Dr. Arim

You finished the Rifaximin course. The bloating went away. Three weeks later — it's back. If that's your story, the antibiotic wasn't the problem. The problem is that your SIBO's root cause was never addressed.

This video isn't another food list. It's a full 10-day roadmap — diet, fiber, probiotics, and post-antibiotic strategy, mapped day by day. Keep a pen and paper next to you..

Welcome! Here, we focus on providing evidence-based medical insights and practical strategies to help you take control of your digestive health. Don't forget to Subscribe for weekly videos on gut health, wellness, and science-backed treatments.

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A stone showed up on your ultrasound — does it need to come out, or can you wait? What actually separates piles from a fissure? And there's one hernia where the surgeon himself will tell you not to operate first.

In this episode Dr. Arim Khan — MBBS, MD Microbiology (resident), background in psychology, advanced training in gut health and the gut microbiome is joined by Dr. Ismail Khan — MS (Surgery), MRCS (England), Minimal Access Robotic and Bariatric Surgery. He operates on gallbladders, piles, fissures, hiatus hernias and obesity every week, but this entire hour stayed on one question: which of these problems resolve with lifestyle, which need proper medical evaluation, and when is surgery genuinely necessary.

We also covered where the myth of a lifelong fat-free diet after gallbladder removal came from, why the same stone measures differently on two ultrasounds, what's being sold as "laser" treatment for piles, and the red flags people ignore for years because they assume it's just gas.

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Can anxiety actually cause your IBS — or is it the other way around? In this episode of The Clinical Code, Dr. Arim | Microbiologist sits down with Dr. Azhar Farooqui, MD Psychiatry, Professor at the Department of Psychiatry, IIMSR Lucknow, to break down the science behind the gut-brain axis — and why your bloating, loose motions, and brain fog might be starting somewhere other than your stomach.

If your reports keep coming back normal but your gut still isn't — this conversation might explain why.

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Can your gut health really cause eczema, acne, or psoriasis? In this episode of The Clinical Code, Dr. Arim | Microbiologist sits down with Dr. Sonal Makhija, MD Dermatology, AFMCP (IFM, USA) to break down the science behind the gut-skin axis — and why conditions like Leaky Gut, SIBO, and IBD might be showing up on your face, not just in your stomach.

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Most people are told they have IBS and stop there. But "IBS" is a label, not a diagnosis — and if you don't know which type you have, every strategy you try is a guess.

In this session, Dr. Arim Khan (MBBS, MD Microbiology Resident, Advanced Training in Gut Microbiome from Stanford, BSc Psychology) breaks down the exact difference between IBS-C, IBS-D, and IBS-M — why stool frequency is the wrong way to identify your type, what the Bristol Stool Form actually tells you, and how the mechanisms behind each subtype differ.

You'll also get a simple 14-day framework to track your own pattern scientifically, instead of guessing.

Full video link in bio

Most people are told they have IBS and stop there. But "IBS" is a label, not a diagnosis — and if you don't know which type you have, every strategy you try is a guess.

In this session, Dr. Arim Khan (MBBS, MD Microbiology Resident, Advanced Training in Gut Microbiome from Stanford, BSc Psychology) breaks down the exact difference between IBS-C, IBS-D, and IBS-M — why stool frequency is the wrong way to identify your type, what the Bristol Stool Form actually tells you, and how the mechanisms behind each subtype differ.

You'll also get a simple 14-day framework to track your own pattern scientifically, instead of guessing.

DISCLAIMER
⚠️ This video is about lifestyle modification and understanding your pattern. It is not medical advice, and it is not a substitute for an in-person clinical evaluation. Red flag symptoms are covered in the video — if you have any of them, see a doctor in person.

The content of this video is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider regarding any medical condition or before making changes to your diet, supplements, or medication. Dr. Arim Khan does not provide acute treatment or prescriptions through this channel.

When I think about “leaky gut”, I don’t start with supplements. I start with what is disturbing the barrier + microbiome?

Some common drivers I look for 👇

→ Gut infections
→ Microbiome disruption / loss of diversity
→ Low fibre + low polyphenol diet
→ Reduced SCFA production
→ Mucus-layer disruption
→ IBD / chronic gut inflammation
→ Celiac disease
→ Frequent NSAID use
→ Excess alcohol
→ Ultra-processed dietary pattern
→ Altered bile-acid metabolism

And remember — dysbiosis ↔ inflammation ↔ barrier dysfunction can become a loop. So “leaky gut” may be a consequence, not the actual root cause.

Which one do you think could be yours? And why?

There are multiple layers of defence:

Microbiota → Mucus → Epithelium + tight junctions → GALT / mucosal immune system

And that mucus layer is far more biologically active than most people realise.

Goblet cells continuously produce MUC2-rich mucus, creating spatial separation between luminal microbes and the intestinal epithelium.

But mucus is also food for certain organisms.

Akkermansia muciniphila, for example, is a specialised mucin-degrading bacterium.

That sounds bad—but normally it isn't.

A healthy gut is continuously running a cycle of:

Mucin degradation → microbial metabolism → SCFA production → epithelial signalling → mucus renewal.

The problem may arise when the ecosystem loses adequate microbial substrates.

A chronically fibre-poor dietary environment can push microbes toward greater utilisation of host-derived mucus glycans.

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We talk a lot about what a woman should eat before pregnancy.

But what about the father?

A recent prospective cohort study published in Annals of Internal Medicine found that lower paternal vitamin B12 and folate concentrations around conception were associated with a higher prevalence of birth defects in offspring.

That does NOT prove that low B12 or folate in fathers causes birth defects.

But biologically, the finding makes us think.

S***m contributes more than just 23 chromosomes.

During spermatogenesis, B12 and folate are deeply involved in one-carbon metabolism — supporting nucleotide synthesis, DNA integrity and methyl-group metabolism, processes relevant to epigenetic regulation.

So preconception nutrition shouldn't automatically be treated as a “women-only” conversation.

Where does B12 come from?

Vitamin B12 is naturally concentrated mainly in animal-derived foods:

🥚 Eggs
🥛 Milk, curd & other dairy
🐟 Fish and seafood
🍗 Chicken and other meats
🥩 Red meat
🫀 Liver and organ meats — particularly concentrated sources

For vegetarians, dairy can contribute B12, while fortified foods may also help. For strict vegans, reliable natural dietary sources are extremely limited, so B12 status deserves particular attention.

And folate?

Think green leafy vegetables, legumes/dals, beans, peas, citrus fruits and other folate-rich plant foods.

But here's the important part:

Food first doesn't mean deficiency should be treated with food alone.

If B12 or folate is genuinely deficient, identify why — dietary insufficiency, malabsorption, medication effects or another underlying cause — and correct it appropriately rather than blindly taking high-dose supplements.

Preconception health isn't just:

“What should the mother take?”

Maybe the better question is:

“How metabolically and nutritionally prepared are BOTH parents before conception?”

The father contributes 50% of the nuclear DNA.

It makes little biological sense to start thinking about his health only after the pregnancy begins.

📚 Annals of Internal Medicine, 2026
📚 Hoek et al., Molecular Nutrition & Food Research, 2020 — systematic review & meta-analysis