[Music] A student ate 20 protein bars every day for 6 weeks. This is what happened to his colon. Jay-Z is a 22-year-old man presenting to the emergency room with abdominal pain and obstation, a complete constipation. He tells the admitting doctor that it had been days since his last bowel movement. Every half hour, he'd feel a cramping so hard that his ears would start ringing. It was the worst pain that he had ever felt in his life. Jay-Z was a college student. He made friends with a girl in his class, Lorie. They studied together all the time. They'd go over lecture materials late, and then they'd get late night takeout with each other as a study break. Sometimes, one of them would forget about class announcement, but because they were always in touch, they served as constant reminders to one another to make sure to never forget anything. They were important to each other. But then Jay-Z started feeling another way about Lorie and she didn't reciprocate. At first, she wanted to stay friends, but as he kept messaging her non-stop, she eventually didn't even want to be that either. Every day after sending her all of those messages, he would wait for her to reply, but he was never going to get anything back again. Sometimes his phone would go off and he'd get really excited, but it always turned out to be someone else messaging him. Depressed, Jay-Z looked in the mirror. He couldn't remember a time in his life when he hadn't been brutally rejected. It's just that this time he really thought that she liked him back. He looked in the mirror and he made a realization it was time for him to go to the gym. Jay-Z was building muscle. He read online about how you needed to do more than just lift weights. What he needed was to eat protein. He noticed how he wasn't eating as much meat and eggs as he originally thought. Actually, he had always eaten a high-fiber diet since he was a kid. lots of vegetables. He started supplementing with protein bars. He saw that these bars were cheaper than regular food. He also noticed that these bars were calorie dense. So, for every bite of bar, it was a shortcut to getting his daily requirements. Jay-Z read that he needed 1 g of protein per pound of his target body weight daily in order to build muscle. If you wanted to be 400 lb of muscle and each bar had 20 gram of protein, then it meant that eating 20 of these bars daily was the way. These were so cheap, so no problem. In his mind, he has to put himself through the fire. Suffering is the only way that he can become his true self. And he started to eat. But then things started to happen. One day, Jay-Z noticed during a bowel movement that it felt like clay. This is going to leave skid marks everywhere, he thought. And he was right. But then he stopped having bowel movements altogether. He noticed that his gut was growing. Jay-Z had been making gains in the gym. He could feel the pump happening in his muscles. The stomach's a muscle, so maybe it's getting jacked now, too, he thought. But as the days passed, Jay-Z had less of an appetite. He felt more and more bloated. The more pain he felt, the happier he convinced himself that he was, because through the fire was the only way to salvation. One morning, Jay-Z woke up on the couch. There was a trash can nearby. He opened a protein bar breakfast and swallowed a bite. But he felt a sour taste flood into his mouth from the bottom of his cheeks like the protein bar was coming right back up. But nothing came up. But he felt something move inside his abdomen. And then the hurt became too much. It became swollen. Suddenly, pain was spread all over his entire midsection. He musters up the strength to bring himself to the emergency room where we are now. At examination, the doctor noticed Jay-Z's distended abdomen and his diffuse pain. He didn't have a fever, and that's important to know because it means that his gut hasn't perforated yet, and it hasn't leaked its contents and bacteria out into his body. Given his recent history of abdominal pain and complete constipation for days, the medical team has some idea of what's happening. When they ask him what he had eaten recently, he tells them 20 protein bars every day for at least the last 6 weeks. And this gives them some clues as to what's happening. Protein bars are usually made of dairy proteins, whey, casein, and milk. Just these proteins as powders, especially casein, becomes thick with water. These are generally higher quality than soy protein bars that you'll find. They become thick and viscous when you grind them up with a little bit of water. Some of this is from the protein, but depending on the bar, there's other ingredients that make it thick. Not only do you want plenty of water with this, but you also just want to make sure you don't eat too many of these because if this gets stuck in your gut, it's over. It's done. Your body's going to be digesting some of this, and that's fine. But there's a limit here. Speaking of skid marks, it's not that the body won't absorb some of the nutrients in the bar, but if not enough water is taken with certain bars, it might be hard to move this through your gut if other foods and drinks are consumed later, which is a problem because Jay-Z ate only protein bars every day for 6 weeks. An abdominal X-ray reveals a markedly dilated bowel in the abdomen with the apex of the dilated loops pointing towards the upper right quadrant. This means that something's wrong with Jay-Z's large intestines. But what is it? The word gut refers to the gastrointestinal tract. It's the stomach and the small and large intestines. Bowel refers to just the intestines of which there are small bowels and large bowels. When you eat, you chew the food in your mouth and your stomach churns it. These are mechanical processing. Saliva and stomach enzymes act on the foods to chemically process them. The mechanical and the chemical processing are done together to break down the foods so that once they enter the bowel, their nutrients can be absorbed. The small intestines absorb fat, protein, and carbohydrates. It's long so that the contact time with kim, the mechanically and chemically processed food is maximized. But then kim enters the large intestines where its water is absorbed. And this is where it becomes feces. What can go wrong here? Well, there's two things to know about large bowel anatomy. First, in order to absorb nutrients and water from food, there needs to be a massive blood supply going through the intestines. You don't want to disturb this ever. The second thing to know is that the large intestines form a rectangle in the abdomen. When food comes in from the small intestines, it goes up the ascending colon, crosses over through the transverse colon, goes down the descending colon, and then through the sigmoid colon before making its way out as the feces that you're familiar with. But here's the problem. The GI tract is a continuous tube from your mouth to your other end, and tubes can get blocked. It's long, so there's many different points of failure. The gut is the one internal body structure that comes into contact with external things all the time. So, there can be a variety of problems. Because it's extractive, when a blockage happens, that blockage gets harder. The kim piles up, continues to get harder, making the blockage worse. that adds to the pressure on that blockage and then the walls of the gut start to stretch as more and more food is added on because there's a huge blood supply going to the gut. This stretch compresses blood vessels starving that part of the gut of oxygen. Gut is a muscle and muscles need a lot of oxygen to function. When it starts to starve of that oxygen, the tissue can start to become damaged before rotting away. This will cause it to perforate and leak the contents of the gut out into the body and all the bacteria and fluids and what would have been feces all come out and cause an infection. The CT scan and X-ray did show that Jay-Z had a blockage, but something more was happening. The sigmoid colon doesn't have an exact location. It's just the segment of large bowel between the descending colon and the rectum. Everyone has different anatomy and the gut is highly variable. The intestines are attached in the abdomen near your back by an organ called the mezzentary. This has fat, blood vessels, lymph nodes, and nerves all going to the intestines. Most of the colon is well attached to the posterior abdominal wall, so it doesn't move. But the sigmoid colon isn't attached to this. The part of the mezzentary that it's attached to is variable, meaning that from person to person, sigmoid colon length is variable. In some people, it's short. In others, it's long. so long that it loops into the right side of their body and it can also ascend high into the abdomen. Jay-Z's anatomy is a long sigmoid colon, a diet of excess dense protein bars with limited water loaded and elongated and distended both ends of his sigmoid colon. This brought these ends together. Once this was in place, all he had to do was strain on the toilet or even just cough, causing some tension in the abdomen and his sigmoid colon twisted on itself. At first, some air and some feces entered into the loop. But as the twist became tighter, a complete obstruction developed. This caused his abdomen to swell. This is called a sigmoid vvulus. Very soon, the pressure on the messenteric blood vessels will block blood flow to his large intestines, choking it off of oxygen and ending with bowel gangrine. This will cause permanent damage, and contents of his gut will leak out into his abdomen, causing a life-threatening emergency if this isn't taken care of immediately as he's sent in for surgery. Given that protein digestion can be a complicated process happening in the stomach with minor parts happening in the rest of the gut afterwards, a gross excess of protein bars taken without enough water can have trouble moving through part of the gut that absorbs water from that food. This constipated him, it stretched his sigmoid colon, and because his anatomy has a long sigmoid colon, it created the perfect condition for things to twist. In the operating room, doctors sent a scope into his body. Because it doesn't look like his intestines have perforated just yet, they may not have to cut him open. They can try to detox his colon and decompress it. Something that Jay-Z could have done to prevent this was to eat fiber. If it was food, it would be found in green leafy vegetables. If it was supplements, it would be psyllium husk powder or capsules, not inulin that you would find in fiber gummies or chewable tablets. Fiber is a kind of sugar, but humans can't digest it. This means that it passes through the gut without getting changed. Sugars have the ability to draw water towards them. So, fiber draws water into the gut and keeps it there, softening the stool. Had Jay-Z consumed fiber with his protein bars and really just eaten any other food, too, he might not have had this problem. But there's something else to know. Ironically, eating too much fiber all the time can also cause sigmoid vvulus. Plant material is undigestible. When extreme excess is eaten, it can linger with water and stretch and distend the sigmoid colon and predispose one to torsion. So Jay-Z's prevention, if also taken to the extreme, can cause the same problem that it could prevent. Surgeons were able to successfully detose and decompress Jay-Z's colon. The operation took less than 15 minutes. When he recovered, he was told about not eating so many protein bars all the time as he was able to make a full recovery. Fellas, I've been there before, too. The point of the gym is to build positive habits, specifically discipline, not self-imulation. No excuses, no substitutes. You got to do it means that you got to do it. But be smart about how you want to do it. People who try to argue with that shall be together alone with their excuses. Thanks so much for watching. Take care of yourself and be