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.
Digestive function · Clear selection
Trust score 5 of 5:Established Medical treatments
Ask why you are taking the PPI and whether the reason still applies. For uncomplicated reflux or heartburn that has settled after at least four weeks, the guideline recommends lowering the dose, stopping, or taking it only when needed.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 2 sources
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With Barrett's oesophagus, severe oesophagitis, previous stomach bleeding or a high bleeding risk, the benefit outweighs the risks. No self-experiments here; this is a medical decision.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 1 sources
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With a high bleeding risk, for example in older age, after a previous stomach bleed or on painkillers together with blood thinners, a PPI lowers the risk of serious bleeding. The benefit outweighs the risks here. What matters is that the reason is noted and reviewed regularly.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 1 sources
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Macrogol binds water in the gut and is usually well tolerated. The guideline strongly recommends it. There is less data on use over many years; with long-term use, talk to your doctor.
Constipation: more than too little fibre 1 sources
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Blood in the stool or black stool, fever, diarrhoea even at night, weight loss, dehydration, anaemia, new, persistent diarrhoea in older people or a trip to distant countries need checking. Then do not experiment on your own.
Diarrhoea: understand it, place it and react the right way 2 sources
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The elastase test in stool shows whether the pancreas makes enough enzymes. In case of deficiency, enzyme capsules with every meal, adjusted to the fat content, are the standard treatment.
Digestive enzymes from mouth to colon: who breaks down what 1 sources
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For typical heartburn, an eight-week trial is the standard. After that, find the lowest effective dose or take them only when needed.
Heartburn and reflux 1 sources
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With warning signs or if acid blockers do not help, a gastroscopy is part of the work-up.
Heartburn and reflux 1 sources
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The test looks for antibodies against tissue transglutaminase (together with total IgA), with a small intestine biopsy if needed. The guideline recommends the test for IBS symptoms.
Lactose, fructose, gluten: making sense of intolerances 1 sources
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Transglutaminase antibodies together with total IgA, as long as gluten is still being eaten. Coeliac disease is a common cause of iron deficiency and can show up only this way for a long time.
Nutrient deficiency in gut problems: when food no longer arrives 2 sources
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Fatty, pale stools and weight loss point to disturbed fat digestion. Elastase in the stool shows how well the pancreas is working; with a deficiency, enzymes with meals are the standard treatment.
Nutrient deficiency in gut problems: when food no longer arrives 2 sources
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Unintended weight loss, blood in the stool, fever, symptoms at night or anaemia belong in a doctor’s practice, even with an existing IBS diagnosis. They can point to inflammatory bowel disease or other causes.
Nutrient deficiency in gut problems: when food no longer arrives 1 sources
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With a probe, you see on a screen what your muscles do when pushing and learn to relax them properly. After 6 months, 80 percent with biofeedback reported major improvement, but only 22 percent with laxatives. The effect lasted at least 2 years.
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Stones, sludge, a thickened gallbladder wall and a fatty liver can be seen well on ultrasound. Blood tests for liver, bile and pancreas are added. This is quick, painless and without radiation.
Pressure under the right ribs: bile, liver and gallstones 1 sources
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For stones with typical colic or complications, guidelines recommend removing the gallbladder, usually by keyhole surgery. For stones found by chance without symptoms, the usual approach is to wait, because most never cause problems. The operation is not without consequences, though: about one in ten people still has symptoms afterwards or develops new ones, and some get lasting diarrhoea from bile acids. So clarify beforehand whether the symptoms really come from the stones; more in the chapter on life without a gallbladder.
Pressure under the right ribs: bile, liver and gallstones 2 sources
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Under 60 and without warning signs, the guideline recommends a breath or stool test for Helicobacter as the first step and treatment if positive. Stop acid blockers beforehand, or the test may be falsely negative, and check afterwards whether treatment worked. Treatment usually consists of several antibiotics plus an acid blocker for one to two weeks. Diarrhoea, nausea and a metallic taste are common and usually pass; the gut flora also needs some time to recover afterwards.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 3 sources
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Faecal elastase is the usual test for pancreatic insufficiency. If it is confirmed, enzymes taken with meals are effective and recommended in guidelines.
Stomach acid, bile and enzymes 1 sources
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With greasy stools, weight loss or risk factors such as chronic pancreatitis, diabetes with digestive problems or after operations, a stool test measures elastase. With genuine insufficiency, enzyme capsules with every meal replace the missing enzymes, with a very good effect.
The digestive chain: how stomach acid, bile and pancreas set each other off 1 sources
Trust score 4 of 5:Well supported Medical treatments
Many guidelines suggest lowering the dose step by step over a few weeks, for example halving it and then taking it every other day, or taking it only when needed. The American gastroenterology association also considers stopping at once possible. How you do it is something to decide with the prescribing practice. Expect a few weeks of temporary acid symptoms due to the rebound effect; this is usually not a relapse.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 3 sources
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Before bile salts or lecithin, it is worth asking what is failing: elastase in the stool for the pancreas, liver and bile values, and with diarrhoea a test for bile acid loss. Only then can treatment be targeted.
Bile, lipase and lecithin: what fat digestion really needs 1 sources
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If the pancreas supplies too few enzymes, enzymes with meals are the standard treatment. Over-the-counter plant and fungal enzyme mixtures are dosed far too low for this.
Bile, lipase and lecithin: what fat digestion really needs 1 sources
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It is prescription-only in many countries and approved for gallstones and certain liver diseases. In cystic fibrosis with pancreatic insufficiency it improved fat digestion in a small study; as a general remedy for fat digestion disorders it is not proven.
Bile, lipase and lecithin: what fat digestion really needs 3 sources
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When the belly visibly distends a great deal, training the breathing and abdominal wall movement can help. In randomised controlled trials, biofeedback that measures the movement of the rib cage and abdominal wall reduced the distension more strongly than a sham treatment. It addresses the disturbed movement, not the gas.
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Senna is recommended as a second-line option. If that is not enough, there are drugs such as prucalopride or linaclotide, which are usually prescribed by a doctor.
Constipation: more than too little fibre 1 sources
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If the feeling of incomplete emptying remains despite soft stools: pressure measurement in the rectum can reveal a pelvic floor disorder. Biofeedback training then helps well.
Constipation: more than too little fibre no source of its own, score based on judgement
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With new constipation, blood in the stool, weight loss or iron deficiency, blood tests (for example thyroid, blood count, calcium) and possibly a colonoscopy make sense. Even if nothing is found, the result helps in choosing treatment.
Constipation: more than too little fibre 1 sources
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If the diarrhoea lasts longer than four weeks, stool samples (pathogens, markers of inflammation), a coeliac blood test and a bile acid test help; with warning signs, a colonoscopy. Microscopic colitis is recognised only in the tissue under the microscope.
Diarrhoea: understand it, place it and react the right way 3 sources
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Loperamide and racecadotril ease watery diarrhoea. Racecadotril does not slow gut movement and performed about as well for infectious diarrhoea in a meta-analysis. With fever, blood in the stool or suspected invasive infection, guidelines advise against anti-motility agents.
Diarrhoea: understand it, place it and react the right way 2 sources
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Watery diarrhoea with three or more stools a day after antibiotics or a hospital stay should be tested for Clostridioides difficile. It is treated differently from an ordinary infection, and anti-diarrhoea drugs that slow the gut are then unfavourable.
Diarrhoea: understand it, place it and react the right way 1 sources
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A hydrogen breath test after milk sugar (or other sugars) can measure whether a sugar is fermented in the large intestine. It is the usual test when lactose deficiency is suspected and the basis for targeted rather than blanket avoidance. How well available it is depends on the country.
Digestive enzymes from mouth to colon: who breaks down what no source of its own, score based on judgement
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In a first, CT-confirmed uncomplicated diverticulitis, the inflammation healed just as well without antibiotics in two large trials. Whether they are needed in an individual case is for your doctor to decide. With fever, severe pain, weakened immunity or complications they remain part of treatment.
Diverticula, haemorrhoids and fissures: what can go wrong at the end of the gut 4 sources
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Prescription ointments with nitroglycerin or calcium channel blockers (diltiazem, nifedipine) relax the cramped muscle. In a Cochrane review, nitroglycerin healed slightly more fissures than placebo (49 versus 36 per cent) and often causes headaches; the calcium channel blockers worked as well with fewer side effects. Botox is another option. Surgery heals most often but carries a small risk of incontinence.
Diverticula, haemorrhoids and fissures: what can go wrong at the end of the gut 1 sources
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Blood in or on the stool, dark blood or blood mixed with stool, changed bowel habits, weight loss or anaemia need to be examined by a doctor, especially from age 50. Even if you know you have haemorrhoids: they can hide another source of bleeding.
Diverticula, haemorrhoids and fissures: what can go wrong at the end of the gut 2 sources
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First an endoscopy to rule out a narrowing or ulcer, then four-hour scintigraphy or a breath test. Drugs that slow the stomach, such as opioids or GLP-1 drugs, should be paused beforehand after discussing it with your doctor, and blood sugar should be in the target range. Otherwise the result is distorted.
Gastroparesis: when the stomach empties too slowly 3 sources
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If acid blockers do not work or only half work, a measurement in the oesophagus (acid and impedance testing) can show whether acid is really flowing back or whether the oesophagus is oversensitive. This decides whether more acid suppression makes sense or another approach, such as drugs that dampen pain perception or relaxation methods.
Heartburn and reflux 2 sources
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If reflux is proven and medication does not work well or is not tolerated, surgery or an endoscopic procedure may be an option in specialised centres. A thorough work-up beforehand is a precondition; they do not help in functional heartburn. These procedures have downsides too: after a wrap operation (fundoplication), difficulty swallowing, bloating and trouble belching are common, in some people permanently, and in some the effect wears off over the years. Discuss benefits and consequences carefully beforehand.
Heartburn and reflux 1 sources
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Positive results are normal in healthy people too. They often lead to unnecessary diets.
Lactose, fructose, gluten: making sense of intolerances 2 sources
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If you already eat gluten-free but want to know whether you have coeliac disease, you must eat gluten regularly again for several weeks before the examination. This should be agreed with your doctor, especially if symptoms are strong. A gene test for HLA-DQ2/DQ8 can rule out coeliac disease when negative, without having to eat gluten.
Lactose, fructose, gluten: making sense of intolerances 1 sources
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Persistent watery diarrhoea after surgery is often due to bile acid loss. The SeHCAT test or a C4 blood test can detect it. Not every test is available in every country; sometimes a treatment trial is used instead.
Life without a gallbladder: diarrhoea, fat and symptoms after surgery 2 sources
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Colestyramine, colestipol or colesevelam bind bile acids in the gut. After surgery, around 80 per cent responded to colestyramine in a meta-analysis. In a randomised trial in bile acid diarrhoea, colesevelam led to remission in 64 per cent, compared with 16 per cent on placebo. These drugs can interfere with the absorption of other medicines, so take them at different times.
Life without a gallbladder: diarrhoea, fat and symptoms after surgery 2 sources
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Blood tests during a pain attack and imaging of the bile ducts show whether a stone is stuck in the duct. If both are normal, cutting the sphincter does not help according to the EPISOD trial and carries the risk of pancreatitis. Then it is worth looking at the stomach, reflux and IBS.
Life without a gallbladder: diarrhoea, fat and symptoms after surgery 2 sources
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A full blood count, ferritin together with CRP, vitamin B12 (holotranscobalamin or methylmalonic acid if needed), folic acid, 25-OH vitamin D, calcium and zinc are sensible. Zinc and calcium in serum say little about the stores.
Nutrient deficiency in gut problems: when food no longer arrives 3 sources
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If B12 is low, it is worth asking about the cause: too little intake, too little stomach acid, missing intrinsic factor (for example in an autoimmune disease of the stomach) or a problem at the end of the small intestine. The cause decides whether swallowing is enough or whether injections are needed.
Nutrient deficiency in gut problems: when food no longer arrives 1 sources
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If you have Crohn's disease of the small intestine, a shortened bowel, pancreatic insufficiency or a gastric bypass, ask your doctor about urinary oxalate. Diet and calcium supplements should be planned medically here.
Oxalate, salicylate, lectins: hidden culprits or internet myth? 1 sources
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If you strain a lot or help with your fingers, mention it. If a defecation disorder is suspected, the guideline recommends a balloon expulsion test and anorectal manometry; a digital examination often gives a first clue.
Trust score 4 of 5:Well supported Medical treatments
The guideline strongly recommends macrogol and sodium picosulfate for chronic constipation. They make daily life easier but do not replace training for a defecation disorder.
Trust score 4 of 5:Well supported Medical treatments
Specialised physiotherapists practise with you how to coordinate breathing, abdominal pressure and pelvic floor, often with biofeedback. The guideline names biofeedback training as the preferred treatment for a defecation disorder. Ask about services near you; they are not available everywhere.
Trust score 4 of 5:Well supported Medical treatments
Without Helicobacter, or if treatment is not enough, a trial of acid blockers is the next step, especially for pain and burning. If there is no effect after a few weeks, talk to your doctor rather than simply carrying on. How to stop them is explained in the chapter on acid blockers.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 1 sources
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With warning signs, from about age 60 with new symptoms, or if nothing helps. The age threshold depends on how common stomach cancer is in a country; ask in your country.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 1 sources
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If upper abdominal complaints such as pressure, early fullness or burning persist, a test for Helicobacter pylori (breath or stool test) is usual. An infection can be treated with a combination of drugs. With alarm signs such as weight loss, trouble swallowing, vomiting blood or black stools, an endoscopy should follow quickly.
Stomach acid, bile and enzymes no source of its own, score based on judgement
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With diabetes or after stomach surgery, fullness, early satiety and nausea can point to delayed gastric emptying. A gastric emptying study can clarify this. Better blood sugar control and adapted eating are then part of treatment. More in the chapter on gastroparesis.
The digestive chain: how stomach acid, bile and pancreas set each other off 1 sources
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If you don’t tolerate iron tablets, don’t simply stop, but have the treatment adjusted: a different form, a different schedule or iron as an infusion. The infusion bypasses the gut completely and causes no gastrointestinal symptoms. And iron deficiency always needs an explanation.
When the supplement itself is the problem: iron, magnesium, excipients and more 1 sources
Trust score 3 of 5:Promising Medical treatments
If you take PPIs for years, have your vitamin B12 checked when the opportunity arises, especially with tiredness, tingling in hands and feet or anaemia. If needed, also magnesium and iron.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 1 sources
Trust score 3 of 5:Promising Medical treatments
If symptoms persist despite a PPI, it is worth asking whether acid is really the cause. Possible alternatives are an oversensitive oesophagus, functional heartburn, a gastric emptying disorder or another illness. An endoscopy or a measurement of acid and reflux in the oesophagus brings clarity; the treatment is then a different one.
Acid blockers (PPIs): what they change in the gut and how to stop them properly 1 sources
Trust score 3 of 5:Promising Medical treatments
The SeHCAT test measures how much of a labelled bile acid is still in the body after a week. Blood tests for C4 (shows increased production) or FGF19 are alternatives. Not every test is available in every country.
Bile acids: when bile causes diarrhoea 2 sources
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Colestyramine, colestipol or colesevelam bind bile acids in the gut. Colesevelam is often better tolerated. After a positive test, about two thirds responded in studies; the greater the loss, the more likely the drugs work. Many stop treatment because of side effects, and these drugs can interfere with the absorption of other medicines.
Bile acids: when bile causes diarrhoea 3 sources
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If a bile acid loss is confirmed, it is worth asking why: ileum inflamed or operated on, coeliac disease, small intestinal bacterial overgrowth, gallbladder removal or no visible cause. Whether something else needs treating depends on this, for example coeliac disease with a gluten-free diet.
Bile acids: when bile causes diarrhoea 1 sources
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Bile acid binders can reduce absorption of other drugs and fat-soluble vitamins. The usual advice is to take other drugs several hours apart. Ask your doctor’s office or pharmacy for the exact gap for your drugs. With long-term treatment, vitamin status can also be checked.
Bile acids: when bile causes diarrhoea 1 sources
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There is often something treatable behind it: a sugar intolerance, small intestinal bacterial overgrowth (SIBO) or delayed stomach emptying. With an overgrowth, an antibiotic (for example rifaximin) also eases the bloating, with a weak to moderate effect in reviews. Treatment follows the cause, not the symptom.
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A time-limited low-FODMAP diet is also recommended for IBS in guidelines and eases bloating in several studies. It should be supervised by a dietitian and loosened again after a few weeks. Important: warning signs such as blood in the stool, unintended weight loss, symptoms at night, fever, vomiting, anaemia or new symptoms from about age 50 should be checked by a doctor and not treated with diets.
Trust score 3 of 5:Promising Medical treatments
If the constipation began after starting a medication, it is worth asking whether there are alternatives or a different dose. Do not stop anything on your own. For opioids there are specific drugs that block their effect on the gut.
Constipation: more than too little fibre 1 sources
Trust score 3 of 5:Promising Medical treatments
If the gut stays sensitive for weeks or months after a stomach bug, post-infectious IBS may be behind it. It is common and treatable; it is worth having it assessed medically instead of taking anti-diarrhoea drugs permanently.
Diarrhoea: understand it, place it and react the right way 1 sources
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With diarrhoea and bloating after sugar and starch, especially since childhood or running in the family, a deficiency may be behind it. Options are a breath test with sucrose, a genetic test or an enzyme measurement in a small intestine biopsy. How available these tests are varies by country.
Digestive enzymes from mouth to colon: who breaks down what 1 sources
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If fibre and toilet habits do not help, rubber band ligation in the clinic can shrink the cushions. It is less painful than surgery; for markedly protruding haemorrhoids, surgery lasts longer. Over-the-counter ointments ease symptoms but do not remove the cause.
Diverticula, haemorrhoids and fissures: what can go wrong at the end of the gut 1 sources
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Opioids, GLP-1 drugs and some other medicines slow the stomach. Whether to adjust or switch them is a joint decision with your doctor, as there are often important reasons for them. Do not stop them on your own.
Gastroparesis: when the stomach empties too slowly 2 sources
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It speeds up the stomach and dampens nausea. Because of the risk of movement disorders (tardive dyskinesia) that can be permanent, many countries now approve it only for short-term use. The risk is probably lower than once thought, but rises with duration and dose, with age, in women, in diabetes and in kidney or liver failure.
Gastroparesis: when the stomach empties too slowly 2 sources
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Domperidone works similarly but barely enters the brain. However, a meta-analysis of observational studies linked it to about a 70 per cent higher risk of dangerous heart rhythm disorders and sudden cardiac death. An ECG and a check of other medications belong before starting. Approval and permitted duration differ by country.
Gastroparesis: when the stomach empties too slowly 2 sources
Trust score 3 of 5:Promising Medical treatments
After longer use, acid can rebound briefly if you stop abruptly. Reduce gradually, in agreement with your doctor.
Heartburn and reflux no source of its own, score based on judgement
Trust score 3 of 5:Promising Medical treatments
Reliably shows whether lactose is poorly absorbed. It does not show whether this causes symptoms.
Lactose, fructose, gluten: making sense of intolerances 1 sources
Trust score 3 of 5:Promising Medical treatments
A new intolerance to milk or sugar after an infection, with weight loss, blood in the stool or night-time symptoms should be checked by a doctor. Possibilities include coeliac disease, inflammatory bowel disease and small intestinal bacterial overgrowth.
Lactose, fructose, gluten: making sense of intolerances 1 sources
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After operations on the stomach or bowel, with Crohn’s disease, coeliac disease or persistent diarrhoea, regular blood checks make sense even if you feel well. Which values and at what intervals is decided by your treating practice.
Nutrient deficiency in gut problems: when food no longer arrives 1 sources
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A stone analysis and a 24-hour urine collection show whether too much oxalate, too little citrate or too much calcium is behind it. Only then is a targeted diet worthwhile.
Oxalate, salicylate, lectins: hidden culprits or internet myth? 2 sources
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Training with a small device at home worked almost as well as in the clinic in one study: 68 versus 70 percent responded. Ask whether this is offered in your country.
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If stool gets stuck despite soft stool and training, or you have to help with your fingers, defecography (X-ray or MRI of emptying) can show whether a rectocele or intussusception plays a part. The finding must be interpreted together with the symptoms.
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It can slowly dissolve small cholesterol stones in a well-functioning gallbladder and prevents new stones during rapid weight loss. The evidence for treating colic pain is thin. After stopping, stones often form again.
Pressure under the right ribs: bile, liver and gallstones 2 sources
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An old antidepressant in a small dose dampens pain perception. In one trial it helped 53 percent versus 40 percent on placebo, especially with upper abdominal pain. Another antidepressant did not help. Common side effects are tiredness, dry mouth and constipation. Caution is needed with heart rhythm problems and together with some other medicines, so only with medical supervision.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 2 sources
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Prokinetics stimulate stomach movement. The guideline names them as a possible option for fullness, the evidence is weak, and approval differs from country to country. Ask what is possible in your country. Some of these drugs carry serious risks for heart rhythm or for lasting movement disorders and are therefore only allowed for short periods; more in the chapter on gastroparesis.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 1 sources
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Gut-directed hypnosis and cognitive behavioural therapy help some people with stomach complaints that do not improve with other measures. The guideline names them as a possible option; the evidence is thin. The chapter on the gut-brain axis describes why this can make sense.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter 1 sources
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If symptoms come as cramps after fatty meals, with vomiting of undigested food, diarrhoea or weight loss, it is worth checking specifically for gallstones, coeliac disease or a gastric emptying disorder.
Sensitive stomach: fullness, upper abdominal pain and Helicobacter no source of its own, score based on judgement
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Discuss with your doctor whether the dose can be lowered or the drug stopped. Usually it is reduced step by step; the US specialist society also considers stopping at once possible. Either way, acid can rebound for a few weeks; this is usually not a relapse. More in the chapter on acid blockers.
Stomach acid, bile and enzymes 1 sources
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If you take acid blockers or metformin long term, eat strictly vegan, are older or notice signs such as tiredness and tingling, the vitamin B12 status can be measured in the blood. This is simple, and a deficiency is easy to correct. Routine testing for every acid blocker user is not recommended.
Stomach acid, bile and enzymes 2 sources
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Acid blockers are important when there are clear reasons. Without such a reason, it is worth reviewing duration and dose with your doctor so that stomach acid can take over its tasks in the chain again.
The digestive chain: how stomach acid, bile and pancreas set each other off 1 sources
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With known lactose intolerance or FODMAP sensitivity, it is worth asking at the pharmacy: often the same active ingredient is available from another manufacturer without lactose or sorbitol. Do not switch or stop prescribed medicines on your own.
When the supplement itself is the problem: iron, magnesium, excipients and more 1 sources
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If symptoms appear shortly after starting a new product, mention it at the doctor’s. Black stools are normal with iron; tarry, shiny stools, blood or severe abdominal pain, however, need to be checked by a doctor immediately.
When the supplement itself is the problem: iron, magnesium, excipients and more 1 sources
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Drugs that activate the bile acid receptor FXR strengthen the FGF19 brake and improved bile acid diarrhoea in small studies. They are not yet approved for this purpose.
Bile acids: when bile causes diarrhoea 1 sources
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If the last part of the small intestine is missing, bile acid replacement can improve fat absorption; this has been tested only in very few people and with non-approved substances. It belongs in the hands of specialist centres for short bowel syndrome.
Bile, lipase and lecithin: what fat digestion really needs 2 sources
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For constipation with high methane, combinations of antibiotics are used. Controlled studies on this are still lacking. Neomycin, often used for this, can damage hearing and kidneys in people with weak kidneys or with longer use, so only after careful medical consideration.
Constipation: more than too little fibre 1 sources
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In severe gastroparesis that responds to nothing else, the pyloric muscle is cut endoscopically. In a small sham-controlled trial (41 people), 71 per cent were clearly better after six months, compared with 22 per cent. The trial was stopped early, long-term data are lacking, and the procedure belongs in experienced centres. Rarely, bleeding or a hole in the stomach wall occurs.
Gastroparesis: when the stomach empties too slowly 1 sources
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Ask whether any of your medications can relax the sphincter or irritate the oesophagus. There is often an alternative or a better time to take it. Never stop on your own.
Heartburn and reflux no source of its own, score based on judgement
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Whether the operation raises colorectal cancer risk is unclear. But the usual screening by age and family history applies to everyone, with or without a gallbladder.
Life without a gallbladder: diarrhoea, fat and symptoms after surgery 2 sources
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With proven aspirin intolerance, a short supervised trial followed by reintroduction can make sense. Without this background, low-salicylate diets for gut symptoms are not supported by evidence.
Oxalate, salicylate, lectins: hidden culprits or internet myth? 2 sources
Trust score 2 of 5:Plausible Medical treatments
A nuclear medicine test measures how strongly the gallbladder empties. Whether a low value justifies surgery is not established. Before surgery without stones, it is worth thoroughly checking other causes and getting a second opinion.
Pressure under the right ribs: bile, liver and gallstones 2 sources