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-legumes

Other symptoms of SIBO are:- constipation and/or diarrhoea- food intolerances-headaches-fatigue-acne Rosacea and other skin conditions. To 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. 

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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Small Intestinal Bacterial Overgrowth (SIBO)

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!

Histamine Intolerance

1% of the world's population has histamine intolerance according to an article in The Journal of Allergy and Clinical Immunology, with 80% of them being middle aged. Personally I see many of my GAPS clients with a histamine intolerance with no restrictions on age.

You would be familiar with the term 'anti-histamines', which are typically used when someone suffers from hay fever, sinusitis or experience an acute skin reaction. Histamines are released from your mast cells due to an inflammatory response. Masts cells are part of your immune system and are regularly called upon to out the flames out of a fire that may be occurring in your body.

When histamine is released it dilates your capillaries, resulting in lowering blood pressure, it contracts smooth muscles (including your lungs), increases gastric secretions, raises heart rate and is a neurotransmitter in your brain (McAuliffe, G. 2015).

Typical symptoms of histamine intolerance:

• rhinitis
• sinusitis
• asthma
• headaches/migraines
• nausea
• flatulence
• abdominal cramps
• diarrhoea
• hives
• flushing
• insomnia
• arrhythmia
• stuttering
• nasal congestion
• sneezing
• abnormal menstrual cycle/dysmenorrhea
• mental disorders such as depression and schizophrenia

Histamine is also found in foods that we eat and fermented beverages (red wine and beer . So when someone has a histamine intolerance, they have an impaired ability to break histamine down in their digestive system and the histamine accumulates, and the person will experience symptoms similar to a hay fever sufferer. There are also foods that may not contain high histamine levels, but may influence a histamine RESPONSE. For a full list of high histamine containing foods and high histamine releasing foods click -histamine-food-list

Are you born histamine intolerant?

Yes and no. There are two enzymes that break down histamine in your digestive system. Diamine Oxidase (DAO) is the most common enzyme that people are insufficient of. To boost the productivity of this enzyme vitamin C and vitamin B6 are needed. The other enzyme that is needed to break down histamine is N-methyltransferase (HNMT). HNMT is needed mostly in the lungs to break down histamine (asthma link?), but is expressed in the kidneys and liver also. To increase HNMT activity the enzyme SAMe ( S- adenosyl-methyl-methionine) is required. You can lack either of these enzymes genetically or they can be blocked by various pharmaceutical drugs (or acquired from health ailments such as leaky gut, small intestinal bacterial overgrowth, candida overgrowth or Epstein Barr virus). Any one can experience symptoms of histamine intolerance, just by ingesting too many high histamine foods. This is referred to mostly as 'histamine excess'.

Testing for histamine intolerance

• Histamine blood serum
• Genetic testing (DNA)
• Methylation profile
• Food allergy test

Management of histamine intolerance

• Keep a food diary for any reactions to histamine foods
• Check if on any medication that could block histamine enzymes or are pro-histamine releasing
• Do you have any symptoms of histamine intolerance?
• Eliminate histamine foods from diet, heal your gut and reintroduce slowly

If you feel that you may have a histamine intolerance, book an appointment to discuss your needs today![bookly-form]

REFERENCES

Maintz, Laura and Novak, Natalija. 'Histamine and histamine intolerance', American Journal of Clinical Nutrition, 2007, 85:1185-96McAuliffe, George. "Histamine', Journal of the Council on Nutrition of the American Chiropractic Association, 2015, Vol.38, No.3 30-33Smolinska, S. Jutel, M. Crameri, R. O'Mahony, L. 'Histamine and gut mucosal immune regulation', 2014, 69:273-281Vickerstaff-Joneja, Janice. & Carmona-Silva, Cabrini. 'Outcome of a histamine restricted diet based on chart audit', Journal of Nutritional & Environmental Medicine, 2001: 11, 249-262