Reversing Crohn's and Colitis Naturally

Fecal microbiota transplantation (FMT) has become one of the most intriguing—and misunderstood—tools in the world of gut health. In this episode, Josh breaks down what fecal transplants actually do, where the science is strongest, and why they should not be treated as a universal “miracle cure.”
The conversation begins with the basic science behind FMT: transferring microbes from a screened donor into a recipient with the goal of restoring microbial diversity and improving the ecology of the gut microbiome. Josh explains how this relates to intestinal health, immune-system regulation, microbial metabolism, nutrient production, and the overall balance of the gut ecosystem.
A major focus is the established use of FMT for recurrent C. difficile infection, including the research discussed in the episode showing dramatically better outcomes than some conventional approaches. Josh then explores why people with Crohn’s disease, ulcerative colitis, IBS, SIBO, and other chronic gut conditions are increasingly interested in FMT—even though the episode emphasizes that applications outside recurrent C. difficile remain investigational.
The most important part of the discussion is what happens when an FMT fails. Josh identifies three major considerations: the relationship between the immune system and the microbiome, the “terrain” or environment into which the new microbiome is introduced, and what happens after the transplant. Factors discussed include chronic stress, environmental exposures, infections, diet, alcohol, processed foods, prebiotics, and other aspects of post-transplant care.
The episode also addresses the serious risks associated with DIY fecal transplants and explains why donor screening and medical oversight matter.
For anyone interested in gut health, inflammation, the microbiome, root cause, or the relationship between the immune system and chronic inflammatory disease, this episode offers a more nuanced way to think about FMT: not simply as adding “good bacteria,” but as attempting to rebuild an entire microbial ecosystem.

TOPICS DISCUSSED:
Why FMT Is Gaining Popularity + The Central Failure Problem
What Fecal Microbiota Transplantation Actually Is
FMT For Recurrent C. Difficile And What The Research Shows
FDA-Approved FMT Products And Delivery Methods
The Microbiome, Microbial Diversity, And Immune-System Relationship
FMT Delivery Methods: Enema, Capsules, And Colonoscopy
DIY Fecal Transplants And Serious Safety Risks
Why Fecal Transplants Fail: Immune System Vs. Microbiome
The “Terrain” Problem And Post-FMT Care
FMT For Crohn’s, Colitis, And Other Conditions: Promising But Investigational

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IBS and IBD are often confused with one another, but they are not the same condition—and understanding the difference may be one of the most important steps in making sense of chronic gut symptoms.
In this episode, Josh Dech breaks down the distinction between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. He explains why IBS is generally considered a functional disorder, while IBD involves structural changes such as inflammation, ulceration, strictures, and tissue damage.
The conversation also explores the surprising similarities between IBS and IBD. Both can involve abdominal pain, diarrhea, constipation, urgency, bloating, dysbiosis, gut-barrier disruption, environmental triggers, stress, lifestyle factors, and medication-related aggravation. Josh also discusses why people with IBD can continue experiencing IBS-type symptoms even when their inflammatory disease is considered to be in remission.
A major focus of the episode is the relationship between IBS and SIBO—small intestinal bacterial overgrowth. Josh highlights research suggesting substantial overlap between IBS and SIBO, particularly in people experiencing mixed constipation-and-diarrhea symptoms.
From there, he introduces a provocative hypothesis: could some cases of IBD potentially develop following an earlier IBS/SIBO pattern? Josh walks through his own population-attributable-risk thought experiment and arrives at a theoretical range suggesting that a substantial percentage of IBD could potentially be connected to this progression.
Importantly, Josh emphasizes that this is a theory requiring further research—not an established conclusion.
The episode ultimately raises a bigger root-cause question: if certain forms of gut dysfunction can be identified earlier, could earlier investigation and intervention potentially change the trajectory of chronic inflammatory gut disease?
For anyone interested in gut health, the microbiome, inflammation, immune-system dysfunction, SIBO, IBS, Crohn’s disease, ulcerative colitis, or root-cause approaches to chronic illness, this episode provides a provocative framework for thinking about where inflammatory bowel disease may begin—and whether there could be opportunities to intervene earlier.

TOPICS DISCUSSED:
IBS Vs. IBD: Fundamental Differences And Similarities
IBS Symptoms, Diagnosis, Subtypes And Rome Criteria
SIBO And Its Relationship To IBS
IBD Symptoms, Inflammation And Structural Damage
Crohn’s Disease Vs. Ulcerative Colitis
Shared Triggers: Stress, Environment, Medications And Lifestyle
The Gut-Brain Axis, Dysbiosis And Gut-Barrier Dysfunction
IBS/IBD Prevalence And Diagnostic Changes
Josh’s IBS → SIBO → IBD Population-Risk Thought Experiment

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Crohn’s disease and ulcerative colitis are often approached primarily through the lens of symptom management, medication, and surgery. But what happens when we start asking a different question: What may have contributed to the development of the disease in the first place?
In this episode, Josh Dech explores a root-cause approach to inflammatory bowel disease (IBD), challenging listeners to look beyond the label and investigate the layers that may influence gut health, inflammation, the microbiome, and immune-system regulation.
The conversation covers the relationship between diet and IBD, including the Crohn’s Disease Exclusion Diet (CDED), Ulcerative Colitis Exclusion Diet (UCED), and Specific Carbohydrate Diet (SCD). Josh also discusses research involving supplements and probiotics such as curcumin, VSL#3, vitamin D, Boswellia, TUDCA, and wormwood—while emphasizing an important distinction: something that helps manage inflammation or induce remission is not necessarily the same thing as identifying and addressing an underlying driver. 
The episode then moves deeper into the root-cause framework. Josh explains why he believes a detailed personal history can reveal important patterns involving early-life factors, antibiotics, food sensitivities, environmental exposures, stress, and microbiome disruption. Rather than automatically ordering extensive testing, he describes using history to determine which potential drivers deserve investigation first.
Several case examples illustrate this approach, including stories involving suspected mold exposure, repeated antibiotic use, structural changes to the digestive tract, and a child with severe ulcerative colitis.
For anyone interested in gut health, IBD, inflammation, the microbiome, immune-system function, and functional medicine, this episode offers a thought-provoking examination of what it means to truly look upstream.

TOPICS DISCUSSED:
The Root-Cause Philosophy Behind Crohn’s And Colitis
Medication, Remission, And The Distinction Between Management And Root-Cause Work
Dietary Approaches To IBD, Including CDED, UCED, And SCD
Supplements, Probiotics, And Evidence Around Remission
Microbiome Disruption And Immune-System Regulation
The Importance Of A Detailed Personal And Medical History
Antibiotics And Other Potential Contributors To IBD Risk
Environmental Exposures, Particularly Mold
Case Studies Involving Patients With Crohn’s/Colitis

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Finding the root cause of Crohn’s disease, colitis, diverticulitis, IBS, and other chronic gut conditions is rarely as simple as ordering one laboratory test. In this episode, Josh Dech explains why a history-first approach can be more valuable than immediately ordering an expensive battery of functional medicine tests.
Josh walks through how he investigates the timeline leading up to chronic gut symptoms, including events that may have occurred months, years, or even decades before diagnosis. He discusses the relevance of factors such as antibiotic exposure, food poisoning, diet, environmental exposures, childhood illness, birth history, ultra-processed foods, and potential mold exposure.
From there, Josh explains how he uses targeted testing to investigate potential contributors to gut dysfunction. The conversation explores the gut microbiome, dysbiosis, environmental toxins, mold exposure, organic acids, hair tissue mineral analysis, blood work, SIBO/IMO testing, genetics, food sensitivity testing, and other specialized assessments.
A major theme throughout the episode is that more testing does not necessarily mean more answers. Josh explains why overlapping tests can provide diminishing returns and why interpreting laboratory data in the context of a person’s history is critical.
The episode also explores the relationship between the microbiome and the immune system, environmental exposures and inflammation, and why identifying potential upstream contributors may be more useful than simply treating downstream symptoms.
For anyone dealing with chronic digestive symptoms or inflammatory bowel disease and wondering where to start with root-cause investigation, this episode offers a practical framework for thinking about gut health, inflammation, microbiome health, environmental factors, and personalized testing—without automatically spending thousands of dollars on every available laboratory panel.

TOPICS DISCUSSED:
Why A Detailed Health History Comes Before Laboratory Testing
Identifying Events And Exposures Preceding Gut Symptoms
Childhood, Birth History, Antibiotics, Diet, And Microbiome Development
Gut Microbiome Testing, Dysbiosis, And The Gut Zoomer/GI Map Concept
Environmental Toxins And Mold Exposure Testing
Organic Acid Testing (OAT) And What It Can Reveal
Hair Tissue Mineral Analysis (HTMA) And Mineral/Metal Patterns
Blood Work, Immune Markers, MCAS/CIRS, And Advanced Testing
Genetic, Hormone, Food-Sensitivity, And VCS Testing

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SIBO—small intestinal bacterial overgrowth—is often treated as though the bacteria themselves are the entire problem. But what if the overgrowth is actually a sign that something deeper in the digestive system has gone wrong?
In this episode of Reversing Crohn’s and Colitis Naturally, Josh Dech takes a root-cause approach to SIBO and explains why simply trying to eliminate excess bacteria may not be enough to create lasting improvement.
Josh breaks down what SIBO is, why the small intestine normally contains dramatically fewer microbes than the large intestine, and what can happen when bacteria migrate into an environment where they don't belong. He explores how excessive fermentation can contribute to bloating, abdominal discomfort, diarrhea, constipation, malabsorption, irritation, and intestinal dysfunction.
The conversation goes deeper into the systems responsible for keeping the gut microbiome balanced, including stomach acid, bile flow, the migrating motor complex (MMC), the ileocecal valve, secretory IgA, antimicrobial peptides, gut motility, stress, medications, parasites, and other potential contributors.
One of the most important concepts in the episode is the difference between treating the overgrowth and addressing its root cause. Josh compares killing SIBO without correcting the underlying dysfunction to putting out a fire without fixing the gas leak.
He also explains the major SIBO-related gas patterns: hydrogen, methane/intestinal methanogen overgrowth (IMO), hydrogen sulfide, and mixed presentations, including how their symptoms can differ.
The episode explores the possible relationship between food poisoning, post-infectious IBS, antibodies, gut nerves, motility, and recurrent SIBO, along with testing options such as IBS Smart, Trio-Smart, lactulose breath testing, and small-intestinal aspiration.
If you're dealing with chronic gut symptoms, IBS, Crohn's, colitis, bloating, constipation, diarrhea, or recurring digestive dysfunction, this episode offers a deeper framework for understanding how the microbiome, immune system, gut motility, and digestive environment can interact.

TOPICS DISCUSSED:
What SIBO Is And Why Excess Bacteria In The Small Intestine Can Cause Problems
Root Causes And Underlying Dysfunction Behind SIBO
The Different Types Of SIBO/IMO: Hydrogen, Methane, Hydrogen Sulfide, And Mixed
Food Poisoning, Post-Infectious IBS, Antibodies, And The Vinculin/Motility Connection
The Migrating Motor Complex, Motility, And Intestinal Stagnation
The Relationship Between SIBO And Crohn’s/Colitis
Stomach Acid, Bile Flow, pH, And The Digestive Environment
SIBO Testing And Diagnostic Options

Want help with your IBD?
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gutsolution.ca

Video Podcast:
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Facebook: @joshdech.health
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