SeekingGutHealth

Alexandra is a Functional Medicine Certified Health Coach & Holistic Nutritionist specializing in IBS, SIBO, and Gut Health. She helps her clients identify the root causes of their chronic gut issues with functional testing, supporting their bodies holistically and implementing the necessary lifestyle changes long-term to regain control of their bodies and enjoy food freedom. Book your FREE SIBO Assessment call now >>>

The SIBO and Endometriosis connection

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There are many different reasons why people might have digestive disturbances like chronic bloating. Common causes include lactose intolerance, inflammatory bowel disease, irritable bowel syndrome (IBS), and so on (the list can be pretty long).

Two of these disorders are frequently connected: endometriosis and SIBO (Small Intestinal Bacterial Overgrowth).

But what does SIBO and endometriosis connection mean? How can both contribute to the digestive symptoms that many don't suspect?

SIBO and endometriosis

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. It means an increase in the number of bacteria and/or changes in the types of bacteria present in the small intestine. SIBO is commonly caused by an overgrowth of various bacteria that should generally be found in the large intestine. (1) So, the issue is with the location.

SIBO can cause classic symptoms similar to IBS (Irritable Bowel Syndrome). These include abdominal pain, discomfort, cramping, gas, bloating, reflux, diarrhea, and/or constipation.

According to studies, up to 84 % of IBS cases are caused by SIBO. (2)

Read more about the SIBO symptoms here. 

What is Endometriosis?

It is a chronic inflammatory condition where the uterine tissue grows on other pelvic organs. It mainly affects the ovaries but can impact the fallopian tubes or the colon.

These tissues respond to the same hormonal changes during the menstrual cycle. They bleed similarly to the uterine lining, but the problem is that it doesn't have access to the outer world as the uterine. (It is called retrograde menstruation) (3)

According to studies, endometriosis can affect around 10–15% of all women of reproductive age and 70% of women with chronic pelvic pain. (4)

Endometriosis symptoms

Endometriosis can cause many symptoms, such as

  • Chronic bloating (often called "endo-belly"),
  • Abdominal pain,
  • Chronic constipation
  • Irregular, heavy, and painful periods,
  • Infertility
  • Mood changes
  • Weight gain (especially the waist area and thighs)
  • Pelvic pain, lower back pain
  • Painful sexual intercourse

All these debilitating symptoms can take a toll on the mind, and many women experience some level of anxiety and depression. (4)

What about diagnosing endometriosis?

It is difficult to diagnose endometriosis and can mimic other gut conditions like IBS, SIBO, or IBD. This is one of the reasons why it takes up to 11 years to be diagnosed with endometriosis. (6)

The next challenge is that no established tool can quickly diagnose this condition. The currently accepted tool is a quite invasive laparoscopy surgical procedure.

The next problem is in the healthcare system, as many doctors are unfamiliar with this condition, miss the signs, or don't refer the patient to the right specialist. Unfortunately, they still commonly give some medications to the patients (like birth control pills) that mask the symptoms.

Many women realize the problem when they want to have a child and undergo a fertility evaluation and treatment. Unfortunately, more than 50% of women with endometriosis are infertile. (5)

What can cause endometriosis?

There are many theories about what eventually leads to this condition, but some of the reasons are hormonal imbalances, typically high estrogen and low progesterone levels, inflammation, genetics, etc. (7)

There is also a connection between environmental toxins (so-called endocrine-disrupting chemicals (EDCs)) and endometriosis. Women should review what they put on their skin daily, check the cleaning products, and avoid packaged foods, especially those containing chemicals such as benzophenones and phthalates. (8)

But any inflammation, gut inflammation, including SIBO, can cause hormonal imbalances. Inflammation is a stress on the body; it increases cortisol, estrogen, and 5 alpha-reductase (9), disrupting the delicate hormonal balance in the body.

Malabsorption is also a contributing factor; if you are not absorbing the necessary nutrients from the food, you won't be able to make the hormones or effectively clear them out.

gut and endometriosis

The connection between endometriosis and SIBO

If you have had any abdominal surgeries in the past (maybe because of an injury or Endometriosis, C-section), then there is a high chance of adhesion formation. (10) Adhesions are irregular bands of scar tissue forming between two structures that are typically not bound together. (11) However, adhesions can form due to inflammatory conditions like IBD, infections, or radiation therapies. So, if you have been struggling with chronic SIBO for a while and underwent surgeries for Endo, then there is a significant connection here.

How is this connected to the gastrointestinal tract? Adhesions can interfere with gut motility, the way food particles, fluid, and bacteria move through the intestines by creating blockages. This may lead to symptoms such as changed bowel movements, chronic bloating, abdominal pain, incomplete or even painful evacuation, nausea, etc. In some instances, adhesions can cause complete bowel obstructions when they entirely block the way and require urgent medical care. (12)

In terms of SIBO, your body has its defense mechanisms against bacterial overgrowth, and one of them is well-functioning gut motility. But when blockages start to happen due to adhesion formation, they block the way how the food particles move through, allowing bacteria to feed on them and grow, leading to various symptoms. (13)

So, if you are dealing with chronic SIBO, meaning that you have relapsed every time despite several treatment rounds and have had any abdominal surgeries in the past, then it's worth looking into adhesions.

Other gut-related connections in terms of endometriosis

The second significant connection is that the gut microbiome plays a crucial role in regulating estrogen. Estrobolome is a composition of gut microbes that metabolize and modulate estrogen in the body. (14) These microbes produce an enzyme, beta-glucuronidase, that can unbind estrogen and recirculate it into its active forms, binding to estrogen receptors and affecting estrogen-related processes.

Why is this important? Because many women with endometriosis may have higher levels of beta-glucuronidase production, causing elevated levels of estrogen that may contribute to the endo symptoms.

What causes this elevated enzyme production is usually gut dysbiosis (an increase in pathogenic gut bacteria and a decrease in "good gut bugs" like Lactobacilli.). There are various reasons why dysbiosis can happen, like frequent antibiotic usage, anti-baby pills, chronic stress, diet, lifestyle, etc.

Liver health and endometriosis

As we may know, the liver is the largest organ in the body. It is responsible for many functions: detoxification processes, immune support, blood sugar management, metabolism, and hormonal health. (15)

Supporting the liver is very important for proper hormonal balance and detoxification. Phase I and phase II detoxification are essential when the body wants to get rid of excess estrogen, for example. These detox pathways require many nutrients, such as B vitamins, glutathione, and so on, for activation.

What about endometriosis treatment?

Endometriosis is a complex condition, and the exact root causes are not known (yet). However, there are some methods of managing symptoms.

Since it's an inflammatory condition, it is essential to reduce inflammation with diet by following an anti-inflammatory diet, adding the necessary nutrients, and managing your lifestyle.

Let's see some helpful ways:

  • Removing the big offenders like gluten, dairy, sugar, processed foods, trans fats, and hydrogenated oils due to their inflammatory properties. (16)
  • Adding anti-inflammatory nutrients like herbs: ginger, rosemary, turmeric, green tea
  • Following a whole food diet includes a lot of colorful vegetables, fruits, and fibers, possibly from organic sources. You can go to the Environmental Working Group's Dirty Dozen list to see the worst offenders if buying all organic produce isn't possible.
  • Opting for grass-fed, pasture-raised, wild-caught animal protein sources
  • Increasing omega-3 fatty acids intake with fish oils or eating fatty fish. A study found that a higher amount of omega-3 ratio can decrease inflammation in endometriosis. (17)
  • Supplementing with antioxidants was shown to reduce chronic pelvic pain in women with endometriosis and inflammatory markers. (18)
  • Removing environmental toxins from the household is very important, mainly plastic, because it contains xenoestrogens (synthetic estrogens) that can disrupt your hormonal balance. (19) Instead, use stainless steel or glass water bottles or food containers, switch to non-toxic beauty products, ditch Teflon cookware, and use ceramic or cast iron pans.
  • Ensuring that you have daily bowel movements is crucial for estrogen detoxification
  • Opening your detoxification pathways to improve detox, such as saunas, rebounding, dry skin brushing, etc.
  • Focusing on the other lifestyle factors such as stress management, exercise, sleep, mindset, relationships, and having a support system

Still, it is crucial to test for SIBO, see if that plays a role in the symptoms, and have a plan to reduce the overgrowth. Additionally, finding and possibly addressing the root causes & contributing factors to SIBO and Endometriosis can help elevate the symptoms long-term.

Should you consider manual therapy for SIBO and endometriosis?

Those who've recently undergone abdominal or pelvic surgeries might experience adhesions as their bodies are trying to heal.

So, if you've been struggling with SIBO or chronic bloating, often feeling heavy without overeating, chronic constipation, or unexplained digestive discomfort despite previous treatments, the culprits might be physical blockages.

Let's imagine if someone could skilfully 'unknot' that hose, restoring the flow in your intestines. This is where manual therapy for gut issues can enter the scene!

Manual therapy techniques involve hands-on manipulation and movement of bodily structures.

When it comes to the gut, such therapies can:

  • Break down adhesions: Gentle and targeted pressure can help break down internal scar tissues, facilitating better organ movement and function.
  • Enhance vagus nerve function: The vagus nerve is pivotal to digestion. Cervical instability can impair it. Manual therapy can help realign structures, indirectly benefiting the vagus nerve and enhancing digestion.
  • Improve bowel transit time: By facilitating smoother organ function and breaking down blockages, manual therapy, such as visceral manipulation, can support better bowel movement, reducing symptoms of conditions like SIBO.
  • Improved circulation: With better movement and lessened restrictions, blood circulation to these organs can improve, enhancing healing and function.
  • Lymphatic drainage: Enhanced manual movement can help drain toxins and excess fluid from the abdominal region, supporting overall gut health.

Incorporating manual therapy into your SIBO and endometriosis healing journey

If you suspect blockages may be an issue, finding a certified and experienced therapist is crucial if you're considering adding manual therapy to your healing regime.

International Association of Healthcare Practitioners lists their recognized practitioners on their site, but make sure to find a therapist trained for Visceral manipulation techniques.

If you are based in the USA, check out Clear Passage's website, which thoroughly explains how manual therapy works and its effect on the gut and other conditions.

The Bottom Line

Endometriosis is a poorly understood condition that affects about 10% of menstruating women. The implications and scope of this disease are far-reaching as it can affect many different parts of the body, from the brain to the digestive system.

Functional lab testing may help you detect any underlying issues contributing to your endometriosis. Having the right information has never been more critical in finding lasting relief.

A holistic approach to dealing with endometriosis is always the best way to ensure that the body is supported from multiple angles.

We need to understand that this condition affects each individual differently.

I hope this information will encourage you to be creative in addressing the symptoms and causes of endometriosis and lead you toward optimal health and wellness.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend consulting with your healthcare practitioner always before trying any treatment or dietary changes.

The SIBO and Endometriosis connection Read More »

How to deal with Hydrogen Sulfide SIBO (H2S)

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Have you heard of the third type of Small Intestinal Bacterial Overgrowth (SIBO): Hydrogen Sulfide (H2S) SIBO? Hydrogen sulfide SIBO has unique characteristics and treatment approaches that are pivotal for those suffering from gut health issues.

What is SIBO?

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition where an excessive amount or abnormal type of bacteria are present in the small intestine, where their numbers should be relatively low compared to the large intestine. (The large intestine houses the highest number of bacteria). These bacteria in the wrong place can interfere with normal digestion and absorption of food by fermenting carbohydrates and fibers and creating byproducts, like gases (methane, hydrogen, hydrogen sulfide). The overgrown bacteria can interfere with normal digestion and nutrient absorption.

This process can lead to symptoms like:

  • Chronic bloating that tends to get worse by the end of the day,
  • Changed bowel movements involving constipation and/or diarrhea or alternating bowel movements
  • Abdominal pain,
  • Nausea,
  • Burping,
  • Fatigue,
  • Muscle or joint pain,

but it can also impact your skin, hormones, and other areas of the body. (1)

SIBO is a complex condition with various root causes, including impaired gut motility, anatomical abnormalities, and a compromised immune system.

What about Hydrogen Sulfide SIBO?

Hydrogen sulfide SIBO occurs when an overgrowth of bacteria in the small intestine produces excessive amounts of hydrogen sulfide gas. This type of gas can have unique and potentially more severe impacts on the body's systems.

This type of SIBO is notorious for:

  • rotten egg smelly gas,
  • diarrhea or constipation,
  • bloating,
  • belching, acid reflux,
  • brain fog,
  • body pain (mostly abdominal pain, bladder, and joint pain),

significantly impacting gut health and overall well-being.

The production of hydrogen sulfide in the gut is a natural process. Still, the excess is often due to a combination of dietary choices, slow intestinal motility, impaired detoxification pathways, and an imbalance in gut flora. These factors create an environment where sulfur-reducing bacteria thrive, leading to Hydrogen sulfide SIBO.

The research found that Fusobacterium and Desulfovibrio spp are two predominant hydrogen sulfide-producing bacteria. (2)

Hydrogen sulfide gas can cause inflammation and interfere with mitochondrial function in excess. This type of gas has been associated with gastrointestinal disorders such as ulcerative colitis, Crohn's disease, and irritable bowel syndrome. (3)

Testing for Hydrogen Sulfide SIBO

Diagnosing Hydrogen sulfide SIBO has historically been challenging due to limitations in testing for hydrogen sulfide. However, advancements have led to the development of specific tests, namely the TrioSmart breath test, at least in the United States, that can directly measure hydrogen sulfide levels in the breath, offering a more accurate diagnostic tool for identifying this subtype of SIBO. The TrioSmart test can measure all three types of gases: hydrogen, methane, and hydrogen sulfide. (4)

Hydrogen sulfide SIBO signs, causes, treatment options

Reducing Hydrogen sulfide in the gut

The treatment for Hydrogen Sulfide SIBO may involve conventional and natural strategies to reduce hydrogen sulfide production and address the root causes of overgrowth.

The conventional approach for Hydrogen sulfide SIBO

The conventional approach often includes antibiotics (Rifaximin with Flagyl or Neomycin) specifically targeted to reduce bacteria that produce hydrogen sulfide. (5)

Natural approaches for Hydrogen sulfide SIBO

Hydrogen Sulfide SIBO Diet

Generally, a low-sulfur diet is recommended, although it is still questionable whether it truly helps this condition as the research is currently limited. The low-sulfur diet means a reduced intake of foods high in sulfur, such as:

  • eggs,
  • dairy products (cow/ sheep/goat milk, cheese, yogurt, cottage cheese, etc.)
  • red meat,
  • dried fruits,
  • legumes (beans, lentils, soy)
  • Vegetables: cruciferous vegetables like broccoli, cauliflower, cabbage, arugula, daikon radish, horseradish, spinach, split peas, turnip, watercress, etc.
  • Certain fruits: grapes, papaya, and pineapple
  • garlic, onion, leek

You can always try a low-sulfur diet for a short period, 1-2 weeks, to see if it reduces your symptoms, but it is not a long-term approach.

Supplements and nutrients:

Herbal antimicrobials like oil of oregano may work to help reduce the overgrowth. Oregano oil contains compounds such as carvacrol and thymol, which have been shown to possess broad-spectrum antibacterial activities. These compounds can disrupt the cell membranes of bacteria, leading to their death or inhibition of growth. In the context of Hydrogen sulfide SIBO, oregano oil could potentially help by targeting the specific bacteria responsible for producing hydrogen sulfide gas. By reducing the population of these bacteria in the small intestine, oregano oil may help decrease hydrogen sulfide production, thereby alleviating some of the symptoms associated with H2S SIBO. (6)

It's important to note that while oregano oil has promising antibacterial effects, its use should be cautiously approached. High doses can irritate the gut lining, and it should not be taken for prolonged periods without the supervision of a healthcare provider.

Another great herb is Uva Ursi (bearberry leaf), well-known for its antiseptic and antibacterial properties, particularly in treating urinary tract infections. Its primary active component, arbutin, is metabolized into hydroquinone, a compound with antimicrobial effects. Uva Ursi can exert antibacterial effects and possibly help modulate bacterial populations in the gut, potentially impacting the bacteria responsible for hydrogen sulfide production.

However, it's important to approach Uva Ursi cautiously due to its potent effects and potential toxicity at high doses. Specifically, the hydroquinone produced from arbutin can be toxic, necessitating careful dosing and, ideally, supervision by a healthcare provider. Its use is typically recommended for a short period of time. (7)

Supplements such as bismuth subsalicylate (the active ingredient in Pepto Bismol) can bind to hydrogen sulfide, reducing its presence in the gut. It has antimicrobial and anti-inflammatory properties, making it effective in combating certain types of bacterial infections in the gastrointestinal tract. (8) (9)

Molybdenum is an essential trace mineral that also acts as a cofactor for enzymatic reactions and may help break down sulfites into sulfates. Many patients reported their brain fog disappearing. Dr. Greg Nigh recommends Mo-Zyme (from Biotics)—it is best to chew it.

Many people fear prebiotics in SIBO, but galacto-oligosaccharides (GOS) may benefit SIBO warriors by stimulating the growth of beneficial bacteria in the gut. Prebiotics like GOS support a healthy microbiome by providing food for probiotic bacteria, such as Bifidobacteria and Lactobacilli, which can enhance gut health and function. In the context of hydrogen sulfide SIBO, the potential effects of GOS could be beneficial; by promoting the growth of beneficial bacteria, GOS might help outcompete sulfur-producing bacteria, potentially reducing hydrogen sulfide production. It can also be a great addition if you are working on eliminating harmful bacteria with antibiotics or antimicrobials so you can help preserve the presence of beneficial gut flora.

If you are a tea drinker, I have good news! Research has shown green tea extract can help reduce levels of hydrogen sulfide because green tea polyphenolic antioxidants can oxidize hydrogen sulfide. (10) (11) Other polyphenols like resveratrol, quercetin, and curcumin may also help inhibit these bacteria.

As with all types of SIBO, it is crucial to support gut motility. Prokinetics are medications or supplements that can help stimulate the muscles of the gastrointestinal tract to move contents along more efficiently. (12) Natural prokinetics include ginger and artichoke, while prescription options might include low-dose naltrexone or prucalopride. (13) (14)

Conclusion

The treatment for hydrogen sulfide SIBO quite differs from other types due to its unique cause and effect on the body. Successfully managing SIBO, including its hydrogen sulfide variant, necessitates a comprehensive, individualized strategy that addresses the condition's multifaceted nature. Dietary adjustments, lifestyle changes, addressing the root causes, targeted supplementation, gut motility support, and bacterial balance are essential for effective management.

Remember, healing your gut is a journey. Incorporating these recommendations can significantly reduce hydrogen sulfide levels, improve symptoms, and enhance your quality of life. Always consult a healthcare professional to tailor these suggestions to your health needs.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

 

How to deal with Hydrogen Sulfide SIBO (H2S) Read More »

From SIBO to Leaky Gut: The Healing Path

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Imagine your gut is a bustling metropolis at the peak of rush hour. Now, envision that all the traffic lights are stuck on green due to some mysterious reason. Chaos ensues, right? That's a bit of what happens in conditions like Small Intestinal Bacterial Overgrowth (SIBO) and Leaky Gut—two gut health predicaments that often share the stage. They can turn the orderly flow of digestion into a free-for-all, leading to discomfort and confusion for anyone caught in the jam.

You may be surprised to learn that a Leaky Gut could be at the root of your depression, anxiety, thyroid problems, skin conditions, food intolerances, autoimmune diseases, fibromyalgia, and many other chronic diseases. Healthcare providers often overlook a leaky gut as a factor in chronic health problems.

Whether you're familiar with these terms or as perplexing as a foreign language menu, we will unpack the complex connection between these two gut health challenges, explore their co-occurrence, and discuss how you can naturally navigate your way to a happier, healthier gut.

SIBO - When bacteria take the wrong exit

Small Intestinal Bacterial Overgrowth, or SIBO, is like an uninvited party crasher in the small intestine. It occurs when bacteria that should be living large in the colon decide to move uptown to the small intestine, where they aren't meant to be in large numbers. These microbial misfits then feast on your meals, fermenting foods, particularly carbohydrates, causing gassiness, chronic bloating, and an array of digestive discomfort (including diarrhea, constipation, abdominal pain, nausea, etc.)

Intestinal Methanogen Overgrowth, IMO, also belongs to this category. In this case, we talk about another type of microorganism, archaea, that can also take residence in the small intestine besides bacteria. For simplicity, we will use the term SIBO in this article.

SIBO and IMO often masquerade as other digestive disorders, which makes them tricky to diagnose. (1)

 

 

Leaky gut when the walls have holes

Leaky gut is a commonly used term for "Intestinal permeability," when the intestines' lining gets damaged.

Imagine your gut lining as a fortress wall, carefully guarding the sanctity of your bloodstream. This wall selectively allows nutrients to pass while keeping out harmful substances. However, when Leaky Gut rears its head, the wall is breached. Tight junctions, the security gates of your gut, become loose. Suddenly, it's less of a fortress and more of a sieve, letting particles slip into the bloodstream that have no business there—prompting inflammation and a whole host of immune responses.

In essence, Leaky Gut gives a green light to substances that should be shown the red. This not only disrupts your body's inner workings but also sets the stage for an ongoing health drama.

When intestinal cells are damaged, enzymes are also not produced for proper digestion. In this case, you may not absorb essential nutrients, leading to other diseases such as allergies, intolerances, asthma, acne, and mental disorders. There is not only a leaky gut but a leaky brain, etc.  (2)

Leaky gut - tight junctions
Relationship between leaky gut and ASD demonstrating the increase of calprotectin {...} (ResearchGate: Gut Pathogens (29))

The unholy alliance - How SIBO may lead to Leaky Gut

So, how do SIBO and Leaky Gut end up in the same sentence, you ask? The connection lies in the fact that the overgrown bacteria in SIBO can produce toxins and by-products as they break down food, which can irritate and weaken the gut lining. Over time, this can turn your gut wall into something resembling Swiss cheese—full of holes and not very good at containment.

What's more, the bacteria can also consume the nutrients your cells need to maintain the gut barrier, leaving the cells weak and unable to repair themselves. This weakening is like taking bricks out of the fortress wall, one by one. Eventually, even the smallest of foes can break through.

A study (3) investigated the relationship between SIBO and Leaky Gut syndrome, and researchers found that individuals with SIBO had a significantly higher incidence of Leaky Gut syndrome.

And here's a compelling thought: just as an unhealthy gut can lead to a myriad of health issues, addressing gut health can create a ripple effect of wellness throughout the body. In this case, treating SIBO could be a key to patching up a Leaky Gut.

Testing for Leaky Gut

Diagnosing Leaky Gut requires a bit of detective work. Common signs may indicate a leaky gut, but you can also test for it.

  • Intestinal Permeability Assessment: This test involves drinking a pre-measured amount of lactulose and mannitol. The levels of these sugars in the urine afterward can indicate how porous the gut lining is.
  • Measuring Zonulin levels: it is a standard marker that is checked on a stool test. Zonulin controls the opening and closing of the gate, the tight junctions in your gut, allowing nutrients to be absorbed. If zonulin levels get high, the opening may take longer or be too big, and unwanted substances can leak through, causing problems. (4)
  • Food sensitivity tests: These can identify which foods your immune system is reacting to, potentially as a result of particles slipping through the gut lining. Honestly, I am not a big fan of food sensitivity testing, but when somebody is reacting to many foods, it indicates that a Leaky gut may be in the background.

What causes a Leaky gut?

There are many factors outside of diet that can cause a leaky gut, such as

  • SIBO (3),
  • Dysbiosis (imbalance between helpful and harmful bacteria in the gastrointestinal tract),
  • nutrient deficiencies (5),
  • an inflammatory diet including excess alcohol, sugar consumption, gluten (6),
  • chronic stress (7),
  • vigorous endurance training (8),
  • chronic inflammation (9),
  • environmental toxins like glyphosate, mold toxicity (10), heavy metals, etc.
  • infections (like Candida) (11) and endotoxins (12),
  • medications (especially NSAIDs like Tylenol and Advil) (13)

 Tangled connections: conditions associated with Leaky Gut

The ripple effects of Leaky Gut extend far beyond occasional discomfort; they can be associated with a variety of chronic diseases. When your intestinal barrier becomes compromised, it's like a crack in a dam, initially small and seemingly insignificant but with the potential to cause major downstream consequences. These can include:

  • Autoimmune diseases: Conditions like rheumatoid arthritis, lupus, type I diabetes, and celiac disease have been linked to increased gut permeability. It's as if Leaky Gut opens the door and, in a rush, the autoimmune disorders, where the body, confused by the influx of foreign particles, begins to attack its tissues. (14)(15)
  • Inflammatory Bowel Diseases (IBD): Crohn's disease and ulcerative colitis, types of IBD, may be exacerbated by Leaky Gut, as the gut's weakened defenses inflame the intestinal lining. (16)
  • Irritable Bowel Syndrome (IBS): Those with IBS may find that Leaky Gut intensifies their symptoms, as their gut is already a battleground for discomfort. (17)
  • Food allergies and intolerances: Like unwelcome guests slipping through a fence, food particles that breach the gut barrier can trigger allergic reactions and sensitivities. (18)
  • Skin conditions: Eczema, rosacea, and psoriasis, the irritated states of our outer shell, can also be linked to what happens within our inner tube, as the gut-skin axis suggests. (19)(20)

Listening to the whispers: signs and symptoms of Leaky Gut

A leaky gut can be a silent adversary, often presenting symptoms that whisper rather than shout. Paying attention to these whispers can be key to early detection and management. Symptoms may include (21):

  • Digestive issues: Chronic bloating, gas, diarrhea, or constipation
  • Fatigue
  • Headaches and brain fog
  • Skin irritations (acne, breakouts, eczema, etc.)
  • Mood swings (anxiety, depression)
  • Joint pain, body pain, muscle stiffness (22)

 

Leaky gut repairing remedies

Natural Healing for Leaky Gut

Dealing with SIBO and Leaky Gut can feel like navigating a labyrinth. However, there are natural strategies you can employ to guide you out of the maze:

Certain lifestyle and dietary changes can help you get back on track. These can include:

  • Learning relaxation techniques to reduce stress levels - Never underestimate the gut-brain connection. Techniques like meditation, yoga, and Tai chi can fortify your gut against the stresses of modern life.
  • Moving your body and avoiding being sedentary
  • Transforming your environment by eliminating toxins (plastics, GMOs, pollutants, mold, etc.)
  • Eating anti-inflammatory, whole foods and limiting refined carb intake and other food triggers
  • Removing gluten (protein in wheat, rye, spelt, barley, and kamut) from the diet. Gluten has been shown to increase intestinal permeability (23)
  • In case SIBO is present, a short-term low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet that aims to decrease fermentable carbohydrates may help reduce inflammation in the gut. (24)
  • Getting adequate quantity and quality of sleep
  • Chew, chew, chew: Digestion starts in the mouth. Chewing thoroughly is like laying a strong foundation for a building—it sets everything else up for success.

You can also support your gut lining healing with the following nutrients (22)(24):

  1. Bone broth or gelatin – helps the healing of the intestinal lining
  2. Prebiotics - feed good bacteria and boost the production of short-chain fatty acids (reintroduce them slowly and gradually if you have SIBO)
  3. Probiotics - help restore the gut mucous layer and prevent pathogens from overgrowth (in the case of SIBO, certain strains may work better than multistrain probiotics). Examples are L. plantarum 299v, L. rhamnosus GG, and L. acidophilus DDS-1 (24)
  4. L-Glutamine – an amino acid that helps repair the gut lining to regrow (25)
  5. Vitamins A and D - fat-soluble vitamins, have many roles, supporting the immune system (24)
  6. Zinc carnosine - unique support for the stomach and intestinal lining (26)
  7. Fish Oil – contains healthy fatty acids, such as DHA and EPA, to reduce inflammation (21)
  8. Curcumin (in Turmeric) - improves intestinal barrier function and reduces inflammation (27)
  9. Digestive enzymes - support the digestion process (24)
  10. Butyric Acid - serves as the primary fuel source for the colon's cells and for healing the lining of the colon and the small intestine. (28)

Of course, there are a lot of other great nutrients, herbs, and supplements that can help heal the gut lining.

Diet, supplements, lifestyle factors, and mindset all play a role in healing. You can see positive results with the right strategy within a few weeks.

Which Comes First: SIBO or Leaky Gut?

The question often arises: which condition do we address first—SIBO or Leaky Gut?

The truth is the healing order can be as unique as the individual, but a general roadmap can guide us.

The symbiotic relationship between SIBO and Leaky Gut suggests that healing one can positively influence the other. However, a common strategy among functional practitioners leans towards taming SIBO first.

Here's why:

  • Quelling the bacterial tide: Addressing SIBO reduces the number of bacteria available to produce the toxins that contribute to Leaky Gut. Think of it as turning down the volume before fixing the speakers.
  • Restoring balance: Once SIBO is under control, the inflammation in the gut often decreases, making it a more hospitable environment for repairing the intestinal lining.
  • Avoiding a vicious cycle: If you focus solely on healing the Leaky Gut without resolving the underlying SIBO, it's like patching up a boat while still taking on water; the issue could recur or never fully resolve.

The steps to gut healing

Healing the gut is a process that requires patience and a strategic approach.

Here's a simplified order of operations:

  1. Eradicate SIBO: Use targeted treatments such as dietary changes, herbal antimicrobials, or prescribed antibiotics to reduce the overgrowth of bacteria in the small intestine. It is still important to uncover the possible root causes of SIBO.
  2. Soothe and repair the gut lining: After reducing bacterial overgrowth, support the gut with nutrients that promote healing of the intestinal lining, like L-glutamine, collagen peptides, vitamin A, etc.
  3. Rebalance the gut flora: Introduce or reintroduce probiotics and prebiotics to nourish and support the beneficial bacteria in your gut.
  4. Reinforce gut function: Implement lifestyle changes that support long-term gut health, including stress reduction techniques, regular exercise, and adequate sleep.
  5. Monitor and adapt: Gut healing is not linear. Regular follow-ups through testing and symptom tracking can help adjust the plan as needed.

The Importance of personalization in healing

While this sequence offers a framework, it is not a one-size-fits-all solution. The interplay between SIBO and Leaky Gut is complex, and factors such as individual health history, severity of conditions, and personal responses to treatment must shape the healing journey.

In some cases, simultaneous treatment of both conditions may be necessary, especially if symptoms are severe and quality of life is significantly impacted. For instance, a healthcare provider may recommend a gentle approach to start repairing a Leaky Gut while also treating SIBO, especially if there are strong indications of a compromised gut barrier, such as autoimmune reactions or chronic inflammation.

Closing thoughts on the healing order

Deciphering whether SIBO or Leaky Gut should be addressed first is not a universal decision. However, the prevailing thought initially steers toward gaining control over SIBO to reduce the onslaught of symptoms and create a foundation for healing the gut lining. It's a bit like calming the storm before repairing the ship.

In the voyage of gut health, understanding the healing sequence is your compass. Working with a knowledgeable healthcare provider allows you to chart a course tailored to your body's signals and needs, leading you toward smoother sailing and restoring wellness.

If you are seeking guidance in your healing journey and need personalized support, book a free SIBO Assessment call, and let's discuss the first steps toward getting back control of your body and health.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

From SIBO to Leaky Gut: The Healing Path Read More »

5 SIBO root causes you need to know for the recovery journey

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You need to know about the common SIBO root causes if you constantly battle bloating, constipation or diarrhea, low energy, and more. For many, the list of symptoms continues, and the frustration grows with the uncertainty of what to eat and how to live a normal life.

These symptoms define the everyday life of those suffering from SIBO (Small Intestinal Bacterial Overgrowth).

However, many people who experience SIBO relapse soon realize that treatment itself may not be enough to get rid of the uncomfortable symptoms.

One important thing to understand about SIBO: SIBO is not an infection!

Certain factors allowed the bacteria to overgrow; identifying these SIBO root causes is critical to healing.

Often, people think it's only one thing that is causing their issues, but typically, several contributing factors are at play. It's crucial to stop just chasing the symptoms and start identifying the root causes of imbalance. Otherwise, we would just be mopping the floor instead of turning off the sink.

What is SIBO?

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition where an excessive amount or abnormal type of bacteria are present in the small intestine, where their numbers should be relatively low compared to the large intestine. (The large intestine houses the highest number of bacteria). These bacteria in the wrong place can interfere with normal digestion and absorption of food by fermenting carbohydrates and fibers and creating byproducts, like gases (methane, hydrogen, hydrogen sulfide). The overgrown bacteria can interfere with normal digestion and nutrient absorption.

This process can lead to symptoms like:

  • Chronic bloating that tends to get worse by the end of the day,
  • Changed bowel movements involving constipation and/or diarrhea or alternating bowel movements
  • Abdominal pain,
  • Nausea,
  • Burping,
  • Fatigue,
  • Muscle or joint pain,
  • Mood changes,
  • Brain fog, poor memory,

but it can also impact your skin, hormones, and other areas of the body. (1)

5 SIBO Root causes for recovery

The SIBO root causes

Understanding the SIBO root causes is crucial in its effective management. SIBO is a complex condition, and its root causes can differ from person to person. This complexity is reflected in the research on complex diseases, which suggests that a multitude of factors may contribute to the onset of such conditions.

SIBO Root Cause #1: the role of gut motility

One of the key root causes of SIBO is issues with gut motility. The movement of the digestive system is crucial in maintaining a healthy balance of bacteria in the gut. When this movement is disrupted, it can lead to an overgrowth of bacteria in the small intestine.

This cause revolves around the role of the Migrating Motor Complex (MMC). The MMC is a pattern of electrical activity that occurs in the smooth muscle of the gastrointestinal tract during the periods between meals. It's often referred to as the "housekeeper" of our gut because its function is to sweep residual undigested material through the digestive tract. The MMC operates cyclically, approximately every 90-120 minutes during fasting periods.

When the MMC is functioning correctly, it helps control the bacterial population in the small intestine by regularly clearing it out, pushing bacteria into the large intestine, and preventing any significant accumulation. However, certain conditions like stress, medications (especially opioids), certain diseases (like Scleroderma), or other underlying causes can disrupt the MMC's functioning, leading to a slowdown or stoppage of this cleaning wave. This disruption can allow bacteria to multiply excessively in the small intestine, leading to SIBO. (2)

SIBO Root Cause #2: the impact of medications

Certain medications, such as proton pump inhibitors (PPIs), often prescribed for conditions like GERD (Gastroesophageal Reflux Disease), ulcers, and other acid-related disorders, reduce stomach acid production. While these medications provide relief from acid reflux symptoms, the reduced acid levels can have unintended consequences. Stomach acid is one of your body's primary defenses against bacterial overgrowth in the upper gut. When its production is inhibited by PPIs, the risk of bacterial overgrowth increases. Furthermore, with decreased stomach acidity, the body might not efficiently break down and absorb nutrients, potentially leading to nutrient deficiencies. Regular and prolonged use of PPIs has been linked to an increased risk of SIBO, emphasizing the importance of using these medications judiciously and under proper medical guidance. (3)(4)(5)

SIBO masterclass

Are you keen to delve deeper into the intricate web of SIBO root causes? Looking for actionable strategies to tackle these triggers head-on?

Then, join the SIBO Root Cause Masterclass to get equipped with the right tools to move on with your healing journey.

Learn more

SIBO Root Cause #3: structural abnormalities in the gut

The physical structure of your gastrointestinal system can significantly influence the growth and movement of bacteria.

Here's how:

  • Small Intestine Diverticula: These are small, bulging pouches that can form in the lining of the digestive system, primarily in the small intestine. These pouches can collect food particles and slow down transit time, allowing bacteria to grow and potentially leading to SIBO.
  • Post-surgical Changes: Surgeries, especially those related to the digestive tract, like gastrectomies or bowel resections, can change the anatomy and movement of the gut. Such changes can create areas where food and bacteria stagnate, leading to bacterial overgrowth.
  • Adhesions are bands of scar tissue that can form between abdominal tissues and organs, typically after surgery (C-section, endometriosis surgery). Adhesions can cause parts of the intestines to stick together, leading to blockages or slow transit times, promoting SIBO.

Other types of obstructions in the gut can also increase the risk of developing SIBO. (6)

SIBO Root Cause #4: reduced digestive juice production

Your body produces various digestive juices, from stomach acid to bile and digestive enzymes. These juices help break down food and also play a role in keeping bacterial growth in check. Factors like aging, certain medications, or other conditions can reduce the production of these juices, facilitating bacterial overgrowth. (7)

SIBO Root Cause #5: poor lifestyle choices

Your daily routines, habits, and choices are pivotal to your health. The gut, often called your "second brain," is no exception. Poor lifestyle choices alone may not directly cause SIBO, but they can contribute to the development of this condition.

Here's how your lifestyle can impact the gut:

  • Dietary choices: the food you consume has an immediate effect on your gut health. Diets high in sugar, processed foods, and unhealthy fats can feed harmful bacteria, promoting their growth.
  • Chronic stress affects your body in numerous ways; the gut is no exception. Persistent stress can weaken your gut lining, reduce stomach acid production, and alter gut motility, creating an environment for SIBO to flourish.
  • Lack of physical activity: Sedentary lifestyles can slow down gut motility, creating an environment where bacteria can overgrow. On the other hand, regular (moderate) physical activity can boost metabolism and encourage healthy bowel movements.
  • Alcohol consumption: Excessive alcohol intake can damage the gut lining and disrupt the balance of beneficial bacteria. It can also decrease stomach acid production, making the small intestine more susceptible to bacterial overgrowth.
  • Inadequate sleep: Your body needs adequate rest for repair and regeneration. Consistently missing out on restful sleep can weaken the immune system, making your body and gut more vulnerable to imbalances and infections.

Your path to recovery

If you suspect you have SIBO, requesting a SIBO breath test to get a diagnosis is crucial. You may need a tailored treatment plan based on the breath test result. Given the individual-specific nature of SIBO's root causes, it's vital to approach treatment on a case-by-case basis. Recovery often involves a combination of dietary changes, antibiotics or natural antimicrobials, and possibly prokinetic drugs to improve gut motility while addressing any root causes.

 

SIBO, while challenging, is manageable. With the right knowledge and tools at your disposal, recovery is not just possible – it's probable. Take the first step towards your gut health transformation and join the SIBO Root Cause Masterclass today. We will break down the five most common root causes of SIBO, going beyond the surface to understand the underlying mechanisms and how they affect your gut health. Armed with the knowledge of the root causes, the next step is a solution-oriented approach. The masterclass offers practical, actionable strategies tailored to each cause, ensuring you have a toolkit to combat SIBO. By deeply understanding the common root causes of SIBO, you're better equipped to prevent and manage this condition.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

5 SIBO root causes you need to know for the recovery journey Read More »

3 reasons why you have constant bloating: SIBO and more

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Bloating is a discomforting and often embarrassing symptom frequently attributed to overeating or diet. However, the causes of bloating can be much more intricate, primarily when related to Small Intestinal Bacterial Overgrowth (SIBO) and other chronic gut issues. Today, I'll explore the phenomenon of bloating, common triggers, and potential root causes behind this symptom. I'll also share some short-term solutions to manage bloating symptoms effectively.

Understanding bloating: what's the norm and the exception

Bloating is a sensation of fullness or swelling in the abdomen that may be accompanied by increased flatulence (gas). It's an uncomfortable feeling and a struggle when you have a pregnant belly look and your jeans feel tight around your belly. You may feel discomfort from trapped gas in your abdomen that can't leave your body, sometimes contributing to abdominal pain.

It's essential to differentiate between occasional, normal bloating and chronic bloating, which might indicate underlying health issues.

normal vs chronic bloating

You might occasionally experience bloating after a hearty meal or consuming gas-inducing foods like beans, cauliflower, or too many raw vegetables in one sitting. Bloating is almost guaranteed if you overeat, don't chew your food thoroughly, or drink carbonated drinks with your meal. These could be normal if bloating resolves on its own and subsides within a few hours or maybe a day.

However, suppose you're constantly feeling bloated even during fasting periods or after every single meal or your bloating is accompanied by other symptoms like nausea or changed bowel movements interfering with your daily activities. In that case, it's not normal and needs to be investigated.

Triggers for bloating

While diet and eating habits are often blamed for bloating and gas, these factors might not be the only primary culprits in chronic bloating cases. For instance, overeating, consuming fatty foods, or drinking fizzy beverages are known triggers for bloating. However, these factors generally cause temporary discomfort.

Continual bloating symptoms often indicate underlying health issues. Stress, anxiety, and lack of physical activity are frequently blamed, but these usually exacerbate the existing problem rather than cause it directly.

Three reasons behind constant bloating: a deeper dive

Several functional reasons could contribute to chronic bloating. Here are some of the main ones:

Insufficient digestive juices

Several glands in the digestive system secrete digestive juices to aid in digestion. These juices contain enzymes that help break down food into smaller parts and different nutrients. The organs that release digestive juices include the salivary glands, stomach, liver/gallbladder, pancreas, and small intestine. (1) These digestive juices also serve as your body's natural defense barrier against infections.

Here is a short overview of some of the digestive juices, their functions, and possible issues:

Salivary glands

Digestion starts in the mouth. When you take a bite of food, enzymes in your saliva, called amylase, start breaking down carbohydrates. Poor oral health, including gum disease, cavities, and missing teeth, can disrupt this critical step, leading to less effective digestion and potential gut issues.

Stomach

Glands in the stomach lining make stomach acid and enzymes that break down food. Muscles of the stomach mix the food with these digestive juices. The stomach secretes proteases to function as the initial site of protein digestion. The stomach has a very acidic environment, with a pH ranging from 1.5 to 3.5. (2)
The higher the number goes, the more alkaline it becomes, which we don't want because an adequate level of acid is required for:

  • Protein digestion
  • Activating pepsin (enzyme)
  • Proper sphincter function (so the valve stays closed and food doesn't reflux back)
  • Stimulating other digestive juices to be released further down your digestive tract
  • Mineral absorption
  • Killing unwanted bacteria and parasites in the food (preventing SIBO or food poisoning)
  • Activating intrinsic factor that is needed for vitamin B12 absorption (3)

Stomach acid production can be negatively impacted by chronic stress (4), Helicobacter pylori infection (5), chronic inflammation, autoimmune disorders (6), and aging (acid levels decrease as we get older). (7) Proton pump inhibitors (PPIs) and antacids are commonly prescribed or purchased medications that lead to low stomach acid production. (8)

Low stomach acid, also known as hypochlorhydria, can cause a wide range of digestive symptoms (9):

  • Heartburn, nausea, acid reflux symptoms, GERD
  • Trouble digesting meat
  • Gas and bloating after eating, early fullness
  • Food allergies and intolerances
  • Nutritional deficiencies (iron, vitamin B12, Magnesium)
  • Hair loss, thinning hair, or brittle fingernails
  • Undigested food particles in the stool
  • Constipation or diarrhea
  • Skin problems, such as acne or eczema
  • Overgrowth of bacteria and yeast (Candida albicans)

Liver

The liver makes a digestive juice called bile that helps digest fats and some vitamins. Bile ducts carry bile from the liver to the gallbladder for storage between meals or to the small intestine for use when food is present.
But bile has other roles besides food digestion. It serves to maintain the intestinal environment clean with its antimicrobial properties. Bile keeps the bacteria in check and prevents them from colonizing the small intestine.
Bile also plays a vital role in removing toxins from the body. Toxins from liver detoxification processes are secreted into bile and eliminated through feces (bowel function). (10)

Stagnant or sluggish bile flow, also known as cholestasis, can be caused by various factors. Some of the causes of stagnant or sluggish bile flow can be drugs, sex hormones, bile duct obstruction (like gallstones), low-fat diet, etc. (11)

Here are some signs of poor bile flow:

  • Greasy, foul-smelling, and light-colored stools
  • Nausea
  • Bloating
  • Diarrhea or constipation
  • Vitamin deficiencies (fat-soluble)
  • Fatigue
  • Migraines
  • Skin problems such as acne or eczema
  • Jaundice
  • Mood swings
  • Liver inflammation

Pancreas

The pancreas makes digestive juice with enzymes that break down carbohydrates, fats, and proteins. The pancreas delivers the digestive juice to the small intestine for proper digestion. The main types of pancreatic enzymes include:

  • Lipase: breaks down fats into fatty acids
  • Protease: breaks down proteins into amino acids
  • Amylase: breaks down carbohydrates (starch) into sugars

Food may not be broken down properly without enough pancreatic enzymes, leading to pancreatic insufficiency or exocrine pancreatic insufficiency (EPI), producing digestive issues such as gas and bloating, feelings of fullness, abdominal pain and cramps, and diarrhea. Sometimes, insufficient pancreatic enzymes can lead to malabsorption and malnutrition. (12)

Small intestine

The small intestine makes digestive juice, which mixes with bile and pancreatic juice to complete the breakdown of proteins, carbohydrates, and fats. Bacteria in the small intestine produce some of the enzymes needed to digest carbohydrates.

If the small intestine cannot absorb the nutrients and fluids, we may talk about malabsorption syndrome. This issue may involve symptoms such as chronic diarrhea (undigested food passes through the digestive system too fast), weight loss (not being able to absorb the nutrients needed for the body), abdominal pain and bloating; pale, bulky, and smelly stools; fatigue, etc. (13)

SIBO (Small Intestinal Bacterial Overgrowth)

Another reason for chronic bloating can be Small Intestinal Bacterial Overgrowth (SIBO). SIBO is a condition when an unusually high number of bacteria grow in the small intestine, where the bacterial population should be relatively low compared to the large intestine. These bacteria in the wrong place ferment carbohydrates and produce gases, leading to bloating, flatulence, discomfort, constipation and/or diarrhea, abdominal pain, nausea, and fatigue. Still, it can also impact your skin, hormones, joints, etc. (14) You can read more about the various types of SIBO here.

But even if you are diagnosed with SIBO, it is still important to dig deeper and discover why you have SIBO. There could be a few reasons behind SIBO bloating, such as low stomach acid, gut motility issues (that hinder the movement of the gut (MMC) to sweep out remaining food particles and waste toward the colon), medications, and adhesions. Learn more about how to tackle the most common causes of SIBO.  

Imbalance in the gut microbiome community

Trillions of microbes like bacteria, viruses, and fungi live in your colon, known as the gut microbiome. The microbiome consists of microbes that are beneficial for us and those that are potentially harmful. The gut microbiome plays a crucial role in digesting food, absorbing and synthesizing nutrients, affecting the immune system, controlling brain health, influencing metabolism, and many other functions. (15)

However, certain factors can disrupt the balance between the microbes, causing digestive symptoms like bloating and gassiness, constipation and/or diarrhea, and other symptoms.

These factors may include the following:

  • Medications like antibiotics can kill both harmful and beneficial bacteria in the gut. (16) While these medications could be life-saving in several cases, they are prescribed way too often, creating a huge imbalance that may take years to restore.
  • Western diet is typically high in processed foods, sugar, and inflammatory seed oils that may feed pathogens in the gut. (17)
  • Particular lifestyle and environmental factors can also negatively impact the gut microbiome, such as chronic stress, trauma, smoking, lack of quality sleep, sedentary lifestyle, environmental toxins, etc. (18)

The consequence of an imbalanced gut microbiome community (dysbiosis) commonly results in symptoms like bloating.

6 things that harm your gut microbiome

How to test for the causes of bloating?

Identifying the root causes of bloating is vital to managing it effectively. The good news is that various diagnostic tests can help pinpoint the causes. I want to clarify two of the most popular tests that could be useful in your bloating healing journey.

SIBO Breath test

Since chronic bloating is one of the leading symptoms of SIBO, a breath test seems like a logical choice among testing options. A breath test for SIBO is a non-invasive test that measures the amount of gases produced by bacteria in the small intestine. The test can be performed at home, and it involves consuming a sugar solution (usually lactulose or glucose) and then measuring the levels of hydrogen and methane (or hydrogen sulfide) in the breath samples at specific intervals. If bacteria are abundant in the small intestine, they ferment the sugar solution by creating gases that the breath test can capture. The breath test aims to determine what type of SIBO and how much overgrowth you have because each type requires a different, tailored treatment plan. (19)

Comprehensive stool test

A comprehensive stool test is a non-invasive diagnostic assessment that can help identify imbalances in the large intestine by assessing the balance of bacteria, yeast/fungus, and other organisms present. The test measures key markers of digestion, absorption, inflammation, immune response, and intestinal function. The test can give us an excellent overview of your intestinal health and help pinpoint the causes of digestive symptoms like bloating.

Managing bloating in the short-term

While long-term solutions are essential, managing immediate bloating symptoms can significantly improve comfort.

Here are a few things you can do:

  • Try dietary changes if you have chronic bloating due to SIBO: Limiting temporarily high FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), foods can help manage symptoms related to SIBO and other digestive disorders. These foods include wheat, onions, garlic, many of cruciferous veggies, dairy products, legumes, etc.(20) Read more about the SIBO and low-FODMAP diet here. Remember that diet alone will not resolve the causes of your SIBO, and it should only be used short term.
  • For those who fight bloating regularly, opting for cooked food instead of raw foods could be a better option for digestion.
  • Practice mindful eating habits by making sure you take the time to sit at the table to eat and chew your food properly. Allowing time to consume your meal in a relaxed manner can help reduce bloating. Not to mention, slow eating can prevent overeating as well. (21)
  • Consider natural remedies like peppermint oil (avoid if you have reflux symptoms or GERD), ginger, and chamomile tea are known for their anti-bloating properties. Other herbs such as cumin, dill, parsley, and basil may be beneficial to reduce flatulence. (21)
  • A gentle exercise routine can help stimulate intestinal contractions, expel gas, and reduce bloating. Walking, yoga, Pilates, and tai chi are all great options. (22)
  • If you experience massive bloating after eating, that is also painful; activated charcoal can help bind excess gas in the intestines and reduce bloating as a quick fix. An important note with activated charcoal is to take it at least 1 hour (but rather 2 hours) away from food, medications, and supplements as it binds to not just toxins but everything else. (23)

Remember, these are temporary measures. It's essential to seek professional help if you experience chronic bloating. Unraveling the root causes of your discomfort is the key to creating a long-term, effective strategy for bloating relief.

Bloating isn't just an inconvenience; it's a signal from your body that something isn't quite right. By understanding the underlying issues, you can address bloating at its root and reclaim your comfort, health, and well-being.

 

This post is only for informational purposes and is not meant to diagnose, treat or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

3 reasons why you have constant bloating: SIBO and more Read More »

Could SIBO or Thyroid Issues Be the Root Causes of Your Constipation?

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Do you often feel bloated, uncomfortable, and struggling with constipation? You're not alone. Millions worldwide grapple with these issues daily, often without realizing the root causes.

Constipation is a common health issue, and many people labeled with IBS (Irritable Bowel Syndrome) are told to accept this symptom as their fate. Still, constipation can be a sign of dysfunction or imbalance, and it can be disruptive and uncomfortable, affecting your overall health.

That's why I've created this essential blog post—to help you uncover the common hidden causes of constipation and take the first step towards reclaiming your health. From Small Intestinal Bacterial Overgrowth (SIBO) to thyroid issues, explore how these health conditions might be the unexpected culprits behind your discomfort.

Let's discover how to manage these conditions to relieve constipation symptoms effectively. By understanding the root causes, you can make targeted diet and lifestyle changes that provide lasting relief.

3 common causes of constipation, SIBO, hypothyroidism

What does constipation mean?

Constipation is a digestive condition characterized by infrequent bowel movements, meaning that you have three or fewer bowel movements per WEEK.

But even if you go to the toilet daily, you can still be constipated. If you strain on the toilet, have difficulty passing stools, or your stool comes out in pellets (and not smoothly and in a long shape) and is hard and lumpy, there is a high chance of being constipated.

Need help identifying your stool type? Check out the Bristol Stool Chart for more information. Types 1 - 2 indicate constipation, while type 3 is considered as tending towards constipation.

But constipation may also be accompanied by other symptoms such as abdominal discomfort, bloating, gassiness, or a feeling of incomplete evacuation. Some people may also experience reflux symptoms, as gas and bloating push up acid to the esophagus. (1)

Constipation is a common digestive problem affecting around 16% of the general population, and women are more likely to suffer from constipation than men. (2)

Constipation may be acute or chronic, lasting many months or even years.

Why should you care about constipation?

Because your bowels are designed to eliminate toxins and waste.

When you have slow transit in the intestines, toxins, and waste get stuck in your body too long, reabsorbed into the bloodstream, and waste putrefies in the colon, feeding pathogenic bacteria and fuelling inflammation. This process can put extra pressure on the liver to work hard on elimination. Consequently, you may experience additional symptoms like hormonal imbalances, skin problems (like acne), brain fog, and headaches.

3 Possible Causes of Constipation (3)

1. Poor lifestyle choices (4)

  • Dehydration: Inadequate fluid intake is one of the most common causes of constipation. When dehydrated, your body draws water from stools to maintain hydration, making them harder and more difficult to pass. Excess caffeine or alcohol intake can also lead to dehydration.
  • Lack or excess dietary fiber intake: A diet low in fiber can contribute to constipation. Fiber adds bulk to your stool, helping it move more efficiently through your digestive tract. But in some cases, eating too much raw foods, veggies, and fiber can contribute to slow digestion, especially in people with SIBO.
  • Sedentary Lifestyle: Physical inactivity can slow your digestive system, leading to constipation. Regular exercise can stimulate intestinal muscles, aiding digestion.
  • Ignoring the urge to defecate.

2. Small Intestinal Bacterial Overgrowth (SIBO):

SIBO is a condition where an excessive amount or abnormal type of bacteria are present in the small intestine, where their numbers should be relatively low compared to the large intestine. (The large intestine house the highest number of bacteria). These bacteria in the wrong place can interfere with normal digestion and absorption of food by fermenting carbohydrates and fibers and creating byproducts, like gases, leading to symptoms like:

  • changed bowel movements: constipation and/or diarrhea,
  • constant bloating, gassiness,
  • abdominal pain,
  • nausea,
  • fatigue, brain fog,
  • skin issues (acne, Rosacea),
  • joint and muscle pain, etc. (5)

 

 

One of the primary reasons revolves around the role of the Migrating Motor Complex (MMC). The MMC is a pattern of electrical activity that occurs in the smooth muscle of the gastrointestinal tract during the periods between meals. It's often referred to as the "housekeeper" of our gut because its function is to sweep residual undigested material through the digestive tract. The MMC operates in a cyclical manner, approximately every 90-120 minutes during fasting periods. (This is one of the reasons why constant snacking is a bad idea with SIBO!)

When the MMC is functioning correctly, it helps control the bacterial population in the small intestine by regularly clearing it out, pushing bacteria into the large intestine, and preventing any significant accumulation. However, certain conditions like stress, medications (especially opioids), certain diseases (like Scleroderma), or other underlying causes (>>check out the SIBO Root cause Masterclass for more information) can disrupt the MMC's functioning, leading to a slowdown or stoppage of this cleaning wave. This disruption can allow bacteria to multiply excessively in the small intestine, leading to SIBO. (6)

Once SIBO has been established, the overgrown bacteria can interfere with normal digestion and nutrient absorption. Moreover, they can produce large amounts of gas (methane, hydrogen, hydrogen sulfide) as they ferment the food that you eat.

Particularly, methane-producing archaea have been linked to constipation, defining it as Intestinal Methane Overgrowth (IMO) since they are technically not bacteria. They have been identified as Methanobrevibacter smithii in the gut and stool tests.

Methane gas can slow down the transit time, leading to constipation. It's a bit of a vicious cycle - the slower transit time allows more time for bacteria to ferment carbohydrates, leading to more methane production and further slowing down gut motility. (7)

3. Thyroid dysfunction

The thyroid gland, a small butterfly-shaped organ located in your neck, plays a pivotal role in your body's metabolic functions. It produces vital hormones – triiodothyronine (T3) and thyroxine (T4) – that regulate metabolism, influencing how your body uses energy and processes food. When the thyroid is underactive, a condition known as hypothyroidism, it can significantly affect your digestive health, particularly leading to constipation.

In individuals with hypothyroidism, the production of thyroid hormones is insufficient, resulting in a slowdown of metabolic processes, including gut motility - the speed at which food moves through the digestive tract. With reduced gut motility, the digestive tract takes longer to process and move stools, often resulting in constipation. (8)

Hypothyroidism and SIBO

The connection between hypothyroidism and SIBO comes back to the gut motility issue. The slowed gut motility in hypothyroid individuals can disrupt the functioning of the Migrating Motor Complex (MMC), the mechanism that sweeps residual undigested material and bacteria through the digestive tract.

As discussed in the previous section, proper MMC function is crucial to preventing bacterial overgrowth in the small intestine. When MMC function is compromised, as in hypothyroidism, it can result in an accumulation of bacteria in the small intestine, leading to SIBO. (9)

Thyroid, Liver Function, and Constipation

The thyroid also has a crucial connection with liver function. The liver is the primary site where T4 is converted into its active form, T3. In cases of hypothyroidism, this conversion process can be compromised, exacerbating the symptoms of low thyroid function. Furthermore, the liver plays a vital role in digestion by producing bile, which helps break down fats. If liver function is affected due to impaired thyroid activity, it can lead to constipation. (10)

Low Stomach Acid and Hypothyroidism

Another digestive issue linked to hypothyroidism is low stomach acid or hypochlorhydria. Studies estimate that around 30% of people with hypothyroidism have low stomach acid. (11) Adequate stomach acid is necessary for breaking down food, absorbing nutrients, and preventing harmful bacteria from entering the gut. (12) Individuals with hypothyroidism often produce less stomach acid, slowing digestion and contributing to constipation. (13)

Other contributing factors

The list is not complete, as there can be many different reasons (4) for being constipated. Here are some other examples:

  • Food allergy/intolerance
  • Stress, anxiety, depression
  • Dysbiosis (imbalance between the beneficial and pathogenic gut bugs in the gut), including bacterial, parasitic, and fungal overgrowth
  • Sluggish liver function
  • Heavy metal toxicity
  • Lack of stomach acid
  • Nutrient deficiencies
  • Metabolic disorders (Diabetes)
  • Structural problems
  • Side effects of medications (anti-histamines, opioids, NSAIDs, antacids, PPI's, antidepressants, etc.), overuse of laxatives
  • Neurological disorders (Parkinson's, Alzheimer's, Multiple Sclerosis, etc.)
  • History of eating disorders (Anorexia Nervosa or Bulimia)
relieve constipation naturally

How to Relieve Constipation Naturally

Understanding the potential causes of constipation can provide effective strategies for overcoming this common digestive issue.

The first step for many people leads through conventional medicine. Doctors may suggest colonoscopy or other testing options based on the symptoms and health history, but unfortunately, I commonly see that many patients end up with laxatives in their hands.

Laxatives have many forms, but they will just treat the symptom, serving as a band-aid approach rather than a long-term solution. Not to mention that laxatives may also come with side effects if used long-term. (14)

Taking a holistic approach could be a better strategy for long-term resolution. Functional Medicine and Nutrition focus on the root causes and treating the body as a whole. Specific functional testing options like gut microbiome testing, SIBO breath test, mineral testing, complete thyroid panel, hormonal testing, etc., can provide a clearer picture of the imbalances happening on a deeper level.

As we've discussed, poor lifestyle choices, Small Intestinal Bacterial Overgrowth (SIBO), and thyroid dysfunction, particularly hypothyroidism, can all contribute to constipation.

Here are some natural strategies to help manage constipation, taking into account these three primary causes:

Improve Lifestyle Choices

Dietary guidelines (15):

  • Increase Fiber Intake: Fiber adds bulk to your stools, making them easier to pass. Include fiber-rich foods such as whole grains, fruits, vegetables, and legumes in your diet. Psyllium, oat, and chia bran can also be a great addition (careful if you have SIBO!). Fiber intake should be increased gradually to at least 30 g/day for men and 25 g/day for women.
  • Decrease sugar, alcohol, and processed foods that have a negative impact on the gut microbiome
  • Bitter foods like radicchio, dandelion greens, arugula, artichokes, and endive can help stimulate digestion
  • Ginger is excellent for stimulating gastric emptying and gut motility
  • Stay hydrated: Adequate hydration can prevent stools from becoming hard and difficult to pass. Aim to drink at least 8 cups of water daily, especially if consuming more fiber. Despite drinking enough water, our cells can still be dehydrated and miss essential minerals like magnesium, potassium, sodium, etc. Adding a pinch of Celtic sea or Himalayan salt can be a great way to replenish minerals for the body.

Other lifestyle changes:

  • Regular Exercise: Physical activity stimulates your digestive system and can help maintain regular bowel movements. Even light activities like walking, yoga, or Qigong can be beneficial. (16)
  • Manage Stress: Chronic stress can exacerbate digestive and thyroid symptoms. Stress management techniques such as meditation, yoga, and deep breathing can be helpful.

Address SIBO to relieve constipation

If you suspect you have SIBO, getting a diagnosis from a healthcare provider is essential. They can order a SIBO Breath test to determine the types of SIBO and the amount of overgrowth you may have.

Addressing SIBO and restoring the normal functioning of the MMC is crucial in resolving constipation linked to this condition.

Dietary modifications, like temporarily limiting fermentable foods: certain carbohydrates, known as FODMAPs, can exacerbate SIBO symptoms. A low-FODMAP diet might be recommended for SIBO-related constipation and bloating. While the low-FODMAP diet can help MANAGE THE SYMPTOMS in the short term, it will not solve the underlying reasons that are possibly causing your SIBO! (17)

Mindful Eating is crucial for overall digestion: eating slowly and chewing your food thoroughly can improve digestion and absorption, reducing the workload on your small intestine. (There is a reason why you have teeth and saliva in your mouth.)

Since MMC is often dysfunctional, prokinetic agents (medications that help increase the motor activity of the gastrointestinal tract) and targeted antibiotic or antimicrobial therapy are common strategies used in treating SIBO. (18)

One particular probiotic strain: Lactobacillus reuteri (DSM 17938), has been shown to decrease methane production and chronic constipation significantly. (19)

Manage Thyroid Dysfunction

Proper testing for thyroid dysfunctions: If you suspect you may have thyroid dysfunction, asking for a FULL thyroid panel is essential. The full panel should include TSH, free T4, free T3, Thyroid Peroxidase Antibodies (TPO Ab), and reverse T3.

Conventional medicine typically considers the TSH level normal between the range of 0.5 - 4.5 mIU/L. However, in functional medicine, a narrower range is preferred for optimal TSH function:  1.0 - 2.5 mlU/L.

Follow a nutrient-rich diet: Certain nutrients, including iodine, selenium, magnesium, and zinc, are essential for thyroid health.

Here are some examples of foods rich in these essential minerals (20):

  • Iodine:
    • Sea vegetables like kelp, nori, and kombu
    • Fish and seafood, especially cod and shrimp
    • Dairy products like milk, cheese, and yogurt
  • Selenium:
    • Brazil nuts (they are exceptionally high in selenium)
    • Seafood, poultry, and eggs
    • Whole grains, like brown rice and oats
  • Magnesium:
    • Green leafy vegetables, whole grains (quinoa and brown rice)
    • Nuts and seeds, like almonds and flaxseeds
    • Legumes, including black beans and lentils
    • Dark chocolate
  • Zinc:
    • Meat, particularly beef, and lamb
    • Shellfish, especially oysters, are a top source of zinc
    • Legumes like chickpeas, lentils, and beans
    • Seeds, such as pumpkin seeds and sesame seeds, and nuts, including cashews and almonds

The bottom line

In conclusion, while constipation can be a disruptive and uncomfortable issue, understanding its causes can guide effective strategies to manage and overcome it. Improving lifestyle choices, addressing underlying conditions like SIBO or thyroid dysfunction, and maintaining a healthy diet can significantly improve digestive health. Your journey to improved gut health and relief from constipation starts with understanding and addressing these key factors.

 

This post is only for informational purposes and is not meant to diagnose, treat or cure any disease. I recommend consulting with your healthcare practitioner always before trying any treatment or dietary changes.

Could SIBO or Thyroid Issues Be the Root Causes of Your Constipation? Read More »