Yesterday I wrote about SIBO, small intestinal bacterial overgrowth. This occurs oftentimes alongside bacterial dysbiosis. Dysbiosis is an alteration of the body’s microbial community making a shift in the population when primarily good bacteria decreases and bad (or pathogenic) bacteria flourish. In simple terms you have less good and more bad. The balance is thrown off.
How can dysbiosis occur? Overuse of antibiotics, poor diets, excessive alcohol intake, overuse of NSAIDs(aspirin, Ibuprofen), and other lifestyle factors.
Many are more used to calling these instances of dysbiosis by the location of the bacterial community shift or the type of change that is taking place. For instance, we call a dysbiosis in the vaginal cavity a vaginal yeast infection. Or a local overgrowth of yeast in the mouth is called thrush. Other examples are SIBO (dysbiosis in the small intestine), vaginosis, and candida overgrowth.
If you have IBS, chronic bloating, distention and indigestion, celiac, crohn’s, colitis, GERD, obesity, food allergies or heart disease, you may have some intestinal dysbiosis.
In order to assist in bringing a better balance to your intestines, eating a specific diet and reintroducing the best bacterial communities can improve the above symptoms/conditions. It is also important to take specific protocols for gut healing to avoid dysbiosis in the future. Taking glutamine for gut healing and nourishing yourself with bone broth, and decreasing sugar intake, especially in the form of soda and other liquid sugar can all help with keeping a balanced bacterial community.
If you have gas, bloating, diarrhea and other uncomfortable symptoms in your gut, you may have SIBO. SIBO, which is pronounced “see-bo”, stands for Small Intestinal Bacterial Overgrowth. This develops when too many bacteria colonize in the small intestine. In a healthy colon (or large intestine) there should be 100 billion bacteria per milliliter but in your small intestine you should have less than 100,000 per milliliter. You can see a big difference between 100 billion and 100 thousand.
SIBO is uncomfortable, usually underdiagnosed and can cause damage to intestinal cells. There are estimates that more than 80% of people with IBS also have SIBO. Individuals with other digestive issues are more likely to have SIBO, conditions such as Celiac and Crohn’s Disease.
What symptoms are present along with SIBO:
In a normal healthy intestine there are cleansing waves that take place between meals and snacks that sweep food through the small intestine into the large intestine. If these cleansing waves are compromised it can lead to more time for bacteria to colonize in the small intestine.
Other anatomical issues such as the valve between the small and large intestines becoming compromised and allowing bacteria to migrate from the large intestine back up to the small intestine.
Chronic inflammation leading to an underactive immune system. Most of the immune cells are located in the intestinal tract, if the immune system is compromised then it can not fight off invading unfriendly bacteria or manage concentrations of bacteria.
Insufficient stomach acid can lead to intestinal bacterial overgrowth. The pH of stomach acid kills acidophobic(or acid hating) bacteria. If the pH is higher than normal, it can lead to certain bacteria surviving that would have otherwise died in the stomach.
If SIBO persists, what else happens?
Many physicians will treat SIBO with antibiotics. This can be necessary depending on the amount of overgrowth. Other treatment options include diets that starve the bacteria. Diet options include: Specific Carbohydrate Diet, GAPS diet, or low FODMAP diet.
Working with a Functional and Integrative Dietitian can help as these diets are implemented. Preventing SIBO from returning is essential, correcting for vitamin and mineral deficiencies and healing the gut lining is very important. If you think you have SIBO, it is important to visit your physician and obtain testing for accurate diagnosis.
Here is tip #1 for preventing SIBO: Encourage cleansing waves in your intestine. Drink hot lemon water or take a shot of apple cider vinegar. You can do this before bed or after meals (just make sure to brush your teeth after). It's also important to wait sufficient time between meals and snacks before eating again (at least 2 hours).
Curious if your health issues are related to food sensitivities? We’ll cover general information regarding food sensitivities, navigate information that may be helpful to determine if your health issue may be related to food sensitivity, and how as a part of my practice we can test and help you overcome food sensitivities.
Let’s start here: WHAT IS A FOOD SENSITIVITY?
Food sensitivity describes a specific immune reaction to a food or food chemical. A reactive food will cause immune cells to release chemicals that are inflammatory. These chemicals are called mediators and you may be familiar with the name of a few of these chemicals like histamine, cytokines and prostaglandins. There are about 100 different types of mediators, those are just a few. These chemical mediators your immune cells release are the DIRECT CAUSE of food sensitivity symptoms and associated inflammation in the body.
ARE FOOD ALLERGIES THE SAME AS SENSITIVITIES?
There is a lot of confusion regarding food intolerances, food allergies and food sensitivities, some of which may be due to the medical community and health professionals using the words interchangeably. However, all of these conditions are different, and created because of very different reactions (or lack of reactions) in the body. Let’s break it down.
Food intolerances are not something your immune system is reacting to. Rather it is most often that your body is not creating an enzyme for food breakdown (or creating enough of the enzyme). The intolerance most people know of is lactose. It is due to inadequate lactase production, so the sugar found in milk doesn’t break down and makes it to the distant parts of your GI tract (read your colon) and the gut bacteria have a hey-day digesting lactose. This causes gas, bloating, and for some diarrhea. The food sensitivity testing I work with does not test for food intolerance, however on the elimination diet we create together, it becomes easy to identify these food issues quickly.
Food allergies are a reaction that your immune system is involved with. Allergies are not exclusive to food either, I’m sure you know this already, but you can be allergies to medicine, insects stings (like bees), pet dander, pollen, mold, grasses, and food. There is only pathway that your immune system reacts to create an allergic response. It is called an immunoglobulin E mediated response or IgE. Symptoms vary, but they are usually immediate and varying levels of severity. Think hives, wheezing, vomiting, blood pressure drop, closing of airways, anaphylaxis. These are the kind of reactions to take very seriously. Most often these types of reactions are known to an individual and are confirmed with skin pricking. If someone tells you they are allergic to peanuts or shellfish, this is typically the type of reaction they are speaking about, and it’s not one to mess around with. The testing done in my practice will not show this type of reaction.
Food sensitivities are the third type of reaction. They are a more complex (almost elegant) type of reaction. It certainly doesn’t leave you feeling elegant, but there are so many different types of immune cells and pathways that are apart of these types of reactions. The symptoms are often delayed, instead of immediate like the food allergies just discussed. Because of this delay, it is hard for an individual to root out the offending foods on their own. These delays can be as long as 36 hours or as short as 2 hours. If it is a migraine that is triggered, how are you to know if it was the papaya in the fruit salad at work today or the coffee cheesecake that was served at the family gather last night? The symptoms that are related to sensitivities are also more varied and have varying degrees of severity. Most of the symptoms are related to inflammation and a cascade of related responses. From muscle contraction, to arthritis, to migraines and IBS.
DO I HAVE A FOOD SENSITIVITY?
If you have an inflammatory or autoimmune condition, most particularly one that is not responding to traditional treatment, you very likely may have a food sensitivity. The most common conditions that can be improved or completely resolved with food sensitivity testing and a related elimination diet are:
During an initial consultation, we will carefully review your symptoms and health history to determine if food sensitivity testing is right for you and may improve your health conditions, or if the test is un-needed and other issues may need to be resolved first. (Other issues could be parasites, small intestine bacterial overgrowth, etc).
I do have some patients that do not present with the typical conditions listed above and are just interested to know if they are sensitive to any foods. We can test and work on a patient specific diet for you to improve energy levels and decrease inflammation in your body based on the testing. There is no harm in testing and it could be a great way to spend your FSA funds before the end of the year!
HOW DOES YOUR FOOD SENSITIVITY TESTING WORK?
The mediator release test (MRT) is a blood test that directly measures the mediators your immune cells release when exposed to foods or food chemicals. There is 150 different foods and food chemicals tested. Things like apples, wheat, dairy, other items include herbs like basil and oregano, even foods like quinoa and rice. Chemicals in common medicines like Advil and Tylenol are also tested. Wouldn’t it be great to know if that medicine you are taking to rid yourself of inflammation or a headache was actually contributing to the problem? By measuring how much mediators your body is releasing, we can quantify just how reactive a food is to your specific body.
WHAT IS THE DIET PROTOCOL LIKE WHEN WE ELIMINATE FOODS?
The LEAP (Lifestyle Eating And Performance) Immunocalm Diet is an individualized diet based on your test results. It is implemented in 5 separate stages, starting with limiting your diet to the least reactive foods and gradually moving on to other foods that are more reactive. The idea is that we lower the inflammation and quiet your immune system and then slowly add back in foods. The diet in it’s most restrictive phase will still allow you to live your life, but we may find out that the food you eat every day for breakfast is something you are reactive to. If that’s the case, we better change it. So there is a level of flexibility you must be willing to practice to see optimal results and healing in your body.
One of the beautiful things about this program is you test, and then you eat food that is good for you, nourishing your body, and you simply remove foods that are harmful and allow your body to heal. Depending on the severity of your condition ( like IBS) you will likely see results within 5-10 days, for those with eczema, it may take a bit longer to see improvement (2-3 weeks). You do not need to take supplements or purchase any type of detoxifying formula to see improvements, the idea is to heal and eat real food.
HOW CAN I GET STARTED?
I’m glad you asked! Let’s set up a 30 minute consultation where you can learn more about it and I can screen you to make sure the test is best for you. It’s only $35 to schedule the initial consult. If you choose to move forward I decrease the price of the testing and package by $35, so you have nothing to lose. Our meeting can be completely virtual, so don’t let distance stop you from getting started and ridding yourself of foods that are harming your body rather than nourishing you! Click here, fill out the form and I will be in touch to set up an appointment.
Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore."
110 N McClelland Street
Santa Maria, California 93454