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#1
07-23-2006, 04:32 AM
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What's the straight dope on diarrhea?
Does diarrhea help you to get rid of the bacteria or whatever is in your guts that shouldn't be? Or is it just a symptom with no function?
Where are the bad microorganisms: in the food in your guts, or in the tissue of the guts? How do you get "tough guts" ie ability to eat dirty food without getting diarrhea, is it like other immunity, ie having the right antibodies? 
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#2
07-23-2006, 04:46 AM
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I don't have answers to your questions, but it's worth noting that the bad smell of the byproducts involved is caused totally or chiefly by bacteria, which are in the water that all human solid waste contains. Diarrhea is more smelly because there are more bacteria (IIRC), but that could be a function of (a) an actual increase of bacteria that needs to be gotten rid of, (b) an increase in water in the stool, or (c) some combination of the above. It's been a while since I've looked this stuff up, but there's my two shekelim.
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#3
07-23-2006, 05:21 AM
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Most of human feces is bacteria. Billions upon billions of tiny bacteria corpses. No, wait, they don't all have to be dead. Billions of bacteria make up your shit. Diarrheal or not.
When I am torturing medical students around the open body (substitutes for campfire) I like to ask them, "Tell me in simple words that any layman could understand what the small bowel is for, then the large bowel." After they struggle through arcane and complex answers I tell them what I was looking for. (This Socratic method of teaching in medicine is known as "pimping", by the way.) The small bowel absorbs the calories out of your food. Every single calorie you are ever going to absorb. All the protein, fat, carbs, minerals, vitamins (except one). All the essential nutrients. Everything out of a GNC bottle that's actually going to be of some use to you comes in through the small bowel. Then what is the large bowel there for? It dries the shit. No kidding. When the chyme (digested food byproducts, but not yet shit - generally odorless, or has a faint smell of food) exits the terminal ileum and enters the cecum, it is a continuous stream of slightly pasty fluid. I tell the students, "If you need an operation that gives you a colostomy, that is, you have to 'wear the bag', and if you are unlucky enough to need it in your right lower quadrant" (putting my hand on the spot), "you have to keep the bag on 24 hours a day. You have to use special sticky sealants to be sure the bag is attached and not becoming detached by the icky stuff flowing out. You have a bag of liquidy stuff hanging off you all the time. "On the other hand, if you need a colostomy in the usual place, over here" (hand on the left loewr quadrant), "then you can put the bag on in the morning after coffee, expel your turds, take it off, shower, put on your shirt, and go to work. You can make love with your spouse without it on. You can put it on when you need to take a dump." This is only true if you aren't having diarrhea. Diarrhea is not a symptom which is of use to the body - in fact, it's highly dangerous if it gets bad. Cholera is essentially an attack of diarrhea (plus vomiting) so bad it kills you in a day or two. Diarrhea kills children in the third world because it dehydrates them and robs them of electrolytes like potassium that are lost with the watery feces; that's why a simple rehydrating solution saves so many lives. Diarrhea means that the function of your colon, which is to dry the shit, is being interrupted. Bacteria (almost always; rarely viruses; occasionally amoebas or other parasites) are making your colon sick, and it's unable to dry the shit. In some cases (like the vibrio of cholera, which makes a toxin which directly affects colonic mucosa cells), the colon turns around and actually pours water out, stealing it from your bloodstream via the capillaries in its wall. Now if you take a microscope down to the colonic mucosa, better still if you take a scientist down with you, you will see that "It dries the shit" means a thousand ingenious and tiny little operations involving miniature potassium and sodium transporters in the membranes of the cells, to suck out these electrolytes and let water diffuse passively after them. Billions of bacteria hang out against these mucosal cells, sometimes helping them actively (E. coli makes vitamin K which we can reabsorb - the only vitamin not absorbed in the small bowel), sometimes helping them passively (great volumes of E. coli may block more dangerous bacteria like shigella and salmonella from reaching the mucosa), sometimes harming them actively (E. coli O157:H7, in uncooked hamburger meat, has killed people's children). All these things are involved in a huge production line, or dance if you prefer, which ends us up with neat little turds instead of a continuous stream of pasty shit. And any large and complex production line can go wrong. Think of ordinary diarrhea as workers throwing their wooden shoes into the machinery they resent, and cholera diarrhea from a vibriotoxin as terrorists taking down the factory with sarin gas. If the factory recovers, the water extraction process begins again, the water goes back into the venous capillaries that drain your gut, and you end up with neat little turds again. A final remark. Why do we have this large system to dry the shit? After all, it's expensive to the body in terms of blood supply, nutrients required, constant maintenance (colonic mucosa cells die and are replaced faster than any other cell in the body), and the presence of a huge reservoir of internal bacteria that can be remarkably dangerous to us. My answer to this question comes from no Cite but makes a little sense. The only large animals in Nature that have continuous pasty dribbles of shit are fish and birds. These animals are hard for large predators to track by the dribble of shit. Let's you and me start on the savannah at five million years ago. You have no colon, and I'll have a colon. There's a sabertooth cat on our trail. Which of us do you think it'll pick off first?
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#4
07-23-2006, 05:33 AM
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The bad microorganisms always start in the food in your guts, where some of them can harm you without even getting into your mucosal wall (by secreting toxins that hurt you). But if you are very unlucky, bad bacteria or amoebas can penetrate into the colonic mucosa cells, or past the mucosa into the wall of the colon itself. The colonic mucosa cells desquamate (fall off) so very often, partly to keep the bacteria from getting any further. (It's sort of kamikaze, now that I think about it. Protect the submucosa! Banzaiiii into the shit stream!) The lamina propria, or the layer of wall around the mucosal crypts (the mucosa is infolded a great deal to give it more surface area), is stuffed with white cells that are there to fight the bacteria. More collections of white cells are staffed along the muscularis mucosae at intervals; they look like small fortresses to me, ready to recruit more soldiers should there be a full-scale bacterial invasion. Outside the muscle wall, the veins that take blood away from the colon run through a layer of tissue called the mesentery that has huge numbers of lymph nodes in it. But people still die now and then when significant numbers of bacteria make it through all these defenses and get into the blood. That's called "sepsis" due to "translocation of bacteria across the gut wall" and its old name is "blood poisoning". Often leads to death. In the absence of antibiotics, always led to death. How do you get "tough guts"? I have no idea. Dopers?
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#5
07-23-2006, 05:55 AM
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But that's the wonder of evolution. Co-evolution - since at least E coli came there with us, evolving all the time.
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#6
07-23-2006, 05:58 AM
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Your explanations were epic and engaging. Thanks for answering questions I didn't know I had!
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#8
07-23-2006, 06:52 AM
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I like the ads at the bottom of the page. "Save on Aerobic Bacteria". "Dog Diarrhea Help -- help your dog the natural way". Just saying.
"Drying the shit" is not many miles away from "conserving as much water as possible while protecting the body from disease". The system may run a little inefficiently, but getting very sick is really hard on the body. The study of nutrition and proper feeding of ICU patients still has its controversies, but very sick people may require an additional 30-40% more calories than normal. "Tough guts", the ability to eat at the night market in Beijing, fruit in Fiji and the street food of Mexico City -- I'd argue you have to have good antibodies. Maybe half of people (according to travel clinics and drug companies which do have a vested interest) get traveller's diarrhea if they go to a foreign place and don't take precautions (peeling fruit, not drinking water, being careful with salads, avoiding street food and uncrowded restaurants). But those who travel a lot know street food and new foods are part of the adventure. You could stay healthy by just eating at popular places that presumably go through ingredients quickly enough to reduce bacterial counts. I think exposure is key, though. I'd argue the longer you stayed in one place, the less sick you'd get -- presumably since this helps you make antibodies. I can't recall getting sick from eating Canadian Tire (street) hot dogs, funnel cake or local carnival crap (cotton candy and pogo dogs); but I sure got the gastro when I went to Beijing, or Goa. (Wise travellers anticipate this and bring their own ciprofloxacin, no worries, unless you're talking about cholera as per gabriela.
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#9
07-23-2006, 07:02 AM
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Thanks, gabriela. I am stunned that anyone is capable of making the digestive tract that interesting and comprehensible. Your students are lucky to have you as a teacher.
One question for you, if you have the time: How does the chyme (digested food) turn into massive amounts of bacteria? Does the bacteria in you intestines just eat it and multiply? Thanks!
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#10
07-23-2006, 08:28 AM
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gabriela!
<<applause>> 
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#11
07-23-2006, 09:20 AM
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Slight nitpick about the absorptive capability of the large intestine: the colon and rectum also actively absorb short chain fatty acids (SCFA). SCFA, such as butyric acid, are small organic molecules containing 4 to 10 carbon atoms, and are produced by bacterial fermentation of carbohydrates in the colon. Normal bacterial activity in the colon produces a lot of SCFA; the colonic mucosa may transport more SCFA per day than it does sodium or chloride. The colonic mucosa uses SCFA as a major energy source; they can be broken down in the mitochondria of the colonic cells. The active uptake of SCFA also plays a role in the absorption of water from the colonic lumen.
The SCFA absorbed by the colon probably are almost all 'burned' by the colon itself, so absorbed SCFA aren't really a major energy source for the rest of the body. However, they do appear to be important in maintaining the health of the colonic lining. There are tube feeding formulas supplemented with SCFA that are used in patients who have lost a significant amount of small intestine , and patients so treated seem to adapt faster to the loss of small intestine. To touch on Renee's last question; bacteria get into the colon via the food we eat. Most bacteria are destroyed by the environment of the stomach and small intestine, but some will sneak through and make it to the colon. Some of the bacteria you eat are adapted to the environment of the colon- once they hit this promised land, they start to multiply like mad. For food, they use whatever protein, carbohydrates, and fats that haven't been absorbed in the small intestine. Basically, they can reproduce faster than they are swept out of the colon by peristaltic action. Significant diarrhea will wash out many of the colonic bacteria, and it can take a while for things to get repopulated and 'back to normal' from a functional standpoint.
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#13
07-23-2006, 11:26 AM
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We Brits like an o in our diarrhoea. (It makes it less sloppy).
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#14
07-23-2006, 11:30 AM
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#15
07-23-2006, 12:03 PM
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I think the title of this thread should have been What's the bottom line on diarrhea?
Or: What's the poop on diarrhea?
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#16
07-23-2006, 12:26 PM
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And those with lactose intolerance, which is a whole bunch of people, will likely get fewer symptoms from dairy products when their colon is colonized with these bacteria. Lactobacillus pills, like Digestive Advantage, are reported anecdotally to be just as beneficial, but I know of no formal studies on them.
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#17
07-23-2006, 01:21 PM
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Question-I've heard that the trend for colonic irrigation is so dangerous partially because of the fact that it flushes all the mucous out of your colon, leaving it unable to fight bacteria-is that true?
I read someone extoling the virtues of enemas because they "flush out the mucous-that's a sign of toxins in your body", and then someone else pointed out, no, that's DANGEROUS if that's happening. (People think I'm crazy because I say I'd rather puke than have diarrhea. I've had bad diarrhea, and unlike puking, which is over in a few seconds, until you have to go again, sometimes with diarrhea, you're sitting there for an hour or more, with horrible, killing cramps. )
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#18
07-23-2006, 02:08 PM
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I've recently had to go through several months of dealing with chronic diarrhea. After getting tested for all sorts of stuff by both my regular MD and a gastroenterologist (Lessee, you had a colonoscopy recently, you don't have giardia, you don't have parasites, you don't have celiac sprue ...), the gastro guy finally concluded that I might have "bile salt diarrhea" (the regular MD had concluded the catchall "irritable bowel syndrome") and put me on an old cholesterol med called Cholestyramine, which is a bile sequesterant. It seems to work. What's more, taking that and extra fiber dropped my cholesterol down far enough that my MD took me OFF the cholesterol / triglyceride med he had been feeding me. It may be possible that the blasted stuff (lopid) was responsible for my diarrhea in the first place, but I'm inclined to simply keep taking the cholestyramine and not pursue the matter.
One thing I'm a bit curious about from my own research - cholestyramine seems to be fairly commonly used following gall bladder removal. Gall stones or a non-functioning gall bladder was not something that the GE discussed, or examined me for, AFAIK. Wouldn't excess bile getting dumped into the colon be symptomatic of that? What's the opinion of OTC loperamide, BTW? My regular MD seemed to think it's terrible and you should never use it. My point of view was that it seemed to provide relief, so until you figure something ELSE out, doc, I'm gonna take it. The GE didn't seem to think it was so bad, as long as you weren't masking the symptoms of an actual serious infection.
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#19
07-23-2006, 04:26 PM
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Please refer to page 1 of the following: FECES. 1. Composition This document from University of Wisconsin, Milwaukee, says: feces are 75% water and 25% solids. Of the solids only 20% is bacteria, 30% cellulose, fat 10 - 20%, inorganic 10 -20%, and undigested protiens 10% Diarrea can be cause by any of a large number of bacteria as well as poor sanitation when preparing foods. Eight Bacteria Causing Diarrea "Tough Guts" are hard to come by. Avoid contaminated foods, practice good sanitation in food preparations, washing all vegetables thoroughly and you may still get a bad case under rare or unusual circumstances. (Montezuma's Revenge!)
__________________
Do nothing simply if a way can be found to make it complex and wonderful spingears
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#20
07-23-2006, 04:48 PM
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You want a neat little pile of turds you can deposit in a hidden place (use the stick to cover that which cometh from thee, as the God of Israel instructed) so that when the sabertooth's coming after you, you don't leave a stinkified trail. And you also want to reclaim all that water you otherwise would've lost in the poop.
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#21
07-23-2006, 04:49 PM
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(wipes tear) Geez.
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#23
07-23-2006, 05:46 PM
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A doctor once told me, "if you're vomiting or have diarrhea, don't take anything to stop it--something has a reason to get out of you, and you should let it." Barring dehydration, of course, is this true?
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#24
07-23-2006, 06:09 PM
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Curious, why does alcohol give you the runs, or at least a loose stool? Is it killing organisms that would otherwise be doing their "dry out the shit" job?
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#26
07-23-2006, 07:49 PM
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With lactose intolerance, for example, milk can set off a long bout of diarrhea. As you say correctly, the usual advice is to let it go because that will remove the undigested lactose as fast as possible. But there comes a point at which the experienced can tell that the spasms are coming from the irritation of the colon rather than the original cause, and that's a good time to take the antidiarrheal and shut the system down to give oneself a break from the misery. And many people have IBS and that used to be called spasmic colon for obvious reasons. If you have IBS then the effect can last much longer than the originating cause would seem to warrant. The body doesn't always shut down like a fine car, but sometimes more like a lawnmower sputtering to a stop. That's where I would draw the line.
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#27
07-23-2006, 08:06 PM
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There are nerve connections between the central nervous system and the enteric nervous system. The sight and smell of food can lead to increased gastric secretion and motility - this is an example of the CNS having an immediate effect on the enteric nervous system. More complex stimuli, like emotional state or increased stress level, can also alter the activity of the gut, although the effects are not always so clean-cut. For example, a vigorous fight-or-flight stimulus, like encountering a bear in your kitchen, will tend to ramp up the activity of the sympathetic autonomic nervous system. This will generally have the effect of shutting off gut motility and secretion and decreasing gut bloodflow while you try to escape the bear - no use wasting the energy on digestion at the moment. Sphincters also tend to tighten up, literally. And yet, another well-described effect of sudden fear is spontaneous voiding of the bowel and bladder. Thus, an individual's GI response to stress is liable to be unpredictable - nausea/vomiting, heartburn, diarrhea, or constipation are all possible. As for levdrakon's question about alcohol and diarrhea - to some extent it depends upon how much alcohol we're talking about, and over how long a period of time. It may also be that something else in the drink, like the tannins in red wine, is causing the diarrhea. Ethanol is an irritant to mucous membranes, and increases the production of gastric acid and pancreatic juices. The lining of the small bowel can be damaged by large amounts of ethanol, and therefore not absorb as much as it normally would. Thus the colon can be exposed to an increased volume of poorly digested material which overwhelms its absorptive capacity (glossing over some details). Chronic alcoholics display permanent changes to the gut mucosa which impair their ability to properly absorb nutrients. In any event, I doubt that enough alcohol makes it to the colon to directly poison the colonic bacteria (barring enemas). Also, the bacteria are not trying to dry out the shit - they are just eating, excreting, dividing, and dying. It is the colonic lining that is working to absorb water, and in the case of SCFA, it is using the by-products of bacterial metabolism to help with the absorption.
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#28
07-23-2006, 08:08 PM
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Fascinating thread. Really validates the adage that no one over 50 should trust a fart....
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#29
07-23-2006, 08:37 PM
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It's my speculation that while antibodies against enterotoxigenic bacteria may give you "tough guts," it's also the colonization of the gut by local strains of E. coli that (1) can protect your mucosa (the way that gabriela described) from the local pathogens better than your native flora can, and (2) your colon needs to accept before they can do that.
spingears, your cite doesn't really address the issue of how much bacterial mass is in feces -- the exact source and state of that 75% water has a lot to do with it. Exapno Mapcase, I thought it was called "spastic colon." levdrakon, heavy alcohol use can inflame colonic tissues, even killing cells outright, which interferes with the shit-drying mission. It can also interfere with absorption in the small intestine, which will (1) force the feces to flow faster and (2) cause undigested nutrients to pass into the colon, where they're eaten by bacteria, which gets the gut gassy. guinastasia, the main purpose of mucus production in the colon is to lubricate the passage of stools. Excess mucus can indicate anything from hemorrhoids to colon cancer, and "colon cleansing" is a boneheaded scam that does no good, may do great harm, and at its worst may cover up a deadly disease state.
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#30
07-23-2006, 09:11 PM
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When I lived in Israel for a year, I phased in local food and water gradually over about two weeks and had no trouble after that, except when I ate something once in East Jerusalem.
However, when I went to Egypt, I was told that I couldn't really acclimate, and that "even the people who live here have diarrhea if they drink the water." Any truth to this? I assumed that in Israel the issue was acclimating, whereas in Egypt it was contamination (rather than local e. coli strains, etc.).
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#32
07-24-2006, 01:19 AM
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Drying the shit!
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#33
07-24-2006, 03:58 AM
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Bravo, gabriela!! You've provided an explanation in moderate depth of a vital bodily function that's wunerfully free of the obscure jargon of the medical priesthood! Thank you and brossa and thank all of you who have contributed to our gut understanding of these issues.
Like others here, I have a question. I'm not asking for medical advice; I know that's verboten here. But maybe someone can help me merely understand the issues. For about 25 years, I've been diagnosed with ulcerative proctitis (for which I take 3 g of sulfasalazine daily). To me, it's trivial in that it hasn't produced the tiniest bit of pain or discomfort, except of course from above average incidence of diarrhea, which frankly isn't that much of a bother. (I'd be interested to know just why this causes diarrhea, but that's not my main question.) My question is: How significant is the loss of nutrient absorption from what seems to be a relatively minor case of ulcerative proctitis? (My gastroenterologist doesn't seem to want to answer such questions). If you choose, you can certainly put it in approximate terms (say 1 to 5, where 1 is trivial and 5 is major).
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#34
07-24-2006, 04:49 AM
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Oh, and by the way, to the best of my own personal knowledge (my gastroenterologist may know differently), I have no extra-intestinal symptoms, and I only observe blood (and only with hard stools) about once a year with no visible mucous ever (although I understand microscopic amounts of blood are common).
This has got to mean an especially mild case, doesn't it? So that the loss of absorption has got to be pretty trivial, right?
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#35
07-24-2006, 05:00 AM
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I'm gonna need QtM or someone to weigh in on Ambushed's question - I've never seen a fatal case of ulcerative proctitis.
In fact, it's not a disease I know, unless it is a different term for ulcerative colitis restricted to the very distal colon. In which case, it wouldn't affect nutrient absorption at all! But I will let people who take care of the living, do the answering.
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#36
07-24-2006, 06:26 AM
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Thanks again!
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#37
07-24-2006, 08:17 AM
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Your bariatric surgeon is concerned because s/he cannot predict how your colon will respond to the drastic environmental alteration of a malabsorptive procedure. It could be catastrophic if the increase in volume, osmolarity, carbohydrate content, changed pH, etc. etc., changed your proctitis to full-fledged colitis, or set off sclerosing cholangitis, or led to breakdown of the surgical connections, or, or, or.... A person with exercise-induced asthma may be able to use an inhaler and jog a mile at sea level, but totally decompensate when doing an Ironman triathlon at Lake Titicaca.
Also, do not underestimate the ability of 6 inches of inflamed colon to dump a LOT of mucus, blood, and fluid. Try thinking of things this way: a un-surgerized person with uncontrolled ulcerative proctitis can have nutritional problems, not because the last couple inches of colon is not absorbing well, but because it is actively secreting so much blood, mucus, and fluid. It's hard to keep a boat afloat if some of the sailors are bailing and some are drilling holes in the hull.
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#38
07-24-2006, 10:29 AM
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http://www.mayoclinic.com/health/probiotics/AN00389 There is growing public and scientific interest in probiotics. Researchers are studying whether probiotics taken as foods or supplements can help treat or prevent illness, such as: Vaginal yeast infections Diarrhea following treatment with certain antibiotics In addition, recent research suggests a number of new potential uses for probiotics. One study in Sweden found that a group of employees who were given probiotics missed less work due to illness than did employees who were not given probiotics. Other studies have found probiotics to be helpful in managing the signs and symptoms of irritable bowel syndrome (IBS). http://en.wikipedia.org/wiki/Probiotics There is no published evidence that probiotic supplements are able to replace the body’s natural flora when these have been killed off. There is evidence, however, that probiotics do form beneficial temporary colonies which may assist the body in the same functions as the natural flora, while allowing the natural flora time to recover from depletion. The probiotic strains are then progressively replaced by a naturally developed gut flora. If the conditions which originally caused damage to the natural gut flora persist, the benefits obtained from probiotic supplements will be short lived. [edit] Benefits Scientists have found a range of potentially beneficial medicinal uses for probiotics. Briefly, they are described below. Managing Lactose Intolerance: Because LAB convert lactose into lactic acid, their ingestion may help lactose intolerant individuals tolerate more lactose than what they would have otherwise.[1] Prevention of Colon Cancer: In laboratory investigations, LAB have demonstrated anti-mutagenic effects thought to be due to their ability to bind with (and therefore detoxify) heterocylic amines; carcinogenic substances formed in cooked meat.[2] Animal studies have demonstrated that LAB can protect against colon cancer in rodents, though human data is limited and conflicting.[3] Most human trials have found that LAB may exert anti-carcinogenic effects by decreasing the activity of an enzyme called ß-glucuronidase [3] (which can regenerate carcinogens in the digestive system). Lower rates of colon cancer among higher consumers of fermented dairy products have been observed in some population studies;[1] the results of which are encouraging however more research is needed. Cholesterol Lowering: Animal studies have demonstrated the efficacy of a range of LAB to be able to lower serum cholesterol levels, presumably by breaking down bile in the gut, thus inhibiting its reabsorption (which enters the blood as cholesterol).Some, but not all human trials have shown that dairy foods fermented with LAB can produce modest reductions in total and LDL cholesterol levels in those with normal levels to begin with, however trials in hyperlipidemic subjects are needed.[1] Lowering Blood Pressure: Several small clinical trials have shown that consumption of milk fermented with various strains of LAB can result in modest reductions in blood pressure. It is thought that this is due to the ACE inhibitor like peptides produced during fermentation. [1] Improving Immune Function and Preventing Infections: LAB are thought to have several presumably beneficial effects on immune function. They may protect against pathogens by means of competitive inhibition (i.e., by competing for growth) and there is evidence to suggest that they may improve immune function by increasing the number of IgA-producing plasma cells , increasing or improving phagocytosis as well as increasing the proportion of T lymphocytes and Natural Killer cells. [4,5] Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections [6] and dental caries in children[7] as well as aid in the treatment of Helicobacter pylori infections (which cause peptic ulcers) in adults when used in combination with standard medical treatments.[8] LAB foods and supplements have been shown to be effective in the treatment and prevention of acute diarrhea; decreasing the severity and duration of rotavirus infections in children as well as antibiotic associated and travelers diarrhea in adults.[4,5,9] Reducing Inflammation: LAB foods and supplements have been found to modulate inflammatory and hypersensitivity responses, an observation thought to be at least in part due to the regulation of cytokine function [4]. Clinical studies suggest that they can prevent reoccurrences of Inflammatory Bowel Disease in adults, [4] as well as improve milk allergies [10] and decrease the risk of atopic eczema in children.[11] Improving Mineral Absorption: It is hypothesized that probiotic lactobacilli may help correct malabsorption of trace minerals, found particularly in those with diets high in phytate content from whole grains, nuts, and legumes.[12] Prevents Harmful Bacterial Growth Under Stress: In a study done to see the effects of stress on intestinal flora, rats that were fed probiotics had no occurance of harmful bacteria latched onto their intestines compared to rats that were fed sterile water. [1] http://www.webmd.com/hw/diet_and_nutrition/tp21170.asp Research has shown that probiotics may help reduce:1 The symptoms of bloating and diarrhea from lactose intolerance. Diarrhea that is a side effect of antibiotics. Flare-ups of inflammatory bowel disease (IBD), which causes diarrhea and abdominal pain. Inflammation of the ileal pouch (pouchitis) that may occur in people who have had surgery to remove the colon.
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#40
07-24-2006, 02:34 PM
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Cervaise, I'd hide along with my crap under a very, very large rock with a very, very small opening!
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#41
07-24-2006, 03:16 PM
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This sounds like the place to ask this, then.
Ok - large colon - paste enters and turds exit, right? When I'm finished pooping, what's behind the turd I just finished with? Is the colon closed behind? Air? Am I being clear? Is the colon a tube with lumps of crap traveling down it or is it more like a pea-pod, closed tightly on either side of the lumps of shit? How do fart bubbles work into this? What actually makes the turds travel down the path? Is it muscular like the throat or is it the crap behind pushing? The mechanics of poop making, only on the Straight Dope.
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#42
07-24-2006, 05:21 PM
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Another "iron gut" question:
I used to have something of an iron gut. Then, about 10 years ago, at age 25, I had a bad bout of food poisoning. (Emergency room, several bags of fluid, and lots of drugs. It took me several weeks to get better.) Understandably, I got gastrointestinal distress at the drop of a hat for a few months afterward. I eventually returned to "normal," but it wasn't my old normal. No more "iron gut." So does it make sense that a bout of food poisoning could permanently change one's digestive sensitivity. Or am I just nuts?
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#43
07-24-2006, 08:35 PM
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I have a question, if I may.
How is it that some foods seem to "make you sick" almost instantly after you consume them? There's no way the food has had time to reach the colon, yet there I am, pooping like mad and swearing I'll never eat that particular food again (while cursing because I know I likely will.) Sometimes, you haven't even had time to finish the meal before it hits you. What's up with that?
__________________
Quid quid latine dictum sit, altum videtur.
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#44
07-24-2006, 08:48 PM
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Quote:
And here's another question. Why does hot pepper make me feel really sick about five minutes before it's ready to come out? I'm not even aware of it the rest of the time, just those horrible moments right before. I'm not talking about the scorched-butt burning effect. This is before that. It's more like, "God, I feel really sick, I wanna throw up but the sick feeling isn't in my stomach."
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#45
07-24-2006, 11:50 PM
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For Belrix:
The colon is more like a pea-pod, although the colon will inflate a bit with gas due to swallowed air and bacterial fermentation. Muscular contraction moves things along, like stripping toothpaste out of a tube. The colon normally contains (moving from cecum to rectum) liquid, semisolid, and solid material at any one time; the closer to the 'exit', the more firm the stool. Colonic transit times vary by person and diet, but can be from 12 hrs to 5 days. The colonic lining has a number of pressure and chemical sensors that help it determine the consistency of it contents. Local networks of neurons in the bowel wall coordinate the muscular contractions of the colon and rectum. These sensory/motor control loops are very finely balanced under normal circumstances. Thus you can (normally) fart without crapping your pants. After pooping, the rectum and far end of the colon will be collapsed down, awaiting filling from the upstream segments. for Green Bean: It's possible that you had some subtle but lasting change in your population of gut bacteria, but it's also not unusual for bowel 'sensitivity' to change over time for no clear reason. My father, for example, loved mushrooms until he was in his fifties, at which time they started giving him terrible cramps. Dunno why. for Levdrakon and Lissa: There are a number of causes for a 'dumping' response like the one you mention. In response to distention of the stomach (by food or even by balloon), the gastrocolic reflex leads to the urge to defecate. You may have a normal reflex that becomes hyperactive in the presence of certain food compounds like fat, alcohol, or spices. Dumping syndrome is a pathologic response, in which the stomach empties into the small intestine too rapidly. The sudden load of food (typically carbs give the worst response) and acid in the duodenum causes cramping and diarrhea. Dumping syndrome is rare, and occurs most often in people who have had stomach surgery or congenital stomach abnormalities. You could also be ingesting something contaminated with preformed bacterial toxins or chemical irritants that can cause a brisk reaction, although those would normally be associated with nausea as well. Even under the worst-case scenario, it still takes hours for material to move from the stomach to the rectum. When patients need to have their entire gut cleaned out in preparation for abdominal surgery, they are given one or more liquid preparations that are designed to be nonabsorbable by both the small bowel and colon: indeed, they may cause a lot of secretion of fluid by the bowel as well. Even with this tailored chemical assault, it still takes many uncomfortable hours for everything to get flushed through. levdrakon's pepper pains also bring up another point: the bowel does not have the same type of pain receptors that the skin does. Gut pain tends to be poorly localized ('around my bellybutton' as opposed to '43 centimeters downstream of my ligament of Treitz') because of the way the nerve fibers are hooked up in the gut and spinal cord. Intestinal pain receptors are most sensitive to excessive stretch and/or ischemia of the bowel wall; they are pretty insensitive to cutting and heat/cold. This is why the spicy Mexican food does not burn constantly along every inch of bowel. Normal skin sensation picks up again along a fairly distinct margin called the dentate line in the distal rectum. While the rectum is only sensitive to distention, the anal canal is much more discriminatory. In fact, part of 'fart control' is the sampling reflex in which the internal anal sphincter relaxes and allows some rectal contents to enter the anal canal, where the superior sensors are able to determine whether it is gas, liquid, or solid. It sounds like your anal canal is noticing the irritant properties of the pepper oils and setting off the alarms. You would not be consciously aware of this as scorched-butt because this is a local reflex loop. You're plenty aware of it after the oils hit the sensitive surface skin of the anus, though.
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#46
07-25-2006, 05:30 AM
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Quote:
May I respectfully ask a few more questions? Here's some background: I wished to pursue the procedure known as the Biliopancreatic Diversion with Duodenal Switch. Although this is often recommended in cases of severe morbid obesity, my BMI is only a modest 36 (but I qualify for bariatric surgery for other reasons, such as OSA). The reason I preferred this was because I have an abnormally low energy expenditure level (1608 Kcals/day) and not only do I eat very little, I often have to force myself to eat much of anything at all; therefore, reducing the size of my stomach would have virtually no effect. I exercise, but this doesn't help enough. For this reason, I concluded that a malabsorptive surgery was pretty much my only option (especially since my apnea is severe and no treatment has worked). Here's a hypothetical: If I insisted on the BPD, and considering the great mildness of my current colitis, in your opinion would a surgeon be foolish to perform the surgery anyway? Say, if I provided some sort of waiver of responsibility? Would I be foolish to risk it? Can you suggest any alternative that I might explore further? Please don't feel pressed to answer; I feel guilty asking so much. Especially if you feel it's an awkward, unfair or unreasonable question. It goes without saying that I hold you to nothing whatsoever! Thanks again.
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#47
07-25-2006, 09:25 AM
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Gabriela,
Thanks very much for all the info on diarrhea and other subjects. Colostomy? It's not my bag. But thanks for the reassuring thought that usually you aren't chained to the damned thing. I am suffering from diarrhea at the moment. I was terrible pain last night, from the cramps, and I kept vomitting and shitting what felt like piss it was so thin, so I went to the hospital and they gave me tablets called U-OSCINE (Hyoscine - N -butylbtomide 10mg) which I think is not an antibiotic, and I took two of those and I felt fine in about 15 minutes. I still had this kind of very slight fluey feeling of chill and aching in my limbs though, which I put down to toxins coming from my gut into my blood. Funnily enough, I forgot to mention the fluey feeling at the hospital, and therefore was most impressed to read that my diagnosis was flu on one of the papers. They also gave me some orange flavoured oral rehydration salts powder to mix with water, that I found very pleasant to drink. I liked your remark: "Inherited kludges, one building on the previous one" Like all of your writing that I've seen, it's theatrical and thought-provoking. I hope you're writing books.
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#48
07-25-2006, 09:27 AM
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That should be Hyoscine-N-butylbromide.
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#49
07-25-2006, 09:37 AM
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Quote:
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#50
07-25-2006, 09:47 AM
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Dr_Paprica, I will try to get some Cipro. Thanks for all you valuable contributions to this thread. "local carnival crap" had me laughing out loud. Pondering your post it occurred to me that birds and fish don't need to conserve water so much. Birds can fly to water easily, and fish, well...
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