Crummy gut? What the…?
If you have to ask what Crummy Gut means, you may be in the wrong place. There is usually no mistaking those of us with crummy guts. Case in point: when I go out with friends, they automatically put me on the aisle so that I do not have to climb over them repeatedly during whatever it is that we are doing — why? Because I gotta poop, people. And when I gotta poop, nothing better be in my way. If you have a crummy gut, chances are that this makes perfect sense.

Just so that you know, I was diagnosed with Crohn’s disease in 1999, a form of IBD. Since then, I have been diagnosed with primary immunodeficiency, which also has associated bowel issues for about 50% of us. So, you could say that I have a double poop whammy…

IBD? IBS? Huh?
First of all, there are really good sites that can give you much better information than you will get here. Chances are you already know about IBD and IBS if you are checking this site out but I thought it would be good to give you the Crummy Gut take.

  • IBD, inflammatory bowel disease, means that you are pooping because your gut is inflamed. If you have ulcerative colitis, your colon is probably inflamed, and you might also be pooping blood. If you have Crohn’s disease, the inflammation could show up anywhere from your mouth to your butt — that being said, it seems as if a lot of us have problems in the lower part of our small intestines (terminal ileum) and the juncture between the small intestine and the colon (ileo-cecal valve). Crohn’s people typically have lesions. Microscopic colitis means that the inflammation is happening on a cellular level — you still poop like crazy but upon initial inspection during a colonoscopy, your gut will not look like hamburger.
  • IBS, irritable bowel syndrome, is a motility problem in your gut. To go to the bathroom like a normal person, there has to be regular and rhythmic peristalsis — peristalsis is muscular contractions that causes poop to move through your gut. Something causes sections of your gut to either stop contracting or to contract furiously. So you have the best of both worlds: diarrhea and constipation.

Where does Celiac Disease fit in here?
Celiac disease (CD) is neither IBD or IBS; it is an autoimmune reaction to gluten. When you have CD, the villi in your gut are damaged from antibodies your body creates in reaction to gluten, a protein in wheat. (If you are wondering, villi are small hairy little “fingers” in the lining of your small intestine; they suck up the nutrients from cheeseburgers, chocolate and other essential food groups.) The symptoms of CD vary but typically include gut issues like malabsorption, cramping, constipation and/or diarrhea — or as I like to refer to it, plug or play.

How does Celiac disease (or gluten intolerance) differ from gluten sensitivity?
I think that this is a good question but then I thought it up. Lots of people are sensitive to gluten — they deal with bloating and stomach discomfort when they eat foods containing gluten. People who are intolerant to gluten, though, suffer serious gut damage from gluten that can lead to malnutrition and other crummy things. People with gluten intolerance have to avoid *all* products containing gluten. People with gluten sensitivity can sometimes scoot by and eat foods with hidden gluten and not have too serious a reaction.

CVID Gut Issues? What the…?
Ah, if only we had the answer to this…About 50% of the people who have Common Variable Immunodeficiency (CVID), which is a form of primary immunodeficiency, have gut issues: gut infections, IBS, IBD, CD, weird inflammatory problems that mimic IBS and IBD — the list goes on. As one very sensitive nurse shared with me, “Sh^t happens when you have a wonky immunity.” I guess, in this case, she meant that literally. CVID gut issues can be difficult to diagnose and difficult to treat. Lucky us.

Colostomy? What the…?
Sometimes, when people have intractable and severe bowel disease, the only option is to surgically remove the diseased part of their gut. If the colon needs to be removed — and the rectum is involved — sometimes the only option is to have a colostomy. At risk of falling into the area of “too much information, ” that means instead of pooping through your butt, you will instead poop through a surgically-created hole in your abdomen through which your intestines now protrude (called a stoma) into an attached appliance (otherwise known as a plastic colostomy bag). Some colostomies are not permanent, some are — and all qualify under the heading of having a crummy gut. Check out this Crummy Gut blog article for more information about life with a bag: Irregular Gut Activity.

Colonoscopy? They are going to do what?!?
Yes, dear one, they are going to put a camera up your rear end. One way to diagnose a crummy gut is to have a procedure called a colonoscopy: that’s where a friendly gastroenterologist sticks a fiber-optic camera up your butt. If you are really lucky, they might combine it with an endoscopy, where they stick the darn thing down your throat, too. Most times you will be sedated through the experience. I say “most times” because during my last colonoscopy/endoscopy duo, the sedation did not take and I was conscious throughout. Trust me on this: you do NOT want to be awake during this procedure. Insist on profofol.

Oh, and the prep beforehand is no piece of cake — well, literally, since you have to fast for up to 48 hours beforehand. You get to drink clear liquids, including (unfortunately) one of a number of different laxatives that make you poop out *everything* that was ever inside you. Remember that rubber band you swallowed as a toddler? Well, it’s coming out now if it did not then. I like to think of the prep for a colonoscopy as being a time when I get to closely bond to my beloved good friend, Mr. Toilet. It’s a special time like no other.