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What Is SIBO and How Do I Know If I Have It?

There may be something lurking within the gut, when and where it is least expected.

We’re probably already in tune with keeping the large intestine healthy, balanced and well-populated with good bacteria (got probiotics?).

But, what about the health of the small intestine that is located before it in the digestive tract?

The truth is, this is where the serious business of nutrient absorption happens before the waste products are sent through to the large intestine or bowel to be expelled.

As you can imagine, there’s quite a slippery slope that ensues when the flora in this critical stretch of digestive highway goes out of balance.

What is SIBO and what are the symptoms?

At its most basic level, SIBO or Small Intestinal Bacterial Overgrowth is when bacteria or other microorganisms, good or bad, grow out of control in the small intestine – an area that would normally have a low bacterial count, as compared to the large intestine.

Microorganisms setting up shop in this area (colonisation) end up damaging the cells lining the small intestine. This is otherwise known as leaky gut or an increase in intestinal permeability.

This, in turn, impairs the digestive process and overall absorption of nutrients which can exacerbate nutritional deficiencies, allow toxins, infections and undigested protein molecules to enter the bloodstream that then cause widespread inflammation, food sensitivities, autoimmune disorders, and other immune reactions.

There are three types of SIBO; methane SIBO, hydrogen SIBO and hydrogen sulphide SIBO. They release methane, hydrogen and hydrogen sulphide gases respectively causing the below symptoms.

The most common symptoms of SIBO are:

  • Malabsorption issues and malnutrition
  • Weight loss (or gain)
  • Nausea and/or vomiting
  • Abdominal bloating or distension
  • Abdominal pain or discomfort
  • Acid reflux or heartburn (GERD)
  • Excessive gas or burping
  • Constipation and/or diarrhoea
  • Fatigue
  • Skin issues like rashes, acne, eczema and rosacea
  • Aches & pains, especially joint pain

As mentioned, one of the biggest concerns with SIBO is that you’re not absorbing essential nutrients, like protein, carbohydrates and fats properly. This can cause deficiencies of iron, vitamin B12, calcium, and the fat-soluble vitamins A, D, E and K.

What causes SIBO?

According to experts, the causes are not clearly defined but contributing factors to being diagnosed with SIBO can include:

  • Ageing
  • Metabolic disorders including diabetes
  • Chronic pancreatitis
  • Diverticulosis
  • Food poisoning
  • Injury to the bowel
  • Recent abdominal surgery

Coeliac disease is also associated with an increased risk for developing SIBO, and can be of a particular concern, as it disturbs gut motility leading to poor functioning of the small intestine.

Another common condition associated with SIBO is Irritable Bowel Syndrome. As a matter fact, studies have found that SIBO occurs simultaneously in more than half of all cases of IBS. It has even been reported that successful elimination of bacterial overgrowth in the small intestine resolves symptoms of IBS too.

The use of certain medications, including immunosuppressant medications, and proton pump inhibitors (acid reflux medications) as well as heavy metal toxicity, low stomach acid, inflammatory diets, and yep, you guessed it, stress are all thought to be contributors as well.

How can you test for SIBO?

It is typically diagnosed using a breath test in which the patient drinks a lactulose sugar-containing drink and exhaled gases are measured.

You can also test it with a stool test which is less invasion and doesn’t require fasting beforehand like the breath test.

If there are too many bacteria, excess gases (hydrogen, methane or both) will be produced. It should be noted that the reliability of this test is considered less than ideal, but is the only test available at the moment. You can find out more information about the SIBO breath test HERE.

What’s the treatment for SIBO?

Most nutritionists advise to adhere strictly to the “SIBO diet” for at least 4 weeks – which may include any (or all) of the following protocols:

  • Herbal antibiotics, including oregano oil
  • A low FODMAP/SCD, biphasic diet, GAPS and/or AIP diet; unfortunately, this includes avoiding garlic & onions
  • Supporting the migrating motor complex with foods and prokinetic supplements
  • Stress management; yes, this can help heal your gut!
  • Repopulating the good bacteria using probiotics, and then feed with prebiotics.

To learn more about the options for treating SIBO, contact Nutritionist Kate for a free 15 minute fatigue breakthrough call.

References

World Journal of Gastroenterology: “Small Intestinal Bacterial Overgrowth Syndrome”

World Journal of Gastroenterology: “Irritable Bowel Syndrome and small intestinal bacterial overgrowth: meaningful association or unnecessary hype?”

Journal of Clinical Gastroenterology: “Gastrointestinal motility disturbances in celiac disease”

Photo by Alicia Petresc on Unsplash

SIBO-friendly Beef Bone Broth Recipe – Slow Cooker Version

Ingredients:

* no onions, leeks or garlic

2lbs beef marrow bones, thawed, grass-fed preferably

3 large carrots, unpeeled

1/2 medium celery root (not stalks)

Combination of fresh “antibacterial” herbs: few sprigs of each – rosemary, oregano & thyme

2 bay leaves

1Tbs apple cider vinegar, unpasteurized

¼ – ½ tsp himalayan pink salt

Water to desired dilution

Instructions:

  1. Preheat oven to 200 degrees C
  2. Wash and chop veggies into large pieces – large enough that they won’t turn to mush.
  3. Place your bones onto a baking sheet and place into the oven. Cook for 30 minutes.
  4. Tie your herb sprigs into a bundle with cooking-safe string.
  5. Once your bones have roasted, pull them out of the oven and put them directly into a slow cooker. Add the veggies and the herb bundle into the cooker with the bones.
  6. Fill a 6-quart slow cooker with fresh water up to about ¾ inch under the rim. Add the bay leaves, apple cyder vinegar and salt.
  7. Cook in your pot on low; you should have a gentle, rolling boil after an hour or so.
  8. Remove the herbs after about 4 hours, otherwise your broth may look strange from the colours seeping out!
  9. Remove the veggies once they’re very soft, but not yet mushy.
  10. Let the bones cook for a total of 12-48 hours. Strain the broth, let cool a bit, and store in glass jars for up to ONE WEEK in your fridge. You can also freeze the broth if you don’t use it right away.
  11. The appearance of a gel-like substance (natural gelatin) is normal and desired – enjoy the gut-friendly goodness!

What is Leaky Gut?

“Leaky gut” is a popular topic in the health and wellness spheres these days. It’s been blamed for many symptoms and conditions that seem to be all-too-common. Allergies, intolerances, joint pain, even autoimmune diseases can all be linked back to leaky gut. But what is leaky gut? What causes it? What kinds of issues are related to it? And most of all, what can you eat for leaky gut?

What is leaky gut?

Simply put, your “gut” (a.k.a. “intestinal tract”) is a tube that makes up part of your digestive system. It’s not as simple as a hose or pipe; it’s an amazing tube made of live cells tightly bound together. Your gut helps your body absorb fluids and nutrients, digests your food, and houses billions of friendly gut microbes.

It’s also selective to what it allows past its barrier. Your intestinal tract purposefully keeps some things from being absorbed, so they pass right on through to the other end to be eliminated as waste. You don’t want to absorb many harmful microbes or toxins into your body, right?

FUN FACT: About 70-80% of our immune system is housed around our gut, so it’s ready for foreign invaders.

Absorption of fluids and nutrients happens when they’re allowed through this cellular tube into the circulation. And this is great! As long as what’s being absorbed are fluids and nutrients. The blood and lymph then carry the nutrients to your liver, and then around to the rest of your body; this is so that all your cells, all the way to your toenails, get the nutrition they need to be healthy and grow.

How does a gut become “leaky?”

Your gut can become leaky if the cells get damaged, or if the bonds that hold the cells together get damaged. Leaky gut can be caused or worsened by a number of diet and lifestyle factors. Dietary factors like too much sugar or alcohol or even eating things that you’re intolerant to can all contribute to leaky gut.

Lifestyle factors like stress, lack of sleep, infections, and some medications can also be culprits in this area. Sometimes, if the balance of gut microbes inside the gut is thrown off, this can also contribute to a leaky gut.

Any contributing factors that alter the balance in your gut may cause our gut to become “permeable” or leak. At this point incompletely digested nutrients, microbes (infectious or friendly), toxins, or waste products can more easily get into our bodies.

Scientifically speaking, a “leaky gut” is known as “intestinal permeability.” This means that our intestines are permeable and allow things through that they normally would keep out. They “leak.”

As you can imagine, this is not a good thing.

How do I know if I have leaky gut?

What are the symptoms of a leaky gut?

Because so much of your immune system is around your gut, the immune cells quickly recognize a “foreign invader” and start their response. This is normal and good if the gut is working properly and not allowing too many things to “leak” in.

But when that happens too much, and the immune system starts responding, the notorious inflammation starts. Once the immune system starts responding it can look like allergies, food intolerances, and even autoimmune diseases.

Because the first place affected is the gut, there are a number of symptoms right there. Things such as:

  • abdominal pain,
  • bloating,
  • gas,
  • nausea,
  • vomiting,
  • heartburn,
  • constipation
  • or diarrhoea.

Not to mention that if foods, even healthy foods, aren’t properly digested, their nutrients aren’t properly absorbed. Poor absorption can lead to lack of essential vitamins and minerals for the optimal health of every cell in your body.

Some of the symptoms can also occur on the skin:

  • Acne,
  • dry skin,
  • itchiness,
  • rashes,
  • eczema,
  • and hives

Even rosacea and psoriasis can be linked here due to their autoimmune component.

It’s possible that even some neurological symptoms are linked with leaky gut. For example:

  • brain fog,
  • fatigue,
  • headaches,
  • inability to sleep,
  • and general moodiness.

Finally, a number of chronic inflammatory diseases are thought to be linked with a leaky gut. Things like Crohn’s, colitis, Coeliac disease, IBS, and MS. Even things like heart disease and stroke are possibilities.

What to eat for leaky gut

The general recommendation is to stop eating inflammatory foods and eat more gut-soothing foods.

Incorporating a gut-soothing diet means cutting out grains, legumes, and dairy. Add to that list, food additives, alcohol, and refined sugars.

  • In their place, add in more green leafy and cruciferous veggies. These are full of nutrients and contain fibre to help feed your friendly gut microbes.
  • You also want to add more sources of vitamin D which can come from fish and egg yolks, and also from the sun.
  • Eat more probiotic foods like sauerkraut, dairy-free yoghurt, and kombucha (fermented tea).
  • You need to make sure you’re getting enough essential omega-3 fats found in oily fish such as salmon and mackerel.
  • Finally, make sure you’re getting some coconut oil and bone broth. Coconut oil has special fats called MCTs (medium-chain triglycerides), and bone broth has essential amino acids.

Conclusion

Leaky gut, or “intestinal permeability” can happen when your gut gets damaged due to too much sugar and alcohol, or eating foods you’re intolerant to. It can also be from stress, lack of sleep, or imbalance in your friendly gut microbes. The symptoms of leaky gut are vast – spanning from digestive woes to skin conditions, even to autoimmune conditions.

It’s important to cut out problem foods and drinks and add in more gut-soothing things like green leafy vegetables, cruciferous vegetables, and probiotic foods. It’s also important to ensure you’re getting enough omega-3 fats, vitamin D, and amino acids.

If you need help tailoring a diet, feel free to respond to this email and I can get you on your way.

Recipe (gut soothing): Slow-Cooked Chicken Bone Broth

Serves 6-8

Instructions

1 whole chicken, cooked, bones with or without meat
3 carrots, chopped
2 celery, chopped
4 bay leaves
4 tbsp apple cider vinegar
Herbs and spices as desired (salt, pepper, paprika, parsley)
2 handfuls spinach

Instructions

1 – Place chicken bones, and meat if using, into a slow cooker.
2 – Add chopped vegetables, vinegar, and herbs/spices.
3 – Cover with hot water (about 2 litres/8 cups).
4 – Cook for 8 hours on medium or overnight on low.
5 – Add spinach 30 minutes before serving.

Serve & enjoy!

Tip: You can strain it before serving, or serve it with the cooked vegetables as soup.

References:

https://www.thepaleomom.com/what-is-leaky-gut-and-how-can-it-cause/

https://www.thepaleomom.com/what-should-you-eat-to-heal-leaky-gut/

http://www.precisionnutrition.com/all-about-nutrition-gut-health

http://www.healthline.com/nutrition/is-leaky-gut-real#section3

https://www.dietvsdisease.org/leaky-gut-syndrome/

http://www.medscape.com/viewarticle/837168

http://www.medscape.com/viewarticle/531603

Photo by Alicia Petresc on Unsplash