The gut-brain, made legible.
Tools, plain-English explainers, and the Rome V science behind the conditions we work on. Start with a check or a quiz, then go as deep as you want.
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.
Start the self-assessment →Find the formula matched to your pattern.
A handful of questions about how your days actually run, pointed at the MGB+ formula built for it.
Take the quiz →The gut-brain glossary.
DGBI, visceral hypersensitivity, central sensitization, nociplastic pain. Every term, plain English.
Open the glossary →Explore by topic
Every piece is written by an ER physician, answer-first, and points back to a clinician where it should.
Nausea, vomiting & CHS
Cyclic vomiting, cannabinoid hyperemesis, and the nausea that hot showers seem to settle.
Why hot showers help nausea, and why nobody can prove it yet
Nobody knows. The relief is real and reproducible, and every proposed explanation is still a hypothesis. The most popular one, heat switching on TRPV1 receptors in...
Read →Cyclic vomiting vs cannabinoid hyperemesis: how to tell them apart
Cyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS) are both disorders of gut-brain interaction (DGBI), a group of conditions where the signaling between the gut...
Read →Abdominal migraine in adults: the diagnosis nobody checked for
Yes. Abdominal migraine has long been filed as a childhood problem, but the Rome framework, the international system that defines gut-brain conditions, now recognizes it is...
Read →What triggers cyclic vomiting syndrome episodes
The most common triggers are stress, lost or disrupted sleep, infections, skipped meals, physical exhaustion, and for some people the menstrual cycle. Cyclic vomiting syndrome (CVS)...
Read →The four phases of a cyclic vomiting episode
Cyclic vomiting syndrome (CVS) runs in four phases: the inter-episodic or well phase between attacks, the prodrome that warns an attack is coming, the emetic phase...
Read →Cyclic vomiting syndrome in adults: the diagnosis that gets missed
Yes. Cyclic vomiting syndrome (CVS) is widely treated as a childhood condition, but adults get it too, and adult CVS is one of the most frequently...
Read →CHS treatment: what helps at home and in the ER
CHS is a disorder of gut-brain interaction (DGBI), the category doctors used to call "functional," and it comes from prolonged, heavy cannabis use. It is not...
Read →How is CHS diagnosed? Why there is no single test
No. There is no blood test, no scan, and no single lab that diagnoses cannabinoid hyperemesis syndrome (CHS). It is a clinical diagnosis, meaning a doctor...
Read →Why anti-nausea meds do not work for CHS
Zofran fails in cannabinoid hyperemesis syndrome (CHS) because it blocks serotonin, and CHS vomiting is not a serotonin problem. The nausea is driven by changes in...
Read →Capsaicin 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 calming an attack is...
Read →CHS warning signs: the prodrome before the vomiting
The earliest signs of cannabinoid hyperemesis syndrome (CHS) are morning nausea, vague upper-belly discomfort, and a nagging fear that vomiting is coming, usually in someone who...
Read →How 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 after the last use....
Read →Scromiting: the ER name for cannabis vomiting, explained
Scromiting is a slang term, screaming plus vomiting, for the intense presentation someone can have during a severe vomiting attack: forceful retching, crying out, doubling over...
Read →Morning nausea when you are not pregnant: what explains it
If you have been searching "morning nausea not pregnant," you already ruled out the first thing everyone assumes. That queasy feeling the moment you sit up,...
Read →Cannabinoid hyperemesis syndrome: what the evidence says
The patient in bed nine has been here before. Four visits this month, each one the same: hours of retching, a normal abdominal exam, and labs...
Read →Why 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, that single detail, where...
Read →Cyclic 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 departments, multiple scans, and...
Read →Reflux & functional dyspepsia
Post-meal fullness, early satiety, and the burn antacids never quite fix.
Peppermint and caraway for functional dyspepsia: the evidence
Functional dyspepsia (FD) is one of those conditions where people get told everything is normal and still feel lousy after every meal. The fullness, the pressure,...
Read →The functional dyspepsia diet: what actually has evidence
Not a proven, named one. Functional dyspepsia (FD) is a disorder of gut-brain interaction (DGBI), meaning real upper-gut symptoms without a structural cause. The dietary research...
Read →The two types of functional dyspepsia: PDS and EPS
The two types are postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). PDS is defined by meal-related symptoms: bothersome fullness after eating and getting full...
Read →Full after a few bites: what early satiety means
Because your stomach is not making room the way it should, and its nerves are reading normal stretch as "full." That combination is the core of...
Read →Heartburn and anxiety: one wire, two symptoms
Here is the thing nobody tells you about heartburn and anxiety: they are not two separate problems that happen to share your worst weeks. They are...
Read →Heartburn after every meal: why the burn keeps coming back
If you get heartburn after every meal, you have probably been told the same thing I heard as a medical student: it is just acid, take...
Read →Taking antacids every day? Read this first
If you are asking whether it is bad to take antacids every day, the honest answer is that the antacid is not the problem. A tool...
Read →Functional dyspepsia: why the stomach won't settle
In the emergency department, upper-belly pain is a triage problem before it is a diagnosis. We rule out the catastrophes first, the heart, the pancreas, the...
Read →Gastroparesis 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 a brick. The exam...
Read →Functional 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 right. The other half,...
Read →When acid blockers stop working (and what's actually going on).
The acid blocker stopped working. That is almost never the actual problem.
Read →Functional 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 never gets made.
Read →IBS & bowel habits
Why IBS is now twice as common, the subdiagnostic middle, and what actually helps.
How much thiamine per day: the RDA, the study doses, and the gap between them
The RDA is 1.2 mg a day for men and 1.1 mg for women, and most Americans already take in several times that from food alone....
Read →Does magnesium help bloating? The honest answer
No human trial has ever measured bloating as an endpoint for magnesium, in any form. Not one. The real evidence is for constipation, with magnesium oxide,...
Read →When to take magnesium glycinate: the timing advice online is mostly invented
There is no human evidence that time of day changes how much magnesium you absorb. Not for glycinate, not for any form. Take it with food,...
Read →Magnesium for constipation-predominant IBS: what the evidence supports
Magnesium is one of the most common questions I hear from people managing IBS with constipation. The honest answer is more interesting than a yes or...
Read →When IBS travels with fibromyalgia and fatigue: the central sensitization cluster
Most people in this situation have the same story. It starts with one problem, say the gut. Then a rheumatologist adds fibromyalgia. A neurologist adds migraine....
Read →'Almost IBS': the people who don't quite meet the criteria
One of the most frustrating sentences a person can hear in a clinic is some version of "everything came back normal, but you don't quite meet...
Read →IBS is twice as common as we thought: what changed
If you follow gut health news, you may have seen a startling headline lately: irritable bowel syndrome is now roughly twice as common as we thought....
Read →Why 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 your waistband cutting into...
Read →Brain fog after eating: why meals slow your mind
You finish lunch, sit back down, and your mind clocks out. The screen blurs, the sentences stop connecting, and for the next hour you are running...
Read →Why 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 →The 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 no time anchors and...
Read →When 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), a months-long wait that...
Read →Inside 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 doesn't. That framing is...
Read →Why most probiotics don't work for DGBI.
The probiotic aisle promises a healthier gut. The trials tell a different story.
Read →SIBO 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 what you do next.
Read →IBS 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 be more different.
Read →Food sensitivities & intolerances
Nickel, histamine, alpha-gal, and the cross-reactions that masquerade as gut disease.
Alpha-gal syndrome: how a tick bite can make red meat a problem
Yes. 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 in mammal meat. After...
Read →Why raw apple makes your mouth itch: pollen-food allergy syndrome
Because your immune system is confusing the apple for pollen. If you have seasonal hay fever, the antibodies you built against pollen also latch onto similar-shaped...
Read →Histamine intolerance: why aged cheese and wine can make you flush
Histamine intolerance is when your gut cannot clear dietary histamine fast enough, so it accumulates and spills over into symptoms. The key player is diamine oxidase,...
Read →Your nickel allergy and your gut: the IBS link most people miss
Yes, in people already sensitized to nickel. The metal that reddens your skin under a cheap ring is also in a lot of everyday food. Swallow...
Read →Hidden food sensitivities: when a food you did not suspect is the problem
Here is the pattern I see over and over. Someone has been chasing a symptom for months. Bloating, headache, an itchy mouth, a skin flare, a...
Read →Ingredients & foundations
The mechanisms underneath the symptoms: what specific nutrients and compounds actually do, and why the form matters.
Does vitamin B1 help fatigue? One good trial, and one that failed to replicate
One good randomized trial found high-dose thiamine cut fatigue in people with quiescent inflammatory bowel disease (IBD). The same team then ran the identical protocol in...
Read →Magnesium glycinate side effects: what is real, what is dose, what is the wrong form
The common side effect is loose stools and cramping, and it is dose-driven, not form-specific. Magnesium you fail to absorb stays in the bowel and pulls...
Read →Magnesium L-threonate vs glycinate: what the human trials actually show
If the goal is correcting a magnesium shortfall, glycinate wins. It delivers roughly twice the elemental magnesium per gram of material, at a fraction of the...
Read →Benfotiamine and inflammation: what the research shows, and what it doesn't
Benfotiamine shows up on a lot of supplement labels with the word "anti-inflammatory" close by. The laboratory science behind that word is real. The human science...
Read →Starting a lipid-soluble vitamin B1? Here is what to expect
Most people who start a lipid-soluble form of vitamin B1 notice almost nothing. That is the honest headline, and it is a good one.
Read →Probiotics for kids' stomachaches: what the newest evidence really shows
The supplement aisle promises a simple fix for a hard problem: a chewable that ends your child's stomachaches. The headlines agree. The shelves are full of...
Read →GLP-1 drugs and vitamin B1: what the Wernicke's reports actually mean
People assume the biggest risks of drugs like Ozempic and Zepbound are nausea and the monthly bill. The medical literature is starting to describe a rarer...
Read →Benfotiamine: the B1 form built for steady nerves
Most people who take vitamin B1 never get the benefit they paid for, because the standard form washes out of the body in hours. Benfotiamine was...
Read →Beta-caryophyllene: the calming-receptor molecule in black pepper
Most people meet beta-caryophyllene without knowing it, in the bite of black pepper and the warmth of cloves, and never learn that it quietly acts on...
Read →Zinc-carnosine: the stomach-lining compound prescribed in Japan
In Japan, zinc-carnosine is a prescription drug for the stomach lining. In the United States, the same molecule sits on a supplement shelf next to the...
Read →Mastic gum: what a Greek tree resin does for the upper gut
Most people meet mastic gum through a health-food label and assume it is another trendy botanical with a thin story behind it. The truth is more...
Read →PEA: the calming molecule your body already makes
Palmitoylethanolamide (PEA) is one of the most-studied molecules almost nobody in America has heard of. Your body already makes it. It has been in the scientific...
Read →Subtle signs of low thiamine most people miss
Severe thiamine deficiency is a hospital diagnosis. I have seen it in the emergency department, and it is dramatic: confusion, unsteady walking, a heart that cannot...
Read →The 3 p.m. crash is not a sleep problem
The afternoon energy crash gets blamed on sleep, and that advice is incomplete. Plenty of people sleep eight solid hours and still hit a wall at...
Read →What an ER doctor learned about chronic gut symptoms
I have met this patient hundreds of times, and never the same person twice. She comes to the emergency department late on a weeknight with pain...
Read →Rome V and disorders of gut-brain interaction: what changed
If you live with irritable bowel syndrome or chronic reflux, there is a decent chance a doctor has described your condition as functional. The scans come...
Read →What the gut-brain axis actually is
Patients tell me the same thing in almost the same words, shift after shift. My scans are clean, my bloodwork is normal, and I still feel...
Read →Thiamine and the gut-brain connection: what vitamin B1 actually does
In the emergency department, thiamine is an afterthought. A cheap vial we push into the patient who drinks too much, then forget by the next chart....
Read →Magnesium 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 changes almost everything about...
Read →Rome 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 functional GI disorders, publishes...
Read →Why 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 of gut-brain interaction (DGBI),...
Read →Why 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 →The 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, and pediatric medicine has...
Read →Allithiamine 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 cells in your brainstem...
Read →The gut-brain axis, plainly explained.
Most people assume the brain runs the show and the gut just follows orders. The wiring says otherwise.
Read →Wired-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 →Magnesium 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 →How 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 to fix bloating, and...
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