The Saturday Scalpel: Issue 14

From the Desk of Dr. Kevin, MD

"You wanna eat dinner at 10pm? Sure. Just make sure to write your pancreas a nice apology letter first."

Hello, My Beautiful Scalpheads.

It’s your boy again, Kev… Back again with a Gut Check Special, so Buckle up!

You think it's just gas?

Or gluten?

Or that one night in Cabo?

Wrong.

Your gut isn't broken because you ate bread. It's broken because you treat it like a trash can and wonder why it's not humming like a Tesla.

Let’s dive into why your colon is crying. And why your IBS isn’t from Satan.

It’s from skipping legumes and living in fight-or-flight like you’re being chased by IRS. (Don’t ask me how I know that. 😑)

Your Gut Barrier: The Wall You Keep Punching

Behind that belly you flex in the mirror is a one-cell-thick barrier. It's the only thing keeping your gut bugs out of your bloodstream.

It renews itself every four to six days like a cellular OnlyFans.

But if your diet is trash and your stress is biblical, that wall leaks like your drunk uncle at Thanksgiving.

Cue inflammation. Cue disease. Cue your dermatologist saying, “We don’t really know what’s causing this rash.”

Microbes: Your Freeloading Roommates

Your gut is home to trillions of bacteria. Some are helpful. Some are total jerks.

The good ones produce magical things called short-chain fatty acids (SCFAs). Especially butyrate.

That’s the duct tape of your colon wall. But they need fiber to do their thing.

And no, fiber doesn’t mean eating one sad flaxseed muffin a week while praying to the gut health gods.

Stress: The Silent Turd in the Room

Let’s get uncomfortable.

Your bloating might not be from kale. It might be from trauma. Yeah, that trauma. The emotional fire you shoved into your amygdala in 2003.

Your nervous system has been stuck in fight-or-flight ever since. And that messes with your gut in ways probiotics can’t fix.

This isn’t woo-woo. This is real.

Chronic stress destroys your gut lining, your microbial balance, and your will to live.

SIBO: Everyone’s Favorite Fake Diagnosis

Ah yes. SIBO. (Small Intestinal Bacterial Overgrowth)

I call it Shitty Interpretations of Bloating, Often.

Okay fine. SIBO is real. But the tests suck.

The breath test is about as reliable as your ex. The so-called "gold standard" is barely used and still flawed.

Even if you do have it, nuking your gut with antibiotics makes things worse. It’s like solving a termite problem with a flamethrower.

Real Gut Rehab Means Real Food

Instead of playing whack-a-microbe with your colon, try this:

• Eat fiber

• Eat more plants

• Eat diverse plants

• Don’t fear food. Reintroduce it

• And yes, expect some farts. That’s called progress.

Your gut is like a busted knee. You don’t heal it by avoiding movement. You heal it by starting slow, staying consistent, and pushing through mild discomfort.

Bonus Belch Fact

If you burp like a frat boy in a beer-chug contest, the problem isn’t gut bugs. It’s air. You’re swallowing it. Constantly. Through gum, straws, soda, and anxiety.

It’s called aerophagia. Google it. Or just stop sucking on paper straws. (They’re bad anyways)

Now…Final Slice

Your gut isn’t just where your food goes.

It’s where your stress hides. It’s where your trauma festers. It’s where your immune system panics.

Stop blaming garlic. Start feeding your damn microbes.

Editor’s note by Dr. Max Maddahali, MD

I’d like to apologize on behalf of Dr. Kevin, who somehow managed to turn gut science into a stand-up set at a dive bar.

But beneath the profanity and metaphors about juice boxes and trauma turds, his advice is surprisingly solid. Gut health truly is at the core of your physical and mental wellbeing. Whether you’re dealing with IBS, inflammation, or just want to optimize your long-term health, it all starts here.

If today’s newsletter sparked any questions, curiosities, or existential dread, feel free to hit reply. We read every response.

P.P.S. What did you think of today’s edition? Seriously, reply and tell us. Even a single word (“lol” or “wtf”) lets us know you’re out there. And gives Dr. Kevin an excuse to go off in the next one.

References:

 https://doi.org/10.1038/nri2653

 https://pmc.ncbi.nlm.nih.gov/articles/PMC9561599/

Chrousos GP. "Stress and disorders of the stress system." Nat Rev Endocrinol. 2009 Jul;5(7):374-81.

Rezaie A, et al. "Hydrogen and methane-based breath testing in gastrointestinal disorders: The North American Consensus." Am J Gastroenterol. 2017 May;112(5):775–784.

 Mayer EA. "Gut feelings: the emerging biology of gut–brain communication." Nat Rev Neurosci. 2011 Jul 13;12(8):453–466.