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Your Brain Is Making You Poop Wrong | Dr. Zachary Spiritos
52:52
Your Brain Is Making You Poop Wrong | Dr. Zachary Spiritos
1.1K views7 months ago
YouTubeMedical Centric Podcast
Hormones & IBS — the connection we can’t ignore Hormones play a big role in IBS symptoms, which is why many people notice flares at specific points in their cycle. Here’s the simple breakdown: • Follicular phase: Estrogen starts to rise. Many people feel a bit more energy and calmer digestion. • Ovulation: Estrogen peaks. For some, symptoms are at their best here. • Luteal phase: Progesterone rises and can slow gut motility, leading to more bloating, constipation, and discomfort. • Menstrual pha
1:15
Hormones & IBS — the connection we can’t ignore Hormones play a big role in IBS symptoms, which is why many people notice flares at specific points in their cycle. Here’s the simple breakdown: • Follicular phase: Estrogen starts to rise. Many people feel a bit more energy and calmer digestion. • Ovulation: Estrogen peaks. For some, symptoms are at their best here. • Luteal phase: Progesterone rises and can slow gut motility, leading to more bloating, constipation, and discomfort. • Menstrual pha
7.3K views9 months ago
FacebookZachary Spiritos
Why Stool Microbiome Tests Aren’t Ready for Primetime (Yet) Stool microbiome tests are everywhere, and the idea behind them is appealing: test your gut bacteria and fix your symptoms. But the science just isn’t ready. Here’s why. 1. They’re not validated A validated test gives the same result no matter where you run it, and we know exactly what the results mean. Microbiome tests don’t work like that. Different companies give different results, and there’s no agreement on what a “normal” microbio
1:55
Why Stool Microbiome Tests Aren’t Ready for Primetime (Yet) Stool microbiome tests are everywhere, and the idea behind them is appealing: test your gut bacteria and fix your symptoms. But the science just isn’t ready. Here’s why. 1. They’re not validated A validated test gives the same result no matter where you run it, and we know exactly what the results mean. Microbiome tests don’t work like that. Different companies give different results, and there’s no agreement on what a “normal” microbio
6.2K views11 months ago
FacebookZachary Spiritos
Let’s talk about MCAS — Mast Cell Activation Syndrome. The tests we have? Honestly… not that helpful. Most have low sensitivity — meaning they can miss the diagnosis even when it’s really there. Serum tryptase? Often normal in MCAS. Urine prostaglandins, leukotrienes? Only elevated if you test right after a flare and the sample is handled perfectly. Real-world sensitivity? Likely under 50%. Here’s the key: one of the diagnostic criteria for MCAS is improvement with therapy. So if your symptoms i
0:30
Let’s talk about MCAS — Mast Cell Activation Syndrome. The tests we have? Honestly… not that helpful. Most have low sensitivity — meaning they can miss the diagnosis even when it’s really there. Serum tryptase? Often normal in MCAS. Urine prostaglandins, leukotrienes? Only elevated if you test right after a flare and the sample is handled perfectly. Real-world sensitivity? Likely under 50%. Here’s the key: one of the diagnostic criteria for MCAS is improvement with therapy. So if your symptoms i
121.7K views9 months ago
FacebookZachary Spiritos
She had every test — and still no answers. Years of abdominal pain. Chronic fatigue. Bloating, heartburn, and unpredictable diarrhea. She saw specialists. Got the scopes. Normal imaging. Normal labs. Still miserable. But during our visit, we went deeper. We talked about patterns. Triggers. Symptoms beyond the gut. And it led us to something that often flies under the radar: Mast Cell Activation Syndrome (MCAS). It’s not an easy diagnosis — but it’s a real one. And here’s the wild part: Just thre
0:12
She had every test — and still no answers. Years of abdominal pain. Chronic fatigue. Bloating, heartburn, and unpredictable diarrhea. She saw specialists. Got the scopes. Normal imaging. Normal labs. Still miserable. But during our visit, we went deeper. We talked about patterns. Triggers. Symptoms beyond the gut. And it led us to something that often flies under the radar: Mast Cell Activation Syndrome (MCAS). It’s not an easy diagnosis — but it’s a real one. And here’s the wild part: Just thre
130.8K viewsApr 3, 2025
FacebookZachary Spiritos
GLP-1 medications can be a very helpful tool in mast cell activation syndrome, and I’ve seen them make a meaningful difference for many people. But the biggest concern that always comes up is delayed motility. That concern is completely valid, because people with MCAS often already deal with dysmotility and slow digestion. So starting a medication that is known to affect gastric emptying understandably creates a lot of anxiety. However, when you look closely at how and why GLP-1s cause digestive
1:15
GLP-1 medications can be a very helpful tool in mast cell activation syndrome, and I’ve seen them make a meaningful difference for many people. But the biggest concern that always comes up is delayed motility. That concern is completely valid, because people with MCAS often already deal with dysmotility and slow digestion. So starting a medication that is known to affect gastric emptying understandably creates a lot of anxiety. However, when you look closely at how and why GLP-1s cause digestive
16.8K views11 months ago
FacebookZachary Spiritos
When constipation doesn’t respond the way it should, I start widening the lens. If someone isn’t improving with laxatives—and their symptoms are more than just “not going”—things like pelvic pressure, heaviness, lower back pain, heavy legs, pain with intercourse, or worsening symptoms with standing or at the end of the day—I start thinking beyond stool consistency. One possibility I consider is the veins around the colon and pelvis. There’s a condition called pelvic venous congestion, where vein
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When constipation doesn’t respond the way it should, I start widening the lens. If someone isn’t improving with laxatives—and their symptoms are more than just “not going”—things like pelvic pressure, heaviness, lower back pain, heavy legs, pain with intercourse, or worsening symptoms with standing or at the end of the day—I start thinking beyond stool consistency. One possibility I consider is the veins around the colon and pelvis. There’s a condition called pelvic venous congestion, where vein
980 views9 months ago
FacebookZachary Spiritos
1:04
Gastroparesis Awareness Month – Let’s Talk Beyond the Basics In the video, we covered three important (and often overlooked) points: 1️⃣ It’s not just diabetes. The most common cause today is idiopathic—often triggered by a viral infection or linked to dysautonomia (like POTS). 2️⃣ Meds alone aren’t enough. Pro-motility drugs (medications to help the stomach empty) exist, but they work best in conjunction with a low-residue diet—foods that leave little residue (smoothies, broths, white rice) —ra
13.9K viewsAug 8, 2025
FacebookZachary Spiritos
0:07
Your scope is normal—it must be IBS. This is a common conclusion in GI, but the truth is, many conditions don’t show up on endoscopy yet still cause significant symptoms—lactose intolerance, MCAS, gastroparesis, CSID, SIBO, cyclic vomiting, and more. And even if it is IBS, the typical advice to “eat more fiber” or “reduce stress” barely scratches the surface. IBS is complex, and a real treatment plan requires a personalized, multi-faceted approach—not just a quick fix. If you’ve been told it’s “
17K viewsMar 16, 2025
FacebookZachary Spiritos
0:32
Why Isn’t Your IBS Under Control? Well, for one… it might not be IBS at all! 👀 So many conditions mimic IBS—CSID, histamine intolerance, bile acid malabsorption (BAM), Crohn’s, SIBO, MCAS—and I often see patients mislabeled with IBS when it’s really something else. Second, we may not have identified your triggers yet. Some people react to foods like FODMAPs, while stress is the biggest culprit for others. And lastly—sleep. You can’t heal your gut if you’re running on empty. Every IBS plan is un
2.5K viewsMar 3, 2025
FacebookZachary Spiritos
0:07
🚨 Not all heartburn is GERD! 🚨 I see this mistake ALL the time—young, healthy people with no classic risk factors (no obesity, no heavy acidic diet, no smoking) getting put on high-dose acid-reducing meds for reflux that doesn’t make sense. But here’s the thing—rip-roaring GERD doesn’t usually hit these patients out of nowhere. So what’s really going on? 👉 Histamine overload! Mast Cell Activation Syndrome (MCAS) can cause classic “heartburn” symptoms, but the treatment isn’t acid suppression—
2.1K viewsMar 4, 2025
FacebookZachary Spiritos
0:11
Let’s talk about SIBO—and why pro-motility agents matter. SIBO stands for small intestinal bacterial overgrowth. It happens when bacteria that normally live in the colon build up in the small intestine instead. This can lead to bloating, gas, nausea, fatigue, and changes in bowel habits—either diarrhea or constipation. Sometimes there’s a clear cause—like narcotics, which slow down gut movement. If we can identify and reverse that cause, great. But when we can’t find a clear reason—or someone ke
43.2K viewsApr 18, 2025
FacebookZachary Spiritos
0:11
“My SIBO test is positive—so this is the answer to everything, right?” Not so fast. Small Intestinal Bacterial Overgrowth (SIBO) can absolutely cause a wide range of symptoms—bloating, gas, abdominal discomfort, and unpredictable bowel movements—and I have a low threshold to treat it when the test comes back positive. Many patients do feel better with targeted therapy, and when that happens, it’s incredibly rewarding. But here’s the thing: SIBO testing is far from perfect. We use breath tests wi
25.1K viewsMay 27, 2025
FacebookZachary Spiritos
0:08
Gastroparesis isn’t just about speeding up your stomach. We used to think meds that help the stomach empty faster—called prokinetics—were the main fix. These include drugs like erythromycin or metoclopramide, and while they help a few, a recent study showed they rarely work on their own. Why? Because gastroparesis isn’t just a motor problem. It’s also a sensory one. The stomach can become hypersensitive, meaning even normal stretching or fullness feels painful or nauseating. So our treatment goe
23.7K viewsApr 22, 2025
FacebookZachary Spiritos
1:35
Can I tell you something? Your gut is leaky. But before you panic… everyone’s is. A little “leakiness” happens every single day — after a big meal, when you exercise hard, when you’re stressed, even when you take an NSAID. That’s normal physiology. Your gut opens the gates, handles the load, and closes them again. The real issue is when your gut can’t turn it off — when those gates stay open and start letting things through that were never meant to cross. That’s what people mean by “leaky gut”:
8K views11 months ago
FacebookZachary Spiritos
0:09
When food hurts, it’s not just “in your head.” MALS — Median Arcuate Ligament Syndrome — was historically thought to be compression of the celiac artery. But we now we’re starting to think it’s often compression of the celiac ganglion plexus, the bundle of nerves that connects the gut and brain. That means imaging focused only on blood flow can look normal — even when the pain is real. For some, MALS is a clinical diagnosis, not an imaging one. It’s one of the most poorly recognized GI condition
2.3K views9 months ago
FacebookZachary Spiritos
0:09
Gastroparesis is no joke. When your stomach doesn’t empty the way it should, it can leave you feeling bloated, nauseated, and just… off. While medications can help, there are also simple over-the-counter tricks that many people find surprisingly helpful: 1. Heating pad – A warm compress over the stomach can soothe cramping and discomfort. Bonus: it helps relax the nervous system. 2. QueaseEASE aromatherapy inhaler – This little stick combines essential oils like peppermint, ginger, spearmint, an
167.6K views9 months ago
FacebookZachary Spiritos
0:14
Look — Cannabinoid Hyperemesis Syndrome (CHS) is a real condition. It causes episodes of severe nausea, vomiting, and abdominal pain in people who’ve used marijuana daily and chronically for years. The only real “cure” is stopping cannabis use altogether. But let’s be clear: That’s not what most of my young patients are dealing with. Too often, someone comes in with nausea or abdominal cramping, and they mention they’ve tried marijuana to help ease the symptoms. Maybe it worked, maybe it didn’t.
1.4M viewsMay 9, 2025
FacebookZachary Spiritos
0:47
When you’re backed up, sometimes laxatives can’t do their job… yet. If stool has been sitting in the colon for a long time, it becomes hard, dry, and difficult to move. Adding a daily laxative on top of that can feel frustrating — or even make symptoms worse. In some cases, a one-time OTC cleanout can create a clean slate so maintenance meds can actually work. This isn’t a detox. It’s not for everyone. But used thoughtfully, it can reduce bloating, pressure, and help reset the system. OTC Cleans
826 views9 months ago
FacebookZachary Spiritos
0:11
I see this all the time. A young, otherwise healthy woman with chronic lower back pain gets told it’s “arthritis” or something degenerative — even when there’s no injury history, no risk factors, and the story just doesn’t fit. When that happens, it’s worth pausing and zooming out. Because in many of these patients, persistent low back pain isn’t coming from wear-and-tear at all. It can be an early clue of hypermobility or one of its related complications — things like altered spinal stability,
259.4K views9 months ago
FacebookZachary Spiritos
0:09
“Growing pains” or something more? Many people with Ehlers-Danlos Syndrome (EDS) were told as kids that their joint pain was just “growing pains.” But here’s the thing — growing pains aren’t supposed to mean chronic joint pain. What are normal growing pains? They’re usually brief muscle aches in both legs, mostly at night, that don’t linger into the day. What they’re not: persistent joint pain, daily discomfort, or pain that interferes with activity. Those symptoms deserve more attention — not d
16.5K views9 months ago
FacebookZachary Spiritos
1:13
Welcome to EverBetter Medicine — a specialty telehealth clinic designed for people who are tired of being told “everything looks normal” when everything feels far from it. We provide personalized care for adults (18 and older) struggling with: • Digestive disorders like IBS, reflux, chronic bloating, constipation, diarrhea, and unexplained abdominal pain • Dysautonomia-related conditions, including MCAS, POTS, and GI symptoms associated with EDS • Weight management challenges that haven’t respon
29.4K viewsMay 27, 2025
FacebookZachary Spiritos
1:12
I’m excited to introduce Mallory to our EverBetter Medicine team! She’s a Georgetown trained nurse practitioner who specializes in complex GI conditions, dysautonomia, and MCAS. She brings a thoughtful, systems-based approach and is now seeing patients in North Carolina and Illinois, with availability starting as early as February. You can book an appointment with Mallory here: https://everbettermedicine.health/request-an-appointment/ | Zachary Spiritos
13.4K views9 months ago
FacebookZachary Spiritos
0:39
Tomorrow at 4:45 PM Eastern, I’ll be going live with Dr. Iris Wang @iriswangmd a gastroenterologist who trained/worked at the Mayo Clinic and the author of the kids’ book Boo Goes Poo (yes, it’s as iconic as it sounds). We’re talking constipation, cutting-edge ways to heal IBS, and a bunch of other can’t-miss GI topics. Come join us live and bring your questions! #ibs #ibsawareness #ibsdiet #ibsfriendly #irritablebowelsyndrome #irritablebowel #fodmap #fodmapdiet #fodmapfriendly #dysautonomia #po
1.1K views10 months ago
FacebookZachary Spiritos
0:06
Did you know that IBS can start after a case of food poisoning? It’s called post-infectious IBS, and it often begins after a bacterial infection—like from undercooked food—that causes diarrhea. For some, the gut never fully recovers. Here’s the simple version: Your immune system fights the infection but accidentally targets parts of your gut’s own nerve wiring—specifically a protein called vinculin. This mix-up slows gut movement and can lead to SIBO (small intestinal bacterial overgrowth). 👉 I
76.5K viewsApr 4, 2025
FacebookZachary Spiritos
0:33
Do you have POTS, hypermobility, or mast cell disease and feel lost about what to eat? These conditions can make food feel like the enemy and create so much anxiety around meals. That’s why tomorrow at 4:30 PM I’m going LIVE with Holly Herrington @everbetterrd — former lead dietitian at Northwestern and now part of EverBetter Medicine. We’ll cover: ❌ What foods to avoid with mast cell issues ✅ What foods to focus on instead 🍴 How to not be overly restrictive 🌱 How to safely expand your menu ov
23.1K viewsAug 18, 2025
FacebookZachary Spiritos
0:08
She had three prior endoscopies. Tried gluten-free. Dairy-free. Low FODMAP. Still bloated. Still cramping. Still foggy. Nothing clicked—until we looked in a different direction: histamine intolerance. We started a low histamine diet and added a DAO enzyme before meals. Within weeks, the difference was striking. Her bloating improved. The cramping eased. The brain fog started to lift. Most people are familiar with IBS or lactose intolerance, but histamine intolerance often flies under the radar.
249.2K viewsApr 17, 2025
FacebookZachary Spiritos
0:36
Cyclic Vomiting Syndrome: It’s Invisible, Not Imaginary If you’ve ever dealt with relentless nausea and vomiting, but every test comes back normal, you might have Cyclic Vomiting Syndrome (CVS). CVS isn’t just another stomach bug—it’s a neurologically driven disorder that starts in the brain, not the gut. Think of it like a migraine, but instead of head pain, your body responds with repeated waves of nausea and vomiting. It can be debilitating, unpredictable, and dismissed too often—but it’s not
3.3K viewsFeb 20, 2025
FacebookZachary Spiritos
0:07
🚨 Not all heartburn is GERD! 🚨 I see this mistake ALL the time—young, healthy people with no classic risk factors (no obesity, no heavy acidic diet, no smoking) getting put on high-dose acid-reducing meds for reflux that doesn’t make sense. But here’s the thing—rip-roaring GERD doesn’t usually hit these patients out of nowhere. So what’s really going on? 👉 Histamine overload! Mast Cell Activation Syndrome (MCAS) can cause classic “heartburn” symptoms, but the treatment isn’t acid suppression—
6K viewsMar 4, 2025
FacebookZachary Spiritos
49:43
Navigating IBS with Dr. Zach Spiritos
637 views4 months ago
YouTubeReal World NP
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