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Category Archive Constipation

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!

Is My Poo Normal?

Yes, I’m serious! (And don’t you sometimes wonder anyway?)

You already know that your poo can reflect your physical, and sometimes even emotional, health.

You may get constipation or have diarrhoea when you eat something that “doesn’t agree with you,” or when you’re super-nervous about something. This is common in conditions such as CFS/ME.

And what about fibre and water? If you’re not getting enough, it’ll probably show in your bowel movements.

What about the all-important gut microbes? If they’re not happy, it’ll probably show in your bowel movements.

Here’s a trivia question for you:

Did you know there is an “official” standard for poo? I mean a university-created chart! One that is used to help diagnose conditions like irritable bowel syndrome (IBS)?

Meet the Bristol Stool Scale

The Bristol Stool Scale was created at the prestigious University of Bristol in the UK back in 1997.

You can see the chart here.

LINK: https://en.wikipedia.org/wiki/Bristol_stool_scale

The scale breaks down type of poo into seven different categories ranging from type 1 which is very constipated, to type 7 which is diarrhoea:

1 – Separate hard lumps (very constipated).

2 – Lumpy and sausage-like (slightly constipated).

3 – Sausage shaped with cracks in the surface (normal)

4 – Smooth, soft sausage (normal).

5 – Soft blobs with clear-cut edges (lacking fibre).

6 – Mushy consistency with ragged edges (inflammation).

7 – Liquid consistency with no solid pieces (inflammation).

Other “poo” factors to consider

You probably guessed that the shapes described in the Bristol Stool Scale are not the only thing to consider for poo health.

Think about how often you go. At least once per day, up to 3 times per day is pretty good. Less than one, or more than three can mean there is something going on.

What about how hard you have to try to go? You want it to be as effortless as possible.

And the colour? It should be brown from the bile that you need to break down the fats you ingest.

And if it’s green after a day of massive veggies, or red after that large glass of beet juice, you’re just fine.

But if you see an abnormal colour, like red or even black, that you can’t explain based on what you ate or drank in the last day or two, you probably want to get that checked out.

What do you do when you have “imperfect” poo?

Well, the first thing to consider is how imperfect it is, and how often it is like that? Once in a while, things aren’t going to be perfect, and that’s A-OK.

If you know you need to get more fibre or water, then try increasing that.

If you haven’t had enough probiotic foods, then try getting more of them.

If you’re super-stressed, then try deep breathing, meditating, or having a warm bath.

Oh, and don’t forget the two most basic pieces of nutrition advice:

  • First, eat a variety of nutrient-dense, minimally processed foods, including a lot of fruits & veggies (and their “fibrous” skins, wherever possible). The fibre in these is not only helpful for pushing food through your gut, but they also feed those millions of amazing helpful critters that live there (your friendly gut microbes.)
  • The second piece of advice is to eat slowly, and mindfully, chewing thoroughly.

These are good habits for anyone and everyone, even when you have perfect poo!

Of course, long-term issues might require a more thorough review with a qualified health care practitioner. Don’t suffer from poo issues for too long before seeking help.

Contact Kate for a free 15 minute consultation.

Recipe (dairy-free probiotic): Super-Simple Coconut Milk Yoghurt

Serves 6

2 cans full-fat coconut milk

2 probiotic capsules,

  1. Open the probiotic capsules and empty contents into the blender. Blend with coconut milk.
  2. Transfer to a sanitized glass jar (make sure it’s not still hot – you don’t want those probiotics to die).
  3. Store it in a warm place for 24-48 hours. If it’s not thick enough for you, you can let it ferment for another 24 hours.
  4. Add your favourite yogurt toppings, and store the rest for up to a week in the fridge.

Serve & enjoy!

Tip: Fermenting food is not an exact science. If this doesn’t work out as you’d like it to, try different brands of coconut milk and/or probiotics.

References:

https://en.wikipedia.org/wiki/Bristol_stool_scale
http://www.precisionnutrition.com/poop-health

Photo by Suhyeon Choi on Unsplash

What to Eat if You Get Constipated

Constipation is the opposite of diarrhoea – it’s when your stool tends to stick around longer than necessary. Often it’s drier, lumpier, and harder than normal, and may be difficult to pass.

Constipation often comes along with abdominal pain and bloating. And can be common in people with certain gut issues, like irritable bowel syndrome (IBS). It’s also very common in people with Chronic Fatigue Syndrome (CFS/ME).

About 14-24% of adults experience constipation. Constipation becomes chronic when it happens at least three times per week for three months.

If you have chronic constipation it can cause fatigue and inflammation in the body as toxins recirculate.

Constipation can be caused by diet or stress, and even changes to our daily routine. Sometimes the culprit is a medical condition or medications. And sometimes there can be a structural problem with the gut. Many times the cause is unknown.

Whether you know why or not, there are some things you can do if you get constipated.

So what to eat if you get constipated?

1 – Eat more fibre

You’ve probably heard to eat more prunes (and figs and dates) if you get constipated.

Why is that?

It comes down to fibre.

Dietary fibre is a type of plant-based carbohydrate that we can’t digest and absorb. Unlike cows, humans don’t have the digestive enzymes to break it down. And that’s a good thing!

Even though we can’t digest it ourselves, fibre is very important for our gut health for two reasons.

First, fibre helps to push things through our system (and out the other end).

Second, fibre is an important food for feeding the friendly microbes in our gut.

There are two kinds of fibre: soluble and insoluble

Soluble fibre dissolves in water to make a gel-like consistency. It can soften and bulk up the stool; this is the kind of fibre that you want to focus on for helping with constipation. Soluble fibre is found in legumes (beans, peas, lentils), fruit (apples, bananas, berries, citrus, pears, etc.), vegetables (broccoli, carrots, spinach, etc.), and grains like oats.

Psyllium is a soluble non-fermenting fibre from corn husks. It’s been shown to help soften stools and produce a laxative effect.

Insoluble fibre, on the other hand, holds onto water and can help to push things through the gut and get things moving. It’s the kind found in the skins and seeds of fruits and vegetables like asparagus, broccoli, celery, zucchini, as well as the skins of apples, pears, and potatoes.

It’s recommended that adults consume between 20-35 grams of fibre per day.

If you are going to increase your fibre intake, make sure to do it gradually. Radically changing your diet can make things worse!

And, it’s also very important to combine increased fibre intake with my next point to drink more fluids.

NOTE: There is conflicting evidence on how fibre affects constipation. In some cases, less insoluble fibre may be better, especially if you have certain digestive issues. So, make sure you’re monitoring how your diet affects your gut health and act accordingly. And don’t be afraid to see your healthcare provider when necessary.

2 – Drink more fluids

Since your stools are hard and dry when you’re constipated, drinking more fluids can help keep everything hydrated and moist. This is especially true when trying to maintain a healthy gut every day, rather than when trying to deal with the problem of constipation after it has started.

And it doesn’t only have to be water – watery foods like soups, and some fruits and vegetables can also contribute to your fluid intake.

Always ensure you’re well hydrated, and drinking according to thirst; this is recommended for gut health as well as overall health.

3 – Probiotics

Probiotics are beneficial microbes that come in fermented foods and supplements. They have a number of effects on gut health and constipation. They affect gut transit time (how fast food goes through us), increase the number of bowel movements per week, and help to soften stools to make them easier to pass.

Probiotic foods (and drinks) include fermented vegetables (like sauerkraut and kimchi), miso, kefir, and kombucha.

More research is needed when it comes to recommending a specific probiotic supplement or strain. If you’re going to take supplements, make sure to read the label to ensure that it’s safe for you. And take it as directed.

If you would like to learn more about how to improve your bowel movements and general digestive health, contact Kate and book a free 15 minute breakthrough call.

4 – Lifestyle

Some studies show that the gut benefits from regular exercise.

Ideally, aim to exercise for at least 30 minutes most days.

In terms of stress, when we’re stressed, it often affects our digestive system. The connection between our gut and our brain is so strong, researchers have coined the term “gut-brain axis.”

By better managing stress, we can help to reduce emotional and physical issues (like gut issues) that may result from stress. Try things like meditation, deep breathing, and exercise.

And last but not least – make sure to go when you need to go! Don’t hold it in because that can make things worse.

Conclusion

Optimal digestion is so important for overall health. Constipation is a common problem.

Increasing our fibre and water intake and boosting our friendly gut microbes are key things we can do to help things move along.

And don’t forget how lifestyle habits can affect our physical health! Exercise, stress management, and going to the bathroom regularly can also help us maintain great gut health.

Have you found that fibre, water, or probiotics affect your gut health? What about exercise, stress, and regular bathroom trips? I’d love to know in the comments below!

Recipe (high soluble fibre): Toasted Oats with Pears

Serves 4

Ingredients

150g oats, gluten-free

Pinch sea salt

300ml water

300ml almond milk, unsweetened

2 medium pears, sliced

4 tsp maple syrup

1 tsp cinnamon

1/2 cup walnuts, chopped

Instructions

Toast oats by placing them in a large saucepan over medium-high heat for 2-4 minutes. Make sure to stir them frequently to prevent burning. Add salt, water, and almond milk to the saucepan of toasted oats. Bring to a boil and reduce heat to medium. Cook, stirring occasionally, for about 20-30 minutes, or until desired tenderness is reached. Divide into four bowls and top with pears, walnuts, maple syrup, and cinnamon.

Serve & enjoy!

Tip: If you want to roast your pears first, place them in a baking dish at 200C for about 10 minutes while you’re cooking the oats.

References:

https://www.dietvsdisease.org/best-laxatives-constipation/

https://www.dietvsdisease.org/chronic-constipation-remedies-for-relief/

https://www.precisionnutrition.com/research-constipation-fiber

https://medlineplus.gov/ency/article/002136.htm

https://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377

https://www.health.harvard.edu/newsletter_article/6-ways-to-enjoy-fiber-in-your-diet

Photo by Aarón Blanco Tejedor on Unsplash

Foods to Prevent Constipation

Many people with chronic fatigue syndrome (ME/CFS) have constipation.

You may have constipation if you have an easy bowel movement less often than once per day. If you have chronic constipation it can cause fatigue and inflammation in the body as toxins recirculate. Below I have listed foods to prevent constipation and lifestyle tips that you can do to make you more regular.

 

Causes of Constipation

  • Diet high in refined foods and low in fibre
  • Over-eating
  • Low water intake
  • Lack of exercise
  • Underactive thyroid
  • Poor liver function
  • Lack of magnesium in the diet

Foods to Avoid

  • Avoid all animal products especially red meats which have a long transit time through the bowel. Only eat these foods in moderation.
  • Cut back on dairy foods which are mucus forming and add to the plaque in the intestines. Instead have organic rice, almond, oat or goat’s milk.
  • Also cut down on full fat cheeses and don’t eat melted cheese over food as it sets like plastic in the bowel.
  • Avoid refined sugars found in cakes, biscuits, desserts and highly processed foods which ferment in the gut causing gas and bloating as healthy bacteria are destroyed. If these healthy bacteria are missing, your digestion and elimination are impaired.
  • When you mix flour and water it makes a gooey paste, it does the same in the bowel, therefore cut down on pastries and flour-based foods.
  • Also avoid foods which you have an intolerance to, for example cow’s milk. Many people do not have the enzyme needed to break down lactose, the sugar found in milk. This can lead to putrefaction in the bowel.

Foods to Eat

  • Flaxseeds (linseeds) are a blend of insoluble and soluble fibres which bulk up the stool encouraging it to move gently through the bowel. Ground flaxseed and use 1 tablespoon on your porridge or in a fruit smoothie every day. Store it in a glass jar in the fridge.
  • Other high fibre foods are fresh and dried figs, blackcurrants, apricots, prunes, almonds, fresh coconut and all mixed nuts. Try eating 8 prunes per day with breakfast for an easier bowel movement.
  • Eat more lightly cooked or raw vegetables and salads to add more fibre to your diet.
  • Drink at least 2 litres of water daily.
  • Replace one meal a day with a fruit smoothie whilst eliminating all flour from any source for at least 2 days. Blend 1 banana, 1 organic apple, 30g blueberries, 1 teaspoon of green powder, 1 tablespoon almond butter, 1 tablespoon of flaxseeds (linseeds) with 500ml almond milk. It’s delicious and packed with fibre.
  • Additionally eat more magnesium rich foods including green leafy vegetables, nuts, seeds and dark chocolate, which relax the colon muscles and encourage a bowel movement.

Why does constipation cause fatigue?

  • If you have constipation, you have toxins recirculating in your system. This can lead to inflammation and fatigue.
  • Also being constipated can put a strain on your liver to constantly try to process and detox the recirculating toxins, leading to chronic fatigue.
  • It can cause bloating and tummy pain leading to discomfort and disturbed sleep, which can lead to fatigue.

 

Furthermore if you would like to find out more about foods to prevent constipation, contact Kate on 07562 868342 for a free 15 minute consultation!

Copyright: tashka2000 / 123RF Stock Photo