“Why has no one explained this to me before? – that makes so much sense! ” This is the most common response that I get when I explain the mechanisms of what is going on in the gut and why discomfort can happen.
Patients often feel a sense of relief that they finally understand why they are experiencing the discomfort; which often is something quite common, and YES there is lot you can do to fix this.
SIBO and IBS – By the Book
Small Intestinal Bacteria Overgrowth (SIBO) is often (but not always) part of the picture during chronic IBS. SIBO can develop when there is an overgrowth of certain strains of microbes in the upper gut and they produce lots of gas – leading to bloating, burping, reflux & indigestion. Depending on the type of the microbe they can also cause constipation or diarrhoea.
This can interfere with digestion and cause more gas production. These microbes usually produce methane or hydrogen gases which can lead to constipation or diarrhea, or a switching between the two. There can also be excess hydrogen sulphide producing microbes – these one produce more of an eggy smelling gas and can be uncomfortable, causing trapped wind and inflammation.
The term Intestinal Methanogen Overgrowth (IMO) refers to an overgrowth of methane producing bugs and often causes constipation, slower movement of the gut and discomfort caused by bloating and trapped wind.
These are now known to be some of the main underlying imbalances in Irritable Bowel Syndrome. However the picture is usually more complex and may also involve changes in stomach acid, digestive enzyme production, bile flow from the gall bladder as well as other factors listed below.
Where to Start:
During your initial 1 hour consultation, I will take a careful in-depth history of your digestive issues and explain to you likely physiological mechanisms of why the discomfort is there before giving some recommendations around a few dietary changes and some targeted supplements that may help. My 3 month Digestion Restore Plan is designed to help you over a 3 month period to understand what is going on physiologically and what changes will be most effective and set you on a path to resolution.
Nutrition is not a magic pill and it can take a year or more for sufficient changes in the microbiome and digestive function to happen and to see good results But understanding what the issue is can sometimes be all that it takes to substantially improve. The quickest recovery I have seen is just 2 days into the plan.
From a Functional Medicine perspective:
Digestive Processes
Digestion begins when we first start to think about the meal we are going to eat, this initiates digestive secretions. Once we have eaten the food it is broken down by acids & enzymes and also the bile salts produced from the gall bladder. All of these phases of digestion can be impacted by stress and other factors. Issues with ‘bile sludge’ are more frequent that we think and it is common for bile to come back up to the oesophagus and throat, causes discomfort: reflux and silent reflux – often underdiagnosed. Bitter foods and supplements can be incredibly
helpful for issues around bile and reflux.
Gut Motility
The gut has a natural “cleaning wave” that moves food along when your stomach and small intestine are empty. If this movement is too slow, food can stay in the gut too long. This can lead to constipation, bloating, and bacterial overgrowth in the wrong places (called SIBO), which can cause discomfort and gas. There are natural solutions to help support this wave for example leaving 5 hours between meals or supplementing with natural MMC stimulants. This is often a good starting place for digestive support and can often resolve gas and bloating caused by
SIBO.
Presence of unhealthy microbes or overgrowths of yeasts
Microbes can flourish if there is an unhealthy gut environment, certain strains of unwanted microbes can secrete inflammatory particles called LPS (lipopolysaccharides) or endotoxins. These toxins, if they pass through into the blood stream can drive inflammatory conditions and affect our mood / brain fog.
Gut lining health
The gut naturally has a degree of permeability but in some people, the gut lining can become inflamed and damaged due to immune reactions to foods and or microbes. This inflammation can cause changes in the microbes which communicate with the immune system, the inflammation may also cause damage to the gut lining, enabling particles through from the gut into the blood stream that should have been excreted. This can drive further inflammation in a
vicious cycle.
Natural solutions would be to remove the triggers that are inflaming the gut lining and support gut healing, reducing the drivers of chronic inflammatory cycle.
Stress and Vagal Tone
Stress has a massive impact on how we digest our foods.
Being in a high cortisol state whilst eating can shut down digestion as we need to be in the ‘rest and repair’ state in order to digest foods properly. There are techniques that we can use to switch the body into the resting state before eating to help balance the production of stomach acid, enzymes and other digestive processes further downstream.