BellyMD/The library/78 pieces, 5 subjects

The gut-brain, made legible.

Plain-English answers from an emergency physician. Every piece answers its question in the first sentence, explains the why, and tells you when to see a clinician.

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78 pieces
Start here'Almost IBS': the people who don't quite meet the criteriaOne of the most frustrating sentences a person can hear in a clinic is some version of "everything came back normal, but...Read the answer Start hereWhy hot showers help nausea, and why nobody can prove it yetNobody knows. The relief is real and reproducible, and every proposed explanation is still a hypothesis. The most popular one, heat switching...Read the answer Start hereBrain fog after eating: why meals slow your mindYou finish lunch, sit back down, and your mind clocks out. The screen blurs, the sentences stop connecting, and for the next...Read the answer
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Is it the cannabis? A CHS pattern check.

Cyclic vomiting that hot showers seem to fix has a name. Walk through the pattern clinicians actually look for.

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The gut-brain glossary.

Disorders of gut-brain interaction, visceral hypersensitivity, central sensitisation, nociplastic pain. Every term, in plain English.

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1

Nausea, vomiting and CHS

Cyclic vomiting, cannabinoid hyperemesis, and the nausea that hot showers seem to settle.

Nausea, vomiting and CHSWhy hot showers help nausea, and why nobody can prove it yetNobody knows. The relief is real and reproducible, and every proposed explanation is still a hypothesis. The most popular one, heat switching...Read Nausea, vomiting and CHSCyclic vomiting vs cannabinoid hyperemesis: how to tell them apartCyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS) are both disorders of gut-brain interaction (DGBI), a group of conditions where the...Read Nausea, vomiting and CHSAbdominal migraine in adults: the diagnosis nobody checked forYes. Abdominal migraine has long been filed as a childhood problem, but the Rome framework, the international system that defines gut-brain conditions,...Read Nausea, vomiting and CHSWhat triggers cyclic vomiting syndrome episodesThe most common triggers are stress, lost or disrupted sleep, infections, skipped meals, physical exhaustion, and for some people the menstrual cycle....Read Nausea, vomiting and CHSThe four phases of a cyclic vomiting episodeCyclic vomiting syndrome (CVS) runs in four phases: the inter-episodic or well phase between attacks, the prodrome that warns an attack is...Read Nausea, vomiting and CHSCyclic vomiting syndrome in adults: the diagnosis that gets missedYes. Cyclic vomiting syndrome (CVS) is widely treated as a childhood condition, but adults get it too, and adult CVS is one...Read Nausea, vomiting and CHSCHS treatment: what helps at home and in the ERCHS is a disorder of gut-brain interaction (DGBI), the category doctors used to call "functional," and it comes from prolonged, heavy cannabis...Read Nausea, vomiting and CHSHow is CHS diagnosed? Why there is no single testNo. There is no blood test, no scan, and no single lab that diagnoses cannabinoid hyperemesis syndrome (CHS). It is a clinical...Read Nausea, vomiting and CHSWhy anti-nausea meds do not work for CHSZofran fails in cannabinoid hyperemesis syndrome (CHS) because it blocks serotonin, and CHS vomiting is not a serotonin problem. The nausea is...Read Nausea, vomiting and CHSCapsaicin cream for CHS: does it actually work?Cannabinoid hyperemesis syndrome (CHS) is the cycle of severe, repeated vomiting tied to long-term cannabis use. One of the stranger tools for...Read Nausea, vomiting and CHSCHS warning signs: the prodrome before the vomitingThe earliest signs of cannabinoid hyperemesis syndrome (CHS) are morning nausea, vague upper-belly discomfort, and a nagging fear that vomiting is coming,...Read Nausea, vomiting and CHSHow long does CHS last after you quit?For most people, the hard part, the relentless vomiting and cramping of the hyperemetic phase, eases within hours to a few days...Read Nausea, vomiting and CHSScromiting: the ER name for cannabis vomiting, explainedScromiting is a slang term, screaming plus vomiting, for the intense presentation someone can have during a severe vomiting attack: forceful retching,...Read Nausea, vomiting and CHSMorning nausea when you are not pregnant: what explains itIf you have been searching "morning nausea not pregnant," you already ruled out the first thing everyone assumes. That queasy feeling the...Read Nausea, vomiting and CHSCannabinoid hyperemesis syndrome: what the evidence saysThe patient in bed nine has been here before. Four visits this month, each one the same: hours of retching, a normal...Read Nausea, vomiting and CHSWhy hot showers stop nausea (and when they don't).If a scalding shower is the only thing that stops your nausea, your body is telling you something specific. In emergency departments,...Read Nausea, vomiting and CHSCyclic Vomiting Syndrome: what it is, who gets it, how it's treated.The average patient with cyclic vomiting syndrome waits eight years for the right diagnosis. By then, most have been through several emergency...Read
2

Reflux and functional dyspepsia

Post-meal fullness, early satiety, and the burn antacids never quite fix.

Reflux and functional dyspepsiaPeppermint and caraway for functional dyspepsia: the evidenceFunctional dyspepsia (FD) is one of those conditions where people get told everything is normal and still feel lousy after every meal....Read Reflux and functional dyspepsiaThe functional dyspepsia diet: what actually has evidenceNot a proven, named one. Functional dyspepsia (FD) is a disorder of gut-brain interaction (DGBI), meaning real upper-gut symptoms without a structural...Read Reflux and functional dyspepsiaThe two types of functional dyspepsia: PDS and EPSThe two types are postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). PDS is defined by meal-related symptoms: bothersome fullness after...Read Reflux and functional dyspepsiaFull after a few bites: what early satiety meansBecause your stomach is not making room the way it should, and its nerves are reading normal stretch as "full." That combination...Read Reflux and functional dyspepsiaHeartburn and anxiety: one wire, two symptomsHere is the thing nobody tells you about heartburn and anxiety: they are not two separate problems that happen to share your...Read Reflux and functional dyspepsiaHeartburn after every meal: why the burn keeps coming backIf you get heartburn after every meal, you have probably been told the same thing I heard as a medical student: it...Read Reflux and functional dyspepsiaTaking antacids every day? Read this firstIf you are asking whether it is bad to take antacids every day, the honest answer is that the antacid is not...Read Reflux and functional dyspepsiaFunctional dyspepsia: why the stomach won't settleIn the emergency department, upper-belly pain is a triage problem before it is a diagnosis. We rule out the catastrophes first, the...Read Reflux and functional dyspepsiaGastroparesis vs functional dyspepsia: the test that separates them.Two patients walk into a GI clinic. Both describe early fullness, upper abdominal pain, nausea, and the feeling that food sits like...Read Reflux and functional dyspepsiaFunctional dyspepsia vs GERD: how to tell them apart.Most people who feel post-meal burning, fullness, or upper-abdominal pain are told they probably have reflux. Half the time, that label is...Read Reflux and functional dyspepsiaWhen acid blockers stop working (and what's actually going on).The acid blocker stopped working. That is almost never the actual problem.Read Reflux and functional dyspepsiaFunctional dyspepsia: the forgotten diagnosis.Millions of adults walk around with burning, fullness, or pain in the upper stomach. Their scopes come back normal. The diagnosis usually...Read
3

IBS and bowel habits

Why IBS is now twice as common, the subdiagnostic middle, and what actually helps.

IBS and bowel habitsHow much thiamine per day: the RDA, the study doses, and the gap between themThe RDA is 1.2 mg a day for men and 1.1 mg for women, and most Americans already take in several times...Read IBS and bowel habitsDoes magnesium help bloating? The honest answerNo human trial has ever measured bloating as an endpoint for magnesium, in any form. Not one. The real evidence is for...Read IBS and bowel habitsWhen to take magnesium glycinate: the timing advice online is mostly inventedThere is no human evidence that time of day changes how much magnesium you absorb. Not for glycinate, not for any form....Read IBS and bowel habitsMagnesium for constipation-predominant IBS: what the evidence supportsMagnesium is one of the most common questions I hear from people managing IBS with constipation. The honest answer is more interesting...Read IBS and bowel habitsWhen IBS travels with fibromyalgia and fatigue: the central sensitization clusterMost people in this situation have the same story. It starts with one problem, say the gut. Then a rheumatologist adds fibromyalgia....Read IBS and bowel habits'Almost IBS': the people who don't quite meet the criteriaOne of the most frustrating sentences a person can hear in a clinic is some version of "everything came back normal, but...Read IBS and bowel habitsIBS is twice as common as we thought: what changedIf you follow gut health news, you may have seen a startling headline lately: irritable bowel syndrome is now roughly twice as...Read IBS and bowel habitsWhy stress makes you bloated (it is not your food)You can eat the same lunch on a calm Saturday and a brutal Tuesday, and only one of those days ends with...Read IBS and bowel habitsBrain fog after eating: why meals slow your mindYou finish lunch, sit back down, and your mind clocks out. The screen blurs, the sentences stop connecting, and for the next...Read IBS and bowel habitsWhy low-FODMAP failed your IBS (and the version that works).Most people doing low-FODMAP are doing it wrong, and the diet itself never asked them to.Read IBS and bowel habitsThe 24-hour symptom log that actually helps your doctor.Most symptom logs I get handed in clinic are useless to me. Forty pages of dense free-text journaling, written under stress, with...Read IBS and bowel habitsWhen to ask for a GI specialist (and when to skip it).A gastroenterology referral is the path of least resistance in primary care. It is also, for most disorders of gut-brain interaction (DGBI),...Read IBS and bowel habitsInside your gut: a tour for adults.Most people talk about "my gut" the way they talk about "my car." One thing. One mood. Either it works or it...Read IBS and bowel habitsWhy most probiotics don't work for DGBI.The probiotic aisle promises a healthier gut. The trials tell a different story.Read IBS and bowel habitsSIBO vs IBS: how to tell them apart.People treat SIBO and IBS like two different diseases. In clinic, they overlap so much that the label often matters less than...Read IBS and bowel habitsIBS vs IBD: a one-letter difference that changes everything.One letter. IBS and IBD look alike on the page and feel alike at the start. The plan after diagnosis could not...Read
4

Food sensitivities and intolerances

Nickel, histamine, alpha-gal, and the cross-reactions that masquerade as gut disease.

Food sensitivities and intolerancesAlpha-gal syndrome: how a tick bite can make red meat a problemYes. In the United States, a bite from the lone star tick can sensitize you to a sugar called alpha-gal (galactose-alpha-1,3-galactose) found...Read Food sensitivities and intolerancesWhy raw apple makes your mouth itch: pollen-food allergy syndromeBecause your immune system is confusing the apple for pollen. If you have seasonal hay fever, the antibodies you built against pollen...Read Food sensitivities and intolerancesHistamine intolerance: why aged cheese and wine can make you flushHistamine intolerance is when your gut cannot clear dietary histamine fast enough, so it accumulates and spills over into symptoms. The key...Read Food sensitivities and intolerancesYour nickel allergy and your gut: the IBS link most people missYes, in people already sensitized to nickel. The metal that reddens your skin under a cheap ring is also in a lot...Read Food sensitivities and intolerancesHidden food sensitivities: when a food you did not suspect is the problemHere is the pattern I see over and over. Someone has been chasing a symptom for months. Bloating, headache, an itchy mouth,...Read
5

Ingredients and foundations

The mechanisms underneath the symptoms: what specific nutrients and compounds actually do, and why the form matters.

Ingredients and foundationsDoes vitamin B1 help fatigue? One good trial, and one that failed to replicateOne good randomized trial found high-dose thiamine cut fatigue in people with quiescent inflammatory bowel disease (IBD). The same team then ran...Read Ingredients and foundationsMagnesium glycinate side effects: what is real, what is dose, what is the wrong formThe common side effect is loose stools and cramping, and it is dose-driven, not form-specific. Magnesium you fail to absorb stays in...Read Ingredients and foundationsMagnesium L-threonate vs glycinate: what the human trials actually showIf the goal is correcting a magnesium shortfall, glycinate wins. It delivers roughly twice the elemental magnesium per gram of material, at...Read Ingredients and foundationsBenfotiamine and inflammation: what the research shows, and what it doesn'tBenfotiamine shows up on a lot of supplement labels with the word "anti-inflammatory" close by. The laboratory science behind that word is...Read Ingredients and foundationsStarting a lipid-soluble vitamin B1? Here is what to expectMost people who start a lipid-soluble form of vitamin B1 notice almost nothing. That is the honest headline, and it is a...Read Ingredients and foundationsProbiotics for kids' stomachaches: what the newest evidence really showsThe supplement aisle promises a simple fix for a hard problem: a chewable that ends your child's stomachaches. The headlines agree. The...Read Ingredients and foundationsGLP-1 drugs and vitamin B1: what the Wernicke's reports actually meanPeople assume the biggest risks of drugs like Ozempic and Zepbound are nausea and the monthly bill. The medical literature is starting...Read Ingredients and foundationsBenfotiamine: the B1 form built for steady nervesMost people who take vitamin B1 never get the benefit they paid for, because the standard form washes out of the body...Read Ingredients and foundationsBeta-caryophyllene: the calming-receptor molecule in black pepperMost people meet beta-caryophyllene without knowing it, in the bite of black pepper and the warmth of cloves, and never learn that...Read Ingredients and foundationsZinc-carnosine: the stomach-lining compound prescribed in JapanIn Japan, zinc-carnosine is a prescription drug for the stomach lining. In the United States, the same molecule sits on a supplement...Read Ingredients and foundationsMastic gum: what a Greek tree resin does for the upper gutMost people meet mastic gum through a health-food label and assume it is another trendy botanical with a thin story behind it....Read Ingredients and foundationsPEA: the calming molecule your body already makesPalmitoylethanolamide (PEA) is one of the most-studied molecules almost nobody in America has heard of. Your body already makes it. It has...Read Ingredients and foundationsSubtle signs of low thiamine most people missSevere thiamine deficiency is a hospital diagnosis. I have seen it in the emergency department, and it is dramatic: confusion, unsteady walking,...Read Ingredients and foundationsThe 3 p.m. crash is not a sleep problemThe afternoon energy crash gets blamed on sleep, and that advice is incomplete. Plenty of people sleep eight solid hours and still...Read Ingredients and foundationsWhat an ER doctor learned about chronic gut symptomsI have met this patient hundreds of times, and never the same person twice. She comes to the emergency department late on...Read Ingredients and foundationsRome V and disorders of gut-brain interaction: what changedIf you live with irritable bowel syndrome or chronic reflux, there is a decent chance a doctor has described your condition as...Read Ingredients and foundationsWhat the gut-brain axis actually isPatients tell me the same thing in almost the same words, shift after shift. My scans are clean, my bloodwork is normal,...Read Ingredients and foundationsThiamine and the gut-brain connection: what vitamin B1 actually doesIn the emergency department, thiamine is an afterthought. A cheap vial we push into the patient who drinks too much, then forget...Read Ingredients and foundationsMagnesium glycinate vs magnesium citrate: pick by what you want it to do.The word magnesium on a supplement label is doing too much work. Magnesium is the element. The form it is bound to...Read Ingredients and foundationsRome V vs Rome IV: what actually changed in 2026.Every six to ten years, the Rome Foundation, the international body of gastroenterologists who define and classify what used to be called...Read Ingredients and foundationsWhy most fiber supplements miss the gut-brain pattern.Fiber is the most over-recommended intervention in gut health. Add fiber, the story goes, and the bowel sorts itself out. For disorders...Read Ingredients and foundationsWhy your gut hates Sunday night.The Sunday-evening gut flare is not in your head. It is in the wire that runs between your head and your gut.Read Ingredients and foundationsThe pediatric gut-brain piece nobody talks about.A child whose stomach hurts every school morning is almost never making it up. The pattern is real, the biology is real,...Read Ingredients and foundationsAllithiamine vs benfotiamine: which B1 wins for the gut?Standard vitamin B1 is an inefficient way to reach the tissues that need it most. The nerves running through your gut, the...Read Ingredients and foundationsThe gut-brain axis, plainly explained.Most people assume the brain runs the show and the gut just follows orders. The wiring says otherwise.Read Ingredients and foundationsWired-and-tired: the nervous-system pattern under most DGBI.Wired in the morning. Dead by 4pm. Awake at 2am. Most people read those as three separate problems. They are one signal.Read Ingredients and foundationsMagnesium glycinate vs oxide vs citrate: which one for the gut?Most magnesium supplements are the wrong form for the job. The form decides the effect, not the milligrams on the label.Read Ingredients and foundationsHow to layer Clear, Cool, and Calm.Most stacks fail because people pick by symptom instead of pattern. They have a bad afternoon, blame bloating, grab whatever bottle promises...Read

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