Getting Real with Reflux

Majority of the people I see in my practice deal with gastro-oesophageal reflux disease on a daily basis. It's reported that between 10-48% of people in Western countries suffer from the disease!The main symptoms of GERD (reflux):

• Heartburn
• Regurgitation of gastric acid into the lumen of the oesophagus (also commonly known as food reflux)
• GIT discomfort

Symptoms can be so bad that quality of life is severely impacted, and also leading to reduced number of days at work.GERD if left untreated, can lead to oesophageal stricture, GIT bleeding, Barrett's oesophagus or even oesophageal adenocarcinoma. There is definitely nothing nice about GERD that's for sure!So what causes GERD?A lot of the research on GERD has stated the major contributors of GERD is lifestyle and nutrition. Other factors are:

• Age
• Body mass
• Smoking
• Physical activity
• Stress

When we start to look at your diet, the main culprits for aggravating reflux are:

• tomatoes
• foods high in fat
• chocolate products
• hot spices
• citrus fruits
• peppermint tea
• coffee
• carbonated beverages
• alcohol

It would be worth noting down your foods that you're consuming and when your symptoms are at their peak. Food diaries are a great way to manage and identify any patterns. You can download one here Food_Mood_Poo_DiaryThe way you eat food can also increase your symptoms. Make sure that you are NOT eating too quickly, big meals, between meals or just before sleep.Other causes of GERD can be physical ones, such as hiatal hernia and Transient Low Esoghageal Sphincter Relaxation (TLESR). These can be identified by an endoscopy; this is a great way to identify gastritis or any other inflammation within the gastrointestinal system.The common treatment for reflux is prescribing proton pump inhibitors (PPI's). This prescription drug is used to decrease stomach acid (therefore reflux). Long term use of PPI's isn't recommended; and other problems can occur such as bacterial overgrowth (very common with Small Intestinal Bacterial Overgrowth sufferers). Eventually, your serum gastrin levels rise and symptoms can flare up again.The most difficult task of coming off PPI's is the rebound effect. This is where symptoms get worse before they get better.There have been numerous studies on the effectiveness of melatonin. Melatonin is mostly known for it's requirement to induce sleep. But did you know that majority of melatonin made is from your digestive tract?Melatonin protects the gastric mucosa, reduces free radicals in stress induced ulcers, inhibits secretion of HCL and pepsin!This makes melatonin ideal for treating GERD!!!Studies found that 3mg of melatonin at night reduced symptoms of reflux. This particular study took 4 weeks to reduce symptoms.If you are experiencing reflux and would like to reduce your symptoms naturally, fill out the contact form below.[contact_bank form_id="2" form_title="show" form_description="show"][/contact_bank]   

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   

Stress & Your GUT

Stress often gets a bad wrap. It's our bodies natural defence mechanism kicking in to allow us to deal with external dangers (you know...when you want to run away from the sabre-toothed tiger) and mental stress (exams, money concerns, balancing work and family). If your cortisol didn't kick in when you felt or experienced any of these situations, we wouldn't cope at all!It's only when stress is long term that things start to get a bit tricky. Long term stress can leave you not only exhausted and feeling drained. but it can impact your body on a physical level as well. It just can be a lot harder to see (until the damage is done).There has been a lot of research on the Brain-Gut connection and how the gut is often referred to as the '2nd brain'. The brain and gut communicate with each other via the central nervous system (the vagus nerve) and the hypothalamic-pituitary-axis (HPA).Your gut not only contains 70% of your immune system, but it produces 90% of your serotonin (your happy hormone) and other feel good hormones such as dopamine and GABA.

So it's no wonder that when our gut is not feeling great, we don't feel so great either!

When you are stressed you release cortisol from your adrenals. But cortisol (bless its little cotton socks..) can promote intestinal barrier dysfunction. To bring it back a few steps, our gut has a protective layer (intestinal barrier), that is there to not only help absorb all the nutrients from the food you eat.  It also acts as a wall to keep out the nasties such as bacteria, fungi, environmental toxins and parasites.

Stress affects the gut in the following ways:

• Gastric secretion (your digestion slows down)
• Gut motility (this could slow down or speed up your digestion)
• Gut function and mucosal blood flow
• Visceral sensitivity (stomach pain)
• Increases inflammation (that word again)

Continual stress exposure can lead to the following digestive conditions:

• Gastro-oesophageal reflux disease (GERD)
• Peptic ulcer disease
• Inflammatory bowel disease
• Inflammatory bowel syndrome
• Food allergy
• SIBO

So what can you do to reduce stress when it's out of control??Let's do some exploring........

1. Do what brings you joy!

Honestly....have you stopped doing something because you're too busy?We often put other family members first before our selves. But a little self care is needed, and trust me. If you come down like a tonne of bricks, the rest of the family will to.List 3 things that you love doing, pick one and start doing it.

2. Meditation

Yeah, yeah....I know you've heard it all before. But there is so much research to prove that it works (that's why it keeps popping up all the time!) If you aren't feeling too confident in starting by yourself. There are now Apps available that can give you guided sessions. Have a look at these...HeadspaceSmiling MindHealthline

3. Get back into nature

Fresh air, no distractions, physical activity and feeling the earth beneath your feet. What more do you need?

4. Delegate

Spread the burden! How many times do you say you're ok, when you're clearly not?This is when family and friends come in handy.

5. Talk to someone

Sometimes by talking over what is troubling you can make you feel so much better. Friend, family member or seek professional help if need be.

6. Time Management

This is a goody if you need to be in 2 places at once or there are a lot of deadlines coming up. It's an oldie, but a goody.

7. Community

See what help is available within your community. The local library is a great place where community events and resources are kept. And a lot of them will be FREE!

REFERENCES

Cahn, Br. et al. 'Yoga, Meditation and Mind-Body Health: Increased BDNF, Cortisol Awakening Response, and Altered Inflammatory Marker Expression after a 3-Month Yoga and Meditation Retreat', Frontiers in Human Neuroscience, 2017 Jun 26;11:315. doi: 10.3389/fnhum.2017.00315. eCollection 2017.Farmer, Adam D. Holly A. Randall and Qasim Aziz, 'It's a gut feeling: How the gut microbiota affects the state of mind', Journal of Physiology, 592. 14 (2014) pp 2981-2988Gladwell. VF et. al. 'The Great Outdoors: how a green environment can benefit all', Extreme Physiology & Medicine,  2013 Jan 3;2(1):3. doi: 10.1186/2046-7648-2-3.Konturek, P.C., Brzozowski, T. , Konturek, S.J. ' Stress and the gut: Pathophysiology, clinical consequences, diagnostic approach and treatment options'. Journal of Physiology and Pharmacology, 2011, 62, 6, 591-599Pokorski, M & Suchorzynska, A. 'Psychobehavioural Effects of Meditation', Advances in Experimental Medicine and Biology, 2017 Jun 25. doi: 10.1007/5584_2017_52  

P For Pyrolles

Pyroluria/Pyrolles is a genetic condition or a result of high oxidative stress when your body produces high levels of kryptopyrolles in the urine. Kryptopyrolles is a natural occurring by product when your body is making haemoglobin and the problem that is causes is that vitamin B6 and zinc bind to kryptopyrolles and then reduces your levels of these nutrients.

Vitamin B6 and zinc are used as cofactors in many metabolic functions within the body. Neurotransmitters such as serotonin, adrenalin and GABA need vitamin B6 and zinc to be synthesised. The end result is that many people with pyrolles do not cope with stress very well, may suffer from depression and is commonly linked with conditions such as ADHD and anxiety.

Testing of kryptopyrolles is relatively easy and is done by a urine sample. Collection of the sample can be the tricky part and needs to be done in a relatively dark room (as light will destroy your sample) and collection also needs to be late morning and done when you are not overly stressed (as this may give you a false positive).

If you do have a positive result, the next step is to have a blood test to indicate your zinc, unbound copper and bound copper levels. If your zinc levels are low (which they tend to be when you have pyrolles) your copper levels will be high and this within itself can lead to many symptoms. Many practitioners will also recommend having your methylation or genetic testing done as well to make sure there are no missing links- it can get to be a very costly process!

Pyroluria is becoming more common in naturopathic clinics as your local G.P will not recognise the condition and will therefore not be able to treat it. But it still does cause many friendly debates among practitioners if the condition is 'real' or not.

Personally, I have done the urine test and was tested positive 18 months ago. It was around the same time that I did the hydrogen breath test for small intestinal bacterial overgrowth (SIBO) which also came back positive. I have not taken the blood test, as I felt if I treated the GUT first perhaps my symptoms of general adrenal fatigue would diminish (treat the GUT first).

In hindsight I think I manage my 'pyrolles' quite well. I always have my zinc/B6 capsule on hand and also have a supply of NAC to support my liver when I start to feel run down or need a little extra support.

I have included a short You Tube clip by William Walsh from The Walsh Institute. He has written a brilliant book 'Nutrient Power' and has had a successful history of treating people with psychological problems with nutrients. There is also a Bio-Balance conference every year on the Gold Coast in Queensland and is open to the public.

If you have pyrolles or you think you may have pryolles and you're interested in making an appointment to have your kryptopyrolle levels tested - contact me today!

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