09Feb
H. pylori infection in the stomach glowing red on dark blue background
23 Nutrition Therapy TeamDiet, Digestion

Healing H. pylori with Nutrition Therapy

Have you been suffering from sharp pains or burning in your abdomen that just won’t go away? Is this pain making it difficult to complete your daily activities? You may have caught an H. Pylori infection. Healing H. pylori requires guidance from a skilled healthcare practitioner. So don’t worry, we will have you feeling better in no time!

What is Helicobacter pylori? 

Helicobacter pylori is a type of bacteria that lives within the stomach. It releases toxins into the lining of the stomach, going through several layers of mucus and stomach tissue. This causes damage to the stomach lining and reduces stomach acid production. 

Stomach acid is necessary to break down proteins, and low stomach acid means food is not digested as fully or efficiently as it would under normal conditions. This affects amino acid absorption, meaning the body is not able to absorb all the nutrients from your food, impacting every cell in the body. 

By limiting amino acid absorption, an H. pylori infection can impact the production of:

  • Antibodies/Immunoglobulins (responsible for fighting against infection)
  • All enzymes (responsible for energy production and other bodily processes)
  • Thyroid hormones, insulin, follicle-stimulating hormone, and all other amino acid-based hormones
  • Hemoglobin and ferritin (store critical proteins transported to all cells and tissues)
  • Neurotransmitters

The body tries to fight against these toxins by using inflammation as a natural defense.  Inflammation is a common response to any type of trauma to the body because it wakes up the immune system and encourages phagocytes, your own personal fighter cells, to come to the area.

The resulting inflammation may be responsible for the pain that you may be feeling from the infection.  Unfortunately, the H. pylori bacterium has evolved to be prepared for the inflammation response and is immune to it, allowing for the infection to persist if not treated properly. 

Testing for H. pylori

There are several easy ways to get tested for an H. pylori infection by your healthcare provider. 

Breath Test

This test is able to identify most people with H. pylori. To take the test, your healthcare provider will have you swallow a solution that contains urea. If H. pylori is present, the bacteria will convert the urea into carbon dioxide after about 10 minutes. Determining whether you have H. pylori is then detected by measuring the amount of carbon dioxide exhaled.

This test can also be used to measure whether the infection has been successfully treated. The breath test for H. pylori is most effective if you have been experiencing symptoms for about six months or less. 

Blood Test

blue medical glove holding h pylori blood test on white background

Blood tests are used to detect the presence of H. pylori antibodies. Antibodies are proteins made by the immune system made specifically to fight certain infections. Once your immune cells come into contact with bacteria, it creates specific antibodies for that bacteria so that it may fight it off more successfully.

After an extended period of time of being infected, the number of antibodies in the blood may begin to decline, which could result in the test having incorrect results. 

Stool Testing 

Stool tests can detect if there are traces of H. pylori in the feces. Since H. pylori resides in the stomach, the bacteria are able to travel through your digestive tract along with digested food. We all know where that ends up!

If treatment is successful, there will no longer be H. pylori present in the gut, so this method can also be used to confirm whether the infection is no longer active. 

This testing method is best for chronic infection, where symptoms have been present for over six months. 

This is the testing method we use with clients because it also analyzes markers for maldigestion, inflammation, dysbiosis, metabolite imbalance, and other possible infections. We choose this method because it gives more information than just whether or not the H. pylori infection alone could be the root cause of your symptoms.

GI effects functional nutrition test comprehensive stool analysis sample report

Endoscopic Exam

An endoscopic exam is a procedure where a small piece of tissue from the stomach lining is tested. This test is usually recommended by your healthcare provider in response to an ulcer, bleeding, or when checking for cancer. Since this examination is used to test for other issues within the gut, it can often miss the infection itself. 

How is H. pylori transmitted?

The most common way to become infected with H. pylori is through consuming contaminated uncooked foods. 

This infection can also be passed from person to person from direct contact with: 

  • Saliva (1/3 of all cases are caught through saliva/kissing) 
  • Oral cavity 
  • Vaginal and prostate fluids 
  • Fecal matter 

Prevention of H. pylori

wash produce carrots endives herbs to prevent h pylori infection

Since this is an infection primarily passed between food and people, H. pylori prevention has a lot to do with safe food preparation and cleanliness. 

Some tips for preventing an H. pylori infection include:

  • Wash your produce
  • Wash your hands regularly, especially after using the restroom or handling uncooked foods
  • Make sure all food is thoroughly cooked 
  • Avoid food and water that is not clean 

With these easy practices, you can protect yourself from H. pylori and many other types of harmful bacteria!

Symptoms of H. pylori infection

woman in black in white holding stomach in pain glowing red

Since the inflammation response to H. pylori is ineffective, the body is left in a state where it is constantly inflamed. Chronic inflammation is stressful on the body because it knows that the bacteria is still there. 

If left inflamed for too long, the body will begin to damage healthy cells within the digestive tract.

Digestion and malabsorption-related symptoms of H. pylori:

  • Belching 
  • Nausea 
  • Constipation 
  • Upper abdominal pain 
  • Heartburn or acid reflux 
  • Gastritis 
  • Indigestion 
  • Amino acid deficiencies 
  • Depression 
  • Joint pain 
  • An ongoing need for HCl or digestive enzymes
  • Weak immune system
  • Fatigue
  • Unstable blood sugar 

Symptoms can occur in clusters as well as change over time.

Other consequences of H. pylori

green helicobacter pylori bacteria

A common failure for diagnosis is that H. pylori can manifest in symptoms that lie outside of the digestive tract such as bladder infections, insomnia, and anxiety.

These types of symptoms can make it difficult to pinpoint the infection as the root cause, so it is important to express when your symptoms first started as well as what was going on in your life at the time.

Extended inflammation can also lead to more serious problems because of the damage done to your cells. 

Examples of less common, but more serious, effects of an H. pylori infection are:

  • Duodenal or peptic ulcers 
  • Mucosa-associated lymphoid tissue (MALT) lymphoma
  • Gastric adenocarcinoma

H. pylori infections are the strongest risk factor for gastric cancer – nearly 75% of all gastric cancer cases can be attributed to H. pylori. This is why it is so important to seek help if you are feeling any symptoms of an H. pylori infection – you need to treat the inflammation before it becomes a more serious concern. 

Co-occurring conditions are more likely if infected with H. pylori

Another important thing to consider is that H. pylori may not be the only factor at play in your digestive struggles.

Since this infection lowers stomach acid, it also makes it easier for other infections and overgrowths to take place within the digestive tract. Many times, we will see both H. pylori and other conditions, such as small intestinal bacterial overgrowth (SIBO), co-occurring. 

If your digestion is out of whack, you should consider getting tested for more than one kind of infection/overgrowth.

If you have both SIBO and H. pylori, H. pylori should be treated first because it occurs earlier in the digestive tract. H. pylori lives in the stomach, while SIBO takes place in the small intestine, and the acidity in the stomach is necessary to heal and prevent SIBO. 

Treatment for H. pylori

The conventional method of healing H. pylori is through the use of antibiotics, but this does not always fully treat the infection or address the consequences of the infection. Doctors may prescribe Prevpac for about 2 weeks along with an anti-inflammatory diet. 

Our approach involves addressing the full spectrum, starting with why the infection was allowed to take place (the root cause) and ending with the symptoms and other consequences of infection.

The following protocol can be utilized to fully treat and heal your body.

Stage 1: Stress Management and Adrenal Support

the word stress written in pencil and half erased

The first step is to resolve any factors that may be causing any additional inflammation. This process focuses on individualized dietary and lifestyle changes. Our team will work with you to discover your personal needs in order to help you find the support program that will work best for you! 

The Importance of Stress Reduction

Reducing stress supports the adrenals and helps to reduce both inflammation and symptoms of an H. pylori infection. Practicing mindfulness and incorporating new stress management techniques train the body to better recognize that it is not in danger, allowing the body to relax more easily.

Reducing inflammation is essential for treating an H. pylori infection, and strengthens the overall health of your gut. Stress negatively impacts every step of the digestive process, and can also lower stomach acid levels. This is why it is so important to address stress when healing H. pylori: the effects of each can compound on each other and make you feel even worse.

After incorporating stress-reducing and anti-inflammatory practices for about 60 days, you can move onto stage 2 of your treatment protocol. Following an anti-inflammatory diet can also be helpful in reducing any irritants to your gut, reducing the severity of painful symptoms.

Adrenal Support for Healing H. pylori

One common effect of H. pylori is adrenal dysfunction (aka adrenal fatigue). Your adrenal glands produce hormones that allow your body to work through stressful situations. After prolonged periods of stress, such as from having an H. pylori infection, you can experience adrenal burnout symptoms including fatigue, brain fog, or widespread inflammation. 

Participating in our personalized Adrenal Reboot Program can help to reset your stress response system, reduce inflammation, and alleviate symptoms of burnout. Another option is our app-based Adrenal Cleanse protocol, more suitable for those who feel they need less personalized support. We also recommend testing for possible food allergies and sensitivities. It’s possible that consuming certain foods results in additional, unnecessary inflammation within your body.  

Stage 2: Treatment phase – Eliminating H. pylori

After strengthening the digestive system through stress management, it is now time to move onto killing the H. pylori infection. Antibiotics can be used, but there is also a more natural approach. These two methods can also be used together if they are determined as the most effective form of treatment by your healthcare provider. 

Herbal treatment of H. pylori may include: 

  • Mastica/mastic gum
  • Slippery elm
  • Deglycyrrhizinated Licorice Root Extract (DGL)
  • Zinc carnosine

During this step, you may need to support your liver detox pathways because H. pylori can be transmitted to the liver through the blood. Extra support will aid in helping against any deterioration of liver function potentially caused by the infection. 

3. Replace healthy bacteria

After successfully killing off your H. pylori infection, it is now time to repair your gut and rebuild any deficits in order to protect from future infections by maximizing gut function. In this step, probiotics (usually multi-strain, high potency) are introduced.

Probiotics are called “good bacteria” because they help fight off bad bacteria and help keep your gut microbiome well-regulated. This is also a good time to begin taking a gastrointestinal (GI) repair powder, glutamine plus herbal support, to repair any damaged GI tissues. 

After this step, we recommend retesting in order to verify that you are no longer carrying H. pylori and that probiotics, the healthy bacteria, have recolonized the GI tract. If your test results show that this is true, your GI tissue is on the road to recovery and the treatment has been successful in healing H. pylori.

If you happen to also be suffering from another pathogen in your GI tract, it is now possible to begin treatment to restore your gut health back to optimal function.

Working with a skilled practitioner is essential to ensure optimal results, as both the dosage and the length of the protocol matter for lasting success. The treatment process takes patience and ongoing support, and having someone to guide you can help keep you on track!

 

If you’ve been having digestive distress and think H. pylori may be the culprit – schedule a free 15-minute discovery call and we can discuss how to plan out the best approach for you!

 

11Dec
woman clutching stomach in pain with outline of digestive organs on white background
23 Nutrition Therapy TeamDigestion

Your Guide to the SIBO Breath Test

Gas, bloating, constipation, abdominal pain, diarrhea… If you are experiencing these symptoms, you may have Small Intestinal Bacterial Overgrowth (SIBO). These symptoms are common for many causes of gastrointestinal distress. So you may be thinking – how do I know it’s SIBO and not something else entirely? Enter the SIBO breath test.

woman clutching stomach in pain with outline of digestive organs on white background

Testing is important to determine whether or not you have SIBO. There are a couple test methods, but the most consistently recommended method is the SIBO Breath Test.

This blog will help you understand the SIBO breath test and kickstart your journey to proper treatment.

Why choose the breath test?

Since many other conditions can cause the same symptoms as SIBO, it is extremely important to be tested before starting any form of treatment. Testing for SIBO will guarantee that you will receive the correct treatment that will alleviate your gastrointestinal distress.

Treatment without confirmation of SIBO through testing can have possible adverse side effects. The use of antibiotics, or herbal antimicrobials and an elemental diet, can negatively impact your health if this is not the treatment you need.  It is important that the treatment you are given will address the problem at hand. You don’t want the treatment to end up causing more problems. So, the confirmation of SIBO before treatment is the best course of action.

The two SIBO testing options are the SIBO breath test or jejunal aspiration. But what about stool tests? Stool tests don’t always provide much meaningful information related to SIBO. This is because the results of stool tests actually reflect what is going on in the large intestine – not the small intestine. Stool tests are useful to obtain an idea of what is going on in your digestive tract, but cannot specifically reveal SIBO.

Jejunal aspiration is a very invasive, expensive test that used to be the gold standard of testing for SIBO. However, because of the nature of the test and a history of false positives and false negatives, it is no longer considered the gold standard.

The SIBO breath test is now the method most recommended because it is noninvasive, not as expensive, and completely safe. The SIBO breath test usually costs about $200, and insurance sometimes covers this cost.

SIBO Testing Explained

The breath test measures levels of hydrogen and methane gas in your breath. These levels relate to the fermentation rate of bacteria throughout your digestive tract. Normally, the small intestine does not have much bacteria or gas production. With SIBO, the gas production will be higher in the small intestine because of the overgrowth of bacteria.

small intestinal bacterial overgrowth

During a SIBO breath test, you drink a sugar solution: either glucose or lactulose. Once this sugar reaches the small intestine, where nutrient absorption occurs, the bacteria ferment the sugar and produce gas. Measuring the gases that these bacteria produce (but that the human body does not) is the best way to determine the presence of bacteria in the small intestine. 

There are 3 types of SIBO, categorized based on the type of gas the bacteria produce in the small intestine. The 3 types of gases are: Hydrogen, Methane, and Hydrogen Sulfide. 

Currently, there are no tests for hydrogen sulfide gas. This means that the SIBO breath test will only include results for hydrogen and methane. However, a skilled practitioner can infer the presence of hydrogen sulfide SIBO based on symptoms and something called a “flatline” result in the hydrogen/methane breath test.

What to Expect When Taking a SIBO Breath Test

As with most tests, there is some preparation required in order to obtain accurate results. For SIBO breath testing, there is an essential prep diet that must be followed. This diet may be followed for up to 2 days based on the direction of your healthcare practitioner. 

Preparation: SIBO Test Diet

Before you can take your breath test, you need to spend at least 12 hours on a special diet followed by a 12-hour overnight fast. If you suffer from constipation, this prep diet period will be extended to 36-48 hours total. If you have taken antibiotics within the last month or laxatives within the last week, it is recommended to wait to take the test. This test should not be administered in this situation because the results will be skewed and inaccurate.

sibo test prep diet with plain white rice and baked chicken on white plate

The prep diet consists of:

  • Baked or broiled animal protein
  • Plain white rice
  • Eggs
  • Small portions of oils or fats
  • Plain water
  • Weak black coffee or tea
  • Salt and pepper
  • Clear chicken or beef broth

This list includes the only things that should be eaten during the 12-hour diet – any additions to this diet will invalidate your breath test results. For vegetarians and vegans, speak with your RD to determine your special diet. 

The purpose of this diet is to starve the bacteria in your small intestine for 24 hours to ensure that the results are accurate. 

Other requirements for taking the test include:

  • Avoiding cigarette smoke exposure
  • Avoiding exercise
  • Waiting one hour after waking up to start the test
  • Following instructions closely to ensure the best results

Taking the hydrogen/methane breath test

close up of blonde woman blowing into breathalyzer sibo test

The test is administered either at a clinic or at home. Taking the test at home means it is your responsibility to follow the instructions closely. You will breathe through breathalyzer device at 15-20 minute intervals over the course of a 2-3 hour period. 

The first breath collection is your baseline. The baseline measures the gas production without any food in your system due to your overnight fast. Having no food in your system means that the bacteria have nothing to ferment and use for energy, so there shouldn’t be much gas production.  

After collecting the baseline measurement, you will consume a sugar solution. The rest of the test measures the bacterial gas production over time, which relates to the amount of bacteria present in each segment of the digestive tract. The higher the levels of gas present = the larger the overgrowth.

After the test is complete, the testing kit will be sent to a laboratory for analysis. The results will be sent back after a couple weeks and should be interpreted by a professional with SIBO test experience.

Click here to watch a very useful video that explains the process of SIBO breath testing.  Watching this video before your test is important for understanding the SIBO testing process, especially if you are doing the test by yourself at home.

SIBO Breath Test Results

sibo breath test sample report

The best way to understand your SIBO breath test results is to have a gut health practitioner interpret them. It is possible that your results will show positive results for both hydrogen and methane SIBO, positive for only one of the two gases, or negative for both. Any result gives enough information to guide what the next steps should be. 

One possibility is that hydrogen levels appear elevated but still fairly low, while methane increases over time during your breath test. This may mean that you have a mixed-type SIBO, where both hydrogen and methane producing bacteria are present. Methanogens that produce the methane gas are actually fed by hydrogen gas, which results in the lower presence of hydrogen gas in the breath test.

Another possibility is that the results graph presents in a flatline for the production of both gases. This means that you tested negative for both hydrogen and methane SIBO. If this flatline occurs and you are experiencing any of the symptoms below, it is highly likely that you have hydrogen sulfide SIBO.

Symptoms of hydrogen sulfide SIBO:

  • Digestive issues
  • Pain (abdominal, joint, visceral)
  • Sensitivity to light and sound
  • Tingling and numbness in extremities
  • Feeling sick and toxic
  • Intolerance to sulfur-containing foods (garlic, meat, seafood, poultry, nuts, seeds, legumes, cruciferous vegetables, and more)
  • Smelly breath and gas

Due to the nuance that is present in this testing method, it is extremely important to work with a professional who has experience with the SIBO breath test. Knowing whether you have SIBO or not, and if so, which type of SIBO is present is essential for formulating the treatment protocol. Each type of SIBO has different requirements for treatment, and each involve a completely different approach.

Retesting hydrogen and methane levels

Usually, after completing the SIBO treatment protocol and your symptoms have subsided, another SIBO breath test is recommended. The reason for retesting is to determine whether or not the SIBO treatment was successful. If the SIBO treatment worked, your SIBO should be eradicated and the SIBO breath test will come back negative for both gases. 

If cost is an issue, another option is to monitor your symptoms and retest only if symptoms return. Recurrence is always a possibility, so be sure to communicate with your functional medicine dietitian if you start to experience the uncomfortable symptoms again.

dietitian woman in white lab coat writing on clipboard with colorful fruits and vegetables and yellow measuring tape on white background

Do you think you have SIBO? Schedule your appointment today to speak with a gut health expert and begin your journey to wellness! 

04Dec
toilet paper roll with black alarm clock with dark background
23 Nutrition Therapy TeamDigestion, Health Conditions

How to Heal SIBO: The 3 Types

If you’re reading this, you probably know a little bit about what SIBO is and you may think that you have it. But simply thinking that you have SIBO isn’t enough to determine what happens next. The next step is to test for SIBO in order to determine if it is actually present (test, don’t guess!). And if you do have SIBO, what type of SIBO do you have? Knowing what type you have is the first step to understanding how to heal SIBO.

There are 3 general types of SIBO, which are categorized based on which gas the microbes are producing in your small intestine.

The 3 types of SIBO (small intestinal bacterial overgrowth) are:

  • Hydrogen SIBO
  • Methane SIBO
  • Hydrogen sulfide SIBO

Each of these types of SIBO require a different approach when it comes to treatment, so knowing which kind you have is extremely important! Keep in mind; it is absolutely possible to have multiple kinds of overgrowth at the same time.

You will often see the 3 SIBO types written as “hydrogen-dominant” or “methane-dominant” because it is possible to have both but one is more dominant than the other.

How to heal SIBO completely depends on which kind or combination you have. So, staying in continuous contact with your functional medicine dietitian is vital to make sure your treatment protocol is the correct one for you!

Hydrogen SIBO

woman in bathroom stall with red wall and stone walls holding stomach and toilet paper diarrhea

This is the most common type of SIBO. These bacteria produce hydrogen gas by fermenting carbohydrates in the digestive tract. 

Signs and Symptoms of Hydrogen SIBO

The large amounts of gas that they produce can lead to severe bloating and abdominal discomfort, which can worsen as the day progresses.

The bacteria also produce serotonin, which increases the contractions of the small intestine. The increased frequency of contractions in the small intestine leads to a decrease in gut transit time, which results in diarrhea. 

There is also another mechanism at play here that leads to faster movement through the bowels and diarrhea. Toxins released by these bacteria can irritate the gut lining, draw more water into the bowel, cause more contractions, and ultimately result in diarrhea. 

It is also possible that you don’t experience diarrhea at all, and don’t experience any other symptoms.

The reduction in gut transit time also contributes to malnutrition due to the malabsorption of nutrients, because there is simply less time for the nutrients to be absorbed. The loss of liquids and electrolytes is also an issue and can lead to dehydration.

hydrogen sibo symptom checklist

Treating Hydrogen SIBO 

Hydrogen dominant SIBO responds well to antibiotics (usually rifaximin), herbal antimicrobials, and the Elemental Diet. Your functional medicine dietitian will evaluate your best course of action based on your medical history.

Methane SIBO

toilet paper roll with black alarm clock with dark background

This type of SIBO is the second most common. Methanogens produce methane from hydrogen gas and carbon dioxide. Technically, these microbes are archaea and not actually bacteria.

There is some discussion of renaming this SIBO type to IMO (intestinal methanogen overgrowth). This name change would account for the fact that the methanogens are not bacteria. Additionally, methanogens can actually overgrow in all areas of the colon. This why SIMO (small intestinal methanogen overgrowth) isn’t the proposed name.

The potential name change highlights the fact that this SIBO type is different than the rest and requires a different approach to treatment.

Signs and Symptoms of Methane SIBO

A common sign of an overgrowth in these archaea is chronic constipation. High amounts of methane can contribute to increased transit time within the digestive tract. The longer time food spends within the colon causes constipation. It is also possible to have diarrhea with this type, but this is less common.

Weight gain and increased body fat is also a common sign of methane dominant SIBO. This is partially due to the longer gut transit time that makes food sit in the gut for longer periods of time, allowing more calories to be extracted and absorbed.

Another reason is because archaea make more calories available to us in the gut by breaking down fiber, which we normally cannot digest by ourselves. This is the same reason cows can survive on grass alone!

methane sibo symptom checklist

Mixed Type: Methane SIBO and Hydrogen SIBO Combined

Since methanogens require hydrogen gas to produce methane, it is common to find this type of SIBO in combination with hydrogen SIBO.

It is thought that the hydrogen type can lead to an overgrowth of methanogens because it provides tons of hydrogen gas that the methanogens need! In this situation, it would be considered mixed type SIBO.

Treating Methane SIBO

Methane SIBO can be much harder to treat than hydrogen SIBO because archaea do not directly respond to antibiotics. Remember – archaea are not bacteria!

If these archaea are being fed by an overgrowth in bacteria that produce hydrogen gas, antibiotics can potentially be useful to get rid of one of the components that the archaea need. Antibiotics kill off the bacteria that produce the hydrogen gas, thus starving the archaea.

For this type of SIBO, it can be more beneficial to approach treatment with herbal antimicrobials or the Elemental Diet

Hydrogen Sulfide SIBO

man holding nose and holding hand up something is stinky on white background

This type of SIBO is a bit different from the first two. Hydrogen sulfide (H2S) is a gas that is actually produced by the human body! H2S is produced throughout the GI tract in a healthy body. In healthy levels, H2S helps to maintain the integrity of the gut lining. However, in excess amounts H2S is actually considered a neurotoxin.

With hydrogen sulfide SIBO, this normally beneficial gas is being produced in levels that are toxic! Too much H2S can lead to nerve damage, chronic gut inflammation, and DNA damage that can lead to colon cancer. The intestinal barrier can become leaky, which increases inflammation and causes other issues. Too much hydrogen sulfide can lead to immune suppression, laying the groundwork for chronic infections.

Excess hydrogen sulfide can also inhibit cellular respiration in mitochondria. Cellular respiration is the process in our cells that pulls the energy out of what we eat!

People with this type of SIBO usually feel sicker overall because of the systemic issues that result from the damage to our mitochondria. Without the ability to convert food to energy, cells can die and tissue death becomes a possibility. This also means that you aren’t receiving energy, and can result in chronic fatigue syndrome.

Signs and Symptoms of Hydrogen Sulfide SIBO

Diarrhea and constipation are both possible symptoms, depending on whether other types of SIBO are present. Abdominal pain and sensitivity are also extremely common. You may also experience gas that smells like sulfur, or rotten eggs. Halitosis (bad breath) and gum disease can also be the effect of excess hydrogen sulfide. 

The non-GI issues that can arise due to the neurotoxic effects of hydrogen sulfide can include:

  • Body pains
  • Increased food sensitivity
  • Tingling in hands or feet
  • Sensitivity to light and sound

If you have hydrogen sulfide dominant SIBO, this doesn’t necessarily mean that you would be experiencing all of these symptoms at once.

hydrogen sulfide sibo symptom checklist

Testing for Hydrogen Sulfide SIBO

With all of the possible issues hydrogen sulfide SIBO can cause, it is obvious how imperative it is to identify this type of SIBO. Unfortunately, this type is not currently testable by all testing methods, but that should change in the near future… 

Update: there is a new test called Trio-Smart that has recently become available, and it is the only SIBO test that currently tests for all 3 types. There is some debate about whether or not this test is accurate. 

There are ways for your functional medicine dietitian to make an educated guess on whether you have hydrogen sulfide SIBO from the current breath tests, but it is not a foolproof method.

About 1 in 10 SIBO cases are due to hydrogen sulfide-producing bacteria. Hopefully someday soon we will be able to test for H2S in a simple and effective way.

Treating Hydrogen Sulfide SIBO

How to heal SIBO caused by H2S-producing bacteria is different from the other types. Sulfur is needed for this gas to be produced, and we obtain that from certain amino acids in our diet. If you have this type of SIBO, avoiding foods and supplements that contain sulfur is essential for recovery. 

Unlike the hydrogen and methane types, this type of SIBO cannot be treated with the Elemental Diet because the medical beverage contains these sulfur-based amino acids. 

A completely different treatment approach is required for hydrogen sulfide SIBO and should be advised by your functional medicine dietitian.

The Importance of Knowing Your SIBO Type

Knowing the type of SIBO you have is extremely important. Without knowing the specific SIBO type, you will not know which type of treatment would be most beneficial. It is essential to know the type of SIBO you have to truly understand how to heal SIBO.

If you’re suffering from SIBO, you will want to pursue the most effective treatment protocol based on both your type of SIBO and your medical history,  guided by your functional medicine dietitian.

Also, retesting after a SIBO treatment protocol is very important because these three types of SIBO can be interrelated. This can sometimes mean that you can get rid of one type of SIBO with the potential of having a second type remaining.

Many times you can have more than one type at once, but one type is suppressed (often the hydrogen bacteria). Hydrogen sulfide and methane both use hydrogen in order to thrive, so getting rid of either of those types might mean you’re left with hydrogen SIBO after treatment.

Now you understand why knowing your SIBO type is so important for laying the groundwork for proper treatment for healing SIBO. Working with a healthcare professional who is familiar with SIBO and who understands how to heal SIBO and all its variations will give you the best results. 

Once you know which type of SIBO you have, you are one step closer to recovery! Schedule your appointment today to continue your journey to better gut health.

type of SIBO determines treatment

 

02Dec
diagram of enteric organs with emphasis on small intestine bacterial overgrowth
23 Nutrition Therapy TeamDigestion, Health Conditions

All About SIBO

Are you suffering from gastrointestinal distress that just won’t get better no matter what you do? It is possible that what you are experiencing is due to SIBO (small intestinal bacterial overgrowth). This would mean that you need more directed help in order to feel better!

What is SIBO?

diagram of enteric organs with emphasis on small intestine bacterial overgrowth

Small intestinal bacterial overgrowth (SIBO) is a condition where the bacteria in the small intestine are growing in much larger numbers than usual.

The small intestine’s job is to absorb nutrients from the food we eat, continuing digestion after food leaves the stomach. The small intestine is the longest portion of our gastrointestinal tract, and normally contains a relatively low concentration of bacteria relative to the large intestine.  

Many people generally learn that bacteria are bad or unhealthy, but the reality is that certain bacteria naturally live in our digestive tract as normal and beneficial microbiota. These beneficial bacteria help prevent other bad bacteria from colonizing and making us sick.

With SIBO, these bacteria have surpassed protective numbers and they are no longer beneficial. The bacteria have often relocated from either the mouth or the large intestine into the small bowel. Here, they start competing with you for nutrients, causing inflammation, and leading to many other health complications.

SIBO is actually a symptom of a larger problem. There are many things that can go wrong in the digestive tract that pave the way for SIBO, so what are the things that can lead to SIBO?

What causes SIBO?

blue image of person with intestines showing with red rod bacteria bacilli

Healthy digestive tracts are designed to prevent SIBO in numerous ways. The acidity of our digestive juices usually kills most bacteria in the stomach, and any remaining microbes are usually destroyed by bile in the duodenum.

The movement within the digestive tract caused by peristalsis and the migrating motor complex (MMC) prevents bacterial adhesion to the intestinal wall and sweeps materials through the digestive tract to be eliminated.

Also, the ileocecal valve blocks the passage of bacteria from the large intestine backwards into the small intestine. All of these things usually help prevent the overgrowth of bacteria in the digestive tract. So what happens when these protections fail?

Low Stomach Acid and Bile Flow

Without the proper amount of stomach acid, bacteria that would typically die in the stomach can now sneak their way into the small intestine.

Disruptions to bile flow leads to a reduction in the antibacterial nature of our digestive system, promoting small intestine bacterial growth.

The bacteria entering our small intestine can come from contaminated food or water. They could even be the bacteria that naturally live in the mouth. Sometimes these bacteria are detrimental to our health; secreting toxins that trigger food poisoning with extremely uncomfortable symptoms, inflammation, and can even lead to the paralysis of the MMC.

MMC Dysfunction

The job of the MMC is to sweep undigested food and bacteria through the digestive tract between meals.

When the MMC malfunctions, bacteria hang out in the small intestine long enough to flourish, a root cause of SIBO. Anything that leads to the dysfunction of the MMC can cause SIBO because the housekeeping isn’t taking place, leaving food in the small bowel for bacteria to thrive on.

Surgery

SIBO can also be a consequence of gastric or abdominal surgeries, constipation, or anatomical structural abnormalities that cause obstructions in the intestines.

Blockages further in the system can lead to bacteria from the large intestine migrating upward through the GI tract and ultimately translocating into the small intestine where they don’t belong.

Chronic Stress

woman in gray tank top holding head looking down on beige background

An overarching root cause of SIBO can actually be stress, which leads to issues with the gut-brain connection.  The underappreciated vagus nerve connects our mind and digestive system, sending signals from digestive organs to the brain and vice versa. This nerve innervates nearly every organ in our torso, supplying them with parasympathetic, rest and digest impulses. 

Stress inhibits the vagus nerve, leading to the sympathetic, fight or flight responses predominating. Digestion is halted during stressful situations, because energy is needed elsewhere in the body in preparation to escape or battle a potential threat.

When digestion is halted, less stomach acid is produced. Another consequence is that the MMC will shut down, leading to the stasis of food and bacteria in our system. It all comes together… stress can cause the problems that lead to SIBO!

The connection between our gut and brain is bidirectional: the situation in our gut impacts our brain, and the situation in our brain influences our gut.

This can turn into an unrelenting cycle where you start off stressed, then your gut starts acting up, then you become even more stressed due to the gut issues, which never improve because you’re stressed out! Yikes, deep breaths… 

Signs of SIBO

woman in pink long sleeve dress holding stomach on white background

Symptoms of SIBO include: 

  • Gas
  • Bloating
  • Diarrhea
  • Constipation
  • Acid reflux
  • Nausea
  • Abdominal cramps
  • Leaky gut
  • Migraines
  • Depression
  • Anxiety
  • Brain fog
  • Fatigue
  • Eczema

Other signs to watch out for are the outcomes of malabsorption: anemia, weight loss, and certain nutrient deficiencies.

SIBO co-occurs with many other conditions including:

  • IBS
  • Leaky gut
  • Celiac disease
  • Ulcerative colitis
  • Crohn’s disease
  • Hypothyroidism
  • Fibromyalgia

According to the SIBO Academy, around 1 in 5 adults in the United States have IBS – and over 1/3 of these cases also have SIBO. There is also a high correlation between SIBO and NAFLD (non-alcoholic fatty liver disease) due to the accumulation of bacterial toxins that cause inflammation.

Since SIBO can present with a wide variety of symptoms and comorbidities, both GI and non-GI, it can often be difficult to identify based on symptoms alone. The non-GI symptoms are neurological and psychological, resulting from dysfunction in the gut-brain connection. It is important to take note of and communicate any symptoms you experience. 

Identifying SIBO requires a comprehensive overview of your medical history including reviewing medications, assessing risk factors, evaluating diet and nutrient levels, and of course, a sibo test.

Testing for SIBO

SIBO can be detected through hydrogen and methane breath tests, which measure the production of these gases within your digestive system.

The SIBO breath test involves drinking a sugar solution containing either glucose or lactulose, and then periodically blowing into a tube to measure the amounts of gas present over time. Blowing into the tube at specific intervals over a period time is important because the timing is what indicates the location in your digestive tract where these gases are being produced.

Breath tests are valuable because our bodies don’t produce these gases – the bacteria do. Bacteria thrive on carbohydrates for energy by fermenting sugars and producing methane or hydrogen gas as a result. In healthy people, the bacteria of the large intestine are exclusively responsible for this gas formation.

With SIBO, the small intestine bacteria also end up producing these gases. Elevated levels of these gases within a certain timeframe of the test can expose the presence of SIBO, suggesting a decreased ability for your body to absorb nutrients and signaling to other potential issues.

There are 3 types of SIBO, dependent on which gas is being produced:

  • Hydrogen
  • Methane
  • Hydrogen sulfide 

It is possible to have more than one type of SIBO present at once, especially methane- and hydrogen-dominant types. Unfortunately, there is not a test available for hydrogen sulfide SIBO yet, but that could change in the near future. (There is now a H2S test, but it has not been recommended by professionals yet)

Healing SIBO

Treating SIBO is crucial because without intervention, the negative symptoms will persist. This can lead to malnutrition resulting from the decreased absorption of nutrients.

zoom in on malnutrition entry in the dictionary

SIBO can lead to nutrient deficiencies of iron, fat-soluble vitamins (A, D, E, K), vitamin B12, and calcium. SIBO can also prevent absorption of macronutrients: proteins, fats, and especially carbohydrates. Deficiencies in any of these nutrients can lead to other complications that can negatively impact your health.

Antibiotics can be used to treat SIBO by killing and removing bacteria from the gut. Initially, this may sound like exactly what we need, but remember that a certain amount of gut bacteria is actually favorable.

SIBO is not an infection and will not respond to treatment the same way infections do. Antibiotics kill both the overgrowth and the beneficial bacteria that aid in digestion. About half of the time, antibiotics for SIBO will return due to the fact that one’s diet and lifestyle often need to be adjusted in order to prevent recurrence.

The most effective approach to treating SIBO and maintaining a healthy gut post-intervention is to utilize the 5R protocol which addresses more than just the removal of the bacterial overgrowth.

The 5R Protocol is an all-encompassing approach that directs attention to all of the factors that can impact recovery.

restore your gut health using the 5 r protocol
  1. Remove excess bacteria by removing stressors and irritants
  2. Replace bacteria using digestive enzymes
  3. Repopulate using probiotics and prebiotics
  4. Repair the intestinal wall with nutrients and supplements
  5. Rebalance lifestyle to support maintenance of a healthy gut

Best Diet for SIBO

food spelling out the word diet on a white plate with a white gold background

Getting rid of the bacterial overgrowth is the first priority, so how do we accomplish that? Many of the diets for SIBO that may be recommended to starve the bacteria can be stressful to follow, difficult to understand, and time consuming. These diets can be extremely restrictive, leading to orthorexia (food obsession) or even further nutritional deficiencies.

There is one diet for SIBO that is easy to follow. It effectively starves the bacteria in just 2 ½  to 3 weeks all while still providing adequate nutrition to the body. This diet for SIBO is called the Elemental Diet. Following this diet for SIBO requires consuming only a medical, complete-nutrition beverage for 2 ½ to 3 weeks. 

This diet can be just as effective as herbal or antibiotic interventions. This makes it a great option for those with stubborn cases or those who want quick results. It is similar to fasting, so social support along with constant contact with your dietitian is essential to ensure lasting results.

After completing the Elemental Diet intervention to remove SIBO, the rest of the 5R protocol should be followed in order to sustain gut healing and prevent relapse.

In the same way that gut health issues don’t appear overnight, SIBO won’t vanish overnight. But with a little time and effort, you can heal your gut microbiome and go back to living your life with less stress, less discomfort, and improved wellbeing!

Do you think you have SIBO? Instead of sitting in doubt, make an appointment today to take the next step to improve your gut health!

28Nov
the migrating motor complex is your guts housekeeper surrounded by cleaning products
23 Nutrition Therapy TeamDigestion, Stress

The Migrating Motor Complex

Imagine… you’re sitting in class taking an exam, or waiting to be called into a job interview. You’re sitting in dead silence until… your stomach growls. Oh no, did everyone hear that? We’ve all been there! Maybe you haven’t eaten recently because you were cramming for the exam or preparing for the interview. These growling noises are actually the result of the migrating motor complex.

Most people have never heard of this before, so we wanted to dive into this topic to explain what the migrating motor complex (MMC) is, why it’s important, and how to enhance its function.

What is the Migrating Motor Complex?

the migrating motor complex is your guts housekeeper surrounded by cleaning products

The migrating motor complex (MMC) is responsible for moving material through our stomach and small intestine, cleaning house between meals or during sleep.

It is active during fasted states in order to push any undigested residues through the upper GI tract and into the large intestine to prepare a clean slate for your next meal.

This housekeeping role is essential because it reduces the chances of bacterial overgrowth. Without the complete removal of any leftover food within your system, bacteria have a chance to gorge on your meal. This can potentially lead to small intestine bacterial overgrowth (SIBO).

Migrating Motor Complex Stimulation

The MMC has multiple phases with varying strengths of contractions. But what stimulates the contractions to begin with?

The first section of the small intestine, the duodenum, is responsible for regulating the gastric contractions of the migrating motor complex by producing motilin when the duodenum is devoid of food.

3d diagram showing where the duodenum is within the human body

Any nutrients present in the duodenum will suppress the release of motilin, preventing the peak contractions from occurring. This is why spacing out your meals is important – grazing throughout the day can actually halt the migrating motor complex and inhibit it from effectively clearing out your system.

The accumulation of digestive juices in the duodenum increases pressure, which stimulates the release of serotonin. Serotonin further increases the pressure, leading to even more serotonin release, which leads to more pressure, which leads to… you can probably see where this is going!

This positive feedback mechanism reveals that more gastric, pancreatic, and bile secretions are associated with higher migrating motor complex activity. These secretions also aid in cleansing the small intestine by preventing bacteria accumulation. So you can imagine that a lack of any of these secretions could lead to an ineffective MMC and bacterial overgrowth.

The MMC and the Gut-Brain Connection

The vagus nerve is responsible for stimulating the migrating motor complex and supporting normal digestion and elimination. This nerve innervates nearly all of the organs in our torso with parasympathetic (rest and digest) impulses. While sleeping, the vagus nerve is most active because this is the time we are most relaxed and in a parasympathetic, unstressed state.

So you can imagine that when the vagus nerve is inactive, under-stimulated, or damaged, that this can cause a lot of issues with many organs in the body. Stress of any kind can send your body into a fight-or-flight, sympathetic response that deactivates the vagus nerve functions.

This is a huge problem because our bodies were designed to exhibit these stress responses when we encounter threats to our lives – not for the everyday stressors that exist in modern society.

Migrating Motor Complex Disorder

Food poisoning is often a cause of migrating motor complex dysfunction. These pathogenic bacteria that enter the small intestine through the stomach can release toxins that cause damage to the vagus nerve, preventing the MMC from working effectively to sweep material – including the pathogenic bacteria – through your digestive tract. The stasis of food and bacteria in the GI tract can lead to further issues, such as diarrhea, constipation, and SIBO.

Traumatic brain injuries, whether they are as mild as hitting your head on something or as severe as a car accident or concussion, can also be a cause of migrating motor complex dysfunction. Due to the gut-brain connection, any injury to the brain could trigger glitches in the migrating motor complex.

man in gray suit and glasses graping forehead sitting at desk with half open laptop

Chronic stress is another – and possibly the most common – culprit of MMC complications. We all encounter stress in our daily lives… this could be stress from work, relationship problems, or overlapping layers of uncertainties about the future. No matter the source of stress, our bodies are automatically reacting in the same ways – in order to ensure our survival. 

In reality, these responses are maladaptive to our current lifestyles. Most of us aren’t facing a fight to the death with a lion on a daily basis, but our bodies are still responding as if we are! The stress response turns off the vagus nerve and shuts down the migrating motor complex, both of which only work when we are in a relaxed, parasympathetic state.

Most of us spend more time in a sympathetic state than our bodies were designed for, and it directly affects our digestive functions. Any issue in your digestive functioning can cause even MORE stress… and it becomes a vicious cycle.

Tips for Enhancing Migrating Motor Complex Function

1. Space out your meals

fork knife and black alarm clock on white plate on blue wood surface

Since we know that the migrating motor complex slams on the brakes the minute we eat something, it makes sense that spacing out meals would be effective in enhancing migrating motor complex function. This also means that constant snacking is often a no-go if you are experiencing issues with digestion.

Eating one nutritionally balanced meal every 3-4 hours is usually recommended to ensure that the migrating motor complex’s housekeeping roles can be completed before you become hungry again.

Fasting overnight is something most of us do without thinking about, and it’s also something that is critical for optimal digestive function. Not eating between your last meal/snack of the day and breakfast should be relatively simple, because the majority of that time you are sleeping (hopefully!).

Giving your system a 12-hour overnight break from processing foods can guarantee that the migrating motor complex has plenty of time to fulfill its housekeeping duties.

2. Support your stress response

woman in camo yoga pants sitting on dock meditating with headphones

Addressing the stress in our lives is often the first step to eliminating digestive issues. Eliminating certain stressors that you encounter frequently is always a good place to start. However, sometimes it isn’t possible to completely remove a stressor from your life. This is where stress management comes into play.

Things like yoga, mindfulness, meditation, deep breathing, and other relaxation techniques are useful in lowering stress hormones, like cortisol. Training your body with relaxation techniques allows you to more easily get into a parasympathetic state. 

You can also support your stress response by using adaptogenic herbs and following an adrenal supplement protocol in coordination with your functional medicine dietitian. All of these things help tone down stress responses and improve vagus nerve function, leading to better digestion. 

3. Try prokinetics

Prokinetics are supplements that stimulate the migrating motor complex by promoting movement through the digestive system. Prokinetics include supplements such as medicinal bitters, ginger, and 5-HTP. Before taking anything, you should speak with your functional medicine dietitian to figure out the right support you need.

The MMC is essential for clearing out our digestive tract of any undigested materials and bacteria, eventually resulting in their elimination from the body. This process is absolutely necessary to prevent uncomfortable symptoms like gas and bloating, and to avoid more serious problems like IBS and SIBO.

Taking the steps to improve your migrating motor complex function today will help you acquire and maintain a healthy gut and relieve you of any gastrointestinal distress.

 

Schedule your appointment today for personalized tips for improving your gut health!

25Nov
stomach drawn with white pills on light blue background
23 Nutrition Therapy TeamDigestion

How Can I Increase My Stomach Acid?

Digestion begins in the mouth, but it definitely does not end there. After chewing and swallowing your food, the first organ in the digestive tract that is put to work is the stomach. Low stomach acid causes digestive dysfunction, and this blog will explain to you why that is.

The stomach produces stomach acid (HCl), which is extremely acidic (about 1.5 pH). Unfortunately, up to 90% of people experience hypochlorhydria (low stomach acid) at some point in their lives, especially as we get older. In this condition, the pH of the stomach acid can be less acidic, around 3-5.

Low stomach acid can result in poor digestion and cause many uncomfortable symptoms. Many people will grab antacids to address their symptoms because they may not realize that the underlying cause might actually be low stomach acid. Luckily, there are many courses of action that can be taken to improve your stomach acid levels without medication.

Why do we need stomach acid?

Stomach acid is essential for multiple reasons. First, it helps break down food in the stomach. The stomach is the first part of digestion where protein breakdown occurs. Without sufficient stomach acid, you may risk ineffective protein absorption due to fewer proteins being broken down into smaller peptide chains and amino acids.

In addition to protein digestion, stomach acid is also important in triggering some digestion of carbohydrates and fats. When your stomach spits out its contents into the small intestine, the acid stimulates your pancreas to release digestive enzymes and your gallbladder to release bile. Without enough stomach acid, the pancreas and gallbladder aren’t sufficiently stimulated to release these juices, and digestion may become less efficient.

Stomach acid is needed to absorb essential nutrients including iron, B12, calcium, magnesium, and zinc. Without the proper breakdown or absorption of nutrients, we end up obtaining less nutrition from the foods we eat. In addition to potential malabsorption of the macronutrients, vitamins and minerals may also be absorbed in lower amounts. This improper digestion can also lead to excess fermentation by our gut bacteria, resulting in problems such as bloating and gas. 

Another reason that we need plenty of stomach acid is that we consume potentially dangerous bacteria with our food and drinks regularly. Our stomach acid is there as a first line of defense against these pathogens, making it less likely that they will take hold further along the digestive tract, making us sick. These pathogens could also cause an imbalance in your personal gut microbiome, causing issues such as small intestine bacterial overgrowth (SIBO).

Signs of low stomach acid

Here are some common symptoms that can stem from low stomach acid:

  • Heartburn or acid reflux shortly after eating
  • Indigestion
  • Bloating
  • Burping or flatulence
  • Nausea, vomiting, diarrhea or constipation
  • Adult acne and other skin issues
  • Vitamin and mineral deficiencies
  • Anemia – iron or B12 deficiency
  • Brittle nails and hair loss in women
  • Fatigue
  • Protein maldigestion and malabsorption
  • Autoimmune diseases
  • Poor immune system functioning

Some chronic health issues that are associated with low levels of stomach acid include: 

  • Food allergies
  • Celiac disease
  • Eczema
  • Gallstones
  • Psoriasis
  • Asthma
  • Gastric cancer
  • Rheumatoid arthritis 

Improper digestion due to low stomach acid can end up affecting your entire body due to the decreased availability of nutrients and increased levels of chronic inflammation.

What causes low stomach acid?

One of the biggest things that affects your entire digestive system is stress. These stressors can include dietary, pathogenic, and emotional stressors, along with pain and hidden inflammation.

When stressed, the stomach produces less stomach acid. This compounds in itself, resulting in less and less stomach acid the more you are exposed to continuous stress throughout your day.

Decreased stomach acid production also occurs as a result of aging. Around age 30-40, stomach acid secretion is usually cut in half compared to our teenage years. This effect continues, with people over 60 years old producing significantly less stomach acid: about 25% of what they did when they were adolescents.

Other things that can lead to low stomach acid levels include drinking alcohol, smoking, caffeine, some antibiotics, malnutrition, and the overuse of antacids.

Low protein, high-carb diets, or diets high in processed foods can also reduce stomach acid levels. Deficiencies in minerals such as zinc – which is needed to produce stomach acid – are also often a cause of reduced stomach acid.

However, stomach acid is needed to absorb zinc, so if you’re suffering from low stomach acid, simply taking zinc is not necessarily effective in improving your stomach acid levels. The stomach acid levels need to be addressed first before you can address the zinc levels. 

How do I know if I have low stomach acid?

You can start by doing a quick baking soda stomach acid test, burp test, or low stomach acid test apple cider vinegar, to see if you might have low stomach acid.

Burp Test:

It is not recommended to do this test frequently.

  • Before you eat or drink anything, and before brushing your teeth
  • Mix a small glass of warm water with about 1/8 tsp of baking soda
  • Drink the entire glass (warning: it will be a little salty and metallic)
  • Set a timer and wait for the burp!

Burp timing and its possible meaning:

  • Before 1 minute = high stomach acid
  • 1-2 minutes = normal stomach acid
  • 3-5 minutes = low stomach acid

Once you’ve done this self-test, be sure to communicate your results with your functional medicine dietitian.

This test isn’t foolproof, but when taken along with a full review of your medical history and analysis of diagnostic tests, it can give your functional medicine dietitian a good idea of your stomach acid levels. Your functional medicine dietitian can then suggest specific nutritional therapy to begin to address your problem. 

Another way to assess for low stomach acid is to get a comprehensive stool testing like Genova GI Effects and look at your products of protein breakdown. If it is high, you are not digesting protein very well and could use some stomach acid support. 

How to Increase Low Stomach Acid Naturally?

Increasing your stomach acid levels will help to improve both your symptoms and your overall digestive function. 

Since everyone is different, please be sure to get guidance from your functional medicine dietitian to determine which course of action will work best for you. 

Here are some things that may be recommended to help bring relief and rebalance your stomach acid levels:

  • Reduce stress using relaxation techniques
  • Chew food thoroughly before swallowing
  • Eat protein at the beginning of a meal
  • Eat fermented foods, if tolerated (kombucha, sauerkraut, kimchi, kefir)
  • Exercise
  • Avoid drinking liquids before and during meals
  • Avoid caffeine, alcohol, and highly processed foods
  • Stay hydrated
  • Try digestive enzymes, bitters, apple cider vinegar or Betaine – HCl supplements*
  • Follow nutritional therapy, as advised by your functional medicine dietitian

* Only take these with guidance from your functional medicine dietitian who will give you a personalized 5 R Protocol

Alternatives to Proton Pump Inhibitors…A note on acid-reducing medications. 

We don’t recommend regularly using antacids or PPIs (proton pump inhibitors) to treat any digestive symptoms before speaking with your functional medicine dietitian. These are meant to be short-term solutions, but many people end up taking them long-term. 

Consequently, cutting out these medications cold turkey can lead to severe pain and burning symptoms. If you’re taking these medications and feel dependent on them, you will need to be weaned off of them gradually and under the guidance of your functional medicine dietitian.

If you have low stomach acid – these medications won’t address the actual problem and often end up causing more problems down the line. These medications are used to reduce stomach acid levels and are often recommended or prescribed by doctors without even checking your stomach acid levels first. Many doctors will assume that your symptoms are caused by high stomach acid, when in reality it is likely to be the opposite. 

If you were prescribed these medications but were actually suffering from low levels of stomach acid, the result may be that you have almost no acid production. So instead of guessing what the root cause of your digestive issues might be, talk to your functional medicine dietitian today to get tested and recommendations for alternatives to proton pump inhibitors!

Do you think you may be suffering from low stomach acid? Let us help you find the root cause of your symptoms and get you on the road to recovery. Schedule your free 15-minute nutrition strategy appointment today!

20Nov
digestive system with neon pink blue green and turquoise
23 Nutrition Therapy TeamDigestion

The Steps to Digestion: A Quick Guide

Do you often experience abdominal pain, bloating, or acid reflux after eating? Do you reach for symptom soothers like Tums or Pepto bismol more often than you’d like to admit? Maybe you pop probiotics because you’ve heard from a friend that they help with bloating, but that isn’t working? Digestive symptoms typically signal that something has gone wrong during one of the steps to digestion.

Digestion is a very complicated process that most people don’t fully understand. There is much more going on than just food going through your mouth, reaching your stomach, and eventually coming out the other end. Each meal travels 26 feet before it ends up in the toilet! That’s 26 feet where potential problems could arise.

digestive system with neon pink blue green and turquoise

The digestive organs usually work in perfect coordination like a well-oiled machine. But like any machine, sometimes things can go wrong. Reaching for over-the-counter (OTC) symptom soothers is not always the best choice to address your digestive issues, especially if you are experiencing these symptoms regularly.

This blog is a quick guide to digestion and a basic explanation of all the steps to digestion. Reading this blog should help you realize that digestive issues are not usually an easy fix!

Digestion Starts in the Mouth

woman smiling and eating a yellow popsicle on white background

Digestion begins when you take a bite of your food and start to chew. The salivary glands in your mouth kick into action, infusing each bite with saliva that is filled with enzymes that kickstart the process of breaking down starches and fat. This fat digesting enzyme is only available in trace amounts for adults. In babies, it’s present in much larger amounts and helps the infant digest the fats in milk.

Chewing is imperative for multiple reasons. The first is because it breaks down your food into smooth bits that can be swallowed without choking. Chewing also helps you burst open foods like seeds that cannot be digested without being physically broken open. Many people eat way too quickly, so be mindful when you eat, and chew your food thoroughly before swallowing!

peristalsis graphic showing how it moves

Once you swallow your food, it travels down your esophagus where wave-like movements direct it towards your stomach. These waves are referred to as peristalsis.  A sphincter muscle allows entry to the stomach, and helps to prevent food from coming back up in the wrong direction. The next steps to digestion are outlined below.

The Stomach breaks down and liquefies your food

black and white xray image of torso organs with red highlight of stomach and esophagus

Once food exits the esophagus, it enters the stomach where it is added to stomach acid, enzymes, and fluids. Your stomach has 3 layers of thick muscles that tighten and relax, churning this mixture thoroughly until your food turns into a liquid called chyme.

There are actually a couple compartments within the stomach. When food enters the stomach, it gets stored in the top compartment shortly and then moves into the lower compartment where the churning begins.

Eventually after a lot of churning, the food becomes chyme: an acidic, mushy food paste that consists of partially digested food and gastric juices. The gastric juices contain concentrated hydrochloric acid, (HCl) water, and enzymes. Stomach acid is extremely acidic (~1.5 pH), but doesn’t damage your stomach due to the mucus produced by the walls of the stomach that protect the digestive lining. This acid will kill most bacteria that sneak their way into the stomach with your food.

At this point in digestion, the starches are partially split and proteins are uncoiled. Fats separate from the rest of the mixture and float on top of the watery, protein and carb-rich chyme. As the chyme leaves the stomach, the fat layer is the last to exit. The more fat in a meal, the slower digestion proceeds, which explains why you feel fuller longer after a fatty meal.

Food exits the stomach a little bit at a time through a valve at the bottom of the stomach called the pyloric valve. Your stomach spits out chyme into the small intestine for a few hours after your meal until it is empty.

The small intestine is responsible for nutrient absorption

The small intestine is an incredibly long and winding organ where the majority of nutrient absorption occurs. There is so much surface area on the walls of the small intestine that if it were laid out flat, it would cover 1/3 of a football field!

This hugely important organ receives and secretes enzymes in response to food to help break down carbohydrates, proteins, and fats in preparation for absorption. You may be able to guess that the role the small intestine plays is actually one of the most important steps to digestion, and you would be correct. Each step is extremely important, but nutrient absorption is essential to life.

The cells along the walls lining the small intestine have finger-like projections called villi that pick up vitamins, minerals, and broken down nutrients once they’re small enough to absorb. Each villus then directs these nutrients into your bloodstream or into your lymph.

villi of the small intestine

The liver and gallbladder are in charge of bile production and storage

Your liver has many functions, but did you know it plays a role in digestion? The liver produces bile, which helps digest fats. The liver sends bile over to the gallbladder for storage, where it remains until needed in the small intestine. Once the small intestine is in need of bile, hormone messengers signal the gallbladder to contract and squirt bile through the bile duct into the small intestine.

Bile is an emulsifier. What this means is that it causes the separated fat layer to become suspended within the watery chyme.  This leads to more fat being exposed to fat-digesting enzymes for optimal absorption. Most bile gets reabsorbed and reused, but some may exit the body with the feces at the end of all the steps to digestion.

diagram of the liver and gallbladder and their parts

It is indeed possible to live without a gallbladder, because the liver will continue to produce bile. But instead of the bile getting stored somewhere, it is delivered directly into the small intestine through a different duct. If you have had gallbladder removal surgery (and even if you haven’t), you may need some supplemental bile and enzyme support.

Your pancreas secretes digestive enzymes

black and white xray image of torso organs with pancreas highlighted in red

Your pancreas is in charge of making digestive enzymes that help break down macronutrients (carbohydrates, proteins, and fats) into smaller and smaller pieces until the nutrients are small enough to be absorbed.

The job of the pancreas is to release pancreatic juices containing these digestive enzymes into the small intestine. Pancreatic juices also include alkaline bicarbonate, which neutralizes the stomach acid that enters the small intestine with chyme. The pancreas plays an essential role in digestion because the small intestine cannot play its role in nutrient absorption without these digestive enzymes.

One type of nutrient that doesn’t get absorbed in the small intestine is fiber. So, fiber will move along into the large intestine for the next steps to digestion. 

Stool is formed in the large intestine

diagram of the intestines and all of its regions

Once the remnants of your food enter the large intestine (colon), digestion and absorption are mostly complete. Essentially all of the carbs, fat, and protein have been digested and absorbed at this point.

The colon absorbs any leftover minerals and reabsorbs water that was donated by other digestive organs earlier in the digestive process. What is left behind is a paste containing water, indigestible fiber, dead bacteria, and any other undigested materials: this is what makes up your feces. The longer stool sits in the colon, the more water is extracted and the harder your feces become, leading to constipation.

A lesser-known organ: the gut microbiota

Our colon contains about 100 trillion beneficial microbes. They outnumber human cells by about 10 times! In a way, the gut microbiota can be considered its own organ. For example, humans don’t create enzymes that allow us to digest fibers, so this is where the gut bacteria come in handy.

Gut bacteria are able to ferment and break down fibers for us. They salvage nutrients for us that we wouldn’t necessarily have access to otherwise. They turn fibers into short chain fatty acids (SCFAs) such as butyrate, propionate, and acetate that benefit us in many ways. For example, SCFAs can give energy to colon cells, can protect against inflammation, and can even promote brain health. 

Our gut microbiota also break down and help recycle the components of bile. They can even produce some vitamins for us, but not in amounts large enough to meet our body’s needs. So it is still very important to make sure you have a balanced diet based on a variety of foods to ensure you are consuming enough micronutrients.

gastrointestinal bacteria friendly vs unfriendly

Our gut microbiota can also be thrown out of balance, in a state called dysbiosis. Dysbiosis occurs when you have a higher proportion of unfriendly bacteria compared to friendly bacteria. This can lead to many other health complications. A comprehensive stool test can be used to determine whether or not you are experiencing dysbiosis or have a balanced microbiome.

Research about the gut microbiota is booming. There is still so much that we don’t understand, but we are just now realizing the impact these bacteria have on our lives.

Potential root causes of digestive dysfunction

hand holding marker and words that say root cause on black background

So now you should understand a little bit about the complex interrelation between the digestive organs. There are many points along the way where problems could arise.

Here are some examples of potential root causes that can lead to various digestive and absorption issues:

  • Not fully chewing your food
  • Sphincter muscle dysfunction between stomach and esophagus
  • Small intestine bacterial overgrowth (SIBO) due to bacteria leaking from the mouth or relocating from the large intestine
  • Low stomach acid production
  • Insufficient bile flow
  • Low production of pancreatic enzymes
  • Motility dysfunction of the small or large intestine
  • Dysbiosis of gut microbiota
  • Chronic stress
diagram showing stress causing brain gut dysregulation and altered motility of intestine

OTC medications simply mask your symptoms but they don’t address the root cause. This is like putting a band-aid on your symptoms, only providing temporary relief. Diving deep into the steps to digestion to really understand your digestive function, and finding the issue your symptoms stem from is often the only way to get rid of uncomfortable symptoms for good! 

Do you need some help figuring out the root cause that your digestive issues are stemming from?

Schedule your appointment today to get your digestive system back in check!

Interested in learning more about digestive health? Read our other blog, “Heal Your Gut with 5 Simple Lifestyle Changes” to learn more about what you can get started on doing today!

19Nov
woman torso in underwear holding hands in heart shape over her bare stomach
23 Nutrition Therapy TeamDigestion, Lifestyle

Heal Your Gut with 5 Simple Lifestyle Changes

There is so much information on the Internet about how to improve gut health and relieve uncomfortable symptoms. It can be confusing to know where to begin if you’re doing the research on your own. Do I need to take any supplements? How about probiotics? Should I avoid certain foods? Should I get tested for – insert any of the multitude of gut conditions here? How do you really find out what is best for you to heal your gut?

Unfortunately, there is not a “one size fits all” answer when it comes to gut health. The types of things listed above should always be done in coordination with a dietitian, who has the knowledge to guide you in the right direction according to your personal needs.

The good news is that there are some easy gut health lifestyle changes that you can start doing today that can help lay the foundation for a healthy gut! 

Here are 5 simple lifestyle changes you can make that will help you to heal your gut!

1. Slow down while eating

Are you the type of person who rushes through their lunch break? Or maybe you’re finished with your meals within a mere 10 minutes. Please stop eating food too quickly! It is important to chew your food sufficiently in order to heal your gut.

Chewing is an essential part of digestion. Chemicals in our saliva, such as digestive enzymes, help us break down certain nutrients. The antimicrobial properties of our saliva also help to kill some potentially pathogenic bacteria that may be present in the things we consume.

Chewing until food is soft and smooth makes digestion easier further down the digestive tract. Not chewing food enough may lead to digestive problems, malnutrition, and dehydration. Bloating, diarrhea, acid reflux, maldigestion, gas, and abdominal cramping can all result from not chewing your food enough.

Mindfulness and eating go hand in hand because it promotes the parasympathetic, rest and digest state. This is the state you need to be in for the digestive processes to kick in and do their job. Avoid stress during meal times, and try to eat slowly to really enjoy your food. This should lead to better digestion and nutrient absorption.

How to slow down while eating:

  • Chew your food about 30 times before swallowing.
  • Aim to swallow only a couple of times per minute.
  • Make mealtimes relaxing and practice mindfulness

2. Quit snacking

Spacing out meals is really critical for gut health. We need to have periods of time without food in our system in order for the migrating motor complex (MMC) to fulfill its housekeeping duties.

The MMC is responsible for flushing out undigested materials and bacteria through our digestive tract to eventually be flushed down the toilet.  If the MMC cannot do its job, bacteria in the gut now have a chance to overgrow by thriving off of the undigested materials that continue to hang out in the gut. Repeatedly stalling the MMC can lead to conditions like SIBO (small intestine bacterial overgrowth), which can lead to many other digestive and systemic issues.

A general rule is to wait about 3 to 4 hours after a meal before eating again. This should ensure that your MMC can serve its purpose, leaving a clean slate for your next meal. Getting your MMC functioning optimally is essential to heal your gut.

Another perfect time for the MMC to perform its housekeeping duties is while you’re asleep! Sometimes that midnight snack sounds really appealing, but our digestive functions work best if given a 12-hour overnight break. So be sure to make your meals count: they should be nutritious, balanced, and keep you full until your next meal.

How to stop mindless snacking:

  • Eat balanced meals containing protein, healthy fats, and complex, fiber-rich carbs with sufficient calories that will keep you fuller for longer
  • Meals should be spaced out about 3 to 4 hours
  • Don’t eat between dinner and breakfast for a 12-hour overnight fast

3. Remove stressors from your daily life

Stress negatively impacts many aspects of our overall gut health. Most people are familiar with experiencing digestive issues when going through stressful situations such as job interviews, a big exam, or a presentation at work.

Spending more time doing the things you love, and less time doing things that stress you out is an easy way to elevate your overall health. Not only will you feel happier… you will also become healthier and each of these leads to an overall increased sense of wellbeing. Healing your lifestyle can directly lead to you being able to heal your gut.

Keep track of the moments when you feel stressed and find the patterns. There may be some things you’re able to remove completely.

  • Maybe your home environment is cluttered and messy?
  • What if you have a toxic relationship with social media?
  • Maybe your email inbox is at 13,000 unread emails?
  • Perhaps you’re always running late?
  • Maybe you tend to procrastinate?

These are all situations that can be avoided and removed.

  • Clean your house to help declutter your mind.
  • Take a weekly social media hiatus and spend the time you gain back on a hobby.
  • Break up the big task of going through 13,000 emails into smaller increments, scattered throughout the week.
  • Leave earlier for work, appointments, and plans with friends.
  • Use time-blocking to organize your time better, leaving no room for procrastination.

Doing the work to remove the stressors that are under your control can put you on the path to better overall health.

Sometimes the things that stress us out are out of our control. If it isn’t possible to completely remove certain stressors, the next best thing would be to improve your response to stress.

4. Practice mindfulness and relaxation techniques

Relaxation techniques that are successful in improving gut health outcomes include things like: deep breathing exercises, mindfulness, meditation, and yoga.

Square breathing (AKA 4×4 breathing, block breathing) during a stressful event is an effective way to help pull your focus off of the negative feelings and elicit a state of calm within the body. To do this, inhale for 4 seconds, and then hold for 4 seconds. Next, you exhale for 4 seconds, and then hold for 4 seconds. Repeat this cycle until you feel more zen and less stressed. It is important to note that when you inhale, your belly should expand rather than your chest.

Mind-body practices like mindfulness, meditation, and yoga have been shown to reduce perceived stress and help regulate stress response systems. Mindfulness involves being more aware and conscious in the present moment.

This can be done by tuning into bodily sensations, paying detailed attention to your surroundings, and allowing thoughts to come and go without judgment. Mindfulness is a form of meditation that can easily be performed any time or place. Yoga, mindfulness, and meditation (in the classic, more formal sense) can all improve your reactions to stressors over time.

Using whichever relaxation technique that best works for you can help heal your gut and improve your overall well being. Being able to respond more calmly to stressful situations comes with practice, and this ability is directly related to the function of a very special nerve in your body: the vagus nerve.

5. Improve your vagal tone

The vagus nerve is often under-appreciated. It relays signals between the brain and almost every organ in your torso, however it works best when we are in an unstressed state. This is the reason why digestion doesn’t work properly when you’re stressed out! The vagus nerve creates what we call the gut-brain connection.

Many people live with chronic stress which directly impacts gut function. This chronic stress can lead to poor vagus nerve function, but there are measures we can take to stimulate the vagus nerve and have an increased vagal tone. Increased vagal tone indicates that you can relax quickly after you experience stress.

Stimulating the vagus nerve can be done in several different ways, and can lead to the dampening of the stress response, putting you in a state of relaxation.  A couple of the easiest ways to stimulate the vagus nerve are possible due to the fact that the nerve runs through the muscles in the back of the throat.

One of these simple exercises includes humming or singing at the top of your lungs while showering or driving to work. Gargling warm salt water for 30 seconds (until your eyes begin to water) will also activate the vagus nerve.

Practicing vagus nerve stimulation can serve to modulate your body’s automatic stress responses, and over time you may actually find yourself more capable of remaining calm and stress-free. Tuning in to your body and being mindful of how you respond to stress — and noting how often you feel stress — is the first step in improving how your body reacts.

 

Now you have a few more tools in your toolkit that will help you to heal your gut!

Always pay attention to your body and trust your gut! Never be afraid to ask for help. 

For personalized guidance for how to achieve a healthy gut, schedule your appointment today!

11Nov
stressed woman juggling responsibilities
23 Nutrition Therapy TeamLifestyle, Stress

Relaxation Techniques: The Top 4 Types

If you’re reading this, you may be feeling the effects of stress and are seeking some relief! This blog will briefly describe the way our bodies – and our gut – respond to stress, and give you some tools to improve your resilience and overall wellbeing. We will discuss the best types of relaxation techniques for stress reduction.

Humans are not well adapted to the modern world 

stressed woman juggling responsibilities

Every day, we encounter minor mental stressors that our ancestors didn’t have to deal with. They had to deal with the physical threat of fighting predators, while we have to deal with things like long work-weeks, financial worries, adapting to life during a pandemic… These things don’t compare when it comes to life and death, but unfortunately for us, our bodies react the same way to both types of situations.

Our bodies have an automatic response to stress, which our brains perceive as a psychological threat. The brain triggers a cascade of events within the body called the stress response, which way back in the day was meant to ensure our survival. Today, the stress response may be triggered multiple times over the course of the day, keeping our cortisol levels high and leaving us in a maladaptive, sympathetic nervous system state.

The stress that so many of us feel on a daily basis can actually be both physically and mentally harmful. Stress has a HUGE impact on digestion and gut health, and luckily for us, there are steps we can take in order to take back control over our gut health in the midst of a stressful life.

The relaxation techniques listed below can be practiced regularly to give you better control over your reactions to stress. But first, let’s discuss the impact stress has on your gut health.

How does stress impact the gut?

For digestion to function normally, we must be in a relaxed, unstressed state where the parasympathetic branch of the autonomic nervous system is in control. Whenever we experience stress, the automatic stress response activates the opposing branch of the autonomic nervous system – the sympathetic branch.

The sympathetic branch inhibits digestive functions, because they are not essential for immediate survival. This can lead to many digestive problems, especially when stress becomes a recurrent aspect of your daily life – when stress becomes chronic.

So what impact does stress have on the gut? Some symptoms (that you may be quite familiar with) that are commonly experienced due to stress can include diarrhea, constipation, nausea, indigestion, abdominal pain, and heartburn.

man in black and white grabbing stomach highlighted in red

Enough bad news… let’s get to the good news! Reducing the stress in our lives is not only possible; it is relatively simple to do. Here are some stress reduction and relaxation techniques that you can add to your daily life today!

Relaxation Technique #1: Vagus Nerve Exercises

The vagus nerve is part of the parasympathetic autonomic nervous system – the branch that dominates only when we’re relaxed. This branch is nicknamed the “rest and digest” branch because digestive processes can only function under a relaxed, parasympathetic state.

Your vagus nerve is connected to every organ in your torso except the adrenal glands, which pump out the stress hormones when you are stressed.

The vagus nerve has many impacts on digestive health, and stimulating this nerve is important for improving resilience in the face of stress. So how do we stimulate this nerve to make it function better?

The vagus nerve runs through the muscles in the back of your throat. Vibrations on these muscles can activate the nerve, which over time can help you bounce back from stress more easily.

Here are a couple simple things you can do to stimulate the nerve and improve your vagal tone:

  1. Gargle warm salt water (until your eyes start watering!)
  2. Sing at the top of your lungs! Or hum loudly.
  3. Use cold water for 1 minute at the end of your showers
woman gargling water in her bathroom

Luckily, practicing vagus nerve stimulation at home can be so simple! Both of these techniques are easy to do and can be added to your daily regimen immediately, so why not try them out today?

Relaxation Technique #2: Practice Mindfulness

Mindfulness involves simply being present in the moment and paying attention to any bodily sensations. We are predisposed to have our minds wander since we are constantly stimulated in our daily lives. Mindfulness techniques center you to notice your current physical and mental state without judgment. The continued practice of bringing attention to the present moment and how you are connecting with your surroundings is clinically shown to reduce stress and negative mental states.

woman meditating at her desk in front of her laptop

A common mindfulness method is to complete a body scan. To do this, you can be lying down, sitting, or standing. Just close your eyes, breathe slowly, and focus on how your body feels starting from your feet upward, or from your head downward. Focus on how your clothes feel on your body, how certain body parts feel touching each other, and any pressure felt from the ground or the chair. Doing this even just a couple times can help reduce stress and induce a feeling of peace.

Relaxation Technique #3: Yoga Nidra

Yoga nidra, also known as “Yogic Sleep,” is a form of pre-bedtime guided meditation that puts you in a very relaxed state. For most people, this form of meditation is much easier to accomplish than sitting still and trying to “clear your mind.” Practicing yoga nidra over time can lead to benefits such as better sleep, reduced stress, and improved wellbeing.

Yoga nidra involves lying down on a yoga mat (or even your mattress), setting a sankalpa (intention), and simply following what the guided meditation says. Some practices are 5 minutes, others can be an hour or longer. There are many audio guides of varying lengths available online that can easily be followed at home, so this practice is accessible to everyone!

woman laying on the floor yoga nidra

Yoga nidra is an easy way to reduce stress, relieve tension and pain, and connect with yourself on a deeper level. Practicing yoga nidra right before you go to sleep can clear the mind and allow yourself to tap into your subconscious self to reach your goals and intentions.

Relaxation Technique #4: Deep Breathing Exercises

One of the best relaxation techniques involves something that we usually do without any thought. Breathing is essential to human life, and is key in both the mindfulness and in yoga nidra practices mentioned above.

The diaphragm is the key muscle that is used in relaxed breathing states. However, many people breathe using their accessory respiratory muscles rather than the diaphragm.

To test whether you’re prone to dysfunctional breathing, place one hand on your chest and the other on your belly. Take a few deep breaths in, and pay attention to which hand is moving. Your belly should be the area that expands when you inhale. If your chest is expanding more than your belly, this is a sign that you might be in a sympathetic state, under stress.

Slow, deep breathing using your diaphragm improves efficiency within the lungs.  Clinical studies also show that deep breathing plays a huge role in our cardiovascular health and helps to decrease blood pressure. It can also promote higher heart rate variability (HRV), which is a sign of high vagal tone.

Studies suggest that practicing deep breathing exercises regularly for 3 months or longer can shift your autonomic nervous system to parasympathetic dominance – this means that deep breathing can modulate your stress response so that you are more resilient in the face of stress!

the words just breathe scratched into the sand on the beach at sunset

Deep breathing exercises have been practiced for centuries, especially in Eastern cultures. Western cultures are just now realizing the advantages of a more holistic approach to wellness, even though many practices have been around for hundreds of years. In yoga, breathing is called “pranayama.” One variation of pranayama is alternate nostril breathing.

How to do Alternate Nostril Breathing:

  • Sit in an upright, relaxed position and close your eyes. Place one hand with your palm facing upwards on top of your knee.
  • With your other hand, raise your pointer and middle fingers and lightly place them in between your eyebrows. Your ring and pinky fingers should cover one nostril, and your thumb covers the other nostril. Do not exert any hard pressure to your nose or forehead.
  • Exhale through your right nostril while holding the left nostril shut.
  • Inhale through your right nostril, then shut the right nostril and release the left nostril.
  • Exhale through the left nostril, while keeping the right nostril closed.
  • Inhale through the left nostril, then close the left nostril and exhale through the right nostril. This step completes one cycle of alternate nostril breathing.
  • Continue these steps for as long as needed to relax the mind.
  • Always inhale through the nostril you just exhaled through.
woman sitting outside in autumn practicing alternate nostril breathing

Another deep breathing exercise that can be used to calm your nerves is called 4×4 breathing (aka square/box breathing).

How to do 4×4 Breathing:

  • Sit or lie down in a comfortable, relaxed position and close your eyes. Release any tension from your body.
  • Inhale through your nose for 4 seconds
  • Hold your breath for 4 seconds.
  • Exhale through your mouth for 4 seconds.
  • Hold your breath for 4 seconds.
  • Repeat this cycle as many times as you want over the course of a few minutes until you feel a sense of calm.

 

Since stress negatively impacts our health, it is important for us to take back control in whatever ways we can. As you can see, none of these relaxation techniques are very difficult, so it is easy to get started today! Pick whichever relaxation technique works best for you, or combine multiple techniques and you may begin to feel less stressed within a short period of time.

woman singing into her shower head in the bathtub

Still feeling stressed over your gut health?

Schedule your appointment today to help you get to the root cause of the problem, so you can start living your best life!

the top 4 types of relaxation techniques

 

 

 

Sources:

https://breathe.ersjournals.com/content/13/4/298

https://www.sciencedirect.com/science/article/abs/pii/S1566070201002673

https://search.proquest.com/openview/9b98ccfa3b77e8dc6667b20e1ca0f96c/1?pq-origsite=gscholar&cbl=37533

https://www.sciencedirect.com/topics/medicine-and-dentistry/heart-rate-variability

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134749/

11Nov
man in pain with upset stomach
23 Nutrition Therapy TeamDigestion, Stress

Stress and the Digestive System

Stress is something that, unfortunately, we are all very familiar with. The gut problems that result from stress are also no stranger to most of us.

This blog will explain some of the physiological changes that happen in the body when we’re stressed out that lead to the discomfort you may be feeling.

Can stress cause gastrointestinal problems?

Think of any gut issue, and it’s extremely likely that it is somehow connected to stress. Many of us have experienced an upset stomach from stress at some point in our lives. There are many gastrointestinal (GI) symptoms that illustrate the connection between stress and the digestive system.

Here are some examples of GI symptoms that are related to stress:

  • Abdominal pain
  • Indigestion
  • Heartburn and acid reflux
  • Diarrhea
  • Constipation
  • Nausea and vomiting
woman holding stomach in pain

To some extent, all of us are familiar with most, if not all, of these uncomfortable symptoms.  Here, we will explain why these symptoms occur to explain the connection between stress and the digestive system.

Low Stomach Acid

Contrary to popular belief, the stomach actually produces less stomach acid (concentrated hydrochloric acid – HCl) when we’re under stress. So how does less acid lead to acid reflux and heartburn?

This happens because the sphincter muscle connection between the esophagus and the stomach relies on sufficient stomach acid production to determine when it should be closed. This means, when stomach acid levels are low, the opening stays open and what little acid there is in the stomach can now enter the esophagus and cause heartburn.

woman in black and white with cartoon stomach on fire

Low levels of stomach acid also cause issues with digestion. Certain nutrients may not be as easily absorbed because they won’t get properly broken down without enough stomach acid.

Also, any bacteria we consume with our food (or even bacteria that naturally live in the mouth) may not be killed, which could lead to food poisoning. This can also lead to other dysbiosis (microbial imbalance) issues in the gut, such as SIBO (small intestinal bacterial overgrowth).

Interrupted Bile Flow

Another symptom that is common with stress and the digestive system is interrupted bile flow. Bile is produced by the liver and stored in the gallbladder. When we’re stressed, bile flow is interrupted and grinds to a halt.

Why does this happen? First of all, the stress response suppresses bile release from the liver into the gallbladder because energy is being diverted away from digestive processes and towards your muscles. Also – since digestion stops when you’re stressed, the stomach doesn’t release any food into the small intestine, which is the signal for the gallbladder to pump bile to aid in digestion.

So why is this a problem? The gallbladder is the storage organ for bile, which assists with fat digestion. When the gallbladder is repeatedly inhibited from releasing its bile stores, the entire biliary system gets disrupted. 

Some issues that can arise include fat malabsorption, fat-soluble vitamin malabsorption, diarrhea, abdominal pain after eating fatty foods, nausea, and feeling heavy after eating. Interrupted bile flow can also cause bile to become over-concentrated with cholesterol and potentially lead to painful gallstones.

gallstones inside gallbladder

Changes to Gut Motility

Gut motility alteration also signals to the connection between stress and the digestive system.

The hormones that are released while you’re stressed out are shown to impact gut motility. This causes the upper gut (your stomach and small intestine) to slow down its digestion process and also decreases the absorption of nutrients. Food stays stagnant in the stomach and small intestine. Stagnant food causes issues such as malnutrition, abdominal distention, bloating, nausea, and vomiting. This is why you can sometimes feel nauseated or even vomit when you’re extremely nervous.

woman holding up cardboard image of intestines

The opposite situation usually happens in the large intestine. During stress, the large intestine speeds up, disregarding its duties of packing our excrement into shape and reabsorbing water. This reduced gut transit time explains why we might experience diarrhea when we’re stressed out.

Heightened Gut Hypersensitivity

Studies also show that sensitivity within the gut increases when we’re under stress. Heartburn and other gastrointestinal (GI) symptoms can actually feel worse when we’re under stress than the same symptoms feel when we’re relaxed.

This relates to irritable bowel syndrome (IBS) – where you experience hypersensitivity in addition to changes in motor function of the gut. Unfortunately, patients with IBS and other GI issues are subject to a vicious cycle where stress contributes to the severity of their symptoms, which then causes even more stress…

Weakened Immune System

Chronic stress can weaken the immune system, making it more likely that we will get sick. When we’re stressed out long-term, the continuous surges of cortisol and other hormones cause widespread inflammation and slow immune cell production, both of which can increase the risk of infection and tissue damage.

sick woman in blanket blowing nose looking at thermometer

Did you know that 60 to 70% of your immune system is in your gut? This makes sense when you really think about it. Our digestive systems are connected to the outside world – humans are essentially just tubes with a lot of complicated accessories.

People consume dangerous pathogens through food and drink every day. Our immune system needs to be especially active in our gut to help protect us from things like food poisoning and small intestine bacterial overgrowth (SIBO).

Hidden Inflammation

Inflammation is valuable in small doses. The inflammatory response is the part of the immune response that promotes tissue healing. Inflammation is supposed to stop once healing is complete, however, this doesn’t always happen. Chronic stress can lead to chronic inflammation, which can then contribute to much larger problems.

woman holding stomach with xray intestines

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are exactly what they sound like – diseases caused by excessive inflammation and irritation in the intestines. These are autoimmune conditions, where your immune system thinks your own cells are foreign enemies. Studies suggest that these diseases are ultimately triggered by disruptions in the immune function within the gut, imbalances in gut microbiota, and leaky gut – all of which can be the result of chronic stress.

A Quick Note About the Gut Microbiome

The bacteria that live in our digestive systems (mostly within the large intestine) are usually beneficial for us. They can produce various products such as essential vitamins and short chain fatty acids that our bodies need. 

Each person’s microbiome is as unique as his or her fingerprint. We obtain these bacteria throughout our lives, starting with our journey through the birth canal and continuing with exposure to the environments and foods we are raised with. These bacteria are there to work with the immune system to strengthen the gut lining, prevent inflammation, and protect against any intruding bacteria from colonizing where they don’t belong.

intestines with blue bacteria

Bacterial Imbalance of the Gut Microbiome

When we experience stress, the gut microbiome is altered. One way this can happen is because when digestion shuts down, any food in the small intestine just hangs out there. This means that our housekeeping system, the migrating motor complex, cannot sweep the small intestine clean of invading bacteria.

Without this housekeeper, any pathogenic or unwanted bacteria that has found its way into our intestines, through our food or from our mouths, is now likely to take refuge there. This can lead to an imbalanced microbiome, uncomfortable GI symptoms, increased colon inflammation, autoimmune diseases like Crohn’s disease, and conditions like SIBO.

microscopic bacteria in intestines

Something that you may find really interesting is that your personal microbiome also affects how you respond to stress. Research indicates that people who are able to stay calm during stressful situations have similar microbiomes, which are very different when compared to those who react the most strongly under stress.

The gut-brain connection is bidirectional, but the signals from the gut to the brain are much stronger than the other direction. We know that chronic stress can change both the proportions and the diversity of these bacteria in your gut. So when stress causes an imbalance in your gut bacteria, the newly reigning gut bacteria may actually diminish your resilience to stress.

It all boils down to the gut-brain connection!

When we’re stressed, the nerve that controls digestive functions doesn’t work properly. This contributes to the issues we spoke about above, like low stomach acid, low bile flow, issues with gut motility, inflammation, and more.

This extremely important nerve is called the vagus nerve, and it has become the subject of a lot of research in more recent years. It also has a vast impact on our mental health! The proper function of gut-brain connection via the vagus nerve is essential to maintaining our health and overall wellbeing.

brain neurons and nerves

You can get started on some relaxation techniques today in order to improve your vagus nerve function and reduce stress, so that you can achieve optimum gut health and function!

For guided assistance to get to the root cause of your gut problems, schedule your appointment today!

I can order your comprehensive stool analysis so we can look for any maldigestion markers, inflammation, dysbiosis, metabolic imbalance, or infection that could be occurring within your gut!

 

 

 

 

Sources: 

http://www.med.unc.edu/ibs/files/2017/10/Stress-and-the-Gut.pdf

https://gut.bmj.com/content/47/6/861

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858318/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140465/

https://www.sciencedirect.com/science/article/pii/S2352289516300509

https://medicalxpress.com/news/2018-03-gut-bacteria-essential-healthy-immune.html#:~:text=The%20gut%20is%20able%20to,may%20impact%20how%20we%20behave.

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