Chapters
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Gut barrier
The gut lining as the border between gut contents and the body. 1 chapter – expand
- Level:Intermediate Mould: mycotoxins in food and damp in the home What mould toxins can do in the gut, which dangers are well established, and which tests and cures do not deliver what they promise. Toxins and mouldInflammationTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
Opportunistic pathogens
Germs that only become a problem when the balance is off. 4 chapters – expand
- Level:Intermediate Opportunistic pathogens Germs that are always there and only become a problem when the balance tips. AntibioticsAcid blockersMedicationProbioticsGut infectionsInflammationTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Fungi in the gut: what is true about Candida Yeasts are part of the normal gut microbiota. When they are a problem and when they are not. AntibioticsGut infectionsTests and diagnostics Plausible How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Parasites in the gut: worms, protozoa and Blastocystis Which parasites make you ill, which are probably harmless lodgers and how to detect them reliably. ParasitesGut infectionsDiarrhoeaTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Gut and cancer: what the gut microbiota protects against, what harms, and why it matters in cancer treatment Fibre and its bacteria protect against colorectal cancer, while some bacteria damage the genome. Why colorectal cancer is rising in people under 50, which germs travel along in tumours, what Helicobacter has to do with stomach cancer, and why the gut microbiota helps decide whether immunotherapy works. FibreInflammationAntibioticsProbioticsTests and diagnosticsMouth and teethFaecal transplantBile acids Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
Microbial diversity
Why many different species keep the gut stable. 1 chapter – expand
- Level:Intermediate Gut tests: what they show and what they do not Microbiome analysis, zonulin, IgG, breath test, calprotectin: which tests are worth it. Tests and diagnosticsCoeliac disease and glutenInflammation Well supported How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
Gut-brain axis
How stress, sleep and nerves steer digestion. 1 chapter – expand
- Level:Intermediate Brain fog and fatigue: when your gut makes your head tired Many people with gut problems feel exhausted and foggy. What studies show, which causes can be checked and what is mere speculation. SleepVitamins and fatty acidsCoeliac disease and glutenInflammationProbioticsTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
Digestive function
Stomach acid, bile and enzymes as groundwork for the gut. 9 chapters – expand
- Level:Intermediate Stomach acid, bile and enzymes The groundwork in the stomach and small intestine determines what reaches the large intestine. Acid blockersMedicationBile acidsAlcoholBloatingTests and diagnostics Well supported How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Bile acids: when bile causes diarrhoea Primary and secondary bile acids, the role of gut bacteria and why antibiotics can shift the balance. Bile acidsDiarrhoeaIBSTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Pelvic floor: when stool won’t come out properly Why straining sometimes does not help, how a defecation disorder shows itself and why biofeedback works better than laxatives. ConstipationExerciseTests and diagnostics Well supported How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Sensitive stomach: fullness, upper abdominal pain and Helicobacter What is behind upper abdominal symptoms when the endoscopy is normal, why the Helicobacter test comes first and what else helps. BloatingIBSAcid blockersTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Pressure under the right ribs: bile, liver and gallstones A feeling of pressure in the upper right abdomen makes many people think of the gallbladder. What makes a real biliary colic, what “thick bile” means medically, and which other causes are more common. Bile acidsTests and diagnosticsBody weightFasting Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Digestive enzymes from mouth to colon: who breaks down what Saliva, stomach, pancreas, gut wall and bacteria each contribute their own enzymes. A map of where each enzyme works, and what happens when one is missing. FODMAPBloatingCoeliac disease and glutenTests and diagnostics Well supported How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Gastroparesis: when the stomach empties too slowly Nausea, vomiting, feeling full after a few bites: in gastroparesis, food stays in the stomach too long. Why it can hardly be separated from functional dyspepsia, what diabetes, viruses and weight-loss injections have to do with it, and what helps. BloatingMedicationBlood sugarTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Life without a gallbladder: diarrhoea, fat and symptoms after surgery Gallbladder removal is one of the most common operations, and most people do well afterwards. Why some get diarrhoea, what lies behind post-cholecystectomy syndrome and why cutting the sphincter usually does not help. Bile acidsDiarrhoeaTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Nutrient deficiency in gut problems: when food no longer arrives Why gut symptoms can leave you short of iron, vitamin B12, vitamin D, the fat-soluble vitamins and zinc, how to read blood results correctly and when supplements really help. NutrientsVitamins and fatty acidsDiarrhoeaTests and diagnosticsBody weight Well supported How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
Small intestine colonisation
When bacteria grow where few belong. 1 chapter – expand
- Level:Intermediate When the small intestine is too densely colonised Bacteria in the wrong place: why fibre can then become a problem. BloatingFODMAPAntibioticsIBSConstipationBile acidsTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
Immune system and inflammation
The gut as the body's largest immune organ. 5 chapters – expand
- Level:Intermediate Immune system and inflammation The gut trains your defences and can also upset them unnecessarily. InflammationMediterranean dietFermented foodsSleepTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.
- Level:Intermediate Histamine intolerance: much searched, little proven Headache after red wine, diarrhoea after cheese? What is known about histamine and what is not. HistamineFermented foodsAlcoholTests and diagnosticsDiarrhoea Plausible How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Allergies and intolerances: how the gut learns to tolerate food Every day the gut has to tolerate foreign protein. How this tolerance develops, what role bacteria, stomach acid and skin play, and why many people feel allergic without being so. AllergiesProbioticsAcid blockersAntibioticsTests and diagnostics Promising How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Autoimmune diseases and the gut: Hashimoto's, vitiligo, type 1 diabetes and more When the immune system attacks the body itself, the gut is often involved – as the place where the immune system learns, as a bystander that gets hit, and perhaps as a co-trigger. What is established, what has only been shown in mice, and what people affected can actually do. InflammationCoeliac disease and glutenVitamins and fatty acidsMedicationTests and diagnostics Plausible How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open. Community
- Level:Intermediate Crohn’s disease and ulcerative colitis: understanding inflammatory bowel disease In Crohn’s disease and ulcerative colitis, the immune system permanently attacks the gut wall. What distinguishes the two, what role genes, smoking, antibiotics and gut microbiota play, why early treatment matters, and what diet, probiotics and faecal transplants really achieve. InflammationDiarrhoeaTests and diagnosticsMedicationAntibioticsNutrientsProbioticsFaecal transplantMediterranean diet Established How we rate the evidence Established Recommended in medical guidelines or supported by several consistent meta-analyses of randomised human studies. Well supported Several randomised studies in humans with largely consistent results. Promising Single randomised or controlled studies in humans, not yet independently confirmed — or many consistent observational studies. Plausible Two cases: first observational or pilot studies with small samples — or a settled basis that is not in dispute, such as movement, sleep or meal pauses. But not tested in humans for symptoms. Experimental Barely studied in humans. Mainly lab and animal studies or theoretical reasoning; whether it helps is open.