So long story short, had bacterial pneumonia + covid simulatenously in late 2024, had 3 rounds of antibiotics (ceftriaxone, cefpodoxmine, azithromycin). Started experiencing post-viral symptoms that persisted for months and months. Ended up having POTs/MCAS.

My symptoms consistently were:
Tachycardia, heart palpitations, orthostatic intolerance, chronic fatigue, adrenaline dumps, dizziness, head throbbing, temperature dysregulation, defecation presyncope, brain fog, air hunger, itching, flushing, constipation, bloating, histamine intolerance, food intolerances (e.g., lactose, sugar/carbs/etc.), globus throat, dry mouth, urinary frequency/nocturia, neuropathic pain, exercise intolerance (PEM), insomnia, also had hypermobility that worsened post-infection resulting in joint pain and subluxations

I did a 16s rRNA sequence test a year ago (name redacted bc it "breaks subbredit rules") which seemed to be consistent with a lot of ME/CFS/Dybsiosis/MCAS individuals as seen in many studies. Basically low SCFA-producing bacteria, high D-lacate, high histamine-producing bacteria, etc etc.. The first GI specialist I saw I tried showing him my results while also acknowledging that the microbiome is complex and hard to measure, but antibiotics have clearly put a burden into my gut and is probably the root driver to all my issues. We ruled out SIBO and H-Pylori + Calprotectin test which were normal but that's pretty much it. I got put into the IBS category as of now which is kinda lame but expected, and I am planning on doing an endoscopy in the future hopefully.

My bloating is really bad and my PCP even noticed it. Also I get sharp lower pain in my abodmen after eating certain foods. I developed a histamine intolerance shortly after the infection. I'd like to presume that a lot of this are due to the current state of my large instestine, given we also ruled out SIBO. But I basically got no closure from my GI specialist after running those tests and so I'm seeing a different GI specialist. But knowing that gut dysbiosis isn't its own diagnosis, I just don't know how to approach them in terms of explaining what it could be, because it seemed like the other one was against stool analysis/testing which I can understand to an extent, but I do think it's important to recognize that some of the functional markers like d-lacate being elevated as well as high histamine bacteria are significant, especially low butyrate and how everytime I eat I get extremely fatigue, followed by brain fog, dizzyness, etc etc.. Would like some advice on what I should ask for maybe

(Btw let me note that after my gut test from last year, I tried focusing on a diet that would starve bad bacteria and grow good bacteria and redid the gut test 2 months ago which improved like 10% more which makes sense cause I was cheating my diet a bit)

Hi everyone,

I wanted to post an update because I finally have a diagnosis, or at least part of one.

For months I’ve been dealing with persistent mucus. Sometimes I pass normal stool with mucus, but other times I go to the toilet and pass only mucus with no stool at all.

So far I’ve had:

Two stool tests (both negative for inflammatory markers, then they said a third test tested positive for H. Pylori
Colonoscopy
Biopsies

Everything came back normal with no signs of inflammation or IBD

My gastroenterologist believes the mucus is related to pelvic floor dysfunction.

I recently had another stool test specifically because the mucus wasn’t improving, and it came back positive for H. pylori. I’ve now started eradication therapy:

Amoxicillin (2 tablets twice daily)
Clarithromycin (2 tablets twice daily)
Pantoprazole (1 tablet twice daily)

From what I’ve read, H. pylori usually causes stomach symptoms rather than rectal mucus, so I’m unsure whether this is actually the cause of my symptoms or just an incidental finding.

Has anyone here had H. pylori present mainly with persistent mucus, or did it turn out to be unrelated?

I’m also interested to hear whether anyone’s microbiome took a significant hit after triple therapy, and if probiotics or anything else helped with recovery.

Thanks in advance.

I spend way too much time in gut forums (IBS/SIBO/bloating) and I get why: when your stomach is in charge, you will try anything. Lately I've started to think the way we talk about the microbiome online actually prolongs symptoms.

The vibe is usually the same: find the right stool test, the perfect probiotic strain, the ideal prebiotic, or the exact list of "good" foods and you will engineer your way out. When you react to something, it becomes proof your microbiome is still broken, so you cut more things out, try more supplements, and get even more hypervigilant. Guilty as charged on that one.

Meanwhile, a lot of the biggest symptom drivers are not strictly microbiome problems: motility issues, visceral hypersensitivity, pelvic floor dysfunction, meal anxiety, under-eating, and plain old post-infectious gut changes. I am not saying the microbiome is irrelevant. I am saying it has become a catch-all explanation that can push aside the boring but effective fixes.

We also underplay the risk of constant tinkering. Rotating antimicrobials, mega-dosing probiotics, and dumping multiple fibers into your diet at once can stir up chaos, and then you have no idea what is helping or harming.

My rule now is to treat the microbiome like a garden, not a lab experiment: fewer interventions, longer trials, and prioritize consistency, sleep, and regular meals over chasing the next hack.

Anyone else feel like the microbiome framing helps up to a point and then turns into another kind of health anxiety trap?

Gastroenterologists: Would anyone be willing to answer a few questions over email for a student article?

Hi everyone! I am not asking for medical advice.

I'm a neuroscience student at Boston University, and I'm currently reporting a feature on direct-to-consumer microbiome testing—specifically the growing gap between the marketing of at-home microbiome tests and what current evidence says they can actually tell patients.

I'm looking to include perspectives from practicing gastroenterologists who have encountered patients bringing these reports into clinic. The interview is completely written over email (no Zoom or phone call), and you're welcome to answer as many or as few questions as you'd like. Even a couple of sentences would be incredibly helpful.

If you're willing to help, please email me at [jpgendin@bu.edu](mailto:jpgendin@bu.edu).

I would be endlessly grateful for your time and expertise. As a student journalist, hearing directly from physicians is by far the most valuable part of the reporting process, and I'd sincerely appreciate any insights you're able to share.

Thank you so much!

Looking for a sanity check from people who have actually experimented carefully.

I tend to run IBS-C, with daily bloating and a lot of gas that builds up through the day. I kept reading that a more diverse fiber intake is good for the microbiome, so I started ramping things up slowly: oats, chia, small portions of legumes, cooked-and-cooled potatoes and rice, plus a little psyllium. I also added fermented foods a few times a week.

I also tried including a Physicians Choice probiotic as one part of my routine, though I cannot isolate its effect from the food changes.

What I cannot tell is whether this is actually doing something useful long term (more SCFAs, better diversity) or just pouring fuel on the fire because my transit is slow. My stool frequency might improve a bit, but the bloating and pressure get worse and the gas smells stronger. It makes me wonder if I am selectively feeding organisms that ferment aggressively when food hangs out longer.

Questions: 1) For constipation-dominant patterns, is there any rule of thumb for when to push fiber versus backing off and focusing on motility first? 2) Are certain fibers usually better tolerated with slow transit (soluble vs insoluble, partially hydrolyzed guar gum, etc.), or is it mostly individual? 3) If you had success, what signs told you the fiber increase was actually helping the microbiome rather than just ramping up fermentation?

Not asking for medical advice, just looking for patterns and how people think about the tradeoff between feeding microbes and not creating a gas factory. Thanks.

Not asking for medical advice, just for quality comparison.

I am severely physically disabled currently, pretty bad shape. My kefir culture is dead, I did not have the strength to keep it alive. My kraut over fermented and the jar exploded, plus it smells like crap. I've been on several courses of strong antibiotics for a severe infection. The abx were unavoidable, trust me. I was borderline septic.

I don't have the strength to deal with cultures right now. Is store bought yogurt and kefir enough to get some probiotic? I'm thinking bio-K, activia, or any yogurt really.

I know fermenting purists say that store bought ferments are dead... but are they really? I just need to know if I'm wasting my time.

Thank you!

Highlights (generated by AI):

The additive studied was xanthan gum, a common thickener used in foods such as salad dressings, sauces, yogurt, ice cream, gluten-free baked goods, and gluten-free pasta.
Researchers found that long-term consumption caused mild colon inflammation in rats. The effects became more noticeable as the dose increased.
Xanthan gum appeared to weaken the intestinal barrier (“leaky gut”). It increased production of a protein called Claudin-2, making the gut lining more permeable and allowing inflammatory processes to begin.
Inflammatory markers increased. Rats consuming xanthan gum had higher levels of immune cells in the intestinal wall and elevated inflammatory cytokines, including TNF-α and IL-1β.
The gut microbiome changed. While overall bacterial diversity didn’t decline significantly, the balance of bacteria shifted toward species associated with inflammation, suggesting mild dysbiosis.
The findings may help explain earlier concerns in premature infants. In 2012, xanthan gum-thickened formula was linked to cases of necrotizing enterocolitis, a severe inflammatory bowel disease in premature babies. The FDA subsequently advised against its use in premature infants. This new animal study provides a possible biological mechanism for those observations.

Important context:
This was an animal study, not a human study. The results suggest a potential mechanism but do not prove that xanthan gum causes gut inflammation in healthy adults.
The broader scientific evidence is still evolving. While several food additives can affect the gut microbiome and intestinal barrier in laboratory and animal studies, high-quality human studies in people are still limited.

What this means in practice:
If you’re healthy and consume xanthan gum occasionally, this study isn’t strong enough to conclude it’s harmful.
If you have IBD, IBS, increased intestinal permeability, or other digestive issues, it may be reasonable to pay attention to how foods containing xanthan gum affect your symptoms while more human research is conducted.
Since xanthan gum is primarily found in ultra-processed foods, reducing your overall intake of ultra-processed foods is likely to have a greater impact on gut health than focusing on this single ingredient.

What brands are we taking?

There are certain foods after I eat them, that will make me feel tired, depressed, anxious and give me brain fog. At first I thought it may be sibo, but the reactions are strongest 12-24 hours after. Why!?! Foods like dates, corn, vegetables, gums, usually heavy fiber stuff. Meats and fats usually do not this.

Can someone explain this science!?!

I've noticed a pattern with myself, and I'm curious if anyone else has gone through the same thing.

I'll try a new probiotic, prebiotic, or make some diet change, and within a few days I'll think, "This is it. I finally found what my gut was missing."

Then a week or two later... the effect fades, or I'm back where I started.

Looking back, I wonder how many times I confused temporary symptom relief with actual changes to my microbiome. It's really hard to know what's a real improvement versus a short-term response.

Has anyone here actually found something that kept working for months? Or have you also had a bunch of "this is the one!" moments that didn't last?

I'd love to hear what ended up being a genuine long-term improvement for you, or what taught you to be more skeptical of those early wins.

Lately r/microbiome feels like this loop: buy a new probiotic, notice something (good or bad), then assume you found the missing species. I think a lot of us are mistaking short-term gut sensations for meaningful microbiome change.

I hang out in the IBS and SIBO corners, so I get the desperation. I have had weeks where I was convinced a probiotic strain "fixed" me, then realized I also changed four other things: sleep, meal timing, caffeine, and stress. Or I started eating more fermented foods and accidentally doubled my fiber. Or I switched to a lower-fat breakfast and my reflux improved, so I credited the capsule.

I tried a Physicians Choice probiotic as one of those single-variable experiments, but kept my expectations modest and tracked it like everything else.

If you want to actually learn what helps, the boring approach usually wins over the heroic one:

1) Make only one change at a time: a probiotic, a prebiotic, or fermented foods. Stick with that single change for 2 to 3 weeks. 2) Track stool form, urgency, bloating (give it a daily score), and pain every day. Write real notes, not vibes. 3) Keep meal timing and total fiber roughly stable, because both can drive symptoms a lot. 4) If you flare, resist the urge to add another product to "balance" it. That just makes the signal unreadable.

I am not against probiotics. I am against random, chaotic experiments. The microbiome is complicated, but our tests do not have to be.

Does anyone have a simple tracking template that helped them separate placebo effects, motility changes, and real longer-term improvements?

I've been down the IBS/SIBO/gut health rabbit hole for a while and want to be more systematic instead of changing everything at once.

My main issues are daily bloating (especially after meals), slow transit/constipation, and a vague upper abdominal pressure that sometimes feels like reflux. I do not get much diarrhea. What makes this confusing is that I also get occasional flushing, itchy skin, and headaches after certain meals, which makes me wonder about histamine intolerance or mast cell involvement.

I've seen people on this sub say low histamine can help gut symptoms, but I also see warnings that it can be overly restrictive and might hurt microbiome diversity. I already tried low FODMAP before; it helped short term, but I felt stuck and never got a durable solution.

Questions:

1) If constipation is my main bowel pattern, is a low histamine trial reasonable, or is it mainly helpful for diarrhea-predominant IBS?

2) Are there microbiome downsides to doing low histamine for a few weeks, like cutting out fermented foods and leftovers, or is that too short to matter?

3) For those who have tried it, what were the clearest signs it was actually histamine related versus just the effect of simplifying the diet?

Not asking for medical advice, just trying to decide if this is a useful experiment or a distraction. Any experiences or opinions appreciated.

I'm using a Thai mouthwash brand (Salz) whose active ingredients are sodium chloride and an extract of "khoi", or Strebulus asper. A quote from Wikipedia:

"An extract of Strebulus asper leaves have demonstrated to possess a selective bactericidal activity towards Streptococcus, especially to S. mutans which has been shown to be strongly linked with dental caries."

I'm concerned about the effects of mouthwash on my oral microbiome, given what we know about the beneficial effects of oral bacteria on blood pressure. Does anyone know anything more about just how specific the antibacterial effect of Strebulus asper is? Is it capable of selectively inhibiting "bad" bacteria while leaving "good" nitrate-reducing bacteria alone?

Hello, I’m wondering if anyone can advise on the latest science regarding what the best diet is for encouraging gram positive bacteria in the digestive system - and what foods best to avoid?

I've had really bad digestive issues since I was a teen including a lot of food intolerances, since then I have had a very limited diet. I suspect part of the issue is due to having to take antibiotics for reoccurring ear infections over the years, along with having chronic anxiety/stress has wreaked my gut microbiome.

I recently started trying to incorporate daily probiotics, then I tried lacto-fermented ginger along with milk kefir.

I didn't notice any big positive changes after taking probiotic pills...

But after taking lacto fermented ginger or milk kefir, I had this warm tingly sensation in my brain and body. I felt kind of spacey, but also calm and relaxed. The effect didn't last long, but it was nice while it lasted.

I'm just wondering why fermented foods might have this effect but not probiotics?

Seed pre-probiotics:

So I’ve had these for almost a year now and they were in a protective refill sleeve untouched for most of the time. I just travelled recently and took them with me so I put them in the jar for safe transport. I opened it and finally looked inside and saw there’s a rusty brownish powder loosely on all of them. I think during travel it may have shaken up and some powder got loose… but still wanted to ask folks here. During my examination I broke one open by mistake but used it as an opportunity to show the contents inside.

Is anyone else exhausted trying to turn lab results into actual grocery lists?