I also focus on digestive issues and IBS as a naturopath, and it is certainly an area of health that I am passionate about.  I find that irritable bowel syndrome (IBS) is a diagnosis often via exclusion and once other health conditions have been excluded, IBS is the diagnosis given.    This basically means that the actual cause of your gut distress is not known.  It is important to exclude other causes which is always part of my treatment plan when working with gut related issues. 

When I am supporting someone with an IBS diagnosis, I always consider anxiety as a cause.  In saying this, I always assess for chronic constipation as the cause, slow gut motility, Post Infectious IBS, endometriosis on the colon, bacterial overgrowth in the small and/or large intestine, bacterial dysbiosis, food intolerances & malabsorption conditions and thyroid disease.  I often recommend functional testing to delve more deeply into what is happening for my clients.  Often Inflammatory Bowel Disease, GERD, H Pylori or more may have been excluded by a gastroenterologist. 

I also find that it may be several health-related issues that may create the “perfect storm” of Chronic IBS.

What I do know without a shadow of a doubt is that in approximately 70% of case gut issues drive anxiety and in approximately 30% of cases anxiety drives gut issues however no matter where it starts, one drives the other so you end up in a gut – anxiety – gut- anxiety circuit and treatment must also focus on both for successful outcomes.

Let’s talk statistics about Anxiety Driven IBS.

Both IBS and anxiety are common health issues for adults in Australia. IBS affects around 1 in 5 of us, whilst 1 in 6 will experience an anxiety disorder in their lifetimes. It’s becoming increasingly well established that our mood and our gut health are intrinsically linked and, anecdotally, many of us are all-too-familiar with the gut-churning effect anxiety and stress can have on our bodies. We’ve previously discussed on the blog about the link between gut health and low mood issues such as depression. But what about other mental health conditions? Do these also affect our gut health? Today we look at anxiety and how it can drive IBS – the mechanisms behind this, as well as some simple strategies to help you manage your anxiety symptoms to improve your gut health.

IBS

Irritable bowel syndrome, also known as IBS, is a really common gastrointestinal condition, affecting around 15% of the general population.  IBS is a chronic functional disorder, characterized by recurrent symptoms of abdominal pain and bloating, as well as constipation, diarrhea, or both.  Despite being common, it’s a complex condition that involves a complicated interplay between gut microbiota, diet, pain receptor dysregulation, and mental health. It’s very common for people with IBS to have concurrent mental health conditions, such as anxiety and depression – up to 90% of people with IBS also have one or more mental health conditions. What’s more, IBS symptoms often worsen during periods of acute stress or exacerbations of existing mental health conditions, and treatment for mental health can lead to reduced IBS symptoms. Recent studies suggest that IBS is actually a disorder of a breakdown in gut-brain communication, rather than being a strictly gastrointestinal health condition.

Anxiety and the Gut

Have you ever been anxious about an event and found you suddenly had to go to the bathroom? Or, if you experience an anxiety disorder, do you find that gastrointestinal symptoms are an issue for you? You’re not alone. Anxiety is one of the most common mental health conditions in Australia; many of us have experienced an anxiety disorder ourselves or have seen a loved one go through it. Anxiety causes both psychological and physical symptoms, with gastrointestinal symptoms being some of the most common issues for those with anxiety. Whilst typical symptoms might include shortness of breath, sweaty palms, and palpitations, acute anxiety can also look like:

• Diarrhoea, constipation, or both
• Abdominal cramping or pain
• Nausea, indigestion, or heartburn
• Loss of appetite, or increased appetite

So, what is going on here? There are a few reasons why these symptoms occur.

1. The Enteric Nervous System and The Gut-Brain Axis

The first reason for this link between anxiety and the gut is because both the gut and brain are connected via a system of nerves called the enteric nervous system (ENS), which is also known as the “second brain”, or the “gut-brain axis”. The enteric nervous system controls aspects of communication between the gut and the brain regarding functions such as digestion and gut motility. In fact, the vital functions of the gastrointestinal tract are almost entirely dependent on the enteric nervous system and things quickly fall apart if it is not working properly. Researchers have also found that the ENS may be responsible for some of the mood changes associated with gastrointestinal conditions like IBS. The ENS and gut-brain axis connects the emotional and cognitive centers of the brain with the gut. It is through this link that our thoughts and feelings affect our digestion and vice-versa.

2. The Physiology of Anxiety and Neurotransmitters

The second reason why anxiety and IBS are linked has to do with the chemical changes that occur in the body in anxiety. Physiologically, anxiety is essentially an overactivation of the fight or flight response, also known as the HPA axis or sympathetic nervous system. This means anxiety, like stress, puts our body into fight or flight mode. When the body is in fight or flight mode, “non-essential” functions such as digestion and immune function are suppressed. People with anxiety often aren’t digesting and absorbing their food adequately, particularly when symptoms are bad. What’s more, anxiety leads to altered levels of many important neurotransmitters, which are the chemicals the nervous system uses to send messages throughout the body. When neurotransmitter levels become altered, communication within the nervous system is compromised, as is communication between the brain and the gut via the ENS. Some of the neurotransmitters that are affected include noradrenaline, GABA, and acetylcholine, among others.

Noradrenaline

Noradrenaline, also known as norepinephrine, is a key neurotransmitter in the sympathetic nervous system (the fight or flight mode). It helps us to feel awake and alert and plays important roles in regulating our behaviour, memory, and learning. Anxiety typically causes noradrenaline levels to be higher than normal, which causes a fast heart right, high blood pressure, suppressed digestion, and slow bowels (meaning constipation). However, in periods of acute stress or anxiety, high noradrenaline can actually stimulate the bowels and trigger diarrhoea. In addition, noradrenaline can also cause alterations to the gut microbiota, leading to dysbiosis, which can make IBS symptoms even worse.

GABA

Gamma-aminobutyric acid (GABA) is our main calming neurotransmitter. Not only does it help us to feel calm, it is also important for helping with physical movement and cognitive function. Low GABA levels are typical in anxiety. Unfortunately, low GABA levels causes an increased sensitivity to pain in the gut, one of the most common symptoms in IBS. Low GABA levels can also negatively affect gut motility and the gut’s immune function, too.

Acetylcholine

Acetylcholine is another important neurotransmitter that is altered in both anxiety and IBS. Acute stress and anxiety cause low levels of acetylcholine in the gut and the brain, which leads to inflammation and increased gut motility, causing diarrhoea.

The Role of Gut Bacteria

Of course, we can’t discuss the gut without also discussing the gut microbiota. The gut microbiota is essential for the health of both the central nervous system (brain) and the ENS, because of the important neurotransmitters these bacteria produce, which are utilized by our nervous system. Bacteria in the gut produce not only serotonin, but also GABA, acetylcholine, and even melatonin. Animal studies show that changing the gut microbiota can trigger anxiety disorders and other mental health conditions, further highlighting how important our microbiota balance is. Gut bacteria directly affect the gut-brain axis, too. Bacteria communicate with nerve cells in the gastrointestinal tract, as well as communicating with the brain via the neurotransmitters they produce.

A Self-Perpetuating Cycle

It’s easy to see how the link between gut health and anxiety can lead to a self-perpetuating cycle for those with anxiety disorders and conditions like IBS. Once you are caught in this cycle, it will continue until both the anxiety and the gut aspects of your health are addressed. This is where as a naturopath I often make a significant difference in Anxiety Driven IBS through guiding you towards treatments that will help to address both the anxiety and the gut, to help make sure you are healing both parts of the issue.

Calming Your Anxiety for Better Gut Health

The good news is there are many ways you can start to gain control of your gut health by addressing your anxiety, and vice versa. Below are some great tips for helping to regain your health.

Herbal Medicines for Anxiety

Each person is unique and for this reason there are many herbs that I use for my KPI of Calm energy. This may also include herbs for more restorative sleep as sleep is critical for reducing next day anxiety.  Some of my favourite herbs include kava, withania, rhodiola, passionflower, lavender and more.

Gut calming herbs

Again, this is dependent on medications and what is unique to each client however some of the herbs I may prescribe include chamomile, lemon balm, peppermint.

Use a Quality Probiotic when indicated

Prescribing a probiotic when someone actually has a bacterial overgrowth can worsen their symptoms when working with IBS.  Once an overgrowth has been excluded and reasons for a lack of healthy gut bacteria has been identified then specific probiotics may be prescribed.

A good quality probiotic can be incredibly valuable in re-establishing a healthy gut microbiota for certain people. Certain specific microbial strains, such as Lactobacillius reuteri, have been found to improve gut motility and reduce pain perception in the gut, demonstrating good potential for use in IBS. However, remember that probiotic supplementation does need to be paired with prebiotics and a healthy, plant food-rich diet to ensure sufficient substrate available for bacterial populations to thrive. Unfortunately, many probiotics available on the market are of inferior quality or don’t contain therapeutic doses of specific bacterial strains that are beneficial for conditions like IBS. If you are interested in taking a probiotic, speak with your naturopath to find the right probiotic supplement for you.

Specific prebiotics

Many prebiotics can produce excess gas that worsen symptoms such as bloating and pain however proper prebiotic prescriptions made in line with symptoms can make a huge difference for symptoms and support good bacterial populations to grow.

Vitamin deficiencies and additional needs

Again, each person has different nutrient requirements depending on levels of stress in their lives including career, family, past history and more (which uses up nutrients), diet, lifestyle, and medications.  Important nutrients for anxiety include magnesium, Zinc, Vitamin B, Vitamin C and more.  The wrong magnesium at the wrong dose can worsen looser stools so be careful.

Blood sugar balancing

When supporting my clients with anxiety, a focus is always made around balancing blood sugar levels throughout the day and night as fluctuations can trigger and worsen anxiety.  Having good energy levels throughout the day is also important as fatigue is a trigger for anxiety in many people.

Manage Your Stress

Finding ways to reduce your stress and improve your stress-coping skills can really help with anxiety. Stress management can be as simple as a daily 30-minute walk or starting a mindfulness practice.

Talk it Out

If you experience anxiety, having a professional you can talk to makes a big difference. If you don’t already, consider booking yourself in to see a psychologist, counsellor, or therapist, who can listen to your experiences and help direct you towards helpful strategies to manage your anxiety.  Performance in Health Wellbeing clinic in Sydney’s Inner West have a team of well qualified professionals to help you.

Book in to see me (Tanya Edwards) for Naturopathic support

If you’re struggling to understand where to start, getting some professional guidance is key.  A naturopathic consultation is an extremely thorough investigation which can help you to better understand your symptom picture and overall health as we work together to develop a holistic strategy to help you regain your health.

Treatment will look at what needs to be excluded.  I may recommend a low FODMAP as a temporary measure to reduce gut symptoms as we figure out what is happening for you and herbs to reduce anxiety and gut issues at the same time.  To find out more, contact Performance in Health today.

References

Annahazi, A., & Schemann, M. (2020). The enteric nervous system: “A little brain in the gut.” Neuroforum, 26(1).

Bercik, P. (2020). The brain-gut-microbiome axis and irritable bowel syndrome. Gastroenterology & Hepatology, 16(6), 322–324.

Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology, 28(2).

Cherpak, C. E. (2019). Mindful eating: A review of how the stress-digestion-mindfulness triad may modulate and improve gastrointestinal and digestive function. Integrative Medicine: A Clinician’s Journal, 18(4), 48–53.

Gros, M., Gros, B., Mesonero, J. E., & Latorre, E. (2021). Neurotransmitter dysfunction in irritable bowel syndrome: Emerging approaches for management. Journal of Clinical Medicine, 10(15).

Hadjivasilis, A., Tsioutis, C., MIchalinos, A., Ntourakis, D., Christodoulou, D. K., & Agouridis, A. P. (2019). New insights into irritable bowel syndrome: From pathophysiology to treatment. Annals of Gastroenterology, 32(6), 554–564.

Jerndal, P., Ringstrom, G., Agerforz, P., Karpefors, M., Akkermans, L. M., Bayati, A., & Simren, M. (2010). Gastrointestinal-specific anxiety: An important factor for severity of GI symptoms and quality of life in IBS. Neurogastroenterology & Motility, 22(6).

Lee, S., Wu, J., Ma, Y. L., Tsang, A., Guo, W.-J., & Sung, J. (2009). Irritable bowel syndrome is strongly associated with generalized anxiety disorder: A community study. Alimentary Pharmacology and Therapeutics, 30(6), 643–651.

Niesler, B., Kuerten, S., Demir, I. E., & Schafer, K.-H. (2021). Disorders of the enteric nervous system—A holistic view. Nature Reviews Gastroenterology & Hepatology, 18, 393–410.

Popa, S.-L., & Dumitrascu, D. L. (2015). Anxiety and IBS revisited: Ten years later. Clujul Medical, 88(3).

Shrestha, B., Patel, D., Shah, H., Hanna, K. S., Kaur, H., Alazzeh, M. S., Thandavaram, A., Channar, A., Purohit, A., & Venugopal, S. (2022). The role of gut-microbiota in the pathophysiology and therapy of irritable bowel syndrome: A systematic review. Cureus, 14(8).

Windgassen, S., Moss-Morris, R., Goldsmith, K., & Chalder, T. (2019). Key mechanisms of cognitive behavioural therapy in irritable bowel syndrome: The importance of gastrointestinal related cognitions, behaviours and general anxiety. Journal of Psychosomatic Research, 118, 73–82.

The post Is Anxiety Driving your IBS? appeared first on Performance in Health.

These days it’s common knowledge that the microbiome – the colonies of bacteria, viruses and fungi that live in our large intestine – are integral to our health and wellbeing and can affect not only our physical but even our mental health. Many people have heard the term “dysbiosis” and understand that an imbalance of microbes in the large intestine can have negative health consequences. However, Small Intestinal Bacterial Overgrowth (SIBO) and also colonic overgrowth remains relatively unheard of by the general population, even as research catches up to the naturopathic knowledge that it is a common issue affecting many of us. So, what is SIBO and how does it occur? In this blog post we take a look into the microbiome, how SIBO develops, and how we can combat this condition using diet, lifestyle, and natural therapeutics.

The Microbiome

The gastrointestinal microbiome is the largest population of microbes in the human body. Approximately 3.8 trillion bacteria reside in our large intestine alone. In fact, the microbiome is made up of roughly ten times as many microbes as there are cells in our entire body. It is primarily composed of different types of bacteria, but also includes some species of fungi and viruses, too. Up to 1,000 different species of bacteria may reside in your large intestine. The microbiome is involved in so many aspects of our health – immune system function, hormonal balance, neurotransmitter function (90% of the body’s serotonin is actually produced by our gut microbiome!) and more. A healthy microbiome relies on overall gastrointestinal health and a good quality diet rich in fibre and fermented foods, which provide both pre- and probiotics to maintain healthy microbial populations.  This community of live species also require a healthy gut, pH and lack of inflammation to thrive and in doing so, benefits the health of your whole body.

What is SIBO?

Small intestinal bacterial overgrowth (SIBO) (which also occurs in the colon (large intestine)in some people), is an excessive and/or abnormal bacterial growth in the small intestine. The small intestine is normally only sparsely populated by bacteria, with small numbers of species such as lactobacilli and enterococci. In some people, there won’t be any bacteria at all in the upper part of the small intestine. SIBO occurs when bacterial populations from lower down the gastrointestinal tract migrate up the gut and colonise the small intestine. These microbes feed on carbohydrates in foods and drinks, producing gases including hydrogen, methane and hydrogen sulphide as a consequence of this feeding process. The bacteria also produce endotoxins as metabolic waste products, which cause inflammation and damage to the intestinal wall, impairing nutrient absorption. Important enzymes and the small, finger-like protrusions (known as microvilli) normally found in the small intestine are lost. Damage to the intestinal lining makes the gut wall more permeable, allowing potentially harmful substances to be absorbed into the blood stream.  It also means that many people will have secondary food intolerances because ethe villi are damaged and the enzymes that live in these villi, literally have no home.  I call them secondary food intolerances, because when the gases are gone, the villi recover, the enzymes have a place to live, and food can now be breakdown down and absorbed properly.  It also means that many people can return to eating these foods again once the overgrowth is cleared.

Causes of SIBO

The body has several defence mechanisms that help to prevent the development of SIBO by creating an intestinal environment that suits beneficial bacteria, while preventing the growth of pathogenic bacteria. Gastric acid in the stomach provides a highly acidic pH, which prevents the growth of certain strains of bacteria, while promoting the growth of others. Likewise, secretions from the pancreas and gall bladder also help to control microbial populations in the small intestine and play an important role in keeping the microbiome populations healthy. The motility of the intestinal tracts also helps to keep food and fluids moving regularly through the gut, preventing stasis. This helps to prevent food sources for pathogenic bacteria being available in the gut long enough for harmful populations to grow. SIBO typically develops because the environment in the small intestine has changed and is no longer able to protect against bacterial colonisation. There are a huge range of potential causes and often there are multiple different factors at play when SIBO develops. Potential risk factors and causes of SIBO include:

Post infectious IBS 

• Food poisoning or infections for drinking water or more can damage the nerves in your gut responsible for proper motility.  Many people who have had Bali belly, food poisoning overseas/in Australia or a terrible gut infection episode often find that their gut has never been the same since.

Medication use

• Proton pump inhibitors (PPIs) are common medications prescribed for reflux, heartburn and managing gastric ulcers, which reduce the acidity in the stomach. Reducing the stomach’s acidity affects the pH in the small intestine too, lowering defences for colonisation from bacteria that thrive in a less acidic environment. Studies show up 50% of long-term PPI users may have SIBO.
• Opioid medications – these drugs delay transit time in the gut, making it easier for bacterial populations to move into the small intestine.

Chronic pancreatitis, poor liver function, non-alcoholic fatty liver disease, gall bladder removal

• Pancreatic enzymes and bile are both important for maintaining gut health. Insufficient levels of either of these secretions can lead to SIBO.

Poor gut motility

• Poor gut motility, such as with chronic constipation or hypothyroidism, means foods that can feed harmful bacteria remain available in the gut for too long. It also means harmful substances meant for excretion can sit in the gut and cause inflammation, worsening symptoms related to SIBO.  Other causes of slow motility can include endometriosis on the bowel, scarring, Inflammatory Bowel Disease and more.

Age (over 75 years)

• With increasing age, motility slows down and the body produces fewer gastric secretions, meaning reduced protection against SIBO.

Stress

• Stress causes huge problems for health and is associated with myriad other health conditions. Anxiety driven IBS can be powerful. In SIBO, it can trigger symptoms by suppressing the normal production of important secretions such as gastric acid. It also slows down motility in the gut, reduces blood flow to the gut and impairs immune function, leaving us without many of the defences that normally protect us against SIBO.

Immune dysfunction

• Conditions that affect the immune system, such as autoimmune conditions, AIDS, and even coeliac disease, can lead to a greater risk of SIBO.

Signs and Symptoms of SIBO

The symptoms of SIBO are variable and often non-specific, which can make diagnosis difficult. There are many other gastrointestinal conditions that can also present in the same way as SIBO. Signs and symptoms of SIBO may include some or all of these:

• Bloating which often gets worse throughout the day
• Reactions to certain foods
• Pain
• Flatulence
• Frequent belching
• Reflux and heartburn
• Diarrhoea
• Constipation
• Nausea
• Fatigue
• Brain fog
• Joint pain
• Signs of malabsorption and nutrient deficiencies, such as iron or vitamin B12 deficiency

Associated Health Conditions

SIBO is a condition that naturopaths have long understood to be a significant contributor to health problems such as IBS. However, it’s only been relatively recently that SIBO has become better recognised by the wider medical community and is becoming more commonly diagnosed. In the past, naturopathic understandings of SIBO as contributing to other health conditions were often dismissed, although advances in knowledge of SIBO have demonstrated that it is, in fact, much more common than previously thought, and is associated with many other health conditions, too. Other conditions that can be associated with SIBO include:

• IBS
• Rosacea
• Dyspepsia
• Coeliac disease
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
• Restless legs syndrome
• Small bowel diverticula
• Pancreatitis
• Hypothyroidism
• Parkinson’s disease, rheumatoid arthritis
• Type 2 Diabetes
• Coronary artery disease
• Past history of abdominal surgery, such as gastric bypass, hysterectomy, or gall bladder removal
• Fibromyalgia
• Non-alcoholic fatty liver disease, cirrhosis

SIBO and IBS

Studies show a correlation between IBS and SIBO. One of the common ways by which IBS and SIBO can be interrelated is through post-infective IBS as mentioned above – that is, IBS that is caused by a gastric illness such as food poisoning. Infection with a gastric pathogen (such as Salmonella or E. Coli) causes an immune response by the body, including the production of antibodies. This ends up causing damage to the nerves that are responsible for gut motility but also to the body’s own intestinal wall, leading to symptoms of constipation or diarrhoea and creating the ideal environment for SIBO.

Nutritional Consequences of SIBO

SIBO can have a number of detrimental effects on nutritional status. As mentioned above when the excess hydrogen and methane gases produce by bacteria destroy villi, absorption and breakdown of foods is impacted, causing digestive symptoms.

Microbes also compete for absorption of important nutrients such as protein, B12, B1 and B3, which can lead to nutrient deficiencies and symptoms of fatigue. Vitamin B12 deficiency can lead to neurological symptoms such as tingling and numbness in the hands and feet, which can progress and eventually become irreversible. The bacteria also metabolise bile salts in the intestines, which are needed for digestion and absorption of fats and the fat soluble vitamins A, D, E, and K, and contributes to symptoms of diarrhoea. Over time, the intestinal damage from SIBO affects mineral absorption, leading to low calcium levels and an increased risk of osteoporosis. It’s easy to see why addressing SIBO is so important to your overall health!

Naturopathic Testing for SIBO

Why is testing for SIBO important? For starters, naturopaths always look to treat the underlying cause of disease, rather than just treating the symptoms. Focusing on symptom management only without addressing the underlying cause would mean there is a good chance of the SIBO returning. In fact, one study found that a whopping 44% of patients experienced a return of symptoms within 9 months of standard treatment. It’s also important to use testing to exclude other conditions that might be causing your symptoms. This is especially important with conditions like SIBO, which often has only non-specific symptoms like abdominal pain and bloating. These types of non-specific symptoms could be due to any number of other conditions. The treatments required for SIBO are different to those for similar conditions such as IBS which may not have bacterial overgrowth at all. Treating the overgrowth and rebalancing the microbiome is the only way to truly alleviate symptoms in the long term and prevent recurrence.

My first focus is via a specific gold standard Breath testing that provides accurate assessment of SIBO and also large intestinal overgrowth. The carbohydrates in the drinks provided are then fermented by the microbes in the small intestine, causing the production of gases such as methane and hydrogen. It is these gases which the breath test assesses for in your exhaled breath.  We know how much gas is produced when normal bacterial amounts are in your gut so calculating an overgrowth is based on this knowledge. I have spent significant time and studies in reading the results from certain breath testing laboratories to ensure correct diagnosis.

In addition to breath testing, other tests that may be required include:

• Full blood count, including to assess for potential gastric infections from your GP
• Coeliac blood testing
• Nutrient status testing of vitamins (A, D, E, K, and B vitamins), and minerals (calcium and zinc)
• Bowel motility test which you can do easily at home

Naturopathic Treatment Options for SIBO

Standard medical treatment of SIBO generally involves antibiotic therapy.  My naturopathic treatment typically last 3 months and uses a multi-pronged approach with herbal antibacterial liquids, motility herbs, herbs for symptom relief such as bloating and pain, a low FODMAP diet to starve bacteria from their food source as we then eradicate them.  It is also very important to treat the cause of the overgrowth, or it will return.

So, lifestyle and targeted nutritional supplementation to address not only the symptoms, but also the underlying cause of SIBO is key. Treatment also focuses on healing any damaged nerves impacting gut motility, healing the gut lining and villi and improving the intestinal environment.

If the above process is done well, a low FODMAP diet which is very restrictive will only be required for 3 months.  I really want you eating FODMAP foods long term as it is very difficult to maintain long-term and it means you miss out on beautiful, healthy foods important for health.  When overgrowth is fixed and we bring the gut back into balance, you won’t produce the extra gas that causes the symptoms and damage meaning you can most likely eat the food you started to react to. 

Below are some examples of key naturopathic treatments. It’s important to speak with your naturopath before beginning any treatments, to make sure the strategies are right for you.

Low FODMAPs Diet in more detail

Utilising a low FODMAPs diet is a highly valuable treatment regime for alleviating symptoms of SIBO and helping to eradicate the pathogenic bacterial colonies in the small intestine. FODMAPs (which stands for fermentable oligo- di-, monosaccharaides and polyols) are specific types of sugars found in many foods which are readily fermented by bacteria in the gut. These foods form a staple source of energy for microbes, and thus can be a source of significant problems for those with SIBO. As the microbes consume and ferment the FODMAPs, they produce high levels of methane, hydrogen and other gases, triggering bloating and abdominal distension, reflux, heartburn, burping, flatulence, constipation, loose stools and discomfort. In fact, this is one of the key pathways by which symptoms of IBS are produced, and a reason why low FODMAPs diets are so commonly used to help with IBS. By eliminating these foods for that 3 month period (may be a little longer if overgrowth is in the large intestine also) from the diet, we are able to “starve out” the harmful bacteria and eliminate them with herbal medicine therapy whilst they are weak.

Some foods that are high in FODMAPs include:

• Garlic, onions, chickpeas, shallots, lentils, kidney beans, cashews, barley, wheat, nectarines, and watermelon are high in oligosaccharides
• Dairy products, including milk, ice cream, cream, yoghurt, and cheeses are high in the disaccharide lactose
• Honey, boysenberries, figs, pears, watermelons, mangoes, asparagus, and dried fruits, are high in the monosaccharide fructose
• Apples, apricots, blackberries, plums, cauliflower, snow peas, and artificial sweeteners are all sources of polyols

As you can see, there are a huge number of foods in the list, which makes the low FODMAPs diet incredibly restrictive. This is why it is a short-term treatment tool only – often around 12 weeks. After this time, foods can be gradually reintroduced. For more information on the FODMAPs diet, see our blog post.

Other Treatment Strategies

Other treatment strategies that might be used include:

• Lifestyle support, such as exercise, to help improve gut motility
• Identifying and removing food intolerances and allergies
• Identifying and treating underlying conditions such as IBD, coeliac disease, endometriosis, or liver dysfunction
• Reducing stress through lifestyle changes
• Dietary changes to support long term microbiome and gut health

Your individual treatment needs will vary based on your whole health picture. If you suspect a bacterial overgrowth may be the cause of your gut issues after reading this blog, please contact me for an initial consultation or fact finding call via the contact tab on the website to arrange further investigations and begin feeling better! 

Although I have a naturopath clinic in Stanmore in Sydney’s Inner West, I work with clients all over Australia via face to face and telehealth to help with this condition.

References

Achufusi, T. G. O., Sharma, A., Zamora, E. A., & Manocha, D. (2020). Small intestinal bacterial overgrowth: Comprehensive review of diagnosis, prevention, and treatment methods. Cureus, 12(6).

Adike, A., & DiBaise, J. K. (2018). Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management. Gastroenterology Clinics, 47(1), 193–208.

Bures, J., Cyrany, J., Kohoutova, D., Forstl, M., Rejchrt, S., Kvetina, J., Vorisek, V., & Kopacova, M. (2010). Small intestinal bacterial overgrowth syndrome. World Journal of Gastroenterology, 16(24), 2978–2990.

Compare, D., Pica, L., Rocco, A., De Giorgi, F., Cuomo, R., Sarelli, G., Romano, M., & Nardone, G. (2011). Effects of long-term PPI treatment on producing bowel symptoms and SIBO. European Journal of Clinical Investigation, 41(4), 380–386.

Danau, A., Dumitrescu, L., Lefter, A., Tulba, D., & Popescu, B. O. (2021). Small intestinal bacterial overgrowth as potential therapeutic target in Parkinson’s disease. International Journal of Molecular Sciences, 22(21).

Khalighi, A. R., Khaligi, M. R., Behdani, R., Jamali, J., Khosravi, A., Kouhestani, Sh., Radmanesh, H., Esmaeelzadeh, S., & Khalighi, N. (2014). Evaluating the efficacy of probiotic on treatment in patients with small intestinal bacterial overgrowth (SIBO)—A pilot study. Indian Journal of Medical Research, 140(5), 604–608.

Lee, A. A., Baker, J. R., Wamsteker, E. J., Saad, R., & DiMagno, M. J. (2019). Small intestinal bacterial overgrowth is common in chronic pancreatitis (CP) and associates with diabetes, CP severity, low zinc levels and opiate use. American Journal of Gastroenterology, 114(7), 1163–1171.

Losurdo, G., Leandro, G., Ierardi, E., Perri, F., Barone, M., Principi, M., & Di Leo, A. (2020). Breath tests for the non-invasive diagnosis of small intestinal bacterial overgrowth: A systematic review with meta-analysis. Journal of Neurogastroenterology and Motility, 26(1).

Rao, S. S., & Bhagatwala, J. (2019). Small intestinal bacterial overgrowth: Clinical features and therapeutic management. Clinical and Translational Gastroenterology, 10(10).

Sachdeva, S., Rawat, A. K., Reddy, R. S., & Puri, A. S. (2011). Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: Frequency and predictors. Journal of Gastroenterology and Hepatology, 26(s3), 135–138.

Shah, A., Morrison, M., Burger, D., Martin, N., Rich, J., Jones, M., Koloski, N., Walker, M. M., Talley, N. J., & Holtmann, G. J. (2019). Systematic review with meta-analysis: The prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease. Alimentary Pharmacology and Therapeutics, 49(6), 624–635.

Su, T., Lai, S., Lee, A., He, X., & Chen, S. (2018). Meta-analysis: Proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. Journal of Gastroenterology, 53, 27–36.

Tziatzios, G., Gkolfakis, P., Papanikolaou, I. S., Mathur, R., Pimentel, M., Damoraki, G., Giamarellos-Bourboulis, E. J., Dimitriadis, G., & Triantafyllou, K. (2021). High prevalence of small intestinal bacterial overgrowth among functional dyspepsia patients. Digestive Diseases, 39, 382–390.

Wijarnpreecha, K., Lou, S., Watthanasuntorn, K., Kroner, P. T., Cheungpasitporn, W., Lukens, F., Pungapong, S., Keaveny, A. P., & Ungprasert, P. (2020). Small intestinal bacterial overgrowth and non-alcoholic fatty liver disease: A systematic review and meta-analysis. European Journal of Gastroenterology & Hepatology, 32(5).

The post Are your Digestive issues caused by Intestinal Bacterial Overgrowth – SIBO? appeared first on Performance in Health.

What is the Gallbladder?

The gallbladder is a small, pear-shaped organ that lies attached to the underside of the liver. The gallbladder’s primary function is to store and concentrate bile, a fluid produced by the liver, and to release bile into the small intestine during digestion. Because of their shared role in the production and secretion of bile, the function and health of the gallbladder is closely linked to that of the liver, and many of the common health issues of the gallbladder are related to (or worsened by) poor liver function and particularly altered bile secretion.

What is Bile and How is it Made?

Bile is one of our “digestive juices”, a fluid substance that is secreted by the body to facilitate digestion and absorption of vital nutrients. Bile is the primary digestive juice used for digesting and absorbing fats and the fat-soluble vitamins A, E, D, and K. It is typically a dark green to yellow colour and has a thick, sticky texture. It is made up of a mixture of water and various dissolved solids, including bile salts, cholesterol, enzymes, and even waste products ready to be excreted, such as bilirubin (a by-product of red blood cell metabolism). Bile salts are one of the key components of bile. They are produced by the liver from cholesterol via a process known as oxidation.

The human body produces around 1 litre of bile per day. Around 90% of bile is transferred to the gallbladder for storage and concentration, while the remaining 10% is deposited directly into the small intestine from the liver. Just before we start a meal, our bodies enter the cephalic phase of digestion, which is where our bodies become primed for digestion – the onset of salivating is an indicator that your body has entered this phase. It is during this phase that neural pathways signal to the pancreas to produce a hormone called cholecystokinin. This hormone stimulates the gallbladder to start contracting, releasing bile into the small intestine. Bile salts are very efficiently reabsorbed by our intestinal cells and are then transported back to the liver for reuse. About 95% of bile salts are reabsorbed, with the remainder being excreted through the bowels. This recycling of bile salts occurs 6 to 8 times a day, every day, and is known as enterohepatic recycling.

Bile, and particularly the bile salts, are vital for the absorption of fat and fat-soluble vitamins. They emulsify fats so that they can be absorbed, acting like a kind of detergent to break larger fat molecules into smaller droplets. These droplets can then be broken down by enzymes in the intestine, and ultimately absorbed through the gut wall. We know that fats are vital to good health, being used for everything from cell walls to hormones, so it is no wonder that having liver and gallbladder issues can so greatly impact how we feel.

In addition to helping with fat digestion and absorption, bile has other important functions for the body, including:

• Elimination of metabolic waste products and toxins, including bilirubin, heavy metals (lead, mercury and arsenic), drugs and medications, hormones, and chemicals
• Helps to neutralise excess stomach acid in the small intestine, preventing symptoms like heartburn and damage to the intestinal wall
• Helps to kill certain harmful bacteria in the gut, while promoting the growth of beneficial bacteria

Bile and the Gut Microbiota

You may be surprised to learn that bile and the gut microbiota are closely linked, and have a relationship that influences digestion, liver function, and even our immune system. Bile acids act like a modulator of gut bacteria, helping to keep the balance of good bacteria over bad. Special enzymes in certain good gut bacteria can metabolise bile acids. Healthy bile flow promotes higher levels of these bile-metabolising bacteria because they use bile acids as a food source with bile acids also inhibiting the growth of other, harmful types of bacteria. The emulsifying, detergent-like activity of bile acids damages the cell walls of certain bacteria species, keeping population sizes of these harmful bacteria in check.

Health Conditions of the Gallbladder

Gallbladder conditions are increasingly common and can often be related to our modern Western diet and lifestyle.

Gallstones

Gallstones (AKA cholelithiasis), are a very common health issue, affecting up to 30% of Australians over the age of 50. The “stones” in gallstones are formed when bile sits stagnant in the gallbladder, allowing for crystallisation of bile salts. People with high cholesterol are particularly susceptible to gallstones. This is because 90% of gallstones are made of cholesterol. If the liver excretes too much cholesterol into bile it becomes supersaturated, making it much more likely for crystals to form. These crystals bind together to form larger stones which can become lodged in the gallbladder.

Obesity, even when otherwise metabolically healthy, increases the risk of gallstones. Other risk factors for developing gallstones include:

• Being aged over 40
• Being female
• Being overweight, or experiencing a rapid shift in weight (either gaining or losing)
• Having insulin resistance, type 2 diabetes, or metabolic syndrome – insulin increases the production of cholesterol in the liver
• Eating a diet high in calories and high in carbohydrates
• Eating a low fibre diet
• Having liver disease

Gallstones are asymptomatic in the majority of cases, but some people will experience symptoms such as intermittent bloating, pressure, or pain in the upper right abdominal area, particularly after eating fatty foods. This intermittent pain can indicate that a stone may be lodged in the neck of the gallbladder.

Cholecystitis – gallbladder inflammation

If the ducts of the gallbladder become blocked due to gallstones, inflammation (known as cholecystitis) can occur. This inflammation can be acute or chronic, and typically includes symptoms such as abdominal pain, nausea, and fever. When symptoms are sudden and severe, it is considered acute cholecystitis. This almost always indicates that the person has gallstones. Chronic cholecystitis, on the other hand, lasts for much longer and is less severe, but may have periods of acute inflammation and pain (known as biliary colic).

Biliary Insufficiency and Poor Liver Health

Whilst not directly related to the gallbladder, insufficient bile production by the liver can produce similar health issues. Signs that you may not be producing enough bile include:

• Pale stools
• Flatulence and diarrhoea
• Floating, foul smelling stools
• Heartburn (due to lack of alkalising effect of bile salts on stomach acid)
• Symptoms are worse after fatty meals

Bile is an important means of eliminating harmful toxins from the body, so insufficient production can lead to issues with many other health conditions, including menstrual condition like PMS and endometriosis that can be affected by hormone levels.

Testing

If gallstones or inflammation are expected, you may be referred for an ultrasound, as well as liver function tests. Naturopaths often refer you for additional testing, including cholesterol, insulin, and a hormone profile, too. These additional tests can help to uncover what is happening with your health and can unlock information about underlying drivers of your condition, so that an effective treatment strategy can be made for you.

Supporting a Healthy Gallbladder

Treatment of gallbladder issues is always a long-term strategy – there are no quick fixes when it comes to gallbladder health! Likewise, prevention of gallbladder conditions also requires long term healthy lifestyle strategies. Naturopathically, treatment strategies for gallbladder conditions almost always include support for the liver, and it’s easy to see why – the two organs are so closely linked both physically and functionally, so when one isn’t working well, the other also suffers.

Medical treatment of gallbladder issues is often focused on removal of the gallbladder once pain becomes unmanageable. The treatment strategies in this section are instead focused on improving your liver and gallbladder function before reaching this point in your condition. But if you have already had your gallbladder removed, read on – there is a section with tips for optimising health post-gallbladder removal below.

Diet and Lifestyle Strategies

Eat Plenty of Fibre-Rich Foods

Fibre-rich foods are so vital for good health for so many reasons, including for gallbladder health. Insoluble fibre, found in foods such as oats and wheat bran, have been found to reduce the level of cholesterol found in bile, which in turn helps to reduce the formation of cholesterol crystals and stones.

Reduce Saturated and Trans-Fat Intake

Saturated and trans fats have been shown to increase the risk of developing gallstones, so saturated fats should be reduced and trans fats eliminated altogether from the diet.

• Choose lean cuts of meat to reduce your intake of saturated fat
• Eliminate foods that contain trans fatty acids, such as margarine, deep fried foods, commercially baked products like cakes and pastries, and frozen potato products such as chips and potato “gems”

Reduce Intake of Refined Sugar

High intake of refined sugars and carbohydrates increases insulin levels, which prompts the liver to produce extra cholesterol. Excess refined sugar intake has been shown to significantly increase the risk of developing symptomatic gallstones, so should be eliminated from the diet.

When eliminating refined sugar from the diet, be aware that sugar goes by many names! Here are just some of the names you might find on the ingredients list of packaged foods and drinks: sugar, table sugar, white sugar, granulated sugar, brown sugar, raw sugar, syrup, molasses, agave syrup, honey, barley malt, malt syrup. And there are so many more! Always read food labels and choose options that don’t have added sugars and sweeteners.

Don’t Skip Meals

Eat regular, healthy meals and avoid skipping main meals. Fasting can increase the risk of gallstones, as bile sits stagnant in the gallbladder for too long. Aim for 3 main meals and one or two small snacks each day.

Eat Mindfully

As we discussed above, bile release is triggered when we enter the cephalic phase of digestion. You can help to make sure you are in this digestive phase by:

• Sitting at the table to eat (rather than eating on the couch or while driving)
• Using a knife and fork and taking your time to eat and experience your meal
• Avoiding distractions during mealtimes, particularly TV and phones

Maintain a Healthy Weight (or Lose Weight Slowly!)

Gaining weight and being obese are associated with an increased risk of gallstones because of higher levels of cholesterol. Similarly, losing weight very quickly increases circulating cholesterol levels because of the cholesterol being released from fat stores. At the same time, bile may sit stagnant in the gallbladder due to reduce food intake, which allows for crystals and eventually stones, to form. If you wish to lose weight, be sure to seek naturopathic guidance before embarking on a weight-loss plan, as they can help you to develop a gallbladder-friendly plan that will help you to lose weight slowly and steadily – which will also help you to keep the weight off long-term.

Gallbladder Removal –Life After Cholecystectomy

Gallbladder removal is a common treatment for gallstones, but it fundamentally changes your body’s digestive functioning and requires careful dietary management for the long term. Because the gallbladder acts as the storage chamber for bile, its removal means there is no longer a place to store bile as the liver is producing it, so a lesser amount is available at mealtimes. This means less bile overall is available for fat digestion, and a greater reliance on the bile that is injected directly into the intestine from the liver itself. This means your body will not be able to digest and absorb fats the same way it used to. Whilst this doesn’t mean you can no longer eat fats at all, it does mean making some changes to what you eat and how. Post-gallbladder removal, it is also important to support the liver, as the lack of gallbladder places additional burden on the liver to maintain health. Below are some tips for maintaining good health after cholecystectomy.

Be mindful of fat consumption

• Avoid high-fat meals, as your body will no longer be able to supply sufficient bile for proper digestion of high amounts of fat – that means no keto diet! A lower fat diet is a much better choice for optimal digestion. Aim for no more than 30% of your calories to come from fats. High fat foods will cause abdominal discomfort and digestive issues.
• When you do eat fats, focus on heart-healthy polyunsaturated and monounsaturated fats from sources such as extra virgin olive oil, hemp seed oil, nuts and seeds, oily fish, and avocados. We still need good quality sources of fatty foods in our diet for healthy cells, brain health, and for fat-soluble vitamins A, D, E, and K.
• Eat fats in small amounts throughout the day, instead of eating them all at once. This reduces how much bile is needed for proper digestion.
• Avoid saturated fatty acids, trans fats, and hydrogenated oils such as soybean and canola oil, which can be detrimental to liver health.

Eat plenty of fresh fruits and vegetables

• Aim for 5 or more serves of vegetables and 2 serves of fruits per day, choosing a variety of colours each day to maximise your nutrient intake.
• Fruits and vegetables provide an abundance of vitamins and minerals, as well as antioxidants which are crucial for optimal liver health.
• These foods also provide plenty of fibre to feed healthy gut microbiota. As discussed above, bile is important in maintaining a healthy microbiome, so providing additional support for healthy gut bacteria is important once your gallbladder has been removed.

Utilise bitters before meals

• Bitter foods and drinks encourage the liver to produce and secrete bile into the small intestine, ready to digest our food. Having bitters around 10-15 minutes before sitting down to eat can help ensure our digestive system is primed and ready for optimal digestion and absorption.

Try a small salad of dandelion greens or rocket as an appetiser or mix the juice of a lemon in 250ml of lukewarm water. Alternatively, herbal bitter remedies can be prescribed for a more potent effect.

Herbs and Supplements for Gallbladder Health

Herbs – Cholagogues

Cholagogues can be used to support healthy gallbladder function and prevent health issues, as well as to treat gallbladder conditions. However, they can be contraindicated, especially if there is a history of bile duct obstruction – always seek naturopathic guidance for a herbal prescription. Cholagogues include herbs such as globe artichoke and agrimony.

Herbs – Bitters

Bitters are a wonderful class of herbs that can be used to help with so many health issues. As the name suggests, these herbs contain lots of bitter principles and have a very strong bitter taste. It is the bitter taste of the herbs that gives them their therapeutic effect. Our bodies have bitter taste receptors not only on the tongue, but throughout the digestive system, increasing saliva, enzyme, and bile production. Bitter herbs activate these receptors and improve digestive function, and even shift the body into the parasympathetic nervous system to reduce issues associated with stress and anxiety. Gentian, wormwood, and globe artichoke are all well-known bitter herbs.

Herbs- Choleretics

Choleretics are herbs that stimulate the production of bile in the liver and promote its secretion into the gallbladder. They’re very commonly used for any conditions associated with the liver or gallbladder. Some commonly known choleretic herbs include milk thistle, calendula, and globe artichoke.

Lipase

Lipase is a type of enzyme that helps to break down fats, making them easier to absorb. Supplementing with additional lipase helps to ease the burden of reduced bile on the gastrointestinal tract after gallbladder removal, or when your gallbladder or liver health is impacting bile production and secretion.

Probiotics & Prebiotics

As discussed above, bile is important for a healthy microbiome. When insufficient bile is being produced, either due to gallbladder issues or removal, a good quality probiotic supplement can help support healthy microbial populations in the gut however prebiotics are more appropriate for many people as they are a food source for your own species.  However, it is important to note that many over the counter probiotics available are poor quality and may not provide you with beneficial amounts of probiotics so it is best to seek naturopathic guidance on choosing a probiotic that will be of benefit to you.

References

Boyer, J. L. (2013). Bile formation and secretion. Comprehensive Physiology, 3.

Crawford, M. (2013). Biliary pain work-up and management in general practice. Australian Family Physician, 42(7). https://www.racgp.org.au/afp/2013/july/biliary-pain

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Housset, C., Chretien, Y., Debray, D., & Chignard, N. (2016). Functions of the Gallbladder. Comprehensive Physiology, 6.

Lammert, F., Gurusamy, K., Ko, C. W., Miquel, J.-F., Mendez-Sanchez, N., Portincasa, P., van Erpecum, K. J., Laarhoven, C. J., & Wang, D. Q. H. (2016). Gallstones. Nature Reviews Disease Primers, 2.

Maldonado-Valderrama, J., Wilde, P., Macierzanka, A., & Mackie, A. (2011). The role of bile salts in digestion. Advances in Colloid and Interface Science, 165(1), 36–46.

Man, S., Gao, Y., Lv, J., Tong, M., Yin, J., Wang, B., Ning, Y., & Li, L. (2022). Metabolically healthy obesity was significantly associated with increased risk of gallstones. European Journal of Endocrinology, 186(2), 275–283.

Tian, Y., Gui, W., Koo, I., Smith, P. B., Allman, E. L., Nichols, R. G., Liu, Q., & Patterson, A. D. (2020). The microbiome modulating activity of bile acids. Gut Microbes, 11(4)

The post  Support a healthier Gallbladder & support healthier digestion following gallbladder removal appeared first on Performance in Health.

Constipation is such a common issue among both adults and children, but often goes under treated or ignored. Constipation can greatly impact on quality of life and can also exacerbate other health conditions, so getting to the root cause of the issue is important for overall health. If constipation is an issue for you, read on to discover some of the most common root causes, as well as naturopathic strategies to help improve your digestive health.

What is Constipation?

Constipation means you are either not having a bowel movement or are finding it difficult to pass a bowel movement (or both). Ideally, we should be opening our bowels daily and stools shouldn’t be difficult to pass – that is, we shouldn’t need to strain or spend long periods of time on the toilet to get things happening.

Medically speaking, chronic constipation generally means fewer than 3 bowel movements per week. In reality, however, we should ideally be opening our bowels every single day. Why? Because our bowels are one of our major channels of elimination for getting rid of toxins and waste products that the body doesn’t need. If we aren’t opening our bowels often enough, these waste products sit stagnant in the bowel, causing inflammation. They may even be reabsorbed by the bowel and re-enter circulation, increasing the toxic burden on the body and creating additional stress on organs such as the liver, who need to process these waste products all over again.

Symptoms of Constipation:

• Stools are difficult to pass: Straining or extended periods of time sitting on the toilet are required
• You feel as though your bowel movement was “incomplete” after evacuating (as if there is more to pass but you are unable to pass anything more)
• Stools are hard and may be smaller than usual
• Abdominal pains from trapped gas can also occur

What Causes Constipation?

There are many, many different causes of constipation and for many people their constipation will be due to a combination of causes. Below are some of the major causes of chronic constipation.

Insufficient water intake

Stools are made up of a high percentage of water, which is what keeps the stools soft enough to move through the digestive tract efficiently. If you aren’t drinking enough water, your stools can end up being too dry and hard, which slows down their transit in the bowel.

Insufficient fibre in the diet

Fibre (undigestible carbohydrates in the diet) is found in foods such as vegetables, fruits and legumes. It is vital for healthy bowel movements, as it makes up the “bulk” of the stool, as well as being a food source for the bacteria in the gut, which play a role in normal stool formation and gut function. Having sufficient bulk in the stool triggers the gut to rhythmically contract (a process called peristalsis), moving the stool through the digestive tract ready for excretion. Too little fibre means this process doesn’t occur properly, leading to slower transit time.

Low physical activity

Physical activity also helps to stimulate the bowel to move stools through the digestive tract.

Certain medications and nutritional supplements

Certain medications, including some pain-killers, antacids and anti-depressant medications, are known to increase the risk of constipation. Nutritional supplements containing iron or calcium can also lead to constipation.

Stress and anxiety

The gut-brain connection is a powerful regulator of our health. Stress and anxiety activate our body’s fight-or-flight response, putting us into a state known as parasympathetic dominance. When in this state, our body down-regulates certain biological functions, including digestion, so that it is ready to respond to perceived imminent threats. This means impaired digestion and, as a result, constipation.

Dysbiosis

The bacteria in our guts are important for so many aspects of our health, and it’s not surprising that they play a role here, too. Our gut bacteria are the biggest producers of serotonin in the body, which is not only our “happiness” molecule, but is also important in maintaining normal gastrointestinal function. Dysbiosis and reduced intestinal serotonin levels can lead to poor gut motility and contributes to chronic constipation.

Pregnancy

Hormonal changes in pregnancy lead to the slowing down of the gastrointestinal tract, which aids in absorbing additional nutrients from food as it passes through. The downside, however, is that this slower transit time can lead to constipation.

Pelvic Floor Dysfunction

A weakened pelvic flood may mean there is insufficient muscle tone for you to properly expel the stool.

Other causes:

• Ignoring the urge to pass stools
• Over-use of laxatives – this can lead to reliance on laxatives in order to have a bowel movement
• Medical conditions such as IBS, food intolerances, diabetes, Parkinson’s disease or multiple sclerosis

Constipation in Kids

Constipation is also a common issue for children, particularly between the ages of 2 and 4 when potty training begins. Whilst some children may experience constipation due to slow bowel transit, up to 95% of chronic constipation in children is due to withholding behaviour, sometimes triggered by a previous painful bowel movement. Withholding and ignoring signals to open their bowels means the stool remains in the large intestine for too long and becomes dry and hard, making it more difficult to pass and further exacerbating the issue.

Health Consequences of Chronic Constipation

­Haemorrhoids

Haemorrhoids are swollen, distended veins which can occur inside or outside the rectum as a result of straining to open your bowels. Haemorrhoids can be painful which can worsen constipation by leading to hesitancy and resisting the urge to open your bowels.

Dysbiosis

Dysbiosis (changes to the normal microflora balance in your gut) may be a cause or an effect of constipation. To learn more about the importance of a healthy microbiome and the health consequences of dysbiosis, click here.

Waste Product Reabsorption

As discussed above, when stools sit in the large intestine for too long, the body begins to reabsorb some of the waste products that are meant to be eliminated. This can lead to issues with other health conditions such as hormonal issues like PMS, as excess oestrogen that would otherwise have been neutralised and eliminated from the body re-enters circulation, contributing to continued oestrogen dominance. The recirculation of waste products also puts additional strain on the liver, which may lead to fatigue, headaches and other issues. 

Combating Constipation, the Naturopathic Way

Fortunately, there are many effective strategies for combatting chronic constipation without resorting to harsh laxatives. Check out the tips below from Sydney naturopath Performance in Health for some of the common effective strategies to beat constipation.

Dietary Strategies

Increase your fibre intake:

• Fibre is the undigestible portion of carbohydrates which are important for healthy bowel movements.
• Include a variety of fibre-rich foods.
• Fruits and vegetables of different colours and textures (consider leaving the skin on vegetables such as potatoes and carrots for added fibre, but be sure to thoroughly wash before preparing).
• Legumes, nuts and seeds are also good sources of fibre, as well as being protein-rich foods.
• Fibre supplements, such as flaxseed meal and slippery elm powder can also be used, however they must be taken with sufficient water, or else they may exacerbate the issue. It’s best to discuss this with your naturopath before using.
• If you need to increase your fibre intake, it’s best to increase it slowly over a period of time to prevent bloating and gas issues.

Increase water intake:

• As a rule of thumb, around 2-2.5L of water per day is required for an adult, and more if you’re physically active.
• Increase prebiotic foods.
• Prebiotic foods feed the beneficial bacteria that support healthy bowel movements.
• Foods such as apples, garlic, onions, and legumes are all excellent sources of prebiotics.
• Reduce your intake of low-fibre foods such as meats, eggs, dairy and highly processed foods like white bread, cakes – reducing your intake of these foods makes way in your diet for high fibre foods.
• Lemon juice in warm water before meals stimulates digestion and can help with constipation.
• Eat “bitters” before main meals.
• Bitter foods such as rocket, or even herbal bitters such as gentian, can help to improve overall digestive function.
• If you do wish to try herbal bitters, speak to your naturopath first.

Supplements

Probiotics:

• A variety of probiotics have been shown to help improve bowel function in constipation sufferers.
• Probiotics have also been shown to be helpful for children with chronic constipation.

Magnesium:

• Some magnesium supplements depending on the type have been shown to help in chronic constipation by acting as an osmotic laxative, stimulating the intestines to draw additional water into the bowels.

Herbal medicines:

• Depending on the cause of your constipation which must be understood first, some safe and effective herbs can help to improve constipation alongside other treatment strategies.  It is important that a trained herbalist prescribes these herbs as they must be used appropriately.  Herbs such as Dandelion root, Globe artichoke, Senna, Yellow Dock, Rhubarb, Magnolia, Ginger and Licorice are some of the herbs prescribed.

Lifestyle Strategies

Daily physical activity:

• Aim for 20-30 minutes of moderate intensity exercise every day – a brisk walk (fast enough to break a sweat) is a great place to start.
• Bowel “re-training”.
• Sitting on the toilet at the same time each morning (for example, after breakfast) can help to “retrain” your brain to associate a certain time of day with opening your bowels, helping you to initiate a regular bowel movement. After a main meal is an ideal time for this, as it takes advantage of the body’s reflex system to increase peristalsis when the stomach is full.
• Bowel “retraining” can be a particularly important strategy for assisting in constipation in children, who should be encouraged to sit on the toilet for 5 minutes after each main meal and try to open their bowels.
• Ensuring optimal posture for bowel movements is equally important. A relaxed posture with feet comfortably supported on a foot stool optimises posture for bowel movements – a “squatting” type position is ideal.
• For children with functional constipation, using a reward system and even a daily diary can also be beneficial.
• Don’t ignore the urge to go! Even if you are unsuccessful in opening your bowels, responding to bowel movement queues by sitting on the toilet helps to retrain your brain to respond appropriately to these queues in future.

What About Over the Counter Laxatives?

Over the counter laxatives are often the first port of call for constipation sufferers, however, as discussed above, frequent use of laxatives to initiate a bowel movement can lead to your body relying on these for every bowel movement. Instead, think of laxatives (even “healthy” and “natural” ones) as being for short-term use only. Once the initial constipation is relieved, it’s best to focus on longer term strategies and addressing the root cause of the issue, to prevent constipation from recurring.

To find out more, contact Performance in Health today for an initial appointment.

References

Cao, H., Liu, X., An, Y., Zhou, G., Liu, Y., Xu, M., Dong, W., Wang, S., Yan, F., Jiang, K., & Wang, B. (2017). Dysbiosis contributes to chronic constipation development via regulation of serotonin transporter in the intestine. Scientific Reports, 7.

Dimidi, E., Christodoulides, S., Scott, S. M., & Whelan, K. (2017). Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Advances in Nutrition, 8(3), 484–494.

Forootan, M., Bagheri, N., & Darvishi, M. (2018). Chronic constipation: A review of the literature. Medicine (Baltimore), 97(20).

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Koppen, I. J. N., Lammers, L. A., Benninga, M. A., & Tabbers, M. M. (2015). Management of functional constipation in children: Therapy in practice. Pediatric Drugs, 17, 349–360.

Levy, E. I., Lemmens, R., Vandenplas, Y., & Devreker, T. (2017). Functional constipation in children: Challenges and solutions. Pediatric Health, Medicine and Therapeutics, 8, 19–27.

Mori, S., Tomita, T., Fujimura, K., Asano, H., Ogawa, T., Yamasaki, T., Kondo, T., Kono, T., Tozawa, K., Oshima, T., Fukui, H., Kimura, T., Watari, J., & Miwa, H. (2019). A randomized double-blind placebo-controlled trial on the effect of magnesium oxide in patients with chronic constipation. Journal of Neurogastroenterology and Motility, 25(4).

The post Living with Chronic Constipation: a Naturopathic approach to healing appeared first on Performance in Health.

Introduction

Mental health is an incredibly important issue affecting a significant number of Australians – nearly 1 in 2 Australians will experience a mental health disorder in their lifetime. Whilst external factors such as stress and environment of course contribute to poor mental health, Changes in our physical health can also impact our mood and may even contribute to or worsen mental health conditions. The importance of our gut microbiome for gastrointestinal health is something that is well established – many of us are aware of the benefits of probiotics for supporting healthy digestion. But how does our microbiome affect other areas of our health, such as our mood? There is growing evidence to support an important link between our microbiome and our mood – the microbiome may have an important role to play in not only helping us to feel happier, but even for helping to support those with mental health conditions such as depression, insomnia, and anxiety. In this blog, we examine the link between our gut, microbiome, and mood, and look at ways to support a healthy gut from a naturopathic perspective.

The Microbiome and The Gut-Brain Axis

The term “microbiome” or “gut microbiota” refers to the trillions of bacteria and other microorganisms that naturally live inside our intestines. We each have around 100 trillion bacteria, made up of approximately 100 different species, living inside our intestinal tract. The exact composition of each of our microbiomes is individual and depends on a range of factors, including genetics, geographic location, diet, and the use of medications, such as antibiotics.

One of the key connections between our microbiome and our mental health is through the gut-brain axis, a two-way communication pathway between our brains and our intestinal tract. This communication highway is mediated by the Vagus nerve, a large nerve that runs up through the centre of the abdomen. Microbes are able to send signals to the brain by directly and indirectly stimulating the Vagus nerve in various ways, but particularly through their ability to produce chemical messengers that send signals to the brain via this nerve. Certain bacteria inside our intestines produce significant amounts of neurotransmitters that are important for our mental health, including serotonin (the “happiness” molecule). In fact, 90% of our body’s circulating serotonin is produced not in the brain, but in our guts by intestinal bacteria, so microbes are playing a bigger role in your mood than you might think! Other important neurotransmitters such as dopamine, noradrenaline, GABA, and acetylcholine, can also be produced by intestinal bacteria. These chemicals play important roles in regulating our mood, anxiety, and even cognitive function.

Our intestinal microbes also influence inflammation levels inside the gut, as well as maintaining normal intestinal wall integrity (i.e. they help to prevent “leaky gut”). This is important, because both inflammation and leaky gut syndrome have been associated with mental illnesses such as depression. Changes in the make-up of the microbiome can lead to an increase in the production and release of inflammatory molecules called lipopolysaccharides. These and other inflammatory molecules send signals via the Vagus nerve up to the brain, causing changes in the brain that can induce symptoms of depression and anxiety.

So, how is the microbiome involved in specific mental health conditions?

Microbiome and Stress

Our microbiome influences how we perceive and react to stress in our lives. Stress leads to changes in the microbiome and can contribute to “dysbiosis” (an unhealthy imbalance of microbes in the gut). Animal studies have shown that a healthy gut microbiome actually helps to regulate our fight-or-flight response (also known as the HPA axis), meaning we are better able to cope with stressors in our lives when our microbiome is healthy.

Microbiome and Depression/ Anxiety

Inflammatory chemical messengers from bacteria have been shown to trigger symptoms of both depression and anxiety. Several studies have found that the types of intestinal bacteria present in the guts of people with major depressive disorder differs to that of the general population. However, there currently isn’t any consensus on any single bacteria that may be causing this link.

Microbiome and Insomnia

Recent research suggests that changes to the microbiome may play a role in insomnia, too. Studies have shown that interfering with normal sleep patterns (such as during shift work) can trigger changes to the intestinal microbiome. Another interesting role of the microbiome in influencing our sleep is in relation to our circadian rhythm, the internal clock that helps us to be awake and alert in the day, and sleepy at night. Studies on the microbiome show that the microbes within our intestines also follow a day-night pattern, fulfilling different functions depending on the time of day or night.

Supporting Your Mood and Your Gut Health

What can you do to help improve your mood and support your gut health? The following provides some tips on supporting both your mental wellbeing and your microbiome.

Eat a healthy diet:

• Certain dietary patterns, such as the Mediterranean Diet, have been shown to improve mental health and also provide lots of the types of foods that are good for supporting a healthy microbiome, too
• Reduce your intake of foods that preferentially feed unhealthy bacteria species – these foods include high sugar foods like cakes, lollies, and soft drinks, as well as foods high in trans fatty acids such as deep-fried foods
• Eat plenty of fibre-rich foods such as fruits, vegetables and wholegrains – Our “good” bacteria feed off of the complex carbohydrates found in these foods
• Our blog on feeding and nourishing your microbiome might also provide important tips https://www.performanceinhealth.com.au/2020/06/11/microbiome-family-gut-health/

Supplement with a high-quality probiotic:

• If you have recently taken medications such as antibiotics, have had a digestive issue such as diarrhoea, or have been through a period of significant stress, your microbiome may well benefit from a boost with a probiotic supplement
• Studies show that supplementing with probiotics can help to improve your mental health. Probiotics have been shown to increase serotonin levels, and clinical trials have shown that just 8 weeks of supplementation can cause marked improvement in symptoms of patients with depression. Other studies show that they are even effective when used in combination with prescribed anti-depressant medications
• The quality of probiotic supplements available on the market varies significantly, so it’s a good idea to discuss your needs with a naturopathic practitioner before beginning supplementation. Naturopaths are able to make recommendations to suit your individual health needs and ensure you are using a quality supplement that will benefit your health due to their extensive studies in this particular field.

Reduce your stress levels:

• As we’ve seen above, stress can affect our microbiome and our mental health, so reducing stress levels where possible is an important strategy for supporting mental wellbeing.
• Regular meditative practices such as yoga and mindfulness are well known for their stress-relieving abilities – check out your local yoga studio, or look into the many free apps that are available if you’d prefer to practice solo
• 20-30 minutes of daily exercise (such as a brisk walk through the neighbourhood) can also help to reduce stress
• Consider seeking the help of a counsellor or psychologist if you feel your stress would be better managed through talk therapy

Consider using herbal medicines:

• Bitter herbs such as gentian can be used before main meals to help improve your digestion and improve the pH in your intestines, which will help to help keep good bacteria happy
• Depending on your specific health needs, herbs such as liquorice, calendula, and chamomile might be beneficial by helping to soothe and heal any inflammatory damage in the intestines caused by dysbiosis
• As always, it is important to seek expert guidance from naturopathic practitioners before using herbal medicines. As a trained herbalist, a naturopath can assess your needs and create a unique blend that will work to best support your healing journey

It is important to remember that everyone’s digestion is unique.  In working with many individuals with Irritable Bowel Syndrome (IBS), strategies to build a balanced microbiome may be more complicated initially and may require a restriction on certain prebiotic foods and low FODMAP food sources.  For this reason, seeking one on one guidance is always recommended.

References

Australian Institute of Health and Welfare. (2021). Mental health. https://www.aihw.gov.au/reports/australias-health/mental-health

Bravo, J. A., Forsythe, P., Chew, M. V., Escaravage, E., Savignac, H. M., Dinan, T. G., Bienenstock, J., & Cryan, J. F. (2011). Ingestion of Lactobacillus strain regulates emotional behaviour and central GABA receptor expression in a mouse via the vagus nerve. PNAS, 108(38), 16050–16055. https://doi.org/10.1073/pnas.1102999108

Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(987).

Desbonnet, L., Garrett, L., Clarke, G., Bienenstock, J., & Dinan, T. G. (2008). The probiotic Bifidobacteria infantis: An assessment of potential antidepressant properties in the rat. Journal of Psychiatric Research, 43(2), 167–174. https://doi.org/10.1016/j.jpsychires.2008.03.009

Du, Y., Gao, X.-R., Peng, L., & Ge, J.-F. (2020). Crosstalk between the microbiota-gut-brain axis and depression. Heliyon, 6. https://doi.org/10.1016/j.heliyon.2020.e04097

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Li, Y., Hao, Y., Fan, F., & Zhang, B. (2018). The role of microbiome in insomnia, circadian disturbance and depression. Frontiers in Psychiatry, 9.

Li, Y., Zhang, B., Zhou, Y., Wang, D., Liu, X., Li, L., Wang, T., Zhang, Y., Jiang, M., Tang, H., Amsel, L. V., Fan, F., & Hoven, C. W. (2020). Gut microbiota changes and their relationship with inflammation in patients with acute and chronic insomnia. Nature and Science of Sleep, 12, 895–905.

Limbana, T., Khan, F., & Eskander, N. (2020). Gut microbiome and depression: How microbes affect the way we think. Cureus, 12(8). https://doi.org/10.7759/cureus.9966

Liskiewicz, P., Kaczmarczyk, M., Misiak, B., Wronski, M., Baba-Kubis, A., Skonieczna-Zydecka, K., Marlicz, W., Bienkowski, P., Misera, A., Pela-Wysiecka, J., Kucharska-Mazur, J., Konopka, A., Loniewski, I., & Samochowiec, J. (n.d.). Analysis of gut microbiota and intestinal integrity markers of inpatients with major depressive disorder. Progress in Neuropsychopharmacology & Biological Psychiatry. https://doi.org/10.1016/j.pnpbp.2020.110076

Morkl, S., Wagner-Skacel, J., Lahousen, T., Lackner, S., Holasek, S. J., Bengesser, S. A., Painold, A., Holl, A. K., & Reininghaus, E. (2020). The role of nutrition and the gut-brain axis in psychiatry: A review of the literature. Neuropsychobiology, 79, 80–88.

Nikolova, V., Zaidi, S. Y., Young, A. H., Cleare, A. J., & Stone, J. M. (2019). Gut feeling: Randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis. Therapeutic Advances in Psychopharmacology, 9.

The post Is your gut affecting your mood? appeared first on Performance in Health.

What Are Common Symptoms of a Liver Problem 

Common symptoms of an underperforming or overburdened liver that is working harder than ever include: 

• Fatigue and exhaustion 
• Regular nausea 
• Persistent skin issues such as acne, dermatitis, rashes, itchy skin, or eczema: as the skin is an elimination organ, when the liver is struggling the body will use the skin to eliminate toxins 
• Frequent headaches and/or migraines 
• New or worsened allergies, new sensitivities to food or your environment: when the liver is overwhelmed, the extra load of toxins which are unable to be detoxified properly cause your immune system to become over-stimulated 
• Poor digestion such as constipation, bloating especially after fatty meals, burping and heartburn 
• Gallbladder issues and gallstones 
• High iron levels and elevated enzymes on liver function tests 
• Sensitivity to alcohol including getting easily intoxicated and experiencing bad hangovers 
• Elevated LDL cholesterol & elevated triglycerides  
• Hormonal imbalances such as PMS, extra heavy periods, blood clots, irregular periods, water retention and unusually sore breasts 

How To Love Your Liver 

When you know that your liver is under strain, here are some tips to love and nurture this super organ: 

1. Eat organic food that has not been sprayed with pesticides or at the very least stick to avoiding the dirty dozen (shown in image below) which is a list of fruit and veges that should be eaten organic due to heavy pesticides.
2. Eat a diet that is rich in green leafy vegetables and includes all colours of the rainbow to ensure you are eating a wide range of nutrients that are used by your liver. Keep your intake high! 
3. Eat good quality sources of protein every day as amino acids are critical building blocks in for every cell of your body.
4. Avoid foods high in preservatives, foods highly processed with excessive sugars such as fructose & corn syrup; with “non-alcoholic fatty liver disease” on the rise, be aware of hidden sugars in your food.
5. Avoid meats with added hormones.
6. Moderate your alcohol consumption. 
7. Drink pure, filtered water.
8. Drink freshly squeezed lemon in water before meals to stimulate liver function or 1 teaspoon of apple cider vinegar in 1/3 cup of filtered water to stimulate digestion and liver detoxification before breakfast.
9. Think carefully before taking too many over the counter drugs unless prescribed by your GP, and consider non-toxic cleaning and skin care products.
10. Include a range of Brassica vegetables in your daily diet such as cabbage, cauliflower, kale, broccoli, brussel sprouts and bok choy as they contain compounds called glucosinolates that increase Phase I and II liver enzymes, supporting your liver to do its job.
11. Add fresh and dried turmeric to your meals readily as it is a wonderful antioxidant and support liver detoxification.
12. Add garlic and onions wherever you can as they contain sulphur which helps the liver in detoxification.

Whilst naturopaths incorporate a range of herbal medicines and supplements to help people repair and support liver health, there is no better strategy than being conscious about the foods you eat and the toxins you expose your body to. And remember that what you put on your skin and what you breath must also pass through your liver. 

The post Ways to Love Your Liver | The Super Organ appeared first on Performance in Health.

The post Autoimmune Protocol Diet | Eliminating & Reintroducing Explained appeared first on Performance in Health.

You see, a healthy immune system’s job is to protect you from foreign invaders such as viruses, bacteria, fungi, parasites and cancer cells. It innately knows not to attack itself. Unfortunately, in autoimmune disease, your immune system becomes terribly confused and it begins attacking your own cells as if they are a foreign intruder. If you are someone that has an autoimmune disease or know someone close to you with one, you will know the pain and anguish autoimmune dishes out. Organ & tissue destruction and dysfunction is not a joy to live with. This is why following an autoimmune diet is vital to managing your condition. 

Interestingly, autoimmune disease is the third most common disease after cancer and heart disease with women affected at a rate of 75% more than men. Surprisingly, I see so little written about it in comparison. 

What does an autoimmune disease do to my body?

Autoimmune disease happens to be on the increase, with certain types given a name in line with the organ or body tissue that is being attacked. An example is the autoimmune disease that I personally live with, day-in-day-out. I have Hashimoto’s Disease which is related to the destruction of the thyroid gland, named after the scientist who discovered it. Basically, autoimmune diseases can attack nearly every part of your body including the nervous system, heart, muscles, joints, gut, lungs, liver, kidney, eyes, thyroid, joints, and skin. Sadly, once you have one autoimmune condition you are also more at risk of having another autoimmune condition or further tissues on target for attack.

Some people have autoimmune conditions that attack multiple tissues. For some people this is so serious that they are prescribed strong drugs which weaken the immune system, this is to make sure that their body does not destroy itself as it can be life threatening. These people are of all ages.  These are the people we need to protect from COVID-19 because an immune system that has been supressed on purpose, cannot fight this terrible virus. 

What are some common types of autoimmune diseases?

Whilst around 80-100 different autoimmune diseases have been identified, here are some common ones you may have heard of:

Then there are autoimmune conditions that affect multiple tissues including lupus (systemic lupus erythematosus) which attacks the joints, skin, kidneys, blood cells, brain, heart and lungs and Sarcoidosis which destroys the lungs, skin, and lymph nodes. 

Autoimmune is a huge subject, far bigger than this blog could possibly cover, so I will do the best I can in explaining it to help you better understand your condition, and the importance of following an autoimmune diet. 

Why do people get autoimmune diseases? 

Simply put, scientific research highlights that it is a combination of genetics and environmental triggers. These triggers include being exposed to bacterial, viral & parasitic infections, stress, exposure to protein components present in certain foods, toxic chemicals, certain medications, and low levels of Vitamin D. 

For the rest of this blog, I will focus on the dietary triggers of autoimmune because one of the most important and powerful factors of autoimmunity is your diet. This is where autoimmune sufferers have real power to help themselves. 

So how does eating certain foods initiate an attack on your body by your immune system? 

It is all about molecular mimicry. This is where the food protein has a very similar structure to some of your own tissue. Normally when the gut lining is healthy, most of these food proteins cannot get through. However when this gut barrier has been breached undigested food proteins are able to enter the bloodstream. Your immune system is not accustomed to these large food particles entering the body and it mistakes them for a foreign invader and will mount a response to attack. Unfortunately, some of these food proteins look very similar in structure to human self-tissue and your body then produces antibodies against itself and starts attacking tissues. As a result, every time that food is eaten the immune system goes into attack.  

How will seeing a naturopath help me manage my autoimmune disease?

As a naturopath, one of the most important aims when working with an autoimmune sufferer is the healing of the gut so that the gut lining becomes strong and non-leaky and undesirable food particles cannot get through. In addition, the health of your gut microbiome (bacteria) is also involved. 

An autoimmune disease diet and lifestyle program are also a focus to help sufferers reduce the attack on self, balance immune dysregulation, improve gut permeability and reduce inflammation. Foods to avoid with autoimmune disease include gluten, grains, dairy, eggs, beans & legumes, nightshade vegetables (white potato, eggplant, tomatoes, capsicum, and spices chilli, paprika, goji berries). 

The good news is that eliminating some of these foods for many people does not have to be a life-time sentence due to the reintroduction of certain foods following an elimination period. As an autoimmune sufferer, I have spent hours experimenting with recipes where I supplement ingredients. An example is the use of tapioca flour & green banana flour instead of normal grain flours when baking bread, muffins, and cakes.   

Keep an eye on my next blog which will discuss the autoimmune diet and recipes in more detail. If you feel that you may benefit from advice on managing your condition more strategically, please book a consultation.

References

Fasano A. (2012). Leaky gut and autoimmune diseases. Clinical reviews in allergy & immunology, 42(1), 71–78. https://doi.org/10.1007/s12016-011-8291-x 

Richard-Eaglin, A., & Smallheer, B. A. (2018). Immunosuppressive/Autoimmune Disorders. Nursing Clinics of North America, 53(3), 319–334. doi:10.1016/j.cnur.2018.04.002

Vojdani A. (2015). Molecular mimicry as a mechanism for food immune reactivities and autoimmunity. Alternative therapies in health and medicine, 21 Suppl 1, 34–45.  https://pubmed.ncbi.nlm.nih.gov/25599184/ 

Vojdani, A., Gushgari, L. R., & Vojdani, E. (2020). Interaction between food antigens and the immune system: Association with autoimmune disorders. Autoimmunity reviews, 19(3), 102459. https://doi.org/10.1016/j.autrev.2020.102459 

Wang, L., Wang, F. S., & Gershwin, M. E. (2015). Human autoimmune diseases: a comprehensive update. Journal of internal medicine, 278(4), 369–395. https://doi.org/10.1111/joim.12395 

The post Why does my diet affect my autoimmune disease? appeared first on Performance in Health.

Modern Science continues to develop a deeper and deeper appreciation of the microbiome’s power in all aspects of human health.

This delights me as naturopathic physicians around the globe have long known that correcting the ecosystem of the gut is of critical importance when treating any patient. From day 1 of my university degree in Health Science, I was educated about the enormous importance of our microbiome. Hippocrates, considered to be the father of conventional and naturopathic medicine back in 460-377 BC taught us that ‘all disease begins in the gut’ and the explosion of scientific studies in recent times, validates his ancient wisdom…..finally.

Introducing, your microbiome Family

Right now, your body is intrinsically linked and has a co-dependent relationship with a rich and diverse ecosystem of trillions of bacteria, fungi and other micro-organisms currently living within your digestive tract. These are called the gut microbiome or as I like to describe them – “your microbiome family”.

The old misconception of this amazing eco-system has seen us willy-nilly kill & destroy our “microbiome families” due to the narrow understanding of their importance in our lives.  You will be shocked when you understand how much they are involved in your life and how very important it is for you to truly care for them.  Your physical health depends on it as does your mental health, mood, longevity and intelligence.  They are part of you, fact.

A balanced microbiome family is your best protection

Dysbiosis is a term used to describe an unbalanced “microbiome family”.   In healthy people, there is a homeostatic balance between commensal (beneficial) and potentially pathogenic types of bacteria and other micro-organisms with no overgrowth of pathogenic species at play. This beautiful balance provides you, the host, with protection.  Protection from foreign organisms doing damage and protection from disease.

Dysbiosis exists due to the loss of beneficial bacteria & micro-organisms or the excessive growth of potentially harmful organisms or the loss of overall diversity.

Unbalancing your “microbiome family” and therefore causing dysbiosis is easy to do.  Factors such as an over-use of antibiotics, exposure to environmental toxins, stress and the typical western diet are all contributors.

Consequences of dysbiosis are far-reaching

The diseases implicated in dysbiosis of your gut “microbiome family” are growing each day due to extensive scientific research studies but include allergic disorders,  inflammatory bowel disease (IBD),  autoimmune conditions such as Hashimoto’s, Type 1 diabetes and Rheumatoid arthritis, obesity and Type 2 diabetes, Autism Spectrum Disorders, depression, anxiety,  weakened immune system, colorectal cancer to name a few.

In addition, dysbiosis of your “microbiome family” may be related to your PCOS or hormonal conditions due to the important role they play in estrogen levels. Emerging evidence also confirms the gut-brain relationship and what this means is that your “microbiome family” talks with your brain and they talk a great deal, real chatty in fact!  Dysbiosis changes the biochemistry of your brain unfortunately and can be related to all manner of mood disorders and behaviours.

What can you do to keep your microbiome family happy?

Whilst it depends on the level of damage, from today the following KPI’s would be a wonderful start in caring for your gut “microbiome family”:

• Always follow antibiotic use with probiotics and prebiotics to feed and support the return of important microbiome species killed by antibiotics & don’t forget that antibiotics kill both bad and good species so use them wisely.

• Consume prebiotic foods and high fibre foods as they are a food source for your microbiome family and in feeding, they produce beneficial chemicals that your body needs.  Prebiotic foods include onion, shallots, leeks, garlic, cabbage, asparagus, beetroot, fennel, snow peas, jerusalem artichokes, oats, chickpeas, lentils, red kidney beans, nuts and seeds, celery, bananas, zucchini, broccoli, kiwi-fruit.

• Add Probiotic rich foods to your weekly menu.  Probiotics are live microorganisms in certain foods and are like employing a temp if a staff member goes on holiday.  They can do the job whilst your own microbiota are given the time to grow in numbers due to the prebiotic foods you are feeding them.   You can find probiotics in natural yoghurt, apple cider vinegar, pickled gherkins, kimchi, miso soup, sauerkraut, tempeh, kefir and kombucha.

• Stop eating so much processed foods and refined sugar.  Be careful when eating conventional meat and eggs as they contain antibiotics that kill good and bad bacteria, buy organic fruit & veggies if possible, or at least thoroughly wash them as conventional varieties are lathered in pesticides which damage your good bacteria.

• Work hard to put in place ways to reduce the stress in your life.  Stress turns off digestion and has a massive impact on your gut “microbiome family”.

Loving and nurturing your gut “microbiome family” is a wonderful thing to do for yourself.  I hope you can see this now.  Any dysbiosis might be contributing to your current health issue or you might be feeling mentally low. As a naturopath, I am very well qualified in this field and can also arrange detailed microbiome testing to help you make necessary changes so that your gut “microbiome family” can flourish.   If you love them, they will love you back I promise.

To book your one-on-one consultation with Performance in Health, the award winning Sydney naturopath, use the form to book here for instant confirmation.

References

Carding, S., Verbeke, K., Vipond, D. T., Corfe, B. M., & Owen, L. J. (2015). Dysbiosis of the gut microbiota in disease. Microbial ecology in health and disease, 26, 26191. https://doi.org/10.3402/mehd.v26.26191

Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. https://doi.org/10.3390/foods8030092

DeGruttola, A. K., Low, D., Mizoguchi, A., & Mizoguchi, E. (2016). Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflammatory bowel diseases, 22(5), 1137–1150. https://doi.org/10.1097/MIB.0000000000000750

Durack, J., & Lynch, S. V. (2019). The gut microbiome: Relationships with disease and opportunities for therapy. The Journal of experimental medicine, 216(1), 20–40. https://doi.org/10.1084/jem.20180448

Flores, R., Shi, J., Fuhrman, B., Xu, X., Veenstra, T. D., Gail, M. H., Gajer, P., Ravel, J., & Goedert, J. J. (2012). Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study. Journal of translational medicine, 10, 253. https://doi.org/10.1186/1479-5876-10-253

Liu, R., Zhang, C., Shi, Y., Zhang, F., Li, L., Wang, X., Ling, Y., Fu, H., Dong, W., Shen, J., Reeves, A., Greenberg, A. S., Zhao, L., Peng, Y., & Ding, X. (2017). Dysbiosis of Gut Microbiota Associated with Clinical Parameters in Polycystic Ovary Syndrome. Frontiers in microbiology, 8, 324. https://doi.org/10.3389/fmicb.2017.00324

The post Feeding & nourishing your precious gut “microbiome family” so they nourish you in return appeared first on Performance in Health.