For the Love of Fibre!

Chances are that someone has told you at one point in your life that you need to eat more fibre.

Maybe you tried to do so and you got constipated or you ended up farting a lot! Or maybe you tried decided to give up because it was too hard.

Well whatever the reason, here are a few fibre tips that can help make increasing fibre a little easier on the digestive system!

#1 - Soak your beans!

• Beans aren’t called the magical fruit for nothing! Beans, which can be a great source of fibre, contain a carb called raffinose. Raffinose can be a bit harder to break down in our digestive systems, which means that our gut bacteria get a lovely meal! When our gut bacteria snack on things they produce gas! Now we do need to show them love, but it can be uncomfortable when you get a bout of wind at Sunday dinner over baked beans!

• In order to help reduce the raffinose load a dose of baked beans or bean salad provides us, we need to soak the beans first! They can be soaked for a few hours or overnight. This will help hydrate them and reduce the gas producing raffinose snack without impacting the overall nutrition of the beans!

#2 - Fruits contain fibre too!

• Whole fruits can have more sugar in them than their vegetable counterparts, but wapping in some fruit for dessert or part of snack time can add in some more fibre to your day!

• Notably high fibre fruits include: pears, citrus (eating the whole inside not just the juice), berries, apples, avocado, kiwis, bananas

#3 - Baked goods and ground meat!

• Shredded vegetables like zucchini, mushrooms and carrot can be added to baked goods and ground meat dishes without altering the flavour too much!

• So making meatballs or cooking ground meat for tacos? try shredding in some zucchini or dicing mushrooms to add some extra fibre in!

• Making muffins? try added zucchini or carrot to give not only extra flavour but also extra moisture!

There are tons of ways to make fibre fun! What do you like to do to add more fibre? I would love to know!

Dr Paige

Do I have a Food Sensitivity? Is it an issue and how to test.

Since I see a lot of digestive issues in my practice I find that food sensitivities are something worth exploring in many. They are quite common and can lead to a variety of different health concerns from digestive complaints, to skin issues such as eczema or psoriasis, to fatigue and joint pain. They are different from severe food allergies, such as an anaphylactic reaction to peanuts that occurs immediately, as they are a more delayed reaction. Food sensitivity symptoms can take up to 72 hours to appear after eating, so a low-grade food sensitivity can be hard to spot. The more severe a sensitivity the quicker and/or more severe you notice the symptom.

What causes food sensitivities?

When we eat foods we are sensitive to it causes the digestive track lining to become inflamed and small “breaks” in the lining occur allowing partially digested food particles to “leak” into your bloodstream, where your immune system sees them as invaders. Your body then produces antibodies (IgG antibodies) which circulate and attach to the food particle. When your body cannot eliminate the antigen-antibody complexes quickly, your immune system mounts a larger response leading to symptoms of chronic inflammation. The more of this food you eat, a higher level of inflammation can occur. So not only can you suffer from local digestive symptoms, it can then cause systemic inflammation.

Damage to the intestinal lining (aka leaky gut) can be caused by several things other than a main food sensitivity, such as gluten. This could be medications including PPIs, antibiotics which disrupt the normal flora in the intestine, overgrowth of other bacteria such as yeast or Candida, other invading bacteria, and high stress causing lower levels of digestive enzymes and blood circulation to the gut.

How do you test for food sensitivities?

The gold standard for food sensitivity testing is an elimination diet. Meaning, you eliminate all the common foods sensitivities such as gluten, eggs, dairy, sugar etc, for 3-4 weeks then reintroduce these foods back in one at a time to investigate what, if any, reaction you have to that individual food. It may be different for different foods, for example, cramping and diarrhea from dairy and bloating and fatigue from gluten.

Another way to test food sensitivities that I do often in my practice is a blood IgG test, testing 96 common food sensitivities with a simple blood prick test. The test is measuring the amount of IgG antigen-antibody complexes produced when your blood is exposed to that food. The higher the level, the worse the sensitivity. I have seen big improvements in patients health when they identify and eliminate their food sensitivities.

Do you have to eliminate foods forever?

Now my goal is never to limit someones diet even more longterm, so I interpret a test result a couple ways.

There may be 1-5 foods that are high on the list and these are generally the true sensitivities, ie - contribute to the leaky gut picture. These foods would be eliminated either longterm or for several months while we heal the gut and address any other contributing factors.

If many foods sensitivities come up, some in moderate levels, it proves there is a leaky gut and systematic inflammation. I advise to limit these foods for the time being and stress the importance of gut healing using probiotics and soothing and healing herbs for the gut. We also may need to explore stress levels, and other systemic bacterial overgrowth contributing to inflammation.

Once we complete a gut healing protocol it is easier to introduce certain foods back into your diet.

Do you have symptoms of a food sensitivity?

If you are struggling with digestive concerns, skin issues, fatigue, joint pain, depression even, and haven’t explored triggers from your diet, I would suggest reaching out to an ND like myself to explore this possibility. As I mentioned above, there may be more to the story that just a food trigger but it commonly has a component in someone health concerns.

Note - If you are noticing digestive concerns triggered by higher fibre foods or the lowFODMAP diet has been suggested and is helpful to you, that may be a different issue all together that we can definitely explore as well.

In health & happiness,

Dr. Karen

Constipation - What moves your bowels?

Regular bowels are an important sign of good health. Our bowels are a primary function of elimination and detox. When this is backed up, we start to use secondary organs of elimination such as your skin, or lungs...which is not ideal. ⠀

Do you suffer from constipation? Check out the bristol stool chart if you haven't seen it before. Constipation could mean daily hard to pass stool, or not going for several days. ⠀

Why are you constipated?

1. There could be an imbalance of bacteria in your gut, aka SIBO, or yeast overgrowth.

2. You could have stagnation of bile from the liver/gallbladder, which is very important to stimulate bowels. ⠀

3. You could have a low fibre diet (but this gets quite complicated for those who have experienced constipation for awhile - due to point #1 typically). ⠀

4. You are not stimulating movement of bowels by moving your whole body. Exercise and twists are key here. ⠀

5. You are STRESSED! If our body is stressed our muscles tighten, including our digestive tract.

What moves our bowels?

1. Get into a routine - We detox during the night for the most part, since our body is at rest, so the morning is when the cycle should be completed, aka a bowel movement. If you wake at the same time each morning, after a good night sleep, your body should start getting into a rhythm and you shouldn’t need extra support. Try it!

2. Try extra support - Try a mug of warm water with lemon. It helps to stimulate liver detox and the warm water gets your intestines warmed up (like a warm up before a big run). Your morning coffee may do the trick as well since it is bitter. Bitters stimulate stomach acid, enzymes and bile secretion, all essential for proper digestion and bowels.

3. Exercise and twist - The simple twist I’m doing above is one way to stimulate the bowels. It’s like wringing out a towel and moves things through. Exercise gets lymph moving, helpful for detox.

4. Hydration - The bowels absorb water to bulk up the stool. This then creates a signal to stimulate a bowel movement. Hydrate with lots of water throughout the day (ideally not ice water, and not just during meals!)

5. Get rid of bad bacteria - Methanobacteria are among those typically high with constipation. Bifido bacteria tend to be low with constipation. These are only 2 patterns I see in practice as it depends on the individual. We ultimately need to eliminate an overgrowth with antimicrobial herbs and a specific diet, then increase the beneficial bugs with supplements or food.

6. Stimulate bile flow - Bile is crucial for proper bowel stimulation. If it is trickling out too often and irritating bowels it can cause diarrhea, and if it is stagnant in the gallbladder (or liver if you don’t have a gallbladder) constipation tends to happen. Simple diet hacks, fibre, cholagogue herbs, and nutrients such as lecithin, and phosphatidylcholine all help to stimulate bile. Cholagogue herbs include milk thistle, burdock, dandelion or artichoke.

7. Relax - I know this is easier said that done but this is key! Deep belly breathing goes a long way to stimulate the vagus nerve ultimately stimulating your bowels.

Questions about constipation? Let me know!

In health & happiness,

Dr. Karen

SIBO - Test Don't Guess

Small intestinal bacteria overgrowth (SIBO) may be more prevalent than we think. Research shows that 50-84% of IBS patients test positive for SIBO. This is with old testing methods that would show many false positives, therefore my assumption is that it is even more prevalent than we think. All it may take for someone to develop SIBO is a bout of food poisoning! That’s it! For some it is more complicated than that.

I have discussed the main reasons someone may have SIBO in a previous post, but let’s jump right into how you accurately diagnose SIBO. In my practice I ask a lot of questions in the first visit. This is because we can gain a lot of clinical information about what may be going on by just getting all the information. A physical exam, specifically an abdominal exam in these cases, is my next step in gathering information. SIBO has a handful of specific symptoms I am looking for which guide my treatment plan. But SIBO also a handful of symptoms that are unique to the individual and can be systemic, for example joint pain, rosacea, hypothyroidism.

Test Don’t Guess

If your symptoms indicate to me that you may have SIBO, before jumping into treatment, it is very helpful to test for it. Not only will this confirm, or deny, a positive result, but it will also guide what type of antimicrobials I’ll use and for how long depending on what the results show. The higher the results, the more rounds of antimicrobials we typically have to do.

The SIBO breath test is the most accurate non-invasive way to diagnose SIBO right now. Research continues to be done to advance our testing methods. The best option is a breath test that is a 3-hour lactulose breath test looking at both Hydrogen (H2) and methane (CH4) levels. This is the type and amount of gas that is produced if you have SIBO. Hydrogen SIBO typically presents as diarrhea (among other symptoms), and methane SIBO typically presents as constipation. The 3 hour test ensures you are testing the entire length of the small intestine, where only a small amount of bacteria should be, not an overgrowth. Stool testing, which we may do for other GI complaints, is only relevant to the large intestine. There is no accurate test yet for a 3rd type of SIBO, hydrogen sulphide. However, there are patterns on the results and patterns in symptoms that may indicate this type. This is not testing for Candida, however it is common for these to present together.

Ultimately if you test positive for SIBO, I treat it. However, 2/3 of patients have shown to relapse post-treatment. There are number of reasons for this but this is why it is always important to treat the patients and not the condition. I aim to treat the root cause along with the SIBO - if we can. Sometimes this isn’t possible depending on the case, so we do are best. It can also take time, and even different circumstances, for example a less stressful job perhaps, to treat the root. 1/3 of cases are luckily non-recurring and the patients feels better quickly and for good. Phew!

All in all, testing is very helpful to me as a clinician if I suspect a bad case of SIBO. It takes the guesswork out of the treatment and ensures a more accurate and quicker treatment result. Treating SIBO is a team effort but the more information we have the better it can be!

Are you interested in getting tested for SIBO? Let me know!

In health & happiness,

Dr. Karen