Know the story.

Symptoms began in 2020 with a now-familiar pattern: nausea and abdominal bloating rising after meals, typically within 30-120 minutes. Symptoms began during COVID/family arguing and after a case of (self-diagnosed) dengue fever. Early work-ups showed bile reflux on endoscopy (with a negative CT). He experiences occasional vertigo in the evenings and waves of pain lasting ~45 minutes (always accompanying nausea), and has psoriasis on his forehead. Over time he noticed that nausea and bloating correlate ~1:1.

Through extensive self-experimentation he identified three decisive meal variables: size, speed, and fat content. Meals over ~500–600 kcal, fast eating, or >7g fat per 400cal consistently triggered a post-prandial wave; in contrast, splitting meals into smaller servings and chewing slowly could prevent a flare altogether. He documented this repeatedly, and on several occasions noted immediate improvement simply by pacing the meal and/or finishing with a walk. When he drifted from these rules, symptoms returned. He learned that dairy is a trigger, and avoids it completely.

Acid support (betaine HCl) was tried early and repeatedly, but each structured trial made things worse - more gas/burping and sharper post-prandial nausea. In late October 2024 a high-dose HCl experiment culminated in the “worst nausea of his life,” and he abandoned the approach. Since then he has treated HCl as contraindicated for him.

He briefly tried EMDR and Somatic Experiencing. Although a session could coincide with a short window of feeling better, he disliked the modalities and stopped quickly. By contrast, movement proved to be a potent, repeatable intervention: gym sessions and even brisk walks could collapse an active flare quickly. He has many entries where a workout immediately improved nausea from a moderate/high level to minimal. The same “movement effect” shows up during high-novelty days: he had some of his best health at amusement parks, with little to no nausea despite imperfect food choices. Together these observations suggest a strong autonomic component superimposed on food mechanics.

The next major turning point was antimicrobial therapy. Beginning in late 2024 and continuing through 2025, structured cycling of antimicrobials (berberine, oregano, allicin, neem, and Biocidin) produced a clear, durable reduction in gas, bloating, and nausea. When he drifts off antimicrobials (supply issues, travel), nausea tends to worsen. In parallel, pre-meal digestive enzymes and digestive bitters became essential tools. These have remained in place even when he simplifies the rest of his supplement stack.

A more recent but important lever is vagal nerve stimulation. Consistent sessions with a VaguStim device (plus simple humming drills and cold showers) reduced the frequency and intensity of post-prandial waves. This effect, combined with the movement/novelty effect, maps to an autonomic component to his symptom loop.

Supplement format also mattered. Taking too many pills throughout the day was stressful and made him identify with his illness, exacerbating symptoms. Switching to gummies was easier, but correlated with more gas. Switching to liquids/chewables and pruning non-essentials improved tolerance. In early 2025 he developed swallowing/pill-sticking episodes that could themselves trigger nausea, so he now prioritizes smaller capsules or liquid forms.

Contextual modifiers remain important. Travel is the most consistent destabilizer: larger/fatty meals, sleep loss, and skipping cornerstone habits often cluster on travel days and precipitate several-day setbacks. Conversely, predictable food environments (e.g., closely controlled private chef meals) and structured routines (consistent supplements, movement, VaguStim) produce his longest stretches of near-normal days. He also noted a few adjuncts with situational benefit (e.g., a wearable neuromodulation band and, on one morning, caffeine making him feel “normal”), but none rival the foundational regimen above. He continues to slowly lose weight because it's challenging to intake enough calories between his meal timing constraints, low-fat meals, and overall 'food-makes-me-feel-worse' pattern.