Just in case you missed part 1…read it first!
So you cannot treat your digestion issues with diet alone. Why not?
I believe many of us with digestion issues, myself included (for too many years), try to use diet to heal our digestion issues. But the truth is you are just going to be living a life of managing symptoms rather than getting to the root cause, treating it and healing for good. Back in November, after years of obsessive researching- I finally found what I was looking for….the root cause.
I imagine I actually did a lot of damage by using the low FODMAP diet (developed only to be used for 2-6 weeks) long term. While it was helping me manage symptoms, for years I did not feed the good microorganisms in my digestive tract. I personally believe this is part of the equation as to why my gut infection continued to worsen over the years, instead of improving.
Six months ago, I had finally found what I was looking for in my research. That IBS is NOT just an irritable bowel…there is either dysbiosis of the gut flora, a gut infection (like a pathogen present) or small intestinal bacterial overgrowth (SIBO). I suspect many with IBS or other digestive issues (like Celiac or Chrons disease) likely have at least a couple of these root causes going on (I personally did)…but I especially believe the majority of those with IBS actually have SIBO. Personally, while I had a few different root causes contributing to my “IBS”, small intestinal bacterial overgrowth was the most prevalent and my focus as the symptoms were making daily life activities unbearable.
Once I found the root cause of my digestion issues, I began to modify my diet until I could determine how to treat it. I began following a specific carbohydrate diet (SCD) with a low FODMAP diet. While I felt much better, I knew I was still managing symptoms and NOT treating the root cause of my symptoms of IBS.
To treat my root cause, I used herbal therapy to help heal my IBS and SIBO. I used antimicrobials (herbal antibiotics) to eradicate the overgrowth of bacteria in my small intestine and dysbiosis of gut flora in my large intestine. And from that moment on, everything changed.
So how do I heal my digestion issues for good?
Getting to the root cause of your digestion issues. That’s how.
While you can technically use herbal antibiotics without testing, I highly suggest testing. To test for SIBO, you can need to complete a breath test. If you suspect a gut pathogen (like a parasite) or dysbiosis of gut flora (like Candida) a stool sample can identify this. In our practice, we can order these tests for you. We always start first with the SIBO breath test since its SO prevalent and also cheaper to purchase.
Once we identify the cause, you can begin to use antimicrobials to heal. Since herbal supplementation is within a dietitian’s scope of practice, this is also something we do with our clients. Meg and I are also happy to work with you if you want to go to your doctor to get antibiotics for treatment. While the antimicrobials have been shown to be just as effective, some people do need actual antibiotics and we can work with you in helping you prepare to what to ask your doctor for. While SIBO is backed by a lot of research, it is still relatively new research. If you plan on working with a conventional doctor, I encourage you to take the studies, the specific test you want ordered and specific request for which antibiotics to use. Again, I am happy to work with my clients if they would rather do this than work with me using herbal supplements. As long as we are treating it, and not managing it- that is all that I care about! I just want you to feel better! Some people respond really well to herbal antibiotics while others need to be treated with medical antibiotics, its very individualized and another important reason why you should work with someone instead of trying to figure it out on your own.
Is there any diet modifications at all that need to be made?
Until you can find a doctor or a dietitian to work with (or until we begin working together!) I recommend following a low FODMAP diet simply just to help manage the symptoms. Depending on the client, I will do the two week FODMAP elimination diet before we begin the healing process. I will especially do this for any client who has never done one before. If a client feels significantly better eliminating FODMAPs, this acts for me as a confirmation of SIBO and/or dysbiosis and that testing and herbal supplementation is a good choice.
While using herbal or medical antibiotics, a liberal of a diet as possible is recommended. I encourage my clients to eat FODMAPs and carbohydrates as much as they can tolerate. This helps to better eradicate the overgrowth as happy and fed bacteria are much more easily killed off. For clients who are extremely FODMAP sensitive, I will use prebiotic supplements to ensure they can have those happy and fed bacteria.
While I am a believer in intuitive eating, I work pretty closely with my clients to ensure they are eating enough while healing the digestion issues. I love the idea of listening to your hunger and fullness cues, but the truth is digestion issues can REALLY throw this off (speaking from personal experience and from working with clients). Undereating is only going to perpetuate the issue as you can encourage adrenal fatigue (medical term for this is HPA axis dysfunction). If you want to learn more about this, I highly encourage joining our free Facebook group– we have been talking all about adrenal fatigue this week! Its hard to eat enough when your stomach is constantly bloated or in pain. I also work with my clients in using our unique approach of instinctual eating. This includes meal spacing, eat a diet higher in fat, moderate carbohydrate (and individualized to the person) and protein, using healing foods like bone broth and turmeric as well as antimicrobial foods like MCT oil, soaking/sprouting foods, etc. I’ll have more to share on our unique approach…soon 🙂
If you have any autoimmune conditions present, there is intestinal permeability present (aka leaky gut)- so I do recommend avoiding gluten containing foods. Personally, I have psoraris so I avoid gluten to treat this and to prevent the onset of further autoimmune conditions from occurring. For those with inflammatory bowel disease, I do work with clients on a more specific diet approach- typically a paleo diet and/or following an autoimmune protocol version of the paleo diet. While I prefer being as liberal as possible with food, for some conditions a more tailored, specific approach- even if only for a short period of time- is good choice to reduce inflammation and heal the leaky gut.
During the initial stages of healing, I do not recommend using probiotic supplements (unless a very specific strand is used) or eating fermented foods, especially for SIBO. I add these in at the last stages of healing to encourage a healthy gut flora for the long term. Read more about that here.
Don’t feel stuck dealing with digestive issues. I cannot tell you how many times over the past ten years I just said “Oh I have IBS” to explain why I had to run urgently to the bathroom, why I couldn’t eat sooo many foods, why I always felt like crap. I never gave up, and I am so incredibly thankful I didn’t. I have finally healed my own digestion issues, and now I am helping others to do the same.
Tell me, do you have digestion issues present? If so, have you identified the root cause and treated it?