How to Fix a Leaky Gut
Do you suffer from gut problems, fatigue, mood issues, hormone imbalances, skin conditions, or autoimmune disorders? Conventional medicine often dismisses Leaky gut even though it’s a common ailment affected by lifestyle, diet, medications, and environmental factors.
I’m sure you’re wondering, what exactly is leaky gut? Could you have it? If so, how do you fix a leaky gut? If you’ve been experiencing chronic health issues that you can’t seem to get a grip on, keep reading for a deep dive on leaky gut, common symptoms, functional lab tests you can run, and how to heal.
By the end of this blog, you will understand the impact that intestinal permeability can have on your body, what you can do about it, and the steps you can start taking today to fix a leaky gut.
What is Leaky Gut?
The digestive tract is a complex system made up of your mouth, esophagus, stomach, gallbladder, pancreas, liver, small intestine, and large intestine. These organs work together to break down food into smaller molecules that the body is able to absorb and convert into energy for growth, and repair by all of your cells. But not everything we consume will be or should be absorbed.
Did you know the gastrointestinal tract is actually outside of your body? This is because the lumen, the lining of the intestine that absorbs nutrients into the bloodstream, is open to the external environment on both ends. A layer of cells separates the inside of the body from the external environment in order to protect us from harmful substances. Between each cell is a space called a “tight junction”, which makes sure nothing unwanted enters the bloodstream by keeping cells close together to form a cohesive barrier. Tiny openings in the lining of the GI tract act as a selective barrier, letting through water and essential nutrients while keeping toxins and bacteria out. These toxins are then expelled from the body through our regular bathroom visits throughout the day. Check out this resource for more information on Intestinal Permeability from The Institute of Functional Medicine.
Increased intestinal permeability becomes an issue when this barrier is compromised and unable to identify or properly separate unwanted substances from the essential nutrients the body needs. When you have a leaky gut, a partially digested protein, allergen, or pathogen can enter the bloodstream. The body will then elicit a natural response better known as inflammation, which in turn causes a further breakdown of the GI tract and a list of symptoms to follow.
Leaky Gut and Inflammation
Leaky gut happens when inflammation breaks down the gut lining tissue to make sugar for the blood stream, essentially shredding the gut lining. Now, rather than acting as a selective barrier, the lining becomes more like a sieve. During this process the villi in the intestine become damaged and are now unable to properly absorb fat soluble nutrients. Essential fatty acids, vitamin D, vitamin E, vitamin A, and vitamin K are the main fat-soluble nutrients. They all play integral roles in a multitude of processes in the body. As villi are being destroyed, crypts within the gut lining deepen, hiding parasites and making them difficult to find and treat.
Spaces between tight junctions are enlarged, allowing all types of bacteria, waste particles, and undigested food proteins to “leak” through the barrier and gain access to blood vessels and the lymphatic system. The body is unable to absorb essential nutrients because of damaged villi and is now absorbing harmful things because of leaky gut.
To try and fight these harmful substances, the immune system continues to mount a response creating more inflammation in these areas because the body senses there is something in the bloodstream that does not belong. As you could probably guess, this only damages the gut further.
Pesticides and heavy metals can damage healthy bacteria in the body. This disrupts the delicate balance of the environment in your gut, making room for unhealthy organisms to grow, which further contributes to leaky gut and allows toxins into the bloodstream.
Once a foreign substance enters the bloodstream, it circulates throughout the body setting off an alarm for your immune system, often leading to more inflammation, food allergies/sensitivities, and even autoimmune diseases. While inflammation’s purpose is to keep the body healthy, over time, chronic inflammation can lead to a string of unwanted side effects and may increase your risk of developing a variety of diseases.
Is Leaky Gut a Real Thing?
Leaky gut is often trivialized in chronic health conditions, but healing the gut is one of the main pillars of functional nutrition. There is a lot of ongoing research surrounding the function of the gut barrier and the effects of these perforations in the gut lining. While there is still a lot to be learned about intestinal permeability, researchers are beginning to see the link between gut health and disease prevention. Let’s take a closer look at what current studies support.
It is possible that some people are born with genes that increase the likelihood of leaky gut. Others may develop weakened gut linings through medication or gut infections. Unbalanced diets that are low in fiber and high in sugar and saturated fats may also contribute to weakening the gut lining.
Leaky gut may even be due to your body’s inflammatory response to excess stress. Age may also play a factor; as we age, our cells are more easily damaged and take a longer time to heal. Often, a combination of these factors contribute to the break-down of our gut barrier.
While some leaky gut is normal, in today’s world, most people have increased rates of intestinal permeability. As stated by Dr. Aimee Quinn, the combination of the factors listed above shifts the question from “do I have leaky gut?” to “how bad is my leaky gut?” Knowing how distressed your gut is can help you determine the level of system imbalances you suffer from.
Through nutritional therapeutic interventions, we are able to support the gastrointestinal tract and keep those tight junctions tight. Preventative care is the key to creating a healthy gut and a robust immune system to support you through life.
What Are the Symptoms of Leaky Gut?
Many health professionals fail to recognize and diagnose intestinal permeability for a few reasons. One, the symptoms are similar to other digestive conditions such as food allergies, Irritable Bowel Syndrome (IBS), Crohn’s Disease, Ulcerative Colitis, and Celiac disease. Many of these labels are just a list of symptoms that may actually be directly related to leaky gut and the microbiome. However, some symptoms aren’t “directly” connected to the gut, instead, may manifest as mental, hormonal, or skin issues. The gastrointestinal tract is often not looked at through a functional scope, making these symptoms easier to miss. That being said, here are some indicators that you may have a leaky gut. Are any of them familiar?
Symptoms may include:
- Diarrhea or Constipation
- Abdominal cramping and bloating
- Digestive issues
- Fatigue
- Joint pain
- Difficulty concentrating
- Confusion
- Skin conditions (e.g., acne, rashes, eczema)
- Mood disorders (e.g. anxiety and depression)
- Food intolerances
- Nutrient deficiencies
Research surrounding the relationship between leaky gut and other conditions are currently unclear if other gut conditions are the cause of leaky gut or a symptom of it.
Conditions that may be associated with Leaky Gut:
- Crohn’s disease
- Irritable bowel syndrome (IBS)
- Diabetes
- Polycystic ovarian syndrome (PCOS)
- Liver disease
- Chronic fatigue syndrome
- Autoimmune diseases, such as lupus, multiple sclerosis, and celiac disease
- Hypothyroid/Hashimotos
Gluten and Leaky Gut
Gluten is a protein found in grains such as wheat, barley, and rye, and is made up of the peptides gliadin and glutenin. Gliadin is the part of gluten that some people have a reaction to.
This protein gives bread its airy texture, doughy feel, and is a stabilizing agent in many processed foods. Most people can digest gluten with ease however, others have gluten intolerance, meaning they are sensitive, and some develop a hereditary autoimmune response called Celiac Disease.
In people who are sensitive to gluten (both celiac and non-celiac), the immune system registers gluten as a foreign invader to the body. The body reacts to gluten’s presence through it’s autoimmune response, which leads to inflammation. This reaction to gluten breakdown can lead to symptoms including bloating, diarrhea, and pain.
Zonulin is a protein that regulates tight junctions in the small intestine. When zonulin is released, the tight junctions open slightly to allow larger particles to pass through the intestinal wall. How does this all relate to leaky gut?
Gluten can cause the gut cells to release zonulin which leaves tight junctions in an open position. Chronic activation of zonulin cells can lead to leaky gut as harmful substances are let into the bloodstream. These harmful substances can trigger an immune system response.
Leaky Gut Syndrome Test
A leaky gut can impact your whole system and is often accompanied by food sensitivities and autoimmune diseases. Functional lab testing provides comprehensive data that can help identify the root cause of your gut symptoms and other health conditions.
GI stool tests give us an inside look at your gut health and allow us to gauge what level of leaky gut you may be suffering from. Stool tests can help to pinpoint the exact levels of different microbes (healthy commensal bacteria balance, pathogenic yeasts, and parasites) in your gut. This shares vital information about what your body needs. If you have leaky gut, this test can help determine the level of bacterial overgrowth and dysbiosis in your system.
In addition to pathogens, there is also another marker we are looking for: Secretory IgA. Secretory IgA is a specialized protein called an immunoglobulin which can tell us more information about your immune system. Sometimes our body isn’t making enough stomach acid to effectively break down the proteins that we eat. The undigested proteins can then cause an immune response to occur within the body. This immune response can cause an increase in secretory IgA.
Using this test we can create a plan to help heal several aspects of the gut. Fixing the problem from all sides can help improve the overall functioning of your gut.
Fixing Leaky Gut Syndrome
When determining how to fix a leaky gut, we need to assess your gut microbiome. This helps figure out your overall gut health.
Consider this: your gut is like a garden. Bacterial overgrowth is like weeds, which can take over and make it difficult for your garden to flourish. After clearing out the weeds, it is important to nourish the gut’s good bacteria (the flowers) in order to repair it.
It is important to heal the gut before attempting to detoxify the gut through diet. Detoxing before “clearing out the weeds” may not help resolve the problem!
Foods to Help
If you suspect you may have leaky gut, consider a stool test to identify any pathogen invasions. After a pathogen killing program, you can begin the healing process by adding more gut-friendly foods to your diet.
Adding more foods that are rich in prebiotics and probiotics will help to nourish the good gut bacteria. This leaky gut syndrome diet includes:
- Yogurt or Kefir
- Fruits and vegetables (i.e., berries, oranges, broccoli, cabbage, carrots)
- Nuts and seeds (i.e., almonds, peanuts, cashews, pine nuts)
- Fermented foods (i.e., kimchi, sauerkraut, miso)
- Whole grains (i.e., oats, corn, quinoa)
Reducing the amount of alcohol and processed foods in your diet helps to reduce the inflammation caused by leaky gut. These foods are often high in added sugar and artificial sweeteners.
It is also important to avoid foods you are allergic or sensitive to, as these foods will cause inflammation and make your leaky gut symptoms worse.
Best Supplements
Oftentimes, the first step to healing the gut is to support the adrenal glands, which help to regulate metabolism, immune system, blood pressure, and stress response – among many other essential functions in the body.
Along with a leaky gut, you may also be suffering from adrenal dysfunction. The body’s stress response in reaction to the unwanted substances in the blood stream triggers the adrenal glands to produce excess cortisol. Eventually the adrenal glands will not be able to keep up with the demands of the body. When this occurs, adrenal fatigue will set in. This can create a slew of symptoms such as fatigue, insomnia, and fogginess.
My 28- day Adrenal Support Cleanse program is designed to jumpstart your path to healing your adrenal system. The Adrenal Support Cleanse is low in sugar and high in healthy fat and protein. It also has various nutrients targeted at nourishing and supporting the adrenal system.
Some people need more support than just diet to reboot their adrenal function. When you work with me and get tested using the Adrenocortex Stress Profile lab test, we are able to get the full picture of the state of your adrenal system and what you need to begin your healing journey.
Lifestyle Changes to Fix a Leaky Gut
Your gut is connected to every aspect of your body. An important connection is between the gut and the brain through afferent fibers called the vagus nerve.
The vagus nerve pathway transfers information from the gut to the brain. This helps to convey important information regarding inflammation, regulation of food intake, satiety, and energy homeostasis.
Lifestyle changes such as exercising regularly, getting enough sleep, practicing relaxation techniques, and managing stress are extremely important to the body’s healing process. Reducing stress can improve conditions in the gut and alleviate stress put onto the brain.
Making small changes can help to support your body in it’s healing process as much as possible.
The Bottom Line
In order to properly treat your leaky gut symptoms, it is so important to work with a functional medicine dietitian. Each and every one of us is unique, so your treatment plan should also be unique. Working with me can help determine the root cause of your symptoms so we can figure out what path of treatment is best for you.
Remember, the only way to know exactly how to heal a leaky gut and determine what your gut needs is through the information gathered from labs and stool analysis. From there, we work together to create a plan using meal plans and supplements that are tailored to your individual needs.
If you’re suffering from digestive distress or other leaky gut symptoms, schedule a free call with me to learn how to fix a leaky gut today! Want more individualized results without picking up the phone, try the Digestive Health Appraisal Form to get started!
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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
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.
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
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
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
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 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.
Sign up for a Comprehensive Root-Cause Analysis to participate in our Gut-Hormone Detox program to reset your stress response system, reduce inflammation, and alleviate symptoms of burnout. Another option is our app-based Adrenal Cleanse diet protocol, for an adrenal reboot. 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 strategy call and we can discuss how to plan out the best approach for you!
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
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.
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
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!
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
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.
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 free 15-min strategy call appointment today to continue your journey to better gut health.
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?
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?
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
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
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.
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.
- Remove excess bacteria by removing stressors and irritants
- Replace bacteria using digestive enzymes
- Repopulate using probiotics and prebiotics
- Repair the intestinal wall with nutrients and supplements
- Rebalance lifestyle to support maintenance of a healthy gut
Best Diet for SIBO
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!