I had a potential new client in my office today who had been diagnosed by her family doctor with Irritable Bowel Syndrome several years ago. When she asked what she should do next, he told her to "go read about it".
There is so much misinformation online: treatments based on outdated science, "it-worked-for-my-sister's-neighbour" stories and down right bad advice.
Unfortunately, she did not have a medical degree or background in research to be able to decipher the good from the bad. She knew that the info she was seeing on Yahoo forums was probably questionable, she didn't know where to go to find good information. So she was referred by her pelvic floor physiotherapist to me. "Reading about it" had done nothing for her and she was sick and tired of daily diarrhea.
She is not alone.
One of the most common causes of IBS is a little known condition called Small Intestinal Bacterial Overgrowth (SIBO) - [read my previous blog post here].
While you should absolutely work with a knowledgeable health professional, there are several tell tale signs that your IBS is actually due to SIBO (and not a deficiency in "reading about it").
5 Key Signs You Might Have SIBO:
If any of these sound familiar, let's set up a time to chat. Book your complimentary Health Discovery Session to discuss your options.
Getting the right testing is the first step to getting better.
The good news is that there are some very good tests you can do to see if SIBO is causing your IBS. Based on your results, we can create a customized plan to get rid of the discomfort, gas, bloating and bathroom embarrassment. Once and for all.
In my next blog, we will talk about some of the testing you should have to finally get rid of your Irritable Bowel Syndrome.
Ever had a "Bridesmaid moment"? One of my patients the other day told me about hers. The thing is, she eats exceptionally healthy, exercises, meditates daily and has one of the sunniest outlooks on life I've ever seen. She did not have food poisoning. But her digestive system was a mess.
In fact, she had been diagnosed with Irritable Bowel Syndrome (IBS) and her doctor also suspected
Irritable Bowel Syndrome is estimated to affect between 10-15% of Canadians (1). I would tend to say that these numbers are extremely conservative because many people with digestive disorders may not seek care from their medical doctors, or it may take several years to receive a diagnosis. In fact, the vast majority of my clients have one or more digestive concerns.
If you have one digestive issue you are likely to have another. They are not unrelated. This is not a fluke. And you're not going to fix it unless you treat the whole system, or more practically, treat you as a person rather than a collection of mouths, stomachs, guts and colons.
The most common digestive issues that I see and treat are:
Treatment for these concerns may not be particularly helpful and can often cause additional concerns. For example, Proton Pump Inhibitors (PPI) are commonly prescribed to treat heartburn. Side effects of Nexium (Esomeprazole) a common PPI, include constipation, watery diarrhea, abdominal cramps, stomach pain, and nausea (2). Other PPIs may decrease absorption of calcium, magnesium, zinc, iron and vitamin B12, increase risk of Community Acquired Pneumonia, C. difficile infection, Traveler's Diarrhea, and Small Intestinal Bacterial Overgrowth (3).
Moreover, these medications work by decreasing acid production within the stomach. While this may alleviate heartburn (read my thoughts on this here), this is like cutting off your nose to spite your face.
The thing is, we need lots of stomach acid. The stomach's job is to burn off parasites, molds, bacteria and viruses to help protect our body from infections. Without a strong acid barrier, our body is not going to be able to protect against these nasty things. In particular, heartburn is associated with Small Intestinal Bowel Overgrowth (SIBO) - a condition of inappropriate types of bacteria hanging out in the small intestine where they shouldn't be. This is relevant because SIBO is conservatively estimated to be the direct cause of Irritable Bowel Syndrome in 40-85% of cases.
That's right, IBS is not idiopathic or in your head. To add more fuel to the fire, a 2009 study showed that people with GERD were 3.5 x more likely to develop IBS and that people with IBS were 2.8x more likely to develop GERD (4).
So, what can we do about it?
Treat the Cause.
Here are the big priorities.
If you find this article helpful or surprising and would like to learn more, I would love to invite you to book a complimentary Health Discovery Session with me to discuss your options.
In happy digestive health,
There's a burning fiery pit in your chest. It's not a heart attack. You've checked with your doctor before.
It's feels heavy, uncomfortable and burns. At your last visit you were told that you probable have GERD. And you think, "what a goofy name for something that feels like hell!"
Heartburn, or Gastroesophageal Reflux Disease (GERD) accounts for one out of three primary care visits, and has been increasing quite dramatically over the last two decades (1). It's now estimated that 18-27% of adults in North America experience heartburn at least once weekly (2), and many experience it daily. Which absolutely sucks.
This sharp increase can be attributed to rising rates of obesity, and is more common amoungst smokers and with age.
Common symptoms of GERD include:
A diagnosis of GERD is often made at the physicians office, and then commonly, anatacids (Gavison, Rolaids, Tums), H-2 receptor blockers (Pepcid AC, Zantac) or Proton pump inhibitors (PPIs, like Prevacid, Losec etc.) are recommended to "stop the burning". If it helps, it is assumed that GERD was your problem.
But we seem to have gotten a little caught up with this idea that burning = too much acid. If you've read my blog "Why Does My Stomach Hurt?" you'll see that it is a little more complicated than that.
Heartburn typically stems from one of four causes:
Very rarely have I ever seen increased stomach acid cause heartburn. Rather, it is most likely a combination of low stomach acid, over-eating and a weak lower esophageal sphincter.
Zollinger-Eillison Syndrome is the only known cause of increased stomach acid, and is a very rare condition where one or more tumours in the small intestine or pancreas (gastrinomas) secrete a large amount of the hormone gastrin which then causes the stomach to produce too much acid (5).
In summary, your stomach is probably not too acidic. But something else is going on, making your uncomfortable. Don't you want to find out.. and fix it?
If you or someone you love is experiencing heartburn and want to treat the cause, please book a Free 15 Minute Health Discovery Session with me.
In our next few blogs, I will outline how to know if GERD is part of a larger puzzle and how you can start improving it naturally.
Until then, happy digesting!
Stopped up. Bunged up. Full of it. Constipated. No fun.
Constipation is something I frequently see in practice, and something I notice that tends to effect women, the elderly and people taking more medication more commonly. Increasingly, I am seeing more issues with young women in their teens and twenties.
Typical recommendations are to avoid constipation is to increase water and fibre, and to consume more leafy greens (again, more fibre). But what if these things aren't helping... or are making the sh*tty situation worse?
Before we get into the why and more importantly, what you can do about it, let's back it up (get it?). You will definitely want to check out my digestion post for more in depth specifics on how the digestive system works.
Constipation is defined as infrequent bowel movements that are often difficult to pass and that is lasting a few weeks or more. Many physicians consider constipation to be 3 or less bowel movements per week. On the other hand, Traditional Chinese Medicine and Ayurvedic medicine consider normal frequency to be 1-3 bowel movements per day with any more or less to be abnormal.
Normal bowel movements should be easy to pass, solid, medium brown in color, with no undigested bits of food, no blood, no mucous, no straining and with only minimal wiping required. Checking your stool every day is a great way to keep tabs on how things are moving.
Constipation can usually be resolved by:
Constipation can also signify:
If you are experiencing frequent or long term constipation, be sure to check with your doctor or Naturopathic Doctor or pelvic floor physiotherapist to rule out the conditions listed above.
You can also book a Free 15 Minute Health Discovery Session with me to learn about your options.
In health & smooth moves,
"My stomach hurts all the time", lamented my third client. That is, my 3rd client today alone. She continued, "I'm bloated all the time, even with healthy food. I'm constipated, then I have loose stool. I never feel like I'm getting everything out!". I also work with her father, who has heartburn, a "noisy gut" and suffers from urgent abdominal pain any time he has to go outside of the house.
2 out of 3 clients I work with have digestive issues.
As long as I can remember, I have had abdominal pain while eating dinner. My immediate family all suffer from Irritable Bowel Syndrome ("Ass Crisis", as we've affectionately deemed it). I have had a vested interest in learning and working with the digestive system from the day I saw my first client.
Fortunately, I have found that most "gut problems" respond extremely well to Naturopathic medicine. If you, or someone you love, has been suffering, this post is for you.
The Digestive System - more than just your stomach
The digestive system encompasses everything from your mouth down until you see it in the toilet (hopefully) the next day.
Digestion starts in the brain, evoking a physical response long before food passes your lips. When we think about food, envisioning how it will taste and feel and actually let ourselves feel hungry, our body gets to work increasing saliva, stomach acid and digestive enzymes. Like a good seduction, digestion is as much a head game as the act of doing it.
Problem Zone 1: eating mindlessly, not letting yourself get hungry, eating in a rush, over-eating etc. so that your body doesn't have time to catch up
Chewing your food thoroughly accomplishes two things:
Problem Zone 2: eating without thoroughly chewing, drinking large amounts of fluids with meals that may dilute your digestive enzymes
The esophagus is a flexible tube that carries food from your mouth to your stomach. At the bottom of the esophagus/top of the stomach is a muscle called the lower esophageal sphincter or the cardiac sphincter. When it opens it allows food from the esophagus in the stomach, otherwise it should stay shut to prevent splash up of acid causing heartburn.
Problem Zone 3: eating too quickly so that food gets stuck or the stomach becomes overloaded; heartburn that creates pain in the esophagus
In the stomach, hydrochloric acid (HCl) is produced by the parietal cells in the stomach. Another enzyme called pepsin begins to work on the food as well, breaking down protein. An acidic environment is required to breakdown our food and prevent pathogens (bacteria, fungi, parasites and other food borne illnesses) from taking hold. After churning in the stomach, the partially digested food (now called chyme) moves past the pyloric sphincter at the base of the stomach and empties into the upper small intestine.
Problem Zone 4: inadequate stomach acid causing poor digestion of food, heartburn and increasing risk of illness, ulcers
As food enters the upper portion of the small intestine, it passes nearby to the liver, gallbladder and pancreas, which all make enzymes to help us digest fats, proteins and carbohydrates (lipase, protease, amylase and others like lactase for digesting lactose, renin, sucrase etc.). This will result in further breakdown of our food.
Problem Zone 5: inadequate fat in diet to stimulate production of lipase and bile, not enough protein in diet to make these enzymes, blood sugar issues that compromise the pancreas' ability to manufacture amylase and keep blood sugar in check, poor functioning of the liver and gallbladder
The Small Intestine
The small intestine has three parts: the duodenum, jejenum and ileum and collectively is about 6 meters (20 feet) long in humans. As it passes through each of these, food interacts with the lining of the intestines, is absorbed and utilized by the rest of the body. Nutrients from our food are absorbed along the small intestine and breakdown continues.
Problem Zone 6: food sensitivities create inflammation along the lining of the small intestine resulting in poor digestion and impaired absorption of nutrients. These can create very dramatic digestive symptoms, and malnutrition.
The mostly digested food enters the large intestine, where water is reabsorbed back into the body along much of its 1.5 meters (5 feet). Different kinds of bacteria work on breaking down the remnants here.
Problem Zone 7: poor bacteria in the colon can cause bloating, gas, distention and pain.
Finally, stool exits the body. Stool is mainly water, combined with food remnants, dead bacteria and cellular waste. If there is inflammation here or in the colon, the remaining material may not be broken down properly.
Problem Zone 8: Hemorrhoids and anal fissures (small cracks around the anus) can block the passage of stool and create pain, bleeding and tearing of the delicate tissue.
Putting It All Together (The Digestive Dream!):
Top 10 Tips to Hack YOUR Digestive System:
If you experience gas, bloating, heartburn, diarrhea, constipation or other digestive concerns and are interested in learning more, please schedule your Free 15 Minute Health Discovery Session with me.
In health & happy digestion,
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Dr. Keila Roesner is a Naturopathic Doctor. When not treating patients she is also an enthusiastic barefoot-strolling, music-loving, yoga-doing kitchen wiz - who also happens to be a wrestling fan.