Kevombat

This is a great question, and a very common problem! First, I applaud you for thinking about this kind of stuff; that can already be a big hurdle for our patients! Obviously, you would need to get your GI system checked properly, if you wanted confirmation if you have an inflammatory disease. That being said, there is always, always, always value in changing life style, even if you suspect you are suffering form inflammation in the gut (let's say you experience lots of stomach pains, diarrheas, etc.).

This might be a boring answer, but it is very true! One of the things you can address is moderation of your junk food intake. Quitting cold turkey will be incredibly difficult, while cutting down is much more easily achievable. It also provides you with smaller goals, that provide tiny milestones for you to reach - which will encourage you even more! Any pound lost will be helpful, not just for you gut!!

Another thing, and I am sure people are aware, is physical exercise. Now, this doesn't mean you start running 5 miles every day. Take it slow, even just making the decision to be more active will already prove helpful! Replace driving to drop off mail at the mailbox with taking a walk, or walk around the office building while eating lunch. Instead of refilling your water bottle once in the morning, just do a couple of ounces, and go more frequently! Hydration is another big one, of course!

You might realize, a lot of this does not even have anything to do with what you are actually taking in! Does that make sense? There is so much damaging stuff that we do or put into our bodies, junk food is just one of them!

Another great tip: moderate smoking (quit if you can, this will be SO helpful!!), moderate alcohol intake. These are super important, just like paying attention to what you eat.

Now, I suspect you would like to know more about actual diet changes! Alright, so first of all, again, moderation on the Junk food. If you feel the urge to snack, try out veggies or fruits over junk. Rule of thumb, plant based and/or Whole Foods are always better than processed food. Lean meat, over red meats. Go for fish! There are a ton of food products that contain just so much nonsense, and lots and lots of sugar and fatty acids. Now, keep in mind, sugar and fats are NOT unhealthy. They are critical to your survival. At the end of the day, everything you consume is energy. If you have a surplus of energy taken in, it will be stored. It can be as easy as that. That being said, especially in re: to your inflammation question, there are so called "good" fatty acids, that have actually been shown to have an anti-inflammatory effect on your gut and body! Fish would be a great source, or any kind of nuts are also very good for that! Probiotics might also help with your microbiota. There are various ways of substituting microbes to your flora, be it pills, drinks or yoghurts. My suggestions is to try out and see for yourself what you like most, because that will make you most likely stick to doing it regularly!

IBS can be such a debilitating and frustrating disease; I am sorry to hear about what you are going through and am happy for you to try out different things to see what works best for you! My take on IBS is this: unfortunately there is currently no cure, which means focus must be on alleviating symptoms and learning how to best live with a disease like IBS. While it is not perfect, there are a great many options out there to start taking things into your own hand!

Diet changes, including to avoid foods that trigger your symptoms, drink plenty of water, eat high-fiber foods, avoid "gassy" foods. Exercise, get good sleep. Take lots of care of yourself. There are also medications and supplements, and I am sure you are aware of some, if not most of them already.

Personally, I believe that IBS is really an umbrella term for a group of conditions that we simply do not understand / have discovered yet. I like to hypothesize that perhaps the microbiota is critical to IBS-like disease, or perhaps viral infections (either current / or even past infections) that have a drastic impact on the makeup of your intestinal mucosa; maybe even much more and more long-term than what we are currently thinking. With that being said, there are super exciting clinical studies of fecal transplants. And while this might sound a bit weird or funny at first, there is huge potential in that type of treatment. Restoring a healthy, balanced gut flora has been shown to alleviate GI symptoms. To be honest, and this is completely unscientific, in my mind that just makes perfect sense! Gut microbiota is there for a reason! There are hundreds of millions of them. Why? They are helping us processing all the stuff that we decide to put into our system; and the things we put into our systems have changed over thousands of years, and vary on environment, region, external exposure, even how you are being brought up. These little fellas are there to help you break down everything and create metabolites (sort of building blocks) during digestion; if you have a healthy gut flora, those metabolites are harmless. If there is dysfunction and/or dysbalance, it just makes sense to me that of course there are going to be unwanted, unhelpful, perhaps damaging building blocks - these metabolites have incredibly harmful potential, such as being able to recruit an excessive amount of your immune cells that then start damaging your mucosa. Honestly, I believe that many things are associated with the gut microbiome that we do not simply understand yet. There is fascinating research being done on the gut-brain axis with hypotheses suggesting that diseases such as Parkinson's are actually regulated by gut microbes! That is insane to me, but also not really a crazy surprise, right?

Long story short, one thing I have not mentioned yet and I personally believe is critical to good IBD care - psychotherapy. Psychotherapy is not only incredibly important to learn how to cope with the disease, deal with stress, etc. it also helps with working through underlying negative beliefs, anxieties, fears, lack of self-worth etc. Since I do believe in an more and more relevant, emergent gut-brain axis, this seems critical to me!

edit: Sorry, I just noticed, I meant to say IBD/IBS in my last paragraph of course!

Actually, and this is commonly unknown, there is a cure - and it's surgery!

If the entire colon and rectum are completely removed surgically, UC is de facto cured. It also removes the risk of developing Colon CA. I believe only a small percentage of patients need this treatment and/or are open to it. It is a massive, very meaningful step to take, after all.

If you are asking about a less radical approach, I honestly do not know. I do know that current research in the field is simply incredible, and I would like to hope to see significant progress during my lifetime.

Truly the question I have been waiting for (except for maybe what objects we extract from bowels..).

Honestly, I do not believe there is a lot of scientific evidence on it being harmful or not. What I can tell you is that is causes short-term discomfort, including pain, bloating, it even increases the risk of an unwanted, uncontrollable spontaneous fart (and we all know how we feel about that). Other than that, I could imagine that perhaps "chronic holding it in" could lead to increased stress levels, just because of the discomfort you may experience; and the risks of elevated stress levels of fairly commonly known.

So, totally unscientific opinion, holding in farts may be less healthy than letting it rip?

Thanks for the question, it's a really great one and I think I could talk about this for hours! For the sake of everyone, I will try and keeps this concise. Personally, I love America. I don't know why, but even as a little kid I always dreamed of coming to the US. I remember vividly, when 9/11 happened and I was 10 years old, I grabbed sheets of papers, taped them together and drew a giant US flag in red, white and blue. Why? I have no idea, I was just very sympathetic with the people of this country at the time!

That being said, there are so many controversial topics in America, compared to Germany. I like to bring up this example: In the US, it is a major election issue if Abortion should be legal or not. In the German state that I am from, one election issue was whether we should increase or decrease the hunt of wolves that have come back to live in the forests. I just think that is insane! Despite Germany and the US being very similar and Western countries, there are issues and topics that are of just entirely different dimensions!

2016 - 2020 was rough, no question, and I will be honest with you, it made me re-think a lot of things I thought about the USA. I am still struggling with the divide that is so, so apparent in this nation, it just makes me sad! This country has unbelievable potential, yet in some areas, there is such a baffling lack of progress.

I love how friendly most people are, most people are incredibly welcoming and open. I love how inclusive regions/areas can be. In Germany, social justice issues are much less prominent, so this is a very interesting thing to witness. I am so, so excited to be working with a very diverse team, because it is just such an enriching experience! I love a lot of the food, especially basically everything baked / sweet. Favorite is brownies! I love how there are people in this country, who are incredibly smart, talented, kind, forward-thinking. I hate, that there is almost always a negative to every positive.

Not to mention maybe obvious ones such as gun violence, police brutality and social injustice, I hate how medical insurance works in this country. I just hate it. As a doctor, it is unfathomable to me how people do not have the right to be treated for medical problems. I also hate how education is so expensive in this country. Burdening young, brilliant minds of the future with crippling financial debt is just insane to me. Obviously, hate is a strong word, but you get the idea!

Overall, I still believe very much in the values of this country, and thankfully things have changed greatly since Biden-Harris. I also believe that most things that I do not like about the US are things that will change, eventually, one day.