Imagine the most beautiful river you have ever seen teeming with life and full of biodiversity. This river not only supplies life to all of the species inside of it, but is a life source to the nature that surrounds it. This river, like any other flows in only one direction, however if this river ecology is dampened by pollution, if enough debris builds up, or if by chance something were to build a dam, we can then start to see the water back-flow. Imagine the back-flow creating stagnant areas of water where things can fester and unwanted species can overpopulate. Worse yet the lack of water downstream could drastically reduce the biodiversity of the entire river, creating a ripple effect in the ecosystem damaging species we may not even realize are there. 

Photo by Pok Rie

The river we speak of is our gastrointestinal (GI) tract (from mouth to anus). This tract is one long connected tube and much like a river it feeds and provides vital nutrients to the rest of the body with unimaginable benefits, imperative to our survival. Just like a real river, in 2020 our GI river can be contaminated, used as a garbage dump, and blocked by various methods. All of this can lead to SIBO (Small Intestinal Bacterial Overgrowth) and/or IBS (Irritable Bowel Disease). Let’s discuss how we are taking a holistic and long-term approach that not many others are taking to help your river come back to life and once again provide life to the rest of your body. 

IBS/SIBO/SIMO Overview

What is SIBO? Small Intestinal Bacterial Overgrowth (SIBO) is a Disorder we are increasingly hearing about. With about 46 million Americans reporting living with IBS, diseases of the digestive tract are running rampant. Many of those (38%+ as estimated in a 2017 study) with IBS do not realize that they may actually have SIBO or what might be a more accurate term SIMO (Small Intestinal Microbial Overgrowth).3 This is a more accurate term because there is much more than just bacteria back flowing into the small intestine from the large intestine. SIMO is an overgrowth/over-inoculation of colonic (large intestinal) microbes which travels up to the small intestine. Our digestive tract is a large, tortuous tube from mouth-to-anus which is compartmentalized into different sections which perform different functions. All of these functions flow in a single direction, much like the healthy flowing river we mentioned at the beginning, making their way down from mouth to anus. 

In our mouth, digestive enzymes (salivary amylase and lipase) help begin the digestive process, as do our teeth, which break food apart. We then swallow food to pass it through the esophagus. Where a small door, called the esophageal sphincter, opens allowing our bite/ bolus of food to pass through the esophagus to the stomach. Once in the stomach, our hydrochloric/stomach acid helps break foods apart to prepare for absorption. Our stomach then passes the food through the next door/ pyloric sphincter to enable it to make its way to the small intestine for absorption. About 28% of our intestinal bacteria resides in the small intestine. This is a type of absorptive bacteria, which facilitates further digestion.Once we have absorbed what we can in the small intestine, whatever is left over and has not been digested passes through the last “door” called the Ileocaecal Valve/sphincter to the large intestine, where it is estimated that 70%+ of our intestinal bacteria reside. This is a special type of bacteria which facilitates digestion through fermentation. Although there is a large focus on bacteria it should be noted that there are many types of microbes here: fungi, archaea, viruses, protozoa and possibly many more. It is here where a majority of our post-fermentation metabolites and gas are produced. These incredible helpers (butyrate, propionate, acetate, etc) are increasingly appreciated for their ability to repair the epithelial lining in the intestines, the protective mucosal layer in the intestines, and facilitate many more protective functions.2 

Whatever is leftover (gas or digestive by-products AKA stool) are passed through the anus. All of this sounds great and streamlined until something causes a back-up. Once this takes place, some of the “doors” can begin malfunctioning allowing back-flow (remember, digestion should be a one way river). 

In SIBO/SIMO, colonic/large intestinal microbes make their way upward to the small intestines and begin fermenting partially digested food particles, creating a large build up of gas, which does not have an exit route as it does when created in the large intestine. When this happens, exaggerated gas, bloating, and discomfort are felt. Many with SIBO/SIMO report they wake with a flat stomach and then as the day progresses they feel 6 months pregnant. With every bit of food or sip of a beverage more bloating occurs. 

Traditional Treatment

We have seen it time and time again. A patient comes into the office and has been on multiple rounds of antibiotics along with a low-FODMAP diet, or in many cases no dietary changes at all. Relying on just an antibiotic like Rifaxmine (the most common type used) is not addressing root causes and it isn’t helping to address all of the microbes (remember, antibiotics only work on bacteria). 

A low-FODMAP diet which is a diet low in fermentable oligo, di, monosaccharides and polyols, is the go to diet for anyone suffering from excessive bloating, BUT this approach does not ask “why did this bloat start to begin with?” and “how did this small intestinal overgrowth happen in the first place?”. The low-FODMAP diet falsely puts the blame on a lot of healthy foods and takes the blame away from many other factors, not to mention all of the chemicals we are using to grow food (separate blog on that coming soon). 

We completely understand that avoiding foods that are fermentable would be a quick way to decrease symptoms, but that is much like racking up credit card debt and just avoiding the payments. You may find that helps in the short term, but later when you try to buy a home or a car, you are screwed. If you are on a low-FODMAP diet currently your goal should be to reintroduce the proper foods as quickly as you can while controlling your symptoms. 

“Foods aren’t gassy, people are!”

Dr. Angie Sadeghi, MD

What we are Doing Different

  1. Root Causes

Remember, GI issues of any kind do not just happen out of thin air. Roots are there, however for many the roots can be different. 

  • Altered Anatomy
  • Immunodeficiency/Immunodepression
  • Drugs (Legal and Illegal)
  • Endocrine Disorders (i.e. Hypothyroid, Diabetes, etc)
  • Environmental Chemicals (i.e. Pesticides, Dioxins, etc)
  • Motility Disorders
  • Alcoholism
  • Celiac Disease
  • Cystic Fibrosis

No matter what your root causes are, it is important to address them. Your care team should be utilizing various diagnostic tools to rule out diagnosis that may have been missed, optimize biomarkers, and continue to monitor your progress. If your care team is not doing this or you feel they have inadequate knowledge/experience then it is vital you find professionals with adequate knowledge. That is why we offer telehealth visits, where we are able to advise you on what to have your care team order and how to proceed with finding root causes. 

  1. Herbal Antimicrobials

Rather than relying on antibiotics alone we have found herbal antimicrobials have been found to perform just as well, if not better than the top antibiotics used to treat SIBO.1 This is most likely because SIBO is actually SIMO and the herbals antimicrobials help to crowd control not just bacteria, but other microbes that have decided to go in the wrong direction. 

  1. Not following a low-FODMAP approach

Foods aren’t gassy, people are! We are taking the blame away from plant-foods because it is humans, not plant-foods that are creating the problems. This truth is not sexy, it won’t sell, and it is something many do not like to hear. It is our microbiome that is unable to handle the fiber, oxalates, lectins, phytates, prebiotics, etc in many of these “gassy” foods from generations if improper agriculture, environmental toxins, bad lifestyle choices, and overall being disconnected from nature. We want practitioners to focus on many of these other factors before thinking of limiting one’s diet of healthy fermentable fibers. 

  1. 100% Plant-Based approach

Why would we recommend a 100% plant-based approach to SIMO/IBS? It may seem counterproductive for some since fiber, oxalates, lectins, etc can irritate the gut, but that is just it. Fiber, oxalates, lectins, etc do NOT irritate a healthy gut. The only reason plant foods irritate ones GI is because of the damage already done to the GI and gut microbiome.

“The question then becomes ‘How do I fix the damage done?'”

This question usually has more than one answer, but one of the answers will definitely be plants. Plants (starchy vegetables, non-starchy vegetables, sea vegetables, fruit, legumes, nuts, seeds and fermented plant foods) will contain the building blocks, not just for your human tissue, but for the TRILLIONS of microbes in your body. Here are some specific reasons why we left the animal products out of the program:

  • There is nothing in animal products that you can’t get from plants.4
  • Animal products do not contain antioxidants, phytonutrients, oxalates, lectins, salicylates, phytates, and fiber. (all of which microbes love to eat)
  • Animals all have a living microbiome that has a relationship with the animal. Once the animal dies/is slaughtered these microbes begin evacuating, dying, and the microbes that thrive on animal flesh remain to digest the animal itself. They create byproducts like: esters, ketones, aldehydes, hydrocarbons, alcohols, benzenoids, terpenoids, nitrogen, and sulfur compounds, amines, volatile fatty acids, and other endotoxins. You can cook and kill the microbes on the animal carcass (chicken breast, fish fillet, sirloin, etc) but you cannot kill the byproducts these microbes have produced. These enter your body when eating the animal and can create systemic inflammation.
  • We are now seeing the rise of “superbugs” which are antibiotic resistant strains of bacteria. We can bring these into our homes unknowingly when we bring animal products into our home. These mutated microbes can wreak havoc on a healthy person’s gut microbiome, let alone someone with a weakened gut microbiome. 
  • Heme iron from animals is inflammatory.
  • Saturated fat from animals is inflammatory
  • Animals can bioaccumulate toxins just like us. The bigger the animal and the more fat the animal has the more likely it will contain bioaccumulated toxins like heavy metals, pesticides, PCB’s, Dioxins and many more.6,7

“.. SIBO is actually SIMO and the herbals antimicrobials help to crowd control not just bacteria, but other microbes that have decided to go in the wrong direction.” 

Your Gut Connection Program Overview

That is why we have designed the first 100% plant based SIBO/IBS program that does not follow a low-FODMAP routine, instead it has 6 phases used to incorporate healthy fiber rich food while eliminating the true risk associated with eating. 

The program is accessed online from anywhere you have the internet, and gives you healthy living guides, meal suggestions, recipes for each phase, and access to an online private group with expert help 24/7. 

In the private group you get access to our experts, educational posts, handouts to use for everyday success, bi-weekly live cooking demos, bi-weekly live educational Q&As, and special guest speakers. 

Is Our Approach Working? 

Yes! We are ecstatic to report the following data:

40% Decrease in Gas and Bloating!

40% Decrease in Abdominal Pain

30% Decrease in Diarrhea and Constipation

34% Decrease in Bloating with Plant-Foods

25% Decrease in Reflux/Heartburn

Bottom Line

  • IBS/SIMO have root causes and you have to look for what those are
  • Drugs and/or supplements alone won’t get rid of your IBS/SIMO
  • Fiber and fermentable foods are good for your body
  • A low-FODMAP diet is not a long term solution.
  • The YGC program is proving a holistic approach that emphasizes eating more fiber in the correct method is working for IBS/SIMO symptoms. 

Sources:

  1. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., … Mullin, G. E. (2014). Herbal Therapy is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth. Global Advances in Health and Medicine, 3(3), 16–24. doi:10.7453/gahmj.2014.019 
  2. Fu, X., Liu, Z., Zhu, C., Mou, H., & Kong, Q. (2018). Nondigestible carbohydrates, butyrate, and butyrate-producing bacteria. Critical Reviews in Food Science and Nutrition, 1–23. doi:10.1080/10408398.2018.1542587 
  3. Ghoshal, U. C., Shukla, R., & Ghoshal, U. (2017). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and Liver, 11(2), 196–208. doi:10.5009/gnl16126 
  4. Hever J, Cronise RJ J Geriatr Cardiol. (2017). Plant-based nutrition for healthcare professionals: implementing diet as a primary modality in the prevention and treatment of chronic disease. May;14(5):355-368. doi: 10.11909/j.issn.1671-5411.2017.05.012.
  5. Pimentel, M., Saad, R. J., Long, M. D., & Rao, S. S. C. (2020). ACG Clinical Guideline. The American Journal of Gastroenterology, 115(2), 165–178. doi:10.14309/ajg.0000000000000501 
  6. Vestergren, R., Orata, F., Berger, U., & Cousins, I. T. (2013). Bioaccumulation of perfluoroalkyl acids in dairy cows in a naturally contaminated environment. Environmental Science and Pollution Research, 20(11), 7959–7969. doi:10.1007/s11356-013-1722-x 
  7. Zennegg, M. (2018). Dioxins and PCBs in Meat – Still a Matter of Concern? CHIMIA International Journal for Chemistry, 72(10), 690–696. doi:10.2533/chimia.2018.690

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s