SIBO

Indigestion - To Test or Not To Test

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I often see new patients with undiagnosed digestive issues, that they have been struggling with for months, sometimes years. They have seen their GP and given either no solutions, a medication they have to stay on to feel better, or referred to a GI specialist and are waiting for many more months to then be told their scope was clear and you just have IBS! I know this can very frustrating! 

This is where Naturopathic Medicine can come in and be very helpful. We have been trained in the ins and outs of the digestive tract and possible conditions and have had many hours of nutrition training to cater a food plan specific for you. I love treating digestive concerns for a few reasons:

  • Time to explain how the digestive tract works 

  • Access to GI lab tests that are specific to the patient

  • Tools such as nutrition, herbs, and neutraceuticals that can be specific for the patient 

  • Most conditions I have found stem from gut health so I can treat skin issues, hormone issues etc by addressing the gut! 

Testing can be an invaluable tool at times and can speed up the treatment process.  I go through the 4Rs in gut health (see post here) with all my patients and usually start with the basics in gut health and/or work with where they are at or how severe their digestive symptoms are, but testing can be very helpful. For example, a recent patient of mine opted to do both the SIBO breath test and the IgG food sensitivity panel during his initial visit so we could gather all necessary information as soon as possible then treat accordingly. On his second visit, we could jump right into the test results, in this case positive for hydrogen SIBO and a sensitivity to a few specific foods, and start antimicrobial herbs specific for his SIBO results. He then saw quick results! I believe we would still have gotten moderate results without testing but with it results happened much sooner and were much better. 

Some GI tests have been criticized in the news as of late but considering the results I see when these tests are included in our clinical diagnoses and ultimately the treatment, I have to disagree with some of their conclusions. A few of the digestive system tests I use are:

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  • IgG food sensitivity - This is a comprehensive test including 160 foods that you could have an IgG sensitivity to. I always make sure patients are aware that if several foods come back as a sensitivity then we are dealing with a “leaky gut” generally and eliminating the bigger culprits is important as well as a lot of gut healing support. 

  • SIBO Breath Test - Many cases of “IBS” are associated with an imbalance in bacteria that cause bloating, gas or bowel movement issues. In the case of SIBO it is an imbalance in the upper GI bacteria and the digestive wave is not functioning correctly. Testing reveals if this is the case, how severe the imbalance is and what type of dysbiotic bacteria is highest. We can then treat more effectively. 

  • GI Mapping or Stool Analysis - In more complex cases or if there is a history of parasites and negative scopes, stool analysis is valuable. Among other things his reveals what bacteria, parasite or virus is running rampant in the gut as well as how much inflammation is present. This test is very comprehensive and informative, but it is also more expensive. 

If you have been dealing with digestive issues for awhile with no diagnosis or direction, testing may be of benefit to you. There are many Naturopathic approaches to healing the digestive system and it is one area I love treating. Come visit me! 

In heath & happiness,

Dr. Karen

(Photo credits: 1 - https://www.everydayhealth.com/digestive-health-pictures/lets-hope-its-just-gas.aspx; 3 - www.sibodoctors.com)

IBS Diet - Why A lowFODMAP Diet Is Not Advised Long-Term

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More and more digestive patients of mine tell me that it has been suggested they go on a low-FODMAP diet (easily fermentable foods) to help/cure their IBS symptoms. Sometimes they are even told to stay on it longterm despite not seeing a big benefit. Unfortunately this is not the best suggestion and can actually cause some long-term side effects leading to worse digestive issues. The only digestive condition that warrants a low-FODMAP diet is something called SIBO, small intestinal bacterial overgrowth, and only for a short amount of time. To simplify, SIBO basically means that bacteria have ascending up from the large intestine into the small intestine where they are not suppose to be and cause symptoms such as bloating, gas, and pain. Yes, many patients with IBS do have SIBO, however it is important to accurately test and properly treat, instead of staying on a restricted diet long-term. 

A low-FODMAP diet keeps symptoms of SIBO under control simply by starving the bacteria in your small intestines. When they don’t have food, they aren’t able to ferment that food and produce unwanted gas. It doesn’t actually get rid of them. Longterm, this can starve the bacteria in your large intestines that have a beneficial role in our gut and overall health as well as potentially set patients up for reoccurrence of SIBO. Studies have shown that a long-term low-FODMAP diet can reduce the diversity and quality of beneficial bacteria in the large intestine.  

Yes this diet can reduce symptoms IF you have SIBO however dietary changes alone are often not enough to treat. We want to actually kill the bacteria vs starve them into a dormant state. A low FODMAP diet (or similar low carbohydrate diet) is only one portion of my SIBO protocol and should only be used for about 6-8 weeks in the final phase. As mentioned, my main goal is to kill the unwanted microbes with antimicrobials, while actually feeding them with FODMAP foods to make sure they are active and easier to kill. This phase does not happen for long as well, only about 6 weeks. 

In the long term, we want to eat FODMAP foods to feed the beneficial bacteria in the large intestines. We also want to keep our diet as diverse as possible to allow greater nutrient density and get a wider variety of nutrients. 

My last point is that SIBO is often a symptom of a deeper digestive problem therefore, after properly treating this condition we then address the root cause, which could be low stomach acid, gallbladder issues, intestinal motility issues, stress and so on. 

Therefore if you have been advised to start a low FODMAP diet, or have been on it for even a few months already, please consider seeing a Naturopathic Doctor like myself to consult on whether this is the right treatment path for you, to get tested for SIBO or to help get to the root cause of your digestive concerns. 

Any questions? I'm happy to help!

In health & happiness,

Dr. Karen

 

 

From Around the Web

1. For the foodies in the HRM - many options to enjoy great local food!

2. A step in the right direction in terms of research for Naturopathic Medicine.

3. Phytoplankton - the newest superfood? Let me know what you think.

4. Stuck in a weight rut with hypothyroidism? Read this blog post for help. (Good tips for w eight loss in general.)

5. Craving vegetable coconut curry? Look no further. 

6. Why I always stress the important of sleep - check out this infographic

7. Dreaming of summer...this recipe gets me more excited!

8. Struggling with "IBS"? It might be more than that. This is a great article written about SIBO by my colleague and friend. 

9. An intro to chakras and how to balance them with yoga.   

In health & happiness,

Dr. Karen