[HN Gopher] New work helps to explain how chronic stress can inf...
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       New work helps to explain how chronic stress can inflame the gut
        
       Author : pseudolus
       Score  : 217 points
       Date   : 2023-05-26 03:54 UTC (19 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | abernard1 wrote:
       | I would just like to point out that in the space of two decades
       | we've whipsawed between "ulcers aren't caused by stress, they're
       | caused by bacteria" to "no actually ulcers might really be mainly
       | caused by stress."
       | 
       | Many such cases. I once wondered whether my decision to not
       | pursue a PhD in physics was a mistake, but I increasingly believe
       | we live in a Dark Ages. It is impossible to take the vapid
       | Science as an institution seriously, especially when it embraces
       | this myth of science being constantly correct.
       | 
       | (And yes, I understand there's a difference between scientific
       | press and actual scientists. And no, you're wrong if you think
       | their self-esteem or general sheltered Mickey Mouse worldview
       | around their importance is any different than the public press.)
        
         | kortex wrote:
         | > "ulcers aren't caused by stress, they're caused by bacteria"
         | to "no actually ulcers might really be mainly caused by
         | stress."
         | 
         | Por que no los dos? H. pylori needs to artificially buffer its
         | micro-environment in order to survive. Anything which disrupts
         | the production of stomach acid or digestive proteins could give
         | it an edge.
         | 
         | Anecdata of 1, but I had a bout of bad chronic heartburn after
         | eating at some sketchy food joint. I was popping omeprazole
         | like crazy. Somehow in researching this, the topic of hydrogen
         | forming bacteria came up. I somehow hypothesized that PPIs were
         | actually exacerbating the problem, because the higher pH was
         | allowing the bacteria to survive. I put myself on a high
         | prebiotic/probiotic diet, stopped the PPIs and antacids, and it
         | resolved completely by a few weeks later. I could easily see a
         | similar thing happening with heliobacter.
        
         | throwaway4220 wrote:
         | Ulcers are not all the same just like cancer is not all the
         | same. H pylori still causes gastric ulcers.
         | 
         | Also the "medical-science" institution you are imagining with a
         | collective self-esteem doesn't exist in any cohesive way. You
         | memorize, read, diagnose and treat.
         | 
         | And please don't lump us in with phDs
        
         | spondylosaurus wrote:
         | Could the ulcer question just vary based on the type of ulcer?
         | I know that h. pylori _is_ a big culprit in people who have
         | ulcers but are otherwise healthy, but IBD causes ulcers too
         | (putting the  "ulcerative" in "ulcerative colitis")--and since
         | stress is a driver of IBD flares, those are certainly ulcers by
         | way of stress. But they occur in different portions of the gut,
         | usually.
        
           | throwaway4220 wrote:
           | Yes ulcers are just erosions of the inner layers of stuff.
           | You can have ulcers in your arteries too.
        
           | joker_minmax wrote:
           | Absolutely does, there are multiple causes of ulcers. Canker
           | sores in your mouth are caused by either stress or vitamin
           | deficiency and they're still "ulcers". And what H. Pylori
           | does is a huge cause of gastric cancer, so pathogens damaging
           | the body is a factor. I agree with the top comment of this
           | tree that we can't see science as set in stone, but many
           | things have multiple causes that work separately or
           | synergistically
        
       | zoogeny wrote:
       | I have a friend who is a Nurse Practitioner. In Canada this is
       | pretty close to a doctor in that they can order tests, diagnose
       | patients and prescribe treatments and medications. She was in
       | private practice for a while.
       | 
       | She talks often about how the most common complaint she saw by
       | far is gut distress with no medical cause. It is so common that
       | the medical professionals call it SLS: Shit Life Syndrome [1].
       | She argues that the vast majority of the people who come in with
       | this complaint have an undiagnosed mental problem. Our systems
       | aren't built to handle this kind of situation. We find and treat
       | acute problems and we don't really address holistic life-style
       | issues. In fact, it is frowned upon. What she usually wants to
       | say is: your life sucks, fix it and you will feel better. Go out
       | for a walk, eat healthier food, make some supportive friends,
       | engage in some self-care, meditate, etc.
       | 
       | I personally believe that a lack of purpose in people's lives is
       | manifesting as pain in our bodies. But that is dangerously close
       | to woo-woo New Age thinking and most people will just reject it
       | off-hand. Instead they will try magnesium pills, apple cider
       | vinegar, avoiding gluten, anti-inflammatory diets, micro-dosing
       | lsd or mushrooms.
       | 
       | As a side note, she also mentioned that the newest fad (not quite
       | at gut distress levels yet) is middle-aged men insisting they
       | have ADHD, demanding diagnosis and prescriptions.
       | 
       | 1. https://en.wikipedia.org/wiki/Shit_life_syndrome
        
         | CharlesW wrote:
         | > _As a side note, she also mentioned that the newest fad (not
         | quite at gut distress levels yet) is middle-aged men insisting
         | they have ADHD..._
         | 
         | The reason for this "fad" is straightforward -- there are a
         | _lot_ of middle-aged humans who are undiagnosed because ADHD
         | was effectively  "not a thing" when GenX were kids.
         | 
         | > _...demanding diagnosis and prescriptions._
         | 
         | Great! People of all ages should advocate for themselves and
         | pursue health care that might improve their quality of life.
        
           | 0xcde4c3db wrote:
           | > The reason for this "fad" is straightforward -- there are a
           | lot of middle-aged humans who are undiagnosed because ADHD
           | was effectively "not a thing" when GenX were kids.
           | 
           | Or to the extent that it was, they only knew of it through
           | narrow or outright inaccurate stereotypes. It's become a
           | somewhat common story over the past few years in online ADHD
           | communities for Gen X and older Millennial parents to get
           | their kid diagnosed and have a "wait, that's not normal?"
           | reaction to the explanation of how the condition actually
           | tends to manifest.
        
             | roundandround wrote:
             | But I think it was normal. Would modern undiagnosed
             | children have flourished in less institutional settings? I
             | think being on the dangerous edge used to be safer than
             | being insufficiently experienced in dangers that were
             | unavoidable and in many cases predatory.
        
             | rightbyte wrote:
             | ADHD have symtoms that could fit anyone. It is about a
             | threshold.
        
           | zoogeny wrote:
           | I think "advocate for themselves" can be reductive. There is
           | a spectrum of advocacy.
           | 
           | One approach is to work with a medical team over time to
           | document symptoms and impact on your life, experiment and
           | document attempted treatment alternatives, escalate to
           | appropriate specialists as necessary, etc.
           | 
           | Another approach is to spend a weekend reading blog posts,
           | forums and chatting with your bros, then convincing yourself
           | of a particular syndrome/disease you must have, urgently
           | scheduling an appointment with a brand new medical
           | practitioner, refusing to discuss your medical history or
           | symptoms since you already know everything, demanding a
           | particular and specific treatment, refusing to discuss
           | alternatives and then becoming hostile and aggressive when
           | that practitioner doesn't immediately write you a
           | prescription for the particular medication or expensive test
           | that you have already decided that you need.
           | 
           | That second approach is a caricature that unfortunately
           | approaches a modern reality, and it isn't what I'd term as
           | "Great!" for anyone involved. The first approach is equally
           | horrible since our system is so back-logged that the amount
           | of time and personal effort between starting the process and
           | receiving the help you need is onerous.
           | 
           | Note that this applies equally well to gastro-intestinal
           | distress as it does to ADHD or any other chronic condition.
        
             | CharlesW wrote:
             | > _There is a spectrum of advocacy._
             | 
             | There are plenty of "pill mills" and "scrip doctors", and
             | plenty of patients who will abuse that gray-market system.
             | That is not what I'm referring to when I talk about self-
             | advocacy by people who need actual, legitimate help.
        
         | southwesterly wrote:
         | Middle aged man with ADHD here. Just found out. Didn't want it.
         | Although it explains a lot of my almost 50 previous years. I am
         | now sad.
        
         | voisin wrote:
         | > What she usually wants to say is: your life sucks, fix it and
         | you will feel better. Go out for a walk, eat healthier food,
         | make some supportive friends, engage in some self-care,
         | meditate, etc.
         | 
         | It's almost like we haven't collectively created a society that
         | aims to increase human flourishing and instead of created a
         | living nightmare with the illusion of progress due to shiny new
         | technologies.
        
           | broguinn wrote:
           | This, so much this. My family often jokes about how I'm the
           | health and fitness "freak", because I care about my wellbeing
           | and stress levels. However, this is very normal in my social
           | circle - and I would argue - in my class and generation. A
           | few examples come to mind:
           | 
           | - The rise of social/fitness loci. Young people socialize
           | through sports, cycling groups, climbing gyms. - The advent
           | of data-driven fitness. So many people have wearables, sleep
           | trackers, follow the science behind health (Huberman podcast,
           | Rhonda Patrick, etc.). - More people are opting for healthier
           | living, generally (regular bedtimes, stopping or greatly
           | limiting drinking, removing stigma from mental health
           | diagnoses).
           | 
           | It feels like this generation is the first to really
           | prioritize physical wellbeing as a primary driver of overall
           | quality of life. I sincerely hope this trend sticks, and we
           | look back 20 years from now and are surprised that so many
           | people for so long neglected the fundamentals of health.
        
         | hirvi74 wrote:
         | > _middle-aged men insisting they have ADHD, demanding
         | diagnosis and prescriptions._
         | 
         | My opinions on the matter, as someone with ADHD, is that I do
         | not personally believe that treatments that can improve one's
         | life should be gatekeeped (gatekept?) sheerly by disorders. In
         | other words, if people have symptoms and medicine has the tools
         | to treat said symptoms, then such tools should be used
         | regardless of the condition. If one is struggling to achieve a
         | life that is within their potential, then why should they be
         | denied something that can assist them? It would be like saying,
         | "only paraplegic people are allowed to use wheelchairs. It
         | doesn't matter if your legs are broken, they still technically
         | work, thus you don't deserve to use a wheelchair." It's not
         | like various psychostimulants commonly used for ADHD weren't
         | used for 70+ years prior to being indicated for ADHD and other
         | conditions.
         | 
         | Personally, I have always hated the false dichotomy of either
         | one having ADHD or not. I do not think it's that simple, and it
         | is surely not a binary condition. The condition is nothing more
         | than a label assigned to an arbitrary set of symptoms. Even the
         | diagnostic criteria is not all encompassing of the many
         | symptoms people with the condition struggle with.
         | 
         | Just thinking about the various people I know in my life, I
         | would confidently say not all them have equal attention spans,
         | executive functioning, etc.. So, what's the arbitrary cut-off?
         | 
         | Another issue that ADHD (and many other conditions) is that
         | there is absolutely no way beyond a reasonable doubt to prove
         | who has the condition and who does not. There is not a single
         | biomarker -- no gene test, no urinalysis, no blood marker, no
         | fMRI brain scan, etc. that can be used to definitely diagnose
         | the condition in a clinical setting. The diagnosis is just a
         | professional and clinically informed opinion using heuristics.
         | 
         | How was I diagnosed? I went through a gauntlet of exhausting
         | interviews and somewhat pseudo-scientific psychometrics -- WAIS
         | IV IQ test, Stop/Go test, and plenty of others that I cannot
         | remember the name of. It's about as legitimate as one can hope
         | for currently... or at least a decade ago.
         | 
         | With all the being said, I definitely think it's a completely
         | real condition, I just think we are operating on a model
         | similar to the Plum Pudding Model of the atom -- it's not
         | completely wrong, but definitely not correct -- but it's the
         | best we have at the moment. The question I often ask myself is
         | that, "Is there something actually wrong with me, or is
         | something wrong with the world we live in?" For me personally,
         | this disorder has no negative health affects other than making
         | me completely incompatible with this world. I mean, I'm within
         | in the range of average height for adults males. My height
         | causes me no issues in my life. However, if I were to play in
         | the NBA, it would cause all kinds of issues. Does that mean I
         | would have a height deficit disorder?
         | 
         | One more thing about the medications, people have no idea what
         | they are messing with. Sure, stimulants would help a majority
         | of people be more productive (caffeine/nicotine are common for
         | a reason), but nothing in life is without a cost. They
         | absolutely help me live a life that I would unlikely be able to
         | without them. That doesn't mean they are sunshine and roses. In
         | some ways, I feel like I made a deal with the Devil. I have had
         | many friends with ADHD and many friends without ADHD that lied
         | to get access to the medications too. I've seen these
         | medications help people reach the heavens, and I have seen
         | these medications drag people through utter Hell.
         | 
         | Anyway, sorry if this is all over the place and somewhat
         | pointless. I do have ADHD after all. ;)
        
           | zoogeny wrote:
           | I really appreciate this response.
           | 
           | > I do not personally believe that treatments that can
           | improve one's life should be gatekeeped (gatekept?) sheerly
           | by disorders
           | 
           | In my most libertarian moments I totally agree. But I also
           | accept (even if I don't agree) that a large number of people
           | believe that the detriments to society as a whole (including
           | to some individuals in particular) caused by the misuse of
           | powerful and addictive substances outweighs the benefits of
           | un-controlled access.
           | 
           | > How was I diagnosed? I went through a gauntlet of
           | exhausting interviews and somewhat pseudo-scientific
           | psychometrics -- WAIS IV IQ test, Stop/Go test, and plenty of
           | others that I cannot remember the name of. It's about as
           | legitimate as one can hope for currently... or at least a
           | decade ago.
           | 
           | The "fad" I was talking about was individuals showing up to a
           | medical professional and having the totally unrealistic
           | expectation that after a one hour consultation they would be
           | diagnosed with a severe mental disorder and that they would
           | walk out that same day with a prescription for a controlled
           | stimulant.
           | 
           | The real path to treatment in our system is much more
           | difficult. You have to demonstrate and document a history of
           | symptoms and their effects on your life. It can take 6-12
           | months in many places to get into a specialist like a
           | psychiatrist. Then it can take many more months of
           | experimentation with alternative treatments before being
           | prescribed medications.
           | 
           | That path is, frankly, atrocious. We are so starved for
           | qualified resources that the system purposely slows things
           | down. If you are able to work and live life even minimally -
           | you are low on the priority list in many cases. There are
           | enough truly horrible cases (severe schizophrenia, bipolar,
           | etc.) that involve people unable to function at all that
           | those who are merely suffering can get ignored. Front-line
           | medical workers gate-keep access to specialists out of
           | necessity, not out of malicious intent.
           | 
           | The patience you demonstrated to get the help you need is
           | commendable but also proof that the system delivers for those
           | who need it.
           | 
           | The alternative path that many choose to take is to become
           | hostile, aggressive or abusive. They refuse to push through
           | the system or to even attempt alternatives. They demand a
           | specific diagnosis and a precise medication and they get
           | angry when they don't get it.
           | 
           | > In some ways, I feel like I made a deal with the Devil.
           | 
           | This is is one reason why the system pushes people to try
           | every alternative possible before going down the route of
           | medication. If someone can find any alternative to medication
           | to manage their symptoms - they ought to avoid the diagnosis
           | and avoid the medicine.
           | 
           | It is just the case that many possible alternatives,
           | including life-style changes, are explicitly forbidden to
           | talk about. So while the medical practitioner may want to
           | say: you need better friends, a better job, a better life in
           | general ... they often cannot. Nor are some aggressive and
           | hostile people willing to listen even if they could.
        
             | hirvi74 wrote:
             | > _But I also accept (even if I don 't agree) that a large
             | number of people believe that the detriments to society as
             | a whole (including to some individuals in particular)
             | caused by the misuse of powerful and addictive substances
             | outweighs the benefits of un-controlled access._
             | 
             | I completely understand where you are coming from. I really
             | think it is a detrimental society that pushes people into
             | that direction. I have noticed that I mainly take
             | stimulants due to the demands of other people. Do I care if
             | my project is not completed on time? No. Does my employer?
             | Absolutely. I wouldn't be surprised if some of that
             | parallels with others. I hate having to kill myself from
             | the inside out just to function in this world, but I do
             | what I have to do in order to survive.
             | 
             | > _The real path to treatment in our system is much more
             | difficult. You have to demonstrate and document a history
             | of symptoms and their effects on your life. It can take
             | 6-12 months in many places to get into a specialist like a
             | psychiatrist. Then it can take many more months of
             | experimentation with alternative treatments before being
             | prescribed medications._
             | 
             | This is where I had a wildly different experience. I guess
             | it is probably because I am not part of the "fad" you are
             | talking about. However, my university had a psych on staff.
             | I scheduled an appointment with him, and I saw him in like
             | a couple days afterwards. He did a basic interview with me,
             | and based on just my behaviors, mannerisms, etc.. He
             | chuckled and said, "You are _so_ ADHD. However, I need to
             | you undergo formal testing out of policy, you should go to
             | <insert name of place.>"
             | 
             | So, I scheduled an appointment, and did all the
             | interviewing testing in two or three sessions, and I was
             | being treated in like two weeks or less. Alternative
             | treatments were actually never even attempted nor
             | suggested. It was straight to medications.
             | 
             | I've still not had many issues getting into doctors, and
             | perhaps I am just very lucky in that regard. I recently
             | left my most recent psych and moved to my GP. He will only
             | treat me because I have a formal diagnosis (e.g.
             | documentation "proving" it). If a psych or another doctor
             | diagnosed me and treated me, that would not be sufficient
             | because my GP claims there wouldn't be enough "evidence" to
             | prove I have the condition. So, I do feel bad for many
             | people who were diagnosed in less formal ways.
             | 
             | I am all for the alternative path, and I am starting to
             | investigate how to go down that path. I have not been very
             | thrilled with psychiatrist. I have many qualms with how
             | psychiatry as a field operates. I am not anti-medicine by
             | any means, but I have never seen nor heard of such a
             | punitive and unscientific field of medicine. Never forget,
             | it's the only field of medicine that can make patients take
             | medicine against their will and involuntarily hold someone
             | against their will.
             | 
             | If you are diabetic, a doctor can prescribe you insulin,
             | but the doctor cannot force you to take the medication. The
             | doctor cannot not commit you despite the fact that
             | abstaining from insulin would cause direct harm.
             | Psychiatrist, however, do have that option depending on the
             | case and the patient.
             | 
             | I have seen around 10 or more psychs/psych NPs in my life.
             | I have always hated how I have had to walk on eggshells
             | around them, so to speak. I feel like they have never taken
             | ADHD seriously and that they act like they are doing me a
             | favor and that I should get on my knees and kiss their
             | feet. Medication not working well? Don't you fucking dare
             | ask for a dosage increase -- what are you some kind of
             | addict?
             | 
             | Not to mention all the random drug tests. Do they test for
             | alcohol or tobacco -- two of the most damaging substances
             | on the planet? Absolutely not. Take CBD with negligible
             | amounts of THC, but enough to pop hot on a urinalysis?
             | Doesn't matter, you are a drug addict. Kiss your
             | prescription, your job, and your life stability good bye.
             | In fact, my previous practice would refuse to treat you and
             | would kick you out of their practice. We had to sign
             | "Controlled Substance Agreements" and all this other
             | horseshit.
             | 
             | Substance Use Disorders are so correlated with ADHD that
             | they are damn near a symptom of untreated ADHD in
             | teens/adults. What field of medicine punishes patients for
             | a medical disorder -- isn't a SUD a valid medical
             | condition? Should a diabetic have their treatment revoked
             | due to a SUD? Not to mention, ADHD medication has plenty of
             | research to back that it does not worsen and may prevent
             | the development of SUDs in people with ADHD.
             | 
             | > So while the medical practitioner may want to say: you
             | need better friends, a better job, a better life in general
             | ... they often cannot.
             | 
             | I completely agree. In fact, I have noticed that myself. I
             | am quite depressed as of lately, however I do not think
             | there is something wrong with me. In fact, it's the
             | opposite. My mind/body is working correctly. I am not in a
             | good place -- miserable job, almost no social life, no
             | hobbies, no goals, no passions, etc.. I mean, who wouldn't
             | be depressed? However, I have been making small steps in
             | the right direction (this isn't my first rodeo). I beat
             | depressions ass many times before, and I will do it again.
             | I refuse medication for it because I feel it would hinder
             | my from making the right steps, and would rather sedate me
             | enough to tolerate my shit situation -- it's what happened
             | last time.
             | 
             | > If someone can find any alternative to medication to
             | manage their symptoms - they ought to avoid the diagnosis
             | and avoid the medicine.
             | 
             | I support this practice too. I do not think medication
             | should be the go-to unless it is completely warranted.
             | Besides, I hate to say it, but honestly, I am not really
             | sure the ADHD meds work all that well to begin with. I
             | often joke that I swear they work better for people without
             | ADHD than those with it.
             | 
             | I mean, are they better than nothing? Absolutely. I still
             | take them for a reason. However, they are far from a silver
             | bullet. I feel like I get about 25%-50% reduction in
             | symptoms, which is enough to help me achieve stability to
             | some degree, but I wish they worked better. The average
             | non-ADHD person is still probably far more productive than
             | I am. Thus, I have been really been considering alternative
             | approaches. It just seems no matter what I do I will always
             | revert to the mean. Maybe that's just how I am supposed to
             | be. =)
             | 
             | This disorder and the trauma that is has caused me will
             | probably always hold me back in life. But hey, in the grand
             | scheme of life, I have a lot to be thankful for, and I am
             | lucky I do not have a worse condition. I'll never be a
             | FAANG developer or work at some fancy start-up, but there
             | is more to living a good life than a maxed out career.
        
       | beardyw wrote:
       | Doesn't answer my question - why? Is there no point to any of it?
        
       | frereubu wrote:
       | In mice.
        
       | orzig wrote:
       | Did anybody else seem to get better after COVID forced a work
       | from home?
       | 
       | I did not think of my commute as especially bad, nor any other
       | part of being in the office, but the timing is pretty
       | coincidental
        
         | st4lz wrote:
         | I had some gut issues and switching jobs to WFH friendly made
         | it all gone away. It's much easier to change your bad habits
         | when you have more control of your environment. It wasn't in
         | COVID times though, it was around 2015.
        
         | kortex wrote:
         | I actually did great for the first few months after switching
         | to WFH, until other stressors overrode any benefit and messed
         | me up in other ways.
        
       | spondylosaurus wrote:
       | After a really really bad (prolonged) work situation, I started
       | getting wicked acid reflux--with a very clear trigger between
       | stress and subsequent symptoms. I remember at one point opening a
       | passive-aggressive email from my boss and instantly feeling like
       | a battery had exploded in my mouth.
       | 
       | The reflux never went away, even after my work situation
       | improved, and some other gastrointestinal symptoms worsened until
       | I recently got diagnosed with Crohn's disease. Which I am
       | genetically predisposed towards, but I still like to say that my
       | shitty boss gave me Crohn's (and not entirely in jest).
       | 
       | Although drugs have helped both issues immensely, I will say
       | there's a pretty substantial link between my symptoms and bouts
       | of stress. A lot of people with IBD (and to some extent, IBS) are
       | all too aware of the paradox that if you spend too much time
       | worrying about the possibility of a flare-up, you're all but
       | guaranteed to have a flare-up. The tummy is a fickle beast!
        
         | orzig wrote:
         | One big open question for me is what my body counts as stress.
         | I have had short, objectively stressful situations, which had
         | no impact. My longer-term stresses feel like they are more of
         | the style "it's a job, that is why they pay you" but switching
         | jobs might have helped? It's not like I can do that enough to
         | get statistical significance. And I don't think an outside
         | observer would consider my new job definitely less stressful
         | than my old one, but there might be some dimension, which is
         | really important to some subconscious part of me. And I don't
         | think an outside observer would consider my new job definitely
         | less stressful than my old one, but there might be some
         | dimension which is really important to some subconscious part
         | of me.
         | 
         | That's part of the reason that I resisted the stress
         | explanation for so long: even if you accept it in general, it's
         | very unclear what to do about it, so I wanted to keep exploring
         | more tangible causes
        
         | [deleted]
        
       | gareth_untether wrote:
       | I've often wondered if huge amounts of stress as a child could
       | cause celiac disease, or be one of the factors. As the child's
       | body is developing, having parents go through a divorce or
       | experiencing a death in the family, could create life long
       | physiological effects.
        
         | ImHereToVote wrote:
         | Kids are simply raised in a fairly fragile way, where
         | strengthening psychological resilience is completely ignored in
         | the upbringing process.
        
           | giraffe_lady wrote:
           | Psychological resilience is difficult to study directly or
           | even define, since experimental isolation or testing of it in
           | children is almost definitionally unethical.
           | 
           | But what a large body of research shows is that the most
           | psychologically resilient adults are those who were _not_
           | forced to demonstrate emotional fortitude in childhood. This
           | makes intuitive sense too, otherwise you 'd expect to see
           | adult children of addicts, war orphans, grown child soldiers
           | etc having the most stable temperaments, a thing that is just
           | notoriously not the case.
        
         | [deleted]
        
         | giraffe_lady wrote:
         | Van der Kolk's and other similar research seems to show a
         | pretty strong correlation between childhood trauma/ptsd and
         | adult inflammation disorders. IIRC the gut link gets a small
         | chapter in the famous book he wrote about that research.
        
       | yosito wrote:
       | For the past few years, I've had gut issues with a very unclear
       | root cause. I was definitely under an insane amount of chronic
       | stress due to the pandemic and isolation when the issues started,
       | but after isolation ended and my life should have been less
       | stressful the issues persisted. Some doctors seemed to take this
       | gut-brain connection thing to mean that it was all in my head
       | since they couldn't find anything medically wrong with me. That
       | was incredibly frustrating because I was experiencing real
       | physical issues like weight loss, hair loss, bloating,
       | indigestion, etc. But all of the tests and biopsies they did came
       | back normal. With functional medicine and a lot of trial and
       | error with diet and lifestyle changes I've gotten to a point
       | where I feel pretty much recovered, though still with a very
       | sensitive gut. I never discovered the root cause of my problems.
       | My leading theories are long-covid, non-celiac gluten
       | sensitivity, or chronic stress. Possibly a combo of those things.
       | 
       | All of that being context, the thing I wonder about this is, if
       | chronic stress does indeed inflame the gut, what does the process
       | of reversing that inflammation look like? It doesn't seem like
       | you can simply remove environmental stressors to undo the
       | inflammation. It seems that there are feedback loops and damage
       | that occur that can take awhile to undo. When someone has a
       | stressful life, it can be difficult just to reduce the amount of
       | stress, much less completely redesign their life to be less
       | stressful. And gut inflammation makes it even harder. Even if
       | they manage to do so, say perhaps by taking a year long
       | sabbatical if they can afford to do so, removing the stress may
       | not be an instant solution.
       | 
       | I hope more research is done in the area of healing from gut
       | inflammation triggered by chronic stress.
        
         | doix wrote:
         | If you want to go a bit off the traditional path, you can look
         | into BPC-157 which is a peptide that was designed to help heal
         | the gut. Nowadays it's mostly used by athletes and anti-aging
         | people to help heal soft tissue damage, but the original
         | purpose was to heal your gut.
         | 
         | If you're in the US, you can probably find an anti-aging clinic
         | with a doctor that you could ask about it.
        
           | yosito wrote:
           | I went way off the beaten path and got into peptides by way
           | of kambo. It's an indigenous medicine that's very
           | controversial with very little controlled scientific
           | research, but it actually made a dramatic difference for me.
           | Might look for into peptide injections, though it's harder to
           | find them in my home country (Hungary).
        
         | dombesz wrote:
         | The main problem is with stress + gut issues, it's a downward
         | spiraling feedback loop. Stress causes gut irritation, gut
         | irritation makes you more stressed. I suggest going to a
         | gastroenterolog, that knows about gut flora restoration.
         | Basically you'll get a Low-FODMAP diet for a month, then RENEW
         | diet for ~1 year, but you will also get a bunch of special
         | probiotics, mostly based on Bacillus Subtilis.
         | 
         | During this time the negative feedback loop is being broken,
         | the gut will have a chance to recover and the symptoms should
         | improve/disappear.
         | 
         | I am slowly finishing this diet and I have to say that apart
         | from a few ups and downs, it helped me tremendously. I have
         | much more energy during the day, less oily skin and hair,
         | smoother skin on my face, and consistent stool.
        
         | XorNot wrote:
         | I got recommended on a previous HN thread to try an L. Reuteri
         | probiotic. This is the one I took:
         | https://www.biogaia.com/product/biogaia-protectis-
         | chewable-t.... There's decent clinical evidence for an
         | effect[1].
         | 
         | The change in my gut health has been _astounding_. There was a
         | period about 1.5 months after I started taking it when things
         | definitely felt worse (which I guess is about the time the
         | bacterial colonization was underway) but since then I 've felt
         | so much better it's incredible. About 1.5 years now with it as
         | my standard and improvement is consistent.
         | 
         | Now for me this was a big improvement, but it works better (for
         | me anyway) when paired with Questran Lite[2] which is
         | prescription (at least in Australia) but has become the darling
         | of GI doctors because it seems to have good results in
         | improving gut health. I was on it _before_ I started the L.
         | Reuteri, but things only improved once I added the probiotic
         | in.
         | 
         | So - in order: try L. Reuteri supplements for about 6 months
         | (because it's OTC). If the gut inflammation is an issue there's
         | evidence that they will in fact help reverse it. If things are
         | still somewhat not great, get a Questran Lite prescription
         | (though there's actually a global shortage going on now).
         | 
         | The L. Reuteri theoretically you don't need to keep taking, and
         | I did try going off them for about 6 months recently, and was
         | mostly fine but eventually started seeing some regression so
         | started taking them again.
         | 
         | [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917019/
         | 
         | [2] https://www.news-medical.net/drugs/Questran-Lite.aspx
        
           | yosito wrote:
           | I tried L. Reuteri. Probably heard about it on HN too haha.
           | But for me that one didn't seem to make much difference. I
           | had really good luck with BB536 though.
        
         | wolfpack_mick wrote:
         | You might want to read 'The Lady's Handbook for Her Mysterious
         | Illness: A Memoir' by Sarah Ramey (Known also from her band
         | Wolf Larsen). She goes back and forth between providing an
         | overview of this 'mysterious illness' from different angles,
         | and her gutwrenching absolute trainwreck of a personal
         | experience of it. It seems you already found your way the same
         | way she eventually did, though.
         | 
         | As the title says, the book is womens body specific - but also
         | a guy i still found it very insightful to read.
        
           | chiefalchemist wrote:
           | Another book to suggest, "The Comfort Crisis" by Michael
           | Easter. In it he does a solid and helpful flyover on how
           | humans evolved vs how we actually live now, and how the
           | disconnect is impacting (negatively) our physical and mental
           | health.
           | 
           | While there are few individual ah-ha moments, seeing
           | everything laid out end to end to end aggregates into a
           | realization that The First World lifestyle is extremely
           | unhealthy and often (premature death) deadly.
           | 
           | Fwiw, in some ways The Comfort Crisis was like physical (and
           | mental) health version of The Coddling of the American Mind,
           | but without the PC-ish type baggage. Note: this comparison -
           | for me - is a compliment as both books look to challenge
           | mainstream narratives and normalizations.
        
             | op00to wrote:
             | I'd rather die of (first world) diabetes at an old age than
             | (third world) malaria as a child.
        
               | chiefalchemist wrote:
               | What's your point? Do you have any value to add? Or is
               | stating the obvious your superpower?
        
         | mial wrote:
         | I'm in the same kind of situation, what functional medicine,
         | diet and lifestyle changes did you try? What worked?
        
           | usernew wrote:
           | Things that don't kill you make you weaker. The other saying
           | only applies to mental hurt, not physical.
           | 
           | From my experience, there's nothing you can really do to fix
           | this beyond 'live a normal healthy life, and let it heal
           | itself, slowly, and not fully.'
           | 
           | I worked at a hospital (in IT) during covid, had to be onsite
           | a couple of days a week. lots of people dying all around, n95
           | all day, etc. not a problem. As I settled in, I realized my
           | manager, and the director, were absolutely toxic people on a
           | powertrip. they didn't care if you said "this is likely to
           | bring down random hospital applications, we need to do it
           | this other way." 2 stars on glassdoor, cowboy hats all
           | around, staff morale not present. they'd come up with
           | technical ideas on how to do something, despite being barely
           | technical people. telling them how to do, say a data
           | migration online, because you're an SME who's been doing it
           | for almost 30 years is a personal challenge, and you get
           | crapped on, overruled, and put in your place. Lots of
           | downtime, lots of patients affected, yet they report literal
           | fake status reports up the chain and generalize-away every
           | issue to the point that the generic statement hides the
           | issue.
           | 
           | I started getting heartburn during the day. Then I started
           | getting hearburn in the morning as my alarm rang. Then I
           | started waking up 5min before the alarm rang, with heartburn,
           | and teenager zits on my face at mid-life. Morning was now a
           | cup of baking soda water instead of coffee. ion pump
           | blockers. more baking soda.
           | 
           | after 6 months, the manager ordered me to execute a migration
           | plan that would shave off 2 days from a year-long plan. I
           | made a nice writeup stating we need to monitor sockets on the
           | array a few days to make sure people aren't actively using
           | the data she want's to trash. Last time she had me do this,
           | she asked over email, and it brought down a whole clinic that
           | was using a share she thought was unused. This time, I was
           | asked not over email, but with a call from her cell phone, to
           | my cell phone.
           | 
           | I said no problem, send me an email or type it in chat, and
           | I'll do it despite the high risk. I was of course fired 5
           | days later, but already had a new fully remote job, which I
           | started 5 days earlier (lol).
           | 
           | The point of the story is - the stomach issue didn't go away.
           | 3 years later, it's still there. It's much less, but that
           | last/final bit, where a couple of times a year I need ion
           | blockers for 2 weeks, and maybe one day a week I still need
           | to start w/ baking soda water - that's probably there to
           | stay. I eat very healty, lots of fiber, I'm fit. That 6
           | months of acidic people did damage that a middle-aged body
           | can't heal all the way.
           | 
           | There's nothing you can do. This is your new thing now, have
           | fun with your new friend. And watch this:
           | https://www.dailymotion.com/video/x6xc3r7
        
             | orzig wrote:
             | I am about five years out from a similar situation, so let
             | me give you a glimmer of hope: I did get better, very
             | slowly. I wish I could say why, I've obviously tried all
             | sorts of things and also a lot of life has happened between
             | then and now, but _don't give up hope_
             | 
             | And best of luck, I suspect you really helped some patients
             | at your former job relative to someone who would have been
             | less conscientious. Maybe even me, we'll never know!
        
           | yosito wrote:
           | I went off the beaten path of things proven by clinical
           | research. So none of this stuff is more than anecdotes, but
           | some of the things that helped for me: digestive enzymes,
           | oregano oil, gluten-free diet, probiotics (BB536, and kefir),
           | mastiha tears, kambo, vitamin B, organ meats. I'm currently
           | refining my daily supplement stack.
        
           | candiddevmike wrote:
           | Tablespoon of apple cider vinegar during meals (mentioned
           | this in the GERD thread, also helps with my gut and brain fog
           | issues too).
           | 
           | There are a ton of rabbit holes you can go down for SIBO,
           | leaky gut, gastroparesis, MMC, etc. All of them revolve
           | around how fast and how well food transits your gut. Longer
           | food stays inside you, the more problems you have.
        
           | fodmap wrote:
           | One of the resources that has helped me the most to
           | understand this issue is https://www.monashfodmap.com/ by
           | Monash University.
        
         | Lapsa wrote:
         | "what does the process of reversing that inflammation look
         | like?" "that can take awhile to undo" think you answered it
         | yourself. stress less and wait
        
           | cpncrunch wrote:
           | Also, have a healthy and easy to digest diet, and don't try
           | to eat too much (don't push too much undigested food through
           | your gut, which will cause further issues by feeding the bad
           | bacteria). Pre and pro biotic food may also help.
        
           | Lapsa wrote:
           | (in the spirit of "eat less, move more" for losing weight)
        
         | skrebbel wrote:
         | To pull an HN evergreen and reply to the overly specific
         | instead of your main point: My wife developed "histamine
         | intolerance" after a time of heavy stress, in a story that's
         | scary similar to yours. It took her years to figure it out,
         | from chance result on a super broad blood test. To confirm
         | this, she changed her diet to be only low-histamine foods and
         | it made all the difference. She went from "a single chocolate
         | chip cookie makes me sick for 3 days" to "mostly leading a
         | normal life, just watch what you eat" in half a year or so.
         | Over time it helped her gut recover to the point that she now
         | generally does not need to watch out much anymore, except in
         | some periods when some old symptoms pop back up and she reverts
         | to low-histamine diet for a while.
         | 
         | Statistically speaking this is probably not it and you
         | considered/tried it already, but just wanted to bring it up in
         | the off chance that you hadn't heard of this before. I mean
         | doctors just said "irritable bowel syndrome! theres no cure
         | sorry bye". She's been writing a low-histamine foodblog for
         | some years, which includes a good starting point for what to
         | eat and avoid: https://histaminefriendlykitchen.com/histamine-
         | friendly-food...
        
           | loh wrote:
           | For years I had the same gut issues described by others here,
           | seemingly caused by a combination of factors. I'll share what
           | helped me solve the problem.
           | 
           | The most effective thing for me seemed to be hitting the gym
           | hard, lifting heavy and sweating a lot.
           | 
           | Alongside that, I went through a lot of trial and error with
           | the foods my body would tolerate. I started with a low
           | histamine/low FODMAP approach, various fasting methods, bone
           | broths (collagen), probiotics (sauerkraut, kefir), etc., and
           | slowly introduced various foods on top of that while noting
           | what made me feel good or bad and basing my diet around that.
           | Everyone is different so what worked for me diet-wise may not
           | work for you.
           | 
           | Lastly, for my particular case, I think liver-boosting
           | supplements like milk thistle and NAC helped significantly
           | (and probably some others for any vitamin/mineral
           | deficiencies, especially D3+K2). I suspect the root cause of
           | my problems was toxic mold plus stress/trauma.
        
         | thevagrant wrote:
         | I went through it for many years. It got to the point where
         | certain foods made me feel unwell. I had brain fog. Felt tired,
         | exhausted. I changed my diet, cut out a lot of processsed foods
         | and got by as best as I could.
         | 
         | In the end I realised stress was a major factor. Diet would
         | have an impact but stress was the triggering agent that would
         | make certain foods much more inflammatory.
         | 
         | I broadened my diet, ate much healthier. Made more effort to do
         | exercise on a regular basis.
         | 
         | Slept regularly, slept earlier. Took time to go hiking or
         | running long distances. Stopped thinking about work after
         | hours. Made an effort to stop worrying about things outside of
         | my control.
         | 
         | It took a few years and I reversed almost all the symptoms.
        
         | browningstreet wrote:
         | Meditation, mindfulness, reframing, emotional self-care,
         | movement, exercise. The usual things.
         | 
         | Not trying to be smug.
         | 
         | But I noticed on a three week vacation, where I was walking 15K
         | steps a day, I lost weight and had zero gut issues while eating
         | freely in restaurants for the duration. Got home, day one the
         | old issues came back. I definitely had a stressful association
         | with my day job and the attendant life. I let a lot of things
         | slip because I allowed that my situation required me to reward
         | myself with lethargy and vices. When I'm above the baseline on
         | self care, I don't turn to the vices as much and my physical
         | systems generally work better.
         | 
         | I got back into my "me first" routine and my gut issues
         | subsided. For me it was like a switch.
        
           | yosito wrote:
           | I'm glad it was so easy for you. For me, I've been living
           | like a self-care saint for over a year. Meditation,
           | mindfulness, gym three times a week, active recovery,
           | sufficient sleep, 15k steps a day, perfect diet, low-stress
           | job, fulfilling sex life, morning sunlight, ice baths,
           | saunas. I'm not OCD or up tight about it, but I'm very
           | consistent. I get constant comments about how I take such
           | good care of myself. A lot of people say they have never met
           | someone who take such good care of themselves. But recovery
           | has only happened very very slowly over the course of many
           | many months.
        
             | clieless wrote:
             | [flagged]
        
               | codyb wrote:
               | Huh? Sex is usually a positive healthwise no? Just being
               | around people, and getting human contact in general.
        
               | clieless wrote:
               | [flagged]
        
             | jmole wrote:
             | It's good to take care of yourself regardless.
             | 
             | But my experience is similar - I quit drinking in
             | 2020-2021, eliminated grain from my diet, and eat probably
             | 80% of my calories in vegetables now. Overall my body is in
             | much better shape than it was then, but something is still
             | wrong with my gut-brain axis. I think what the article
             | misses is the microbiome factor. Any active microbiome is
             | going to produce metabolites, and some of those metabolites
             | can be destabilizing and disabling to the enteric nervous
             | system, even if they're not producing something as acutely
             | toxic as a bacteria like C. Diff.
             | 
             | Of all the things I've tried, I've never felt as stress-
             | free or clearheaded as I have near the end of a fast.
        
               | yosito wrote:
               | Out of curiousity, have you tried activated charcoal?
               | It's not good to take frequently because it blocks
               | nutrient absorbtion, but if I'm feeling really awful or
               | just need to feel clear for a day so I can focus on
               | something important, charcoal seems to mop up some of the
               | toxic metabolites and give me a short break.
        
             | browningstreet wrote:
             | I understand how frustrating it is.
             | 
             | I had a food intolerance test. I replaced every item in my
             | kitchen (new coffee maker [after ditching coffee for a
             | while], new pots and pans, new cooking utensils). I did
             | multiple elimination diets. I went to doctors (one doctor,
             | when I said I had no issues in Europe and lots of issues
             | immediately upon returning responded, with no mocking at
             | all, I should consider moving to Europe) most of whom
             | simply told me to go Whole 30 or Mediterranean diet (been
             | there, done that).
             | 
             | I hoped a lot of it would subside when I eliminated the
             | relationship in my life, too (alas, maybe.. not sure).
             | 
             | When I did the elimination diet the doctors said it could
             | be a combination of things, it could be things that will
             | take longer than a cycle of elimination to identify, etc.
             | 
             | They didn't know.
             | 
             | I guess there's always: therapy.
             | 
             | Wish I had a better answer, and not having answers is
             | stressful enough. I did a lot of "letting go" and "eating
             | freely" hoping a more carefree attitude would help. It
             | always seemed like something else though.
             | 
             | My doctor _friend_ says if he simply instructed all his
             | patients to eliminate gluten from their diets he would
             | still succeed with 80%+ of his patients having problems...
             | 
             | I'm quite a bit better, but given that my parents are
             | European immigrants, I do think.. ultimately.. I'm better
             | off back there in their food system.
        
         | cjdell wrote:
         | I recommend an Organic Acid Test (OAT). I've been struggling
         | with gut problems similar to yours for years but then it got so
         | much worse during the lockdowns. At the time I survived it by
         | embracing fasting and keto diets but that wasn't much fun.
         | 
         | More recently my OAT discovered fungal activity and an enormous
         | vitamin C deficit. Potentially this has been going on for more
         | a decade and it would explain why I'm so tired all the time.
         | Treatment through supplementation is in the early stages but
         | I'm already feeling noticeably better.
        
         | enkid wrote:
         | Inflammation is an immunological reaction. It can be triggered
         | a few different ways. Chronic inflammation is either because of
         | a chronic infection or some sort of immune disorder. Chronic
         | immune disorders don't just stop. They have a trigger and then
         | keep going for the rest of the suffers life at some level. They
         | can be controlled, but they can't be cured. This is because of
         | the way the adaptive immune system works, which produces
         | antibodies. Antibodies do a lot of different things, but one of
         | the things they do is trigger inflammation in the presence of a
         | specific protein. Your body has the capability of producing
         | antibodies for basically any conceivable protein. Once an
         | antibody is triggered, by having cell damage while the antibody
         | is "activated." Your body replicates the B-cell that makes that
         | specific antibody and the antibodies stick around in your blood
         | stream. This is why you become "immune" after getting a
         | vaccine, your body is able to "remember" the antibodies it
         | needs to use in case you catch the real disease. When there is
         | cell damage and the presence of another protein, your body
         | could "remember" the wrong antibody. If it's environmental,
         | this is an allergy. If it's from your own body, making the
         | antibody attack some component of its own body, it's an
         | autoimmune disorder. Once triggered, there's no known way to
         | reverse that negative association. Immune disorders are also
         | incredibly difficult to diagnose.
        
           | clieless wrote:
           | [flagged]
        
           | yosito wrote:
           | > When there is cell damage and the presence of another
           | protein, your body could "remember" the wrong antibody.
           | 
           | I'm skeptical of this part. Aren't there always a huge number
           | of proteins present in the body when cell damage occurs? For
           | example, if I get a cold, and I eat chicken soup to prevent
           | it, according to your explanation, I could develop antibodies
           | for chicken soup. This doesn't seem to happen significantly
           | often.
        
         | johnnymorgan wrote:
         | Stress is a catch all medicine uses when they have no idea.
         | 
         | Did anyone check your gut flora and provide an analysis, did
         | anyone every take a sample before to compare to?
         | 
         | Diet changes is probably heavy protein, some greens, no carbs
         | type style?
         | 
         | I'd recommend diving into probiotics, you'll get very little
         | help from most doctors as they don't know shit about it (pun
         | intended!)
         | 
         | Years and years of IBS like symptoms, like 20+ years of it.
         | Probiotics, fermented foods, protein and greens...I shit like a
         | god now.
         | 
         | Stress affects stuff, that's normal but it's never a single
         | source issue when it comes to overall health.
         | 
         | If you ain't pooping right, solve that first.
        
         | bujak300 wrote:
         | Like sibling posts say, inflamed gut leaks histamine, inflames
         | it more and leaks more. Try low histamine and in general low
         | processed and spicy food diet for a while to reset this
         | feedback cycle. Good start:
         | https://www.mastzellaktivierung.info/downloads/foodlist/21_F...
        
           | yosito wrote:
           | I tried a low histamine diet for a few months. Including DAO
           | enzymes and histamine lowering probiotics. Didn't seem to
           | make a difference for me. Eventually I found out that spicy
           | food actually helps me a lot: it's anti-inflammatory and
           | prokinetic.
        
             | corywright wrote:
             | After 6 months of testing different diets to try to solve
             | my migraines, I eventually discovered an ultra-low
             | histamine diet resulted in a ~90% decrease in my headaches.
             | Then I began trying different DAO products before eating
             | foods with histamine, but the headaches returned. I
             | eventually discovered NaturDAO (available via Amazon) and
             | its much higher 1,000,000 HDU per pill. Taking two of these
             | before any meal or coffee finally worked to stop the food-
             | induced migraines for me. Hope this helps.
        
         | biomcgary wrote:
         | I've been in biotech long enough to see that the beaten path
         | (traditional drugs) does not have robust answers due to
         | patentability.
         | 
         | Post-stress inflammation can persist due to latent infections
         | of various kinds. To accelerated recovery, I would recommend a
         | course of plant-based anti-pathogen treatments. (Not going to
         | shill a specific one.)
         | 
         | My non-verbal son has autism and gastrointestinal issues.
         | Unfortunately, all the pediatricians would test for is C-diff.
         | After years of problems expressed in the most challenging
         | behavioral ways(!), we finally had an MD (trained as a
         | naturopath) prescribe a battery of pathogen tests
         | (https://www.gdx.net/gut-health) that identified an obscure
         | protozoa. Nearly, overnight difference upon treatment (a drug).
         | The remaining GI issues were addressed with plant-based
         | treatment. I've also suffered from GI issues that improved
         | substantially with anti-fungal focused supplements (e.g.,
         | French Tarragon leaf).
         | 
         | I would recommend eating a diverse range of fermented food too
         | (yogurt, real sauerkraut, etc), since they compete with
         | pathogens for resources.
        
       | pizza wrote:
       | Hope it's really that simple.
        
         | senectus1 wrote:
         | ha!
         | 
         | and how in todays world do you feel we can avoid stress?
        
           | throwaway4220 wrote:
           | Actually my gi physician has ibd pts see a therapist on every
           | yearly visit
        
       | w10-1 wrote:
       | We have decades of partial answers as to how the brain affects
       | the gut, but none are anywhere near complete.
       | 
       | This finding, that some gluco-corticoid derivatives inhibit cell
       | maturation, is new in its specifics but there was plenty of
       | evidence to suggest the hypothesis. But it's a tiny part of an
       | entire ecosystem. People are already told to avoid NSAID's, so it
       | will have little clinical impact.
       | 
       | Saying "autoimmune disease" is as precise as saying you have a
       | performance problem in the cloud. Worse, people mistakenly use
       | that term for any chronic immune-system-mediated syndrome.
       | 
       | Even worse, saying that "People are sick because society is
       | stressed, so we should reduce stress in society" completely
       | misdirects useful resources. People who want to do good need to
       | dig in and do the work, not hand-wave.
       | 
       | Chronic immune-mediated diseases fall in the crack between
       | primary care and GI specialists. The specialists only have time
       | for surgery or drugs, and primary care doesn't have the expertise
       | for the patient months-long self-experiments required to isolate
       | relevant factors (among diet, stress, infectious disease,
       | microbiome, genetics).
       | 
       | This is a structural health-care opportunity for anyone able to
       | take it. Private equity could fund practice groups with a few
       | doctors and 6:1 advanced-practice providers, partnered with
       | diagnostics and EHR peers, carefully working through and evolving
       | GI algorithms and diagnostics. The alternatives (surgery and
       | drugs) are expensive and ineffective and the incidence is high,
       | so the market is definitely worth pursuing. Longer-term, it may
       | help with automating the actual practice of medicine, where each
       | patient is an experiment with a series of knowns, some negotiated
       | interventions, and a track record of results: all invaluable data
       | for this case and those like it, and a methodology applicable to
       | other chronic immune diseases. Automating the accumulation of
       | expertise scientifically in a practice system is really the
       | future of computers in medicine. It will never happen via
       | diagnostics (Quest, LabCorps) or EHR (Cerner/Epic) because their
       | virtues are contra-indicated in the continuous experiment of
       | treating chronic disease.
        
       | AndrewKemendo wrote:
       | If we look at this research and also look at the recent analysis
       | that 1/10 people have some kind of autoimmune disease like
       | Crohn's then it seems safe to conclude that stress is literally
       | slowly killing us.
       | 
       | Seems like the root issue might just be society wide stress and
       | anxiety at levels and at a scale never seen before. We can jaw
       | all day about how GDP has never been higher and how much TV there
       | is to watch now, but we've never been chronically sicker and
       | we're trending the wrong direction.
        
         | uLogMicheal wrote:
         | I had a GI tell me every time I visited him that stress has
         | zero connection to the manifestation of my Crohn's symptoms.
         | Yet here I am; years later, I'm off all the meds they
         | prescribed and 95% of my days are symptom free through keto
         | dieting and yoga to manage the stress. The stress of the
         | corporate world was literally killing me, I do much better
         | working on startups - a different kind of stress.
        
         | joker_minmax wrote:
         | Agree. A lot of people talking about cures here (and a lot of
         | pseudoscience), but not a lot of people exploring the societal
         | psychological aspect. I've noticed a lot of people, especially
         | younger people in America, creating their identity entirely
         | around consuming things that are short-lived trends. It really
         | leaves people empty once the tide goes the other way. It's like
         | systemic insecurity. I'm wondering how fostering more
         | concreteness in our culture (as well as workplace structure
         | changes) could help with this, but I have no idea how to
         | approach it from the ground up.
        
       | meliorika wrote:
       | Evolutionary, stress helps an animal to survive an imminent
       | danger. Stress (glucocordicoids) divert your energy to either
       | flee or fight. Digestion? It's not important if survival is at
       | stake. You can survive with a bloated stomach but not a missing
       | stomach.
       | 
       | If stress is chronic then you get the bad stuff all the time.
        
       | Wonnk13 wrote:
       | It's nothing more than an anecdote, but I can't help but
       | correlate the fact that I was diagnosed with colon cancer in late
       | 2016. I joined as one of the first 12 employees of a startup a
       | few years earlier and I can absolutely say with respect to stress
       | and nutrition it was one of the roughest periods of my life.
        
       | venk12 wrote:
       | Whoa. I have been struggling with this issue for a long time. My
       | gut has turned very sensitive and bloated. I could have a hard
       | day even if I have strong coffee. Let alone skip a meal. My
       | medical diagnosis doesn't show any problem with my stomach or
       | gut. I used to smoke and there used to be times when it was
       | stressful at work and I believed it was natural for anyone these
       | days. After 2 years of stoppinh smoking + taking care of my diet
       | + medicines it is still not gone completely. It's uncomfortable
       | to live with this.
        
       | andy_ppp wrote:
       | So did IBS go away when they gave people relaxation courses and
       | stopped them watching YouTube videos about nuclear annihilation?
        
         | readthenotes1 wrote:
         | Not sure mice are worried about human annihilation ...
        
         | manmal wrote:
         | I know your comment is tongue-in-cheek, but in my experience
         | chronic stress is more caused by financial hardship, bad
         | relationships, overwork and other daily life stuff.
         | 
         | (I wrote my comment before you massively edited yours)
        
           | scruple wrote:
           | > chronic stress is ... caused by financial hardship, bad
           | relationships, overwork and other daily life stuff.
           | 
           | Or living in / growing up in an environment where these are
           | the major concerns. Cycles, etc.
        
       | ajuc wrote:
       | I first got IBD when I was 18 and preparing for the final high
       | school exams that decided which university I can get to. Then I
       | got it under control, but it returned several times, always when
       | I was under a lot of stress.
       | 
       | BTW asthma also gets much worse with stress
        
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