All 885 tips from all chapters, sorted by topic and confidence score. See what is well supported and what is still experimental.
| Topic | Established | Well supported | Promising | Plausible | Experimental |
|---|---|---|---|---|---|
| Gut barrier | 3 | 4 | 13 | 2 | |
| Opportunistic pathogens | 6 | 28 | 12 | 4 | 1 |
| Bacteriophages | 1 | 3 | 2 | ||
| Microbial diversity | 6 | 10 | 21 | 11 | 2 |
| Gut-brain axis | 4 | 14 | 12 | 7 | 1 |
| Digestive function | 18 | 34 | 32 | 8 | |
| Small intestine colonisation | 8 | 11 | 9 | 1 | |
| Immune system and inflammation | 8 | 15 | 16 | 8 | 2 |
| Total | 45 | 113 | 118 | 52 | 9 |
Tap a number to see the tips below. Darker cells contain more tips.
Immune system and inflammation · Clear selection
Trust score 5 of 5:Established Medical treatments
The European guideline recommends: first a detailed history, then a skin prick test or specific IgE in the blood, and if needed tests for allergen components. If results are unclear, a medically supervised challenge test is the gold standard. A positive test without matching symptoms does not mean an allergy.
Allergies and intolerances: how the gut learns to tolerate food 1 sources
Trust score 5 of 5:Established Medical treatments
Blood in the stool, diarrhoea for weeks, symptoms at night, weight loss or fever need investigating. A low calprotectin in the stool speaks strongly against IBD, but a raised one does not prove it. The diagnosis is confirmed by colonoscopy with tissue samples, in Crohn’s disease supplemented by an examination of the small intestine, for example by MRI or ultrasound.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 3 sources
Trust score 5 of 5:Established Medical treatments
In mild to moderate ulcerative colitis, mesalazine, as tablets or suppositories, is the foundation. Steroids help in a flare but are not for long-term use because of their side effects. For maintenance there are immunomodulators, biologics against certain messengers or against the migration of immune cells, and newer tablets such as JAK inhibitors. Which drug suits depends on the form, severity, age and other conditions. Immunomodulators, biologics and JAK inhibitors dampen the immune defence and raise the risk of infections; some have other rare risks. Before starting, vaccination status and tuberculosis are therefore checked, followed by regular monitoring. For most people the benefit outweighs the risks, because untreated inflammation causes harm too.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 3 sources
Trust score 5 of 5:Established Medical treatments
In children, exclusive liquid formula for six to eight weeks is the recommended first treatment. It calms the inflammation about as well as steroids, without their effects on growth. After that, maintenance therapy usually follows, along with a gradual return to normal food.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 1 sources
Trust score 5 of 5:Established Medical treatments
Persistent joint pain, skin rashes or diarrhoea with blood should be examined by a doctor.
Eating against silent inflammation no source of its own, score based on judgement
Trust score 5 of 5:Established Medical treatments
The guideline recommends measuring total IgA together with the transglutaminase antibodies. With IgA deficiency, IgG-based tests are used. Important: do not eat gluten-free before the test.
IgA: the antibody that keeps the gut clean, and what vitamin A, D and omega-3 have to do with it 1 sources
Trust score 5 of 5:Established Medical treatments
Faecal calprotectin and CRP in the blood help distinguish inflammatory bowel disease from IBS.
Immune system and inflammation 1 sources
Trust score 5 of 5:Established Medical treatments
Dermatitis herpetiformis is confirmed with a skin biopsy showing typical IgA deposits, together with coeliac antibodies in the blood. If confirmed, the gut also needs medical follow-up.
Trust score 4 of 5:Well supported Medical treatments
Allergy societies explicitly advise against them. IgG against foods is a normal reaction to what you eat, not a sign of an intolerance.
Allergies and intolerances: how the gut learns to tolerate food 2 sources
Trust score 4 of 5:Well supported Medical treatments
Coeliac disease is clearly more common with both and often causes few symptoms. A blood test for tissue transglutaminase antibodies while you are eating gluten will clarify this. Iron deficiency, bloating, diarrhoea or hormone levels that are hard to keep stable are further reasons to test.
Autoimmune diseases and the gut: Hashimoto's, vitiligo, type 1 diabetes and more 3 sources
Trust score 4 of 5:Well supported Medical treatments
With Hashimoto's, type 1 diabetes, or vitamin B12 or iron deficiency without a clear cause, autoimmune gastritis may be behind it. Antibodies against parietal cells and intrinsic factor in the blood give clues; it is confirmed by gastroscopy. After that, lifelong vitamin B12 and regular check-ups are usually needed.
Autoimmune diseases and the gut: Hashimoto's, vitiligo, type 1 diabetes and more 2 sources
Trust score 4 of 5:Well supported Medical treatments
In Crohn’s disease with a risk of a severe course, strong treatment started early led to clearly more remissions and fewer operations than stepping up gradually. The goal is a healed lining and a normal calprotectin, not just fewer symptoms. Talk to your care team about how you will measure success.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 3 sources
Trust score 4 of 5:Well supported Medical treatments
Anyone who has had ulcerative colitis or Crohn’s disease in the colon for some time should go for regular surveillance colonoscopies. When and how often depends on duration, extent and other conditions such as inflammation of the bile ducts. Ask your care team about the right schedule.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 2 sources
Trust score 4 of 5:Well supported Medical treatments
Roundworms from dogs and cats can pass to humans, especially children. How often to deworm or test the stool depends on the animal, its lifestyle and the country; ask your vet for a suitable plan. Remove faeces from the garden and play areas promptly.
Dogs and cats: what pets do to your gut, immune system and nerves 1 sources
Trust score 4 of 5:Well supported Medical treatments
Whether there is inflammation in the gut is shown not by a feeling but by a stool test for calprotectin, plus blood values such as CRP. If you have persistent diarrhoea, abdominal pain, weight loss or blood in the stool, have it checked before experimenting with diets on your own.
Eating against silent inflammation no source of its own, score based on judgement
Trust score 4 of 5:Well supported Medical treatments
With a diagnosed disease such as Crohn’s disease or ulcerative colitis, diet is part of treatment, but not instead of medication. A dietitian experienced with these diseases helps avoid deficiencies and handle flare phases properly.
Eating against silent inflammation no source of its own, score based on judgement
Trust score 4 of 5:Well supported Medical treatments
Naltrexone can make opioid painkillers ineffective and trigger withdrawal. Before surgery or pain treatment, tell the care team that you take LDN.
Low-dose naltrexone (LDN): hope, studies and limits 1 sources
Trust score 4 of 5:Well supported Medical treatments
Tryptase should be measured as soon as possible, within a few hours of an attack, and also when symptom-free. Only the comparison shows a rise. Experts also recommend specifically checking for allergies, mastocytosis and other causes before the diagnosis is made.
Mast cells: alarm cells in the gut, histamine and the disputed MCAS 3 sources
Trust score 4 of 5:Well supported Medical treatments
In 100 healthy people, the mast cell count in the colon lining varied so much that it overlapped with that in IBS. A “raised” value in a biopsy is therefore not proof. A biopsy is useful for detecting mastocytosis with special stains.
Mast cells: alarm cells in the gut, histamine and the disputed MCAS 1 sources
Trust score 4 of 5:Well supported Medical treatments
Before you dampen abdominal pain with a product, it should be clear where it comes from. Warning signs such as blood in the stool, unintended weight loss, symptoms at night or fever always belong in medical hands.
PEA (palmitoylethanolamide): the body's own inflammation brake in a capsule 1 sources
Trust score 4 of 5:Well supported Medical treatments
For children and teenagers with Crohn's disease, exclusive formula and the Crohn's Disease Exclusion Diet with formula are proven therapies. They are run with gastroenterology and a dietitian and have a fixed end.
SCD, GAPS and the autoimmune protocol: what strict elimination diets can and cannot do 2 sources
Trust score 4 of 5:Well supported Medical treatments
Feeling better on a diet does not rule out inflammation in the gut. Faecal calprotectin and check-ups show whether the disease is really quiet. Do not stop medication on your own.
SCD, GAPS and the autoimmune protocol: what strict elimination diets can and cannot do 2 sources
Trust score 4 of 5:Well supported Medical treatments
With psoriasis and persistent diarrhoea, blood in the stool or abdominal pain at night, think of inflammatory bowel disease; faecal calprotectin is a first test. Before starting some biologics, such as IL-17 inhibitors, mention any gut symptoms: new bowel inflammation is rare under them, but has been described.
Trust score 3 of 5:Promising Medical treatments
In infants, spitting up and crying are very common and mostly harmless. Acid blockers and antibiotics have their place, but should only be given for a clear reason, also because of the possible link with allergies.
Allergies and intolerances: how the gut learns to tolerate food 2 sources
Trust score 3 of 5:Promising Medical treatments
In spondyloarthritis the gut lining is often inflamed without anyone noticing, and inflammatory bowel diseases are more common. If you also have abdominal pain, diarrhoea or blood in your stool, bring it up. A stool test for calprotectin is a simple first step.
Autoimmune diseases and the gut: Hashimoto's, vitiligo, type 1 diabetes and more 2 sources
Trust score 3 of 5:Promising Medical treatments
In active ulcerative colitis, more people reached remission with donor stool than with placebo in studies, in an Australian study 32 versus 9 percent. According to Cochrane, however, the evidence is still weak, and whether the effect lasts is unclear. In Crohn’s disease, good studies are lacking. Only in studies or specialised centres, never do-it-yourself.
Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease 2 sources
Trust score 3 of 5:Promising Medical treatments
DAO in the blood only roughly reflects DAO in the gut. What counts is a food diary, a low-histamine trial phase and ruling out other causes.
DAO: the enzyme that intercepts histamine from food 2 sources
Trust score 3 of 5:Promising Medical treatments
With persistently low DAO or a newly appeared intolerance, coeliac disease, inflammatory bowel disease and small intestinal bacterial overgrowth should be considered. Treating them often treats the DAO weakness too.
DAO: the enzyme that intercepts histamine from food 1 sources
Trust score 3 of 5:Promising Medical treatments
If you or your child have diarrhoea for a longer time, tell the doctor whether a new animal has come into the home, especially a puppy, or whether the animal itself has diarrhoea. That helps to think of germs like Campylobacter and to test for them specifically.
Dogs and cats: what pets do to your gut, immune system and nerves 1 sources
Trust score 3 of 5:Promising Medical treatments
Allergies, coeliac disease, inflammatory bowel disease and mast cell disorders can cause similar symptoms.
Histamine intolerance: much searched, little proven no source of its own, score based on judgement
Trust score 3 of 5:Promising Medical treatments
Values of affected and healthy people overlap strongly. A diagnosis should not be based on it alone.
Histamine intolerance: much searched, little proven 2 sources
Trust score 3 of 5:Promising Medical treatments
Some medicines inhibit DAO in the lab or release histamine. If symptoms began with a new drug, talk to your doctor or pharmacist instead of stopping it yourself.
Histamine intolerance: much searched, little proven 1 sources
Trust score 3 of 5:Promising Medical treatments
If you have conspicuously frequent respiratory infections, recurring gut infections such as Giardia or several autoimmune diseases, you can have your blood immunoglobulins measured. There is no IgA replacement; the consequences are treated.
IgA: the antibody that keeps the gut clean, and what vitamin A, D and omega-3 have to do with it 2 sources
Trust score 3 of 5:Promising Medical treatments
If you make little IgA or often have infections, you benefit especially from up-to-date vaccination protection. Ask your doctor which vaccinations are recommended in your country.
IgA: the antibody that keeps the gut clean, and what vitamin A, D and omega-3 have to do with it no source of its own, score based on judgement
Trust score 3 of 5:Promising Medical treatments
If you are ill unusually often, have long-lasting infections or several autoimmune symptoms at once, you can have this checked by a doctor, for example with a blood count and immunoglobulins. Behind it there may be a treatable immune deficiency or coeliac disease.
Immune system and inflammation no source of its own, score based on judgement
Trust score 3 of 5:Promising Medical treatments
The largest placebo-controlled trial so far showed no healing of the lining. Stopping an effective therapy in favour of LDN can fuel inflammation and complications.
Low-dose naltrexone (LDN): hope, studies and limits 3 sources
Trust score 3 of 5:Promising Medical treatments
The two largest trials found no meaningful difference from placebo for pain. Exercise and other proven treatments remain the foundation.
Low-dose naltrexone (LDN): hope, studies and limits 2 sources
Trust score 3 of 5:Promising Medical treatments
In a study of 55 people with IBS, the antihistamine ebastine brought considerable relief over 12 weeks in 46 per cent, compared with 13 per cent on placebo, and reduced abdominal pain. A trial is reasonable with medical supervision; it is not yet a standard treatment in the guidelines.
Mast cells: alarm cells in the gut, histamine and the disputed MCAS 1 sources
Trust score 3 of 5:Promising Medical treatments
People who have eaten strictly for a long time often need help widening their diet. A dietitian plans the order, checks nutrients and notices if fear of food is creeping in.
SCD, GAPS and the autoimmune protocol: what strict elimination diets can and cannot do 2 sources
Trust score 2 of 5:Plausible Medical treatments
If symptoms began with a drug from the list, talk to your doctor or pharmacist. There are often alternatives.
DAO: the enzyme that intercepts histamine from food 1 sources
Trust score 2 of 5:Plausible Medical treatments
Recurring attacks with dizziness, shortness of breath, swelling, a very fast pulse or fainting should be examined medically, including for allergy and mast cell disorders. There are blood tests for this, best taken during or shortly after an attack.
Histamine intolerance: much searched, little proven 1 sources
Trust score 2 of 5:Plausible Medical treatments
Some labs offer “sIgA in stool” as a marker of mucosal defence. No study was found showing that the value improves diagnosis or treatment. The values vary a lot, for example with stress and infections.
IgA: the antibody that keeps the gut clean, and what vitamin A, D and omega-3 have to do with it no source of its own, score based on judgement
Trust score 2 of 5:Plausible Medical treatments
Most sensible when well-supported treatments have been exhausted. Clarify together: off-label use and costs, side effects such as vivid dreams and sleep problems, and how you will measure success after a few weeks.
Low-dose naltrexone (LDN): hope, studies and limits 2 sources
Trust score 2 of 5:Plausible Medical treatments
Before starting, liver and kidney values should be known, and your doctor should know all other medications, especially painkillers, cough and diarrhoea remedies, which may contain opioids. Pregnancy, breastfeeding and liver disease are reasons for particular caution.
Low-dose naltrexone (LDN): hope, studies and limits no source of its own, score based on judgement
Trust score 2 of 5:Plausible Medical treatments
Decide beforehand what “better” means, for example a diary score or a number of pain-free days. If nothing measurable has changed after the agreed time, stopping is a reasonable decision, not a failure. Carrying on out of hope does not make it work.
Low-dose naltrexone (LDN): hope, studies and limits 1 sources
Trust score 2 of 5:Plausible Medical treatments
In a study of 60 people with IBS, the mast cell stabiliser ketotifen reduced the gut's hypersensitivity and the symptoms. Whether this was due to the stabilisation or the antihistamine effect remained open. Availability and approval differ by country. Common side effects are drowsiness and weight gain.
Mast cells: alarm cells in the gut, histamine and the disputed MCAS 1 sources
Trust score 2 of 5:Plausible Medical treatments
If you have rosacea along with bloating, diarrhoea or abdominal pain, you can talk to your doctor about a breath test for bacterial overgrowth and possible rifaximin treatment. The evidence rests on small studies; without gut symptoms this is not a rosacea treatment. Whether rifaximin is approved for this varies by country.
Trust score 1 of 5:Experimental Medical treatments
In a small randomised trial of 20 young adults with newly diagnosed type 1 diabetes, the body's own insulin production was better preserved after a transplant of their own stool than with donor stool, an unexpected result. For hair loss there are case reports. It is not a treatment for any autoimmune disease, and do-it-yourself faecal transplants are dangerous.
Autoimmune diseases and the gut: Hashimoto's, vitiligo, type 1 diabetes and more 3 sources
Trust score 1 of 5:Experimental Medical treatments
For inflammatory bowel diseases there are so far only animal and lab results. The ongoing trial tests PEA in addition to standard therapy, not instead of it. Tell your care team if you take PEA.
PEA (palmitoylethanolamide): the body's own inflammation brake in a capsule 2 sources