IBS

Leaky Gut - Yes there could be "holes" in your gut!

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As a Naturopathic Doctor who sees a lot of gut issues, I get questioned often by people who have heard the term leaky gut, wondering what it is and if it could be the cause of their health issues. This is something I do see often in practice and I find very important to fix in order to treat a number of different issues, such as IBS, eczema, depression and most autoimmune disorders.

What is leaky gut?

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Your gut is actually quite fragile as the lining of your intestines is made up of only 1 layer of cells, called enterocytes, lying between your gut lumen and the blood vessels. A border of microvilli on top increases the surface area to aid in absorption of nutrients, water and electrolytes. The intestinal lining also regulates the trafficking of environmental antigens (1) . These enterocytes are held together by tight junctions, like water-way locks, preventing the cells to come apart when inappropriate. Remember the childhood game red-rover? This is the game your gut is always playing. However, damage to the gut lining from inflammation and stress, releases a protein called zonulin which weakens these tight junctions making the lining more permeable (2) and ultimately creating small gaps between the enterocytes that cannot close up. Food particles, or antigens get absorbed between the cells now instead of through the cells, activating an inflammatory and/or immune response in the gut and blood stream.

What health issues can this cause:

  • Local inflammation - IBS symptoms such as bloating, cramping, diarrhea, constipation

  • Autoimmune conditions (1) - Hashimotos thyroiditis, Rheumatoid arthritis, Lupus and IBD, MS

  • Systemic conditions - eczema, psoriasis, acne, joint pain, headaches, seasonal allergies

  • Mental/emotional issues - depression and anxiety, chronic fatigue

What causes leaky gut:

  • Gluten - this was the first thing found to increase zonulin levels

  • Bacteria and infections - or bacterial endotoxins also found to increase zonulin levels

  • Stress - this decreases stomach acid and digestive enzymes leaving larger particles of food to descend into the intestines which irritate the gut lining

  • Medications such as proton pump inhibitors, antibiotics and NSAIDs

  • Simple sugars and food additives

How to fix leaky gut:

If you haven’t read my blog post about the 4Rs in gut health, I’d lead you there to shed a little more light on my whole gut healing protocol. Ultimately we need to reestablish the zonulin-dependent intestinal barrier function to close up those gaps between the cells. There are a few favourites of mine that been shown to be very effective at REPAIRING the gut, but don’t forget to REMOVE, REPLACE and REINOCULATE as well.

  • L-glutamine - this is my go-to for any gut issues, from mild to major. Always given in powder form to ensure a high enough dose.

  • Collagen - helps to support and strengthen the gut lining like glutamine. I love the brand Sproos that I carry in my practice.

  • Zinc carnosine - studied to heal the gut, including the stomach lining after H.pylori or an ulcer or after NSAID use

  • Mucilaginous herbs - marshmallow, aloe vera, DGL, slippery elm

If you struggle with any of the conditions listed above do not hesitate to reach out to discuss the best treatment options for you! Heal your gut to heal your body and start feeling yourself again.

In health & happiness,

Dr. Karen

References:

1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/

2 - https://www.ncbi.nlm.nih.gov/pubmed/21248165

3 Causes of SIBO That Have You Suffering

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Irritable bowel syndrome has been a diagnoses of exclusion for many years. If the symptoms are severe enough you are referred for a colonoscopy or an endoscopy, and if tests are clear you are given the diagnosis. If the symptoms are mild enough, no testing is done and the diagnoses is given. This is an umbrella term however. In my practice I see varying causes of IBS since we are looking at the root cause. SIBO, or small intestinal bacterial overgrowth, is one very common cause of IBS. MDs do not have access to other GI tests like a SIBO breath test, or lack knowledge that SIBO is something that can be treated. I see many people with irritable bowel syndrome that show typical signs of SIBO. We test for it and treat accordingly. But WHY do they have it is the big question? 

Symptoms of SIBO

Common symptoms of SIBO are bloating, either with no known trigger food or very predictable trigger foods such as garlic, onion, greens, apples etc, abdominal pain, heartburn, either chronic constipation or diarrhea. Other associated conditions are rosacea, cystic acne, chronic pain, IBD, and even hypothyroidism! The list goes on. This is why I ALWAYS ask you about your gut! 

What Causes SIBO

There are many causes of SIBO that have been shown but I want to point out the most researched and most common causes. One of these may relate to you. 

  • Food poisoning - aka bacterial gastroenteritis. This is actually the #1 cause of SIBO. When you get food poisoning your body produces certain antibodies that decrease the motility of your gut. The wave of motility is called your migrating motility complex (MMC) and it is a very important housekeeping function of your gut to clean everything out in the directly of your bowels. When the MMC is disrupted certain “bad” bacteria in your large intestines can ascend upwards into your small intestines and start fermenting foods they aren’t supposed to (aka SIBO). Note - if you’ve had food poisoning once you are more likely to get it again due to the production of these antibodies so please be careful. 

  • Stress - This is the most common cause I see in practice. When we have chronic stress our bodies are in fight or flight mode and not rest and digest mode. This leads to a decrease in stomach acid, digestive enzymes and bile production. Stomach acid and enzymes suppress the growth of bacteria and they are also helpful in stimulating the MMC. Stress also affects the enteric nervous system (that gut-brain connection) which stimulates the MMC.

  • Abdominal strictures or adhesions - Scar tissue can occur from abdominal surgery, Crohns or Colitis or even endometriosis. The scar tissue then interrupts the proper flow of the gut, aka the MMC. 

As you can see all those causes have an affect on the MMC in our gut. The list does go on unfortunately including issues such as hypothyroidism, opiate use and even traumatic brain injury. 

If you suffer from the above symptoms, have been diagnosed with irritable bowel syndrome but given no treatment, or have digestive issues and have dealt with any of the issue above do not hesitate to get in touch. Let’s get to the root cause of your digestive concerns and help you feel better for good!

In health & happiness, 

Dr. Karen  

The 4 R’s in Gut Healing - How to Heal IBS

You have heard it from me time and time again that the gut has a huge influence on the rest of our body, especially our immunity, our hormones, our mental health and skin health. Many common symptoms that I see in my practice start in the gut. Whether you have an issue with depression, eczema, an autoimmune condition or simply been diagnosed with IBS, this system to treat the gut is a great place to start. 

Benefits of Eating Seasonally

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With the colours changing on the trees, it is time to take advantage of those last good trips to the famers market and stock up on delicious, nutritious fall foods. There are several reasons to eat foods that are abundant at this time of year. We want to eat a seasonal and varied plant-rich diet to support our body and its natural processes. Michael Pollen says “eat foods, mostly plants, not too much.” I would add (among many things) to eat seasonal foods, mostly plants, not too much because of their benefits. 

It is so easy to forget about seasonal eating with modern day food processing and worldwide distribution. The lines have gotten blurred as to what foods are appropriate when, creating a monotone diet that was not possible in the past. Here are a few reasons why eating seasonally is important:

Most flavour and nutritional value:

Foods travelling less km will lose less nutrients and therefore provide greater freshness, flavour and health benefits. Plants get their nourishment from the sun and soil so when that changes so do their nutrients. Have you ever eaten a spaghetti squash in the spring and realized it is much harder to shred and tastes bland? Or a peach in the winter that tastes nothing like the fresh ripe juicy peach from the summer? This is exactly what I am talking about. Nutritional changes in food have been studied often for example a Japan study found 3 times more vitamin C in spinach harvested in the summer versus winter. 

Eating seasonally supports our health-promoting microbiome:

What is your microbiome you ask? It is the abundance of good bacteria that resides in our digestive system (and all over actually) that help your overall health including immune health, digestive health, skin health, blood sugar balance, weight management and so much more! Our gut bacteria is ever changing for the good and eating seasonally contributes to this. Fall foods contain things like resistant starch (in foods such as onions, leeks, garlic) which feed the good bacteria, as well as polyphenols providing antioxidant support. A highly processed diet with sugar, unhealthy fats and carbs can negatively shift the microbiome within 24 hours! Luckily with can remain calm in knowing it can shift back within that time frame by eating a plant-rich healthy diet. So you can forgive yourself for indulging over the weekend. One idea is that in the fall we want to limit fruit that we indulged in in the summer as too much fructose-rich fruit and a more sedentary life may cause a yeast overgrowth leading to feeling bloated, moody and with skin changes. 

Lower prices:

Due to an abundance of produce that is easier to grow prices usually drop.

Decrease carbon footprint: 

I am all for outsourcing foods such as avocado, superfoods such as matcha or acai berries, and cold pressed coconut and olive oils but we should take advantage of what we have close to us to reduce our food mileage. 

Community: 

Finally there are many studies on the benefits of building a community around you to live longer and feel happier and what better way to do that than around food! Take advantage of those friendly faces at the farmers market stalls or CSA pickups while getting your seasonal foods, but why not build a community around cooking those foods as well. It could be with family on the weekend prepping meals for the week, or with friends one evening during the week to break up the mundane work work. Get creative :)

Check out a list of seasonal foods below. These foods are rich in phytonutrients and fibre, along with delicious resistant-starch options:

  • Acorn Squash
  • Artichokes
  • Arugula
  • Beets
  • Broccoli
  • Brussel Sprouts
  • Butternut Squash
  • Celeriac
  • Delicata Squash
  • Escarole
  • Garlic
  • Leeks
  • Onions
  • Pumpkins
  • Radishes
  • Rutabega
  • Spaghetti Squash
  • Sweet Potatoes
  • Sunchokes/Jerusalem Artichokes
  • Turnips

Seasons should form the natural backdrop for eating and in Canada we have wonderful seasons to take advantage of for our overall health. 

In heath & happiness, 

Dr. Karen