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

When the symptoms started cranking after a meal, my first reaction was to put my hand on my gut, and I could easily feel my gut discomfort in my hand. I first noticed that in September of 1996, but I didn’t know what to make of it. It was clear the motility was somehow deranged, but how? I was clearly feeling movement, but we could be talking like a million movements every day at the very least. How is the gut able to contract at such a ridiculous velocity?

 

Then I had an epiphany. I thought about an aerosol can and how it works. There is a high flow through a small nozzle that opens up into the air. Put your hand in front of that and how does it feel? For that matter, how does it feel against your skin when you shower? This is the exact same sensation! Now it became clear how the gut muscles pull off this trick. Consider three adjacent circular segments in normally functioning small bowel. Let’s start with a given segment nearest the mouth as contracted shut. The second segment over closer to the anus contracts, and the third segment over relaxes. This will cause digesta to flow aborally into the third segment. This is peristalsis.

 

Now consider how the pathological gut produces this odd symptom. In this scenario, the third segment is nearly fully contracted, but not so much that it’s completely sealed off. It’s open just enough to create a pinhole. As the second segment contracts, it forces digesta through this pinhole at high velocity, producing a spray that slams against the walls of the intestinal lumen. It does this with so much force that one can easily feel the vibration through the whole abdominal wall.

 

Back when I was a child growing up, I lived in an apartment building and at one point, the landlord had these painters paint the corridors. To do so efficiently, they used spray paint. That memory was very vivid, and this symptom reminded me of that, so from here on in, I will refer to this symptom as spray painting.

 

So do other people experience it? I believe so, but it’s clearly extremely rare. I have done Google searches over the years and have come across a few dozen anecdotes among the entire English-speaking Internet describing a symptom that sounds like spray painting. At the same time, it has not been described in the medical literature and hence can be considered unknown to medical science.

 

Interestingly, there are some significant differences between my spray painting and those of these other people. They don’t report that eating after a prolonged fast causes the symptom to stop, and it’s not clear what portions of the gut it affects in them. It may not be as specific as it is with me.

 

By the way, in case you were wondering how does the gut sense spray painting, there’s a very interesting story about it. When Filippo Pacini, the Italian anatomist, was dissecting a hand during medical school class in 1831, he came across these strange structures that were later renamed after him, Pacinian corpuscles, even though to be fair,  Abraham Vater, of ampulla of Vater fame, was the original, true discoverer. They detect movement, and they were later found in cat mesentery thus explaining how the super rare individuals like myself who have spray painting feel them. By the way, when a fetus kicks inside a pregnant woman, it is these Pacinian corpuscles sensing that motion.

 

However, there is a second, even more uncomfortable sensation that is completely internal. The best description I have come up with is to imagine taking a metal cheese grater and folding it into a cylinder such that the prongs face outward and then imagine placing it inside the lumen of the intestine so that when the intestine contracts, it the intestinal wall is forced against the cheese grater’s prongs. Fittingly, I call this symptom, the cheese grater.

 

Do other people have the cheese grater? I do not know, and I do not know if there is a way to know. While I don’t think there are many ways to describe spray painting, there are certainly other ways a person could describe the cheese grater. At the same time, given both symptoms often occur together, in the same locations and are affected by meals in the same way, it’s probably the case that only very individuals on the planet who have ever experienced these exact symptoms.

 

Both symptoms afflict the same gut regions although not necessarily at the same time. Spray painting has a preference for the distal and terminal ileum and the sigmoid. The cheese grater likes the transverse colon. Anyway, as I previously explained, my experiments revealed that continuous eating tended to suppress spray painting, but amplify the cheese grater, somewhat of a paradoxical effect. Regardless, given this situation, one meal a day four hours before bed was the way to go as far as eating was concerned.

 

Still, while I had essentially guaranteed relief for the four hours before going to bed, I was dealing with awful discomfort all throughout the day as the air swallowing was driving it.

 

The medical literature wasn’t of much help in helping me decipher these two symptoms. As for spray painting, I didn’t see any other play other than to suppress the gut motility as much as possible. As for the cheesegrater, the literature was consistent (sound familiar?): the mechanism had to be visceral hypersensitivity.