So after years of a tummy that reacted to certain foods, being diagnosed as gluten intolerant in 2016, really suffering in 2021 and 2022, following a FODMAP diet recommended by my doctor (don’t recommend) and getting to a point where I only ate the same plain things everyday, I finally paid out this year to work with a nutritionist. She recommended a comprehensive GI stool sample test which I did and the resulted showed…
• Secretory IgA is raised with no parasitic, bacterial or yeast causation. So this could be due to food sensitivities such as gluten
• Methane, variance and abundance is raised and so this could be due to possible SIBO
• Beta-glucuronidase is raised which may indicate a small level of inflammation
• SCFA's are low, meaning that there may be a need to increase beneficial species
• Relative commensal abundance is high in some areas but low in some beneficial strains such as Akkermansia spp.
• Cholesterol is raised, meaning possible fat malabsorption, bile acid flow is required for the breakdown of fats and fat soluble vitamins
• Ruminococcus bromii is high and this may cause IBS/slight inflammation
• Lactobacillus spp. was not cultured and this is a key beneficial strain
• Calprotectin is low, meaning that we are not looking at a concerning picture of inflammation in this report
• There was also no blood in the stool
I was told this indicated that there were no major concerns and just indicated a imbalance from being on Omeprazole for 2 years (enlarged thyroid incorrectly diagnosed as reflux) and food intolerances and possible SIBO.
So I was put on a plan of supplements. I take Live Bacteria, B12 spray, Saccharomyces Boulardii, Digestive Enzymes and Zinc.
Things have improved greatly although I’m still limited by intolerance and I find big meals hard to digest. Too much veg or anything that requires a bit of effort does cause me some discomfort but things are still so much better than they were.
Now my nutritionist wants me to start taking Slippery Elm and Glutamine 3 x a day but if have found that she has prescribed quite a lot that doesn’t agree with me. Originally it was 7 different things but 2 didn’t agree with me and are just sat in the cupboard and they weren’t cheap! I also get sent to specific dispensary she uses and a code is automatically applied so she must be getting a cut of the sales. I’ve been told in other groups that quite often nutritionists will over sell supplements because they take a cut and I do feel a little bit like this.
She now wants me to take the SE and G so I’ve just spent another £40 buying these. I took a SE last night and then took another this morning and I’ve felt quite nauseous all day and had heartburn. I’ve had nothing else different and this is the only thing different. My tummy also feels a bit out of sync and like I need the loo but don’t need to go (it’s hard to explain).
I’ve done some reading on SE and see a lot to say it can aggravate IBS symptoms and there is limited evidence that it does anything. I felt fine before I started taking it but don’t feel great today. All she says is “hopefully it will settle down” and seems intent on me taking them but I’m not convinced.
I would love some feedback on these and whether they sound like they are needed as I’m not sure anymore and definitely not feeling too shiny today
Thanks in advance
Kim xx
Written by
Kimsy17
To view profiles and participate in discussions please or .
Slippery Elm is very good if there is something wrong happening in the actual stomach, such as gastritis or an ulcer etc. Otherwise, I am unsure about how useful it would be.
Now Glutamine is pretty good for gut healing and is contained in things like bone broth, which is very healing.
It just perhaps could be that you don't need anything which lowers acid in your stomach (not talking about the rest of your gut here, but just the stomach itself) Oddly, LOW stomach acid can cause heartburn and similar symptoms! So things like PPI drugs can actually make that worse, if it is that.
Food won't digest properly with low stomach acid, especially proteins. A bit of a flag that there might be low stomach acid is indigestion after eating protein!
It does figure that if you aren't digesting properly, you could feel nausea and discomfort of course.
If you DO have low stomach acid, I have found that herbs which come into the category of "bitters" are extremely helpful, and so is Manuka honey. (avoid anything with Senna though if you get any herbal bitters)
I tested this out in winter 2020-2021 when I temporarily had reflux symptoms. I took nothing else. They went by early Spring 2021 and haven't come back (yet) I made my own herbal bitters mix from a few herbs and took a wineglass full three times a day.
Yes, many practitioners suggest purchasing products from certain websites, and using a special code that they give you for a discount etc. They have a vested interest, that is obvious.
What makes that naughty, is if you HAVE to have those items. If they are just suggested as perhaps something you might like, that is not so naughty, and it's up to you.
Most of those websites offer really nice-sounding stuff at extremely high prices. So with the discount code, you get so much percentage off...but still end up paying rather a lot for some experiment that may not help you.
They are genuine websites, not scams, so there's nothing horrid going on, but basically you could end up paying hundreds of pounds for things that don't necessarily do you any good.
It can be a real minefield. People with IBS are perfect for the kind of practitioners who want someone to be there all the time buying things, paying for tests etc. Because IBS is so irrational and up and down, and chronic.
Some of the practitioners actually do believe in what they are doing. They are not trying to be a parasite on your finances. They believe they can help. But sometimes they are out of their depth with IBS, yet keep on going, and it keeps on costing!
Whatever....do remember that you are in charge, not someone else, and you are free to pause, stop, or go in another direction any time you see fit. Sometimes practitioners can make us feel chained to them, having to obey every word! Feel your way and if something doesn't suit, at least let that person know "it's no good".
Oh PS....you can always try a good probiotic like Alflorex or Symprove or something, to re-balance your microbiome?
thank you so much for your response, it’s been a great help.
So as far as I’m aware, I don’t have any intestinal/digestive issues going on other than an imbalance so I myself am slightly confused as to why I am being given slippery elm. As soon as I google it, all I see is that it’s recommended for reflux and constipation but I certainly don’t suffer with constipation and I don’t get reflux either. It’s been sold to me under the premise of improving the gut lining but I’m not convinced.
Glutamine, I’m a little unsure of as well, partially because I’ve seen so many results with people saying that it’s aggravated Dega, and having already been told that I’m sensitive and more likely to react to things, I really don’t want to go backwards.
the omeprazole was given to me on an incorrect diagnosis. My doctor thought I had globus pharynges, which was aggravated by acid vapours, and that was why I was prescribed it and left on it for two years, but it turns out it was the onset of an enlarged thyroid. I’ve had blood tests which have confirmed my thyroid is working as it should, which is why I weeded myself off the medication nearly a year ago and ever since I’ve been working on trying to heal my gut, but although it’s healed, I think I still have lost a lot of the ability to have too much of a variety with different food types.
I definitely filled the live bacteria and digestive enzymes that I first started taking almost a year ago have made a difference. I did stop taking them for a few months until my nutritionist suggested restarting them but she said there was evidence in my stool test to show that I had begun taking them, and they had started to have an effect, and I noticed simple things like my gut, making more noises when I’m digesting food and a little bit of wind, whereas previously my gut didn’t make a sound unless it was reacting. I’ve also started to lose weight whereas previously I was on just over 1000 cal a day and was not losing anything which I was told can be when the gut is in such a poor state , so I’m confident that it’s working but I think for me I just get overwhelmed with the share volume of supplements, I’m expected to take without really any understanding of why I’m taking them, and when I do research some of them, all I see are side-effects that I am sometimes getting and also feedback that prolonged use is detrimental
Oh dear. Sounds like the road I went down and sorely regretted it. Probably the main reason you'd started to feel better initially is the taking of probiotics that have seemed to suit you. However, this would be the first port of call for anyone with IBS i.e. giving different probiotics a go. I wish I'd known this before I'd engaged nutritionist services and wasted thousands on tests, fees and supplements. Many people with IBS will come up with similar results from a stool sample i.e. microbiome being a bit out of wack. Unfortunately, the nutritionists are not scientists and believe me it takes a scientist to make any sense out of the tests they put you up for. Many of their courses only have basic English and Maths as prerequisites. I picked 2 of the 'best' I could find in the UK and they weren't particularly bright and I found holes in many of their arguments. It is a money making machine. I bought loads of expensive supplements (by logging in so they got their cut too) that didn't agree with me - money in the bin - literally.
Regarding having problems digesting too much veg - I think the average person might find this. Perhaps stick with normal portion sizes per veg item or smaller amounts but with greater variety (which is better at diversifying the microbiome needed to help with IBS).
If you are generally in a much better place (without the new supplements), isn't it worth stopping there? The nutritionist is sending you down a rabbit hole that you might find difficult to get out of (I can say that since this happened to me - they made my condition far worse in the end).
Regarding Slippery Elm - this is normally for reflux. Are you suffering from reflux right now? When you take new supplements some may not agree with you - I found this for many of them - I had loads of partially filled bottles that I ended up throwing out - one of them cost £75! I took a product that contained slippery elm and that disagreed with me.
You are better off doing your own research.
I was recommended L-Glutamine, I did my own research into this and decided not to take it for the following reasons:
"Reported adverse reactions are mainly gastrointestinal ... They include constipation and bloating"
"There is one older report of two hypomanic patients whose manic symptoms were exacerbated following the use of 2 to 4 grams daily of L-glutamine.
The symptoms resolved when the L-glutamine was stopped. These patients were not rechallenged, nor are there any other reports of this nature.
The most common adverse effects observed in clinical trials of Endari were constipation (21%), nausea (19%), headache (18%), abdominal pain (17%), cough (16%), extremity pain (13%), back pain (12%), and chest pain (12%) [FDA Label]."
glutamine is a precursor to glutamate or glutamic acid. When this conversion occurs, the properties and effects of glutamate can be attributed to glutamine.
Glutamate is one of two excitatory neurotransmitters in the brain that can cause anxiety. Excesses in brain tissue (remember the gut-brain correlation)
can also cause cell damage. So while glutamine in excess seems benign, once it converts to glutamate, that status is called into question.
glutathione produces bacterial growth, proving it can become food for invasive pathogens.
Another study (2) shows the virulence of cancer cells when exposed to glutamine. A third study (3) shows increased mortality among patients given glutamine.
Glutathione has also been linked to the thinning of gut lining when used long term.
Thank you so much for your detailed response, I really do appreciate it. I definitely agree with you that it does seem to be a bit of a moneymaking scheme and I am not the most optimistic of people at the best of times, so I automatically look for the worst. I definitely think that the live bacteria and digestive enzymes that I first started taking have made the most difference and that came from a lovely woman who ran a company that makes them and never at any point has she charged me a penny for the plethora of advice that she gave me. She did also recommend that I took omega-3 and garlic capsules but garlic is a bit of a trigger for me, so I was reluctant and she also recommended a charcoal cleanse every quarter as the seasons change.
I’m glad I had the stool test to eliminate there being anything else . I’m glad I had that because my mum and Nan both had diverticulitis and my mum, mum also has a hiatus hernia, so it reassured me that it was nothing more than an imbalance and I definitely feel miles better than I did this time last year, but I am very cautious of falling down a rabbit hole of supplements and I question how many of them I actually need. Looking around I can see that zinc can cause nausea, cramps and loss of appetite, which I do suffer with at times and I can see some of the other things that I take aren’t really prolonged use and more if there’s a deficiency or something particularly wrong. When I google slippery elm all I see is that it’s recommended for reflux and I don’t suffer with reflux at all. Yeah sure I sometimes get heartburn depending on what I’ve eaten and if it’s particularly acidic I notice it a bit, but I certainly don’t suffer with reflux every day so I question why I’m being given it and my tummy was definitely unhappy yesterday after taking the morning dose and I feel like the last of it is just working its way out this morning. Prior to that, I felt fine.
I did come to blows a little bit with my nutritionist as I found her response one time to me, asking questions about a reaction to food a bit blunt, considering I’ve changed my entire outlook based on her advices, so I stopped taking everything except the live bacteria and digestive enzymes and I felt fine. When I spoke to her Almost a month later, she encouraged me to go back and take the zinc, B12 and Saccharomyces, but I can’t honestly say I noticed any difference in taking them. At one point, she’s also recommended Apple cider vinegar for me, but then when I mention it the next time, she tells me that that can make my symptoms worse, so I feel a little bit confused and conflicted by all of the information.
Although it pains me because I’ve just showed out nearly £50, I don’t think I will pursue the slippery elm and glutamine because I see a lot of negativity about them and I don’t really see the benefits for me taking them.
The confusion from the nutritionist is the same that happened with me. They would flatly say they don't recommend certain things, only to recommend it a week later. They really don't know what they are doing or can't seem to hold all the threads together which can be very complex - they confuse themselves! I would walk away from that relationship. As I've said I had a very poor experience and from all the ones that I didn't employ. You are better off following your gut (excuse the pun) and your own research. I can tell you right now that you probably know more than they do. Plus they should never pressure anyone to take anything and believe me whatever they recommend won't be worth your trouble or could make you more ill.
yes that’s exactly the thing. When we first talked, she said the apple cider vinegar would be beneficial as my stomach had not been making enough acid due to the PPI medication. In our first conversation, she even gave me a link to a “digestive boosting drink“ which consisted of turmeric, lemon juice, and apple cider vinegar. then, when I mentioned to her that I was starting to experience a little bit of heartburn, when I started eating more and asked about the apple cider vinegar, she said not to take it because she felt that it would exacerbate my symptoms.
I then messaged her once to say that I had a handful of salad with my jacket potato (I always buy spinach, watercress and rocket salad) and about an hour later I found myself on the loo. Not a normal IBS attack where I’m trying to expel the contents of my stomach, but enough that it made me feel I needed to sit on the toilet, and her response was just to not eat any raw fruit and veg. Yet, she knows very well that I quite often eat olives, pickles, cucumber, tomatoes, carrots… So, when I questioned it, she said “I think we’re getting our wires crossed”. I’m definitely not getting my wires crossed because I know what my symptoms are like. I sometimes just feel that she doesn’t take the opportunity to look at my notes before responding.
I really can’t see any evidence as to why she has suggested these two new supplements, but yesterday I just felt really out of sorts. heartburn, nausea and just a delicate tummy. A bit like how it feels when you’ve had a stomach bug and you feel like you’re gonna need the toilet at some point but you don’t. Thankfully all the other side effects have died off today, but my tummy still feels a bit more delicate and I have had to pop to the loo a couple of times and it’s not as it normally is. Nothing else has changed other than putting that into my system so I think I’m going to put my foot down and not continue to take them.
I am happy to take supplements if I genuinely feel they are going to make a difference, but some of the ones that I’m taking I’m not convinced make that much of a difference and the fact that I stopped taking them for a good three weeks after I lost my temper with her response showed me that they couldn’t have been making that much of a difference because I haven’t noticed a difference since adding them.
A lot of my stomach issues now seem to be blamed on the fact that my hormones have changed because of changing my pill, which I do understand to a degree, but it just feels like we’ve gone from blaming medication to my hormones now.
I’m very lucky that the original lady that I spoke to for free who recommended live bacteria and digestive enzymes has recommended that I contact her and send her over a copy of my stool sample results, but my nutritionist is very reluctant to give them up. I’m starting to get angry with her because they’re my confidential notes And test results on my body so I should have a right to access them
You have paid for those stool tests so you should get a copy of the results. That is ridiculous her holding onto them. Even my numpties gave me a copy. Though I suppose, another angle might be that showing those to someone else might just take you down another rabbit hole.
The more people I speak to about these nutritionists, there is a general trend of a theme. They should be banned or at least regulated.
Well originally when the results came back they were sent to her and I questioned why I’d not been sent it. She said because the test was so comprehensive, there would be a lot that I didn’t understand, so she sits down with the doctor 1st to go through the report, and then presents me with a simplified report on the findings.
She then said she would upload it to the practice app that we used communicate, but I can’t see any signs of it.
I messaged her last night and asked for a copy, and she said it was under the “labs“ tab, but there’s no tab called that so I’m not sure where they are, but I’ve asked her for a copy direct to my email address
I don’t intend on taking them anywhere else, I posted in the group that is run by the woman who makes my live bacteria and digestive enzymes. I just said that I wasn’t sure all the supplements I was taking were needed. (basically what I’ve posted here) and she’s asked me to send my message to her along with a copy of the results and she can look into whether I actually need them.
I’m confident she won’t promote me taking anything else as she only offers four different supplements herself, so I’m confident I won’t be sent down a rabbit hole of spending of fortune
Hi Kimsy. It sounds like you’ve had some really detailed tests and results, and this should help in the long term. I am on the Zoe programme and my microbiome score was very poor (16 out of 100) because of a poor variety and balance of gut bacteria. I have found it difficult to change to a higher fibre diet (which is good for the microbiome) because I don’t have the bacterial cultures to digest it (a bit of a Catch-22 situation). However, on discussing this with Zoe nutritionists, they have come to accept two important things: firstly, because IBS is a dysfunction, a theoretically good diet won’t necessarily be appropriate in individual cases; and, secondly, because my microbiome has been 40 years in the making (resulting from a low fibre diet after a bad bowel infection resulted in IBS-D), it could take a long time to rectify.
So my advice would be to be patient (though I wish the same could be said of the urgency associated with IBS!) as, after 6 months of little change (Zoe seems to think that you can see changes in weeks!), there are signs of my bowel settling down. This may be the result of several things (and could all be undone by incautious Xmas eating!), but it makes sense to me that conditions like IBS can be quite intractable and do need time to sort out. So, as you have a lot of options, I would try each one (possibly in turn), but be conscious that they might take some time to work. Also, whether they do or don’t work with other people is not a good guide as to how they might affect you, so keep an open mind and give anything a shot. None of these things can do any real harm and, if they don’t work or make the symptoms worse, simply try the next on the list. An actual cure might be difficult to obtain, but better control is certainly a realistic option.
Thank you so much for sharing your journey, it’s been really encouraging to read. Yes, I must admit I do find it difficult to eat the very diet expected of us because I do struggle with digesting certain things. A roast dinner for example, packed with veg just will not agree with me. I’m very cautious with what I eat on a roast dinner and I have carrots and three pieces of broccoli and I am able to digest that fairly well. I know later that evening I may be slightly windy but then so on my husband and daughter so a little bit of it is also understanding that now my gut is working better, I will get a bit of wind does things digest. For a long time I existed on barely any food and ate chicken and rice for dinner every evening, so I think my gut didn’t have to do any work so now when I get a bit windy and I can hear my tummy making noises, I automatically panic that something is wrong, whereas that’s how normal guts do tend to sound.
I definitely feel so much better than I did this time last year. I visited my doctor this time last year to say that my gut was ruining my life and I felt like I couldn’t leave the house and he prescribed a drug that slowed the gut down and recommended the FODMAP diet. I do wish I hadn’t followed that diet because I feel I’ve cut a lot of things out that I previously had no issue with and now do you have an issue with but there is definitely progress.
I think I just feel a bit cautious that I am being given quite a lot of supplements and I sometimes question whether that is just making sales and ticking boxes instead of actually needing it? I googled things like slippery elm and I really cannot see why I’ve been prescribed it because it’s not really for the symptoms that I’m getting and I know there have been several supplements. The nutritionist has recommended that I’ve had to stick in the cupboard because they just don’t agree with me. I don’t get on very well with fibre in high quantities.
I know that I will never be “normal“ and I’ve been advised that I am hypersensitive, but it would just be lovely to be able to go out for dinner or lunch with my family and not feel so worried and nervous. I hate feeling like a burden to them at times and feel that they always make sacrifices for me. I’d love to just be able to go away or go on holiday and know that as long as I stuck to simple things that I could partake
One thing I might suggest is to try to avoid food with insoluble fibre, and concentrate on those with soluble fibre, which is less irritating to the gut; I provided a list of screenshots to huggit which you can see on her “Fibre in the diet” post. You would probably have cut these out during your FODMAP diet anyway though, if you were on it too long, the bacteria you need to digest fibre will disappear (as they have done with my low fibre diet). Consequently, they may take some time to recover but, at least in theory, a gradual intake of more fibrous foods might bring them back!
In my opinion, the problem with doctors is they seem to give out PPI drugs like sweets, as if they are the one answer to any gut disturbance. They have their place, but are often wrongly prescribed, prescribed for too long, or the monitoring isn't diligent.
Personally I have a dislike of them. But I am sure they have helped some people when prescribed for certain things correctly.
I have heard that PPI's can actually make IBS worse.
They can definitely contribute to a tendency to develop SIBO.
I have a theory (not sure if I'm right as I'm not a doctor) that symptoms of reflux and upper tummy problems can often be caused by constipation, or slow bowel transit. That sometimes maybe the stomach acid isn't too much, but the gut transit is too slow and things back up and there may even be a tiny amount of "gastroperesis" going on with some fermentaion taking place in the actual stomach (?)
I only started to wonder about that because of carefully observing my own symptoms in winter 2020-2021 when I temporarily had a reflux-type set of symptoms, and drawing conclusions from what I was experiencing then.
Sometimes if we have IBS D predominantly, we think there can't be any constipation. But there can be lots of reasons for that possibility: sometimes overflow diarrhea, and sometimes not going enough despite passing a few loose stools. Like something is backed up. That could be caused by slow bowel transit even though it doesn't compute.
Or sometimes if we have IBS- mixed (M), there can be times the gut transit speeds up, and times it slows down, all for no clear reason!
I would say if Glutamine makes you worse and you have given it a fair trial, common sense says to leave it out and see what happens. Not everything that's supposed to be "good for gut health" suits every one of us.
Yes, you might have to be a bit more disciplined with foods, and keep a food diary too. Personally, (and sadly) I have had to cut out a lot of nice foods from my diet in order to gain any ground. Always with the intent on finding a "capsule" diet that is easy on me but does contain as many nutrients as possible. Yes. I miss all thise foods, and yes, it's awkward sometimes socially, but I stick with it, and now and again, try very tiny amounts of foods I used to like and be able to eat. wait a couple of days, note the results, keep including them if there's no bad response. Or including them sometimes, but not at more sensitive times for my gut.
Through it all, I continue to take a multivitamin and mineral A-Z, plus a B complex, and in winter a vegan D3, because I know my diet is more restricted than it ought to be. Just as a safety net.
Probiotics don't ALWAYS help IBS, or if they do a bit, aren't the cure-all for just some people. Though they are always worth trying, and if there is help from them it's worth it!
Yes I have tried slippery elm powder and it made me feel much the same as you describe. (We give to our dog and it works very well for her!) Think I have tried every supplement etc under the sun and have seen nutritionists etc have also been recommended all the supplements that you were recommended by Linda of Just for Tummies agree she is very nice but I'm afraid they didn't help me - still searching for an answer! Only thing I have not tried is acupuncture.Glad to hear that you feel better than you did last year that's a start isn't it!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Ibs has finally broke me!
Lansoprazole make IBS worse
FODMAP phase 2 (reintroducing)
IBS, SIBO, Histamine 
Bloating and Snacking 
