Gut Inflammation & Dysbiosis / SIBO & IBD

Table of Contents

Key Takeaways

  • Understand the common signs of SIBO

SIBO is a controversial topic, but one that is gaining traction within the health community. We explore the common causes of this condition, and ways to use nutrition, lifestyle and supplements to try and reduce symptoms.

  • Understand how SIBO is frequently diagnosed

  • Know how to modify diet, lifestyle and use supplements to minimize symptoms

  • Understand the etiology of IBD IBD is a serious medical condition that is rapidly increasing in prevalence in the modern world. We discuss the multifactorial causes of IBD, and ways to modify nutrition and lifestyle around this disease, to try and reduce the number of “flares” that require additional medical attention.

  • Apply changes in nutrition, lifestyle and supplementation to reduce the exacerbations in disease

  • Understand the purpose of the supplements listed in the slides, along with a high level understanding of how those supplements function

SIBO

• An outgrowth of the microbiota in the small intestine

GI tract isn’t all equal in terms of amount of bacteria <1000 in stomach, <10000 in small instesting, <10000000000 in large intestine

Common symptoms include:

  • Stomach pain after eating
  • Bloating
  • Cramps
  • Consistent feeling of fullness
  • Gas

SIBO is more frequently associated with:

Inflammatory:

  • Viral infections
  • Celiac
  • Gut autoimmunity

more inflamed your bacteria, the more bacteria

Poor gut motility

  • Nerve damage
  • Gastric bypass surgeries
  • Hypothyroidism - slowing down of all biological processes

Causes?

  • Physical structure abnormalities in the small intestine
  • Altered pH
  • Altered or decreased immune function (specifically decreased Ig production)
  • Poor muscular movement of the small intestine

Diagnose SIBO

  • Excess bacteria in the small intestine can lead to the release of the gases hydrogen and methane, which can be identified through a breath test

    will confirm that you do have SIBO but doesn’t mean you don’t have some form

  • Other more invasive tests exist that involve sampling the gut products from the small intestine

Working to Reduce SIBO-

Diet

  • Start with a low FODMAP diet (Fermentable Oligo-, Di-, Mono- saccharides And Polyols)
  • Foods to FOCUS on:
    • Carbs: • Sweet potato/yams, rice, rice noodles, oats, winter squash, summer squash, green beans, bell peppers, carrots, spinach, blueberries, strawberries, melon, citrus fruits, pineapple, corn, corn tortillas, gluten free cereals (corn or rice based), quinoa
    • Proteins: • Beef, chicken, lamb, pork, turkey, fish, eggs, lentils
    • Fats: • Cheese- all firm varieties, cottage; ricotta cheese, yogurt (plain and lactose-free) • Milk- (lactose-free) Almond, hemp, quinoa, rice, or oat milk, ghee, butter • Almonds, Brazil nuts, hazelnuts, macadamias, peanuts

Supplements

  1. Gut Barrier Healing

    reduce inflammation which reduces bacterial load Zinc Carnosine • Protects and stabilizes the gastric and intestinal mucosal lining • Zinc is a critical co-factor for many enzymes involved in cell proliferation, especially in epithelial cells

    co-factor makes enzymes function properly

    • Carnosine has also been shown to play a role in wound healing and improves the absorption of zinc

    GI Revive • Cocktail of multiple ingredients with anti-inflammatory/barrier repair ingredients • Mixture of high, medium and low level of scientific support for each ingredient

  2. Reduction of the bacterial outgrowth

    • Apple cider vinegar (2oz daily): Acts as a natural antibiotic • Berberine (500mg daily): Anti microbial properties along with a ton of other reported health benefits • Oregano oil 600mg daily: Natural antibiotic

  3. Restoring healthy/probiotic bacteria

    A randomized controlled trial of VSL#3 (twice daily for 8 weeks) in patients with IBS showed that abdominal bloating was significantly reduced as compared to placebo

Additional Lifestyle Suggestions

• Reduce high intensity training for several weeks, as this is a known gut barrier disruptor • Improve sleep quantity significantly if at all possible • Reduce stress as the excess cortisol is a known gut barrier disruptor • Use well cooked, crock pot style recipes, avoid raw cruciferous veggies to make digestion as easy as possible

really well broken down before you even eat them

IBD

Group of diseases involving the small and large intestine

  • Crohn’s and Ulcerative Colitis represent the most common types of IBD
    • Despite being very different diseases they share many common symptoms • Pain • Diarrhea • Bleeding • Cramping • Weight loss • Anemia

Causes

  • Genetics are strongly associated with IBD, with genes related to the immune system and intestinal barrier function
  • Diet is clearly an associated risk factor as well
    • Gluten sensitivity is is reported in 23.6% and 27.3% of Crohn’s and UC patients respectively
    • High protein diets are also associated with IBD relapses
  • Microbiome may contribute as well
  • History of antibiotic usage is also linked to IBD
    • Individuals are more likely to have had Abx in the 2-5 years prior to the onset of disease

REMINDER!!!

• Unless you are a RDN, you are not authorized to treat diseases • However, you can work with these patients and take their medical condition into account while building out their lifestyle adjustments related to overall health and happiness

How to Work Around IBD

  • Many of the typical rules get flipped on their head for people suffering from gut inflammation
  • Veggies and “roughage” while great for a health gut are often problematic for an inflamed one
    • Start with several WEEKS up to a full MONTH of NO veggie intake of any kind
    • Start adding back in veggies that are extremely well cooked, peeled and seeded
      • Crock pot and pressure cooker works best
  • Reduce overall fiber intake

30-50 is normal for athletes

  • Avoid high fat/fried foods

  • Add protein in smaller doses throughout the day, don’t avoid completely

  • Many patients with IBD have nutritional deficiencies due to poor absorption. As a result, consider adding:

    • Iron rich foods (Blackstrap Molasses, well cooked baby spinach)
    • B12 supplements
    • Electrolytes
      • Bone broths are particularly helpful
      • Potatoes, bananas, tomatoes, avocados, melons, grapefruit, oranges (remove outer pulp), coconut water

Trying To Heal With Nutrition And Supplements

Gut Barrier Healing • Zinc Carnosine • GI Revive

Microbiome restoring VSL#3 • Resistant Starch / Sodium Butyrate

Potato Starch Guidelines

Rich source of resistant starch Start with a small dose and increase every 10-14 days • 1⁄2 tsp • 1 tsp • 1.5 tsp • 1 TBSP • 1.5 TBSP Overall goal, including from regular food, would be 15-30 grams/day

Take Home Points

  • The gut and the microbiome are intimately connected to how our body operates
  • Dysbiosis and/or leaky gut are closely connected to a number of disease states
  • Diet, lifestyle and smart supplementation can improve your gut health, having far reaching consequences for the body overall

Practical Application

  • Eat a diverse diet rich in fiber to increase the diversity in your microbiome
    • Eat MOST of your food within the daylight hours
  • Exercise, sleep and actively work to minimize stress
  • Smart supplementation
    • For everyone:
      • VSL-3 probiotic (anti-inflammatory, anti-obesity, pro mental health)
      • Potato starch or resistant starch (SCFA generation)
  • For those with leaky gut type issues, add:
    • Zinc Carnosine
    • Berberine
    • Expand based on specific symptoms

Notes mentioning this note

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