Is bloating getting you down?
“Why can’t anyone tell me how to fix this?”
Anonymous client
Do you feel like air is trapped in your system, and you cant even wriggle it out? Do you find at times it is really quite painful? Enough to get in the way of your enjoyment of life?
Well, I am pleased to tell you that there is something you can do about it. But first you need to get as close as you can to the root cause. In this article I am going to take a look at the most common causes of abdominal bloating, abdominal pain, burping, farting and excess gas generally. Along with these symptoms, often comes diarrhoea or constipation or both (alternating), and less commonly fatigue, acid reflux, fullness after meals, nausea, brain fog, mood disorders (anxiety and depression), skin rashes, nasal mucus and respiratory problems eg asthma. With the right approach, all these should significantly improve if not disappear completely.
If you went to your GP with a bunch of these symptoms, you would be told that you have IBS, which merely provides you with a convenient label for your symptoms – it doesn’t tell you what is causing them or what to do about them. 20% of the world population has IBS (Irritable Bowel Syndrome). It is the most common functional gastrointestinal disorder and yet it is so poorly understood – not only by those who suffer from it but also by the many doctors who try to treat it.
What could be causing these symptoms?
Well here is the long list:
Food allergy
Food sensitivity
Carbohydrate intolerance (malabsorption)
Celiac disease
SIBO (Small intestine bacterial overgrowth)
Yeast overgrowth
Low stomach acid (often due to taking a prescribed Proton Pump Inhibitor)
Parasites
Inadequate chewing (I kid you not!)
At the more serious end of the spectrum these symptoms are also associated with Inflammatory Bowel Disease (IBD) and cancer.
This article is going to cover the first three in depth, and the next two briefly.
Food Allergies and Sensitivities?
‘The old saying goes: one man’s medicine is another man’s poison. Nowhere is this truer than when it comes to our different and unique responses to food. And nowhere is there more controversy than around the subject of food allergies and consequent illness. This prevents doctors from helping millions of people suffering from allergic, inflammatory, immune or toxic reactions to the ordinary food they consume every day’. (Mark Hyman - The Ultra Simple Diet, Simon & Schuster 2007).
Many people realise that they are having issues with food; they know something in their diet is not agreeing with them, but if they ask to be tested they are usually recommended a skin-prick allergy panel or perhaps a conventional blood test. This type of allergy testing is useful but only looks at one way we react to foods – an immune response known as IgE. There are a number of other types of reaction that can be triggered by certain foods or food categories. There also seems to be much confusion around terminology, with terms such as allergy, intolerance and sensitivity used interchangeably. So what is the difference between a food allergy, a sensitivity and an intolerance? This article aims to comprehensively set you straight on this most relevant aspect of our overall health – one that impacts c 80% of us to a greater or lesser extent.
IgE reactions (‘Allergies’)
When people think of food allergies, they think of someone eating a peanut and ending up in A&E with a swollen tongue, hives, dizziness or the inability to breathe (anaphylaxis). Without immediate treatment (with an injection of adrenaline) it can be fatal. That is an IgE reaction where the immune system produces immunoglobulin E antibodies, aimed at a protein that it views as ‘antigenic’ (foreign/potentially dangerous). Each type of IgE has a specific “radar” for each type of allergen.
Antibodies are part of our immune system and our bodies produce them in response to foreign substances like bacteria and viruses, but also to foods, dust, dander and pollen. Antibodies help the body mount an immune system response against such invaders (by sending a message to your mast cells to secrete histamine) causing an allergic reaction.
Nine foods are responsible for the majority of allergic reactions: cow’s milk, eggs, fish, peanuts, sesame, shellfish, soy, tree nuts and wheat. However being allergic to a food many also result in your being allergic to a similar protein found in something else. This is called ‘cross-reactivity’. This happens when the immune system confuses one protein for another. For instance, if you are allergic to birch tree pollen (a primary airborne allergen responsible for hayfever symptoms in the springtime), you may well have reactions triggered by peach, apple, pear, plum, coriander, fennel, parsley, celery, cherry and carrot!
Although the symptoms are often not as severe as described above (usually rashes, vomiting, diarrhoea, blocked nose), an IgE reaction, which can be triggered by just a single molecule of that food, shows up pretty quickly – like between a couple of minutes and a couple of hours. This is correctly called an ‘allergy’ and it turns on an aggressive histamine reaction which is what creates the symptoms. So these reactions can be serious but often aren’t.
IgG and IgA reactions (‘Sensitivities’)
However there are two other types of immunogenic (immune-system-triggering) food reactions that are much less dramatic and far more common. These are IgG (where the immune system produces Immunoglobulin G antibodies - 75% of total antibodies in blood) or IgA reactions (where the immune system produces Immunoglobulin A antibodies - 10-15% of antibodies, mainly in mucus membranes) – again towards a protein that it views as ‘antigenic’. The biggest culprits for these reactions are gluten, cow’s milk and soy milk, with eggs not far behind.
The extent of symptoms (abdominal pain, rashes, asthma, cramps, constipation, diarrhoea, colic, migraines sinus & nasal congestion, fatigue) relate to the amount and frequency of ingestion of the food, and are typically delayed – anywhere from a 12 hours to a 72 hours, making it more difficult to make the association between offending foods and the symptoms. The symptoms can be quite subtle and many people live with them for years, if not their entire lives, often not aware of the root cause.
This is correctly called a ‘sensitivity’ but is no less important despite its less dramatic title. Mostly ignored by conventional medicine, this reaction creates suffering for many more people and plays a significant role in many chronic illnesses and weight problems.
Both IgE allergies and IgG sensitivities are on the rise in our culture for many reasons. Often we develop sensitivities to foods we eat all the time, and over-consumption puts our body into a hyper-alert mode. Over time, immune reactivity in the gut exerts wear and tear on the gut lining, inhibiting nutrient absorption, ultimately causing the breakdown of the gut barrier that protects our immune system from the outside world of food, microbes and toxins that are passing down our digestive tract. This is known as Leaky Gut. If you don’t know you have a sensitivity and you keep eating the offending foods, you increase your risk of developing an autoimmune disease, neurological disorders, and more.
Leaky Gut
Over 60% of our immune system lies just beneath the gut barrier. When the lining of the gut breaks down, undigested food particles, toxins and remnants of microbes, get through the barrier into our blood stream and trigger an immune system reaction (more food sensitivities), which sets off a chain reaction leading to inflammation throughout your body (systemic inflammation), but for no productive reason. While so doing, it has compromised the immune system’s reserves to fight bacteria, viruses and parasites.
This can lead to a whole host of serious conditions: headaches/migraines, joint pain/arthritis, depression, weight gain, inability to lose weight, water retention, fatigue, brain fog, autism, heart palpitations, hyperactivity, mood problems, sleeping problems, sinus and nasal congestion, acne, eczema and autoimmune disease. These conditions are all associated with inflammation.
Just to be clear, while the original reaction to a food starts in the gut, it doesn’t necessarily create gut pain, and it doesn’t necessarily stay contained in the digestive tract. Through having a ‘Leaky Gut’ the inflammatory process that started in the gut spreads and manifests in other areas of the body, sometimes quite far away. This condition is the biggest driver of autoimmune disease, which is escalating at the rate of an epidemic in the Western world.
While I am here, and while you are contemplating the seriousness of Leaky Gut, it might be as well to quickly revise all the things that contribute to a breakdown of our precious and oh-so delicate gut barrier:
1) Food allergens and sensitivities eg gluten, causing inflammation within the gut
2) A nutrient poor diet, high in sugar and white flour and low in fibre
3) Nutritional deficiencies in zinc, vitamin A and vitamin D
4) Overuse of antibiotics, medications and NSAIDs (ibuprofen and paracetamol)
5) Exposure to environmental toxins – chemicals, pesticides/herbicides, plastics etc
6) High levels of stress
7) Elevated blood sugar (either from diet or high levels of stress)
8) Excessive alcohol or fructose intake
Which foods are likely to trigger IgG or IgA?
While everyone is different, there are some foods that irritate the immune system more commonly than others. These are (in order) gluten (a protein in grains including wheat, barley, rye, spelt and kamut), casein (a protein in dairy eg milk, cheese, butter, yoghurt), corn, eggs, soy, nuts, citrus fruits, nightshade vegetables (tomatoes, potatoes, red peppers, aubergines), and yeast (baker’s yeast, brewer’s yeast, wine, vinegar, fermented products).
How should I respond?
A diet that minimises foods that provoke these responses will calm your immune system and decrease inflammation (and therefore symptoms). Inflammation is the tool of our immune system and is at the heart of many conditions that are detrimental to health and quality of life. Considering that our gut would cover much of a tennis court if stretched out from end to end, controlling even a small amount of inflammation in something this size provides huge benefits. Research continues to emerge regarding the consequences of inflammation in our gut and how foods trigger an inflammatory process throughout the body.
As inflammation decreases, the intestinal lining begins to heal. Happily, rebuilding the gut results in strong protection for the body from irritating foods. Look after your gut lining, and you are far more likely to be able to eat what you want without worry.
Calming down your immune system
With 70% of our immune cells housed in our gut, a healthy gut contributes heavily to our “immune tolerance”. A ‘tolerant’ immune system is what we want. A tolerant immune system is a healthy immune system, prepared to fight infection when necessary, but not in a state of hyperactivity or hypervigiliance. An out-of-balance immune system (either underactive or overactive) creates inflammation that can set off a cascade of events ultimately resulting in many symptoms and conditions, or worsening existing ones.
To calm our immune system we need to minimise stress, heal Leaky Gut, support the gut with Zinc, Vitamin A, Vitamin D, Vitamin C, and maybe dose with the probiotic that majors on Bifidobacter, which trains the immune system to be tolerant. Curcumin is also useful as it dampens excessive immune response.
How do I know if I have Food Sensitivities?
While there are blood tests to help you identify IgE, IgG and IgA sensitivities, they are expensive and not entirely reliable. I use three different ones depending on the client and the issues at play, Cyrex Labs, Precision Diagnostics and KBMO, all US-based laboratories, but all available in the UK now. A lot of controversy surrounds blood tests that screen for food sensitivities based in IgG and IgA. As IgA resides in the mucosal layers of our body, this is not very efficiently tested via blood, but IgG testing has been found to be useful. Food exclusion diets based on the results of these tests have without doubt provided relief for symptoms of ulcerative colitis, IBS, migraines and skin disorders.
The Gold Standard test (and the only way you will know for sure what foods are a problem for you) is to eliminate them fully (that means 100% I am afraid, not 95%) from your diet for a short time (4 weeks). This is not only totally reliable but costs nothing! To be effective, eliminations must be cold turkey. The most common offenders (dairy, grains, legumes and soy) along with gut antagonists (artificial sweeteners, processed foods, industrial seed oils and alcohol) need to all be removed from the diet for this period (making your diet Paleo) and then reintroduced in quantity one at a time (pref not the gut antagonists).
By removing all the possible culprits, you will cause your armies of immune cells to cease their action and gradually return to barracks. The plan is then to catch them unawares! Only one food should be reintroduced at a time, with 4 days break before you introduce the next food. Re-introductions need to be done in quantity, over consecutive days – 2 full servings for each of 3 days in a row. You need to realistically challenge your immune system’s tolerance with normal portions and preferably a variety of preparations. If your immune system doesn’t like the food, YOU WILL NOTICE! Look for inflammatory symptoms (which may be quite different from the symptoms you previously experienced). Pay careful attention to your entire body and energy levels. Common symptoms of a food sensitivity include headache, lethargy, stomach upset, stomach cramps, achy joints, muscle pain, trouble sleeping, itching, depression/anxiety, and skin breakout eg eczema. If symptoms appear, move on to the next step.
Then what do I do to get rid of them?
Once you have identified your sensitivities, whether by testing or by an elimination diet, you need to remove your most severe sensitivities from your diet for a period of 4 months (again cold turkey and 100% - one slip and you will need to go back to the beginning again). This will allow the immune system to calm down (the antibodies to those foods, with their half life of 21 days, will reduce to about 5% of their previous level) and the gut barrier to heal (some healing supplements eg L-Glutamine and Zinc Carnosine would be a good idea).
At the end of this period you need to re-introduce carefully and in a structured way (as above). 2 normal servings per day for 3 days in a row. Only reintroduce one food at a time. Stop the reintroduced food after 3 days and take a 4 day break before trying another food. Smaller, interrupted, inconsistent or overlapping food intake during reintroduction will produce equivocal results which will be very frustrating for you after you have invested so much time and patience in the elimination process. Make notes of what happens.
If you do this, there is a very good chance that you will be able to reintroduce all or nearly all of the foods removed with no effects after a few months. There is often a food (or two) that requires a further elimination (maybe for a total of 6-9 months), and very occasionally I find there is a food that simply cannot be successfully reintroduced even after a year of elimination. These are probably permanent sensitivities that simply need to be avoided long-term.
If you suspect that your food sensitivity is driving a more severe condition like inflammatory bowel disease (IBD), Crohn’s disease or ulcerative colitis, the Autoimmune Protocol (AIP) diet, which goes a step beyond Paleo by removing eggs, nightshades, coffee, nuts and seeds, might be prudent. In a 2017 study, 11 out of 15 IBD patients who adopted an AIP diet achieved clinical remission in just 6 weeks! This further supports the idea that the gut health and food sensitivities are intricately linked.
In my opinion everyone should do a form of elimination diet at least once in his/her life, since many people don’t even realise that they have symptoms until they experience what it is like to live without them. For example you might think that you have frequent headaches or acne breakouts because it runs in your family, but after doing an elimination diet you might notice these symptoms in fact resolve when you remove the offending foods. I only found out that I had a problem with cow’s milk after I did a two month elimination of it to accompany a client who was struggling with eliminating dairy. I had had no apparent issue with cow’s milk until that point.
Of course you could take the view that you would rather not know, and not lose what appears to be your ability to tolerate a particular food. That is not wise. Your immune system will be constantly activated by that food, and that will wear down your gut lining. You will get a Leaky Gut. Ultimately an inflammatory condition, and worse, an autoimmune disease, will catch up with you.
Non-Celiac Gluten Sensitivity
I can’t complete an article such as this without a paragraph on this sensitivity. Firstly, for clarity, Celiac Disease (CD) is not technically an allergy but an autoimmune disease, involving an inflammatory immune response to gluten that severely damages the gut. Unfortunately many patients with CD have no gastrointestinal symptoms and so may not even know they have it. These silent forms are far from harmless. We know that in people with silent celiac (with no gut symptoms) about 50% of them have skin manifestations like eczema or dermatitis. Most dermatologists don’t realise this, let alone the general public.
CD only screens for antibodies to one of many components of gluten – alpha-gliadin. There are many other components of gluten that people can react to – a condition called NCGS – Non-Celiac Gluten Sensitivity. Despite its inexact diagnosis, NCGS is real and there are numerous studies to prove it. Double blind, placebo-controlled trials indicate that people who don’t have CD or a wheat allergy can (and do) react horribly to gluten. This can produce a wide range of symptoms: fatigue, abdominal pain, diarrhoea, constipation, bloating, headache, anxiety, brain fog, eczema, asthma, joint pain, depression.
Unfortunately, many doctors still don’t take NCGS seriously, which does a huge disservice to those suffering. In fact NCGS if undiagnosed can be even more serious than CD. Leaky Gut, leading to systemic immune activation and systemic inflammation are consequences of it. By continuing to eat gluten, people with NCGS are at higher risk of developing arthritis, Hashimoto’s thyroiditis, multiple sclerosis, gluten ataxia, diabetes and even Lou Gehrig’s disease.
If you are one of these, you should absolutely cease. There are many gluten-free alternatives now on the market, some of which are extremely pleasant.
Food Intolerances
The triggering of an immune system reaction is not the only reason that you might not be tolerating a certain food. Food ‘intolerances’ are nothing to do with activating your immune system – so, not caused by the generation of antibodies attacking proteins. An ‘intolerance’ means that the body is not able to process or digest (ie breakdown) and absorb the food appropriately. So ‘malabsorption’ is another word for food intolerance. This can result from specific enzyme deficiencies (which can be genetic or due to lack of ingredients to make that enzyme), damaged gut lining inhibiting the release of those enzymes (maybe due to inflammation in the bowel from food allergies/sensitivities or celiac disease), lack of stomach acid and therefore inadequate breaking down of the food prior to absorption, lack of a healthy diverse microbiome, or other gut issues.
In the normal course of events the food you eat travels through your stomach and into your small intestine for absorption. Anything that isn’t digested and absorbed there continues on to your large intestine where bacteria break it down by fermentation. When bacteria start fermenting the foods, they release gases such a hydrogen and methane. If these gases build up too rapidly without effective release from the body, it can cause symptoms such as abdominal pain, fullness, indigestion, bloating, gas, cramps, skin reactions, nausea, diarrhoea and constipation. The onset can be minutes or can come on over days, and the degree is portion dependent.
Often it is difficult to distinguish a food intolerance from a food sensitivity because both the timing of onset of symptoms and the symptoms themselves are very similar. However food intolerances don’t represent anything like the same risk to your health. Yes, they can be very uncomfortable, but the real danger comes, maybe surprisingly, from nutrient dense foods being eliminated from the diet for a long period of time. Also eliminating these foods doesn’t actually cure the problem. So the trick is to eliminate problem foods for a relatively short time to give some relief from symptoms, get on and heal and rebalance the gut, and then reintroduce as many foods as possible while optimising stomach acid and supplementing with good quality digestive enzymes.
FODMAPs
FODMAPs in my experience cause more problems than any other category of food. These are short-chain carbohydrates fermented by gut bacteria to produce hydrogen. The most problematic FODMAPs are lactose, fructose, inulin, and sorbitol; these are specific food ingredients that are commonly hard for humans to digest and thus create a potential feast for your gut microbes that are waiting patiently in your colon (or in your small intestine if you have SIBO).
Lactose is found in milk and dairy products
Fructose is found in fruit, honey, agave syrup, processed foods
Sorbitol is found in berries, apples, apricots, avocados, cherries, peaches and plums (stone fruits).
Inulin is found in asparagus, bananas, chicory, garlic, leaks, Jerusalem artichokes, onions, soybeans. (NB. These are also naturally occurring prebiotics, which is normally a welcome food for our gut bacteria, but prebiotics are not advised for Inulin intolerant people as they will trigger their symptoms).
With the first two, lactose and fructose, people will often suffer from consuming these foods due to low or no production of the enzyme needed to digest them. Lactase is the enzyme that digests milk-sugar, lactose. It is present in babies and young kids, presumably so they can digest breast milk, but many people don’t maintain lactase production beyond childhood. For those that do maintain it, they can easily lose it due to damage to the gut lining from antibiotics or infection which results in a (temporary) drop or loss of lactase production. If you are lactase-enzyme deficient, you won’t be able to digest lactose in milk or milk products, and you have therefore acquired an intolerance. Conveniently with lactose intolerance, you can consume a supplement Lactase at the time of the meal which will help you digest lactose. Similarly, Xylose Isomerase (often referred to as Fructase) is a fructose-digesting enzyme that will help your body to digest the Fructose in food.
FODMAP intolerance is often a struggle for people who are sensitive to gluten, due to the damage that gluten has inflicted on their gut lining. It is also a common intolerance in people who have irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO). By sticking to a low FODMAP diet most will get relief from symptoms, but, as I have already said, it isn’t advisable in the long term because you are removing nutrient dense, antioxidant-rich foods that increase microbial diversity and give rise to the production of butyrate (a by-product of microbial fermentation) which is essential for colon health. So, while reducing FODMAPs on a short term basis, it is essential to be looking upstream to the root cause of the problem and addressing that.
When you come to reintroducing FODMAPs (after 4-6 weeks of removing the moderate to high FODMAP foods), you need to reintroduce slowly and systematically to determine tolerance. Pick one class of FODMAPs at a time to reintroduce. Try small quantities of that food every day for three days to assess tolerance. Then increase portion size over the next 3 days if the food is tolerated. If not, try another food from the same class or move on to another class of FODMAPs, leaving a few days if experiencing symptoms.
Most people aren’t sensitive to all the different classes of FODMAPs. So experimentation to find out what does trigger your symptoms is really important so that you can add as much of the other foods back into your diet as possible.
There is an excellent device called a Food Marble, which allows you to measure your FODMAP intolerances by measuring the amount of hydrogen and methane in your breath, and thus work out which foods are triggering you. From there you can go on to work out the dose of each food that you can tolerate. Absolutely brilliant. I have recommended them to a number of my clients.
Fodmate from Microbiome Labs is one of the best fodmap-specific enzyme products. It is a digestive enzyme blend that helps break down potentially troublesome FODMAPs, helping to overcome occasional digestive issues without the need for a prolonged, complicated, restrictive diet.
Phytochemicals
Apart from FODMAPs, the body can also react to a whole bunch of phytochemicals in foods. Phytochemicals are chemical compounds naturally found in plants – they give plants their colour, flavour and aroma. Eating them is normally beneficial. But there are a number of troublemakers for those who have sensitive guts or poor gut health. Here are the most common ones, which, to reiterate, are not a problem for those who have great gut health, but which can be most unpleasant for those that don’t:
Lectins – carb-binding proteins found mainly in legumes, nightshades and grains. They have an affinity for the gut lining tissue (epithelium) and can interfere with nutrient absorption. They are known for causing GI tract irritation and are implicated in decreasing stomach acid production (bad) and causing inflammation. Soaking legumes significantly reduces the lectin content, as does pressure cooking.
Salicylates – naturally occurring aromatic chemicals that help plants defend themselves against insects and fungi. (they are the main ingredient in aspirin, muscle relaxants, topical acne products and cough medications). They can cause symptoms such as congestion, swelling, hives, brain fog,, gut issues and fatigue.
Oxalates – are organic compounds found in varieties of plants inc leafy greens, legumes, nuts, seeds, cacao, soy and fruit. They have an affinity for binding to minerals such as calcium or iron and are thus associated with kidney stone development. Accumulation of oxalates in the body is implicated in muscular pain syndromes such as fibromyalgia and autoimmune conditions such as lupus and rheumatoid arthritis.
Amines/histamines – these are organic compounds formed during protein breakdown from cooking, aging (think leftovers), maturing/fermenting (cheese, pickling, vinegar) and ripening (fruit and avocados). Symptoms associated with amine intolerance most notably are migraines or headaches, blocked nose, eczema, rashes, high blood pressure, and gut distress. Low diamine oxidase (DAO, an enzyme produced in the small intestine to break down histamine) can contribute to this intolerance. Classic histamine symptoms include congestion, itching, swelling, shortness of breath, tearing, but it can often cause gastrointestinal symptoms such as bloating, nausea, vomiting and diarrhoea.
Just to reiterate, Food Intolerances will not show up on a Food Sensitivity test. And these phytochemicals are more complex to identify and resolve than FODMAP intolerance, so if your symptoms don’t resolve with your newfound knowledge on food sensitivities, allergies and intolerances, then you might need to seek the advice of an expert.
Food additives
These can also cause intolerances. The addition of sulphites, nitrates, food colourings to foods may enhance their appearance, flavour and reduce bacterial growth so that their shelf life is extended. However sulphites have been shown to cause asthma attacks, MSG and nitrates cause headaches, hives or other skin reactions (generally not serious), and food colourings (red and yellow in particular) are linked to anaphylaxis which can be life threatening.
How to overcome a Food Intolerance
Whereas people with food allergies generally have them for life (although children sometimes can outgrow allergies to milk, egg, wheat and soy), just as with a Food Sensitivity, you may well be able to do something about a Food Intolerance by healing your gut. Here are some ways to fix your gut:
Increase stomach acid – using supplementation, apple cider vinegar or Swedish bitters. Stomach acid is needed for digestion. Although many people think they have too much stomach acid, they may in fact have too little.
Get tested and treated for SIBO or dybsiosis to re-establish a health gut flora
Eat fermented foods and consider taking a probiotic supplement
Drink bone broth. The gelatine, glycine, and glutamine in bone broth all have beneficial effects for the mucosal lining of the gut. (Alternatively supplement with L-Glutamine)
Anyone heard of SIBO?
SIBO is a condition that means that gut microbes are in the wrong place. We have microbes living in every part of our body and this is totally normal and healthy. As we move through the digestive tract, the number of microbes at each site increases. We have the most microbes in our large intestine, or colon, which is where they ferment (eat) the fibre that we haven’t digested and absorbed. In so doing they create gas as a natural byproduct of their digestion, but that gas is low down in the GI tract and releases in little farts all day/night long - this is totally normal!
However, sometimes beneficial microbes can migrate upwards, via the ileocecal valve (which should normally keep them out) into the small intestines, (where they definitely shouldn’t be hanging out). Here they find wildly abundant food sources from our semi-digested meals and wreak havoc by producing excessive hydrogen, giving rise to abdominal pain, bloating, diarrhoea, constipation, gas and burping. They also disrupt the fine balance of the small number of resident bacteria that are an essential part of a healthy small intestine.
Welcome to SIBO – Small Intestinal Bacterial Overgrowth. SIBO unfortunately isn’t in the “uncomfortable but not a risk to your health” category. Not only is it quite uncomfortable, it significantly interferes with digestion of food and absorption of nutrients, primarily by damaging the cells lining the small intestine (the mucosa) which is where all our food is absorbed. And of course, as you will understand, that leads to Leaky Gut.
SIBO can be confirmed with a carefully executed breath test, and it needs to be distinguished from a Food Intolerance, as the treatment is antibiotics or herbal antimicrobials (with diet) which is quite different to a Food Intolerance. And you can’t run the Food Intolerance breath tests if you have SIBO as you will get false positives.
I am not going to go into what causes SIBO or how SIBO can be treated as it is a complex subject, but suffice to say that it is a very common condition and difficult to treat, and both patient and practitioner have to have commitment, dedication and patience! However it is possible – I have done it.
Parting shot
Although we have a lot to learn about food intolerances and sensitivities, ever-growing research proves that they aren’t psychological or make-believe. Don’t just put up with them. Don’t blame the discomfort on genetics. Don’t allow yourself to think they don’t really matter. They do, and you don’t want the consequences down the road of ignoring them.
There is a lot to take in in this article, but I hope that if there are two things you take away from it, it is 1) that symptoms that might seem uncomfortable but benign, like bloating and excess gas, can do serious damage to your gut over a period of time, and 2) that non-gut symptoms are very frequently connected to a gut problem, even if there are no gut symptoms. We are now really coming to understand from a modern scientific evidence perspective that there is a gut-brain connection, there is a gut-skin connection, there is a gut-immune and autoimmune connection and there is a gut-metabolism connection. So if you are not feeling on tip-top form, thriving and full of energy, look first to your gut health. It isn’t a cure-all, but before you go looking into other things, I strongly advise starting with the gut, optimising your gut health and then re-evaluating, because there is a very wide array of symptoms that may rectify after you have improved your gut health. All disease begins in the gut. Hippocrates knew that 2500 years ago, but we conveniently forgot.