Gut concerns are so prevalent in today’s society. Many people suffer from symptoms that range from mild to severe. Common complaints include bloating, excessive gas, constipation, and diarrhea. other notable symptoms include indigestion, heartburn, abdominal pain, cramping, and nausea.

If you experience any of these symptoms regularly, you must listen to what your body is telling you. Gut dysfunction creates a domino effect of more severe consequences. Improper gut health leads to nutrient deficiencies, immune system dysregulation, autoimmune conditions, and inflammation in your brain, joints, and other areas. Your body depends on a healthy working digestive tract.

I’m intimately familiar with gut dysfunction. In this two-part blog, I’ll share my story, along with ways to determine if you have Irritable Bowel Syndrome (IBS) or Small Intestinal Bacteria Overgrowth (SIBO). I’ll also share some emerging treatment options for these conditions.

MY RELATIONSHIP WITH GUT ISSUES

I noticed something was seriously wrong with my gut in 2011, during my first year in medical school. I’d need to unbuckle my pants halfway through the day because I was bloating so badly. Along with the bloating came abdominal pain, excess gas and constipation.

Thankfully, I learned more about these symptoms in school as I experienced them, but most people don’t know what a regular bowel movement is, because we don’t really talk about it. (Not many people like to go to the doctor and talk about their poop!)

I thought I might have Irritable Bowel Syndrome (IBS), which is is a functional disorder, meaning it’s a diagnosis of exclusion. IBS is defined as abdominal pain at least once per week, on average, over three months or longer. The abdominal pain needs to be associated with two or more of the following experiences:

• Bowel movements (Does the pain subside afterward?)
• How many times per day you poop (It should be at least once per day.)
  
• What your poop looks like (Hint: If it’s regularly hard-to-pass or watery, it’s not normal.)

These symptoms also help determine whether your IBS has a sub-type of constipation, diarrhea, or both.

I went to a gastroenterologist, who confirmed I had IBS with a sub-type of constipation.

INITIAL TREATMENT

My prescription was to drink more water, eat more fiber, and get more exercise. But those overly simplified recommendations didn’t help. In fact, when I increased my vegetable intake and took a fiber supplement, my bloating worsened. I took laxatives to help with constipation, but they just caused more bloating and abdominal pain.

Side note: One of the reasons I often recommend naturopathic care over traditional medicine is experiences like these. Internal physical healing frequently requires deeper, more intuitive work than what pills and simple suggestions can provide.

THE NEXT STEP

In naturopathic medical school, we learn a lot about what it means to have a healthy diet, so I looked at my own to explore what I could do differently.

I took an IGG blood test from US Biotek to determine by food sensitivities. It turns out, dairy and gluten were the main culprits of even less obvious symptoms I had, including acne and morning puffiness.

I eliminated both from my diet, but my constipation and abdominal bloating didn’t improve. Then I learned more about SIBO.

WHAT IS SMALL INTESTINAL BACTERIA OVERGROWTH (SIBO)?

Drs. Allison Siebecker and Steven Sandberg-Lewis were professors at the naturopathic university where I studied. In 2014, they were teaching and treating a condition called SIBO. The more I learned from them, the more I realized my symptoms fit the SIBO description.

SIBO causes about 60% of IBS. SIBO is essentially an accumulation of bacteria from our large intestine, which goes up into our small intestine, where it shouldn’t be.

MMC: AN UNDERLYING CAUSE

A common underlying cause of bacteria ending up in the small intestine is due to an impaired Migrating Motor Complex (MMC). When functioning correctly, this complex sweeps debris out of your small intestine, so nothing overgrows.

There are lots of risk factors that can impair your MMC, including food poisoning. When we have food poisoning, our bodies can create an autoimmune response to the bacteria’s endotoxins that caused us to become sick.

Proton pump inhibitors are another risk factor. When used long-term, heartburn pills such as Prilosec OTC or Omeprazole decrease your stomach acid, which washes away the bacteria you consume through food. That bacteria can then get in your small intestine and overgrow, causing SIBO.

Adhesions in the abdomen, which often happen after surgeries and endometriosis, can also put you at risk because your MMC becomes stuck to the abdomen’s wall.

I had all of these risk factors. Lucky me!

WHAT OVERGROWN BACTERIA DOES

When bacteria overgrow in your small intestine, you get carbohydrate malabsorption via bacterial fermentation. That means bacteria are fermenting carbohydrates before you can break them down to absorb correctly. This produces hydrogen and methane gas, which builds up in your small intestine. Bloating, ab pain, nausea, indigestion, and nutrient deficiencies are common side effects.

Inflammation in the small intestine also leads to a leaky gut, which happens when loose food particles trigger the immune system and cause systemic symptoms like fatigue, brain fog, joint pain, headaches, skin conditions, etc. This is important to know, as lots of chronic issues people wouldn’t immediately associate with digestion, actually are related to gut health.

HOW DO YOU GET OPTIMUM GUT HEALTH?

Stay tuned for this answer next week. I’ve thrown a lot of information your way, which will take some time to digest (har har). In the meantime, I encourage you to explore which symptoms I listed that you may have. You may find it helpful to keep a daily food diary of what you eat, when you eat it, and how it makes you feel afterward.

If you have specific concerns related to your health, book an in-person or online visit with me! Diagnosing and treating IBS and SIBO is a careful process. I’d love to use my personal experience and naturopathic knowledge to safely and gently get you back to optimum gut health.

Until next time!