Read my first post about the Gut Microbiome here. 

     Do you feel bloated 30 minutes after eating a meal? Or have unexplainable abdominal pain, cramping, gas, diarrhea or constipation? Does it seem like eating foods you used to be fine eating now cause discomfort? These symptoms are not normal and you could have IBS, a bacterial overgrowth in your gut or are experiencing gut dysbiosis (gut bacteria that is outa whack).  Find out the symptoms, how one develops these issues and what to do about it to feel better. 

     Approximately 1 in 5 people have IBS and it is second to the common cold for top  reasons for missed days of work. For the most part, the mechanism behind IBS has largely been a mystery and so typical treatment only targets symptoms and doesn't get to the root of the problem.  Just recently though, I listened to a few interviews with Dr. Kenneth Brown, a Gastroenterologist and researcher who studies the gut as well as IBS and a number of other gut related diseases.  I found his interviews pretty interesting since I'm very fascinated by gut health and have suffered from IBS off and on for about 10 years. His research has shown that if you have digestive issues, like bloating and cramping, then it is likely that you have an overgrowth of bacteria in part of your digestive tract.  This can be caused by chronic stress, a particularly stressful event or an infection that put the body under stress.  

     Dr. Brown’s findings (other researchers are discovering this as well) are easier to understand with a bit of a refresher on our digestive organs. The stomach is very acidic in order to kill any bacteria from the outside world that we have ingested. Our food then moves to the small intestine and it is fairly sterile at that point.  The small intestine does most of the digesting and absorbing.  Unabsorbed food from the small intestine moves to the large intestine where there are all kinds of bacteria.  We have more bacterial cells in our large intestine than human cells in our body.  It’s fascinating that we have an entire ecosystem living inside us!  This unabsorbed food feeds our gut bacteria.  They produce many things like neurotransmitters, vitamins, hormones and short chain fatty acids (SCFA), which provide us with energy, additional nutrients and helps the body absorb certain minerals. One specific SCFA, butyric acid, provides energy to our gut cells, which can help keep our gut lining healthy, preventing endothelial permeability, or as it’s more commonly known as, leaky gut.  Butyric acid is also speculated to decrease the risk of colon cancer, among other benefits.  

      Back to the cause of bacterial overgrowth and the subsequent issues associated with it.  Stress can cause bacteria to get into parts of the digestive tract that they aren’t supposed to be in, like the small intestine.  They get trapped and feed on the large amount of carbohydrate that is being absorbed there.  This causes many undesirable symptoms like bloating after a meal, gas, abdominal pain, cramping, diarrhea or constipation. This is called small intestinal bacterial overgrowth or SIBO.  It is estimated that 84% of IBS sufferers have SIBO as the underlying cause of their IBS.

     We can also get a bacterial overgrowth in our stomachs.  It was once thought that stress caused ulcers.  But stomach ulcers are largely attributed to the overgrowth of a certain bacteria called H. Pylori, or sometimes chronic use of non-steroidal anti-inflammatory drugs (NSAIDs), like Advil and Aspirin.  H.Pylori buries into the mucosal layer of our stomachs and neutralizes pH in the area around it, which decreases the acidity of the stomach. This can result in heartburn, indigestion and stomach pain.  Decreased acidity also prevents our stomach from being able to kill all the bacteria that comes into it, resulting in some bacteria making its way to the small intestine, causing SIBO.  It is estimated that more than 50% of the world’s population have H. Pylori in their stomachs, however, 85% are asymptomatic and unaffected.  H. Pylori, like the other bacteria in our system, has co-evolved with us for thousands of years and there is evidence that it can also benefit the host, if there isn’t an overgrowth and subsequent symptoms.

     Irritable Bowel Syndrome is considered a trashcan diagnosis. Many people have digestive issues and when one particular cause cannot be identified, IBS is typically diagnosed.  From my understanding, there are many factors that play into it.  There could be a gut dysbiosis where the balance of good bacteria to bad bacteria is off. Or it is likely that there is a bacterial overgrowth in another part of the digestive tract as mentioned.  Stress is a major component of IBS.  In fact, two-thirds of IBS sufferers have anxiety, depression or other psychological issues prior to the development of IBS and many that don’t fall into this category, find they develop anxiety or depression because of the nature of the symptoms. So, what’s the treatment then?

     Well first of all, stress management. Think back, have you recently been through a stressful event or experienced a bout of chronic stress or an infection? If so, you could have a bacterial overgrowth in your small intestine.  Stress reduction can be really beneficial for mitigating digestive issue symptoms.  Exercise, meditation, yoga, stretching, using the sauna or hot tub, as well as learning to say no to people and engagements, surrounding yourself with positive, like-minded people and doing pleasurable activities can all help to reduce stress.  Nutrition and what we put through our digestive system is just as important as stress management.  A low carb diet is really beneficial as carbs are what the bacteria flourish on in the small intestine (remember, the small intestine is supposed to be sterile).  As well, the low FODMAP diet has been proven to be quite effective at alleviating bloating, gas, abdominal pain, constipation and diarrhea. 

     How does it work? Well, FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polysaccharides, basically, any fermentable carbohydrate. Any carbohydrate that isn’t absorbed well in the small intestine moves to the large intestine, which prompts fluid to enter the gut. This can cause discomfort and diarrhea, for certain people.  FODMAPS then start to ferment, which causes bloating, gas, cramping and even nausea for IBS sufferers. Most people, however, don’t feel any of these symptoms and fermentable fibre or prebiotics are a healthy part of one's diet as they keep the good bacteria happy and fed. 

     For a full list of high and low FODMAP foods, please see here. (I don't necessarily support other parts of this site).  The major foods being wheat, dairy, beer, wine, strong coffee, artificial sweeteners, garlic, onion, many condiments, processed meats, juice and pop, and some fruits and vegetables. 

     It can be a bit difficult to adapt to a low carb or low FODMAP diet, however, it is quite effective at alleviating symptoms in a very non-invasive, natural way and without side effects of medications.  If you have digestive issues that have been preceded by a stressful event, and now have issues with foods that you once were okay eating, then contact me and I can help.  Beyond my understanding, I have years of personal experience and love working with people to improve their digestive issues.  

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