“Somewhere, something incredible is waiting to be known.”—Sharon Begley.

As I was watching TV, after just having consumer dinner, I realized I suddenly had no symptoms, no symptoms at all. My gut was so quiet you could hear a pin drop. I decided to do some experiments on the weekends. One thing I had noticed earlier was that as severe as my weekday symptoms were they tended to be worse on the weekends. It wasn’t clear if this was because they were actually worse, or I was more focused on them, though I was pretty focused on them all the time. So the weekend was the perfect time for testing. I started the day with my symptoms moderately severe, which was the normal state of affairs at this point. Then I ate a meal and lo and behold within a short order of time, the symptoms just stopped. I could actually feel them calming down. So I waited and waited and after several hours, the symptoms started up again, this time even more intense than before the meal. I began testing different foods and discovered there was a very specific correlation between when the symptoms would restart and the size and nutrient composition of the meal. For example, for a glass of orange juice, the symptoms would begin in about thirty minutes. For two cans of Ensure, a nutritional drink, it was about two hours. An entire block of cheddar cheese, about four hours. A large pizza, about five hours. These timings were reliably reproducible. If you remember when farting first started, it happened every seven minutes. Once again, we see evidence of a clock in the gut. But what was is causing the symptoms to behave this way? I think I have an answer, and if you’re a scientist of gut motility, I think the answer will surprise you.

The gut basically exists in one of two states, a fed state and a fasting state. The fasting state is further divided up into three phases, phase I, phase II, and phase III. These states describe the activity of the gut muscles, and each one starts in the stomach and works it way to the end of the small bowel, the terminal ileum. The three phases of fasting keep cycling until one eats. At that point, a fed state takes over. Once the meal is digested and absorbed, the fasting state returns. It appears that my symptoms are specific to the fasting state, and they disappear during the fed state. This is a major insight. First, it means I won’t have to give up eating. In fact, I can now look forward to dinner every night. Wow. I learned that on average, my now fully packed dinner keeps my gut calm for four hours. My plan was to be asleep before that time was up and as it turns out, this plan pretty much worked without fail. By the way, it also means that my symptoms never awoke me from sleep, and I slept extremely well during this period despite the enormous stress the symptoms inflicted.

Second, it implies that the nerves that control the fed state are different somehow from the nerves that manage the fasting state. My hypothesis is that the enteric nervous system appears to actually be two different nervous systems. This is entirely unknown to medical science, and I am reporting it here for the first time.

A valid question here is if this is the case, why have we seen it reported in the literature? The answer to that one is twofold. Consider that real aerophagia hadn’t been reported until 1998, so like that, it’s probably super rare (though I don’t know why any of these phenomena are so rare), and second, it wasn’t easy to discern, even after having it for a while.

To those of you who study gut motility, I am particularly interested in your thoughts here.

But this in and of itself was throwing a slew of more observations at me. Without getting into the rich details of the two weird abdominal sensations at this time (that’s forthcoming) what I can tell you is that they are highly location specific. When the symptoms start up from a slumber, they always start in the exact same spot in the lower left quadrant. Based on this exact location and the timing, this region corresponds to the distal ileum. Then within fifteen minutes or so, the lower right quadrant is engaged. This corresponds to the terminal ileum and cecum. Shortly after, the rest of the colon is engaged, starting with the ascending the transverse, descending and sigmoid. The rectum is spared. You’ll also notice the remainder of the gut, the esophagus, stomach, duodenum, jejunum and proximal and mid ileum are all disease-free.

That the distal ileum on downward except for the rectum is affected by the disease suggests there’s a correlation between the disease and the gut flora. That is, after all, where the gut flora reside. Remember how it appeared that clindamycin made the symptoms worse bringing the distal ileum into the fold.

This pattern of symptoms has two other things to say concerning our knowledge of gut motility. First, when the symptoms slow down and stop, that happens pretty quickly, within fifteen minutes or so. Our understanding of gut states tell us they originate in the stomach and propagate aborally (away from the mouth) over time. My observations suggest the actual migration occurs way faster, like an order of magnitude faster.

Second, when the symptoms stop, the colon is also affected. However, it is believed that fasting and fed states of the gut don’t apply to the colon. My observations indicate this is incorrect. The colon and the distal/terminal ileum are essentially in lock step.

You might be wondering what would happen if I just ate one meal followed by another, or if I just ate continuously. I wondered too and did a number of experiments to find out.

For example, one series of experiments I did consisting of eating a potato chip or a cookie once a minute over the course of several hours to maintain a continuous fed state. It turns out this has a paradoxical effect. Ordinarily, the two weird sensations occurred together, but here the first one, which I will call spray painting (a detailed explanation of these symptoms is forthcoming), would be suppressed, but the other weird sensation, which I will call the cheese grater, came on particularly strong. 

Now just what is the nature of these weird sensations?