Natural Medicine

SIBO Part 1: What is it and what do we actually need to treat?

*Note: This article concerns a specific condition, but the themes discussed apply to many conditions. Read on if you feel inspired!

There are many names for the nonspecific digestive symptoms that could mean that you have S.I.B.O. (aka Small Intestine Bacterial Overgrowth). A few of them include irritable bowel syndrome, gas, bloating, heartburn, nausea, tummy troubles, constipation, diarrhea and so on. It turns out that about 60% of people who would get the diagnosis of irritable bowel syndrome if they talked to a conventional medical doctor actually have this syndrome called SIBO. It’s a condition where the bacteria that normally live happily in your colon (aka the large intestine aka further down the digestive pipes) begin to grow in large numbers in the small intestine. The pattern of symptoms that may mean you have this condition consists of digestive disturbances such as those listed above, usually worsened by eating foods rich in fiber like apples, raw vegetables, ground flaxseed, whole grain foods etc. You also might have noticed a seemingly random improvement in your digestive symptoms when you took antibiotics for some unrelated reason. For many, these symptoms come on after a bout of food poisoning, though for some it’s hard to pinpoint when they started, or they have been going on for so long that you can’t remember the origin story.

The trouble that I see with this label of SIBO is that it simply describes your current predicament, but not how it came to be, or how to unravel the root causes so you can actually heal. No two people experience SIBO the same, because their bodies are reacting individually to a unique set of stressors. This is a problem that applies to any disease, and explains why a given treatment for a given disease only works for some percentage of those people with the disease.

The concept of a disease is an interesting thing. I know this sounds like the beginning of a long philosophical musing, but stay with me for a moment. In conventional medicine certain symptoms are often lumped together, given a name, and considered to be a specific disease. For example: if you are coughing and sneezing and have a runny nose and low energy, that “disease” is called a cold. If you have a burning sensation in your chest after eating certain foods, that’s called acid reflux or gastro-esophageal reflux disease in medical terminology.

The thing is, this is a reductionist way of looking at things. People develop similar symptom patterns that could be lumped into disease categories for different reasons, and if you just lump them all under the same disease title and give them all the same treatment, you’re missing the why of it, and therefore missing the opportunity to treat the root cause so the person can heal and eventually stop needing treatment.

So instead, what if we looked at each person as an individual and approached symptoms in a different way. If someone comes to me with burning in their upper chest after eating certain foods, I think “This person’s body is responding in the best way it knows how to a stress or a combination of stresses in their environment. Why is that? What are the stresses at work here? (And I’m not just talking about emotional stress, though that plays a role.) What can we do to shift this pattern? I find this approach to be much more successful in helping my patients to feel better.

So what about SIBO?

Now, we could do testing, identify SIBO, leave it at that and treat each person with SIBO the same... But that would not be very successful because SIBO is actually a result of deeper imbalances that vary from person to person. These imbalances may be in the digestive tract, endocrine system, musculoskeletal system, nervous system, immune system or mental/emotional system (or likely a combination!). If we don’t figure out where these imbalances lie and address them, then the so-called disease will just keep coming back over and over again.

Stay tuned next month for a discussion of the types of underlying imbalances at work in SIBO.

If you are ready to receive some individualized support with your health concerns, please be in touch. 

Wishing you vibrant health, 

Dr. Jennea

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7 Tips for Natural Relief from Heartburn

Heartburn or acid reflux is a condition where the acid made in the stomach backs up into the esophagus causing some seriously unpleasant sensations like: 

  • A burning sensation in the chest or throat
  • A gnawing sensation in the solar plexus area
  • Nausea
  • An acidic taste in the mouth
  • Cough and/or hoarseness

It is still often assumed that heartburn is the result of the stomach producing too much stomach acid, and therefore medications like Tums or Prilosec are prescribed to neutralize the acid or prevent the stomach from manufacturing it. In fact, it’s usually too little stomach acid that causes or contributes to heartburn, so these medicines actually worsen the problem in the long term (Though they can certainly provide short term relief).

Check out my blog post Why I hate Prilosec, Tums and Zantac for a more detailed discussion of the root causes of acid reflux and the health problems that can result from long term use of acid blocking medications.

Luckily, it is totally possible to be permanently heartburn free by discovering the root causes and using some simple natural therapies.

1. Avoid common heartburn triggers:

Note: These foods are not the CAUSE of heartburn. If they were, anyone who ate these foods would have heartburn, and that is not the case. They are a trigger for people who are already susceptible to this condition, so avoiding them can offer some relief while we work on the true root causes.

  • Spicy foods like salsa and hot sauce
  • Coffee, chocolate and caffeine
  • Greasy foods
  • Cigarettes
  • Alcohol
  • Mint  (Peppermint relaxes the sphincter at the bottom of the esophagus, making reflux more likely)
  • Acidic foods like tomatoes and citrus
  • Carbonated drinks
  • Refined carbohydrates like cookies, pastries, bread and pasta

2. Pay attention to how you eat

Your body can’t make enough stomach acid to properly digest your food and prevent heartburn if you’re stressed or rushed while eating. Slow down and give your body a chance to do its job.

  • Take 10 deep belly breaths before meals to help your body get ready for digestion.
  • Sit down while eating and take your time. Chew each bite fully.
  • Avoid eating within 3 hours of bedtime

3. Identify food allergies/sensitivities

For some folks, certain foods other than those listed above will exacerbate their acid reflux. This is a sign that you may be allergic or sensitive to that food. Identifying and avoiding foods that you are allergic/sensitive to can go a long way toward stopping heartburn. The best way to do this is through an elimination diet. Check out my blog post on allergies (Allergies: Getting to the guts of the problem) for information on how to do an elimination diet. Just scroll down in the blog post until you get to the Remove phase of the Four R Program

4. Check in on your hormones

Elevated progesterone can relax the lower esophageal sphincter or "LES". This sphincter is a band of muscle that lies at the bottom of the esophagus and should stay closed at all times except when you swallow, preventing reflux.

Progesterone levels are high during pregnancy, and this is one of the reasons that pregnant women are more prone to heartburn (The other reason is the growing baby squashing your stomach up against your diaphragm).

Non-pregnant women can develop hormone imbalance with low estrogen and high progesterone which can contribute to heartburn. Consider getting your hormone levels checked and working with your doctor to balance them out if necessary. 

5. Make use of some soothing herbs

There are a number of herbs that have a "slippery" quality when they get wet. These can be used to coat the esophagus and stomach lining as you swallow them and help sooth and heal inflamed tissue. Pick one or two of the following and take them between meals or as needed during bouts of acid reflux.

Marshmallow tea - Steep 1 TBSP of the root in 8 oz of water for 30 minutes, and drink 1 cup as needed. You can make larger amounts and refrigerate for up to 3 days so you'll have it on hand when you need it. (Safe in pregnancy)

Aloe vera juice - Drink 1 oz as needed. 

Deglycyrrhizinated licorice (DGL) - Chew 1-2 tablets (~500-1,000 mg) as needed for heartburn. Note: This type of licorice will not raise blood pressure

Slippery elm lozenges - Chew or suck on 2-4 lozenges as needed. (Safe in pregnancy)

6. Gentle abdominal massage

One often-overlooked factor that can cause or worsen heartburn is called hiatal hernia syndrome. This is a condition where the top of the stomach presses up against the bottom of the diaphragm. Hiatal hernia syndrome is less severe than a true hiatal hernia in which part of the stomach actually sticks up through the diaphragm into the chest cavity, but it causes problems none-the-less. 

A gentle abdominal massage technique that takes about 15 minutes can help correct this syndrome and offer immediate and often dramatic relief if this is part of the root cause of your acid reflux. Seek out a naturopathic doctor or functional medicine doctor trained in visceral manipulation or applied kinesiology for this treatment. 

7. Increase your stomach acid with foods or herbs

Sour and bitter tasting things stimulate the body to get ready for digestion. One of the ways they work is by signaling your stomach to make acid. Choose one of the following and use it 15 minutes before meals and large snacks. 

I saved this recommendation for last because for people who have been struggling with heartburn for a long time, especially those taking an acid blocking medication, going off the medicine and increasing stomach acid can sometime cause increased symptoms. First addressing the 6 recommendations above can go a long way toward making it easy and painless to wean off your medication and restore normal stomach acid levels. 

Bitters - 15 drops directly on the tongue or in a little water. Here are a couple kinds I like. 

Lemon juice - Squeeze 1/4 lemon into a glass and dilute with a little water. It should still make your mouth pucker. 

Apple cider vinegar - 1/2 to 1 oz mixed with a little water. Choose an organic one like these made by Bragg or Spectrum

Bitter greens - chew on a bit of dandelion green (make sure you get it from somewhere that isn't sprayed with pesticides), endive or other bitter greens. You can even get fancy by starting your meal with a small salad of bitter greens with an apple cider vinegar or lemon based dressing.

 

If you have been struggling with heartburn for some time now, taking these steps to address the root causes and get over it for good is such a wonderful thing to do for your long term health. Please let me know if I can offer you any support. 

Warmly, 

Dr. Jennea

 

Check out my earlier blog post Why I hate Prilosec, Tums and Zantac

 

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What is with all the Anti-ND press lately?

There have been a number of opinion pieces in popular blogs and online news sources lately that speak poorly of naturopathic medicine. In case you’ve seen one of them and wondered what to make of it, I thought I’d weigh in.

These articles pretty much all say something along the lines of: “NDs aren’t real doctors”,  “NDs practice woo woo pseudoscience”, and “NDs are hurting people.” While I’ve pretty much stopped reading these types of articles because they all use the same tired, opinion-based, fact-light formula, what I see is really going on here is this:

NDs are gaining traction as a serious force in healthcare. We are licensed to practice medicine in 18 states and counting. We practice safer and more effective medicine for most chronic diseases and it scares the hell out of some in the conventional world who are witnessing the beginning of the end of the conventional way of practicing medicine: i.e. a corrupt, prescription mill bought by pharmaceutical companies whose best offering is managing symptoms, not preventing or healing diseases. A recent study out of Johns Hopkins University medical school reported that, after heart disease and cancer, medical error is the third leading cause of death in this country. People want better, safer healthcare. NDs are taught to understand the limits of our medicine and when to refer, but when treating non-life threatening chronic diseases, what we do is incredibly safe. The cost of our malpractice insurance (much, much less than MDs) reflects this.

To be clear, there are plenty of MDs and DOs who know how much the medical system in this country needs an upgrade, and are changing with the times, or have been quietly practicing similarly to NDs for years. Those are not the people writing these articles.

There is more and more high quality evidence supporting the efficacy of what NDs do, and the body of research will continue to grow. And the biggest reason of all that our numbers are growing and more states are licensing NDs is this: Our patients are so happy to have access to safe, effective, cause-resolution healthcare.

So…

In conclusion, haters will hate, and the best evidence that a movement is taking off is increased fussing from those entrenched in the old way of thinking.

 

Yours in health,

Dr. Jennea Wood, ND