To pull an HN evergreen and reply to the overly specific instead of your main point: My wife developed "histamine intolerance" after a time of heavy stress, in a story that's scary similar to yours. It took her years to figure it out, from chance result on a super broad blood test. To confirm this, she changed her diet to be only low-histamine foods and it made all the difference. She went from "a single chocolate chip cookie makes me sick for 3 days" to "mostly leading a normal life, just watch what you eat" in half a year or so. Over time it helped her gut recover to the point that she now generally does not need to watch out much anymore, except in some periods when some old symptoms pop back up and she reverts to low-histamine diet for a while.

Statistically speaking this is probably not it and you considered/tried it already, but just wanted to bring it up in the off chance that you hadn't heard of this before. I mean doctors just said "irritable bowel syndrome! theres no cure sorry bye". She's been writing a low-histamine foodblog for some years, which includes a good starting point for what to eat and avoid: https://histaminefriendlykitchen.com/histamine-friendly-food...

Meditation, mindfulness, reframing, emotional self-care, movement, exercise. The usual things.

Not trying to be smug.

But I noticed on a three week vacation, where I was walking 15K steps a day, I lost weight and had zero gut issues while eating freely in restaurants for the duration. Got home, day one the old issues came back. I definitely had a stressful association with my day job and the attendant life. I let a lot of things slip because I allowed that my situation required me to reward myself with lethargy and vices. When I’m above the baseline on self care, I don’t turn to the vices as much and my physical systems generally work better.

I got back into my “me first” routine and my gut issues subsided. For me it was like a switch.

I went through it for many years. It got to the point where certain foods made me feel unwell. I had brain fog. Felt tired, exhausted. I changed my diet, cut out a lot of processsed foods and got by as best as I could.

In the end I realised stress was a major factor. Diet would have an impact but stress was the triggering agent that would make certain foods much more inflammatory.

I broadened my diet, ate much healthier. Made more effort to do exercise on a regular basis.

Slept regularly, slept earlier. Took time to go hiking or running long distances. Stopped thinking about work after hours. Made an effort to stop worrying about things outside of my control.

It took a few years and I reversed almost all the symptoms.

The main problem is with stress + gut issues, it's a downward spiraling feedback loop. Stress causes gut irritation, gut irritation makes you more stressed. I suggest going to a gastroenterolog, that knows about gut flora restoration. Basically you'll get a Low-FODMAP diet for a month, then RENEW diet for ~1 year, but you will also get a bunch of special probiotics, mostly based on Bacillus Subtilis.

During this time the negative feedback loop is being broken, the gut will have a chance to recover and the symptoms should improve/disappear.

I am slowly finishing this diet and I have to say that apart from a few ups and downs, it helped me tremendously. I have much more energy during the day, less oily skin and hair, smoother skin on my face, and consistent stool.

Stress is a catch all medicine uses when they have no idea.

Did anyone check your gut flora and provide an analysis, did anyone every take a sample before to compare to?

Diet changes is probably heavy protein, some greens, no carbs type style?

I'd recommend diving into probiotics, you'll get very little help from most doctors as they don't know shit about it (pun intended!)

Years and years of IBS like symptoms, like 20+ years of it. Probiotics, fermented foods, protein and greens...I shit like a god now.

Stress affects stuff, that's normal but it's never a single source issue when it comes to overall health.

If you ain't pooping right, solve that first.

I recommend an Organic Acid Test (OAT). I've been struggling with gut problems similar to yours for years but then it got so much worse during the lockdowns. At the time I survived it by embracing fasting and keto diets but that wasn't much fun.

More recently my OAT discovered fungal activity and an enormous vitamin C deficit. Potentially this has been going on for more a decade and it would explain why I'm so tired all the time. Treatment through supplementation is in the early stages but I'm already feeling noticeably better.

If you want to go a bit off the traditional path, you can look into BPC-157 which is a peptide that was designed to help heal the gut. Nowadays it's mostly used by athletes and anti-aging people to help heal soft tissue damage, but the original purpose was to heal your gut.

If you're in the US, you can probably find an anti-aging clinic with a doctor that you could ask about it.

I got recommended on a previous HN thread to try an L. Reuteri probiotic. This is the one I took: https://www.biogaia.com/product/biogaia-protectis-chewable-t.... There's decent clinical evidence for an effect[1].

The change in my gut health has been astounding. There was a period about 1.5 months after I started taking it when things definitely felt worse (which I guess is about the time the bacterial colonization was underway) but since then I've felt so much better it's incredible. About 1.5 years now with it as my standard and improvement is consistent.

Now for me this was a big improvement, but it works better (for me anyway) when paired with Questran Lite[2] which is prescription (at least in Australia) but has become the darling of GI doctors because it seems to have good results in improving gut health. I was on it before I started the L. Reuteri, but things only improved once I added the probiotic in.

So - in order: try L. Reuteri supplements for about 6 months (because it's OTC). If the gut inflammation is an issue there's evidence that they will in fact help reverse it. If things are still somewhat not great, get a Questran Lite prescription (though there's actually a global shortage going on now).

The L. Reuteri theoretically you don't need to keep taking, and I did try going off them for about 6 months recently, and was mostly fine but eventually started seeing some regression so started taking them again.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917019/

[2] https://www.news-medical.net/drugs/Questran-Lite.aspx

You might want to read 'The Lady's Handbook for Her Mysterious Illness: A Memoir' by Sarah Ramey (Known also from her band Wolf Larsen). She goes back and forth between providing an overview of this 'mysterious illness' from different angles, and her gutwrenching absolute trainwreck of a personal experience of it. It seems you already found your way the same way she eventually did, though.

As the title says, the book is womens body specific - but also a guy i still found it very insightful to read.

"what does the process of reversing that inflammation look like?" "that can take awhile to undo" think you answered it yourself. stress less and wait