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What is Dysbiosis – and What You Can Do About It

You have within you trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract.  This lively bunch of microbes is known as your microflora. Often referred to as “The Garden Within,” your microbial garden can shift out of balance. Think about how a garden can become overgrown with weeds. When that happens, we say a person has dysbiosis.

Three Ways Dybiosis Can Impact Your Gut

  1. Too much of the bad stuff overgrowing in the gut is the most basic imbalance.  An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast (candida albicans is a particularly common and unwelcome yeast in large amounts), are two examples of overgrowth that cause dysbiosis.  An unwelcome virus or parasite can also cause overgrowth imbalance.

    To treat this type of dysbiosis we sometimes prescribe medications to kill unwanted bacteria, parasites, or yeast, but more often we use gentler, broad-spectrum anti-microbial herbs to weed the garden, improving the balance of good and bad bacteria. We also use probiotics and fiber-rich foods to encourage growth of the good while we get rid of the bad.
  2. Microbial undergrowth can be the culprit. It is rarer than the situation above, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise.  An under-abundance indicates we need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. We do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.
  3. Your microbiome settles in the wrong place. Living microbes are wanted, but we need them to live where they belong, and not take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well.  Herbs and antibiotics are our go-to for treating SIBO.

Could you have dysbiosis?

In our medical practice at Blum Center for Health, we suspect an imbalance in the flora (a dysbiosis) in anyone who complains of stomach troubles. Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have stomach upset after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating, we think of dysbiosis.  If you have bowel problems, like excessive gas, lower belly pains, constipation, or diarrhea – then dysbiosis is our prime suspect too.

Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, also make me suspect dysbiosis.  We are becoming more and more aware the impact our microbiome has on our whole being – our whole health – and our disease processes.

When I see someone whose health concerns are not primarily digestive in nature – even those who report having a perfect digestive system – I usually investigate their microbiome, and will almost always prescribe a probiotic. Why? Because sometimes dysbiosis is silent gut-wise, while still causing trouble in other areas of your body.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  

How do you know if you have dysbiosis?

How does your internal garden grow?  The tests we most often request are simple:  Stool, breath, and urine testing – all of which give us a picture of what your personal microbiome looks like.  We learn from the test results how many beneficial bacteria are growing, and how many malicious bacteria have taken up residence in your gut. We use that information to create your personalized treatment plan.

With some patients we assume dysbiosis without testing – and just get you started on the good stuff  – probiotics and healthy, fiber-rich foods.

Not sure if you have dysbiosis? Take our Assessment and find out!

How did you get this dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as does any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

What to do if you suspect you have dysbiosis:

If you live in our neighborhood, make an appointment! In our practice at Blum Center for Health we take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. We take your health seriously and get to the root of the problem rather than simply throwing medication at it. For more information, call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

 

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

 

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FODMAPs Chart for treating SIBO and IBS

FODMAPs Chart for IBS and SIBO

As I discussed recently on Facebook Live, Small Intestinal Bacteria Overgrowth (SIBO) is an all too common gut ailment that can lead to many uncomfortable symptoms like chronic diarrhea or constipation, bloating, lots of gas, and abdominal cramping. SIBO is caused by an overgrowth of gut bacteria in the small intestine, crowding this area in high numbers where they don’t belong (only 10% should be in the small intestine, and 90% in the large intestine) and is particularly common in those with Irritable Bowel Syndrome (IBS).

Because all your nutrients are absorbed in this part of your gut, SIBO can cause malabsorption and lead to deficiencies of vitamins, minerals, fats and amino acids. Fortunately, herbal supplements and dietary changes can provide quick relief.  For instance, our Gut Cleanse Packets are designed to clear out the overgrowth of bad bacteria and yeast, but dietary changes can help, too, and may be necessary especially if you have lots of symptoms.

One category of food should stand out for those with SIBO and IBS – Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols (FODMAPs). FODMAPs are foods that are fermented by the bacteria in your bowels. When you have SIBO, there are lots of bacteria that are exposed to these foods very soon after you eat, and the fermentation creates excessive amounts of painful gas. Thus, foods high in FODMAPs are more painful to digest and foods low in FODMAPs are easier to digest for those with this condition.  

But, temporarily eating a restricted FODMAP diet won’t just reduce your digestive symptoms, it also reduces the gut bacteria’s access to food and thus assists in rebalancing your gut microbiome for optimal health. If you have IBS and aren’t sure if you have SIBO, you can often diagnose yourself by following the low FODMAP diet.  If you feel much better, then you likely have SIBO.  So what is the low FODMAP food plan? The food lists won’t necessarily be intuitive. Bananas and blueberries are some of my favorite low-FODMAP foods, while delicious fruits like apples and mangoes can actually cause acute pain!

Rather than trying to guess what foods should be high or low in FODMAPs, use this handy FODMAP Chart.

Once you’ve taken a moment to review the chart you may be shocked at how many foods could pose a problem for you. A FODMAP diet is a very restrictive diet, that’s why I don’t recommend it as a long-term solution. But, switching to a FODMAP diet could give you quick relief and the control to permanently improve your gut symptoms. Then once you’ve got a handle on your symptoms you can begin to progressively introduce foods back into your diet seeing what works for you.

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Your Microbiome: Caring For What’s Inside You

Microflora

There are literally trillions of bacteria in our digestive tracts.  They make up what is called the microflora, because under a microscope they look like little (micro) flowers (flora).  We refer to it collectively as our microbiome and they play an unbelievable role in synthesizing vitamins, producing natural antibiotics and degrading and eliminating toxins.  There are more of them in our bodies than human cells.

Think about it, we are walking around harboring and supporting this microbiome, an entire ecosystem within us.

Recent science has taught us that the microbiome also dictates aspects of who we are – our personalities, what diseases we will get, our mood, the size of our girth. Most of us are oblivious to it, we pay no attention to it at all except for to take a probiotic, until it hurts.

Internally we are 98.6 degrees, very moist and we have a tube that runs through us that is 30 feet long that has an opening on each end (the mouth and the anus).   This internal environment is the perfect breeding ground for microbes – both good and bad.

Outside, external, influences often upset the balance.  How we control the external influences determines the delicate balance of good and bad players.  It is up to us – we must care for them, it is critical to good health and requires more than a probiotic.

Factors That Affect the Microbiome:

Stress, the food we eat, genetics, how much time we spend outdoors, if the windows of our homes are open or closed, our exposure to animals, toxin and chemical exposure, antibiotic use throughout our lives, how we were born — C-section or vaginally — whether we were breast-fed, how often we bathe – all affect our microbiome.

For most of us, our guts are a mess.  We have created a microbiome that looks very different from what nature intended for each of us.  So how do we get back to the farm?

Increase These Foods to Support your Microbiome :

  • Eat a rainbow of colorful vegetables and some fruit every day. They will provide fermentable fibers that feed our healthy flora.
  • Include coconut products like coconut oil, milk, yogurt and kefir. Coconut is filled with medium chain triglycerides which feed the cells lining our intestines, and has yeast-killing properties.
  • Include Ghee, which is clarified butter. Ghee is filled with butyrate, a critically-important fatty acid for the care and feeding of cells in our colon.
  • Eat organic, non-GMO These foods are low in pesticides and have not been genetically modified, which can alter your flora and damage you intestinal lining, causing leaky gut.
  • Include healthy anti-inflammatory oils like fish, flax, olive oil.
  • Choose grass-fed, pasture-raised, or free-range organic animals when possible. This will limit the hormones, antibiotics, and pesticides that we are expose our microbes to when eating animals raised in typical feed lots.  Also, the meat from grass fed animals have higher quality, anti-inflammatory fats than corn fed animals.

It is Equally Important to Remove These Foods:

  • Processed food high in sugar, white flour, baked goods, food dyes and preservatives. These foods and chemicals promote the growth of the wrong kind of bacteria in our gut.  Eating this way should be a permanent change.  This includes fruit juices, dried fruit, and all added sugar or artificial sweeteners except stevia.
  • Gluten, dairy, soy, corn, eggs and peanuts because these foods are the most common triggers for reflux, constipation and abdominal discomfort, as well as other non-gut related symptoms.
  • Foods high in histamines: Shellfish, processed or smoked meats and sausages, wine.  Many people are affected by histamine intolerance, caused by the body’s inability to break down histamine in the gut causing crazy allergy reactions. Reactions to histamines can look like allergic reactions, including nasal congestion as well as headaches, dizziness and digestive discomfort.
  • All alcohol

 

Live in our neighborhood? If you’d like to heal your, consider joining my HealMyGut 30-Day Program on Tuesday, April 17th at either 10am or 6pm Blum Center for Health. To learn more or enroll, Click Here.

Don’t live near Blum Center?  Try our online HealMyGut program that includes daily email support, a private Facebook group, and weekly live one-hour coaching calls.

About Mary: Mary Gocke, Director of Nutrition at Blum Center for Health, has been successfully using food and nutrition science to treat and heal people with chronic illnesses and acute conditions for over 25 years. When Mary’s not helping people feel better through nutrition, this mother of two grown children can be found practicing yoga, which she has taught for years, or in her kitchen cooking something colorful.

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Healing Irritable Bowel Syndrome

Stomach pain from IBS

In my Functional Medicine practice, many people come to me with stories of terrible digestive distress, often labeled as Irritable Bowel Syndrome, or “IBS. ”This diagnosis is often given to people with a wide range of functional digestive issues like GERD or reflux, heartburn, burping, bloating, feeling full, abdominal pain, diarrhea, constipation,  or incomplete bowel emptying. Conventional approaches to treatment usually begin with an acid blocking medication, called a proton pump inhibitor (PPI), like Prilosec or Prevacid.  Many studies show these medications cause more harm than good and are not the ultimate answer.

Instead, we need to get to the root cause of these issues and this is where Functional Medicine really shines!

Here are the most common causes of digestive issues that need to be explored and treated to heal Irritable Bowel Syndrome.

Once you address these, you can be cured once and for all:

  • Food sensitivities or allergies
  • Lack of appropriate digestive enzymes or stomach acid
  • Motility disorders
  • Inflammation of the gut lining
  • Imbalance of the microbial flora
  • Digestive disorders that don’t allow nutrients to be absorbed
  • Leaky gut causing systemic inflammation
  • Overgrowth of certain bacteria that are associated with systemic illness.

Using Functional Medicine To Treat IBS

  1.  Fix your food.
    This can be as simple as modifying your diet — adding gut-healthy foods and eliminating your personal food triggers are imperative to healing your gut and reducing symptoms. We always start with an elimination diet for 3 weeks, removing gluten, dairy, soy, corn and eggs, the most common triggers for IBS. Remember, this is an experiment and has 2 parts: after the 3 weeks are finished, carefully reintroduce each food, every 3 days, one at a time, and this is when you can really determine if the food is a trigger for you.
  2. Consider stool and breath testing to take a closer look at your gut microbes and digestion.
    If changing your diet doesn’t fix the problem, then we recommend further testing. We need to evaluate your gut microbes, which are the 100 trillion bacteria that live in your intestines. They need to be in balance….. after all, your microbiome is your inner garden and you want to be sure your garden is flourishing. We also need to make sure your digestion is working well.  We use functional testing to get more information, and the results help guide my treatment with herbs, supplements and probiotics to gently nudge the bacteria into a healthier state, support your digestion, and resolve your symptoms.Here are some suggestions to try on your own and get you started.
  • Digestive enzymes
  • Bitters or ginger
  • Probiotics
  • Magnesium citrate – when constipated.
  • Cleansing herbs like berberine – in cases of bacterial overgrowth.
  1. Remember, the single most important thing to do is to change your understanding of your gut.
    Let’s start to think of the gut as what it really is – a seemingly simple but actually incredibly complex tube, responsible for grabbing the necessary nutrients out of the food you eat, keeping you healthy by killing infectious disease, removing toxins from the body through the stool, supporting your immune system, and even moderating your mood by producing and affecting neurotransmitters and hormones like serotonin and estrogens.  The gut is important!

In our practice at Blum Center for Health we take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address your gastrointestinal condition. We help you change your relationship to food, make necessary adjustments to exercise, sleeping and stress reduction, all things that influence motility and the health of your gut. Lifestyle changes works in unison with dietary and our medical solutions to provide lifelong relief.

Are you ready to calm your irritable bowel? A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

 

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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An Apple A Day? Better Make It Two!

An Apple A Day

Apples have long been associated with a healthful diet. After all, the adage, “An apple a day keeps the doctor away,” which originated in the 1860s, is a common refrain around the world. (1)

Yet for some people, like those Small Intestinal Bacterial Overgrowth (SIBO), apples can trigger digestive symptoms like bloating and gas. If you find apples give you these symptoms it is a sure sign that our 30-Day HealMyGut program is for you. Once you heal your gut apples will once again become a staple to your diet.

The fact is we need apples!

Researchers are finding that the humble apple is not only nutritious but also has healing powers that begin in the gut.

One study (2) in Japan demonstrated that the population of friendly bacteria, bifidus and lactobacillus, increased significantly by eating two apples a day for two weeks. The pectin in apples seems to play a significant role so drinking a glass of apple juice does not have the same benefit.

The finding is significant because apple pectin is a prebiotic — a non-digestible dietary nutrient, which beneficially influences the intestinal bacteria by stimulating their growth. These “friendly” bacteria fight inflammation and prevent a host of digestive problems. In essence, apples provide your gut bacteria the food they need to do their job.

Further, in another study a research team at Washington State University (3) compared several different types of apples to measure the amounts of non-digestible compounds they contain, and they found that Granny Smith apples, (yes those tart, green apples!), contained the highest levels of prebiotics, including dietary fibers and polyphenols.

Clearly, food is indeed medicine. Adhering to the old adage, “An apple a day” is good for you. There are thousand of varieties to try. Don’t wait …treat your gut to the healing powers of apples today!

As Dr. Blum says, “A healthy gut equals a healthy immune system, and using food as medicine is always the path towards getting there!

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters.

References
1. Story behind an apple a day. Ely, M. Washington Post Online. https://www.washingtonpost.com/lifestyle/wellness/history-behind-an-apple-a-day/2013/09/24/aac3e79c-1f0e-11e3-94a2-6c66b668ea55_story.html

2. Effect of apple intake on fecal microbiota and metabolites in humans.
Shinohara K, Ohashi Y, Kawasumi K et al. Anaerobe 2010; 16(5): 510-515

3. Condezo-Hoyos L, Mohanty IP, and Noratto GD. Assessing non-digestible compounds in apple cultivars and their potential as modulators of obese faecal microbiota in vitro. Food Chemistry. 2014.

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3 Simple Steps To Great Gut Health

By Susan Blum, MD

If you have gas or bloating after you eat, or if you experience constipation and/or loose stools, or any type of intestinal discomfort, you have a problem with how your gut is functioning. While this is commonly labeled irritable bowel syndrome, or IBS, the diagnosis doesn’t tell you why you’re having this problem.

Usually, the issue is something called dysbiosis, which means your gut flora isn’t healthy. You might have an overgrowth of harmful bacteria, yeast or parasites, or you might not have enough of the good stuff: those probiotics you find in yogurt and cultured foods.

But who cares about a little gas or bloating?

You should! Your gut flora needs to be fixed, because the symptoms you’re having could just be the tip of the iceberg. A whopping 70% of your immune system is located in your gut and if the flora are out of balance, you have an increased risk of something called Leaky Gut Syndrome, and this can lead to autoimmune disease.

Here are my tips to heal your gut, which will treat your symptoms and keep your immune system happy, too.

  1. For your digestive symptoms, find out whether or not you’ve got food sensitivities, which could be causing the problem. Check yourself for gluten and dairy by removing them both from your diet at the same time for three weeks, and then reintroduce each one at a time, four days apart and monitor how you feel.
  2. For your flora, eat cultured food every day, like coconut or almond milk yogurt and kefir, sauerkraut or kimchee, and consider taking a probiotic supplement.
  3. If the above doesn’t do the trick, consider a gut-cleansing program using herbs like berberine or oregano to remove the harmful microbes. Our new HealMyGut program will help you do just that!