As someone with IBD, I really wish the hard science about bacteria would start to filter into actual treatments. I know there are possibilities there, and many patients have found avenues of success, but there is so much guesswork involved that it is very frustrating. Hopefully there will be definitive answers in the future. My gastroenterologist, who has quite a lot of training from very good schools, has absolutely nothing useful to say, in terms of the microbiome.

It's starting to filter into actual treatments. I've been doing research in the field of host-microbiome interactions for the last 8-10 years. And in the last couple of years, it's gone from a fringe to a mainstream topic.

I know a few places in Europe where they are already doing fecal microbiome transplants on a daily basis. For example, Quadram Institute & NHS Norwich. They have had some adverse events, so it's not totally safe, but I think the benefits already outweigh the risks if it's having a significant impact on your quality of life.

New research avenues include, for example, doing a phage-only transplant. And obvious things like matching donors by HLA haplotypes. Both should improve safety.

Still, I understand progress is too slow for patients. Most research institutions are pretty bad at polishing, industrializing and translating basic theories into clinical benefits. They just like to churn out small papers. I have sometimes considered to spin off as a non-profit maybe to speed things up.

Theories are beginning to be understood quite well. It's mostly about cross-reactive bacterial epitopes and self antigens [1]. Plus metabolites. A very complex network, but some epitopes are central. For example, Ro60 in Lupus or insulin in T1D and their corresponding bacterial mimics. With sufficient data, we could easily throw in a personalized cocktail of phages that could halt many autoimmune disorders and tumors with high probability. That's the vision for the next 10 years, I think.

[1] https://www.nature.com/articles/s41579-020-0367-2

As someone with IBS, totally agree with you. I wish the research would trickle down into actual treatments. I have started following a lot of research about gut etc but very little of it leads to something that can mass consumed.

I spent thousands of dollars on trying out medications, tests, visiting a number of highly trained doctors etc, nothing came up in tests and at the end almost all doctors threw their hands up and categorized my gut issues as IBS which is just a catchAll term for which there is no specific treatment other than trying out a number of things.

Fellow IBS sufferer here. I understand and share your pain.

There isn't any magic pill yet but until someone invents it I can tell you I've found great comfort following the FODMAP diet.

I've wasted ten horrible years until I discovered that Monash University diet.

Ten years of pain and expending.

Hoping it can help you as well https://www.monashfodmap.com/

For anyone who doesn't feel like viewing a slideshow website, FODMAP stands for "Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols"

Which is basically Cereals (what make beer) onions, garlic, and beans; Lactose; Fructose; and at least two of the "Sugar Alcohols".

As someone who had their gut biome wrecked by aggressive antibiotics, i was told i will probably have to take probiotics for the rest of my life, but i managed to track down two things that will 100% all the time cause pain - Garlic and Onions. I'm not entirely sure which is worse, but i'd wager garlic. For a long time i assumed it was certain types of oils, too.

Basically if you're adhering to this "Low FODMAP" diet, you're meandering between "slow carb", "atkins", and several other dietary restrictions.

That "fructose" one though, that's a doozy. There are tons of health ramifications to avoiding all of the stuff on the list, so if you suffer from intestinal stuff, it'd probably be best to experiment with each thing on the list (on the site) and see if it causes discomfort, how much, how long, etc.

Anecdotally the onions are way worse for me than garlic, although the latter doesn't do me any favor.

To anyone wanting to learn about FODMAPs, Monash University blog (1) helps to understand this very complex topic.

(1) https://www.monashfodmap.com/blog/

Low fodmap was of enormous help to me too. For years I thought I had gluten issues, as most bread caused me trouble.

Turns out every wheat product with the exception of sourdough wheat bread is high fodmap! I tried low fodmap and nearly instantly got a lot better. And I can now eat some fodmaps by reintroducing in lower amounts.

Highly recommend anyone with ibs try this. It is complicated but you can get free or cheap apps that let you search ingredients fast to figure out what to remove.

And the great part is the intolerance is quantity based. So, celery in a recipe? No problem. Just don’t eat a massive amount of it. Very much unlike any kind of hard avoidance plan.

This won’t solve all issues but give it an honest shot. Mine has moved from seriously debilitating to minor inconvenience.

Exactly, that have been my personal experience too.

Identifying the triggers, and keeping an eye on quantity are the keys for me. It isn't an easy process but it makes a world of difference as you say.

Was diagnosed with IBS just after university, then (similarly) spent 10 years suffering and experimenting when I ended up switching to an ultra-low carb diet for unrelated reasons. Within weeks, I started to feel better and for the next 12 years felt great - so much so, that my family (wanting me to enjoy something sweet) started buying me "Keto-friendly" bars with < 2g of net carbs, but also with erythritol. That was a mistake, as within weeks of enjoying the bars, I was back to dealing with IBS. I'm six weeks into trying to undo the 'damage', and starting to feel a bit better, but I'd definitely advise people who have IBS to always be cautious with trigger foods - certainly the ones that personally cause them issues, but also others on the list.

That's a good advice. I wish you the best with your recovery.

Thanks, yes I have been following fodmap for years now and reduced my gluten intake as well and that has helped a bit. Although its only recommended for 3 to 6 months.

I have also slowly been introducing foods I have been avoiding back and so far I have been able to tolerate them well

Yes, the key is to try to have the less restrictive diet without the food that triggers your symptoms.

About gluten, in my case I found out that it wasn't the problem but fructans.

I agree with your overall message but in this case I would like to point out one thing - a lot of fad diets were first adopted by people and then researched to see if they are helpful where as Fodmap has been specifically researched for the gut and only after it has been shown to be helpful, its now being recommended by doctors.

Obviously you should talk to your doctor before adopting the diet. It may not provide all of the nutrients that your body needs and its normally only recommended for 3 to ~6 months. Its may also not work well for some variants of IBS / IBD / other gut issues and may even be a detriment - so talk to your doctor.

Personally its been helpful for me. A lot of people also may not need to do fodmap and instead just do a elimination diet. For example you may not know it but may be suffering from lactose intolerance or gluten intolerance and so on. Probably easier to try that first as well.

I don't have an "overall message"; they asked why they were being downvoted for sharing a genuine opinion, and I explained how much the comment looks like an advert. I am already convinced that gut microbiome affects people and diet affects people.

I did remove my question because I understood that it didn't add up anything interesting to the discussion.

Thank you for answering anyway. Your comment helps me to see why my post could be seen as not well intentioned.

I have IBS symptoms basically fully in times of stress, days on end, otherwise things are fairly normal. I wonder if either my understanding of IBS is false, or it's not biome related for me.

I suffer from IBS as well and out of all the things that flares up my IBS, stress is a prominent one. Reading research papers, its been seen that gut biome changes based on stress - look up gut-brain connection, theres been a few books written about it as well.

Its a fairly new thing - from about 15 years back. Nowadays one of the treatments that a gastroenterologist could recommend if they have exhausted everything else is low dose anti-depressant.

Key is to identify what is causing stress and treat that

I agree. For me, relaxing breathing techniques help me when having an stress episode.

Check out hyperbiotics. They had a submission here a while back, and have both probiotic and prebiotic products. They were started by microbiome researchers.

Also I’ve heard promising things about fecal transplants for biome restoration.

I had Ibd for 10 years, did a microbiota transplant and, literally, the day after it was gone. I am not sure why this treatment is not being pushed for Ibd,bbut it was nothing short of miracolous.