Please help - unknown gastrointestinal issues

[IcySport3592]

Over an year ago, I felt very anxious so I started cutting my abdomen (I stopped many months ago) and made some mild pink scars. Then, I developed gi issues that I never had before I cut. I especially cannot smell, sense, or control my gas as well as I used to.

Some of my other symptoms include gas during or right after eating or drinking, regurgitation at the beginning that stopped, incomplete bowel movements, involuntary abdomen lurching, abdominal discomfort, "popping bubbles" in abdomen, buzzing sensation near rectum, hunger or dissatisfaction, and weight loss.

I also tested positive for SIBO after I started cutting and took metronidazole and rifaximin that didn't help with my other symptoms.

Do you know what my problem is? Thank you for your help.

[Ken_PA]

Here's a must watch, 30 minutes. You should watch it at least twice.
https://www.youtube.com/watch?v=8tBBfnXtrAk
"SIBO and SIFO with Dr Satish Rao"

[IcySport3592]

Thank you, I will watch it when I have time.

[Ken_PA]

"Do you think my gut nerves or vagus nerve [and/or brain nerves] could be permanently damaged?"
Inflammation originating in the gut because of microbes can affect nerves via the inflammatory molecules they secrete. The vagus "nerve", btw, is a bundle composed of tens of thousands of individual nerve fibers.

Permanent damage? Offhand, I can't think of any mechanism for that. There is no reason I see to believe it can *initiate* an autoimmune attack, such as in Multiple Sclerosis. But it can worsen any pre-existing autoimmunity or autoinflammatory condition. I don't mean to be alarmist, there is no reason to believe you have permanent nerve damage - but there is ongoing inflammation which will cause downstream effects as long as the dysbiosis continues.

[IcySport3592]

What do think is the extent of nerve damage I have? Could any nerves be severed? Could the nerves controlling my gut muscles be damaged?

[IcySport3592]

I always feel that my anus is a little "open", like gas could escape unconsciously. I also can't really control it even if I consciously try to. I had some fecal incontinence before but not anymore. Do you think I could have internal and external sphincter or pelvic floor muscle damage or impairment? If so, can this be repaired? Could this be related to my gut microbiome or stress?

[IcySport3592]

I used to have stabbing abdominal pain or cramps frequently over an year ago but without the other symptoms I described in my post. Now I occasionally have abdominal pain but it’s not as sharp. (Is this because my gut nerves are affected?). Could I have IBS, or just a gut-brain axis problem, or both? Could IBS cause permanent nerve damage? Thank you so much for your help.

[Red_Star]

The number one cause of SIBO is low stomach acid. There are numerous reasons for low stomach such as stress, h pylori bacteria, gastritis, aging to name a few.

In my case my low stomach acid has not caused SIBO as I love to eat intermittent fasting style 16:8.  Low stomach acid affects nutrient absorption and so does SIBO. Nutrients you need for good mental and physical health. Plenty of nutrients are needed for serotonin, dopamine etc.

My top three symptoms of low stomach acid are bloating after eating, rectal itching (undigested food causing irritation) and iron deficiency (eventually iron deficiency anaemia if the stress continues). To help with stress and anxiety I love ASMR! There are over 13 million ASMR videos on YouTube! For low stomach acid betaine HCL with pepsin (only with protein meals) and digestive enzymes.

There are two videos I highly recommend watching on YouTube in regards to low stomach acid and SIBO:

Dr Berg: How To Get Rid Of SIBO (Small Intestinal Bacterial Overgrowth) with Intermittent Fasting

Dr Axe: How To Naturally Treat Low Stomach Acid

[IcySport3592]

Thank you, I will look into that.

[Red_Star]

No worries. :)

[Ken_PA]

"clicking skull"
I can't think of any mechanism for that. Somewhere I think I saw you say you are a 14 yr old girl, is that correct? Is the clicking from the top of the skull? Where the separate plates eventually fuse.

[Ken_PA]

"Sometimes there is a mild clicking sound inside my head, could this mean anything?"
That's not specific enough. Is it maybe from the neck, like when you rotate your head? Or from your jaw? Inner ear? If you have joint problems, that would be significant and possibly immune related. Do you have hyper flexible joints? (Ehlers Danlos Syndrome has lots of unusual downstream effects.)

"Do you think my gut microbiota is the reason why I cannot really control my gas anymore?"
Very possibly. Look up 'Infectious diarrhea' which occurs when harmful microbes infect the intestines and release toxins that cause inflammation and damage to the gastrointestinal lining.

  'Can you explain why you think anxiety or another psychological factor like depression are not the main factor for my gut microbes?'
That was my guess, and it's not really my field. You probably know more about GBA than I do. If e.g. GABA vs glutamate is a big factor for you personally, and very especially if stress episodes worsen your gut symptoms dramatically. Then what evidence based medicine might have to say gets trumped by your own carefully observed experience.

  

[IcySport3592]

Got it, thank you for your time and help!

[IcySport3592]

For my first question, sometimes the clicking sound happens when I move my head, and it seems to come from my skull but not from my jaw. I don't have joint issues. Could this be related to my gut-brain axis problems?

[IcySport3592]

Do you think my gut nerves or vagus nerve could be permanently damaged?

[IcySport3592]

and/or brain nerves

[IcySport3592]

from gut microbiota and/or inflammation and damage to gastrointestinal lining?

[IcySport3592]

What do you think is (are) the main factor(s) for my gut microbes?

[specialmom]

I do want to point out that mental health and gut health go hand in hand. I have a son who has had a mighty mental health battle the past two years and has always had a very slow GI tract. Constipation is something that has sent us to the hospital as it worked like a bowel blockage.  So, I monitor things with him. He does take a prebiotic, probiotic, works on diet and stool softeners as needed. When he is constipated, his mood dips. His anxiety soars. When it is better, this improves to the point that HE has noticed. However, I think it is the other way around. Your gut situation would result in ups and downs with mood verses your mood resulting in your gut flora. Serotonin receptors are up and down your gut. Most functional medicine docs do treat gi issue as part of their mental health care of patients. Emotional issues and disorders can create gi issues as it can slow down your gi, speed it up, cause nausea, etc.

Now, you are cutting. My son has severe anxiety including intrusive thoughts. I'd dig in deep for your psychiatric care. Often cutting is a way of coping. But it is highly dysfunctional. My son has found himself better on a basic ssri after trying many different classes of psychiatric drugs and therapy for proper coping strategies. There was a time considered low dose lithium (he is not bipolar) as it apparently works very well on intrusive thoughts.  I'm not sure what type of anxiety you have but it can be relentless.  We've learned so much about it.

I like that you speak of the vagus nerve because we use some of the various strategies to help too. I like the hand on forehead and hand on chest with gentle presses myself. I'm not sure where you've learned about things to try but feel free to post on the anxiety community and we can talk about that more.  I know this is about your gi issues.

Are you  by any chance neurodiverse?

As to Sibo, have they begun any treatment for you or given you any dietary advice?

[specialmom]

I do agree with Ken, that cutting unlikely led to sibo or the other issues you describe. But rather the state of your gut in general. This can get better.  Constipation which can be impacted by mental health, diet, and a lot of factors can contribute to overgrowth of bacteria in the gut. A slow gi tract is problematic.

[IcySport3592]

Hi specialmom, thank you for your response. I hope your son is feeling better now and his health and anxiety is improving. And for me, I will try to find better coping strategies. For your question, yes, I am autistic. The doctor has not given me any treatment plans or dietary advice for SIBO. I had constipation a few times and don't think it happened again.

[specialmom]

There is such a hand in hand relationship with GI issues, slow gi tract and autism.  So, I get it. My son is a lot more regular with the strategy of keeping his bowels moving as quick as possible at all times. Do you take a probiotic? We use an over the counter one that I buy on Amazon that seems to be helpful. They say to buy two different types and alternate between the two. When my son was at the emergency room with fecal bowel impaction, they told him to drink one cup of dark grape juice a day.  That helped. Fresh fruit helps. Less processed food. And he takes just a basic stool softener (not laxative).  Water/liquid is critical. Think of your gi tract as a water slide. It needs the water for things to move easily. If you speed up your gi tract a bit, it will likely help with sibo.  And if you have chronic constipation, you have have encopresis. https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494  It's mostly talked about with children but anyone can suffer this.  Here are some basic ideas on what to eat and not to eat with sibo.  https://www.healthline.com/health/sibo-diet

[IcySport3592]

Got it, thank you. I will try to change my diet.

[IcySport3592]

Hi specialmom and Ken,

Do you think cutting could have triggered or worsened my gut-brain axis dysfunction? Could cutting have triggered an autoimmune response because of my gut-brain axis dysfunction?

I also took Gas-X but it has not helped at all and may have given me more gas. Should I stop taking it when I'm on a diet?

Might I need an endoscopy, colonoscopy, or other further testing? Thank you.

[specialmom]

No, I don't think it would have. Cutting is mental health related and is superficial. I think your gut issues are related to the things I mentioned earlier. The cutting is a separate issue that you need to address. Things like DBT therapy are excellent for cutting.  Do you know much about that? I would work on the diet and take a probiotic. That's what would probably help most. What are you doing for therapy?

[IcySport3592]

Got it, thank you. I don't know much about DBT therapy. In therapy, we did not discuss a specific thing to work on. The therapist sometimes gives me reading materials and exercises to learn more about a topic and reflect on myself. She sometimes asks me to act out a situation or draw it. She helped me a little bit with anxiety with imagery before.

[IcySport3592]

Sometimes there is a buzzing/vibrating sensation in my rectum or anus. Should I see a doctor?

[Ken_PA]

Well, it can be fixed but probably will take a long time and a LOT of dedication. For both the anxiety and the gut dysbiosis. You sound like you surely have the necessary brain power, so if you have the willpower I think you can accomplish anything. Then you'll have trained yourself for a whole lifetime of accomplishing things.

There is no magic pill.

First step, 3 ways to defeat bad GI microbes:
- starve them, which is temporary
- outcompete them with probiotics, which may or may not work
- kill them with plant antimicrobials

Here is a doc recommending 3 possibilities for antimicrobials. Naturals are not always best for every problem, but for this they probably are much better than drugs.
- oregano oil, which is powerful so start slow
- berberine (he says, but I'd choose that last)
- raw garlic, better than capsules - and dried spice/powder does nothing. Can you take a garlic clove, smash it with something flat and take that? It takes a little toughness.

Others will recommend different things.

A radical temporary approach is the carnivore diet, which even though it is a trendy fad now - it can still be useful for some people medically. Yeast or gut bacteria would starve - but they'll come back quickly after their starving ends.  


I'd think that anxiety is a contributing factor but not the main factor, regarding the gut microbes.

Best of luck to you, write again with any questions.

[IcySport3592]

Thank you for taking the time to write again. I have a few more questions: Sometimes there is a mild clicking sound inside my head, could this mean anything? Do you think my gut microbiota is the reason why I cannot really control my gas anymore? Can you explain why you think anxiety or another psychological factor like depression are not the main factor for my gut microbes?

[IcySport3592]

To clarify, by "gut microbiota", I meant gut-brain axis, how the nerves in my gut and brain connect together.

[Ken_PA]

Hello, it's important to know if there is not bacteria (SIBO) but instead there's fungus (SIFO). The antibiotics you took against bacteria can clear the way for a fungus such as Candida to thrive and really take over. Antibiotics don't kill fungus, they actually aid the fungus. So the new triple test measures not only methane and hydrogen gas in the breath (SIBO), but also hydrogen sulfide (SIFO). Or there can be both SIBO and SIFO.

Candida can also be overgrown down in the colon, not just stomach and small intestine. Yeast/fungus also make odorless carbon dioxide; but since we all naturally exhale carbon dioxide, there can't be a breath test for that. Yeast really loves to feast on sugar, so if you eat a lot of sugar that makes things worse.

Take a look on youtube for some videos made by SIFO/Candida patients and doctors. They won't all be the same. It can be complicated.


I hope you can overcome the trauma that led to the cutting. I don't see how shallow surface cutting can have physically affected the GI tract so don't feel as if you caused the GI problems. But yes, anxiety can make the GI worse, as can even meds like SSRIs.

[IcySport3592]

Thank you for replying and reassuring me about my cutting. I will look into SIFO. Do you think the underlying cause to my symptoms might be gut-brain axis dysfunction from stress and anxiety? If this is the case, is there a way this can be repaired?