Hello,

I’m reading Clever Guts with great interest – Thank you.

Having suffered IBS with constipation for years, I’ve experimented with diet along many of the lines suggested. Amongst many avenues, I’ve recently found drinking Kefir (Bio-tiful) quite helpful (also forked out a lot on probiotic pills with seemingly less effect). My GP is helpful & sympathetic. Recently however, we have introduced a laxative (Macrogol) and this is has been very helpful in relieving symptoms. The GP says this can be used indefinitely (I’m aged 59 and otherwise in rude, high-intensity-rowing-machine health).

I’m wondering a fews things: (a) what’s the relationship between Macrogol and gut health? (b) is continuing with Kefir etc a waste of time used alongside the Macrogol? (c) is the GP right about the long-term use of Macrogol?

Antibiotics are referred to throughout the book; can’t see laxatives in the index!

Charming subject! Any advice hugely appreciated!

Thanks very much again!

Hi POL,
I don’t have an answer to this I’m afraid, but I’m in exactly the same situation as you. I’ve been on macrogol for years for IBS and I make my own kefir, which, as you said is definitely helpful. I’ve tried an internet search to see whether macrogol affects gut mirobiome, but I can’t find anything about it. I’ll follow this thread in the hope that someone might know.

Hi Barbara
Sorry to hear you have the same problem – but interested to know you have a similar ‘solution’ and question.
It would be great if anyone has some knowledge to share on this. Like you, I’ve googled whether macrogol (or other laxatives) affect gut mirobiome but without finding anything directly on the topic.

Hi
I suffered for years from IBS constitpation until I discovered linseeds (flaxseeds). I can honestly say they changed my life! When wet they coat thenselves in a gel and therefore do not cause the irritation that bran sometimes does. Most days I have one desertspoonful of whole seeds and one of ground seeds with my breakfast (I do this myself in a coffee grinder but you can also buy them ready ground). They are full of healthy oils and also good for the biome. Win, win! I haven’t taken laxatives for over ten years.

Hi again Barbara
I’m not a medical doctor – but this article:

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0062815

concludes:

“We interpret our results as showing that any differences in the fecal microbiota before and after colonoscopy are no greater than those seen in normal subjects over time. We conclude that consumption of PEG does not have a significant impact on gut microbiota in the majority of subjects, although a minority of subjects…”

PEG = Macrogol (see Wikipedia)

I’m far from 100% certain I understand the full significance of this… but maybe someone can explain more!

Thank you Dorset Cream

I have used Linseeds before but am happy to give it another go.

May I ask: what do you eat them with? Muesli/cereal? I’ve never tried eating as many as that – partly because I don’t much like the taste. But if it works who cares!

Hi

I usually have my linseeds for breakfast with fruit and natural yogurt but have been known to quaff them in a glass of juice or even water in extremis (e.g. on holiday). Have the green flaxseed bread from the book in the oven and I reckon a slice of that would more than suffice for a day. I think it is important to have plenty of liquid with any high-fibre food otherwise it jsut makes the problem worse.Hope it helps!

Hi Dorsetcream

Many thanks! Then I will try with yoghurt & fruit. Yes, I drink masses of water… I call it ‘the water torture’… 🙂

Hi, POL that’s an interesting study, thanks. If macrogol can affect it short term I assume that long term use might well have an effect. I might try gradually cutting it down, replacing it with Dorsetcream’s linseeds. (Thanks Dorsetcream.). I’d much prefer to use something natural. Good luck all. 😀

Dr Mosley may have limited his comments on laxatives (= drugs) to avoid giving medical advice. The best placed to answer your questions would probably be your gastroenterologist or a young-ish pharmacist.

Having said that, the PubMed website indexes studies and reviews published in many scientific journals.

Drugs/ organs/ systems have several names so you may need to try multiple search terms.

Could I ask, have people taking kefir regularly (if so how much and how often?) noted an improvement in constipation? I read that it can help but that in some cases it can cause constipation. I’d appreciate your thoughts. Thanks.

In my expereince, I would say that it does help – but ‘quantifying’ the effect is far from easy.

Ref other parts of this thread: I’ve managed to quit the macrogol (or any other chemical laxative), with the help (apparently at least) of a combination of kefir, linseeds and water, and a diet predominantly of cheese, fruit and vegetables. I’ve also largely cut out wheat products — subsituting corn crackers to eat with the cheese (I miss bread and wheat biscuits a lot, but don’t miss the effects — so make them an occasional treat).

It’s therefore difficult to tell how much the kefir is individually responsible for benefit. I’ve also taken on board Michael Mosely’s advice about welcoming the right kind of bacteria generally rather than shunning them (eg, I’ve been making a point of eating somewhat over-ripe fruit and cheese… er, not licking the pavement…)

That said, I use the macrogol when travelling – and frankly I still find the whole thing a bit of an unpredicatble mystery…

Hope this helps!

Thanks so much for the prompt and helpful response.

Ah! Perhaps I misread – maybe you mean much much Kefir to take per day?

I suppose I drink about 250ml per day — in the morning generally, maybe two lots of 125.

I’d be interested in what others take too.

Thanks i did, that’s great.

http://www.gutmicrobiotaforhealth.com/en/bowel-preparation-may-affect-gut-microbiota-composition-affect-results-experiments/

Hi Pol

Do you keep a food/symptom diary? Its hard to respond without. Tweaking your diet as recommended in CleverGuts might improve everything but without a starting point its hard to advise

Hi Graham

Thanks for the message and the article. I kept a food/symptom diary a long time ago; it was relatively useful at the time, but, well, things are not so bad these days and I’m extremely busy… I suspect my IBS is as much to do with anxiety as food; constipation is related but independent, and luckily both are kind-of-OK at the moment, thanks perhaps to the regime described above, plus the (professionally related) anxiety factors being low at the moment.

I take it that the relevance of the article is that bowel preparation involves laxatives? I’ve had 3 colonoscopies (last one two years ago) and in each case Picolax (not Macrogol) was used. All proved clear, thankfully, but I have wondered whether my symptoms were aggravated by the investigations.

Where you perhaps responding to my initail message posted in June? My messages today were in response to DJSN.

POL: I agree the detailed food and symptom diary, with weighed and measured quantities, is key.

The snippets of information in each post might suggest imbalances/ lack of variety/ nutrient deficiencies.

Nutritionally corn/ maize is not a substitute for wheat. You mention few other mineral rich foods (beans, lentils, seeds, nuts, wholegrains, pseudograins). No sources of healthy fats (oily fish, seeds, certain nuts, olives, avocado).

POL: You mention lots of calcium (dairy) but little magnesium (seeds, brans, cocoa), no haem iron, no vitamin D, no omega-3s.

Magnesium particularly is lost in sweat and loose stools, too much water may flush it out. Important in mental health/ anxiety, muscle relaxation/ regular bowel movements.

Corn/ maize is a source of omega-6s, and spikes blood sugar. Overall potentially inflammatory. Consider having your cheese with fruits (berries, apple or pear slices), raw vegetables (pickled onions, fine asparagus, (celery, bell peppers, sprouting broccoli, cauliflower florets) depending which you tolerate best.

Firefox7275 – Many thanks for the info.

In fact I do have quite varied diet – plenty of nuts, seeds, pulses and some fish – I was just being relatively brief. Also the word ‘predominant’ was hiding in there somewhere — but the advice is appreciated. I was unaware of the properties of Corn you mention — although in my experience the corn biscuits are very much kinder on my system than wheat, and I eat neither in large quantities. I also eat cheese with apple or pear regularly; berries I’ll try. As I say, my system is in a fairly OK phase at the moment – and I’m not neurotic about it, just like to be able to live well and full of energy. Thanks again. I realise that I didn’t respond to your earlier message re gastroenterologist etc – apologies.

Albeit the advice in Michael’s book is excellent, the truth is there IS no such thing as a one-size fits all optimal diet. It depends – and what it depends on is your micro biome. So if everything is working fine – no health problems -then great, follow the general advice but if the general advice doesn’t seem to work for you – have your micro biome analysed.

Here’s why: https://www.youtube.com/watch?v=0z03xkwFbw4

GrahamSPhillips: Thanks. To what extent is the content of the microbiome influenced by non-external factors? Obviously we all eat different things, are exposed to different environmental factors, from the womb and birth onwards… so in that sense it’s easy to understand why eveyone’s microbiome will, to varying degrees, be different. But presumably (this is the bit I don’t understand) each person’s body also has some influence on this? Are some ‘internal’ bodily factors more inmportant than others, I wonder? If so, what are they?

I might consider having my microbiome analysed. If anyone here has expereince of this, it would be intersting to hear about. Eg., did the analysis provide info that was useful, could it be acted on beneficially, cost, etc.? Thanks.

Dear POL and others,
Gastrointestinal problems which are caused by inflammation.

I would refer you to Chapter 14 “Pain and inflammation” of “The Miracle of the New High-Dose Fish Oil”
by Dr Barry Sears , available through Amazon.

Yes, everyone’s body is of course different…that is why blood tests :-
AA/EPA
TG/HDL
Fasting Insulin

as explained in Chapter 9 of the above tome.

kindest regards

Q: To what extent is the content of the microbiome influenced by non-external factors?

A: It starts at childbirth (natural or otherwise) then breastfeeding or not (breast milk contains around 200 bacteria) then childhood infections treated by repeated antibiotics. Then environment (for example living on a farm, surrounded by animals – or even just having a pet dog! But by far the greatest influence seems to dietary

Q: But presumably (this is the bit I don’t understand) each person’s body also has some influence on this? Are some ‘internal’ bodily factors more important than others, I wonder? If so, what are they?
A: The evidence eg from identical twins studies) is that the individual body/genetic makeup has surprisingly little influence and that diet is the crucial thing.

More here: https://www.youtube.com/watch?v=0z03xkwFbw4

Hi all,

I am new to the forum and have gained so much reading through your posts.
I also suffer from IBS with constipation and was on long term laxatives until I discovered the Low FODMAP diet and Psyllium Husk. It has changed my life. I have two tbsp in a smoothie each morning and I now, after 28 years of constipation, go to the toilet naturally every day. Hooray!!!
I am considering taking making Kefir myself to improve my gut flora but fear the constipation. I tried a shop bought version in very small amounts and my bowels stopped moving. Should I persevere?

Have you tried the gut clearing smoothy with kiwi, Avocado, water, chi seeds?

also the breakfast chia post I have also tried with a combination or linseed and chia seeds with some fruit very nice gluten free lactose free etc

so far having begun to experiment with this I have not been doubled over with gut pain and things are moving much better

So Grateful my GP suggested reading this book! I am hoping the medical laxatives can go soon and never be needed again

I had got so scared of my gut creating that I had narrowed my diet to the same thing everyday to lessen the pain on reading this book I understand I had reduced my biome to just digest the same every day so they were having a ball and now have to get some friends to join them increase my gut function and well being