Episode Details

A listener wrote in after being prescribed low-dose amitriptyline for bloating and fullness that have followed him since his gallbladder came out seven years ago. It didn't do much — so he came back with three sharp questions: what's the actual mechanism, why are the old tricyclics still the go-to drugs despite their side effects, and is anything new being designed specifically for functional dyspepsia? This episode works through the gut-brain axis, visceral hypersensitivity, gastric accommodation, and the duodenal frontier, and lands on an uncomfortable finding: the drugs that work are the drugs that are messy. We also flag an honest limit — post-cholecystectomy symptoms are not the same as idiopathic functional dyspepsia, and the evidence base is an extrapolation. Episode #007453 — open it directly at myweirdprompts.com/007453