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Comment by jamal-kumar | Hacker News Reader

I had really bad IBS from consuming water on a tropical island in Panama one time and suffered for a few years with even my doctor friend telling me "Damn that sucks, not much you can do except manage". Pretty horrible symptoms until I discovered L. Reuteri. [1] I read that it's been a bacteria that was more commonly found in samples until around the 1950s when people started consuming more garbage processed food and was sold. Simply stated, it changed my life. It emits a substance called Reuterin which inhibits the growth of other more harmful bacterial species. [2] I can't speak personally for suffering on the level of Crohn's disease, but there's positive research out there regarding it. [3] [4]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917019/

[2] https://en.wikipedia.org/wiki/Reuterin

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270012/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468961/

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> Damn that sucks, not much you can do except manage

This has been my entire experience with gastroenterology as a field. Once they rule out cancer there's really not much they can do for you. Meanwhile, I'm waiting for the revolution in our understanding of the microbiome.

I’ve been throwing up for a year straight. Recently it has gotten worse. The only thing that seems to help is weight loss. I just feel like there’s shit in the back of my throat multiple times a day (which I mean, there is) but the only way to clear it to my body’s satisfaction is throwing up. Gastroenterologist took a look and said everything looked fine. Thanks, doc, very helpful.

Not sure why people flagged the guy who said if I smoked a lot of pot it could be causing this. He’s totally right, my doctor did in fact ask me if I smoke a lot of marijuana or anything, as it can cause excessive vomiting. But no, that’s not why in my case at least. If someone could unflag him that’d be cool but I apparently can’t.

If you smoke a lot of pot it could be that cannabis hyperemesis thing people are getting

My teenager kid is having stomach pain, mostly after eating food. This has been going on for 3-4 years and we have seen 2 different doctors. They have done stool test, endoscopy and colonoscopy. However, everything is clean and they can not find a cause or treatment. So my child keeps taking pain killer almost every day and avoid eating when she is out. Unfortunately, they do not have any idea what might be going on while obviously something is wrong.

Does that happen with all food? Have you tried an elimination diet? Unfortunately chronic conditions like this are an absurd amount of trial and error in many cases.

Yes, it is not really predictable. There are certain food that is worse like pop-corn but we can not say that a certain group of foods trigger it.

That’s really unfortunate. I second what other people have recommended about attempting an elimination diet. I went on a ketogenic, minimal processed food diet of foods and it resolved a lot of these issues. I went back to eating like crap and the issues came back with a vengeance.

My philosophy is try what the doctors say and if that doesn’t work it’s time to expand your search space. Like troubleshooting code.

Please only take painkillers continuously under the direction of your doctor. A lot of people don’t realise this, but NSAIDs like ibuprofen and other types like paracetamol / acetaminophen do negatively impact your liver and / or kidneys, especially after repeated use. Always read and adhere to the label of the medication you take.

You should get a gastric-emptying study done. I had similar symptoms and was diagnosed with gastroparesis. Unfortunately, it's one of those "not much we can do" situations, but knowing what the underlying issue was allowed me to find a diet that got me back to a semi-normal life.

I’m not a doctor, and I don’t like to be that person pretending they know anything about other people’s problems, but two things come to mind, both long shots, that may plausibly help with the sensation of something in your throat: Gaviscon and Chloraseptic. Gaviscon (supposedly) reduces reflux by changing the physical properties of the contents of your stomach. Chloraseptic literally numbs your throat.

They’re both available OTC. Read the labels before using :).

You could also try seeing an ENT.

Interesting. I was thinking of the mechanics of what's going on and it always feels like there's gunk I can't cough out in the back of my throat. Tried some Mucinex today, going to take it tomorrow morning and see if it prevents my early morning puke (which is mostly dry heaving as there's nothing actually in my stomach). I never ever feel nausea while I'm laying down or sleeping.

I do worry that with Chloraseptic I'm treating the symptom but not identifying and mitigating whatever the cause is, but I might try it to help keep me from throwing up! My wife recommended it the other day but I dismissed her out of hand. I really should listen to her more.

I just recently watched "Diagnosis" on Netflix. One of the cases seems similar. It may not help directly, but it's an all around interesting show, might want to have a look.

Have you tried an elimination diet? Did one a decade ago and it really changed my life.

I think the vomiting might be a combination of food sensitivities causing problems and allergies. I ate nothing but meat and cheese for a few days (as I know I don’t react to these) and felt much better, but then I tried to stop taking my allergy medications and I started throwing up again.

I’ve lost 80 pounds before doing elimination, then 60 the last time (if I go back to SAD, I gain weight again).

Today I took Mucinex and Flonase and Xyzal, and haven’t thrown up yet. But there’s definitely some sort of food that I’m eating that exacerbates whatever is already happening. Thanks for the advice.

I had horrible sinus headaches and post nasal drip. It bothered me so much when a doctor would prescribe me flonase, just treating the symptom. It was all food, try chicken and rice. I live off meat and dairy now, but dairy can give people mucus so I'd cut it out initially. Also with the meat, avoid deli meats and bacon in the initial tests as they have sodium nitrite, turned out to be a trigger for me. Gluten too. Look at all the FODMAPs. Carnivore diet is a good shotgun approach.

Do you have an introduction to it? ie something that covers which food groups are most likely to be the culprit, what kind of grouping to make etc?

For digestion issues it is usually a FODMAP, gluten, lactose, fructose, legumes. Everyone is different though so I try to not bias things. Chicken and rice, I'd recommend cutting out caffeine and sugar but it's a bit extreme, just mind what you drink for fructose and lactose.

did the same thing almost 5 years ago, changed my life as well!

Consider getting tested for lyme disease if you haven't already.

has a pharyngeal pouch been excluded?

I couldn't swallow pills before, my gastroenterologist performed surgery which corrected that. She also proscribed pills which address my GERD

That's fair. Guess I'm mostly talking about the other end of the system :)

There are actually biologic treatments for Crohn's/UC, not everyone responds but they produce remission which can spare or prolong time to surgery for many.

it's perfectly okay to cut out everything that triggers GERD, see fiber menace

My life would be significantly less enjoyable without the foods that trigger my GERD. I'll stick with the small, cheap pill that lets me continue to enjoy carbonation, hot drinks, spice, chocolate, acidity, dairy, fried foods

If that pill is esomeprazole / Nexium or other proton-pump inhibitor, do note that repeated use is correlated with early onset osteoporosis.

My doctor informed me of the side effects when she gave me the prescription.

My advice is to go to microbiome experts like Dr Borody, he has a lot more tools to help like fecal transplants and antibiotica for Crohn (long story, look at his videos). Borody is the one who invented the triple antibiotics therapy for the helicobacter pylori.

had the same experience. spent a couple thousand on colonoscopy and when the results were benign and it was "just" IBS, the gastroenterologist basically told me to go fuck myself. And eat more fiber.

Fellow IBS-sufferer here. Runs in my family.

So doing a search for "Reuteri" on Amazon, I immediately see several pages worth of supplements, with such helpful reviews as "HELPS DIGESTION. ENLARGES TESTICLES."[0]

How do you separate the trustworthy supplements from the snake oil?

[0] https://a.co/d/4Qa1iy1

There's one supplier I trust out of Sweden called Biogaia. [1] Look for the keith haring lookalike box art. I don't buy anything off of that website but it's something you can get a couple of weeks supply of from the pharmacy for under 100$.

Amazon is so full of scams, Jeff Bezos really needs to be held to account for that.

[1] https://www.biogaia.com/

> There's one supplier I trust out of Sweden called Biogaia

Which supplement from them are you referring to?

Probably https://www.biogaia.com/product/biogaia-gastrus/ ?

Yeah that's the brand, I've seen that in the USA and this in international markets [1]

[1] https://www.biogaia.com/product-country/biogaia-protectis-ch...

Thanks.

At my hospital we prescribe Lactobacillus reuteri for older patients on broad spectrum antibiotics to reduce the risk of C. difficile infection. The brand name used is ProTectis which appears to be exactly the BioGaia product another commenter was describing.

We have actually recently stopped using protectis in this way as the evidence base is too thin to justify the cost, but suffice to say that the Biogaia protectis is sufficiently genuine to be prescribed in UK hospitals.

If reddit anecdotes are to be believed the enlarged testicles are true.

https://www.reddit.com/r/Supplements/comments/9pdrg1/my_expe...

https://www.reddit.com/r/Supplements/comments/m3ywju/questio...

There are more but just linking these two.

In places like this on reddit, so many posts are just influencer accounts.

You'd probably be better off reading such reddit forums, and presuming the exact opposite happens.

This is another area to clean up, in the digital age.

Just echoing this. I've worked with marketing agencies who use Reddit to post things like this for their clients.

Both of those posts have the OP linking to specific products, with one of the OPs blatantly posting a referral link to a specific product.

Even without the links or mentioning specific products or brands, marketers will post things like this to build up markets, audiences and anticipation for new products, in this case it is a specific species and variant of bacteria.

It's pretty easy to suss out a lot of those accoutns just by looking at profile age and their comments. Sure, sometimes people sell their accounts but it'll be apparent eventually.

> Fellow IBS-sufferer here. Runs in my family.

I see what you did there.

Interestingly, may not be all wrong: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879365/

Yes its shitty chumbucket type marketing but there's still some potential.

Having any sort of active microbiome is probably a good idea and an intended aspect of the human digestive system. I don’t know that this one specifically is better or worse but I would probably consider probiotics a decent idea to try.

The testes thing is… I guess vaguely plausible. I’m bemused everyone in the reviews seems to be confident that this is desirable. It seems like desperate people are just flocking to some study on rats.

Sure, but the parent comment was suggesting a specific bacterium, so I would want to make sure whatever probiotics I'm buying contain it. And normally I would probably just rely on getting them through a trusted vendor (e.g. my neighborhood grocer/pharamcy/health food store), but if I'm forced to shop online to make sure it has this specific thing in it...I want something I can check to vouch for its quality, yeah?

For example, pretty much every bottle of probiotics you buy will claim it contains "Over XX billion CFUs (colony-forming units?) in every pill!" But, are more better? Are they the right kind? Will I get 60 billion CFUs in a pill if I just dehydrate some pond water?

> And normally I would probably just rely on getting them through a trusted vendor (e.g. my neighborhood grocer/pharamcy/health food store), but if I'm forced to shop online to make sure it has this specific thing in it...I want something I can check to vouch for its quality, yeah?

Oddly enough, with the food/supplement I'm most familiar with, kava, the worst quality you can find is in brick and mortar establishments. The trusted vendors are all online-only and dedicated entirely to the one product instead of just trying to stock their shelves with every supplement on the planet.

Well I guess my thought process (however incorrect it might be) is that from a food safety perspective--not necessarily a supplement efficacy perspective--there's a greater bar to pass for the FDA to allow something to sit on the shelf at CVS than to get it from some random vendor on Amazon that might not even reside in the US.

I see. The fact is, the FDA doesn't regulate what's in supplements so it could be grass in those pills whether they come from Utah or Uttar Pradesh.

As for food safety, the standards are the same whether manufactured in the US or outside. The FDA ensures they comply with HARPC and are made in cGMP facilities.

https://iherb.com/search?kw=Reuterin

Since it’s a Lactobacillus, I wonder if you can take the supplements and introduce it in home made yogurt?

Then just consume the yogurt regularly.

Not sure if anyone has ever tried anything like that..

It looks like this strain will indeed culture a yogurt - https://www.luvele.com/blogs/recipe-blog/how-to-make-l-reute...

The part titled "THE BEST MILK TO USE" is not good advice. UHT (ultra heat treated milk) is far better to use for yoghurt making than normal milk (I say "normal" for someone from the UK where most milk consumed is pasteurised at lower temperatures to avoid denaturing the milk).

Denaturing is a plus for making a yoghurt, and the high temperature also further removes bacteria that may spoil the yoghurt. It also means you don't need to go through the initial heating portion of most recipes and go straight to the fermentation phase at a lower temperature.

This is seriously awesome. We make yogurt at home anyway, so it is very easy to introduce this.

I’m assuming we can just add this to our culture and not make yogurt using just this, but I guess that will require some experimentation.

Yes you can make yogurt out of it. Technically speaking, lactobacillus refers to the fact that this bacterium produces lactic acid not that it consumes lactose.

It’s easy to confuse.

I just finished making 2 liters of yogurt with this bacterium this morning.

Is your yogurt culture just this bacteria or did you start with regular yogurt culture and added this?

Reuterin which is a broad spectrum antibiotic... Ironic.

How did it change your life? Did you take a supplement containing it, or was it some experimental treatment?

I don't have the shits every day anymore. Got it at a pharmacy.

Along those same lines, Visbiome and homemade kefir (the kind at the store isn't technically kefir) helped me out immensely.

Do you need to keep taking this or is it enough to take it a while and repopulate your guts ?

How long until you saw results ?

I took a couple of 40$ boxes of it for a few weeks and ever since, I've had no problems. Pretty great!

I buy a box every now and then since then just to keep it up. It's like the most expensive probiotic on the shelf, but it works.

Oh yeah, and I also stopped consuming crap that goes in the fridge or freezer ready to eat a long long time ago. I think that might have something to do with it. They found that there's certain harmful bacterial species which proliferate in such environments [1]

[1] https://ask.usda.gov/s/article/Can-bacteria-grow-in-the-refr...

Also, people who are eating too many pre-made/processed/frozen foods might not be eating enough fresh, organic fruits and vegetables, which are a great source of helpful bacteria and the prebiotic fibers that keep them alive.

Jumping on this, modern refrigeration has helped us, as humans, tremendously in a lot of ways but hurts us too. Your example is a good one, but there's also certain kinds of mold that grow in the fridge on berries that cause weird stomach problems if you don't wash your fruit when you take it out.

Any references for this? We eat a lot of refrigerated berrys.

I'm sorry. I tried to find it, but my google foo can't come up with the type of mold it was to narrow my search.

It was a study I read years ago, but it'll take me a while to find it. Give me a day or two and I'll try to get it for you!

Which tropical island, specifically?

It sounds horrible, I'm sorry that happened to you.

Isla Bastimentos. It's in an archipelago that was like a pirate enclave back in the day where they speak a mixture of Spanish, English and French. Very cool place, I go to that region at least once a year actually - But that first one I was pretty naive and did what you shouldn't do, which is consume tap water (even if boiled) on a tropical island.

What's fun to do in that region is waking up early to take one of the speedboats that drops you off on cayes zapatillas, which are these small islands you can walk around in around 20 minutes. Make sure to bring water and wear sunscreen of course, but you get to feel like you're on a treasure island for a day and there's good snorkeling/diving reefs around there as well.

Are you saying you always boiled it and still ended up sick? If so, terrifying.

Just once. Drink bottled water when you go to these places. They are tropical islands covered in jungle trees where pumas swim between these islands, it's not that hard to realize why when you think about how water flows in a place where everything is trying to kill. It's terrifying until you realize all nature isn't disney.

Where do you get it?

Pharmacy

Go to any health food store and they’ll have a refrigerated section of all the placebo bacteria supplements you could ever want.

You can test if a probiotic is actually alive. They may not provide the effect you want but they’re probably not placebos. The good ones at least.

Test I found if anyone else is wondering.

https://drformulas.com/blogs/news/probiotic-milk-test-how-do...

Can it be done with disposable syringes? They are available cheaply for kids's experiments and sometimes look more anaerobic than saran wraps.

You speak from a position of disparagement but I'm living proof ¯\_(ツ)_/¯

The world has no shortage of “I don’t understand this so it couldn’t be important” in daily life, let alone online.

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