Alcohol & Leaky GUT

Australians have a reputation for our excessive alcohol drinking. It's within our culture to have an outdoor lifestyle, BBQ's, laid back attitude, scorching sun.....with a bevvy in our hands.The negative impacts of alcohol consumption is evident. I'm not about to start educating you about the physical and mental effects of alcohol. You can do so here.I see many people within my practice that have a leaky gut. A thorough health history is taken with all of my clients; and all usual suspects of a leaky gut are marked off:

• antibiotic use
• prescription medication
• post-infectious IBS
• stress
• operations
• reproductive health
• diet

But have you ever considered your alcohol intake?

Excessive alcohol intake (binge drinking), causes inflammation and creates gaps within our intestinal wall. Ethanol reduces good bacteria and increases unwanted endotoxins (bad bacteria). Alcohol is metabolised by the liver, and produces free radicals as a result. Which causes oxidative stress within our body.Increased inflammation travels to our brain, and increases depression, foggy thinking and 'sickness behaviour'.Alcohol impairs our nervous system and reduces nutrients such as zinc, Vit. D, folate and SAMe.Due to the intestinal permeability, conditions such as SIBO, Inflammatory Bowel Disease and some colon cancers can occur.

So what can you do to heal a leaky gut caused by over alcohol consumption?

Studies have that supplementing with the following have a positive impact in either inflammatory markers or intestinal permeability measures:

• Zinc supplementation- 50mg per day after a meal
• Vitamin D supplement
• SAMe supplementation
• Co-enzyme A supplementation
• Fish oil (anti-inflammatory)
• Vitamin C (anti-oxidant)
• Magnesium
• Glutamine

Probiotics:

• Lactobacillus LGG
• Bifidobacterium Infantis
• Bifidobacterium bifidum
• Lactobacillus plantarum
• Lactobacillus casei Shirota (yakult)

Prebiotics:

• Oats at 10gm per 1kg body weight.

Ways to reduce alcohol intake.....

• Stay within the 'drinking in moderation' guidelines
• Abstinence of alcohol- replace alcohol with a healthy habit.
• Swap to red wine. Studies have demonstrated that red wine contains polyphenols. Polyphenols are beneficial for gut bacteria.
• Identify the triggers of alcohol consumption. Avoid or reduce the triggers could lead to less alcohol intake.

Useful Resources:

Website- Hello Sunday MorningWebsite- Sexy SobrietySupport- Alcoholics AnonymousSupport- Drink WiseREFERENCESBarve, Shirish et. al. 'Development, Prevention & Treatment of Alcohol Induced Organ Injury: The Role of Nutrition, Alcohol Research, Vol. 28, No. 2 pg. 289-302Bishehsari, Faraz. et. al , Alcohol and GUT derived Inflammation', Alcohol Research, Vol. 38. No. 2 pg. 163-171Engen, Phillip A. et. al. 'The Gastrointestinal Microbiome- Alcohol effects on the composition of Intestinal Microbiota', Alcohol Research, Vol. 37, No.2Leclercq, S. Timory, P de. Delzeme, NM. Starket, P. (2017) 'The Link between inflammation, bugs, the intestine and the brain in alcohol dependence', Translational Psychiatry   

Why Short Chain Fatty Acids are the Key to Optimal Health

Short chain fatty acids (S.C.F.A's), sounds like something that you should be avoiding all together. But you couldn't be more further from the truth.https://www.facebook.com/Thenaturopathshop/videos/2196534210567444/?ref_page_id=1518149341739271&acontext=%7B%22source%22%3A5%2C%22action_history%22%3A[%7B%22surface%22%3A%22page%22%2C%22mechanism%22%3A%22main_list%22%2C%22extra_data%22%3A%22%5C%22[]%5C%22%22%7D]%2C%22has_source%22%3Atrue%7D

So what are SCFA's?

SCFA's are made in your colon. They are produced by your gut bacteria, when you consume carbohydrates and I'm not taking about refined carbs either- more on this later). SCFA's are a 6 carbon chain (hence the name short) and can either be of 3 metabolites- butyrate, propionate, acetate (there are a couple of others but they only make up 5% of total SCFA's).Butyrate can be used instantly by some cells in your colon; while the rest can transported to your liver and enter the rest of your system by your blood.

The benefits of SCFA's..............

Studies have shown that SCFA's reduce the risk of cardiovascular disease, Type 2 diabetes, insulin resistance, obesity (basically metabolic syndrome) and some colon cancers.Research has also shown that SCFA's are anti-inflammatory, and that people who had ulcerative colitis and Irritable Bowel Syndrome (IBS), had lower than normal levels of SCFA's.

How Do I Increase my SCFA's Levels?

SCFA's are influenced by diet. Yes, the food you eat. As I mentioned before; SCFA's are made by your bacteria when they digest certain carbohydrates. These carbohydrates are mostly found in vegetables, fruit, wholegrains and legumes.All these foods also have one thing in common, they contain high amounts of fibre.

What FIBRE????

Yes! Here's the glitch.....you might be currently following a low FODMAP, SIBO, or a High FAT/Low Carb diet. All of these diets dramatically reduce your intake of natural fibre. You can avoid this by really focusing on the vegetables you can eat, so this doesn't happen. This is why long term Low FODMAP diets aren't recommended for long periods.This can be the hardest part when you are healing your gut. Especially if you have IBS/SIBO and feel like you bloat even from water. This is because your gut lining is hyper-sensitive and you need to go extremely slowly when you are starting to re-introduce regular foods.Legumes are a fantastic source of fibre, but many people just can't tolerate them. So after you have done adequate healing of your gut (can be different for everyone). You can start with brown lentils, drain the can, and freeze them into ice cube trays. This way you are just introducing a tiny amount daily.There are many types of fibre, but some fibres in food are also called 'prebiotics'. This term is used a lot more these days. The way I like to explain it is that prebiotics are 'feeding' your gut bacteria, which will make them grow big and strong. This method is excellent when you have low numbers in a beneficial bacteria (all you need to do is eat the right foods to build them up again). The end result will be that you have built up your gut ecosystem naturally with foods.

Foods That Feed Your Gut Microbiome

Listed below is a snap shot of foods that feed your healthy gut bugs - these foods contain either inulin, fructo-oligosaccharides, galacto-oligosaccharides.Jerusalem artichoke, yacon tubers burdock roots, chicory roots, dandelion roots, garlic, onion, leeks, asparagus, globe artichoke.Legumes, Brassica-family, vegetables, fresh beans, rye sourdough, sunflower seeds, pumpkin seeds, LSA mix.Polyphenols also feed your gut bugs. Polyphenol foods are:black elderberries, black currants, blueberries, cherries, strawberries, blackberries, plums, raspberries, apples, black grapesFlaxseed meal, chestnuts, hazelnuts, pecans, purple carrots, red carrots, purple potatoes, red cabbage, spinach, red onions, broccoli, carrots, red lettuceRed rice, black rice, red and white quinoa, whole grain, rye brad, olives and olive oil

How Do I Measure SCFA's?

This can be done only by stool testing. There are quite a few on the market that give you varying results. But you can easily find more about your SCFA's levels by completing a CDSA (Comprehensive Diagnostic Stool Analysis) or by a UBIOME test.If you would like to know more about SCFA's or specific stool tests; fill out the contact form below and I will get back to you.[contact_bank form_id="2" form_title="show" form_description="show"][/contact_bank]REFERENCESCheng et. al. (2017) Effects of Functional Oligosaccharides and ordinary dietary fibre on intestinal microbiota diversity, Frontiers in Microbiology, 1-11Edwards et. al. (2017) Polyphenols and Health- interactions between fibre, plant polyphenols and the gut microbiota, Nutrition Bulletin, 42, 356-360Ros-Covian et. al. (2016) Intestinal short chain fatty acids and their link with diet and human health, Frontiers in Microbiology, Vol.7, Article 185, pg.1-9Singh et. al. Influence of diet on the gut microbiome and implications for human health, (2017), Journal of Translational Medicine, 15:73, 1-17      

Bloated Belly Blues

In my younger years I used to have an ironing board stomach (actually the ironing board look went up to my collar bone). And the words 'muffin top' were not something that I resonated with. That was until I had my 3rd child, and I just had to look at food for my stomach to inflate like a balloon.I do believe that there has been muscle weakness in that area and this has been a reason for my relaxed tummy look, but the biggest cause was because I had SIBO.SIBO stands for Small Intestinal Bacterial Overgrowth. And it means just that the gut bacteria that should be in your large colon, are now playing happy families in your small intestine.So what does this have to do with bloated tummies???A lot actually. It now means that the bacteria that are in your small intestine are out of balance. And these new kids on the block love feeding off the food we eat. Mostly carbs!So when they have also relished in the pasta you just ate, so are the unwelcomed bacteria. And they then release gases after eating, which then causes your tummy to also fill up with air and look bloated!The foods that mostly trigger a bloated belly are:- bread, crackers, biscuits, cakes. Anything with wheat and gluten.- milk, cream, soy, cheese- alcohol- refined sugars, sweeties, lollies etc.- additives and preservatives-legumesOther symptoms of SIBO are:- constipation and/or diarrhoea- food intolerances-headaches-fatigue-acne Rosacea and other skin conditionsTo treat a bloated belly naturally you can eliminate the unwanted bacteria by using herbal antibiotics; and avoid foods that feed the bacteria until the gut lining heals and the cause of your SIBO has been rectified.If you would like to know more about SIBO, please fill out the contact form below.[contact_bank form_id=2 show_title=true show_desc=false]   

Small Intestinal Bacterial Overgrowth (SIBO)

[bookly-cancellation-confirmation]Whenever I have mentioned to people that I have small intestinal bacterial overgrowth, their first reaction is- 'You have what'?...

It is slightly on the wordy side and so I will just use the acronym SIBO instead, to save my little typing hands.

SIBO is what its name suggests- an overgrowth of bacteria residing in the small intestines. We all have colonies of gut flora within our digestive system (also known as our microbiome) and these species all have their place where they should be and also be at certain levels to maintain our mood, immune and digestive system to function properly. But when there is an imbalance or certain gut flora are living somewhere in our gut that they shouldn't be (in this case its the small intestine) then we get SIBO!

What are the symptoms of SIBO?

• Bloating after meals
• Burping after meals
• Flatulence
• Constipation
• Diarrhoea
• Constipation AND diarrhoea
• Stomach pain
• Reflux
• Nausea
• Skin rashes- acne rosacea
• Joint pain
• Restless Leg Syndrome
• Associate conditions- fibromyalgia, hypothyroidism, diabetes, celiac disease, obesity

You do not have to have all of these symptoms to have SIBO and it can be so common to other ailments related to digestion- especially Irritable Bowel Syndrome (IBS). I will discuss SIBO vs. IBS a little later.

What are the causes of SIBO?

• Very typical to have been caused by an infection (food poisoning etc.)
• Stress- the motility of your digestive system slows down and digestive enzymes are lowered (mostly HCL) and will cause inflammation in the gut.
• Abdominal surgery-endometriosis, appendicitis, caesarean
• Excess consumption of carbohydrates
• Blind loops (gastric bypass)
• Initial colonisation of microbiome
• IBS
• Alcoholism
• Medications- proton pump inhibitors, narcotics
• Celiac disease

Pathophysiology of SIBO-

Generally, inflammation is the main cause of SIBO and if you look at any of the causes above they will all produce inflammation at some stage. Along our small intestine we have these projectile fingers all the way along that are called microvilli. The microvilli have brush boarder enzymes that help you digest and breakdown your food, so it can be absorbed into the blood stream and used for energy or where ever the body needs it.

When there is inflammation of the microvilli, damage is caused and will create tiny gaps. This can create huge problems such as leaky gut, food allergies (due to food not being broken down and the digestive system attacking it), nutritional deficiencies and you guessed it....SIBO.

This then can cause another cycle of events because the small intestine tries to flush out the excess of bacteria and opens up it's little tight junctions and creates more gaps for food etc. to enter. The damaged microvilli then are not able to do their job properly because they are damaged, so food (mostly carbohydrates) can often ferment and cause gas- belching, reflux and flatulence .

There is a natural wave found in the small intestine called the migrating motor complex (MMC). This wave occurs every 90 minutes and has a sweeping motion that pushes your solid matter down towards your colon. In SIBO the MMC is impaired and will also create gas production due to fermentation. The bacterial imbalance will also 'feed' off the carbohydrates and this is another cause of gas production.

Testing for SIBO-

The testing for SIBO is non-invasive and is performed by a simple breath test done at home. It is called the Hydrogen Breath test, which test the levels of hydrogen and methane after drinking a lactulose solution. 10 breath test are performed every 20 minutes and the rise of either (or both) of these elements will determine if you have SIBO or not. A 2 day prep diet is required, where little carbohydrates are consumed to starve the bacteria. Following the 2 day prep diet is crucial, as a false negative may occur.

The benefits of doing the test is that you know which bacteria to treat and this can alter your treatment protocol. You will also see what levels your bacteria is sitting at. For instance, I was high in both hydrogen AND methane and my levels raised to an amount that I needed to take the anti-microbial for 12 weeks instead of 6 weeks.

Treatment for SIBO-

The treatment for SIBO is based on diet changes, anti-microbial/anti-bacterial supplements, improving the MMC and breaking down the biofilm. Biofilm is a protective mucosal layer that covers your gut bacteria. The good and bad bacteria do it, so its not an unusual thing to occur. But, some bacteria are very stubborn and lie very deep within your mucosal layer. Some bacteria (candida albicans) also have a hook at one end and they hook them selves into your gut wall for extra adhesion. Once the treatment has finished, you can start pumping yourself up again with probiotics.

I believe the most integrative aspect of treating SIBO is obviously eliminating the excess bacteria, but focusing on healing your gut wall. This is where pharmaceutical treatment fails unfortunately. The administration of antibiotics does kill the bacteria, but the gut wall hasn't healed, so you will find that SIBO symptoms return very quickly because the gaps between the junctions are still there.

The way to heal your gut wall is by avoiding inflammatory triggers to begin with and foods that feed the bacteria. There is usually much discussion on whether to starve or feed the bacteria. But, I have found that by starving the bacteria, not only increases the death rate, but it will also improve candida symptoms.

Meat/fish stock is the best way to heal your gut lining. The gelatine that is extracted from the joints/tendons make a nutritious and healing stock that is full of natural collagen. Unfortunately, there has not been enough emphasis on this and is really the key to long term success.

There have also been a few dates linked to treating SIBO. all of them are low in carbohydrates, as it is the disaccharides that are difficult to  digest and cause the most symptoms in SIBO. Most people will try all of the diets to see which one gives the best results before taking action and doing the breath test. There is FODMAPS, Specific Carbohydrate Diet (SCD) and Gut and Psychology Syndrome (GAPS) diet. But, you will receive a recommended food list to treat SIBO specifically if you decide to take the Hydrogen Breath Test.

You can order a test kit from SIBOTEST.com, but you will need a qualified practitioner to interpret the results for you and to gain access to the supplements required.

What is the link with IBS and SIBO?

You can see from the list of symptoms that SIBO and IBS are very similar. There is a link, and it is mostly that if you have IBS there 60-80% chance that you have SIBO as well. This could be due to the fact that you can develop IBS the same way as you can develop SIBO and that is by post infectious gastroenteritis. The four main organisms that cause gastroenteritis are:

1. Campylobacter jejuni
2. Salmonella
3. E.coli
4. Shigella

These organisms release a toxin called Cytolethial distending toxin B (CdtB). This toxin is very similar to a protein vinculin. Vinculin helps protect the interstitial cells along your gut wall to keep it nice and healthy and tight. But unfortunately, when high levels of the similar looking toxin CdtB is released the body starts to attack vinculin and develops anti bodies. This leads to an auto immune response. Don't worry too much- this doesn't happen to everyone!

If you would like to make an appointment with me regarding your digestive complaint, you can do so here: