cured people and compared to others looking for commonalities (Hydrogen
cases only). What follows is a plan I put together based on those cured individuals correlations in treatment.
Again, please do not take this as “THE CURE”. This disease is expensive even with insurance and I don’t want you all
spending money needlessly because you only read this. This plan is the bare minimum approach I could put together
based on the data I found. I have included costs as I have incurred so you can be aware prior to starting a
treatment. All costs are out of pocket
**Baseline SIBO**
1. Take trio smart breath test to determine which sibo you have. Hydrogen, Methane (IMO) Hydrogen Sulfide. Cost $290
(make sure Dr orders or test includes Lactulose for test)
2. Take IBS smart blood test to determine if you have certain antibodies (physician required to order) (if positive,
treatment may need to be different) (not researched) Cost $199, I was billed $220. This test requires you go to a
blood draw location to collect the sample. Cost $50
3. Get full nutritional assessment for deficiencies (Dr bloodwork) Cost Varies
4. Alternative testing. FoodMarble Aire 1 or 2. 1 is Hydrogen only, 2 does Hydrogen and Methane. You can get a
lactulose prescription (cost $15) and test with that or just test with everything you eat. (I have the Aire 1, wish
I bought the Aire 2, even though I was methane negative just to monitor. Love this device and I log breaths almost
hourly and when I wake up in the middle of the night. Really helped me figure out foods that made me worse and how
well intermittent fasting affected treatment)
5. (2022.09.30) Get a full stool sample. Some people do one that looks at different bacteria levels. I did one that
looked for variations and parasites. I don’t know which approach is better. I took a simple one at my primary care
and it ruled out some basics. TI am scheduled to take the Doctors Data: CSA +P Comprehensive Stool Analysis +
Parasitology (a three day collection test)
Recommend 1 upper endoscopy (have them take cultures looking for candida). Colonoscopy if GI recommends (typically
for constipated patients). Avoid taking PPI’s.
Find a Functional Medicine Dr or good naturopath
Your diet has to change for now. Complete sibo diet or low fodmap to determine major triggers. Work with function,
ND or GI Dr. Diet typically means little to no snacking, big meals 3-4. Intermittent fasting while avoiding
fermentable foods.
**Determine underlying cause(s) and TREAT underlying cause(s) (Incomplete list)**
1. Hashimoto (Hypothyroidism)
2. H Pylori
3. SIFO/SIYO (Candida)
4. B12 or iron deficiencies
5. C-Diff
6. Food intolerance tests (gluten)
7. IBS (D-M-C)
8. Crohn’s
9. Parasites
10. Histamine Intolerance
11. PPI use
12. Mold Disease
13. Bile acid malabsorption
14. EPI
15. Low stomach acid
16. Low good flora
17. Heavy metals
18. Anxiety and Stress
19. Ileocecal valve syndrome
20. Vegus nerve disorders (research at home exercises)
21. Estrogen dominance
22. Lyme/EBV
23. Endometriosis
24. Fibroids
25. Post surgical adhesions
26. Psychological issues - trauma (C-PTSD), PTSD, anxiety, depression and others.
27. Other Unknowns
Typical Autoimmune question: Chicken or the Egg. Sibo can cause autoimmune – autoimmune can causes sibo
User: shereadsinbed
“SIBO=damage to gut lining= leaky gut=food particles escaping into blood stream=body sees them as intruders= chronic
immune reaction=autoimmune disease
And/or Autoimmune disorder= motility issues= SIBO”
**Sibo Treatment**
Three Phase approach once treated underlying cause. Order of phases can vary from person to person. Phase 2 is not
recommended as first phase. Phase 3 is the cheapest of each phase.
**Phase 1**
2 weeks antibiotics (40% effective) (Cedar-Sinai) (I personally believe this number is inflated)
Xifaxan for hydrogen (Some studies show adding Augmentin)
Xifaxan, neomycin, bismuth (Pepto Bismal will work) for methane (IMO)
Hydrogen sulfide (Sorry I don’t have any in depth research on this. Likely treat like IMO)
Either treatment take a Biofilm disrupters: Couple options- 30 minutes before food. (Some take this before every
meal) (Some take this exclusively for a month before taking antibiotics)
1. NAC (N-Acetyl-L-Cysteine) 600-1000mg- Biofilm disrupter (considered phase 1)
2. Priority One - Biofilm Phase 2 (Phase 2 is stronger, some only need phase 1, hospitals have stronger than phase 2
used post surgery)
Recommend antifungal (Diflucan) with either as fungus can grow while bacteria die
Diet: Dr Pimentel Recommend eating a high fodmap diet while on xifaxan. (There is mixed results on this approach,
I’m not sold on the idea that feeding the bacteria brings them out more for the antibiotic to kill. Either it is
protected by a biofilm or it is not.)
(During and end of phase 1 felt no change in Symptoms) (took this treatment 3 times over the course of a year. No
change with any round.
**Phase 2**
2-3 weeks strictly elemental diet (gives body rest) (80% effective) (Cedar-Sinai) My own research from people’s
posting does not support that data. I don’t believe this fixes sibo but that it is an important step to healing your
gut. Allows parts of your body to rest like you would an overworked muscles. It is designed to be sipped slowly.
Best practices seem to show to have a chilled drink or with ice. Make 1 to 2 scoop beverage 6-12 ounces, add more
water if needed. Use a straw to sip over an hour. (The straw helped me not gulp it) Make a glass every 2 hours. Try
to consume min 10 Scoops a day (1500 calories). Cost $800-$1500 2-3weeks (prescription required, still not covered
by insurance)
[https://sibosurvivor.com/elemental-diet-for-sibo/](https://sibosurvivor.com/elemental-diet-for-sibo/)
(There are some out there that say elemental diet cured them. They typically did 3 weeks. More often than not I see
this in YouTube channels and then I listen carefully. Many say they started herbal supplements after the elemental
diet and “then” they started feeling better)
Antifungal needed. Elemental diet feeds thrush significantly due to sugars. Brush teeth after EVERY meal, find
antifungal mouthwash
(During and at end of phase 2 the only change I felt was no bad farting and less headaches. I did however feel like
all the joy in my life was sucked out while on this diet. Again, my research results indicate this doesn’t fix sibo
but helps your body rest on your way to fixing sibo) (Please do your own research)
Ending Phase 2 treatment: Low fodmap diet/Elemental diet blend. Don’t just switch back to food. Make a 1 meal a day
transition. Recommend not fatty meat only the first week. (Some of you will have no issue transitioning back to
food and others will be really hard)
**Phase 3**
Medications: Start on low dosage (below listed is final dosage)
Biofilm disrupters: Couple options- 30 minutes before food. (Some take this before every meal) – Reference Phase 1
for options
Herbal protocol: 4 weeks herbal antibiotics (three choices below). Some users say take only twice a day. To be
consumed with food unless notated otherwise. Recommend pill boxes to keep track of what you have taken when. Diet:
Dr Weitz recommends low fodmap with on herbal antibiotics
1. FC Cidal (2 caps 3 times day), Dysbiocide (2 caps 3 times day) and ADP Oregano (200mg 30min before meals)
[https://digestivewarrior.com/](https://digestivewarrior.com/) 2 bottles of 120 fc, 2 bottles 120 days, 3-4 bottles
120 adp Cost$400-$500
2. Candibactin BR (2 caps 3 times day) and AR (2 caps 3 times day) and Oregano (200mg 30min before meals)
Amazon (costs not calculated) (Not taken by this user)
3. Berberine Complex (2-3caps 3x day), Neem Plus(1 cap 3x day) and ADP Oregano (200mg 30min before meals)
Amazon (costs not calculated) (Not taken by this user) (usually taken by methane positive users)
(I CANNOT STATE THIS ENOUGH. NOT ENOUGH RESEARCH OUT THERE ON HOW THESE HERBALS AFFECT YOUR LIVER) Blood tests for
you’re a/g ratio and Globulin are very important when taking these. I don’t see any studies showing they will damage
your liver but it can’t be understated that supplements have the potential to do so. I don’t want you to cure sibo
and end up needing a liver replacement in the process.
I believe the effectiveness of each herbal antibiotic depends on which overgrowth you have: **Escherichia coli,
Enterococcus spp., Klebsiella pneumonia, Proteus mirabilis or unknown others.** Since previously noted we don’t have
that info, it is harder to recommend which one of the 3 options to start with. This makes me sad as I know a lot of
users are doling out money they don’t have on approaches that may not work. I have not researched if anyone has
determined a correlation and since most user treatment is done unscientifically and without a control, it will
likely be years or decades until that is fully locked down. If after finishing 4 weeks with no change, try switching
to another option. Keep daily journal of dosage, length of time and results. (Be mindful of supplements if you have
liver issues) (Foodmarble Aire 1&2 is a great tool for keeping track of food and results)
I’ve found another plan that matches the above with a few tweaks. Uses same drugs but different dosage, and
alternates meds. I like this plan as it seems to give your liver a break and ended up being the one I followed. Plan
is 6 weeks as opposed to 4. Link below.
[https://f.hubspotusercontent10.net/hubfs/4004166/Articles%20and%20Abstracts/SIBO%20Protocol.pdf](https://f.hubspotusercontent10.net/hubfs/4004166/Articles%20and%20Abstracts/SIBO%20Protocol.pdf)
While on this plan, heartburn increased, farting decreased, took less naps during the day, ran a few times,
headaches stayed away for the most part. Burping remained consistent. (I completed one round of herbal antibiotics
without much change. I am switching back to regular antibiotics and a different Prokenetic. (2022.09.11) finished
neomycin, 4 days let of xifaxin, headaches returning, heartburn is down, feeling shitty on a daily basis)
(2022.09.15 My energy is not what is was while on the herbals)
If you are taking a supplement and you start to feel really bad then you have to make the hard decision of continue
or quit. Feeling like crap could mean your body is rejecting the medicine or it could mean the sibo bacteria is in
die off (herxheimer reaction) which is good. No one can confirm which is which and I get nervous when I see users
tell someone to quit or continue. I recommend you get a functional Dr for any approach you take to review your plan
and how it aligns with your current conditions. They will be able to better direct you when to continue or quit.
Many people are asking for advice off of a few words posted and that isn’t wise.
For those with concerns of leaky gut. 2 options
L-Glutamine 850 mg per capsule – Amino acids can work to protect the mucous membrane of the esophagus and intestines
(2022.09.15 will begin taking this soon)
Tributin X – I took this one. 1 pill per meal to start. Move up to 3 per meal. (Didn’t change anything for me.)
[https://healthygut.com/product/tributyrin-x/](https://healthygut.com/product/tributyrin-x/)
**Supplement Support post Phase 3**
Motility agent for MMC (Prokenetic) to keep gut moving and keep sibo from repopulating. Recommended after herbal
antibiotics unless currently constipated.(reason given is you don’t want the antibiotic moving too quickly through
your system) Use for minimum of 6 months after completing phase 3. Examples: Prescription: Motegrity (side effects
suicide, depression), Low dose erythromycin 50mg nightly (most big pharmacies wont’ have it, has to be compounded by
pharmacist and insurance won’t cover Cost $50 per month). Non Prescription: SIBO MMC, Motilpro, Antrantil,
Integrative Therapeutics Motility Activator
I took Integrative Therapeutics Motility Activator 2 times a day and LDE 1 at night.
2022.09. Switched from LDE and Therapeutics to Motilpro
MMC description below and why it isn’t the same as your bowel movements
**Jordan J**
“So. . .the MMC is a series of self-cleansing waves that passes through the stomach and small intestine \*in the
absence of food\*. It's not the same thing as peristalsis which moves food through your system. Stool consistency is
determined not by the MMC but by the colon, whose job it is to remove water from what you've eaten as it passes
through. So, folks with D can still have MMC issues. Since the more we look into the MMC the more it seems as though
it's involved in the majority of SIBO cases, and it's not obvious who has MMC issues without special testing,
doctors are recommending prokinetics to most or all SIBO patients, at least for use for several months
post-antibiotics, to reduce the chance of relapse.”
[https://agutsygirl.com/2019/04/26/a-gutsy-girls-master-guide-to-prokinetics/](https://agutsygirl.com/2019/04/26/a-gutsy-girls-master-guide-to-prokinetics/)
**Additional Supplements**
Some people will need additional supplements, depending on their root cause.
Ox bile to bind bile acid (I have not taken)
Betaine HCL to produce stomach acid (Thorne most recommended) (I have not taken) Some Dr’s recommend bitters over
HCL as they stimulate natural acid production. Bitters Extra by Vitanica is one product but I believe it has to be
prescribed.
Digestive Enzymes (I do take but is prescription for my EPI, ZENPEP $17,000 monthly) (Did not change any of my
symptoms by itself) (Not sure it is really doing anything frankly) (If insurance didn’t pay for it, I wouldn’t take
it)
Allicin (Typically taken by Methane Dominate users as anti-microbial) (I have not taken)
**Complete**
After completing phase 1-3 if your sibo remains, it is possible you have yet to discover all the underlying causes.
Doesn’t mean you haven’t, just a possibility. Sibo is very complex and requires a unique combination approach
tailored specifically to you and can only be discovered through trial and error. You can still be bloated and sibo
free. Testing is required to know if sibo is gone but gut damage can remain and take months to restore to normal.
**Last resort (Phase 4?)**
Find a location that will do a fecal transplant (FMT) (pill form). Dr used to be able to treat sibo this way before
2014 when regulations changed. FDA now only allows for C-diff in the US with insurance. Screw you FDA! I did find a
company in California that will do it sans insurance. Cost min $5k and the initial consult is $400. Link below. (I
did my initial consult and the Dr ordered a stool test which was another $400. He also prescribed different
supplements to take in the meantime. I don’t post cost to be discouraging. I don’t want people to have to guess.)
[https://www.puretyclinic.com/fecal-transplant-fmt-santa-barbara](https://www.puretyclinic.com/fecal-transplant-fmt-santa-barbara)
Success study on FMT Link
[https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01630-x](https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01630-x)
Important note from other user: Dr Pimentel determines this to be ineffective. Reminder his studies are around
patients with food poisoning as root cause. Either way, FMT is definitely understudied in application beyond c diff
and expensive.
**Diet**
(2022.09.14) I don’t speak a lot on diet because this disease is vastly different for everyone and what foods make
their symptoms worse. You may read it’s okay to eat this or that so you do and it makes you so sick. Then you are
frustrated and I know you are already frustrated because who else reads this far if they aren’t already at their
wits end. Each person must trial and error what foods work for them. A general rule of thumb around diet is low
fodmap and intermittent fasting. For me I stop eating at 7pm and won’t eat until after 9am. If I follow this, I
generally feel better. If I wake up at midnight and snack, I feel it in the morning.
**Final Notes**
I’m sure people reading this have read or heard of many other options, supplements and approaches. I am not
discounting those options, I just did not find a commonality when reviewing personal stories of cured individuals.
Brands may vary as well.
One consensus was stay away from prebiotics and probiotics, except (Saccharomyces Boulardii) and only with limited
use. Some report that even this strain has variations and you can end up with the wrong one. (I have not done that
much research into it)
I am wary of any Dr that just promotes their stuff, natural or prescription, any admin that says they have the cure,
or any plan that promotes pre or probiotics. I immediately run from anyone that says they were “cured” but you have
to DM them for their method.
Stay away from any form of acid suppressor (PPI). I know for many with heartburn, this is a very tempting go to
(myself included). 100% show this will make your sibo worse and it did mine. (Suggestions given to me but I haven’t
tried: Apple cider vinegar I glass of water (morning), charcoal tablets, GasX. More research should be done by the
user before taking these to ensure they are not just another form of acid suppression)
Please get out there and read everything you can. Even if it has conflicting info. Glean from others what passes the
smell test and figure out what works for you. Don’t stop reading an article because it has conflicting info. There
may be a nugget in there that leads you down another path. There are not short cuts or quick fix pills.
Please note that links are for reference only. I have ZERO association with any of the sites and if you find
something cheaper elsewhere, buy it elsewhere. Just be careful to know what you are buying. I have not posted links
to any site I have not bought from personally.
**Items to explore:**
LDN Low dose Naltrexone for autoimmune disorders 0.5- 4.5mg dose. For people with inflammation and autoimmune
disorders. Dosage varies significantly from person to person. Seems highly unregulated even though it requires a
prescription.
[https://ldnresearchtrust.org/what-is-low-dose-naltrexone-ldn](https://ldnresearchtrust.org/what-is-low-dose-naltrexone-ldn)
[https://www.youtube.com/watch?v=z0p0ykSzy9o&ab\_channel=LDNscience](https://www.youtube.com/watch?v=z0p0ykSzy9o&ab_channel=LDNscience)
If you have questions, I will answer what I can. I will not give you definitive yes or no on items I have not
researched.
See follow up links in below post
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gallery_urls: []
- id: 1hpaex2
title: 'LDN helped with my UC '
subreddit: r/LowDoseNaltrexone
author: Timmay1974
score: 21
comments: 21
url: https://www.reddit.com/r/LowDoseNaltrexone/comments/1hpaex2/ldn_helped_with_my_uc/
created_utc: 1735518823
selftext: >-
I have had ulcerative colitis for 15 years, and was unable to keep it in remission. However after starting at .5mg
and working up to 4.5mg, I have had great results taking LDN. I now take the 4.5mg nightly and am amazed by what’s
it’s done for me. I have a loved one that also takes LDN for her arthritis that has been a blessing for her also.
post_hint: ''
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- id: 1798cwp
title: Autoimmune Fatigue and Pain Management
subreddit: r/Biohackers
author: AmITheAsshole_2020
score: 6
comments: 12
url: https://www.reddit.com/r/Biohackers/comments/1798cwp/autoimmune_fatigue_and_pain_management/
created_utc: 1697469325
selftext: >-
I have Ulcerative Colitis, and in addition to the more graphic symptoms, I also deal with chronic fatigue and pain.
I'm mostly in remission with Rinvoq. Fortunately, my PCP is open-minded and willing to get creative and experiment.
For pain, we have tried codeine, Norco, and morphine. I have attempted THC/CBD. None of these solutions have been
entirely adequate. They either weren't effective, or the side effects, such as spaciness, were untenable. Lyrica was
effective for some unrelated back pain but didn't touch the daily, chronic pain.
For fatigue, I'm on 200mg of modafinil. It's sort of effective, but come 2-4 PM, I desperately need an hour-long
nap, and by 8 PM, I'm in bed.
My bloodwork is spot on, and there are no vitamin or mineral deficiencies. My cardiologist and pulmonologist have
both given me a clean bill of health.
I'm making an appointment with my PCP to renew my meds and hope to find some options and inspiration in this
subreddit. I saw a reference to LDN and dug into that a bit. It seems like an option, but I would love to get
suggestions for other things I can investigate.
Thanks!
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- id: 1ufstno
title: What do you wish more people understood about living with ulcerative colitis?
subreddit: r/UlcerativeColitis
author: Acceptable-Bar-4559
score: 53
comments: 64
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ufstno/what_do_you_wish_more_people_understood_about/
created_utc: 1782437462
selftext: >-
I've been reading through posts here and one thing that stands out is how different each person's experience with UC
can be. From flares and remission to finding the right treatment, it seems like there's no single path that works
for everyone.
For those who have been living with UC for a while:
* What's something you wish family, friends, or even healthcare providers understood better?
* What has made managing appointments or long-term treatment easier?
* If you could give one piece of advice to someone who's newly diagnosed, what would it be?
I'm interested in learning from real experiences and appreciate anyone who's willing to share.
Thanks in advance!
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- id: 1m3pp8n
title: Remission is Possible - What I Learned After 20 Years with Ulcerative Colitis
subreddit: r/UlcerativeColitis
author: LaCremerie
score: 266
comments: 102
url: https://www.reddit.com/r/UlcerativeColitis/comments/1m3pp8n/remission_is_possible_what_i_learned_after_20/
created_utc: 1752908118
selftext: >
I’ve had ulcerative colitis since I was 24—I'm now 44—and I’ve been in remission for the past 10 years. I was
initially prescribed Salofalk (Mesalazine), but it didn’t work for me. These days, I manage my UC with
Imuran(Azathioprine) an immunosuppressant, a restricted diet, and regular exercise.
A bit of backstory: when I was first diagnosed, I had just started my career as a city bus operator. Needless to
say, it was a nightmare. I often experienced urgency while driving a packed bus, and there were more than a few
close calls where I nearly soiled myself on the job. It was humiliating, stressful, and physically exhausting.
I’ve dealt with the full range of UC symptoms, such as severe bleeding, drastic weight loss, and multiple hospital
stays. Things really changed for me when I started having kids. That gave me a bigger reason to get better, not just
for myself but for them. One way I managed UC at work was by using the washroom at every possible opportunity, even
when I didn’t feel the urge.
So, I began tracking everything, what I ate and how I felt afterward. I kept a detailed log of symptoms ranging from
mild to severe: abdominal cramping, black or foul-smelling stool, excess gas (farting / burping), urgency, blood in
the stool, and how often I was going to the washroom (which used to be 4 to 10 times a day). Alongside that, I
logged exactly what I was eating each day.
I used a trial-and-error method, starting by eating freely, then removing foods one by one to see which ones
triggered flare-ups. If you want to try something similar, you could either start this way or take a stricter
approach: stick to only ‘safe’ foods first, and gradually reintroduce others to identify your triggers.
For me, foods high in potassium seemed to be a problem, bananas, avocados, and salmon all triggered symptoms. Dairy
was another major issue: milk, yogurt, cheese, ice cream, and cream cheese were all off-limits. Fried foods, heavily
spiced meals or specific spices, beer, and alcohol also made the list. But keep in mind: your list might look
completely different, which is why personal tracking is so important.
To this day, I’m still on an immunosuppressant (Imuran), which is definitely keeping my condition in check, but
combining that with a disciplined diet and exercise routine has kept me in remission. If you feel like you’ve tried
everything and nothing's working, this might be a path worth exploring.
Be patient, it’s a slow, frustrating process, and you might not see instant results. Some foods that trigger
symptoms can take a while to show their effects, which is why the symptom log is so important. Even something subtle
like excessive gas or foul-smelling stool can be a clue that your gut isn’t agreeing with something you're eating.
Now at 44, with four beautiful kids, still working my city job, and able to take vacations and road trips whenever
and wherever I choose, I’m truly grateful I never gave up on myself. UC tried to control my life, but I took that
control back. It wasn’t easy, and it won’t be perfect, but healing is possible. Stay curious, stay determined, and
don’t lose hope. You’ve got this.
Wishing you strength, healing, and all the best on your journey.
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- id: 1qq3qb2
title: How I put my Ulcerative Colitis into long-term remission (personal experience)
subreddit: r/UlcerativeColitis
author: charming-devil
score: 5
comments: 74
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qq3qb2/how_i_put_my_ulcerative_colitis_into_longterm/
created_utc: 1769677793
selftext: >-
I was diagnosed with Ulcerative Colitis (UC) in 2012. From 2012 to 2017, I dealt with flare-ups and depended on
medication. Since 2018, I’ve been completely symptom-free and eventually stopped taking medication under my own
judgment. I’ve now been in remission for several years.
This is not medical advice just my personal experience with what worked for me.
What I changed:
1) Diet and exercise
I cleaned up my diet and made a journal, after lots of trial and error I ate selected food that didn't made my flare
up worse, also made regular exercise a habit. Nothing extreme just consistent healthy eating and staying active.
This alone made a noticeable difference in my energy, digestion, and overall inflammation.
2) Supplements
My regular stack:
Multivitamin
Probiotic
Omega-3
ZMA
Vitamin D3 + K2
During my active UC days, I took these daily. Now I take them about 3-4 times a week or on alternate days.
3) Intermittent fasting (major factor for me)
I do 24-48 hour fasts once or twice a week.
Originally, I started fasting simply because eating and digestion felt uncomfortable during UC. Over time, I noticed
that fasting significantly improved my symptoms. I believe it helped my gut rest and may have supported healing and
better gut flora balance.
Fasting was the biggest turning point for me.
I’ve been symptom-free since 2018 with no medications and normal daily life. UC may not be “curable” in general, but
in my case, lifestyle changes especially fasting, diet, and consistency put it into long-term remission.
Again, this is just my experience. Everyone’s UC is different, and what worked for me may not work for others. I’m
sharing this in case it helps someone explore lifestyle changes alongside medical care.
Edit 1 - Again this is not a medical advice. THIS IS WHAT I DID WHICH WORKED FOR ME. I didn't stop my medication
suddenly, when I was in remission I gradually decreased the dose to see how the body was reacting. When I felt
healthy I stopped completely.
Edit 2 - people asking me about my diet , after lots of trial and error I found steam and boiled food without any
condiments didn't make my UC worse. I mostly ate boiled chicken and eggs rice and sauteed veggies. Bcz of UC i even
suffered from urticaria so I really had to eat plain food which doesn't make my body release histamine. After I
would feel better i would introduce some food in my diet to see how I was reacting and it went like that. The key is
to keep a food journal, take your meds, take food ( prebiotic probiotic) that will heal your gut flora
Edit 3 - Read Read Read , read as much as you can, educate yourself about the subject, about a healthier lifestyle
and diets. It's an auto immune disease and unfortunately can happen to people living a healthy and active lifestyle
however with modern sciences and meds you can definitely live with it or even cure it. Don't stop your meds. Consult
your doc. I stopped gradually over a period of 3-4 months lower doses over time.
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- id: 1ugrdxn
title: Doctor uses Trichinosis to Cure Ulcerative Colitis
subreddit: r/UlcerativeColitis
author: VictoryBeginning9350
score: 12
comments: 31
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ugrdxn/doctor_uses_trichinosis_to_cure_ulcerative_colitis/
created_utc: 1782529960
selftext: >-
What do you guys think about this? I thought parasites were bad.
"Joel Weinstock, a gastroenterologist who heads a research team at University of lowa, asked six patients with
intractable inflammatory bowel-disease to quaff worm-eggs in a liquid solution, specifically the eggs of
Trichurissuis, a whipworm (parasite that looks like a whip) normally found in pigs. Within about two weeks, five of
the six patients went into remission - for up to five months."
"Dr. Joel Weinstock then used trichinosis to cure Crohn's Disease, Ulcerative Colitis, and Inflammatory Bowel
Syndrome in humans."
[https://www.nature.com/articles/540S103a](https://www.nature.com/articles/540S103a)
https://www.gastrojournal.org/article/S0016-5085(22)00802-2/fulltext
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- id: 1r2ghvq
title: Ulcerative Colitis Microbiome Treatment Succeeds in Phase Ib Trial
subreddit: r/UlcerativeColitis
author: sam99871
score: 171
comments: 33
url: https://www.reddit.com/r/UlcerativeColitis/comments/1r2ghvq/ulcerative_colitis_microbiome_treatment_succeeds/
created_utc: 1770860883
selftext: A pill containing 8 different kinds of bacteria had a 63% clinical remission rate.
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- id: 1uhefg8
title: Ulcerative Colitis -remission with Antibiotics (personal story)
subreddit: r/UlcerativeColitis
author: OskarWasTaken
score: 6
comments: 18
url: https://www.reddit.com/r/UlcerativeColitis/comments/1uhefg8/ulcerative_colitis_remission_with_antibiotics/
created_utc: 1782595545
selftext: >-
I developed ulcerative colitis in December 2024. I came out with all the usual symptoms, and some unusual symptoms.
The usual symptoms were urgency, blood, loose stools. I was going 15-20 times a day.
The unusual symptoms were rashes, fatigue which was extremely terrible, dry skin.
I had months of hospital visits, hospitalisations, medicines that didn’t work, steroids that didn’t work and left
long lasting effects on my bones, and still nothing that really helped solve my issues to a degree that I could have
a normal life.
I had turned my attention to alternative ways to treat my colitis in the form of pro biotics, I took many of them. I
had met with the owner of a health shop for the pro biotics and more, he sussed out from my rash and previous
illnesses before December 2024, which I had a fever with rash in the summer of 24’ , and he suggested I may have
Lyme disease.
I had testing with the NHS, which came back Negative, however I found with research that with certain strains it
would give back false negatives a lot of the time, and NHS testing alone is not reliable.
I had private testing done separate tests, separate of the NHS, and it was positive.
Still terribly ill, but marginally better, I went to Ireland for treatment as the NHS refused to give me
antibiotics.
I had 3 days of antibiotics with Dr Jack Lambert in Dublin and I was a different person, symptoms subsidised and I
was really good.
I had a few months of going up and down but now with new sets of antibiotics, it’s a new me, I am just really so
much better.
I left out alot of details, but I expect this post won’t be too popular, most people here are going to dislike that
I achieved remission with antibiotics and dislike I didn’t use conventional methods but hey, if you’re here in good
faith I’ll answer any questions .
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- id: 1tvwav2
title: What Careers Have Worked Well for You with Ulcerative Colitis?
subreddit: r/UlcerativeColitis
author: Exahros
score: 14
comments: 21
url: https://www.reddit.com/r/UlcerativeColitis/comments/1tvwav2/what_careers_have_worked_well_for_you_with/
created_utc: 1780507568
selftext: >-
Hey everyone,
I'm a 30-year-old trying to figure out my long-term career path, and I'd love to hear from others living with
ulcerative colitis.
I've been fortunate enough to be in remission, and I'm incredibly grateful for that. At the same time, I know
remission isn't guaranteed forever, so I'm trying to make career decisions that take both my current health and
potential future flares into account.
For the last 10 years I've worked retail, and I'm currently pursuing a Bachelor's degree in Cybersecurity. I already
have a few IT certifications, but lately I've been questioning whether it's the right fit for me.
The three paths I'm currently considering are:
• IT/Cybersecurity
• Physical Therapist Assistant (PTA)
• HVAC
Each appeals to me for different reasons.
IT seems like it may be easier on my body and provide flexibility during flares, but I struggle with whether I'll
find it fulfilling long term.
PTA appeals to me because I enjoy fitness, health, helping people, and building relationships.
HVAC appeals to me because I enjoy hands-on problem solving and working with my hands, but I wonder if the physical
demands and unpredictable bathroom access could become difficult if my UC ever becomes active again.
I'd love to hear:
• What do you do for work?
• Has UC influenced your career choices?
• Have you ever left a job because of your UC?
• What careers have worked well for you?
• What careers would you avoid?
• If you were in remission and choosing a career again, what factors would you prioritize?
I sometimes feel stuck between choosing a career I enjoy and choosing a career that gives me the flexibility and
security I may need if my health changes in the future.
Any advice or personal experiences would be greatly appreciated.
Thank you.
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- id: 1ua2ldq
title: So sick of Ulcerative colitis
subreddit: r/UlcerativeColitis
author: Cute_Score5494
score: 17
comments: 13
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ua2ldq/so_sick_of_ulcerative_colitis/
created_utc: 1781877108
selftext: >-
Hello everyone. 30 f
Got diagnosed with UC July of 2024
I had to switch GI doctors because I moved and my new doctor is very hard to get an appointment with so I dont have
one until July 1st. I did get a fecal calprotectin test done yesterday so waiting for the results of that mine have
came back very high about 8000 back in 2024 but I had a colonoscopy on April Ist they said I was in remission but
had Chronic active colitis with focal reactive lymphoid hyperplasia in my Sigmoid.
I got into a flare on May 18th some bleeding and mucus. Some days its all blood and mucus somedays its somewhat
formed and looks like the blood is darker and jelly like and pink mucus which i haven't had before. Even with my
worst flare back in 2024 it was bright red and filled the toliet bowl bright red.
I dont have really any other symptoms besides being tired.
Weirdly I got into a flare May 2024-July 2024 then again May 2025- about July 2025 and now again May 2026? Has
anyone else experienced having flares at the same time each year? Or is it just a weird coincidence? Is the dark red
jelly like blood something to be more concerned about?
Ugh im so sick of stressing with this disease. I miss my old life.
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- id: 1tupusa
title: Is there anyone in here who has ibd (ulcerative colitis or crohns?)
subreddit: r/GilbertSyndrome
author: NovelIllustrious120
score: 0
comments: 18
url: https://www.reddit.com/r/GilbertSyndrome/comments/1tupusa/is_there_anyone_in_here_who_has_ibd_ulcerative/
created_utc: 1780404261
selftext: 'Im asking since the doctor suspect that I have it because of the symptoms im going through.. '
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- id: 1t163g4
title: This Treatment For Ulcerative Colitis Worked For Me
subreddit: r/UlcerativeColitis
author: Appropriate_Land5236
score: 0
comments: 23
url: https://www.reddit.com/r/UlcerativeColitis/comments/1t163g4/this_treatment_for_ulcerative_colitis_worked_for/
created_utc: 1777669857
selftext: "I kept my UC in remission for 11 years by taking Psyllium Seed (Plantago ovata) powder mixed with water 3 times a day. It worked as well as the Pentasa I used for 2 years. When I reached the end of my tolerance for Pentasa, I switched to ground whole Psyllium Seeds. It's the inner part of the seed that's beneficial, not the husks, I sifted them out. Here's just one research paper I found with a Google search.\n\n[Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn's Disease and Ulcerative Colitis (GETECCU) - PubMed](https://pubmed.ncbi.nlm.nih.gov/10022641/)\n\n**Results:**\_Of the 105 patients, 102 were included in the final analysis. After 12 months, treatment failure rate was 40% (14 of 35 patients) in the Plantago ovata seed group, 35% (13 of 37) in the mesalamine group, and 30% (nine of 30) in the Plantago ovata plus mesalamine group. Probability of continued remission was similar (Mantel-Cox test, p = 0.67; intent-to-treat analysis). Therapy effects remained unchanged after adjusting for potential confounding variables with a Cox's proportional hazards survival analysis. Three patients were withdrawn because of the development of adverse events consisting of constipation and/or flatulence (Plantago ovata seed group = 1 and Plantago ovata seed plus mesalamine group = 2). A significant increase in fecal butyrate levels (p = 0.018) was observed after Plantago ovata seed administration.\n\n**Conclusions:**\_Plantago ovata seeds (dietary fiber) might be as effective as mesalamine to maintain remission in ulcerative colitis.\n\n"
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- id: 1qnfjbv
title: UCED ulcerative colitis exclusion diet
subreddit: r/UlcerativeColitis
author: Flat-Fisherman-8773
score: 0
comments: 31
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qnfjbv/uced_ulcerative_colitis_exclusion_diet/
created_utc: 1769432842
selftext: >-
I was using Google's notebook lm to research diets and UC. I was asking about the types of diets I knew of and was
surprised when it mentioned the ulcerative colitis exclusion diet.
I've not heard of it and it seemed to make a lot of sense.
It's a shame I can't upload images. I asked it to summarize and included below.
I'm going to give it a go. I thought it might help some people here.
Here is a high-level overview of the Ulcerative Colitis Exclusion Diet (UCED) tailored for a Reddit post.
\*\*\*
\### \*\*The Ulcerative Colitis Exclusion Diet (UCED): A Quick Overview\*\*
The UCED is a specific nutritional protocol designed to induce remission by repairing the gut’s mucus barrier and
reducing the production of toxic sulfides \[1\]. Unlike general "clean eating," it focuses heavily on altering the
gut microbiome through specific food textures and nutrients.
It is divided into two phases: \*\*Phase 1 (Strict Induction, Weeks 0–6)\*\* and \*\*Phase 2 (Liberalization, Weeks
7–12)\*\* \[1\].
\#### \*\*1. The Golden Rules (Applies to All Phases)\*\*
\* \*\*Strictly No Additives:\*\* You must avoid all emulsifiers, thickeners, and preservatives. This means no
store-bought sauces, commercial salad dressings, or processed snacks \[2, 3\].
\* \*\*No Red or Processed Meat:\*\* Beef, pork, sausages, and deli meats are excluded to reduce sulfur exposure
\[2\].
\* \*\*Single-Ingredient Seasoning:\*\* Do not use spice blends (like taco seasoning or curry powder). Use fresh
herbs, pure salt, and single spices (like turmeric or ginger) \[3, 4\].
\#### \*\*2. Phase 1: Induction (Weeks 0–6)\*\*
This phase is the most restrictive. You build your meals around "Mandatory" and "Allowed" foods.
\*\*Mandatory Daily Foods (Therapeutic Core):\*\*
\* \*\*Chicken Breast:\*\* Lean protein source \[5\].
\* \*\*2 Eggs:\*\* Must be eaten every day \[5\].
\* \*\*Yogurt:\*\* Daily intake required for probiotics \[5\].
\* \*\*Cooked & Cooled Potatoes:\*\* You must cook potatoes and let them cool (can be reheated) to generate
\*\*resistant starch\*\*, which feeds good bacteria \[5, 6\].
\* \*\*Bananas & Apples:\*\* Required daily for pectin \[5\].
\*\*Allowed Foods (Fillers):\*\*
\* Rice (unlimited) and pasta (allowed amounts) \[5\].
\* Fruits and vegetables (generally peeled to aid digestion) \[5\].
\* Homemade clear broth (chicken or beef) \[7\].
\#### \*\*3. Phase 2: Liberalization (Weeks 7–12)\*\*
If you respond well, you add variety while keeping the core rules \[8\].
\*\*New Additions:\*\*
\* \*\*Legumes:\*\* Lentils, chickpeas, and beans \[9\].
\* \*\*Whole Grains:\*\* Oats, quinoa, and potentially whole grain bread (if additives-free) \[9, 10\].
\* \*\*New Veggies:\*\* Sweet potatoes and red peppers \[9\].
\#### \*\*4. Practical Tips for Success\*\*
\* \*\*Making Stock:\*\* Never use bouillon cubes (too many additives). Make your own simple stock with chicken
bones, water, carrots, and fresh herbs \[7, 11\].
\* \*\*Snacking:\*\* Stick to whole foods like hard-boiled eggs, fruit, yogurt, or homemade potato salad (with
olive oil, no mayo) \[10, 12\].
\* \*\*Eating Out:\*\* Extremely difficult due to hidden additives in oils and marinades. If you must, order plain
grilled chicken and plain steamed rice \[Conversation History\].
\* \*\*Flavor:\*\* You \*can\* make food taste good! Use fresh basil, parsley, rosemary, thyme, ginger, and garlic
(if tolerated) \[4, 13\].
\*\*\*
\*Always consult your dietitian or GI team before starting, as portions are often personalized in clinical settings
\[12\].\*
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- id: 1tmlg97
title: Ulcerative Colitis Diet, intermittent fasting, Inflectra
subreddit: r/UlcerativeColitis
author: No-Inevitable413
score: 12
comments: 14
url: https://www.reddit.com/r/UlcerativeColitis/comments/1tmlg97/ulcerative_colitis_diet_intermittent_fasting/
created_utc: 1779650264
selftext: "Questions at the end \nHistory: \nI’m a 27M. I was diagnosed with Ulcerative Colitis when I was 23. Without going too deep into it, that first year was a really, really rough time in my life. I took Prednisone, mesalamine, then got eventually got on Entyvio.\n\nEntyvio worked great for about 2 and a half years. I’ve got a great job as a supervisor in my construction industry, a volunteer firefighter, applying for full time full time job in the fire service, and in college. My favorite hobby is hitting the gym and lifting weights. I try to eat 150 grams of protein a day and 3000 cals, and was essentially able to eat any food and energy drinks or whatever I wanted. Essentially forgot about the UC besides the biweekly Entyvio Injections.\n\nOctober 2025 I suppose the Entyvio stopped working. Started having symptoms again and went to the hospital and got back on prednisone. Prednisone didn’t seem to help much. Really struggled with resolving it with diet, especially while working. My doctor got me started on a different biologic called Yesintek in January which seemed to start working for a couple weeks so I tapered down off the prednisone. \_As soon as I stopped taking the prednisone, back to 15-20 bm’s a day with blood. Lost 30 lbs. Yesintek not working either. Back on prednisone\n\nColonoscopy in April showed “Moderate” active pancolitis with hemorrhoids. My life has been unbearable! I felt like I was going crazy. Not sleeping more than an hour at a time. Not liking to look at myself in the mirror. Not able to volunteer at the fire department for fear of having an accident while on a call. Scared to get in my car and drive to work or the grocery store. Shitting myself in my car. Or while picking up my garbage can from the curb, I have a long driveway lol! Not sure how I’ve still been showing up to work.\n\nSo I had enough and am taking a medical leave from work for 2.5 weeks. I’ve decided to do whatever it takes to take my life back!\n\nThrough reddit research and YouTube videos, Here is my new routine I’ve been trying for the past few days:\n\n·\_\_\_\_\_\_ Intermittent Fasting: Only eating between noon and 8pm. Mudwtr mushroom coffee in morning.\n\n·\_\_\_\_\_\_ Diet change: no nuts, dairy, spicy, caffeine. Also trying gluten free and (mostly) dairy free. Big smoothies with banana, blueberry, avocado, kefir, and plant based protein powder. Salmon, shrimp, chicken, organic vegetables. Eggs.\n\nI used to try to cram as many calories as I could in the day to meet my fitness goals, including whey protein. I think the whey protein and dairy may have been a part of the problem. \n\n·\_\_\_\_\_\_ Probiotics: Making my own Kefir at home, mixing in smoothies daily. Also eating homemade sauerkraut I got from a friend. Optimizing the gut microbiome seems to be a common theme in Kenny Honnas videos.\n\n·\_\_\_\_\_\_ Supplements: Probiotic supplement in the morning. Turmeric curcumin powder. Testosterone boosting supplement. I used to take creatine daily, and plan to resume creatine once my bowel movements are formed again.\n\n·\_\_\_\_\_\_ KPV peptide. Started first dose yesterday. 0.2mg per day subcutaneous injection. This one makes me nervous since it is not FDA approved by online it says it helps with intestinal healing and IBD support. Plan to do an 8 week cycle and see what happens.\n\n·\_\_\_\_\_\_ Exercise: Back in the gym doing light weight training. My usual split workout Legs, Back and Bis, and chest and Tris, then rest day.\n\n·\_\_\_\_\_\_ Medications: Started first dose of Inflectra (Remicade generic) last week. Second dose in scheduled in 2 weeks. I read that it takes a couple of weeks or months for it to start working. I’ve come to the conclusion that I can’t solely rely on biologics. In the meantime I’m willing to try it if it means it could help.\n\n\_I’m also taking an antidepressant Desvenlafaxine for the past month to help with my mental health going to try it for 6 months.\n\nAnd of course trying to taper off of the Methylprednisolone, feel like it hasn’t helped the last 6 months and have a suspicion it’s making me feel worse. I’m down to 8mg per day currently.\n\n\_\n\nFor discussion:\n\n·\_\_\_\_\_\_ I used to use a Reverse Osmosis water filter for drinking water. I haven’t used it since I moved but I still have it, I figured since I’m on well water at my house there isn’t any harmful chemicals or chlorine. Has anyone had any experience with or noticed any difference switching to RO filtered water?\n\n·\_\_\_\_\_\_ Does anyone have any experience or insight with KPV peptides? While in a flare or continued while in “remission”?\n\n·\_\_\_\_\_\_ Has anyone had any luck with a natural doctor rather than conventional doctor? I found a naturopathic doctor in the area that specializes in autoimmune conditions but am skeptical whether there would be any benefits or new information I would gain from paying for an appointment.\n\n·\_\_\_\_\_\_ Finally, another controversial topic, does anyone else think they developed UC or a different autoimmune condition after receiving the COVID vaccine?\n\nThis is my first post. I’ve been reading other posts about UC on Reddit. During dark times, it has helped me feel like I’m not alone with this disease. I value being apart of this community. Thank you everybody."
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis remission after antibiotics
- id: 1tyt4hl
title: >-
Fecal transplants are quietly becoming a last resort for kids with cancer, autism, and failing guts, and the early
results are hard to ignore
subreddit: r/microbiomenews
author: Technical_savoir
score: 996
comments: 64
url: https://www.reddit.com/r/microbiomenews/comments/1tyt4hl/fecal_transplants_are_quietly_becoming_a_last/
created_utc: 1780780684
selftext: >-
Link to Study
Restoring Microbial Balance: Clinical Applications, Challenges, and Future Directions of Fecal Microbiota
Transplantation in Pediatric Disorders
https://www.mdpi.com/2076-2607/14/6/1241
The Core Issue
A gut microbiome (the trillions of microbes living in your digestive tract) that gets knocked out of balance can
cause serious problems in children, especially kids already dealing with cancer, organ transplants, or developmental
conditions. Antibiotics, chemotherapy, and disease itself can wipe out the good bacteria, leaving the door open for
dangerous infections and worse outcomes.
The Finding
Fecal microbiota transplantation (FMT), which means transferring healthy donor stool into a sick patient to rebuild
their gut community, is well-established for one specific thing in kids: beating back recurrent C. difficile
infections after antibiotics have failed. A single FMT procedure clears the infection about 81% of the time, and a
second round pushes that closer to 90%. Beyond C. difficile, the research is promising but still early, covering
inflammatory bowel disease, autism spectrum disorder, and drug-resistant bacteria.
Why It Matters
Kids with leukemia, those who just had a stem cell transplant, and children on heavy immunosuppressants are among
the most vulnerable to gut collapse, and they have the fewest safe treatment options. FMT could help reconstitute
their microbiome, potentially reducing transplant rejection complications and improving survival. For children with
autism, one open-label study found meaningful improvements in both gut and behavioral symptoms after a modified FMT
protocol, though that result needs much larger trials before anyone draws firm conclusions.
Limitations of Study
Almost all the pediatric data comes from small, single-center studies or case series, not large randomized trials.
Pediatric oncology patients are routinely excluded from rigorous trials, so the field is stitching together evidence
from adult data and anecdotal reports. Long-term safety, especially in immunocompromised children, is still largely
unknown, and FMT protocols vary wildly across studies, making it hard to compare results.
Conflicting Interests
Current clinical guidelines from NASPGHAN and ESPGHAN recommend against routine FMT in immunocompromised children
outside of established C. difficile indications, citing the limited data and real risk of transmitting infections
through donor material.
Interesting Statistics
• Single FMT clears recurrent C. difficile in about 81% of pediatric cases; a second procedure brings success closer
to 90%
• In adult ulcerative colitis data (which pediatric guidelines currently borrow from), FMT achieves remission in
roughly 37% of patients versus 18% in controls
• Among four pediatric oncology patients with recurrent C. difficile tracked in one series, two resolved after one
FMT and one required six separate procedures
• C. difficile rates are notably higher in children with cancer, IBD, and recent organ transplants
• Reduced microbial diversity during the peri-transplant (around the time of transplant) period in pediatric
leukemia patients is linked to greater risk of graft-versus-host disease and worse survival
• The systematic review pulled from 113 publications covering trials through December 2025
TL;DR
Poop transplants reliably cure recurrent gut infections in kids at a nearly 90% rate, but using them for cancer
patients, autism, and IBD is still early-stage science that needs real randomized trials before it becomes standard
care.
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- id: m6tpb2
title: >-
Things that worked me, got HS at 19. Now 24M (Stress, Antibiotics (Bad), Dexidin/Hibiclens, Insulin Resistance,
Sleep, Ulcerative Colitis). I want to help.
subreddit: r/Hidradenitis
author: wazzupmydude
score: 27
comments: 9
url: https://www.reddit.com/r/Hidradenitis/comments/m6tpb2/things_that_worked_me_got_hs_at_19_now_24m_stress/
created_utc: 1615961304
selftext: "I got my first HS flare \\~5 years ago during my 2nd year at university. That same month, I also had my first flare of Ulcerative Colitis, an autoimmune disease, but I didn’t know I had it until 3 years later in 2018. Along the way, I tried many things, from avoiding nightshades to topicals. I know that I was very lucky to only have Stage 1 (groin, armpits, some on neck/back scalp) and I feel for every one of you, regardless, this was a very stressful period of my life. While I can’t go back in time to guide my 19-year-old self, so I just wanted to share what worked for me, in the hope that it helps someone else going through it.\n\nThat first year was terrible, it’s weird to say, but back then, there was even less information about this than there is now. The link between HS and autoimmune diseases had not been established and all I was told by my Derm was that lifelong antibiotics were the only choice. I think this subreddit has like 2k members. I didn't know much about health care, I was just a normal 19yo. Didn't even know what a chronic disease was.\n\n**Weight / Insulin Resistance**\n\nOver the years, my HS has strongly correlated with my weight. Now I was a skinny person on the surface, but really I was just very skinny fat. Most of this fat was around the abdomen/side, so it's hard to notice over clothes. I started at around 166 pounds in 2015. The first time I didn't have HS for several months was in 2017 when I dropped to 148 pounds. I was trying to eat very healthily, to potentially curb what I thought was IBS (later turned out to be UC) and the HS. By Feb 2018, I was back at 170 after several months of working out and \"bulking\". And as my weight rose, the HS came back. I'm not saying that weight = HS, but potentially increasing weight means high caloric intake and higher glycemic food. When you gain weight, there is a direct correlation to increased insulin resistance, which is associated with higher inflammation. I know losing weight can be hard, but please try what you can. I want to see more people become healthier. This will likely have a good effect on the gut, but that is a whole other chapter.\_\n\n**Dexidin / Hibiclens / Biofilms**\n\nI read research a couple of years ago about the high incidence of biofilms for this disease, which is really no surprise. There are two components, inflammation, and bacteria. While bacteria do not cause this disease, the higher inflammation makes you more prone to infection. So lowering bacteria will not cure you of this disease, but it should significantly decrease the cases of cysts becoming infected. Using benzoyl peroxide or Hibiclens can really help with this. BUT, a lot of people do not use this correctly. Hibiclens breaks down in the presence of SLS, which is found in pretty much all other soaps. This is why you might have noticed that Hibiclens soap is very runny, it is specifically formulated so it doesn't breakdown. When applying Hibiclens, do not let SLS soap go on the area. You want the Hibiclens to stay on the skin so it can continue killing bacteria for the next 18-24 hours. Weekly bleach baths can also help, but again, this isn't a cure, but we want to decrease infection chances. You want to leave the Hibiclens on the affected area for 3 minutes and I do this every day, even when I'm in remission.\_\n\nA lot of ppl get expensive prescription benzoyl peroxide + clinda tubes. I never noticed it being significantly better than 5% benzoyl peroxide alone. You can get a very large tube / 10% wash for cheap. I like washes better since I can leave them on for 10 minutes before I shower and they won't bleach clothing.\n\nThese things were not an overnight fix, it simply made it so that I never had cysts with pus. I still have HS, so let's say during a stressful week, I might still get a cyst, but there is a 95% chance it won't be infected or have pus.\_\n\n**Ulcerative Colitis**\n\nMy UC started the same months as my HS. This can't be a coincidence, at least not in my opinion. Many times my HS and UC flares have aligned. There is a gut component, but if you look past what the trendy naturopaths are saying, fixing your gut is very difficult. It doesn't really require supplements or probiotics etc. Probiotics especially are very short-term colonizers of the gut. I'm not saying they don't help, but people often neglect activity, weight, mental health, diet, etc in place of quick fixes that they are sold. There is some interesting data on how 7+ days fast can impact gut bacteria. I've also previously tried the SCD diet for 6 months with good results. I've experimented with taking turmeric (2mg C3 daily), zinc, probiotics, mutaflor, ashwagandha, folate etc. At the end of the day, I've noticed minimal changes with these, and my mental health trumps all of them.\_\n\n**Antibiotics**\n\nRight before I got HS/UC, I was put on antibiotics for 4-6 weeks for sinusitis. I don't know, maybe it's linked. Needless to say, I did try antibiotics for other skin issues after my HS diagnosis. But whenever I stopped, it only got much much worse. I like topicals a lot more. Long-term antibiotics aren't great.\_\n\n**Sugar**\n\nAvoid at all costs. Bad for weight, insulin resistance, and inflammation. Focus on low glycemic foods. I gotta say, I eat fairly unhealthy but if I'm active/happy the HS doesn't flare.\n\n**Stress / Sleep**\n\nI think these two are as expected, more stress generally meant more HS. For what it's worth, I don't think eustress rarely caused HS. Oddly enough, I rarely had a flare during finals, but I would usually be pretty motivated and prepared. Emotional stress wreaked havoc, rumination, family issues, those were a flame that took so long to control once started. I would really suggest some CBT-based books, such as Feeling Good by David Burns if you have depression/anxiety.\_\n\nI don't know if I'm just a blabbering idiot, but anyways I just wanted others to know what worked and maybe give some hope. Things aren't perfect, but if my 19yo self could see the state of my HS, he would be pretty content."
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- id: 1pmjezk
title: I Analyse Your Stool for a Living (and I Have UC). Let’s Talk Calprotectin.
subreddit: r/IBD
author: Chris-flow
score: 119
comments: 36
url: https://www.reddit.com/r/IBD/comments/1pmjezk/i_analyse_your_stool_for_a_living_and_i_have_uc/
created_utc: 1765732692
selftext: "# All about Faecal Calprotectin:\n\nOh Faecal Calprotectin, how many colonoscopies you have potentially avoided. You have my thanks.\n\nLet’s talk about this test, first identified in the early 1990’s, but only widely adopted in the NHS years later. (I could write an entire post on NHS bureaucracy… unless you prove a test saves a load of money, it doesn’t get adopted.)\n\nFast forward to 2015–2018, and this test finally became routine. It’s now an essential tool for monitoring disease, treatment response, and helping diagnose IBD.\_*(Not perfect for everyone, more on that later.)*\n\nIt’s often difficult to distinguish between\_**IBS**\_and\_**IBD**. That leads to unnecessary colonoscopies (hello money-saving!). Calprotectin allows doctors to tell the two apart quickly and safely.\n\nIf you were diagnosed before this test existed (like me in 2013), it often meant being poked, prodded, and having the C-word thrown in. Faecal calprotectin would have smoothed that journey massively. That’s why it’s one of my favourite tests and a genuine success story for the NHS and for IBD care.\n\n# Indications for Testing\n\n* Marker for acute inflammation,\n* Estimation of gastrointestinal inflammation degree,\n* Parameter for monitoring Crohn’s disease, ulcerative colitis or the patient’s status after removal of polyps,\n* Discrimination between patients with inflammatory bowel disease (acute Crohn’s disease and ulcerative colitis) and irritable bowel syndrome without the need for colonoscopy.\n\n# What is Faecal Calprotectin?\n\nCalprotectin is a\_**calcium/zinc-binding protein complex**\_released by\_**neutrophils**\_(the most abundant type of white blood cell) acting as part of the innate/first responder immune response.\n\nNeutrophils release calprotectin anywhere in the body where inflammation occurs, but\_**only gut inflammation causes it to appear in stool**, which is why this test works.\n\n[Neutrophils \\(the big pink ones, red cells behind them\\) - always like the ones that look like smiley faces.](https://preview.redd.it/74vyi2i8d77g1.jpg?width=2000&format=pjpg&auto=webp&s=b66ae8b2be87c86be27749ee0b2017713efddcb7)\n\n# What Does Calprotectin\_Do? Why Do Neutrophils Release It?\n\n**1.It’s an antimicrobial weapon.**\n\nCalprotectin binds the metal ions\_**zinc**\_and\_**manganese**, which bacteria and fungi need to grow.\n\n*Rathan than directly attacking them, it starves them. A strategy known as “****nutritional immunity.****”*\n\n\n\n**2. It amplifies and regulates inflammation**\n\nThis is part of why IBD becomes a problem. The double edged sword of any auto-immune condition.\n\nCalprotectin acts as a distress signal called\_**DAMP**\_(Damage-Associated Molecular Pattern). It binds to immune receptors like\_**TLR4**\_and\_**RAGE**, triggering cells to release inflammatory messengers called\_**cytokines**\_(IL-1β, IL-6, TNF-α). These cytokines are a focus of much research in regards to IBD.\n\n*In infection this keeps you alive. In IBD, the system misfires and becomes chronic.*\n\n\n\n**3. It helps neutrophils survive in hostile environments**\n\nInflamed tissues are acidic, hot (think fevers), and filled with reactive chemicals. Calprotectin helps neutrophils stabilise themselves so they can keep fighting.\n\n\n\n**Summary:** Calprotectin isn’t “just something we measure”, it’s a powerful tool the immune system uses. We just take advantage of the fact it calprotectin in the stool is a measurable protein directly proportional to the inflammation in the gut.\n\n# How We Run Faecal Calprotectin in the Lab\n\nSend me some poo.\n\nWe don’t need much (actually 15mg, which is pea sized).\n\nDon’t get it contaminated with toilet water! (My preferred method is to put lots of toilet roll in the bowl first to catch it).\n\nBlood and mucus is ok in sample, dont aim for it, don’t avoid it. The idea here is to get a good representative sample of the overall stool. Like a mini poo :)\n\nThe sample is stable for 3 days at room temperature, but we prefer to receive it the same day.\_We store it at 2–8°C and test it within 48 hours.\n\n**If frozen at –20°C**, it’s stable for 12 months. Though freezing can sometimes cause a slight artificial increase, because neutrophils may burst and release more calprotectin. Your lab/doctor will likely take this into consideration when interpreting results so it isn’t an issue.\n\n\n\n# The ELISA Method (How the Test Actually Works)\n\n**1.**\_**Your sample, along with standards and controls (these are known results we use to make sure the result is correct), is added to a test plate.**\_The plate is already coated with special antibodies that specifically capture calprotectin.\n\n**2. If calprotectin is present, it sticks to the plate.**This happens during the first incubation step.\n\n**3. A second antibody is added that attaches to the captured calprotectin.**This second antibody has an\_**enzyme**\_attached to it. So now you have a “sandwich”: Antibody — Calprotectin — Enzyme-linked Antibody.\n\n**4. A colour-forming solution is added.**The enzyme reacts with this solution (called\_**TMB**), turning it\_**blue**, and then\_**yellow**\_when the reaction is stopped.\n\n**5. The strength of the yellow colour reflects how much calprotectin is in your sample.**A stronger colour = more calprotectin, a weaker colour = less calprotectin\n\n**6. A calibration curve is used to calculate your exact result.**The machine compares your sample to known standards and produces a real number (e.g.,\_**75 µg/g**,\_**500 µg/g**, etc.)\n\n*This is why it’s such a reliable, quantitative test for inflammation.*\n\n[Faecal Calprotectin ELISA reagents. Boxes and boxes of these line our cold room!](https://preview.redd.it/6egf0qehd77g1.jpg?width=2000&format=pjpg&auto=webp&s=ff8b2e214022267de2fd02b47a2fb91e598f0f94)\n\nhttps://preview.redd.it/tneqpeehd77g1.jpg?width=2000&format=pjpg&auto=webp&s=950a66bf6cc06b23955ca61266255669ef0947bb\n\n\n\n\n\nhttps://preview.redd.it/4xgdmabjd77g1.jpg?width=2000&format=pjpg&auto=webp&s=f002988cd913cfd2a9eb2d8f993deec6a32752d6\n\n[We use an automated analyser called the DYNEX® DS2 ELISA system. It’s not the most complicated analyser, or the biggest, but this baby will set you back around £100,000 if you want one!](https://preview.redd.it/qru16cbjd77g1.jpg?width=2000&format=pjpg&auto=webp&s=7d3b5912418fe940faadff382438342ed1ae505c)\n\n[If you think your poo smells, imagine 100 other people just like us. So yeah, we use a fume cupboard to pull that smell away from our nostrils and into the lovely fresh Manchester air.\_](https://preview.redd.it/euud0flkd77g1.jpg?width=2000&format=pjpg&auto=webp&s=b714f1242746f352f6562ef9b1cc84f2b266b619)\n\n# Result Interpretation:\n\n>\n\nEach lab may establish their own reference ranges based on their local population. As confusing as that sounds, there may be small differences. Also, these reference ranges are based on the test kit: Manual — IDK® Calprotectin (MRP8/14). Widely used within the NHS UK.\n\n\n\n# Reference Ranges for Faecal Calprotectin in ADULTS (>12 years old):\n\n**Konikoff MR & Denson LA (2006) Inflamm Bowel Dis 12:524–534 doi:10.1097/00054725-200606000-00013**\n\n**Important:**Make sure you check the units your lab is reporting in, and convert if required!\n\n* The median value in healthy adults is 25µ/g (mg/kg)\n* Samples with a calprotectin concentration\_**< 50 µg/g**\_are regarded as negative.\n* Samples with a calprotectin concentration\_**between 50 µg/g and 100 µg/g**\_are regarded as borderline positive. We recommend repeating the measurement at a later time point in order to confirm the result.\n* Samples with a calprotectin concentration\_**> 100 µg/g**\_are regarded as positive.\n\n**Note:**\_Many confounding factors can cause increased levels of faecal calprotectin in the absence of IBD or IBD in a quiescent disease phase, e.g. use of NSAIDs (non-steroidal anti-inflammatory drugs), any intercurrent gastrointestinal infection, and the presence of malignancies. These factors should be considered in the interpretation of the test results and therapy of IBD.\n\n\_\n\n# Normal Ranges for Faecal Calprotectin in Paediatrics (0 - 12 years Old)\n\n**Hestvik E et al. (2011) BMC Pediatrics 11:9 doi:10.1186/1471-2431-11-9**\n\n**Method:**\_302 apparently healthy children, age 0–12 years, in Kampala, Uganda, were tested for faecal calprotectin concentration.\n\n**Table 1: Faecal calprotectin concentration in apparently healthy children by age.** \n95% confidence interval (95% CI) is indicated in brackets.\n\n|**Age**|**Number (%)**|**Median calprotectin \\[µg/g\\] (95% CI)**|\n|:-|:-|:-|\n|0–3 months|14 (4.6%)|345 (195–621)|\n|3–6 months|13 (4.3%)|278 (85–988)|\n|6–12 months|27 (8.9%)|183 (109–418)|\n|1–4 years|89 (29.5%)|75 (53–119)|\n|4–12 years|159 (52.6%)|28 (25–35)|\n\n\n\n# Normal Ranges for Faecal Calprotectin in Paediatrics (4 - 17 years Old)\n\n**Fagerberg UL et al. (2003) J Pediatr Gastroenterol Nutr 37:468–472**\n\n**Method:**\_117 healthy children age 4–17 years were tested for faecal calprotectin concentration.\n\n**Table 2: Faecal calprotectin concentration in healthy children by age.**\n\n|**Age**|**Number**|**Median faecal calprotectin \\[µg/g\\]**|\n|:-|:-|:-|\n|4–6 years|27|28.2|\n|7–10 years|30|13.5|\n|11–14 years|27|9.9|\n|15–17 years|33|14.6|\n\n**Conclusion:**\_The suggested cut-off level for adults (< 50 µg/g) can be used for children aged 4–17 years.\n\n\n\n# FAQ’s:\n\n**1. Is there a test better than a Faecal Calprotectin?**\n\nYes there is: The excretion of Indium-111-labelled neutrophilic granulocytes has been suggested as the “gold standard” of disease activity in inflammatory bowel disease. However, measuring 111-indium-labelled granulocytes is very costly (patient’s hospitalisation, analysis and disposal of isotopic material) and is connected with radioactive exposition of the patients. For this reason, a repeated application to children and pregnant women is not recommended.\n\nFor the NHS - this isn’t available - and frankly, wouldn’t be needed in 99% of cases in my opinion.\n\n\n\n**2. Does a high faecal calprotectin always mean IBD?**\n\n**No.**\n\nCalprotectin rises whenever neutrophils enter the gut – and that can happen for several reasons:\n\n* Gastroenteritis (viral or bacterial)\n* Food poisoning\n* NSAIDs (ibuprofen, naproxen)\n* Coeliac disease\n* Diverticulitis\n* Post-polypectomy\n* GI bleeding\n* After intense exercise\n\nA single elevated result\_**does not equal IBD**. Doctors look at the full clinical picture, this will include symptoms, trends and repeat tests.\n\n\_\n\n**3. Can IBS raise faecal calprotectin?**\n\n**No.**\n\nIBS\_**does not**\_cause inflammation, so calprotectin stays normal.\n\n\_\n\n**4. How quickly does calprotectin respond to treatment?**\n\nUsually\_**2–8 weeks**, depending on:\n\n* Steroids → fast drop\n* Biologics → slower but steady\n* Mesalazine → moderate drop\n* Antibiotics → varies\n\nRegular tests help us so much. It’s hard to make conclusions on one sample alone, but repeating (as annoying as it is) is so important. Trends are crucial for good interpretation.\n\n\_\n\n**5. What are the best practices for stool collection?**\n\n**Pea sized**\_amount.\_**Good representation**\_of the overall stool (think mini poo).\_**Don’t aim for blood and mucus**, but don’t avoid it either.\_**Same day collection**\_is best at room temp, but freezing may be required logistically.\_**Don’t contaminate it**with water!\n\n\n\n**6. Is faecal calprotectin raised in cancer? Is colonoscopy the only way to know?**\n\nI’m always careful discussing cancer because it’s easy for fear to take over, so please trust your doctor’s interpretation here.\n\nWhen interpreting patients results,\_**this is where medical experience really plays.**\_It’s hard to explain how we develop this almost sixth sense. When you interpret these results all day long, subtle differences in the overall picture (I can't stress this enough, the whole story of the patient is considered) can be glaringly obvious to the professional that a colonoscopy must be performed urgently. We will highlight it with a phone call, the doctor will also recognise it.\n\nThere is overlap in colorectal cancers and IBD symptoms. There’s no hard or fast rules I can put into a clear table. Plus, if IBD isn’t in remission all that cell repair puts you more at risk of developing cancer. Hence, the 5 year colonoscopies (don't miss your next one!)\n\nIf we look at faecal calprotectin alone, it is simply a\_**marker of inflammation**, not cancer itself. Calprotectin\_**can**\_be elevated in colorectal cancer or polyps, but that’s because these conditions provoke\_**local inflammation**, not because calprotectin is a cancer signal. It rises because neutrophils release calprotectin in response to irritation in the gut, and that irritation can come from many causes.\n\nIn fact, levels in cancer are often\_**much lower**\_than what we see in active IBD, and cancer is far less common than infections, IBS/IBD overlap, or benign inflammatory conditions.\n\nSo while cancer can raise calprotectin, a high result\_**does not**\_mean cancer - it simply tells us that inflammation is present and needs investigating.\n\nDoctors will interpret the\_**full clinical picture**\_based on:\n\n* **Symptoms**\_(e.g., persistent change in bowel habit, weight loss, blood mixed in stool, low haemoglobin/anaemia, usually in people over 40–50)\n* **Lots of blood tests**and the relationship between them can give clues \n* And if there is any concern, a\_**colonoscopy**with histological interpretation is the definitive test. This is also the reason regular colonoscopies once diagnosed with IBD is VERY important.\n\n**Bottom line:** Calprotectin alone can’t indicate if it's cancer or IBD. However, in combination with other tests and symptoms it may highlight the urgency of performing a colonoscopy (which will give you all the answers).\n\nIf there is one thing I would advise, is,\_**you know your body.**\_All the tests in the world won’t beat a colonoscopy. If you want, it's your right to demand a colonoscopy - that will give you a definitive answer.\n\n**7. Why do I need a colonoscopy if I can just test faecal calprotectin?**\n\nIn short, you can’t beat a colonoscopy. It's the ‘gold standard test’. Faecal Cal has its place in differentiating between IBS and IBD, monitoring IBD disease progression and response to treatment. However, as healthcare professionals it's our job to rule things out. A colonoscopy will give you a much more definitive answer than any non-invasive, in-vitro sample.\n\n**8. Does a negative Calprotectin = no inflammation?**\n\nLot’s of people have asked me this: I have all the symptoms of a flare, but my results appear normal. Why?\n\nI really tried hard to find an answer for this (it's quite common!). It’s possible to get a false negative for example, say you diluted it with toilet water, maybe that particular stool sample wasn’t collected correctly, lab errors, very early flare activity. But\_**if it’s been repeated**\_and your bloods (I.E. CRP) are all negative as well, these are my thoughts and reasoning why:\n\n**1. Proctitis (rectal only):**\_probably the biggest reason may be that inflammation is right at the end of the bowel, the stool may pass\_**above**\_the inflamed area before calprotectin has a chance to mix through it.\n\nMine started as proctitis (it's since spread up a little bit). My CRP and FC (faecal calprotectin where always low, but a colonoscopy diagnosed it. When it spread up a little bit, suddenly FC was high, my CRP was relatively\n\n**2. IBS overlay:**\_a colonoscopy would show active inflammation and prove me wrong. However it may be that the symptoms are overlapping whilst in IBD remission. IBS won’t have blood, but other than that, the symptoms can be fairly similar!\n\n**3. CRP non-responders:**\_This is certainly a known thing, and not anything to worry about. 20 - 30% of patients can be non-responders. Causes can be genetic, and seem to be more common in UC than Crohn's.\n\n*Lewis JD (2011) Gastroenterology 140:1817–1826 doi:10.1053/j.gastro.2010.11.058*\n\n*D’Haens G et al. (2012) Inflamm Bowel Dis 18:2218–2224 doi:10.1002/ibd.22917*\n\nSo unfortunately, that was the best I could find or think of - it just happens to some patients. To be honest, if your results are normal, it isn’t saying you don’t have IBD or invalidating your symptoms. It's saying your body is doing a fairly good job handling it. That’s a good thing!\n\n\_\n\n**9. Do you get used to testing poo?**\n\nYup! I only added this bit to get one point across.\_**Don't ever be embarrassed.**\n\nAside from our duty to remain professional, you really do get de-sensitised to it. Its just poo. I mean, obviously im going to wear gloves/PPE and use a fume cupboard. But if you think i haven't seen worse than yours, i have.\_**It doesn't bother us, and it shouldn't bother you.**\_\n\n\n\n\_\n\n**Thanks for reading,**I really hope it's useful and interesting. It’s a long one, took me a long time to write, but honestly Faecal Cal deserves it!\_\n\nIt will never replace a colonoscopy when needed, but it serves a really important part of our\_repertoire\_of diagnostic tools for IBD. I'm incredibly grateful for the NHS providing it as a service from a personal and professional perspective.\_\n\nYou keep sending. I’ll keep testing.\n\nOriginal article found at: [https://www.ib3discreet.com/blogs/main-just-for-fun/i-analyse-your-stool-for-a-living-and-i-have-uc-let-s-talk-calprotectin](https://www.ib3discreet.com/blogs/main-just-for-fun/i-analyse-your-stool-for-a-living-and-i-have-uc-let-s-talk-calprotectin)\n\nTake care, and all the best on your IBD journey.\n\nChris\_\n\n[](https://www.ib3discreet.com/blogs/main-just-for-fun/why-ib3-packaging-had-to-be-different)"
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- id: 1ltbpgp
title: I'm scared
subreddit: r/ostomy
author: WhatEver069
score: 66
comments: 55
url: https://www.reddit.com/r/ostomy/comments/1ltbpgp/im_scared/
created_utc: 1751835033
selftext: >-
I'm currently in the hospital after a nasty fever landed me in the hospital on friday (i have Acute Severe
Ulcerative Colitis), it's currently almost 11 pm, and in roughly 11 hours, i'll be put under for my
ileostomy-surgery.
I'm scared. I'm really, really, REALLY fucking scared.
Please, if you've had a good experience with the surgery, can you share it with me? My anxiety is in overdrive.
(Will crosspost in the UC-subreddit too, just in case)
EDIT; hi, everyone! It's wednesday, and i've finally gotten my wits to me again, so figured i should probably update
y'all.
My surgery got pushed back because an emeegency-case came in through the doors, and while i was waiting, something
weird happened. I stopped having blood in my stool, and then it firmed up to basically "remission"-type. I told a
nurse, and after some clarifying questions, she ran off to grab a doctor. While the OR was being cleaned and prepped
for me, the doctors decided to cancel my surgery, and give the antibiotics and rinvoq a chance.
I'm still not out of the woods, but my bloodtests look a lot better, and i feel a lot better- the only hangup is my
BMs.
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- id: 1u8ajit
title: Mild flare after 8 years of remission
subreddit: r/UlcerativeColitis
author: 123swim
score: 6
comments: 5
url: https://www.reddit.com/r/UlcerativeColitis/comments/1u8ajit/mild_flare_after_8_years_of_remission/
created_utc: 1781703724
selftext: >-
Diagnosed with left side, ulcerative colitis over 15 years ago, had successful short term remission and 2 flares
previously until I got onto Entyvio and was in deep remission for 8 years that pulled me out of a year long flare.
sadly, I am currently in a mild flare after 8 years of remission on Entyvio. My doctor confirmed that by body did
not develop antibodies against the medication so there is hope by increasing the dosage from 8 weeks to 4 weeks with
a prednisone taper over the course of 4 weeks may help.
My flares are triggered by the same thing every time. Antibiotics. Now, it didn’t happen everytime I needed a course
but it is a major cause for all three of my flares up. Normally. I do my best to not take antibiotics as we have a
major overusage problem but this time I had no choice as I had an UTI. I ended up getting Cdiff from the antibiotics
and when I completed the round of medication to clear up the cdiff it was too late. I went in for a colonoscopy and
had mild proctitis but the rest of my colon looked good.
Has anyone have experience pulling through a mild flare with increase dosage + prednisone? I do like that Entyvio is
gut focused and if this does not work. My doctor is going to require me to change medications. Is there anything
similar to Entyvio that doesn’t suppress the whole immune system that’s more gut focused?
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- id: 1u3ush8
title: 1 week post op - hysterectomy, salpingectomy, and endo excision
subreddit: r/hysterectomy
author: ok_sense_80
score: 7
comments: 3
url: https://www.reddit.com/r/hysterectomy/comments/1u3ush8/1_week_post_op_hysterectomy_salpingectomy_and/
created_utc: 1781269657
selftext: >-
Updates like this really helped me as I was preparing, so I wanted to post something like it in case it helps
others.
I am 36F and had a total hysterectomy with salpingectomy (removed everything except the ovaries) plus endometriosis
excision surgery 1 week ago on June 5th. Surgery was done laparoscopically & robotically.
Going into the surgery, my main symptoms were debilitating period cramps, spotting outside of my period, intense
rectal spasms during ovulation, and really severe dysmotility/constipation issues--I did not feel defecation urges,
was dependent on suppositories/enemas to have a bowel movement, and suffered from incomplete evacuation with
constant bloating. I also have severe ulcerative colitis (UC), but have been in deep remission for the past 3 years.
A colorectal surgeon was part of my team in case I needed a resection since my bowel symptoms are so prominent and I
am high risk with my UC history, but neither of my surgeons nor my GI specialist was sure the surgery would help my
dysmotility because my colon is also full of scar tissue from past UC flare ups, which can also cause motility
issues. But the fact that my motility issues have gotten progressively worse WHILE in UC remission made me feel that
endo was driving my symptoms. My biggest fears going into surgery were 1. that the surgery wouldn't help my
dysmotility at all, which is really impacting my quality of life and 2. that I would wake up with an ostomy bag,
something I've been trying to avoid since being diagnosed with UC 12 years ago and going through multiple severe
flare-ups. I'm also afraid this surgery will trigger a UC flare, which happened a few years ago after an unrelated
surgery--fingers crossed.
Prior to surgery, I had a pelvic ultrasound that showed nothing and an MRI that showed potential uterus/rectal
tethering and thickening of uterosacral ligaments, both suggestive of endo, along with an indistinct and prominent
junctional zone, suggestive of adenomyosis.
Surgical findings: Endometriosis "everywhere": right and left pelvic sidewalls, the entire rectouterine pouch (right
+ left posterioir cul de sac, anterior cul de sac), all over my uterus. There was also a fibroid on my uterus, an
endocervical polyp, and "fibroconnective tissue with extensive hemorrhage and degenerative changes" on my left
ovary. Hearing my surgeon say there was endo everywhere and that my "uterus was a bad place," plus seeing the
official pathology results, was so validating I was in tears!
Post-surgery: Woke up in a lot of pain and was given IV fentanyl, followed by IV hydromorphine a little later (I'm
intolerant to oxy class of opioids). Felt extremely disoriented and was "lazy breathing" so was given oxygen. co2
pain was present in my diapgragm, making it really hard to take a deep breath (sharp pain). I was extremely nauseous
and puked at least once, was feeling generally just bad, and really didn't want to leave the hospital but they made
me (lol) once I was able to walk to the bathroom and pee. I had asked to have my catheter removed while I was still
under because I have a bit of a catheter phobia--really glad I asked and didn't have to deal with the removal in the
post-surgery state I was in. They discharged me with hydromorphine (which I didn't take at all) and Journavx, a new
non-opioid pain medication, which I took for the first 4 days.
Days 1-4 post op: The co2 pain was SO. FREAKING. BAD. Literally got to a 10/10 for pain. I had a crying panic attack
night 2 because I couldn't take a breath without extreme sharp pain in my diaphragm and shoulder. I can't believe
there is nothing that can help this aside from time. I was taking gas-x around the clock, using a heating pad 24/7,
walking, etc. and it just wouldn't lighten at all. The only position I could tolerate was lying on my left side with
my knees bent a bit. I couldn't even tell how my actual pelvis/incisions felt because the co2 pain was so
distracting. On day 2 I did take milk of magnesia because I felt so scared to push and poop especially with my
history of constipation, so on day 3 I had diarrhea all day (which was fine with me). One of my steri strips also
already came off day 1 post op, surgeon said it was fine. I had posted earlier about how my surgeons office wouldn't
authorize more than 2 days for my partner to take off work via letter, and I can say now how bullshit that is--I
definitely needed them here days 1-4 at the very least (they ended up taking 4 days off + had a weekend after
surgery).
Day 5-6 post op: co2 pain finally lessened!!! I also had a natural bowel movement urge and was able to poop without
aid of suppositories and literally cried tears of joy because of my dysmotility history and suppository dependence
prior to surgery. This was the outcome I was hoping for 😭!!!! I do feel a lot of soreness in my rectum while
pooping which makes it difficult to do the act of pooping, but the fact that I am able to go at all makes me so
happy. Yesterday I actually went like 5 times and experienced a lot of gas but I think my colon is just waking up
and my gut bacteria is repopulating after the pre-surgery antibiotics. Also when gas passes the rectouterine pouch I
do get an intense soreness type pain. My whole belly has generally been sore post-surgery but nothing compared to
period pain. I've been able to go on multiple walks per day, but do get tired easily. Day 6 I made dinner for the
first time, otherwise have been taking it easy re: chores and mostly just relaxing while my partner runs the house
(does laundry, walks the dog, cooks, etc.)
Today is day 7 and I am excited to keep improving and experience life without debilitating pain and dysmotility :).
Ask me anything!!
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title: >-
I just got diagnosed with UC after a terrible flare that ended up with me hospitalized. I'm feeling a little
hopeless about my future right now. Can anyone give me a little hope or some positive stories about how this doesn't
have to ruin my life?
subreddit: r/UlcerativeColitis
author: leomaxxx15
score: 20
comments: 23
url: https://www.reddit.com/r/UlcerativeColitis/comments/1q1p4bi/i_just_got_diagnosed_with_uc_after_a_terrible/
created_utc: 1767328280
selftext: >-
This has been a very long journey of pain and discomfort and terrible experiences unfortunately. I'm probably going
to put a lot of detail in, just because I need somewhere to just get all of this out. I am so sorry for the
disgusting details, but I feel it's probably important. I'm also on mobile and in the hospital on a fair amount of
drugs, so I apologize for formatting/typos. There wi be a tldr at the end if you don't want to read all of this,
which is fair enough!
About a year ago, I (22f) went on vacation to the Dominican Republic. While I was there we went on a hike through
basically a cow shit infested swamp with no advanced knowledge of what said hike wound be like, so we had no
protection in the form of long pants/sleeves or bug repellant. I was swarmed and needed up with hundreds of bug
bites. When I got home, a week later, I noticed a bug bite was getting infected. It got worse and worse, and by
early January, my leg was so infected I was in danger of losing it. I was on so many different antibiotics that
either didn't work, or that I was allergic to. I ended up on a round of a few different, very intense antibiotics
for weeks to finally kick the infection. My stomach was all messed up after that, despite my best efforts to keep my
gut health intact by taking probiotic, drinking kefir, having yogurt, etc.
Anyway, a few months go by, and I'm in my last semester of my undergrad degree. I'm still having some stomach issues
and I'm not able to eat much without feeling sick and having issues, but I manage to get through the rest of of the
semester without too many problems.
Then I move home, back with my mom and siblings for the summer. Due to other extenuating life circumstances, almost
immediately we were thrown into a sudden move across the state. I spent most of the summer packing up the house and
helping my mom prepare to stage and sell our house, as we were doing it ourselves without a realtor. Long story
short, it was very stressful. My stomach issues became a lot worse. I was dealing with weeks of severe constipation,
to the point where I wasn't have a bowel movement for weeks at a time. I finally did an enema after nothing else
worked, and it was one of the most painful things I've done, but it did get things moving. I vomited a lot, but
after that started a stream of near constant bloody diarrhea every single time I went to the bathroom. I wasn't in
terrible pain, but it would come and go in waves. The diarrhea was constant, and always bloody. I was beginning to
feel a bit weak and dizzy, but paid no mind to it, as I had to sell a house, and there was more important things I
had to deal with.
In August we finally moved and when we got to the new house, my stonach/digestive issues got even worse. I was in a
lot of pain every time I ate, no matter was. I couldn't seem to find a pattern no matter what. I cycled through
waves of constipation, diarrhea, and a mix of both, where I wasn't able to have a real bowel movement, but a little
bit of watery, mucus bloody diarrhea would pass everytime I used the bathroom. This continued for a few months, and
it was most bearable, though annoying and uncomfortable. I tried to ignore it, as I had just started a new job, and
was taking a few online classes to finish my degree. I was probably at the highest state of constant stress that
I've been in in my whole life, and chalked my stomach issues up to that, and hope it would stop when I finished the
classes. Besides, I had no time or energy to deal with these problems. I had been to a GI doctor a few times, and
they scheduled a SIBO breath test and CT scan, as well as an endoscopy and colonoscopy for later in January. The
SIBO test came back negative, and the CT scan showed colitis and backed up stool, but nothing diagnostic.
About a month ago, the constipation and pain got so severe. I was doubled over in pain, and just unable to ignore it
anymore. I was spending hours in the bathroom, sometimes unable to pass anything except for blood. My entire abdomen
hurt to the touch and was tender. I cried at the slightest touch to the lower left side of my abdomen, it was so
bad. I could feel a hard lo there, as well as in other places in my intestines. I was anemic and unable to absorb
the thyroid replacement meds I take to survive. It was getting to the point where I was getting severely sick. I
couldn't eat, I couldn't sleep, and had to call out of work multiple times because I just couldn't stand up due to
the pain. On late Sunday night (the 28th) I finally gave in to the fact that I need to go to the hospital, which I
was trying to put off for as long as possible. I hasn't been sleeping for days, and was exhausted and absolutely
miserable with pain. I had spiked a fever and was throwing up everytime I had a bowel movement due to the nausea and
pain. At around 2 am that night I went to the hospital.
While there, they did another ct scan finding again colitis, but no back up of stool. Unfortunately because of the
insane super going around, the hospital was overflowing with people, and I had to stay on a stretcher in a hallway
for over a day and half, which caused such severe anxiety and panic attacks, despite my nurses' best efforts to keep
me calm and pain free with morphine and valium. The morphine helped a little bit, but did not fully take care of my
pain, and at this point I was panicking that I just would never heal or feel better. They moved up my colonoscopy
and and endoscopy so that I could have it done ASAP at the hospital, but as I didn't have a room, I was facing the
possibility of having to go through the bowel prep (which I was already terrified of) on tbe middle of a crowded ER
hallway with no privacy and no bathroom nearby. Having a bowel movement was already so incredibly painful that I
nearly passed out and vomited every single time I had to go.and my geary rate would spike into tbe 150s every time.
I was miserable. Thnak god it took a little longer than expected foe the bowel prep meds to be brought from the
pharmacy outside the hospital, as the hospital pharmacy didn't have the tablet forms, which was the only kind I
thought I was capable of doing.
By the time the meds got through, I finally got my own room with a private bathroom, so I was able to do all the
bowel prep in the saftery and privacy of my own hospital room which I will forever be greatful for. It was a
miserable experience, and I've never felt more sick or weak as I did doing all that.
Wednesday morning, I finally got both upper and lower scopes done and finally got answers. Not answers I wanted or
was hoping for, but I finally at least had a reason for the pain I was going through. I have severe ulcerative
colitis. Over 2/3rds of my large intestine is absolutely destroyed in lesions, ulcers, and open wounds. I saw the
ouctures, it looked absolutely terrible, but I finally understood what was causing my pain.
After being on a liquid only diet since Sunday night, (it's Thursday now) I was finally allowed to have solid food
today. I was so beyond excited, because even though I was still in so much pain, I was starving and wanted real
food. I finally ate something and to my dismay I felt like absolute dog shit after, despite the steroids and othe
pain meds I was on.
So now I'm just at this place where I'm worried I'm never going to be able to eat agai. I love food. I love for
food. I love eating, and trying new things, and every night I got to bed excited about what I get to eat the next
day. I'm mourning my ability to eat, and I'm worried di ei never be able to enjoy food again. I'm worried I will
never be able to go into remission. I have other chronic pain issues, and I have always had issues with pain and
pain medications. I'm extremely sensitive to medications of all kinds, and if there is a side affect, I will get it.
I'm just worried that no meds will work to out me into remission, and I'm just never going to be able to enjoy food
again.
I just have so many plans for the rest of my life. I just graduated with my bachelor's degree, and my plan was do
reavel the whole world ans try as many foods as possible. I wanted to see the world and try as many unique foods and
cuisines as possible, and now I don't even know if I will be able to travel at all anymore. It's just not fair. I
can't help but feel so depressed and angry and pissed off at what's happened to me.
TLDR: I've just been in the hospital for the last 5 ish days and diagnosed with severe ulcerative colitis. Over 2/3s
of my large intestine is covered in ulcers and sores. I'm just feeling very depressed about the outlook and the
future of my life. I'm struggling to see how I will be able to live my life the way I want to with this diagnosis
and my other medical history.
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- id: 1su24hp
title: Advice for someone who is unsure of getting surgery please
subreddit: r/gastricsleeve
author: Miss__Milly
score: 2
comments: 9
url: https://www.reddit.com/r/gastricsleeve/comments/1su24hp/advice_for_someone_who_is_unsure_of_getting/
created_utc: 1776995534
selftext: >-
Hello all! I’ll try to keep this post as short as I can, but it’ll be a bit lengthy! The TL;DR though is basically;
33F, UK, 430lbs, unsure about surgery, looking for advice from people who’ve had gastric sleeve surgery as to
whether or not I should get it.
To start with, I live in the UK (England), am 33F, 5’8, and currently 430lbs. My highest weight was 498lbs (I
couldn’t I let myself hit 500 😅) a few years ago, but my weight has fluctuated in the 400s for the past 5 or so
years.
I’ve always been a ‘bigger’ person, even as a child I was wearing adult sizes and the first time I remember weighing
myself was when I was 11 or 12 and was 213lbs. I’m sure it’s no surprise to anyone here that I have been on and off
diets my whole life from when I can remember my first one at age 7. I have the most terrible relationship with food
of anyone I personally know and honestly, the thought of having the surgery and not being able to enjoy food as much
or eat as much as I do now is not only a strange thought but also an absolutely terrifying one.
I have a few health conditions. I have fibromyalgia, chronic fatigue syndrome, ulcerative colitis, anxiety,
depression, thyroid issues (hypothyroidism, past goitre that required surgery, current goitre), and was diagnosed
with type 2 diabetes in January 2026. I was able to put my diabetes into remission within 2 months by changing my
diet to a lower carb one, but I’ll touch on that more in a bit!
A little bit more information about my lifestyle is that I used to work as a carer for people with dementia so was
on my feet and on the go 12 hours a day and loving life! Despite having fibromyalgia, it didn’t have a huge impact
on my life and with some reasonable adjustments from my employer, I could work full time in my role no problem.
However, in 2018 when I had to have half of my thyroid removed, my body seemed to go absolutely haywire with extreme
chronic pain and exhaustion like I’d never felt before. I tried to work through it and made myself more and more
unwell. Getting so run down from the CFS caused tonsillitis constantly which put me in hospital on one occasion, and
on so many different antibiotics for the others. I ended up getting C.Diff from all the antibiotics (thankfully no
one in the nursing home had it or was unwell in any way, just in case anyone is feeling worried for them!) which
turned into a week-long stay in the hospital and my ulcerative colitis diagnosis.
Again, I tried to go back to work but I had run myself down too far. I’ve not been able to work since 2019.
I have tried so many different diets over the years (Sugar Busters, the Egg Diet, SlimFast, Slimming World, Weight
Watchers, Keto, Lower Carb (not as low as Keto), Juicing, Plant Based, SlimPod, Intermittent Fasting, OMAD, and
that’s all I can remember off the top of my head!) and I give my absolute all into all of them… for a while.
I’m obsessed with food. If I’m ’dieting’ (I try not to say I’m on a diet but just ‘choosing to eat lower carb and
healthier foods’ as that makes me feel like I’ll stick to it better!) I will track everything meticulously, use
ChatGPT as my personal food assistant to reassure me that what I’m eating is fine, how I’ll stay on track after a
‘family celebration meal’, what I should eat at that meal… all of that sounds fine, until I tell you I will think
about that one meal and obsess over it and talk about it multiple times per day every single day as soon as I know
it’s coming, whether it’s a month away or a week away. I’m already anxious about food at Christmas time!
If I’m not ‘dieting’ and eating whatever I want, I will eat WHATEVER I want. And I want it all. I will easily rack
up a £90 junk food order from a grocery store on UberEats and eat it all with my mum over the course of a day or two
multiple times per week. I will go into my savings so that I can continue to eat anything I want then and there.
I will eat and eat and eat, I feel like I don’t have a full signal or feeling. I do intermittent fasting purely
because the only thing that’ll stop me eating all through the night is the magical click of a ‘start fast’ button in
my fasting app.
From the beginning of January, just as I was diagnosed with type 2 diabetes, I took my health into my hands and said
“this will be the time I lose all this weight, I know it will be. I’m so motivated and excited that this time next
year I’ll be so much less massive than I am right now!” and I did so well. For two months I ate lower carb, I
enjoyed it, I really felt ‘this time I will do it!’ - I had my good friend, ChatGPT, to talk to about every single
aspect of my eating, I had it there to reassure me that I’m doing everything right and even though I was terrified
that I was going to ‘fall off the wagon’ and go back to how I was before like I had with every other diet, it
assured me that that wouldn’t be the case this time and talking about my worries over it is showing how far I’ve
come. Welllllllll… mid-March I had some family emergencies which in turn affected my health and the odd ‘I’ll just
have a meal deal while I’m going to be at the hospital visiting for so long’ turned swiftly into ‘oh, another £75 on
junk food on UberEats? That’s fine because I’ve done so much and am too tired and hurting too much to think about
eating healthily’ and I didn’t want to eat healthily. I wanted to eat everything, unless it was healthy.
From early January to the 2nd of March, I’d taken my HbA1C from 53 (diagnosed with diabetes) to 35 (well within the
normal range for non-diabetic people) and lost 19lbs.
From mid-March up until 2 days ago (mid-late April) I gained 12lbs of that back, and have noticed diabetic symptoms
coming back too.
(As of two days ago, I’m back to my lower carb eating and tracking in MyFitnessPal alongside my intermittent
fasting, but I do have a couple of birthday celebrations for family members coming up within the next couple of
weeks which I’m already anxious about but trying to act relaxed about)
Now, here comes the medical bit! I had my first appointment with a bariatric surgeon a few days ago (this is why I’m
back to eating healthily; I got inspired again!) and told them I don’t know if I want surgery but I don’t know what
I can do to meaningfully sort out my weight issue. The options were that I can be referred to a weight loss service
which allows me to see a psychologist for food-related behaviours and lifestyle changes, as well as a dietician (the
dietician for this service was also in the appointment and honestly, both her and the surgeon were such kind and
compassionate lovely people), or I can be prescribed Mounjaro on the NHS for 12 months but only if it’s leading up
to having the gastric sleeve surgery. They said we could do both of these alongside each other, or we could come
back to the 12 months of Mounjaro and surgery after I’ve completed the other weight loss service, but either way
they think Mounjaro would be hugely beneficial for me but I’d have to find someone who will prescribe it to me
privately if I am not going through surgical route.
Here’s the tricky bit with that - because of having ulcerative colitis, I can’t find any pharmacies that’ll take me
on as a patient. I’ve tried SheMed, Voy, Juniper, Boots, and Asda, and I was then told by a pharmacist that I’m
likely to run into this problem everywhere I go and that I’d really need to see a private doctor.
I’d be more willing to do that (paying for appointments, follow ups, monitoring, as well as the Mounjaro itself) if
I had made up my mind about not wanting the surgery. It would, of course, be much easier for me if the NHS could
handle it all!
So here’s where I’m at a crossroads. I know the benefits of surgery far outweigh the cons, but to me, the cons of it
are ginormous and deep-rooted.
The cons, in my eyes, being that I won’t be able to enjoy food like I do now. All of my family’s celebrations are
centred around food, I’m worried I won’t be able to enjoy it with them and will be left out and jealous of everyone
else enjoying it and eating platefuls at a time (or even a whole plateful at all!).
As I said before, I’m 33, I can’t work due to pain and exhaustion, but that also means that I can’t do much else - I
have no social life, I live with my mum, I don’t have hobbies, I don’t have a partner, I don’t have children, I
don’t have a pet, I just have food. (I don’t mean to sound dramatic, it’s just that that really is how it feels -
food is my personality, eating is my hobby, being fat is just who I am) - I’m scared about what will happen to me if
I can’t have this anymore. I’m also very close with my immediate family (who are all also overweight, but nowhere
near the same extent as me) and we are all very ‘food focussed’ so I’m also afraid that it’ll cause a gap between
us.
It leaves me thinking, what happens when the one thing I’ve always relied on to bring me comfort and happiness is
taken away from me? Why can’t I just be a ‘normal’ person and not have this obsession with it? Why do I have to have
surgery and never enjoy my food properly again? Why and HOW have I managed to get into this position in my life when
I have always thought to myself, even from a young teen, ‘I’ll never let myself get huge!’ So why and how has this
happened?
And then I also worry, vainly, what if I have this surgery and lose loads of weight and am happy in how I look
finally… but still can’t find someone who’ll love me? What if I’ve done all this and turned my life around and still
can’t have my ‘happy ever after’… and to make matters worse, I can’t even comfort myself with food?
I know being overweight doesn’t make someone unloveable, and I hope I haven’t offended anyone or made it seem like I
think overweight people don’t deserve or can’t find love. I am talking purely about myself and the way I feel about
myself and how I let my weight take away so much of my self confidence and who I am as a person.
I know that all these thoughts and behaviours are unhealthy and need to change for good, but I can’t imagine my life
any differently and am scared to, even though I know how beneficial the surgery would be for me.
So, I suppose really I’m asking what would you do if you were in my shoes? Have you been in my same or similar
situation and if so, please share your stories with me!
I know the obvious answer is ‘have the surgery, your life is a mess’, but even though it’s the most physically
obvious answer, it’s not the mentally obvious answer for me.
Although I feel like I’m a ‘special’ case (don’t we all?) and no one else has ever had this extreme obsession with
food, I know there are plenty of people here who have had the same food experiences as me (or even more severe,
though I can’t mentally fathom that) but who have managed to turn everything around and are soaring. I just can’t
imagine it happening for me.
Thank you so much if you’ve taken the time to read this and for any helpful, insightful, understanding words or
advice you can give.
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title: >-
Fecal transplants are quietly becoming a last resort for kids with cancer, autism, and failing guts, and the early
results are hard to ignore
subreddit: r/microbiomenews
author: Technical_savoir
score: 3
comments: 1
url: https://www.reddit.com/r/microbiomenews/comments/1tyt48q/fecal_transplants_are_quietly_becoming_a_last/
created_utc: 1780780665
selftext: >-
Link to Study
Restoring Microbial Balance: Clinical Applications, Challenges, and Future Directions of Fecal Microbiota
Transplantation in Pediatric Disorders
https://www.mdpi.com/2076-2607/14/6/1241
The Core Issue
A gut microbiome (the trillions of microbes living in your digestive tract) that gets knocked out of balance can
cause serious problems in children, especially kids already dealing with cancer, organ transplants, or developmental
conditions. Antibiotics, chemotherapy, and disease itself can wipe out the good bacteria, leaving the door open for
dangerous infections and worse outcomes.
The Finding
Fecal microbiota transplantation (FMT), which means transferring healthy donor stool into a sick patient to rebuild
their gut community, is well-established for one specific thing in kids: beating back recurrent C. difficile
infections after antibiotics have failed. A single FMT procedure clears the infection about 81% of the time, and a
second round pushes that closer to 90%. Beyond C. difficile, the research is promising but still early, covering
inflammatory bowel disease, autism spectrum disorder, and drug-resistant bacteria.
Why It Matters
Kids with leukemia, those who just had a stem cell transplant, and children on heavy immunosuppressants are among
the most vulnerable to gut collapse, and they have the fewest safe treatment options. FMT could help reconstitute
their microbiome, potentially reducing transplant rejection complications and improving survival. For children with
autism, one open-label study found meaningful improvements in both gut and behavioral symptoms after a modified FMT
protocol, though that result needs much larger trials before anyone draws firm conclusions.
Limitations of Study
Almost all the pediatric data comes from small, single-center studies or case series, not large randomized trials.
Pediatric oncology patients are routinely excluded from rigorous trials, so the field is stitching together evidence
from adult data and anecdotal reports. Long-term safety, especially in immunocompromised children, is still largely
unknown, and FMT protocols vary wildly across studies, making it hard to compare results.
Conflicting Interests
Current clinical guidelines from NASPGHAN and ESPGHAN recommend against routine FMT in immunocompromised children
outside of established C. difficile indications, citing the limited data and real risk of transmitting infections
through donor material.
Interesting Statistics
• Single FMT clears recurrent C. difficile in about 81% of pediatric cases; a second procedure brings success closer
to 90%
• In adult ulcerative colitis data (which pediatric guidelines currently borrow from), FMT achieves remission in
roughly 37% of patients versus 18% in controls
• Among four pediatric oncology patients with recurrent C. difficile tracked in one series, two resolved after one
FMT and one required six separate procedures
• C. difficile rates are notably higher in children with cancer, IBD, and recent organ transplants
• Reduced microbial diversity during the peri-transplant (around the time of transplant) period in pediatric
leukemia patients is linked to greater risk of graft-versus-host disease and worse survival
• The systematic review pulled from 113 publications covering trials through December 2025
TL;DR
Poop transplants reliably cure recurrent gut infections in kids at a nearly 90% rate, but using them for cancer
patients, autism, and IBD is still early-stage science that needs real randomized trials before it becomes standard
care.
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- id: 1nqwxzn
title: Just talking about my stoma surgery
subreddit: r/ostomy
author: lightonyourface
score: 42
comments: 24
url: https://www.reddit.com/r/ostomy/comments/1nqwxzn/just_talking_about_my_stoma_surgery/
created_utc: 1758879442
selftext: >-
I've been reading posts on here from people who hate their stoma, and I understand how hard it is to adjust to it.
At the same time, I've never had this problem, and I feel lucky.
I had a severe case of ulcerative colitis. I was diagnosed last year around the middle of September, and after going
into remission, everything seemed to be going well. However, I started feeling unwell just a few months later, and I
ended up in the ER with a fever of 39°C (102°F) that had started a week earlier and wouldn't go away, as well as
blood coming out of my rectum. A few days earlier, when I contacted my gastroenterologist, who knew my medical
history, he prescribed me a specific antibiotic that didn't help at all (I suspect he prescribed this one because I
mentioned having reflux and he thought it was a stomach-related problem, but I also had reflux the last time I had
an UC flare and, as I said, I was passing blood, so...). I had trouble eating and drinking because my throat hurt so
much and, by the time I got to the hospital, I was already feeling bad. The doctor who treated me in the ER
suspected toxic megacolon, but no one took him seriously.
After the ER, I stayed in the general surgery department for three days because there were no free beds in the
gastroenterology/inflammatory bowel disease/chronic inflammatory disease department. Finally, I was admitted there.
I didn't eat or drink while I was in the general surgery department and I was so weak, blood was still coming out
and I wasn't sleeping at all.
The doctors tried many different antibiotics. They kept giving me one for Clostridioides difficile even though the
tests came back negative. They also did an infliximab injection (I wasn't doing any biological therapy yet, just
mesalamine). I was getting X-rays and CT scans every day to monitor my progress. My bowels seemed to become less
dilated over the days, but I was still passing blood.
My surgeon showed up at the department and briefly mentioned the possibility of surgery along with my
gastroenterologist, but they didn't explain what the surgery consisted of. They never talked about stomas, and I was
so tired that I didn't think to ask more questions.
The doctors kept saying that I was reacting well to the infliximab injection and that I was going into remission
again. Boy were they wrong.
I was anemic at that point, but my blood tests showed that it was manageable. I got 6? or 7 blood transfusions, but
I kept having hemorrhages. Then, my hemoglobin levels dropped significantly, and I had to undergo emergency surgery.
My surgeon told my parents that my hemoglobin levels were at 2 g/dL when I got into the operating room (I also had
another hemorrhage there; that's my last memory before my surgery). He explained to them that my body was recycling
blood from my other organs to keep me alive. I would have died if my body hadn't reacted the way it did, if I had
gotten to the operating room just 30 minutes later, and if my surgeon hadn't been good at his job.
I woke up in the resuscitation room, completely clueless about what had happened. I still had no idea that I now had
an ileostomy. I was exhausted, and I didn't even notice the bag on my belly. I couldn't even move my arms. I didn't
see it until they transferred me to the surgery/surgical oncology department, and the nurses changed it.
The funny thing is that I didn't think much of my stoma. I was confused, but it didn't gross me out. I just didn't
understand how my small bowel ended up coming out of my abdomen (and how it could just stay out).
Besides, I was completely worn out at this point. My weight had dropped to 40 kg/88 lbs, I was still anemic, and I
hadn't eaten anything in days. I just didn't care about anything else, it was basically a miracle that I was still
alive.
I stayed in the hospital for about two months. I was too weak to walk, and I kept fainting after a few minutes. It
was difficult to sit up in bed or get out of it. I hated my drainage tube, which I ended up keeping for 20 days, and
I just couldn't sleep properly. No one told me that I was supposed to follow a specific diet after my surgery, so I
ate things that could have caused a blockage (it happened once, but no one cared). The stoma nurse made me use
Coloplast convex bags that didn't fit me. They didn't stick to my skin, so I had to change them constantly. After
the first month, I went home for a few days, but I had to go back because I was bleeding from ulcers in my small
bowel near the stoma. The doctors told me that I might have Crohn's disease. I don't have an official diagnosis
because the biopsies of the ulcers weren't significant enough to indicate the disease. However, my doctors still
talk about it as if I have it. I'm going to discuss this with other gastroenterologists and see what I can do.
Anyway, I stayed at the hospital for another month because of this, and then I finally went home.
I had a rough time. I hated being at the hospital and had a bad experience with most of the doctors and nurses.
However, I never hated my stoma; I just hated the things associated with it, such as the pain from my scars, the
drainage tube, the bag changes, and how weak my body felt after everything I had been through. I'm just grateful for
my stoma and my body for not giving up when I was about to die and for enduring all of this.
I've dealt with depression since I was a teenager, and having a chronic illness certainly doesn't help. But this
experience has shown me that my body is stronger than I thought. Despite the thoughts that still cross my mind, I
know I should be proud of myself.
Not even damn prednisone made me hate my stoma. I was just angry because my bag kept peeling off and I couldn't
shower like I used to. But all of this is manageable, and I deal with it better than before (thankfully, I'm no
longer taking glucocorticoids).
I got a bit carried away writing this post, I'm sorry it's so long, but talking about my story is definitely
cathartic.
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- id: 1qxx6f9
title: Relief & Amazing BM’s for 2 weeks following Colonoscopy - why?
subreddit: r/SIBO
author: Old_Sky8705
score: 3
comments: 12
url: https://www.reddit.com/r/SIBO/comments/1qxx6f9/relief_amazing_bms_for_2_weeks_following/
created_utc: 1770419632
selftext: >-
For a background, I have ulcerative colitis that was deemed in remission for the first time back in November. With
that, you must do bowel prep which totally cleanses you out. For about 1-2 weeks after the cleanse, I had AMAZING,
perfect bowel movements. However, with time, my SIBO symptoms came back; sticky stools, messy wiping, gassy, bloat,
etc.
I told my GI, and he suggested I just do bowel cleanses as needed instead of another round of antibiotics since my
SIBO was no responsive last time I had antibiotics + he doesn’t want me to get C. diff.
Has anyone else had relief from their symptoms following a colonoscopy? Should I do the cleanse, and see if I can
keep my motility up so I don’t relapse?
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- id: 1prq1bm
title: Anyone treat successfully without antibiotics?
subreddit: r/ureaplasmasupport
author: Rooted-in-love
score: 2
comments: 18
url: https://www.reddit.com/r/ureaplasmasupport/comments/1prq1bm/anyone_treat_successfully_without_antibiotics/
created_utc: 1766268316
selftext: >-
Hi everyone, new to this group and just looking for answers.
So, I got diagnosed with ureaplasma after a hysterscopy/ lap for uterine fibroids/ endo late September. I think
I've likely had this infection on and off for about two years though. We had a 20 week loss October 2 years ago and
I chose to get a d&c than go through stillbirth. I think this is likely when ureaplasma became an issue for me
though.
I have spent a majority of these last two years in very poor health. Mostly my main focuses have been an ulcerative
colitis flare up and endometriosis. Well I'm incredibly disappointed because we were going to ttc after this last
lap. Instead I got terrible cramping, itching, and burning, and had to pee even more frequently. My OB said this
won't go away without antibiotics but I'm hoping that may only be one treatment option. I'm seeing integrative
health doctor who says with time this can be treated naturally, but so far I'm still having symptoms though they are
maybe a bit better, less burning. I've been taking vaginal probiotics for about a month, and now about a week of
boric acid. I'm supposed to continue that 2 weeks, and then start something else. I'm also supposed to start NAC but
I'm waiting to do that till after a sibo breath test this coming week.
I want to be clear I'm not opposed to modern medicine. I just think there's usually natural ways to heal as well and
I'm personally very scared with good reason for taking antibiotics.
My ulcerative colitis often has flared up from antibiotics. A flare of this is bleeding and mucus and ulcers in the
colon. It can be very serious and I've spent a year and a half until about a month ago in a flare taking biologics
and steroids. I actually just recently got back into remission, but I'm scared more antibiotics could cause a flare
up again. I'm also allergic to doxcycline. If a bit of azithromycin would actually be enough to clear this up, I'd
probably take it but from what I've found this isn't hardly ever enough?? I have had pretty good tolerance to this
specific antibiotic, but most ice tried have either caused uc flare or 4 of them I've been allergic to
(clindamyacin, keflex, doxycycycline, amoxicillian).
I'm desperate here for getting this cured. We really want to have a baby, and I know this is important to cure
first.
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- id: 1jwosw7
title: Getting AS from biologics?
subreddit: r/ankylosingspondylitis
author: Itstime0000
score: 0
comments: 41
url: https://www.reddit.com/r/ankylosingspondylitis/comments/1jwosw7/getting_as_from_biologics/
created_utc: 1744375005
selftext: >
Hi,
I have looked in multiple sub reddit, and google all i could, but couldn't find something relevant to my questions.
It would be great to have opinions, or personal experiences, as I find it difficult to find answers, and want to
check if anyone can relate.
I have Ulcerative colitis, started in 2020, and after a few months of pain and doctor / ER visits, i got diagnoses
with it, and started on an 8 weeks Prednisone course and Asacol (Mesalamine). over the next 4 years i did a few
prednisone courses, with a few months without in between courses, the prednisone would work in taking down the
flare, but a month or so after ending the course, the UC would slowly flare again, and i would be back on an 8 week
prednisone course 3 or 4 months after the last round. Asacol did nothing. Last year, i switched gastroenterologist,
and he decided to put me on biologics, since the multiple Prednisone courses were taking a toll on my health and not
sustainable long term, and Asacol clearly didn't work for me.
I started on Infliximad (Remicade biosimilar) in June 2024, and a week later, my SI joint was painful. I had been
off any meds for a few month with no symptoms of AS until then. I didn't worry, thought it was just back pain). then
a month later i got prostatitis. Went to a urologist who believe it was bacterial as at my age (39), it's rare. did
a month of antibiotics for nothing. Pretty severe morning stiffness also became the norm.
I kept on being on infliximad, every 8 weeks (after initial load) then 6 weeks as it was not working long enough. SI
pain never went away, and increased, prostatitis became chronic, coming and going. then i had terrible morning
stiffness. I started to understand something else was going on. Had a couple of doc appointments, they believed it
was nothing unusual somehow... I also mentioned it to my gastroenterologist overseeing my treatment, didn't do much
regarding checking on that.
After doing all the research myself i found AS, and realized that it is most likely it. I managed to get an
appointment with the local specialist in AS, and an MRI. he confirmed it is definitely AS.
I had none of those symptoms before starting biologics. Then i stopped Infliximab late November, as my liver
couldn't take it, and enzymes kept climbing. I stayed unmedicated until January, and then started a short steroid
(Prednisone, 6 weeks) course to help the liver inflammation go down. All symptoms of AS disappeared. But I can't
confirm if it is because of the prednisone or stopping Infliximab. Then at the end of the steroid course, i started
on a Humira Biosimilar (Yuflima), For both UC and AS, as it should potentially work on both.
My UC seems in complete remission, but a couple of days after starting, AS came back full force, SI inflammation,
prostatitis, stiffness...
My dermatologist (that i saw for a check up due to Remicade risk of increased skin cancer) randomly asked me if AS
started after starting on biologics, which i confirmed, and she mentioned she has seen patients get another auto
immune disease (not AS) after starting biologics, and i should talk to my main doctor about it. Affirming some of
what i was already thinking, that AS might have come as a result of starting that medicine?
Which takes me to my main questions. Have any of you experienced something similar, whether AS or not, having a new
auto immune condition appear as a result of starting biologics? If so, did you stop, and did it go away? I will
consult with my main doctor overseeing the treatment, but I would love to hear opinions.
Sorry for not managing to make this short, i feel details and timeline might be important. Thank you for reading!
Edited: added clarity to med courses.
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- id: 1rv854g
title: The top new and updated threads in the last week on the Human Microbiome Forum
subreddit: r/HumanMicrobiome
author: AutoModerator
score: 1
comments: 1
url: https://www.reddit.com/r/HumanMicrobiome/comments/1rv854g/the_top_new_and_updated_threads_in_the_last_week/
created_utc: 1773664347
selftext: "# New Threads\n\n* [A virus hiding inside bacteria may help explain colorectal cancer (Feb 2026, n=877) Distinct prophage infections in colorectal cancer-associated Bacteroides fragilis](https://forum.humanmicrobiome.info/threads/a-virus-hiding-inside-bacteria-may-help-explain-colorectal-cancer-feb.1322/)\_\n* [Why some gut microbes persist after fecal transplants (Feb 2026) Temporal dynamics of gut biosynthetic gene clusters link persistent colonization and engraftment in fecal microbiota transplantation](https://forum.humanmicrobiome.info/threads/why-some-gut-microbes-persist-after-fecal-transplants-feb-2026-tempora.1323/)\_\n* [Specific gut bacteria species linked to muscle strength (Mar 2026) Roseburia inulinivorans increases muscle strength](https://forum.humanmicrobiome.info/threads/specific-gut-bacteria-species-linked-to-muscle-strength-mar-2026-roseb.1324/)\_\n* [A single course of antibiotics can leave a lasting mark on the gut microbiome (Mar 2026) Antibiotic use and gut microbiome composition links from individual-level prescription data of 14,979 individuals](https://forum.humanmicrobiome.info/threads/a-single-course-of-antibiotics-can-leave-a-lasting-mark-on-the-gut-mic.1325/)\_\n* [Memory loss is fuelled by gut microbes in ageing mice (Mar 2026) Intestinal interoceptive dysfunction drives age-associated cognitive decline](https://forum.humanmicrobiome.info/threads/memory-loss-is-fuelled-by-gut-microbes-in-ageing-mice-mar-2026-intesti.1326/)\_\n* [Rod Clair does successful FMT from his wife for diverticular disease, IBS, severe gastritis, chronic fatigue, and more (Dec 2021, fecal microbiota transplant)](https://forum.humanmicrobiome.info/threads/rod-clair-does-successful-fmt-from-his-wife-for-diverticular-disease-i.1327/)\_\n* [Scientists Tried to Age Young Ovaries with Old Microbes but Accidentally Made Them More Fertile (Mar 2026) Estropausal gut microbiota transplant improves measures of ovarian function in adult mice](https://forum.humanmicrobiome.info/threads/scientists-tried-to-age-young-ovaries-with-old-microbes-but-accidental.1328/)\_\n* [10-year-old Emma puts severe Ulcerative Colitis in remission with DIY FMT from her mom (2013)](https://forum.humanmicrobiome.info/threads/10-year-old-emma-puts-severe-ulcerative-colitis-in-remission-with-diy.1329/)\_\n* [Gut microbiota modulation via repeated donor fecal transplantation improves motor and gastrointestinal symptoms in drug-naïve Parkinson’s disease: a randomized phase 2 trial (Mar 2026, n=72)](https://forum.humanmicrobiome.info/threads/gut-microbiota-modulation-via-repeated-donor-fecal-transplantation-imp.1330/)\_\n\n[View all new content](https://forum.humanmicrobiome.info/whats-new/)\n\n\_\n\n# Updated Threads\n\n* [Getting lab test results for donors at FMT clinics](https://forum.humanmicrobiome.info/threads/getting-lab-test-results-for-donors-at-fmt-clinics.1319/)"
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- id: 1rr84h8
title: Melissa’s relentless battle with ulcerative colitis
subreddit: r/colitisunfiltered
author: colitis-unfiltered
score: 1
comments: 0
url: https://www.reddit.com/r/colitisunfiltered/comments/1rr84h8/melissas_relentless_battle_with_ulcerative_colitis/
created_utc: 1773266873
selftext: >-
When Melissa first began experiencing intense diarrhea, she had no idea she was about to be pulled into a battle
that would test her body, mind, and her trust in the healthcare system.
Diagnosed with ulcerative colitis at age 46, her story is one of persistence, multiple hospitalizations, and a
stubborn refusal to let go of her large intestine. “I wasn’t ready to lose my colon,” she says. “I had to believe
there was another way.”
Melissa’s symptoms escalated fast. “The diarrhea that I was having was not like I had a bug or like a stomach flu,”
she says. “There was urgency. Then rectal bleeding. I was really wiped out, exhausted. I was literally brought out
in an ambulance.”
She was hospitalized for nearly two weeks and treated with IV antibiotics “like I had a parasite or something.” On
the last day of her first hospitalization, doctors finally performed a colonoscopy and delivered the diagnosis:
ulcerative colitis. But what should have been a moment of clarity was just another haze of confusion.
“The doctor was like, ‘You have ulcerative colitis. Come back in a couple of months, let the dust settle.’ And it
really wasn’t overly informative or overly tactful,” says Melissa. “So I was kind of left on my own to sort of
digest it and take it all in.”
But the dust didn’t settle. Melissa’s condition worsened. Her weight dropped dangerously. Her hemoglobin and
hematocrit levels were critically low. She needed blood transfusions. She was hospitalized again.
“I needed another opinion,” she said. And she got one, along with failed treatments. She was put on biologics, but
her body played hardball. Remicade didn’t work. Neither did Entyvio. Not long after, doctors hovered at her bedside,
urging her to have her colon removed. “They were all at my bedside ready to remove my colon and I wasn’t having it,”
she says.
Melissa figured that if there was another way out of her predicament, she was going to fight for it. That was a
non-negotiable for her. And she did.
Melissa knew she hadn’t yet found the right gastroenterologist, or the right treatment, for that matter. That came
with her third opinion. “She was really not afraid to push the envelope,” Melissa says. “She did combination drug
therapy to try to knock me into remission. That was really what set me straight.”
Melissa quickly started a regimen of Entyvio every four weeks in combination with Xeljanz. “It was that combination
of those two medications that really knocked me into remission,” she says.
During this rollercoaster, Melissa realized there can be a stark difference between general gastroenterologists and
IBD specialists. “The guy I saw first, he could have been a specialist in reflux disease. But does he really live
and breathe ulcerative colitis and Crohn’s disease on a daily basis? No. It really took finding someone that’s super
specialized in inflammatory bowel disease to treat someone the best way possible.”
Like many IBD patients, Melissa found the beginning of her IBD journey incredibly isolating. “I didn’t want to talk
shit with everybody,” she says. “So that caused a little bit of separation. People ask how you are, and you’re
thinking, ‘I went to the bathroom 10 times or I’m bleeding.’ Those are not things you necessarily want to talk
about.”
Her flares left her stuck on the toilet. “I wanted to be home,” she says. “I wanted to be near the bathroom. I
certainly didn’t feel social.” Her advice for family and friends? “Don’t ask too many questions. Let them know that
you’re there. Ask them to let you know if there’s anything they need. Provide space. If you’re getting the feeling
that they want to be alone, that’s okay.”
Over time, Melissa began to find healing not just physically, but mentally and emotionally. “I also had a lot of
stress in my life,” she says “I did meditation, yoga, then I got into diet changes.That’s when things started to
turn around.”
Melissa now describes herself as “ultra conscious” about her wellness, “My sleep, my stress, my diet… all of those
things, I am ultra conscious on a daily basis.”
Now in remission, Melissa is paying it forward. Drawing from her experience as a nurse, and her time working in
insurance, she offers 1:1 coaching and support through her Substack channel My Ulcerative Colitis Victory. “Between
my lived experience, personal and professional, I can give back. I’m looking forward to doing that,” she says.
She believes in the power of community and awareness, “I see people on TikTok, young girls in bikinis that have
colostomies. There’s a lot more openness now. There’s a movement out there that’s going in the right direction.”
If she could speak to the version of herself from the day of her diagnosis, “I would say breathe. Everything’s gonna
be okay. You’ll get through this.”
And Melissa got through it. Her story is a reminder that remission is possible, even after a long, chaotic, and
painful fight. It’s a story of standing your ground when everyone around you says to surrender.
More at www.colitisunfiltered.com
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis nicotine remission quit smoking flare
- id: 1o8l3m2
title: Three Day Smoking Update - PLEASE DO NOT START SMOKING!
subreddit: r/UlcerativeColitis
author: kryptikguy
score: 82
comments: 76
url: https://www.reddit.com/r/UlcerativeColitis/comments/1o8l3m2/three_day_smoking_update_please_do_not_start/
created_utc: 1760655743
selftext: >
[ORIGINAL POST, FOR CONTEXT](https://www.reddit.com/r/UlcerativeColitis/s/HocL15cxBC)
[RECENT POST, SOMEWHAT CONTROVERSIAL COMMENTS](https://www.reddit.com/r/UlcerativeColitis/s/c7bzh5tzJw)
To start off, for all those that said I didn’t know what I was talking about and that cigarettes could not help UC,
I’m still 100% symptom free. I had a few folks mention they would be willing to smoke cigarettes if they could also
get relief. I can’t emphasize this strongly enough… **DON’T START SMOKING**. Here is why I say that.
As I’ve mentioned in prior posts, I started smoking 15 years ago to control UC. I saw near immediate results, and
achieved deep remission for the entire 15 years following that I smoked. I didn’t care why, I just enjoyed living
my life. **THIS WILL NOT BE THE CASE FOR EVERYONE**. I stopped smoking in May of this year, and within six weeks I
was in another flare. It continued to get worse, and this past week I decided to smoke a single cigarette before
bed one night. The horrible eczema that had developed, as well as all UC symptoms, literally disappeared
overnight. I woke up the next morning completely rash free, and had a normal BM. No blood, no mucous, just a nice
clean poop. Even the toilet paper was clean. Miracle, right? Not exactly. This time, I wanted to know why. So
I’ve spent the last two days doing deep research.
It turns out not all Ulcerative Colitis is created equal. There are different subtypes. This is quite possibly why
some medicines work for some people, and not for others. Some medicines might make symptoms worse for people. It
could also explain why medicines work for varying lengths of time, and then stop, as the immune response to certain
triggers shifts. My research so far, based on searching for info on what I have experienced prior as well as what
I’m experiencing now, point to my Ulcerative Colitis being a specific subtype. One that is an unusually
neuroimmune-sensitive subtype. That means it is inflammation governed by nervous system balance as much as by the
gut's local immune response. What does that mean? At face value, my Ulcerative Colitis is highly reversible. It’s
obviously also a subtype that is nicotine responsive. Since I’ve found the trigger, nicotine, it can be easier to
manage. Add it, and my symptoms disappear overnight. Remove it, and they come back. This also means that my
inflammation is immune-modulated, rather than due to irreversible tissue damage like what others may be
experiencing. It is biologically easier for me to control than other subtypes. That is why I say, **PLEASE DO NOT
START SMOKING**. It would not be ethical of me to leave people thinking that cigarettes are the magic bullet for
this disease. It helps me, but I am apparently one of the lucky ones with this unlucky disease.
The onset of severe eczema with this flare, and the overnight disappearance is what led me to start digging deeper
into the “why” this time around. It turns out that the UC symptoms and the eczema flare are possibly linked by Th2
type immune activation. Nicotine suppresses Th2 cytokines. That explains why my UC flare and eczema flare both
presented at roughly the same time, and both disappeared overnight after just one cigarette. That points to me
being highly sensitive to the nicotine, which allows it to cause a very fast shift in my immune tone. This also
indicates that the inflammation could be partly driven by overactive immune signaling rather than actual structural
damage. That, along with the deep remission I enjoyed for 15 years, means it is apparently reversible without the
need for biologics. (It could also mean I need to talk to a specialist about a possible immune dysregulation
pattern.)
I’m still digging, but I’m finding all of this extremely informative. I’m grateful that my UC appears so easy to
manage. Once I’ve got this flare completely in my rearview, it should theoretically be possible for me to
transition to patches and/or gum, and step down the dosage until I find the proper balance. Adding holistic methods
like the heavy prebiotic/probiotic diet I’ve been on, along with the supplements I’ve been taking, also looks like
it helps with this subtype of UC. That explains why I was seeing positive results when I started incorporating the
dietary changes. I know a lot of folks are struggling with this disease. Hospital visits, medicine hopping, mental
toll, etc. Please do not add cigarettes to your arsenal. They are not necessarily going to help, and accordingly
to my research they can actually worsen other subtypes of UC.
This will likely be my last post here. I have enjoyed interacting with everyone, even those that threw hate my way
for my previous posts. I know how debilitating this disease can be, and my hope is that everyone can ultimately
find whatever they need to help them enjoy their best life possible as they navigate these murky waters. Be well, my
friends.
**EDIT: SINCE FOLKS ARE MESSAGING ME ASKING FOR LINKS TO INFO**
https://www.sciencedirect.com/science/article/pii/S1568997221002998
That’s an excellent article to get you guys down the rabbit hole for UC pathology and the role the immune response
plays in disease onset, development, and progression. It discusses in detail a few of the concepts I approached in
my wall of text. There are dozens of sources cited, and it even explains why all these biologics seem to have
roughly the same success/failure rates. And to all the folks that said I was a fool for not trusting my doctor and
jumping on the biologic train, and to those that said I should “trust the science”… here’s your damn science.
Definitely a good read. Enjoy!
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- id: 1q6xh8n
title: Smoking
subreddit: r/CrohnsDisease
author: Potential-Rent5629
score: 6
comments: 17
url: https://www.reddit.com/r/CrohnsDisease/comments/1q6xh8n/smoking/
created_utc: 1767833786
selftext: >-
I was diagnosed with Ulcerative Colitis in August 2024, and since then, I haven't achieved full remission. In March
2025, I started Remsima, and during the summer, I switched to Stelara.
While things were going relatively well, in December I experienced very severe pain and vomiting. The pain was
different from what I felt during a typical flare-up. After spending about a month in the hospital and undergoing
countless tests, my doctor told me that I even tho I already have colitis I also might have Crohn’s disease. It will
become certain whether it’s Crohn’s or not over the next few years.
Is anyone in the same situation? It feels like shit that i don't have a clear diagnosis and i probably won't for the
next years.
In terms of diet and meds my doctor told me having one or the other its not much of a difference.
My main issue is that i smoke. Not a lot but for the last 2-3 years, I have been smoking every day. and I find it
very difficult to quit. I know that smoking doesn't negatively affect UC, but for Crohn’s, they say you absolutely
must quit.
Do you think its possible smoking made it worse from the start?
I also read here that while nicotine is harmful, weed doesn't seem to affect some people negatively.
Tell me your thoughts:)
post_hint: ''
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- id: 11m1iyy
title: >-
TIL Dr. Sigmund Freud was addicted to smoking and failed to quit for good throughout a 45 years long battle that
included 33 operations for cancer of the jaw, an artificial jaw replacement, and attacks of "tobacco angina"
exacerbated by nicotine . He was known to smoke up to twenty cigars a day.
subreddit: r/todayilearned
author: Story_Man_75
score: 9624
comments: 453
url: https://www.reddit.com/r/todayilearned/comments/11m1iyy/til_dr_sigmund_freud_was_addicted_to_smoking_and/
created_utc: 1678294598
selftext: ''
post_hint: ''
url_overridden_by_dest: https://www.druglibrary.org/schaffer/library/studies/cu/cu24.html
preview_image_url: ''
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- id: 1ta2hdk
title: >-
Noninvasive magnetic stimulation of a specific brain region that regulates self-control significantly reduced how
much people smoked, reduced nicotine cravings and may help people quit, finds new double-blind, sham-controlled
randomized clinical trial.
subreddit: r/science
author: mvea
score: 2078
comments: 79
url: https://www.reddit.com/r/science/comments/1ta2hdk/noninvasive_magnetic_stimulation_of_a_specific/
created_utc: 1778504134
selftext: ''
post_hint: link
url_overridden_by_dest: https://hollingscancercenter.musc.edu/content-hub/News/2026/05/08/rewiring-the-urge-to-smoke
preview_image_url: >-
https://external-preview.redd.it/DqtBcwysQA6LK3gkFF55LcKLbmqqufiH416glYluiOs.jpeg?auto=webp&s=dd469abd1b028f38ce8eb9f50120d17254666ccd
gallery_urls: []
- id: blp2xm
title: >-
First day of nicotine patch. Smoked for four 4 years, and finally decided to quit. How did you guys handle your
first few weeks?
subreddit: r/AskMen
author: SoysauceWithRice
score: 5887
comments: 1140
url: https://www.reddit.com/r/AskMen/comments/blp2xm/first_day_of_nicotine_patch_smoked_for_four_4/
created_utc: 1557225153
selftext: >-
Necessary edit: like holy shit guys. I'm blown away from how big this post has gotten overnight! I'm truly grateful
for all you for the helpful advice and stories! I've yet to read all of them, but I will do my absolute best to
respond to everyone! I love you all!
Edit: because I cant spell, and thanks for the silver whoever you are!
Edit: I've gone from a pack a day to barely half a pack day now and it's only been one day. My urges arent as bad,
it's more of the oral fixation that people have mentioned. But I've gone from destroying myself with cigarettes to
destroying my body with weights. I picked up lifting a couple weeks ago, but its intensified since a couple days
ago, when I decided I needed to get help to actually getting help. Gym has been a great rehab for me so far!
I've been going straight to bed after dinner to fight the daily routine, and wake up an hour later or two to lift
for a bit, and its helped tremendously. Minty gum is becoming my best friend, and my coworker, the only other one
that smokes started his day one today! So that's a plus!
Thanks everybody for your emotional support and I'd be more than glad to share my journey with yall if youd like!
post_hint: ''
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- id: 8ks7lc
title: >-
TIL - The guy who wrote the dialogue for Portal was diagnosed with Ulcerative Colitis while working on it. He tried
to quit Valve, and Gabe Newell gave him extended leave and told him that his only job was to get better.
subreddit: r/todayilearned
author: killedbyhetfield
score: 15656
comments: 439
url: https://www.reddit.com/r/todayilearned/comments/8ks7lc/til_the_guy_who_wrote_the_dialogue_for_portal_was/
created_utc: 1526818022
selftext: ''
post_hint: link
url_overridden_by_dest: https://en.wikipedia.org/wiki/Erik_Wolpaw
preview_image_url: >-
https://external-preview.redd.it/XuXOTucU9MxxPXxsJMt_h0PTWWSRMmNWuWBEwaqtenY.jpg?auto=webp&s=7617b47ec0fb4cc1c8401a6b14eac126d4610454
gallery_urls: []
- id: 1sxzz3o
title: >-
A single dose of psilocybin outperforms nicotine patches for quitting smoking. The results suggest that psychedelic
treatments might offer a highly effective new approach for people struggling to overcome tobacco addiction.
subreddit: r/psychology
author: mvea
score: 1395
comments: 63
url: https://www.reddit.com/r/psychology/comments/1sxzz3o/a_single_dose_of_psilocybin_outperforms_nicotine/
created_utc: 1777379326
selftext: ''
post_hint: link
url_overridden_by_dest: https://www.psypost.org/a-single-dose-of-psilocybin-outperforms-nicotine-patches-for-quitting-smoking/
preview_image_url: >-
https://external-preview.redd.it/WKfvzKfuAi6Pwt-IWslBqF2LVkc5TeoZNVpEv85HzRY.jpeg?auto=webp&s=f609b3e59b878a0fa6ed1a6d602b60cc20e25990
gallery_urls: []
- id: q9pa6z
title: >-
When I quit smoking I used my nicotine money on water as a motivator to keep being healthy. Two years later I have
my own dedicated hydro fridge
subreddit: r/HydroHomies
author: theredcore
score: 8908
comments: 177
url: https://www.reddit.com/r/HydroHomies/comments/q9pa6z/when_i_quit_smoking_i_used_my_nicotine_money_on/
created_utc: 1634435155
selftext: ''
post_hint: image
url_overridden_by_dest: https://i.redd.it/rd8u1xg91xt71.jpg
preview_image_url: https://preview.redd.it/rd8u1xg91xt71.jpg?auto=webp&s=bfadede593a378bb2f4b115f01e79ec7d6c2d2fb
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- id: r0t73x
title: Out of Remission
subreddit: r/UlcerativeColitis
author: Grouchy-Western-5757
score: 3
comments: 2
url: https://www.reddit.com/r/UlcerativeColitis/comments/r0t73x/out_of_remission/
created_utc: 1637718414
selftext: >-
So im pretty much new to UC still, diagnosed in July of this year but after a while I was finally sorta put into
remission with Inflectra, no more blood, 3 stools a day no predisone and no urgency so id say it was better and a
win. Now all of a sudden I caught an upper respiratory infection I believe it was and I started bleeding again.
Guess that caused my immune system to start working harder.
During this time I decided to drink white wine, it seemed to settled with me well but I'm also trying to quit vaping
as well which has seemed to be a HUGE trigger no matter what I do. I can quit mentally but my colon will literally
not let me. I've tried to take it slow but every time i do the blood just comes back. I've dimmed it down from 50mg
to 35mg to 30mg but Im gonna try to keep it at 30mg and see during my next infusion if it gets better.
Does anybody else have an issue with flaring when trying to quit smoking/vaping? It's really annoying seeing as I
finally feel like I have to mental strength to finally quit but my colon won't allow it. Pretty sure this is what
caused the Ulcerative Colitis in the first place. (My First Flare)
post_hint: ''
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- id: 1srne12
title: lifelong ban on buying cigarettes
subreddit: r/whennews
author: krizzalicious49
score: 14459
comments: 1429
url: https://www.reddit.com/r/whennews/comments/1srne12/lifelong_ban_on_buying_cigarettes/
created_utc: 1776777409
selftext: "[https://www.bbc.co.uk/news/articles/cn08jy6w0l5o](https://www.bbc.co.uk/news/articles/cn08jy6w0l5o)\n\n**Children aged 17 or younger will face a lifelong ban on buying cigarettes, as the Tobacco and Vapes Bill clears Parliament.**\n\nBoth the Commons and Lords have settled on a final draft of the \"landmark\"\_[legislation,\_external](https://bills.parliament.uk/bills/3879/publications)\_that aims to stop anyone born after 1 January 2009 from taking up smoking to create a smoke-free generation.\n\nWhen it gets royal assent, ministers will also have new powers to regulate tobacco, vaping and nicotine products, including their flavours and packaging.\n\nIt is part of a series of measures aimed at tackling the health effects of smoking, one of the UK's leading causes of preventable death, disability and ill health.\n\nVaping will be banned in cars carrying children, in playgrounds and outside schools and at hospitals, expanding smoke-free laws.\n\nVaping would still be allowed outside hospitals in a bid to support those trying to quit.\n\nOutdoor hospitality venues like pub gardens and wider open spaces such as beaches and private outdoor spaces are not included in the plans.\n\nPeople will also be able to continue smoking and vaping in their homes.\n\nHealth minister Baroness Merron told the Lords on Monday: \"This afternoon marks the end of this Bill's journey throughout Parliament.\n\n\"It is a landmark Bill, it will create a smoke-free generation.\n\n\"It is, in fact, the biggest public health intervention in a generation and I can assure all noble Lords it will save lives.\"\n\nLord Naseby, a Conservative former MP, said the Tobacco and Vapes Bill \"does upset a great many people in that industry\", including retailers.\n\nHe added: \"What we really need is a proper understanding of how we educate people not to take up smoking.\"\n\nResponding to Lord Naseby, Lady Merron said: \"I can overall assure Lord Naseby, as I've done on a number of occasions, about how closely we have worked with retailers, and we will continue to do so.\"\n\nSarah Sleet from Asthma + Lung UK said the legislation promised to transform the nation's health.\n\n\"Now that this groundbreaking bill is finally over the line, we have a chance to go further to protect public health and hold the tobacco industry to account.\"\n\nShe urged the Government needs to make sure existing smokers aren't left behind by providing widespread smoking cessation support.\n\n\"Right now we have a postcode lottery, which is why the tobacco industry should pay through a levy to reduce the harm they cause by funding these crucial services across the UK,\" she said."
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- id: 1s1u8ha
title: I didn’t even know I had high blood pressure.
subreddit: r/Wellthatsucks
author: Least-Notice7832
score: 17588
comments: 2112
url: https://www.reddit.com/r/Wellthatsucks/comments/1s1u8ha/i_didnt_even_know_i_had_high_blood_pressure/
created_utc: 1774301346
selftext: >-
I (35m) don’t have insurance so I don’t go to the doctor or the hospital unless I need to be there. I was feeling a
little off so I ended up checking my blood pressure and it was like 180/108. Next day I felt a tad bit worse so I
went to the emergency room knowing it was a little high and they told me I should’ve gone to treat it years ago. The
thing is I’ve always felt fine I hardly ever feel sick and the high blood pressure never made me feel bad until just
recently. Now I gotta check it everyday and take a pill unfortunately. Don’t know for how long maybe for the rest of
my life.
Edit: This was a month ago, I’m good now thankfully, taking the proper medication 🙏🙏
Edit Edit: Sorry I didn’t expect this to blow up like I almost did lol I’m 6 ft 225lbs, married, I have a 15yr old,
7yr old and a 2 yr old. I don’t think it’s a genetic thing, my parents don’t have high BP my 62yr old dad took his
like a month ago along with me and his was literally 120/80. Anyways, I wasn’t being very active at all, I never
really had any headaches, no symptoms, only thing I felt the day I went in was some anxiety, slight pressure on my
chest, shortness of breath and a tingling sensation on my fingertips. I drank a lot of monster in my teenage years.
Smoked a lot before about a pack a day then half a pack and I was down to about 2 smokes a day while on the pouches.
I maybe had 2-4 beers every other day at most during the week but I did binge drink on the weekend. When I went to
the hospital they were pretty surprised that I didn’t roll in in a wheelchair, they took blood and nothing was out
of the ordinary, gave me a pill and took me to a room until my BP was back down then they let me go. Since then I’ve
cut back on beer, completely quit using nicotine pouches, only smoke cigs socially and I’m going on long speed walks
at the park while pushing my toddler on his stroller. I do drink a ton of water everyday I always have (probably
because I live in a desert), not sure if it matters. I’m now averaging 140s/70 & 58 avg BPM while on medication
after a month, they had me on metoprolol 25mg but I got tinnitus while on that so they just switched me to
lisinopril 20mg and I’m checking my BP on the daily. I will keep a lookout for the dry cough, Feel much better now
thank you to everyone with the kind words glad I’m still here for my family ❤️
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- id: 1qzjb2q
title: A question for those of you who have quit smoking and nicotine, please -
subreddit: r/GenX
author: RikkiLostMyNumber
score: 112
comments: 368
url: https://www.reddit.com/r/GenX/comments/1qzjb2q/a_question_for_those_of_you_who_have_quit_smoking/
created_utc: 1770581259
selftext: >-
Hi All, I am 55M and have been using nicotine (usually smoking cigarettes) for about 40 years now. I have been
cigarette free for longish periods here and there, in fact have not had one in over three years now, but still use
various forms of nicotine delivery every day.
I should also mention that I have used and enjoyed nicotine so long I have no memory whatsoever of not using it (my
mom smoked while pregnant with me, so that may be a factor), and I enjoy the effects immensely.
I am now down to 6, 2mg lozenges per day, and I fear that I am so hopelessly addicted to nicotine that I can never
successfully give it up and should just resign myself to having to buy these things forever. I would love to hear
your thoughts on this as I am about to buy several months of nicotine lozenges running in the $400-ish range. TIA!
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- id: 1b5lltw
title: >-
Nicotine e-cigarettes are more effective in helping people quit smoking than conventional nicotine-replacement
therapy (NRT), according to the latest review of 88 studies (from US, UK, Italy) and more than 27,235 participants
subreddit: r/science
author: giuliomagnifico
score: 1490
comments: 161
url: https://www.reddit.com/r/science/comments/1b5lltw/nicotine_ecigarettes_are_more_effective_in/
created_utc: 1709484372
selftext: ''
post_hint: link
url_overridden_by_dest: https://www.umass.edu/news/article/e-cigarettes-help-more-tobacco-smokers-quit-traditional-nicotine-replacement
preview_image_url: >-
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gallery_urls: []
- id: hv0vsk
title: >-
Dopamine Returns to Normal 3 Months After Quitting Smoking [lack of dopamine potentially explains some of the anger,
irritability and depression related to quitting nicotine that goes beyond the three-day withdrawal period]
subreddit: r/quittingsmoking
author: levelbest247
score: 1467
comments: 420
url: https://www.reddit.com/r/quittingsmoking/comments/hv0vsk/dopamine_returns_to_normal_3_months_after/
created_utc: 1595305830
selftext: ''
post_hint: link
url_overridden_by_dest: >-
https://psychcentral.com/news/2016/07/31/dopamine-function-returns-to-normal-3-months-after-quitting-smoking/107912.html
preview_image_url: >-
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gallery_urls: []
- id: wjuve
title: >-
Quit smoking with a shot: Injecting gene encoding an anti-nicotine antibody into mice blocks the addictive chemical
from entering the brain.
subreddit: r/science
author: Jerkbeef
score: 1945
comments: 660
url: https://www.reddit.com/r/science/comments/wjuve/quit_smoking_with_a_shot_injecting_gene_encoding/
created_utc: 1342279405
selftext: ''
post_hint: link
url_overridden_by_dest: http://stm.sciencemag.org/content/4/140/140ra87
preview_image_url: >-
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis phosphatidylcholine lecithin remission
- id: ubiu7i
title: Experiences with (delayed release) phosphatidylcholine for treating Ulcerative Colitis?
subreddit: r/UlcerativeColitis
author: Lightninghead
score: 2
comments: 6
url: https://www.reddit.com/r/UlcerativeColitis/comments/ubiu7i/experiences_with_delayed_release/
created_utc: 1650885781
selftext: >-
Has anyone tried this? or delayed release Lecithin put another way. there's a study that looks really promising:
[https://pubmed.ncbi.nlm.nih.gov/15951544/](https://pubmed.ncbi.nlm.nih.gov/15951544/)
[https://gut.bmj.com/content/54/7/966](https://gut.bmj.com/content/54/7/966)
people with UC tend to have way less phospholipid saturation in ileal / colon mucus which usually acts as a
protective barrier [https://pubmed.ncbi.nlm.nih.gov/19504612/](https://pubmed.ncbi.nlm.nih.gov/19504612/)
delayed release helps phosphatidylcholine reach the colon. which is a major component of colon mucus. it looks like
it works by restoring the protective effect of mucus which is lacking in a lot of people with UC, allowing proper
healing to take place.
6g of the formulation a day (contained 30% phosphatidylcholine, 21% phosphatidylethanolamine, and 8%
phosphatidylinositol) showed improvement in 90% of people, clinical remission in 53% of people taking it vs 10% in
placebo group. worked by 2-4 weeks into 3 months. dose split into 1.5g 4x daily after meals. Eudragit s-100 was
the thing that let it reach the small intestine which then impacted the colon
there was another study which showed a nice benefit over placebo different formulation & solely phosphatidylcholine
[https://pubmed.ncbi.nlm.nih.gov/24796768/](https://pubmed.ncbi.nlm.nih.gov/24796768/)
finally a phase 3 follow up study which oddly didnt induce remission, conflicting with the first 2 studies. BUT in
the analysis below this looks to have been caused by taking mesalazine alongside it (which interferes with the
phosphatidylcholine uptake by mucus). Plus they used different delivery mechanism so mostly got dissolved in the
duodenum instead of the colon
"It turned out that mesalazine acts as a detergent and prohibits PC access to the surface of the mucus. Since
mesalazine is poorly absorbable, it stays in the lumen and generates with the delayed released PC a foam (micellar
solution) with high intermolecular affinity, prohibiting to fill empty PC-binding sites on mucin 2 "
[https://www.karger.com/Article/FullText/514355](https://www.karger.com/Article/FullText/514355) analysis of 4
trials shows promise in it 3/4 positive results
\-
Looking around I can't find any delayed release lecithin / phosphatidylcholine available to buy. (interesingly i saw
a product combining lecithin + pectin for horses who have gastric ulcers).
going [by this](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996791/) taking it orally normally makes its way
mostly to the jejunum (upper small intestine).
so I wonder if there's a way to get it lower to the right place with standard stomach acid resistant capsules or
something?
The [2nd
trial](https://www.researchgate.net/publication/262073736_First_Multicenter_Study_of_Modified_Release_Phosphatidylcholine_LT-02_in_Ulcerative_Colitis_A_Randomized_Placebo-Controlled_Trial_in_Mesalazine-Refractory_Courses)
showed good results still just being gastric acid resistant, when not paired with mesalazine, even though it's not
the optimal way of going right to the lower part of small intestine which gives the full effect. the forumulation
dissolves at 5.5ph unlike the first study which was at 7ph. so this one probably started disolving in the duodenum
before the lower parts of the small intestine, and showed results.
3.2g of phosphatidylcholine delivered like this over 4 doses daily, \~30% remission rate vs 15% in placebo, with
82.9% of ppl seeing some improvement. this goes to 53% remission with 90% improvement rate if you can find a way to
get it to the lower distal ileum intestine, at half the dose.
post_hint: self
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gallery_urls: []
- id: 1ufstno
title: What do you wish more people understood about living with ulcerative colitis?
subreddit: r/UlcerativeColitis
author: Acceptable-Bar-4559
score: 54
comments: 64
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ufstno/what_do_you_wish_more_people_understood_about/
created_utc: 1782437462
selftext: >-
I've been reading through posts here and one thing that stands out is how different each person's experience with UC
can be. From flares and remission to finding the right treatment, it seems like there's no single path that works
for everyone.
For those who have been living with UC for a while:
* What's something you wish family, friends, or even healthcare providers understood better?
* What has made managing appointments or long-term treatment easier?
* If you could give one piece of advice to someone who's newly diagnosed, what would it be?
I'm interested in learning from real experiences and appreciate anyone who's willing to share.
Thanks in advance!
post_hint: ''
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- id: 1m3pp8n
title: Remission is Possible - What I Learned After 20 Years with Ulcerative Colitis
subreddit: r/UlcerativeColitis
author: LaCremerie
score: 264
comments: 102
url: https://www.reddit.com/r/UlcerativeColitis/comments/1m3pp8n/remission_is_possible_what_i_learned_after_20/
created_utc: 1752908118
selftext: >
I’ve had ulcerative colitis since I was 24—I'm now 44—and I’ve been in remission for the past 10 years. I was
initially prescribed Salofalk (Mesalazine), but it didn’t work for me. These days, I manage my UC with
Imuran(Azathioprine) an immunosuppressant, a restricted diet, and regular exercise.
A bit of backstory: when I was first diagnosed, I had just started my career as a city bus operator. Needless to
say, it was a nightmare. I often experienced urgency while driving a packed bus, and there were more than a few
close calls where I nearly soiled myself on the job. It was humiliating, stressful, and physically exhausting.
I’ve dealt with the full range of UC symptoms, such as severe bleeding, drastic weight loss, and multiple hospital
stays. Things really changed for me when I started having kids. That gave me a bigger reason to get better, not just
for myself but for them. One way I managed UC at work was by using the washroom at every possible opportunity, even
when I didn’t feel the urge.
So, I began tracking everything, what I ate and how I felt afterward. I kept a detailed log of symptoms ranging from
mild to severe: abdominal cramping, black or foul-smelling stool, excess gas (farting / burping), urgency, blood in
the stool, and how often I was going to the washroom (which used to be 4 to 10 times a day). Alongside that, I
logged exactly what I was eating each day.
I used a trial-and-error method, starting by eating freely, then removing foods one by one to see which ones
triggered flare-ups. If you want to try something similar, you could either start this way or take a stricter
approach: stick to only ‘safe’ foods first, and gradually reintroduce others to identify your triggers.
For me, foods high in potassium seemed to be a problem, bananas, avocados, and salmon all triggered symptoms. Dairy
was another major issue: milk, yogurt, cheese, ice cream, and cream cheese were all off-limits. Fried foods, heavily
spiced meals or specific spices, beer, and alcohol also made the list. But keep in mind: your list might look
completely different, which is why personal tracking is so important.
To this day, I’m still on an immunosuppressant (Imuran), which is definitely keeping my condition in check, but
combining that with a disciplined diet and exercise routine has kept me in remission. If you feel like you’ve tried
everything and nothing's working, this might be a path worth exploring.
Be patient, it’s a slow, frustrating process, and you might not see instant results. Some foods that trigger
symptoms can take a while to show their effects, which is why the symptom log is so important. Even something subtle
like excessive gas or foul-smelling stool can be a clue that your gut isn’t agreeing with something you're eating.
Now at 44, with four beautiful kids, still working my city job, and able to take vacations and road trips whenever
and wherever I choose, I’m truly grateful I never gave up on myself. UC tried to control my life, but I took that
control back. It wasn’t easy, and it won’t be perfect, but healing is possible. Stay curious, stay determined, and
don’t lose hope. You’ve got this.
Wishing you strength, healing, and all the best on your journey.
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- id: 1qq3qb2
title: How I put my Ulcerative Colitis into long-term remission (personal experience)
subreddit: r/UlcerativeColitis
author: charming-devil
score: 6
comments: 74
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qq3qb2/how_i_put_my_ulcerative_colitis_into_longterm/
created_utc: 1769677793
selftext: >-
I was diagnosed with Ulcerative Colitis (UC) in 2012. From 2012 to 2017, I dealt with flare-ups and depended on
medication. Since 2018, I’ve been completely symptom-free and eventually stopped taking medication under my own
judgment. I’ve now been in remission for several years.
This is not medical advice just my personal experience with what worked for me.
What I changed:
1) Diet and exercise
I cleaned up my diet and made a journal, after lots of trial and error I ate selected food that didn't made my flare
up worse, also made regular exercise a habit. Nothing extreme just consistent healthy eating and staying active.
This alone made a noticeable difference in my energy, digestion, and overall inflammation.
2) Supplements
My regular stack:
Multivitamin
Probiotic
Omega-3
ZMA
Vitamin D3 + K2
During my active UC days, I took these daily. Now I take them about 3-4 times a week or on alternate days.
3) Intermittent fasting (major factor for me)
I do 24-48 hour fasts once or twice a week.
Originally, I started fasting simply because eating and digestion felt uncomfortable during UC. Over time, I noticed
that fasting significantly improved my symptoms. I believe it helped my gut rest and may have supported healing and
better gut flora balance.
Fasting was the biggest turning point for me.
I’ve been symptom-free since 2018 with no medications and normal daily life. UC may not be “curable” in general, but
in my case, lifestyle changes especially fasting, diet, and consistency put it into long-term remission.
Again, this is just my experience. Everyone’s UC is different, and what worked for me may not work for others. I’m
sharing this in case it helps someone explore lifestyle changes alongside medical care.
Edit 1 - Again this is not a medical advice. THIS IS WHAT I DID WHICH WORKED FOR ME. I didn't stop my medication
suddenly, when I was in remission I gradually decreased the dose to see how the body was reacting. When I felt
healthy I stopped completely.
Edit 2 - people asking me about my diet , after lots of trial and error I found steam and boiled food without any
condiments didn't make my UC worse. I mostly ate boiled chicken and eggs rice and sauteed veggies. Bcz of UC i even
suffered from urticaria so I really had to eat plain food which doesn't make my body release histamine. After I
would feel better i would introduce some food in my diet to see how I was reacting and it went like that. The key is
to keep a food journal, take your meds, take food ( prebiotic probiotic) that will heal your gut flora
Edit 3 - Read Read Read , read as much as you can, educate yourself about the subject, about a healthier lifestyle
and diets. It's an auto immune disease and unfortunately can happen to people living a healthy and active lifestyle
however with modern sciences and meds you can definitely live with it or even cure it. Don't stop your meds. Consult
your doc. I stopped gradually over a period of 3-4 months lower doses over time.
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- id: 1ugrdxn
title: Doctor uses Trichinosis to Cure Ulcerative Colitis
subreddit: r/UlcerativeColitis
author: VictoryBeginning9350
score: 13
comments: 31
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ugrdxn/doctor_uses_trichinosis_to_cure_ulcerative_colitis/
created_utc: 1782529960
selftext: >-
What do you guys think about this? I thought parasites were bad.
"Joel Weinstock, a gastroenterologist who heads a research team at University of lowa, asked six patients with
intractable inflammatory bowel-disease to quaff worm-eggs in a liquid solution, specifically the eggs of
Trichurissuis, a whipworm (parasite that looks like a whip) normally found in pigs. Within about two weeks, five of
the six patients went into remission - for up to five months."
"Dr. Joel Weinstock then used trichinosis to cure Crohn's Disease, Ulcerative Colitis, and Inflammatory Bowel
Syndrome in humans."
[https://www.nature.com/articles/540S103a](https://www.nature.com/articles/540S103a)
https://www.gastrojournal.org/article/S0016-5085(22)00802-2/fulltext
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- id: 1r2ghvq
title: Ulcerative Colitis Microbiome Treatment Succeeds in Phase Ib Trial
subreddit: r/UlcerativeColitis
author: sam99871
score: 169
comments: 33
url: https://www.reddit.com/r/UlcerativeColitis/comments/1r2ghvq/ulcerative_colitis_microbiome_treatment_succeeds/
created_utc: 1770860883
selftext: A pill containing 8 different kinds of bacteria had a 63% clinical remission rate.
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- id: 1uhefg8
title: Ulcerative Colitis -remission with Antibiotics (personal story)
subreddit: r/UlcerativeColitis
author: OskarWasTaken
score: 5
comments: 18
url: https://www.reddit.com/r/UlcerativeColitis/comments/1uhefg8/ulcerative_colitis_remission_with_antibiotics/
created_utc: 1782595545
selftext: >-
I developed ulcerative colitis in December 2024. I came out with all the usual symptoms, and some unusual symptoms.
The usual symptoms were urgency, blood, loose stools. I was going 15-20 times a day.
The unusual symptoms were rashes, fatigue which was extremely terrible, dry skin.
I had months of hospital visits, hospitalisations, medicines that didn’t work, steroids that didn’t work and left
long lasting effects on my bones, and still nothing that really helped solve my issues to a degree that I could have
a normal life.
I had turned my attention to alternative ways to treat my colitis in the form of pro biotics, I took many of them. I
had met with the owner of a health shop for the pro biotics and more, he sussed out from my rash and previous
illnesses before December 2024, which I had a fever with rash in the summer of 24’ , and he suggested I may have
Lyme disease.
I had testing with the NHS, which came back Negative, however I found with research that with certain strains it
would give back false negatives a lot of the time, and NHS testing alone is not reliable.
I had private testing done separate tests, separate of the NHS, and it was positive.
Still terribly ill, but marginally better, I went to Ireland for treatment as the NHS refused to give me
antibiotics.
I had 3 days of antibiotics with Dr Jack Lambert in Dublin and I was a different person, symptoms subsidised and I
was really good.
I had a few months of going up and down but now with new sets of antibiotics, it’s a new me, I am just really so
much better.
I left out alot of details, but I expect this post won’t be too popular, most people here are going to dislike that
I achieved remission with antibiotics and dislike I didn’t use conventional methods but hey, if you’re here in good
faith I’ll answer any questions .
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- id: 1tvwav2
title: What Careers Have Worked Well for You with Ulcerative Colitis?
subreddit: r/UlcerativeColitis
author: Exahros
score: 14
comments: 21
url: https://www.reddit.com/r/UlcerativeColitis/comments/1tvwav2/what_careers_have_worked_well_for_you_with/
created_utc: 1780507568
selftext: >-
Hey everyone,
I'm a 30-year-old trying to figure out my long-term career path, and I'd love to hear from others living with
ulcerative colitis.
I've been fortunate enough to be in remission, and I'm incredibly grateful for that. At the same time, I know
remission isn't guaranteed forever, so I'm trying to make career decisions that take both my current health and
potential future flares into account.
For the last 10 years I've worked retail, and I'm currently pursuing a Bachelor's degree in Cybersecurity. I already
have a few IT certifications, but lately I've been questioning whether it's the right fit for me.
The three paths I'm currently considering are:
• IT/Cybersecurity
• Physical Therapist Assistant (PTA)
• HVAC
Each appeals to me for different reasons.
IT seems like it may be easier on my body and provide flexibility during flares, but I struggle with whether I'll
find it fulfilling long term.
PTA appeals to me because I enjoy fitness, health, helping people, and building relationships.
HVAC appeals to me because I enjoy hands-on problem solving and working with my hands, but I wonder if the physical
demands and unpredictable bathroom access could become difficult if my UC ever becomes active again.
I'd love to hear:
• What do you do for work?
• Has UC influenced your career choices?
• Have you ever left a job because of your UC?
• What careers have worked well for you?
• What careers would you avoid?
• If you were in remission and choosing a career again, what factors would you prioritize?
I sometimes feel stuck between choosing a career I enjoy and choosing a career that gives me the flexibility and
security I may need if my health changes in the future.
Any advice or personal experiences would be greatly appreciated.
Thank you.
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- id: 1ua2ldq
title: So sick of Ulcerative colitis
subreddit: r/UlcerativeColitis
author: Cute_Score5494
score: 18
comments: 13
url: https://www.reddit.com/r/UlcerativeColitis/comments/1ua2ldq/so_sick_of_ulcerative_colitis/
created_utc: 1781877108
selftext: >-
Hello everyone. 30 f
Got diagnosed with UC July of 2024
I had to switch GI doctors because I moved and my new doctor is very hard to get an appointment with so I dont have
one until July 1st. I did get a fecal calprotectin test done yesterday so waiting for the results of that mine have
came back very high about 8000 back in 2024 but I had a colonoscopy on April Ist they said I was in remission but
had Chronic active colitis with focal reactive lymphoid hyperplasia in my Sigmoid.
I got into a flare on May 18th some bleeding and mucus. Some days its all blood and mucus somedays its somewhat
formed and looks like the blood is darker and jelly like and pink mucus which i haven't had before. Even with my
worst flare back in 2024 it was bright red and filled the toliet bowl bright red.
I dont have really any other symptoms besides being tired.
Weirdly I got into a flare May 2024-July 2024 then again May 2025- about July 2025 and now again May 2026? Has
anyone else experienced having flares at the same time each year? Or is it just a weird coincidence? Is the dark red
jelly like blood something to be more concerned about?
Ugh im so sick of stressing with this disease. I miss my old life.
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- id: 1tupusa
title: Is there anyone in here who has ibd (ulcerative colitis or crohns?)
subreddit: r/GilbertSyndrome
author: NovelIllustrious120
score: 0
comments: 18
url: https://www.reddit.com/r/GilbertSyndrome/comments/1tupusa/is_there_anyone_in_here_who_has_ibd_ulcerative/
created_utc: 1780404261
selftext: 'Im asking since the doctor suspect that I have it because of the symptoms im going through.. '
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- id: 1t163g4
title: This Treatment For Ulcerative Colitis Worked For Me
subreddit: r/UlcerativeColitis
author: Appropriate_Land5236
score: 0
comments: 23
url: https://www.reddit.com/r/UlcerativeColitis/comments/1t163g4/this_treatment_for_ulcerative_colitis_worked_for/
created_utc: 1777669857
selftext: "I kept my UC in remission for 11 years by taking Psyllium Seed (Plantago ovata) powder mixed with water 3 times a day. It worked as well as the Pentasa I used for 2 years. When I reached the end of my tolerance for Pentasa, I switched to ground whole Psyllium Seeds. It's the inner part of the seed that's beneficial, not the husks, I sifted them out. Here's just one research paper I found with a Google search.\n\n[Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn's Disease and Ulcerative Colitis (GETECCU) - PubMed](https://pubmed.ncbi.nlm.nih.gov/10022641/)\n\n**Results:**\_Of the 105 patients, 102 were included in the final analysis. After 12 months, treatment failure rate was 40% (14 of 35 patients) in the Plantago ovata seed group, 35% (13 of 37) in the mesalamine group, and 30% (nine of 30) in the Plantago ovata plus mesalamine group. Probability of continued remission was similar (Mantel-Cox test, p = 0.67; intent-to-treat analysis). Therapy effects remained unchanged after adjusting for potential confounding variables with a Cox's proportional hazards survival analysis. Three patients were withdrawn because of the development of adverse events consisting of constipation and/or flatulence (Plantago ovata seed group = 1 and Plantago ovata seed plus mesalamine group = 2). A significant increase in fecal butyrate levels (p = 0.018) was observed after Plantago ovata seed administration.\n\n**Conclusions:**\_Plantago ovata seeds (dietary fiber) might be as effective as mesalamine to maintain remission in ulcerative colitis.\n\n"
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- id: 1qnfjbv
title: UCED ulcerative colitis exclusion diet
subreddit: r/UlcerativeColitis
author: Flat-Fisherman-8773
score: 0
comments: 31
url: https://www.reddit.com/r/UlcerativeColitis/comments/1qnfjbv/uced_ulcerative_colitis_exclusion_diet/
created_utc: 1769432842
selftext: >-
I was using Google's notebook lm to research diets and UC. I was asking about the types of diets I knew of and was
surprised when it mentioned the ulcerative colitis exclusion diet.
I've not heard of it and it seemed to make a lot of sense.
It's a shame I can't upload images. I asked it to summarize and included below.
I'm going to give it a go. I thought it might help some people here.
Here is a high-level overview of the Ulcerative Colitis Exclusion Diet (UCED) tailored for a Reddit post.
\*\*\*
\### \*\*The Ulcerative Colitis Exclusion Diet (UCED): A Quick Overview\*\*
The UCED is a specific nutritional protocol designed to induce remission by repairing the gut’s mucus barrier and
reducing the production of toxic sulfides \[1\]. Unlike general "clean eating," it focuses heavily on altering the
gut microbiome through specific food textures and nutrients.
It is divided into two phases: \*\*Phase 1 (Strict Induction, Weeks 0–6)\*\* and \*\*Phase 2 (Liberalization, Weeks
7–12)\*\* \[1\].
\#### \*\*1. The Golden Rules (Applies to All Phases)\*\*
\* \*\*Strictly No Additives:\*\* You must avoid all emulsifiers, thickeners, and preservatives. This means no
store-bought sauces, commercial salad dressings, or processed snacks \[2, 3\].
\* \*\*No Red or Processed Meat:\*\* Beef, pork, sausages, and deli meats are excluded to reduce sulfur exposure
\[2\].
\* \*\*Single-Ingredient Seasoning:\*\* Do not use spice blends (like taco seasoning or curry powder). Use fresh
herbs, pure salt, and single spices (like turmeric or ginger) \[3, 4\].
\#### \*\*2. Phase 1: Induction (Weeks 0–6)\*\*
This phase is the most restrictive. You build your meals around "Mandatory" and "Allowed" foods.
\*\*Mandatory Daily Foods (Therapeutic Core):\*\*
\* \*\*Chicken Breast:\*\* Lean protein source \[5\].
\* \*\*2 Eggs:\*\* Must be eaten every day \[5\].
\* \*\*Yogurt:\*\* Daily intake required for probiotics \[5\].
\* \*\*Cooked & Cooled Potatoes:\*\* You must cook potatoes and let them cool (can be reheated) to generate
\*\*resistant starch\*\*, which feeds good bacteria \[5, 6\].
\* \*\*Bananas & Apples:\*\* Required daily for pectin \[5\].
\*\*Allowed Foods (Fillers):\*\*
\* Rice (unlimited) and pasta (allowed amounts) \[5\].
\* Fruits and vegetables (generally peeled to aid digestion) \[5\].
\* Homemade clear broth (chicken or beef) \[7\].
\#### \*\*3. Phase 2: Liberalization (Weeks 7–12)\*\*
If you respond well, you add variety while keeping the core rules \[8\].
\*\*New Additions:\*\*
\* \*\*Legumes:\*\* Lentils, chickpeas, and beans \[9\].
\* \*\*Whole Grains:\*\* Oats, quinoa, and potentially whole grain bread (if additives-free) \[9, 10\].
\* \*\*New Veggies:\*\* Sweet potatoes and red peppers \[9\].
\#### \*\*4. Practical Tips for Success\*\*
\* \*\*Making Stock:\*\* Never use bouillon cubes (too many additives). Make your own simple stock with chicken
bones, water, carrots, and fresh herbs \[7, 11\].
\* \*\*Snacking:\*\* Stick to whole foods like hard-boiled eggs, fruit, yogurt, or homemade potato salad (with
olive oil, no mayo) \[10, 12\].
\* \*\*Eating Out:\*\* Extremely difficult due to hidden additives in oils and marinades. If you must, order plain
grilled chicken and plain steamed rice \[Conversation History\].
\* \*\*Flavor:\*\* You \*can\* make food taste good! Use fresh basil, parsley, rosemary, thyme, ginger, and garlic
(if tolerated) \[4, 13\].
\*\*\*
\*Always consult your dietitian or GI team before starting, as portions are often personalized in clinical settings
\[12\].\*
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- id: 1tmlg97
title: Ulcerative Colitis Diet, intermittent fasting, Inflectra
subreddit: r/UlcerativeColitis
author: No-Inevitable413
score: 12
comments: 14
url: https://www.reddit.com/r/UlcerativeColitis/comments/1tmlg97/ulcerative_colitis_diet_intermittent_fasting/
created_utc: 1779650264
selftext: "Questions at the end \nHistory: \nI’m a 27M. I was diagnosed with Ulcerative Colitis when I was 23. Without going too deep into it, that first year was a really, really rough time in my life. I took Prednisone, mesalamine, then got eventually got on Entyvio.\n\nEntyvio worked great for about 2 and a half years. I’ve got a great job as a supervisor in my construction industry, a volunteer firefighter, applying for full time full time job in the fire service, and in college. My favorite hobby is hitting the gym and lifting weights. I try to eat 150 grams of protein a day and 3000 cals, and was essentially able to eat any food and energy drinks or whatever I wanted. Essentially forgot about the UC besides the biweekly Entyvio Injections.\n\nOctober 2025 I suppose the Entyvio stopped working. Started having symptoms again and went to the hospital and got back on prednisone. Prednisone didn’t seem to help much. Really struggled with resolving it with diet, especially while working. My doctor got me started on a different biologic called Yesintek in January which seemed to start working for a couple weeks so I tapered down off the prednisone. \_As soon as I stopped taking the prednisone, back to 15-20 bm’s a day with blood. Lost 30 lbs. Yesintek not working either. Back on prednisone\n\nColonoscopy in April showed “Moderate” active pancolitis with hemorrhoids. My life has been unbearable! I felt like I was going crazy. Not sleeping more than an hour at a time. Not liking to look at myself in the mirror. Not able to volunteer at the fire department for fear of having an accident while on a call. Scared to get in my car and drive to work or the grocery store. Shitting myself in my car. Or while picking up my garbage can from the curb, I have a long driveway lol! Not sure how I’ve still been showing up to work.\n\nSo I had enough and am taking a medical leave from work for 2.5 weeks. I’ve decided to do whatever it takes to take my life back!\n\nThrough reddit research and YouTube videos, Here is my new routine I’ve been trying for the past few days:\n\n·\_\_\_\_\_\_ Intermittent Fasting: Only eating between noon and 8pm. Mudwtr mushroom coffee in morning.\n\n·\_\_\_\_\_\_ Diet change: no nuts, dairy, spicy, caffeine. Also trying gluten free and (mostly) dairy free. Big smoothies with banana, blueberry, avocado, kefir, and plant based protein powder. Salmon, shrimp, chicken, organic vegetables. Eggs.\n\nI used to try to cram as many calories as I could in the day to meet my fitness goals, including whey protein. I think the whey protein and dairy may have been a part of the problem. \n\n·\_\_\_\_\_\_ Probiotics: Making my own Kefir at home, mixing in smoothies daily. Also eating homemade sauerkraut I got from a friend. Optimizing the gut microbiome seems to be a common theme in Kenny Honnas videos.\n\n·\_\_\_\_\_\_ Supplements: Probiotic supplement in the morning. Turmeric curcumin powder. Testosterone boosting supplement. I used to take creatine daily, and plan to resume creatine once my bowel movements are formed again.\n\n·\_\_\_\_\_\_ KPV peptide. Started first dose yesterday. 0.2mg per day subcutaneous injection. This one makes me nervous since it is not FDA approved by online it says it helps with intestinal healing and IBD support. Plan to do an 8 week cycle and see what happens.\n\n·\_\_\_\_\_\_ Exercise: Back in the gym doing light weight training. My usual split workout Legs, Back and Bis, and chest and Tris, then rest day.\n\n·\_\_\_\_\_\_ Medications: Started first dose of Inflectra (Remicade generic) last week. Second dose in scheduled in 2 weeks. I read that it takes a couple of weeks or months for it to start working. I’ve come to the conclusion that I can’t solely rely on biologics. In the meantime I’m willing to try it if it means it could help.\n\n\_I’m also taking an antidepressant Desvenlafaxine for the past month to help with my mental health going to try it for 6 months.\n\nAnd of course trying to taper off of the Methylprednisolone, feel like it hasn’t helped the last 6 months and have a suspicion it’s making me feel worse. I’m down to 8mg per day currently.\n\n\_\n\nFor discussion:\n\n·\_\_\_\_\_\_ I used to use a Reverse Osmosis water filter for drinking water. I haven’t used it since I moved but I still have it, I figured since I’m on well water at my house there isn’t any harmful chemicals or chlorine. Has anyone had any experience with or noticed any difference switching to RO filtered water?\n\n·\_\_\_\_\_\_ Does anyone have any experience or insight with KPV peptides? While in a flare or continued while in “remission”?\n\n·\_\_\_\_\_\_ Has anyone had any luck with a natural doctor rather than conventional doctor? I found a naturopathic doctor in the area that specializes in autoimmune conditions but am skeptical whether there would be any benefits or new information I would gain from paying for an appointment.\n\n·\_\_\_\_\_\_ Finally, another controversial topic, does anyone else think they developed UC or a different autoimmune condition after receiving the COVID vaccine?\n\nThis is my first post. I’ve been reading other posts about UC on Reddit. During dark times, it has helped me feel like I’m not alone with this disease. I value being apart of this community. Thank you everybody."
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- id: 1u9cm29
title: Fungi spike during ulcerative colitis flares while bacteria stay remarkably stable, a new study finds
subreddit: r/microbiomenews
author: Technical_savoir
score: 31
comments: 7
url: https://www.reddit.com/r/microbiomenews/comments/1u9cm29/fungi_spike_during_ulcerative_colitis_flares/
created_utc: 1781803684
selftext: >-
The Core Issue
Most gut microbiome research fixates on bacteria and largely ignores fungi. In ulcerative colitis, that blind spot
may matter because the fungal community appears to behave very differently from its bacterial neighbors depending on
disease activity.
The Finding
A prospective study of 87 UC patients found that fungal abundance was significantly higher during active flares
compared to patients in long-term remission. Bacterial loads, by contrast, stayed stable across all disease states.
The ratio of fungi to bacteria also shifted upward during flares, suggesting inflammation may be reshaping the
balance between these two microbial kingdoms.
Why It Matters
If fungi respond to UC inflammation while bacteria don't, the fungal microbiome could eventually serve as a more
sensitive marker of disease activity. It also opens the question of whether fungi are passengers riding the flare or
something actively contributing to it.
Limitations of Study
Only one stool sample was collected from flare patients, and the flare group was larger than the remission groups,
which limits direct comparisons. The findings are associative, not causal.
Interesting Statistics
• Fungi were vastly outnumbered: median fungal copies measured around 927,000 per gram of stool versus roughly 428
billion bacterial copies, a ratio of about 1 to 461,000
• Fungal abundance was significantly higher in flare patients than in long-remission patients
• The fungal-to-bacterial ratio was elevated during flares compared to both remission groups
• Fungal load varied more over time than bacterial load, suggesting fungi are more sensitive to environmental
shifts
• A modest but meaningful drop in the fungal-to-bacterial ratio was observed at the eight-week follow-up mark
TL;DR
During UC flares, fungal populations surge while bacteria barely budge, pointing to an under-studied microbial
dynamic that may reflect or influence disease activity.
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- id: 1r0wh42
title: >-
newsflash week 06.2026 - special edition. The Nutritional Architecture of Ulcerative Colitis: A Synthesis of Dietary
Interventions and Pharmacological Synergies (2024-2026)
subreddit: r/UlcerativeColitis
author: achchi
score: 65
comments: 19
url: https://www.reddit.com/r/UlcerativeColitis/comments/1r0wh42/newsflash_week_062026_special_edition_the/
created_utc: 1770716482
selftext: "***Disclaimer: This newsflash is for informational purposes. Always consult with your IBD-specialized dietitian or GI team before making significant dietary changes.*** \n \nThe therapeutic paradigm for ulcerative colitis has shifted fundamentally between 2024 and 2026, transitioning from a reactive, symptom-based model to a proactive, evidence-based integration of nutritional science and advanced pharmacology.\_Current clinical guidelines now recognize diet not merely as a supportive measure for symptom relief but as a critical modifier of the gut microbiome, intestinal barrier integrity, and the pharmacokinetic efficacy of medical therapies.\_This special edition synthesizes the latest findings from international consensus conferences, randomized controlled trials, and longitudinal cohort studies to provide a comprehensive framework for dietary management in the modern era of UC treatment.\_\_\_\n\n# The Etiopathogenesis of Diet in Ulcerative Colitis\n\nThe rising global incidence of ulcerative colitis is increasingly linked to environmental triggers, with dietary patterns serving as a primary driver of disease risk and progression.\_The \"Westernization\" of the global diet, characterized by a high intake of ultra-processed foods, refined sugars, and animal fats, is strongly associated with the disruption of the gastrointestinal ecosystem.\_\_\_\n\n**Urbanization and the Microbiome**\n\nResearch published in 2025 emphasizes that urbanization leads to a significant decrease in the consumption of natural fibers and a corresponding rise in the intake of artificial additives.\_This dietary shift results in a precipitous drop in microbial diversity within the human gut, a condition known as dysbiosis.\_When the intestinal microbiota is dysbiotic, the immune barrier function is compromised, triggering an abnormal immune response in genetically susceptible individuals.\_This cycle is self-perpetuating: inflammation further exacerbates microbial imbalance, which in turn fuels more inflammation.\_\_\_\n\n**Early Life Influences and Epigenetic Modulation**\n\nThe foundational tone of the immune system is often established in early life. Short breastfeeding duration has been identified as an environmental trigger associated with a higher risk of developing inflammatory bowel disease later in life.\_Conversely, the protective role of \"methyl donors\"—nutrients such as methionine, folate, choline, and betaine—has gained prominence in 2025.\_These compounds, found abundantly in fruits, green leafy vegetables, and legumes, act as cofactors for enzymes that shape gene expression.\_High dietary intake of these donors is associated with a reduced risk of UC, particularly in individuals exposed to high levels of air pollution or those who are heavy smokers.\_\_\_\n\n|Dietary Component|Impact on Risk/Pathogenesis|Biological Mechanism|\n|:-|:-|:-|\n|Ultra-processed Foods|Significant Increase|Disruption of mucosal barrier and microbial diversity\_|\n|Red and Processed Meat|Significant Increase|Production of hydrogen sulfide; SCFA oxidation inhibition\_|\n|Methyl Donors|Reduction|Epigenetic regulation and gene expression stabilization\_|\n|Mediterranean Diet|Significant Reduction|Promotion of anti-inflammatory bacteria (e.g.,\_*F. prausnitzii*)\_|\n|Dietary Fiber (Soluble)|Reduction|Production of short-chain fatty acids (SCFAs)\_|\n\n\_\_\n\n# Deconstructing Problematic Foods: Triggers vs. Myths\n\nA central challenge for patients and clinicians alike is distinguishing between foods that cause temporary functional symptoms and those that drive biological inflammation. By 2025, several long-held dietary myths have been clarified through rigorous trial data.\_\_\_\n\n**Red Meat and the Sulfur Hypothesis**\n\nOne of the most consistent findings in UC research is the association between high red and processed meat intake and the risk of disease flares.\_Unlike Crohn's disease, where meat intake has a less clear impact on relapse, UC patients appear particularly sensitive to the sulfur content of meat.\_High meat consumption leads to a decrease in the oxidation of short-chain fatty acids (SCFAs), which are the primary energy source for colonocytes.\_This inhibition thins the protective mucus lining of the gut, facilitating bacterial translocation and inflammation.\_Reducing the intake of beef, lamb, pork, and processed meats (like deli meats and sausages) is now a core recommendation for maintaining remission.\_\_\_\n\n**The Dairy Controversy**\n\nThe belief that all patients with UC must avoid dairy is increasingly viewed as a myth by the scientific community.\_While some patients may have a primary or secondary lactose intolerance, current consensus indicates that there is insufficient evidence to support the universal restriction of dairy products for the management of UC inflammation.\_In fact, fermented dairy products such as kefir and certain yogurts may provide symptom relief and help restore microbial balance in patients in remission.\_Guidelines published in 2025 suggest that patients should only limit dairy if they have a confirmed intolerance, and even then, low-lactose options like aged cheeses or lactose-free milk are often well-tolerated.\_\_\_\n\n**Gluten and Wheat: Protein vs. Carbohydrate**\n\nGluten sensitivity is frequently reported by UC patients, with approximately one in three claiming some level of non-celiac gluten sensitivity.\_However, emerging human data presented at the 2025 ECCO Congress suggests that the true culprit in wheat may not be the gluten protein but rather the fructans—a type of fermentable carbohydrate (FODMAP).\_Studies have shown that fructans can induce greater symptoms of gas and bloating than gluten in IBD patients.\_Therefore, while a gluten-free diet may alleviate symptoms for some, it is often due to the incidental reduction of fructans rather than a biological reaction to gluten itself.\_\_\_\n\n**The Additive Crisis: Emulsifiers and Thickeners**\n\nA critical area of investigation in 2025-2026 is the impact of food additives on the gut barrier. Emulsifiers such as polysorbate-80, carboxymethylcellulose (CMC), carrageenan, and maltodextrin are ubiquitous in the Western food supply, used to enhance the texture and shelf-life of thousands of products.\_\_\_\n\n* **Carrageenan:**\_High-quality trials have indicated that restriction of dietary carrageenan may benefit patients with UC.\_One randomized controlled trial showed that patients exposed to even small amounts of carrageenan experienced significantly higher clinical activity scores and increased levels of inflammatory markers like interleukin-6.\_\_\_\n* **Maltodextrin and Polysorbate-80:**\_These additives have been shown to alter the gut microbiome and weaken the intestinal lining.\_The ENIGMA study (2023) and follow-up data in 2025 suggest that these substances can increase the abundance of inflammatory bacterial species and compromise the gut's physical defenses.\_\_\_\n\nAs of 2026, international organizations advise that it is \"prudent to limit intake\" of these specific additives for all individuals with IBD.\_\_\_\n\n# Therapeutic Dietary Patterns: Inducing and Maintaining Remission\n\nWhile no single diet is a substitute for medication in moderate-to-severe UC, specific nutritional strategies have demonstrated efficacy in inducing clinical response and maintaining long-term stability.\_\_\_\n\n**The Mediterranean Diet: The Gold Standard for Maintenance**\n\nThe Mediterranean diet (MD) is currently the most robustly recommended dietary pattern for IBD patients.\_Rich in monounsaturated fats (olive oil), fruits, vegetables, whole grains, nuts, and lean proteins (fish), the MD emphasizes minimally processed, anti-inflammatory whole foods.\_\_\_\n\nClinical data through 2025 confirms that the MD is associated with a lower risk of developing IBD and a higher likelihood of maintaining remission.\_Key components such as omega-3 fatty acids and polyphenols have been shown to enhance gut microbiota diversity and reduce systemic markers of inflammation, such as C-reactive protein (CRP).\_The MD is particularly favored because it carries a low risk of nutritional deficiencies compared to more restrictive diets.\_\_\_\n\n**IBD-AID and SCD: Targeting the Microbiome**\n\nThe Inflammatory Bowel Disease Anti-Inflammatory Diet (IBD-AID) and the Specific Carbohydrate Diet (SCD) focus on modifying the bacterial balance by restricting certain complex carbohydrates.\_\_\_\n\n* **SCD:**\_This diet eliminates all grains, lactose, and most processed sugars, focusing instead on monosaccharides, fresh fruits, vegetables, and unprocessed meats.\_While pilot studies show benefit in pediatric populations, data in adults remain limited.\_\_\_\n* **IBD-AID:**\_An evolution of the SCD, the IBD-AID incorporates prebiotic and probiotic foods to actively foster beneficial bacteria.\_Clinical trials in 2024 showed that IBD-AID, especially when combined with fecal microbiota transplantation (FMT), could induce both clinical and endoscopic remission in patients with mild-to-moderate disease.\_\_\_\n\n**Low FODMAP Diet: Symptom Management Only**\n\nThe Low FODMAP diet is specifically indicated for the subgroup of UC patients who are in clinical remission but continue to suffer from irritable bowel syndrome (IBS)-like symptoms.\_While highly effective at reducing bloating, flatulence, and diarrhea, the Low FODMAP diet has\_**not**\_been shown to reduce inflammation or induce mucosal healing.\_Long-term adherence is discouraged, as it may lead to a reduction in beneficial bacteria that thrive on fermentable fibers.\_\_\_\n\n**Emerging Perspectives: Ketogenic and Carnivore Diets**\n\nIn 2024 and 2025, several case reports were published detailing universal clinical improvements in patients following ketogenic or \"carnivore\" diets.\_These diets, which focus almost exclusively on animal-based proteins and fats while eliminating all plant foods and carbohydrates, theoretically \"starve\" harmful microbes and reduce the \"residue\" passing through the colon.\_\_\_\n\nHowever, the medical community remains cautious. While these diets may offer quick symptom relief by functioning as an extreme elimination strategy, they lack essential phytonutrients, antioxidants, and prebiotic fibers.\_There is also a significant concern regarding the increased risk of colorectal cancer due to high saturated fat and meat intake—a risk that is already elevated in the UC population.\_Most experts suggest that these are not sustainable long-term strategies and may lead to nutritional inadequacy.\_\_\_\n\n# Interactions Between Diet and Ulcerative Colitis Medications\n\nOne of the most profound advancements in 2025 is the detailed understanding of how dietary intake and patient physiology interact with the expanding pharmaceutical armamentarium for UC.\_\_\_\n\n**5-Aminosalicylates (5-ASAs / Mesalamine)**\n\nMesalamine is the cornerstone of therapy for mild-to-moderate UC, but its efficacy varies significantly between patients.\_Recent research has identified twelve previously uncharacterized microbial acetyltransferases that can inactivate 5-ASA in the gut.\_This microbial metabolism converts active 5-ASA into N-acetyl 5-ASA, which lacks anti-inflammatory properties.\_\_\_\n\nFurthermore, dietary fiber intake can influence the delivery of 5-ASA. Changes in gut pH and transit time caused by fermentable fiber may affect how pH-dependent mesalamine tablets dissolve and distribute within the colon.\_For patients with distal disease (proctitis or proctosigmoiditis), topical preparations (enemas or suppositories) remain the preferred route to bypass these upper-GI metabolic interactions.\_\_\_\n\n**Biologics (Anti-TNF, Vedolizumab, Ustekinumab)**\n\nFor advanced biologic therapies, the primary \"dietary\" interaction is not with specific foods but with patient adiposity.\_Obesity, which affects 20-40% of IBD patients, is strongly associated with inferior response to biologic therapy.\_\_\_\n\n* **Pharmacokinetics:**\_High body weight is associated with more rapid clearance and a higher volume of distribution for biologic agents, leading to lower \"trough\" concentrations of the drug in the blood.\_\_\_\n* **Inflammatory Burden:**\_Visceral fat independently contributes to a higher systemic inflammatory burden through the secretion of pro-inflammatory adipokines like resistin and leptin.\_\_\_\n\nResearch suggests that lifestyle-induced weight loss may improve the response to biologics by normalizing drug clearance rates.\_While this impact is most pronounced with anti-TNF agents (infliximab and adalimumab), it is also observed with vedolizumab and ustekinumab to a lesser degree.\_\_\_\n\n**JAK Inhibitors (Upadacitinib, Tofacitinib)**\n\nJAK inhibitors are oral small molecules that offer rapid onset of action. However, they are subject to significant food-drug interactions.\_\_\_\n\n* **Fat Intake:**\_High-fat and high-calorie meals have been shown to increase the absorption (*Cmax*\_and\_*AUC*) of upadacitinib by 30-40%.\_While the drug can be taken with or without food, maintaining a consistent eating pattern when taking the medication ensures predictable steady-state concentrations.\_\_\_\n* **Grapefruit Interaction:**\_Consumption of grapefruit or its juice should be strictly avoided during treatment with upadacitinib.\_Grapefruit inhibits the enzymes responsible for breaking down the drug, which can lead to dangerously high blood levels and increased risk of side effects like low blood counts or serious infections.\_\_\_\n\n**S1P Modulators (Ozanimod, Etrasimod)**\n\nS1P modulators are the newest class of oral therapies for UC. Etrasimod, approved in late 2023, represents a second-generation modulator with a more favorable profile than ozanimod.\_\_\_\n\n* **Food Independence:**\_Etrasimod has fewer drug-drug and food interactions compared to ozanimod and does not require a complex dose titration at initiation.\_\_\_\n* **Mechanism:**\_It selectively activates S1P receptors to block the migration of inflammation-causing lymphocytes into the colon.\_\_\_\n\n**Corticosteroids**\n\nWhile essential for inducing remission in severe flares, corticosteroids are now strongly discouraged for maintenance therapy due to their systemic side effects, including impact on bone mineral density and metabolic health.\_Nutritional optimization—particularly ensuring adequate calcium and Vitamin D intake—is mandatory for any patient requiring even short-term steroid use.\_\_\_\n\n|Medication Class|Key Agents|Critical Dietary Interaction|Actionable Advice|\n|:-|:-|:-|:-|\n|**5-ASAs**|Mesalamine, Balsalazide|Microbial inactivation by gut bacteria\_|Monitor fecal calprotectin; consider topical formulations\_|\n|**Thiopurines**|Azathioprine, 6-MP|Dairy products (Xanthine oxidase)\_|Avoid dairy 1 hour before/2 hours after dose\_|\n|**JAK Inhibitors**|Upadacitinib, Tofacitinib|Grapefruit\_; High-fat meals\_|Strict avoidance of grapefruit; take consistently with or without food\_|\n|**Biologics**|Infliximab, Adalimumab|Obesity / Adiposity\_|Weight management to improve drug trough levels and response\_|\n|**S1P Modulators**|Ozanimod, Etrasimod|Potential interactions (Ozanimod > Etrasimod)\_|Monitor for liver function; few food-specific restrictions for Etrasimod\_|\n\n\_\_\n\n# Nutritional Monitoring and Requirements: 2024-2026 Standards\n\nAs UC management becomes more personalized, the role of nutritional assessment has been elevated to a core clinical requirement.\_\_\_\n\n**Energy and Protein Needs**\n\nA systematic scoping review published in early 2026 highlights that nutrient requirements fluctuate significantly over the disease course.\_\_\_\n\n* **Energy Expenditure:**\_Measured resting energy expenditure (mREE) ranges from approximately\_24\_kcal/kg/day\_during acute severe flares to over\_30\_kcal/kg/day\_during remission (fat-free mass).\_\_\_\n* **Protein:**\_Requirements are significantly higher during active inflammation to facilitate tissue repair. Standards for 2025-2026 suggest\_1.2−1.5\_grams\_of\_protein\_per\_kilogram\_of\_body\_weight\_per\_day\_during a flare, returning to approximately\_1\_g/kg/day\_in remission.\_\_\_\n\n**Micronutrient Deficiencies: The \"Hidden\" Malnutrition**\n\nPatients with UC are at high risk for \"overnutrition\" (obesity) coupled with \"undernutrition\" (micronutrient deficiencies).\_Regular screening for the following is now mandatory\_:\_\_\_\n\n* **Iron:**\_Should be monitored at diagnosis and at least every 12 months in remission, and every 3 months during active disease.\_\_\_\n* **Vitamin D:**\_Monitored annually due to high rates of osteopenia in IBD.\_\_\_\n* **Vitamin B12:**\_Especially critical for patients who have undergone ileal pouch surgery.\_\_\_\n* **Calcium:**\_Inadequate intake is present in one-third of UC patients.\_\_\_\n\n# The Role of Adjunctive Supplements: Fact vs. Fiction\n\nBy 2025, several supplements have undergone rigorous evaluation to determine if they truly influence disease activity.\n\n**Curcumin: A Validated Adjunct**\n\nCurcumin, a component of turmeric, has emerged as one of the most effective adjunctive therapies for UC.\_Meta-analyses of multiple randomized controlled trials show that curcumin significantly improves clinical and endoscopic remission rates when added to standard 5-ASA therapy.\_\_\_\n\n* **Efficacy:**\_Significant improvement in clinical remission (RR = 2.33) and clinical response (RR = 1.93) has been observed.\_\_\_\n* **Mechanisms:**\_Curcumin targets inflammatory pathways, provides antioxidant support, and helps modulate the microbiota.\_\_\_\n* **Delivery:**\_High dosages and topical enema forms have shown potential for even greater efficacy.\_\_\_\n\n**Fiber Supplements: Psyllium and Beyond**\n\nWhile the benefits of prebiotics (like inulin) remain unclear and can sometimes worsen symptoms during a flare, specific fibers like psyllium have shown promise.\_Supplementation with\_7−20\_g/day\_of psyllium may reduce relapse rates in UC by providing a consistent source for SCFA production, provided it is introduced gradually.\_\_\_\n\n**Alcohol: The Risk of Exacerbation**\n\nThe general recommendation in 2025 is for UC patients to avoid or strictly limit alcohol.\_\_\_\n\n* **Relapse Risk:**\_Longitudinal data presented at DDW 2025 shows a significant correlation between alcohol intake and UC flares (Risk Ratio 2.62).\_\_\_\n* **Mechanism:**\_Alcohol increases gut permeability (\"leaky gut\") and alters the microbiota.\_Furthermore, sulfites in wine and beer can trigger disease activity.\_\_\_\n* **Medication Interference:**\_Alcohol can interfere with the metabolism of almost every class of IBD medication, including biologics and immunosuppressants, leading to potential loss of efficacy.\_\_\_\n\n# Emerging Science: The 2026 Horizon\n\nThe future of UC management (2026 and beyond) is defined by the integration of \"precision medicine\" and \"biotherapeutic\" interventions.\_\_\_\n\n**Anti-TL1A: A New Class of Advanced Therapy**\n\nResearch in 2024 and 2025 has focused on TNF-Like Ligand 1A (TL1A), a cytokine that drives both inflammation and fibrosis (scarring).\_Investigational anti-TL1A agents—including\_tulisokibart,\_afimkibart, and\_duvakitug—have shown encouraging results in moderate-to-severe IBD.\_\_\_\n\nIn the RELIEVE UCCD trial (2025), duvakitug significantly outperformed placebo in achieving endoscopic response at 14 weeks.\_Tulisokibart has similarly shown high rates of clinical remission (26% vs. 1% for placebo) in highly refractory patients.\_A major breakthrough is the development of a \"companion diagnostic\" test that can predict which patients are genetically most likely to respond to this class of drug.\_\_\_\n\n**Live Biotherapeutics: The MH002 Trial**\n\nThe StarFish-UC study (2026) is investigating\_MH002, a live biotherapeutic product containing specific live bacteria designed to restore normal gut function.\_This represents a shift from \"generic\" probiotics to highly targeted biological medicines that aim to treat the underlying microbiome damage in patients insufficiently controlled by 5-ASAs.\_\_\_\n\n# Conclusions and Practical Recommendations\n\nThe synthesis of scientific knowledge from 2024 to 2026 provides a clear roadmap for the dietary management of ulcerative colitis. Success in the modern era requires a transition from restrictive \"elimination\" mindsets to a proactive \"optimization\" strategy.\n\n1. **Prioritize the Mediterranean Pattern:**\_Unless a specific medical reason exists for restriction, the Mediterranean diet should be the foundational eating pattern for all patients with UC to support long-term remission and cardiovascular health.\_\_\_\n2. **Mitigate Known Instigators:**\_Patients should actively reduce the intake of red and processed meats, as well as ultra-processed foods containing emulsifiers like carrageenan and maltodextrin.\_\_\_\n3. **Optimize Medication via Adherence and Diet:**\_Be aware of specific food-drug interactions, such as the avoidance of grapefruit with upadacitinib and dairy with thiopurines.\_Weight management is essential for patients on biologics to ensure adequate drug concentrations.\_\_\_\n4. **Use Supplements with Evidence:**\_Curcumin should be considered a standard adjunctive therapy for enhancing the efficacy of 5-ASAs.\_Psyllium can be a helpful fiber supplement if introduced slowly during remission.\_\_\_\n5. **Personalized Professional Guidance:**\_Because UC is highly heterogeneous, every patient should ideally have access to an IBD-specialized dietitian to navigate the complexities of nutritional assessment, fiber texture modification during flares, and the avoidance of restrictive-diet-induced malnutrition.\_\_\_\n\nThe current era of UC treatment proves that while medication provides the tools for healing, nutrition provides the foundation upon which those tools operate. Integrating these two pillars is no longer optional but a prerequisite for achieving deep, durable, and steroid-free remission.\_\n\n \n***Disclaimer: This newsflash is for informational purposes. Always consult with your IBD-specialized dietitian or GI team before making significant dietary changes.***\n\n# Further Reading: Sources for Every Level\n\n**Level 1: The Basics (Patient Guides & Easy Reads)**\n\n* Crohn’s & Colitis Foundation: What Should I Eat? — A foundational guide on food variety and flare-friendly choices .\n* Cleveland Clinic: Managing Diet During an IBD Flare — Practical advice on soft, bland foods and fiber reintroduction.\n* Healthline: UC Diet Plans and Personal Triggers — An overview of standard diet types and a guide to using food journals.\n\n**Level 2: Clinical Depth (Summaries & Expert Consensus)**\n\n* Nutritional Therapy for IBD: ECCO 2025 Conference Highlights — Summaries of the latest expert talks on urbanization, fiber, and methyl donors.\n* KFF Health News: The Additive War — A deep dive into why the FDA is taking a second look at emulsifiers like Polysorbate-80.\n* MGI Clinic: The Truth About the Carnivore Diet — A critical analysis of why \"starving\" bad microbes may have long-term costs.\n\n**Level 3: Scientific Rigor (Professional Guidelines & Clinical Trials)**\n\n* AGA Clinical Practice Update (2024): Diet and Nutritional Therapies in IBD — The current medical standard for dietary management in clinical settings.\n* ECCO Consensus (2025): Dietary Management of IBD — The definitive European guidelines on maintenance therapy and nutritional assessment.\n* MDPI Nutrients: Mediterranean Diet and Microbiome Synergy — Academic papers exploring how plant polysaccharides decrease colitis severity.\n* The RELIEVE UCCD Trial (2025): Efficacy of Duvakitug (Anti-TL1A) — Phase 2b trial results showing a 48% endoscopic response rate in moderate-to-severe disease .\n* Critical Reviews in Food Science (2026): Nutrient Requirements for UC — A systematic scoping review of energy and protein expenditure over the disease course.\n\n\_***Disclaimer: This newsflash is for informational purposes. Always consult with your IBD-specialized dietitian or GI team before making significant dietary changes.***"
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Update available: v1.8.3 → v1.8.5
Run: npm install -g @jackwener/opencli
Query: ulcerative colitis FMT remission fecal transplant
- id: 1tyt4hl
title: >-
Fecal transplants are quietly becoming a last resort for kids with cancer, autism, and failing guts, and the early
results are hard to ignore
subreddit: r/microbiomenews
author: Technical_savoir
score: 990
comments: 64
url: https://www.reddit.com/r/microbiomenews/comments/1tyt4hl/fecal_transplants_are_quietly_becoming_a_last/
created_utc: 1780780684
selftext: >-
Link to Study
Restoring Microbial Balance: Clinical Applications, Challenges, and Future Directions of Fecal Microbiota
Transplantation in Pediatric Disorders
https://www.mdpi.com/2076-2607/14/6/1241
The Core Issue
A gut microbiome (the trillions of microbes living in your digestive tract) that gets knocked out of balance can
cause serious problems in children, especially kids already dealing with cancer, organ transplants, or developmental
conditions. Antibiotics, chemotherapy, and disease itself can wipe out the good bacteria, leaving the door open for
dangerous infections and worse outcomes.
The Finding
Fecal microbiota transplantation (FMT), which means transferring healthy donor stool into a sick patient to rebuild
their gut community, is well-established for one specific thing in kids: beating back recurrent C. difficile
infections after antibiotics have failed. A single FMT procedure clears the infection about 81% of the time, and a
second round pushes that closer to 90%. Beyond C. difficile, the research is promising but still early, covering
inflammatory bowel disease, autism spectrum disorder, and drug-resistant bacteria.
Why It Matters
Kids with leukemia, those who just had a stem cell transplant, and children on heavy immunosuppressants are among
the most vulnerable to gut collapse, and they have the fewest safe treatment options. FMT could help reconstitute
their microbiome, potentially reducing transplant rejection complications and improving survival. For children with
autism, one open-label study found meaningful improvements in both gut and behavioral symptoms after a modified FMT
protocol, though that result needs much larger trials before anyone draws firm conclusions.
Limitations of Study
Almost all the pediatric data comes from small, single-center studies or case series, not large randomized trials.
Pediatric oncology patients are routinely excluded from rigorous trials, so the field is stitching together evidence
from adult data and anecdotal reports. Long-term safety, especially in immunocompromised children, is still largely
unknown, and FMT protocols vary wildly across studies, making it hard to compare results.
Conflicting Interests
Current clinical guidelines from NASPGHAN and ESPGHAN recommend against routine FMT in immunocompromised children
outside of established C. difficile indications, citing the limited data and real risk of transmitting infections
through donor material.
Interesting Statistics
• Single FMT clears recurrent C. difficile in about 81% of pediatric cases; a second procedure brings success closer
to 90%
• In adult ulcerative colitis data (which pediatric guidelines currently borrow from), FMT achieves remission in
roughly 37% of patients versus 18% in controls
• Among four pediatric oncology patients with recurrent C. difficile tracked in one series, two resolved after one
FMT and one required six separate procedures
• C. difficile rates are notably higher in children with cancer, IBD, and recent organ transplants
• Reduced microbial diversity during the peri-transplant (around the time of transplant) period in pediatric
leukemia patients is linked to greater risk of graft-versus-host disease and worse survival
• The systematic review pulled from 113 publications covering trials through December 2025
TL;DR
Poop transplants reliably cure recurrent gut infections in kids at a nearly 90% rate, but using them for cancer
patients, autism, and IBD is still early-stage science that needs real randomized trials before it becomes standard
care.
post_hint: ''
url_overridden_by_dest: https://biomesci.com/fmt-children-c-difficile-success-rate-limits/
preview_image_url: ''
gallery_urls: []
- id: 13443zq
title: >-
Capsulized Fecal Microbiota Transplantation Induces Remission in Patients with Ulcerative Colitis by Gut Microbial
Colonization and Metabolite Regulation (Apr 2023, n=22, multi-donor) "FMT induced clinical remission and clinical
response in 57.1% (12 of 21) and 76.2% (16 of 21) of UC patients"
subreddit: r/UlcerativeColitis
author: ImTrying2FixU
score: 32
comments: 25
url: https://www.reddit.com/r/UlcerativeColitis/comments/13443zq/capsulized_fecal_microbiota_transplantation/
created_utc: 1682891563
selftext: ''
post_hint: ''
url_overridden_by_dest: https://journals.asm.org/doi/10.1128/spectrum.04152-22
preview_image_url: ''
gallery_urls: []
- id: tvmlmb
title: >-
Strain-resolved analysis in a randomized trial of antibiotic pretreatment and maintenance dose delivery mode with
fecal microbiota transplant for ulcerative colitis (Apr 2022, n=22) "Of patients who received antibiotic
pretreatment, 6 of 11 experienced remission, versus 2 of 11 non-pretreated"
subreddit: r/HumanMicrobiome
author: MaximilianKohler
score: 20
comments: 15
url: https://www.reddit.com/r/HumanMicrobiome/comments/tvmlmb/strainresolved_analysis_in_a_randomized_trial_of/
created_utc: 1649026807
selftext: ''
post_hint: link
url_overridden_by_dest: https://www.nature.com/articles/s41598-022-09307-5
preview_image_url: >-
https://external-preview.redd.it/VezFNtHK-6fvYyPd9inTUdP7vtuu6IbJVjOVPtMwuyo.jpg?auto=webp&s=319466f018f4420e48686bf9c6105bf198f3676b
gallery_urls: []
- id: vpq03a
title: >-
Efficacy of Fecal Microbiota Transplantation in the Treatment of Active Ulcerative Colitis: A Systematic Review and
Meta-Analysis of Double-Blind Randomized Controlled Trials (Jun 2022) "Clinical remission or response significantly
higher in patients who received FMT compared with placebo"
subreddit: r/IBD
author: MaximilianKohler
score: 14
comments: 9
url: https://www.reddit.com/r/IBD/comments/vpq03a/efficacy_of_fecal_microbiota_transplantation_in/
created_utc: 1656762263
selftext: ''
post_hint: link
url_overridden_by_dest: https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izac135/6619552
preview_image_url: >-
https://external-preview.redd.it/BMcV6skyYcXjaD3Pq5FLqijv5vCtru32PeDPZVK5GYY.jpg?auto=webp&s=821ea2fa65753cbb7222db7b4a7aa8d943fc218c
gallery_urls: []
- id: 134425p
title: >-
Capsulized Fecal Microbiota Transplantation Induces Remission in Patients with Ulcerative Colitis by Gut Microbial
Colonization and Metabolite Regulation (Apr 2023, n=22, multi-donor) "FMT induced clinical remission and clinical
response in 57.1% (12 of 21) and 76.2% (16 of 21) of UC patients"
subreddit: r/HumanMicrobiome
author: ImTrying2FixU
score: 29
comments: 1
url: https://www.reddit.com/r/HumanMicrobiome/comments/134425p/capsulized_fecal_microbiota_transplantation/
created_utc: 1682891428
selftext: ''
post_hint: ''
url_overridden_by_dest: https://journals.asm.org/doi/10.1128/spectrum.04152-22
preview_image_url: ''
gallery_urls: []
- id: 13442xb
title: >-
Capsulized Fecal Microbiota Transplantation Induces Remission in Patients with Ulcerative Colitis by Gut Microbial
Colonization and Metabolite Regulation (Apr 2023, n=22, multi-donor) "FMT induced clinical remission and clinical
response in 57.1% (12 of 21) and 76.2% (16 of 21) of UC patients"
subreddit: r/IBD
author: ImTrying2FixU
score: 6
comments: 3
url: https://www.reddit.com/r/IBD/comments/13442xb/capsulized_fecal_microbiota_transplantation/
created_utc: 1682891484
selftext: ''
post_hint: ''
url_overridden_by_dest: https://journals.asm.org/doi/10.1128/spectrum.04152-22
preview_image_url: ''
gallery_urls: []
- id: vpq0v5
title: >-
Efficacy of Fecal Microbiota Transplantation in the Treatment of Active Ulcerative Colitis: A Systematic Review and
Meta-Analysis of Double-Blind Randomized Controlled Trials (Jun 2022) "Clinical remission or response significantly
higher in patients who received FMT compared with placebo"
subreddit: r/UlcerativeColitis
author: MaximilianKohler
score: 10
comments: 8
url: https://www.reddit.com/r/UlcerativeColitis/comments/vpq0v5/efficacy_of_fecal_microbiota_transplantation_in/
created_utc: 1656762341
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Long-term efficacy and safety of monotherapy with a single fresh fecal microbiota transplant for recurrent active
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Long-term efficacy and safety of monotherapy with a single fresh fecal microbiota transplant for recurrent active
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Fecal microbiota transplantation versus glucocorticoids for the induction of remission in mild to moderate
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