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

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?

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

Food Friday: Fresh Salad Rolls with Peanut Sauce

These are not mine - We ate ours too fast to get a good pictures :)

If you are looking for a fresh and delicious meal this summer that requires minimal stove time look no further! These do take a little longer to make than the average meal but I find it a little meditative and you can make a big batch all at once to last you a couple meals. So perhaps choose a night you aren’t in a rush, or prep things ahead of time. You can get creative with these salad rolls depending on what vegetables you like. You can swap out chicken as well for marinated and sautéed tofu or shrimp.

What you can prep ahead of time - marinated chicken, peanut sauce, julienned veggies.

Ingredients:

Chicken:

• 2 boneless, skinless chicken breasts, cut in half horizontally to make 4 cutlets

• zest and juice of 1 lime

• 1/4 cup fish sauce or 1 tbsp soy sauce

• 2 tsp coconut sugar

• 2 slices red/green jalapeño - optional

• 1.5 inch piece fresh ginger, sliced

Peanut Sauce:

• 1-2 garlic cloves, minced

• 1/2 cup peanut butter or almond butter

• 2-3 tbsp lime juice

• 1/4 cup soy sauce/tamari

• 2 tbsp maple syrup

• 1 tbsp sesame oil

• 1 tbsp ginger, diced

• 1 tbsp apple cider vinegar

• 4-6 tbsp water (more if needed)

• hot sauce or Sriracha to taste - for a kick if you want

Wraps:

• 1/4 cup thinly sliced red cabbage

• 2 carrots, peeled and julienned

• 1/2 red pepper, julienned

• 1/4 cup basil leaves

• about 1.5 cups vermicelli noodles

• rice paper wraps

Directions:

1. Chicken: Add all ingredients including the chicken to a bowl or ziplock bag and marinate for 10 minutes to overnight. Heat 1-2 tbsp olive oil in a pan over medium heat. Add chicken to pan and cook until evenly cooked and browned on each side, about 5 minutes/side. Alternatively BBQ the chicken. Set chicken aside on a wood cutting board and slice thinly.

2. Peanut sauce: Add all peanut sauce ingredients to a food processor and process until smooth adding water by tbsp as needed. Add more water as needed to get the consistently you want. This peanut sauce will keep in the fridge up to a week.

3. Noodles: Cook noodles accordingly to package, drain and rinse in cold water and place in a bowl.

4. Wraps: Set all salad roll ingredients up so to easily grab. Fill a shallow bowl, that is slightly bigger than the rice paper wraps with warm water. Soak a rice paper wrap in the water just until pliable, 30-45 seconds (depending on thickness of rice papers); remove and lay flat on a tea towel lined cutting board (the towel will absorb excess water and help to keep it not sticking). Layer vegetables, chicken, a few basil leaves and noodles across the bottom third of wrap. Fold bottom end up, both sides in then roll up tightly. Be careful not to overstuff the wrap or it will be harder to roll. You quickly learn how much to fill. Repeat for remaining ingredients.

5. Eat! Dip in or drizzle peanut sauce over the wraps while you enjoy!

These are always a hit at my house and the peanut sauce is always a treat. Any leftover peanut sauce can you used in a stir-fry.

In health & happiness.

Dr. Karen

3 Causes of SIBO That Have You Suffering

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  

Stop Sneezing and Start Breathing! A Guide to Spring Allergies

Well the sun is finally starting to come out along with warmer temperatures (please please stay!!), but that doesn’t mean all happy times for those who suffer from spring allergies. Pollens and other allergens are starting to come out and cause sneezing, itching and runny noses. Naturopathic medicine can be very helpful in battling these spring allergies, so you don’t have to rely on over-the-counter, or even prescribed, anti-histamines forever! 

I know what it is like, I have been there. When I was younger I would get chronic hives if I didn’t take Reactine daily. I also could barely function without Reactine, eye drops AND Flonase in the morning one summer when at camp, especially when there was fresh cut grass! Fast forward to a year or so later with no allergies at all, after seeing an ND myself and working through some of the suggestions below. 

3 Main reasons for chronic allergies:

• Poor adrenal function - The function of your adrenal glands are very much connected to your immune system. I see it time and time again, that if someone is drained due to chronic stress they start to have more sensitivities, allergies or just get sick more often. 

• Poor liver detoxification - Think of your body as a bucket. If there is too much toxicity going into the body but poor detoxification from the liver, that bucket is going to overflow and symptoms such as allergies start to occur. We need to empty the bucket somewhat by aiding in liver function. 

• Poor digestion - The digestive system is a main organ of elimination. It also makes up about 70% of our immune system. When we are eating food we are sensitive to, too much sugar or processed foods we damage the gut and its proper function. The digestive system is also affected by such things as chronic stress and chronic use of antibiotics. More damage to the gut leads to a poor immune system and poor elimination. It is that simple. 

Solutions for your allergies:

1. Clean up your diet - If you suffer from spring allergies every year I would advise you to start cleaning up your diet at least 3-4 weeks before allergens start to affect you. This means decreasing the amount of sugar you eat, decrease processed foods and takeout and figure out other food sensitives you may have to avoid for now. Just that will strengthen your immune system and proper detox. Your body can focus on controlling inflammation elsewhere instead of your gut. Add heathy foods such as fresh veggies, fruit and even a little local honey will benefit your digestive system, liver and immune system. 

• Add a probiotic - This is especially important if you suffer from digestive concerns or you have had multiple rounds of antibiotics throughout your life. We want to repopulate the gut with those good bugs to support the immune system. Not all probiotics are created equal though so please come see me if you are unsure what to take. Start with one with at least 11 billion units, try coconut kefir or include fermented foods into your diet. 

• Introduce Urtica diocia (Nettle leaf) - This mineral rich herb acts to revitalize the liver as well as inhibits masts cells (an important part of your immune system) from releasing allergens. This makes it very helpful for spring allergies. It can be taken as a tea or added to a supplement. 

• Quercetin - This is a plant flavonoid found in foods such as apples, kale and onions, which was a key player in eliminating my allergies. It has a low bioavailability in food so a good quality supplement is necessary to do the trick. Quercetin helps to down-regulate histamine release from mast cells, instead of completely blocking it like over-the-counter anti-histamines do. That means you may need higher doses at first but will not have to take it long term, unlike Reactine or Aerius. 

• Take vitamin C - Not only is vitamin C a powerful anti-oxidant and anti-inflammatory, it helps support the adrenal glands as well. The can be given in a Myers IV in clinic or in a buffered supplement form.

With these few suggestions you can minimize or even completely resolve your chronic sneezing and itching! Depending on the severity of a patients allergies, I tend to give a combo of these suggestions. If your allergies are chronic and severe you may need a more comprehensive liver detox program. This is something I can guide you through at the clinic. 

In health & happiness, 

Dr. Karen