Future Implications for Digestive Health

Hi everyone. This is Sony Kasom, host of fourteen forty Explores. Today, I'm handing things over to my colleague Dina Fine Marin, fourteen forty's health and medicine editor. for an episode I think you'll love I'll be back next time. Enjoy Everyone farts Not occasionally, but all the time In fact, recent research suggests the average adult may be passing gas more than thirty times a day Yet for something so universal, we spend a lot of energy pretending it isn't happening. Because let's face it. Farts seem childish They're embarrassing But in hospitals and inside labs, scientists are starting to take them very seriously. I think Flash lens is the best place to monitor gut microbial metabolism That's Fart scientist Brantley Hall to him Gas isn't just some giggly punchline. It's more like evidence Tiny status report from your gut microbiome So what happens when one of our most useful health signals is also the one we're most embarrassed to talk about Tod The science of Farts. Why we do it, why it sometimes smells, why humans across centuries can't stop laughing about it and why Brantley Hall at the University of Maryland is asking thousands of Americans to wear Bluetooth underwear sensors that track every time they fart We'll hear from him and dive into all of this and more in today's episode I'm Deina Fine Marin and this is fourteen forty Explorers a show where we unpack elements of our daily lives Stay with us So where did FRs actually come from The answer starts earlier than you may think Not weigh down in your colon or your stomach But the moment you eat So let's begin there with one hypothetical bite of a sandwich Bread, turkey, lettuce, maybe some onions if you're feeling socially reckless The moment you take that first bite, the Fart Genesis story begins The far prerelude, if you will That sandwich enters a thirty foot long tube that runs from your mouth to your anus It's known as your gastrointestinal tract Muscles in the wall of that tube squeeze in tiny waves, a process called peristalssis They push food downward like toothpaste through a very long tube And the whole trip can take anywhere from one day to three days The first major stop the stomach Think of this like an acid bath This is where your sandwich bite gets churned, squeezed, and hit with strong acid and digestive enzymes until it becomes a soupy sludge time From there, your sandwich moves into the small intestine which, despite the name, is actually the longest part of your digestive system It's about twenty feet of tightly coiled tubing This is the extraction phase Here, your body pulls out the valuables sugars, fats, proteins, vitamins, things your bloodstream can carry off and turn into energy, muscle, and thoughts Then eventually whatever's left that your body can't fully break down moves into the large intestine. AA the cololon Despite the name, the large intestine is actually shorter than the small intestine It's only about five feet lightider Think of this place as a fermentation chamber. Here trillions of microbes live out their lives in one of the densest ecosystems on Earth Scientists call this the gut microbiome There microbes help digest your food, produce gases, and shape everything from bloating and irritable bowel syndrome to your long term health. and those microbes are hungry Here's University of Maryland microbiologist Branty Hall The microbes in your gut can effectively digest anything that you eat And what they especially love are the tougher leftovers largely what scientists call fiber which is a type of carbohydrate your body can't fully break down on its own Think of things like beans Broccoli, whole grains, lentils Because it can't be absorbed as well Fiber keeps moving down into the colon And that's where the microbes take over and start to feast on it As they feast, they create gas as a byproduct most of which is odorless. As the gas builds in the colon, pressure builds. Some of it gets absorbed back into the body Some of it may have also exited earlier in the process as a burp But the rest Eventually, it has to come out And ta, the fart. The grand finale of digestion Min microbial eruption from deep inside your gut Sometimes that eruption is completely, shall we say, imperceptible But occasionally, It's not. The molecules that you smell, these gases are typically like hydrogen sulfide, methane diol but also some other ammonia and kind of like ammonium containing compounds. That rotten egg smell? That's sulfur compounds like hydrogen sulfide Tiny amounts, but powerful And it seems they likely smell bad for a reason It's related to our preference for not eating rotten food humumans try to avoid poisoning And so when you smell hydrogen sulfide and methane thol, It's a true signal of microbial metabolism And so we're trying to eat foods that haven't been metabolized by microbes. In other words, your nose likely evolve to keep you away from food that's already been broken down by microbes out in the world Maybe lying out in the saavannah because that can make you sick. If twist is inside your gut, that same process is exactly what digestion is supposed to do Okay That's normal flatulence. The everyday cost of digestion working exactly as it should. But what happens when the gas doesn't move through the system the way it should? when it builds up when bloating becomes painful When farting stops being Funny One in five people report excess intestinal gas And if I'm being generous, one in three people said that they were bloated recently. So bloating is a really big problem. Bloating is also a nicer way to say it than like I'm very flashulant. I think people wna say, you know, I feel bloated It's kind of a very difficult problem to solve because there's multiple causes of bloating and there's very few objective measures of like what's going on And so they kind of have to give patients bad advice or give them a series of tests where hopefully all the answers are no. And you end up with this disease of exclusion called IBS. ritable bowel syndrome It's a very common condition, affecting an estimated tencent to fifteen percent of adults in the United States and worldwide It can mean cramping, bloating, constipation, diarrhea, and excessive gas It can be painful and embarrassing And as he mentioned, it's often surprisingly hard to diagnose compared to many other common health conditions Part of the problem is that doctors rely on symptoms people describe rather than something they can measure Things like Do you feel bloated How much you farting which is strange Because if something's wrong with say your heart, doctors can measure it in real time But if something's wrong with your gut, they mostly have to ask you how it feels And therein lies another cruel twist Because fARTS might actually be one of the very best real time signals we have of what's happening inside the digestive system That's because every fart contains gases produced by your gut microbes as they break down food So in each one is information about what your microbes are eating active they are, how well your body is digesting certain foods? And whether something in that system is a bit off Too much gas might mean certain foods aren't being broken down correctly Too little might mean something else is wrong Even the type of gas, hydrogen, methane, It can hint at which microbes are doing the work. In other words, Farts are packed with information The problem is For decades, scientists had no good way to measure them So they studied poop instead poop only shows you the end result what your body didn't use. It doesn't tell you what's happening in real time. or much less pleasantly, they perform dctal tube studies a process that involved inserting a tube into the rectum and directly measuring intestinal gas Not exactly something people volunteer for twice Basically, until recently, getting a real time picture of flatulence was incredibly difficult And that's where Brantley Hall, our expert comes in He thinks there may be a much better way to measure what's happening in our gut. and maybe help people suffering from bloating and IBS in the process It involves smart underwear, bluetooth sensors, and thousands of volunteers willing to strap them on and record their guests We'll get there But first, it helps to know this Humans have been fascinated by farts for centuries Long before microbiome labs, there were court jesters, stage performers, old timey scientists all trying to understand or profit from, the art of passing gas That wonderfully weird history is next after the break Before FAarts were data and science, they were a mix of entertainment and embarrassment That strange combination seems to be universal. Across cultures and centuries, we seem to laugh at farts and be deeply ashamed of them Why Part of it may be the surprise factor A sudden involuntary noise from a part of the body that we spend most of our lives pretending doesn't exist partart of it It's about decorum Humor often comes from breaking social rules, and few rules are clearer than don't make bodily noises in public Ft is funny because it's a tiny social disaster, which shatters decorum Some of the oldest recorded jokes are basically fart jokes. Ancient Greek comedy used them to great effect Medieval manuscripts illustrated them. And in twelfth century England One man even turned farting into a royally sponsored profession He was commonly called Roland, the Farter. According to Fe records from the time, Roland was given land from King Henry II in exchange for performing at court every Christmas His act, listed in Latin, is loosely translated as a jump, a whistle and of art simultaneously The act clearly involves some pretty precise coordination timing and sphincter control Sure, it sounds a bit ridiculous, but it also tells us something useful Fart humor was not just for kids or caaverns, it made it all the way to the King's court And then a few centuries later in Japan Artists turn flatulence into visual spectacle In the Edo period, scrolls in forformally known as Fart battles show people using fRs like weapons. People bend over and blast each other while others fan the air And then in seventeen eighty one, Benjamin Franklin gave Farts the Elightenment treatment In a satirical essay often called Fart Proudly Franklin argued that passing gas was natural. The real problem was not the gas itself, but the smell fake proposal, with scientists should figure out how to make flatuls pleasant, even perfume like So fast forward to modern times, and yes, there are still professional fers Google it Here's microbiologist Brantley Hall again on what those acts may truly be offering. I think some of them are truly eating a very high high fibberid itiet and farting a lot. while others are sucking air into their rectum and expelling it on demand, which is also very interesting. I don't know how they found they have that skill But eventually, Flatulence made its way off stage and into the lab It took a while, but by the early twentieth century, gastroenterologists began measuring intestinal gas Not because parts were funny, but because as we mentioned, they were clues. In the nineteen seventies, gastroenterologist Michael Levck became a leader in the field. Widely called the King of Farts, he published extensively on flatuls and the gases inside them But science was still mostly stuck with the problem How do you actually measure a fart other than asking, So, how much you farting Then in the early two thousands, something happened and it wasn't about farts at all It ended up changing Fart science anyway Scientists got much better at sequencing and reading DNA Before that, studying gut microbes was incredibly hard Many of these microbes are anaerobic, which means they often may die when exposed to oxygen So if you tried to grow them in a normal lab dish, they might die before you could study them It was sort of like knowing there was an entire city living inside the gut, but being locked outside the gates New DNA sequencing changed that Instead of trying to grow microbes, scientists could just take the samples off and from stool and read the genetic fingerprints the microbes left behind Suddenly they could identify who was living there without needing to keep them alive in a lab And that led to huge projects like the Human Microbiome Project and the American Gut proroject where thousands of people sent in samples to help map the hidden ecosystem inside us From these pivotal studies and related works, we learned Western guts look different than non western guts that humans have less microbial diversity than many primates. that your dog may be sharing part of his microbiome with you And that diet, especially fiber, shapes a huge part of this invisible world For the first time, scientists could really see the cast of characters living inside the gut And that made one thing even more frustrating They knew more than ever before about who was there. But they still struggle to understand what those microbes were doing in real time Why did one person eat beans and feel fine? while another looked like they'd need to move up a pant size before the next meal Why did some people live with constant bloating, pain and gas, while others didn't? Getting some data from Poop could help But that picked up information at the end of the process Basically, it show the leftovers Ats were different They were real time evidence of microbial activity while digestion was still happening And yet even with all this new science Doctors were still often stuck asking the same question You guessed it by now. So, how much are you farting And that's where our microbiologist, Brantley Hall comes in. again. notot because he set out to become a FAart scientist Actually, it started because a key experiment in his lab kept failing We're microbiologists and Gut microbes can't grow in atmosheric oxygen, so we have to grow them in a special bubble It's kind of like if you saw a Sinfeld bubble boy It's like we're growing microbes inside of that bubble, but that bubble has no atmospheric oxygen in it. So we were trying to measure hydrogen in there. Our sensor wasn't working And so we thought, maybe we should take it out and fired on it because that's the microbial metabolite we're trying to measure as well So I took it home over one weekend and parted on it. and the signal was extremely strong And we thought, oh, well, maybe we're doing this all wrong Inead of doing it, you know, in the lab, we should do it in people Instead of trying to recreate gut chemistry in the lab Why not measure it where it's actually happening in actual humans living actual lives, eating actual sandwiches at lunch The problem was until very recently, there was no practical way to do that. You couldn't exactly send people home with a rectal tube But in recent years, consumer electronics have been getting dramatically smaller Wireless chips, tiny batteries, Bluetooth transmitters Basically the same miniaturization that gave us things like AirPods suddenly made it possible to build tiny, wearable gas sensors The technology we're using is brand new. There's been a revolution electronics. I think AirPods and wireless headphones in general have driven a lot of this innovation. So when people ask like, what is the actual electronic basis of our smart underwear device? It's kind of like an airPod with a nose. Air pod with a nose And that's how fart science moved from the deeply imprecise So how much are you farting? to something much more useful Dr. Brantley Hall's Human Flattis Alice. His lab is building tiny wearable sensors, basically smart underwear that measure the hydrogen in your flatulence over several days while you're going about your normal life Remember, hydrogen is a huge part of our farts And that's only part one with a smart underwear Part two is food Participants also photograph everything they're eating, so Brantley's team can compare meals, microbes, and flashlens patterns at large scale. The goal is to finally define what normal actually looks like If someone goes to the doctor in the future and they say, I have excess flatulence I hope to give the doctor the baseline for what access might be And so we'll have thousands of people rather than just dozens of people And we'll be able to understand how far from the average this person actually is and whether it likely represents a problem or not Brantley sent me one of the same kits for mailing to thousands of volunteers. So I open the package Inside, there's a quarter size sensor that goes on the outside of your underwear He and his team produced it with a three D printer in his lab And then there's a clip to hold the sensor onto your underwear, and several spare clips as well. There are instructions that politely describe with the diagram, the target zone of where to place the sensor And then there are details in there about how to download the app, upload the data There's also a charger similar to the one I would use for my phone Paul asks people to wear the device for most of three days Taking it off during intense exercise, showers And if you're going through airport security I guess that makes sense. The censor may look suspicious and be hard to explain So each morning, you're supposed to briefly take it off, plug it in, and upload your results The payoff You get your own personal flatulence report Big farts, small farts, patterns, timing, and also how you are comparing with others in the study, your percentile So on two of the three days, I found that I was right around average. But on the day I chowed down on bean tacos The sensors definitely detected the aftermath Bike City, as you may expect But people don't typically process food within hours of eating So I asked Brantley, what was going on there He told me there were several possibilities Some of that gas could be early fermentation from the fibers in the beans But more likely, it's actually what's called the gastrocholic reflex Essentially, when you eat, your gut gets a signals to start moving everything along. So if gas from earlier meals had been building up, Dinner basically opens the floodgates Or maybe he said it was a combination of the two So it's not as simple as beans in gas out I was fascinated As Braantley explained, the timing combined with the food logs and the fart sensors tells us something about transit and fermentation that you'd never pick up from bloating symptoms alone. And as for Brantley The real hope for this work goes beyond curiosity. As we mentioned, for many people with IBS or chronic bloating today, the medical advice can feel brutal It's basically stop eating almost everything you enjoy Brantley wants to do better. Right now people get an extreme diet. where they can basically eat nothing containing fiber And that exclusion d is extremely hard It kind of ruins your life, because you can't go out to eat. You have to eat all the very defined food, very boring food But if we could figure out people's individual triggers We could have people eat a more diverse, delicious diet rather than this extremely restrictive diet hopefully that will lead them to reduce their symptoms while still kind of enjoying life and eating healthy food. That really is the payoff, the freedom from the guesswork that for years has been the default in this painful area. Brantley hopes that he'll have his first raft of data for publication later this summer hisis dream to begin to fill in more details about which foods cause problems for your bodies and which ones aren't beyond you know, issuing general advice about He wants us to eat well and to still enjoy our lives We started with a simple question is a fart It turns out, it's kind of the end of digestion food your body couldn't break down, handanded off to trillions of microbes turned into gas and then eventually released And we've spent centuries laughing at that release We turned it into performances for the King of England Battles in Japanese art, even a satirical essay by a founding father But now scientists like Brantley Hall are asking whether we should also listen to it Because for people living with real pain Understanding flatulence could mean something much better. Real answers And maybe that requires changing the way we think about farts in the first place I think that We should kind of d stigmatize them so that people can more readily eat healthy food. I think like our diet is a crisis and that we need to eat healthier foods One of the things we need to do to overcome, you know, this dietary barrier is kind of accept farts and talk about them more and measure them more and not sigmatize them the way we do today Maybe that's the real lesson here For most of human history when we heard of Fart We laughed orr we cringed We were wrong becausecause the whole time it was information. hiding in plain sight And only now with sensors small enough to actually capture it in real life Are we starting to catch up Not just to laugh But to listen And maybe finally to understand Many thanks to Brantley Hall for joining us in today's episode and thanks to all of you for listening to fourteen forty Explorers I'm Deina Fine Marin Make sure to follow the show and leave us a review on Spotify, Apple, or wherever you listen to your podcasts And let us know what you thought of this episode at podcasts at join fourteen forty. com fourteen forty Explorers is a production of Rhyme media for fourteen forty media This episode was produced by Nicolo Minoni and edited by Dan Bobkoff Our fact checker is Alice Jones and our sound designer is Jay Cowitt The executive producer at Rime is Dan Bobkoff, and the executive producers at fourteen forty are Sony Cassen and Drew Steigerwall