Category: Digestion

By Joan Haynes, NMD

Your unique make up of the bacteria, viruses, protozoa, and fungus that compromise your microbiome have a profound effect on how you digest food, fight disease, and even your mood and behavior.  The GI MAP test offered by Diagnostic Solutions provides an easy and affordable way to understand what may be growing inside you.  

Some of the conditions and symptoms associated with a disturbed microbiome:

• Abdominal pain
• Asthma
• Autism Spectrum Disorder
• Autoimmune conditions
• Bloating
• Cancer
• Chrohn’s disease
• Constipation
• Depression/Anxiety
• Diabetes
• Diarrhea
• Eczema
• Food sensitivities and allergies
• Frequent illness
• Gastritis
• Gastroesophageal reflux
• Hormonal imbalance
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Obesity
• Small intestinal bacterial overgrowth
• Ulcer
• Ulcerative colitis

If you think you may have an imbalance in your microbiome, consider testing.  Learn more about the GI MAP test see a sample test here. https://www.diagnosticsolutionslab.com/tests/gi-map.

Just as important as running the test is knowing what to do with the results:

Our naturopathic medical doctors at Boise Natural Health Clinic have been extensively trained in interpretation and treatment of altered gut microbiomes.   If you would like to be tested, just call and we’ll set you up for an appointment.

by Joan Haynes, NMD

Up at night with heartburn?  Worried about the side effects of acid blocking prescriptions?  Learn what other options you can explore to tame the discomfort and optimize your digestion and thereby your overall health.

Conventional medicine offers patients little insight into the cause of heartburn and instead puts a band aid on the problem by prescribing stomach acid-blocking medications such as Pepcid and Nexium.  Often patients take these medications for many years, leading to nutritional deficiencies and diseases such as osteoporosis and dementia. There are other options. 

Here are factors your naturopathic physician considers in patients with heartburn:

• Evaluate food and lifestyle factors
• Improve digestion
  • Evaluate for low stomach acid  See Reflux: Could You Have Low Stomach Acid?
  • Consider enzymes, bitters, bile acids
  • Asses stress reduction needs
• Correct nutritional deficiencies
• Screen for gallbladder and pancreatic problems
• Soothe and repair inflamed tissue with natural remedies
• Screen for H. pylori and dysbiosis – imbalance in the gut flora
• Evaluate for hiatal hernia
• Promote smoking cessation if needed
• Evaluate if weight loss is needed
• Screen for more serious diseases such as ulcers or inflammation in esophagus

Reducing or eliminating acid blocking medications can be uncomfortable and even impossible without laying the proper foundation for healing.   It often helps to get professional help through the many variables – the naturopathic physicians at Boise Natural Health Clinic can all help navigate your way to pain-free digestion. 

What I’m Reading

by Joan Haynes, NMD

This little TED book, written for a non-medical audience, is an engaging explanation of the ground-breaking science in the last few years about the microscopic life within our bodies.  It’s a quick read to help us understand how these tiny creatures play a role in nearly all aspects of our health.

Rob Knight is the Director of the Microbiome Initiative at the University of California, San Diego and the co-founder of the American Gut Project and the Earth Microbiome Project.  He wrote the book with science journalist Brendan Buhler to explain why these new findings matter to everyone.  You can also watch Knight’s TED talk at www.TED.com.

As you may have heard before, there are 10 times more microbe cells in our body than human cells.  The average adult is carrying about three pounds of microbes – roughly the weight of your brain.  Knight explains how different sets of species inhabit different parts of the body, where they play specialized roles.

Knight also explains how new technology makes identifying the microbes easier.  Here is a sample copy of the stool test we’ve been running in the clinic with great results:  GI-MAP DNA Stool Analysis.  For just a few hundred dollars, we get a report looking for pathogenic microorganisms (bacterial, viral, and fungal/yeast) as well as the healthy population of bacteria.  Also included are useful gut function measures that look for inflammation, immunity, leaky gut and more.

By Joan Haynes, NMD

I’ve been trying out a new test on patients for that last year with great results. I’ve helped diagnose Giardia in a 2-year case of diarrhea after cancer treatment, a little boy with failure to thrive with C. diff, and a Lyme patient with Microsporidia. These results are exciting
because when I first began my practice almost 20 years ago, the only way we could test for pathogens in the gastrointestinal tract was a culture which left up to 50% of the bacterial species undetectable. I hardly ever ran tests looking for a microbe because it was so expensive and inconclusive. Now we have access to new and affordable testing using DNA, which has transformed the field of microbiology, making diagnosis much easier.

Paraphrased from the lab’s web page: The Gastrointestinal Microbial Assay Plus (GI-MAP) was designed to assess a patient’s microbiome from a single stool sample, with particular attention to microbes that may be disturbing normal microbial balance and that may contribute to illness. The panel is a comprehensive collection of microbial targets as well as immune and digestive markers. It screens for pathogenic bacteria, commensal (friendly) bacteria, opportunistic pathogens, fungi, viruses, and parasites.

If you are harboring pathogens, you might have some of the following symptoms:

Gastrointestinal symptoms:

Abdominal pain

Bloating
Constipation
Crohn’s disease
Diarrhea
Food poisoning
Gastric cancer
Gastritis
Gastroenteritis
Gastroesophageal reflux
Irritable bowel syndrome
Small intestinal bacterial overgrowth (SIBO)
Ulcer
Ulcerative colitis
Vomiting

Autoimmune conditions:

Ankylosing spondylitis
Reactive and Rheumatoid arthritis
Thyroiditis (Hashimoto’s, Grave’s)

Allergic Disease:

Asthma
Eczema

If you think you might have an imbalance in your microbiome, consider testing.  Look at a sample test here.   The Diagnostic Solutions Lab will bill your insurance with a deposit.

By Dr. Joan Haynes, NMD

“Leaky gut” is also known as “increased intestinal permeability”.  Our intestinal tract is a semipermeable membrane, allowing very small molecules through in order to absorb nutrients.  Inflammation causes more permeability in the lining of the gastrointestinal tract and incompletely digested food particles, toxins, and waste get through into the blood stream.  The immune system then has the task of dealing with those invaders and can result in a variety of symptoms.

Causes of Leaky Gut:

1. Stress and age
2. Infection or imbalance of the microorganisms in the gastrointestinal tract
3. Irritation from chronic constipation
4. Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) like asprin and ibuprophen (Advil)
5. Food intolerances, particularly gluten
6. Pro-inflammatory foods such as alcohol, sugar, and highly processed foods

Symptoms of Leaky Gut:

1. Digestive issues that might be labeled as irritable bowel syndrome (IBS) such as gas, bloating, discomfort, diarrhea.
2. Seasonal allergies, chronic sinus congestion, asthma
3. Autoimmune diseases such as rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, etc
4. Chronic fatigue syndrome
5. Chronic achiness, arthritis, fibromyalgia
6. Chronic headaches
7. Mood issues such as depression, anxiety, ADD, ADHD, mental fogginess
8. Skin issues such as acne, rosacea, eczema, psoriasis
9. Food sensitivities and intolerances
10. Difficulty losing weight

Possible Testing for Leaky Gut:

There is no definitive testing, so often we are using clinic symptoms and history to help diagnosis. Sometimes though we need more information and one or more of these labs can be useful:

1. Food sensitivity testing can be useful – if more than a couple of foods show up positive on an IgG blood test, leaky gut is strongly suspected.
2. Stool testing for gastrointestinal infections.
3. Lactulose and mannitol test. The patient drinks a premeasured amount of these non-metabolized sugars and the degree of permeability is reflected in the levels of the sugars recovered in a urine sample collected over the next 6 hours.

How to Heal a Leaky Gut:

1. Diet – sometimes a general anti-inflammatory diet is enough, but other times people need to identify and remove specific food intolerances using a formal elimination-rechallenge program or food sensitivity testing through a blood test. See Are Foods Causing Your Symptoms.
2. Sometimes using digestive enzymes or hydrochloric acid (to be used cautiously) can help breakdown foods into smaller particles.
3. The amino acid L-glutamine is useful to heal the gut which is often given with other herbs and nutrients. At BNH we often use a Metagenics product called is UltraInflammX, a medical food shake high in glutamine, easy to assimilate protein, carbs and healthy fat, along with nutrients and anti-inflammatory herbs such as turmeric, ginger and rosemary.
4. Bone broths and green vegetable drinks are useful for easy nutrient assimilation.
5. Probiotics and fermented foods.
6. Stress reduction if needed. See What is Adrenal Fatigue.

Joan Haynes, NMD

It may seem counter intuitive, but strangely enough, the symptoms of stomach acid over-production and under production are very similar.  Proper stomach acid levels actually cause the sphincter muscle at the top of the stomach to close.  If there is not enough acid, the valve stays open, causing what little stomach acid there is to reflux and cause heartburn and erosion.  A healthy amount of stomach acid keeps the lower esophageal sphincter muscle tight, preventing the acid from refluxing.  Naturopathic doctors often have great success treating reflux by restoring normal stomach function.

Misdiagnosis and Mistreatment are Common

Stomach acid levels decline as we age, with poor nutrition, and with stress.  Acid-blocking medications such as Pepcid, Tagamet and Zantac are commonly prescribed control the symptoms, but do not address the underlying problem.  Studies show these medications are may lead to longer term health problems such as osteoporosis, colorectal cancer, bacterial infections and damage to both the kidneys and liver.  These medications are only palliative and are very hard to discontinue if used for a long period of time.

Symptoms of Low Stomach Acid

Acid reflux, heartburn, burping, gas, bloating, nausea are common.  Often there is an inability to digest meat well.  Feeling heavy or overly full after meals, despite eating a normal amount.  Sometimes, even if there are no gastrointestinal symptoms, I’ll screen some patients for low HCL if they have poor mineralization health conditions, such as those with anemia, osteoporosis, thinning hair, thin nails, and nervous system problems like insomnia, anxiety, and restless leg syndrome.

The Importance of Stomach Acid and Immunity

Besides being essential for digestive health, the acid acts as a natural barrier against infection – fighting pathogenic bacteria, virus and parasites.  When patients are travelling out of the country, I will often test them for low HCL, and if they can tolerate taking a little, I have them take HCL when they eat to reduce the risk of food borne illness.

Treatment

When treating reflux, we need to consider several factors:

1. Food allergy identification –   Often sensitivity to one or more foods is the cause of symptoms.
   READ MORE – Are Foods Causing Your Symptoms
2. Heal inflammation – the reflux into the esophagus needs to be quieted before supplemental HCL is put into the stomach or until a person can tolerate their own normal stomach acid levels.  Deglycerinated licorice, marshmallow, slippery elm, aloe are all demulcent herbs that sooth and coat the lining of the intestinal tract.
3. Test for and treat low stomach acid – I use the “titration” method of HCL testing.  I give my patients a sample of a pharmaceutical grade betaine hydrochloric acid (with pepsin) and have them increase their dose systematically with certain meals.  Then they report back to me and I help them sort out what their reaction told us and their dose if HCL is needed.
4. Consider adding enzymes and/or bile.  The stomach makes HCL, but the gallbladder makes bile necessary for fat absorption and enzymes breakdown carbohydrates, fats and proteins.  You may need supplemental correction for those deficiencies as well.

Be Careful Treating Yourself – PLEASE READ

If you’ve been on acid blocking medication for a long time, I suggest you work with a professional to explore this issue.  If there are ulcers or erosions in your esophagus or stomach do not attempt to take hydrochloric acid – you may make matters worse.  You’ll need to heal the inflammation first and then explore discontinuing your medication.

Joan Haynes, NMD

Do you suffer from bloating, gas, belching, or abdominal pain with meals? If so, maybe your gallbladder is causing the symptoms.

The gallbladder is a digestive organ located in the upper right portion of the abdomen directly underneath the liver. The liver makes bile which is stored and concentrated in the gallbladder. As food leaves the stomach and enters the small intestine (duodenum), bile is secreted. The main function of bile is the digestion and absorption of fats. Bile also helps us absorb fat soluble nutrients and eliminate drugs and other compounds such as hormones.

Symptoms of Gallbladder Dysfunction

Symptoms of Chronic Gallstones

• Can have no symptoms
• Abdominal pain following meals high in fat
• Right sided abdominal pain but can be anywhere in abdomen
• Radiating pain to the right shoulder
• Bloating, gas, belching

Symptoms of Acute Cholecystitis (gallbladder attack that may require immediate surgery)

• Abdominal pain with fever, nausea, vomiting

Tests Used to Diagnose Gallbladder Problems

Adapted from www.webmd.com

There are many choices of tests your doctor may order for you depending on your symptoms. Some are more commonly used than others.

• Liver function tests (LFTs), which are blood tests that can show evidence of gallbladder disease.
• A check of the blood’s amylase or lipase levels to look for inflammation of the pancreas. Amylase and lipase are enzymes produced in the pancreas.
• A complete blood count (CBC), which looks at levels of different types of blood cells such as white blood cells. A high white blood cell count may indicate infection.
• The use of ultrasound testing which uses sound waves to image the intra-abdominal organs including the gallbladder.
• An abdominal X-ray, which may show evidence of gallbladder disease, such as gallstones. (not commonly used, may be an incidental finding)
• A computed tomography (CT) scan that constructs X-ray images of the abdominal organs. This test may follow ultrasound if there are more questions.
• A HIDA scan. In this test, a radioactive material called hydroxy iminodiacetic acid (HIDA) is injected into the patient. The radioactive material is taken up by the gallbladder to measure gallbladder function. This test also is referred to as
  cholescintigraphy.

Food Allergies and Sensitivities can be a root cause of gallbladder attacks

Since the 1940’s, James Breneman, MD reported that food allergies can initiate gallbladder  attacks and gallbladder disease. One study found that 100 percent of a group of patients were symptom free after following an elimination diet. Dr. Breneman believes that food allergies cause inflammation and swelling of the bile duct, which restricts bile flow from the gallbladder.

At Boise Natural Health Clinic, we offer ways to help identify food sensitivities with lab testing and formal elimination-rechallenge diets.

Treatment for Acute Attacks

1. Fever, nausea and vomiting may require immediate medical attention and surgery.
2. If immediate medical attention is not needed, your Boise Natural Health physician can make other recommendations such as the herb wild yam room (among others) that is antispasmodic, to provide relief of gallbladder spasms and pain.
3. Specific homeopathic remedies may also be recommended chosen based on your specific symptoms may also provide symptom relief.

Treatment for Chronic Symptoms

Many times a gallbladder ends up being surgically removed. However, it may be possible to preserve your gallbladder and improve long term digestive health with proper care. You may want to consider:

1. Correct dehydration to increase water content in bile
2. Identify and remove or desensitize food allergies
3. Decrease fat in diet and increase dietary fiber
4. Repair nutritional deficiencies found in gallstone patients – vitamins E and C and omega 3 fish oils for example
5. Increase solubility of the bile by using nutritional lipotropic (liver supporting) compounds and herbal cholagogues (stimulates bile flow). Your Boise Natural Health physician can customize a formula for you.
6. Chemical dissolution of gallstones using plant terpenes, bile acids and lecithin

If you’ve had your gallbladder removed, consider the following:

1. Replace the function of the gallbladder with bile salts. 1 to 2 tablets of professional quality bovine bile salts with each meal improves digestion and the absorption of fats.
2. Evaluate what dietary and lifestyle factors contributed to the dysfunction of your gallbladder.

Oliver Oil Gall Bladder Flush

At Boise Natural Health, we do not recommend olive oil flushes to treat gallbladder problems. We have been taught that this procedure is dangerous because the large amounts of oil causes contraction of the gallbladder which in turn can cause existing stones in the gallbladder to become lodged in the bile duct causing an emergency situation. Some people see “stones” in the
toilet after doing an olive oil flush. A 2005 study in the Lancet (a much respected medical journal) analyzed the chemical makeup of the “stones”. These are not gallstones, but are soap solids created in the emulsification process of the olive oil.

In Summary

Gallbladder symptoms diagnosed early and will lead to earlier treatment and may function may be restored. If the gallbladder cannot be saved, there is still work to do by identifying the cause of the malady in the first place and supporting digestion for optimal absorption.