Category: Digestion

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How To Tell If You Have SIBO or IBS?

Irritable bowel syndrome, also known as IBS, is the most common gastrointestinal diagnosis.

How common is IBS?  Scientific tests show that 10%-15% of Americans suffer from IBS. IBS is more common in women with almost twice as many women having it than men.  IBS is characterized by a cluster of symptoms, including recurrent abdominal discomfort, as well as a change in the frequency and/or consistency of bowel movements. Diagnosis is based on these symptoms; there is no official test for IBS. 

Due to this broad definition, at times ‘IBS’ is considered a catch-all term for anyone suffering from digestive symptoms who does not have inflammatory bowel disease. When assigned too broadly, it can provide a diagnosis without adequate investigation into the root cause of symptoms, and treatment may focus solely on providing temporary symptom relief rather than permanent resolution. Additionally, IBS is often falsely determined to be solely psychogenic, denying patients access to further investigation while reducing the cause of their suffering to ‘all in their head’. 

Changing Tides in Digestive Health

 Thankfully, our understanding of gut health – and gut disease – is changing rapidly.  Recent research indicates that the development of IBS is multifactorial, and is largely influenced by the health of the gut microbiome, the complex microbial ecosystem that houses fungi, viruses, and bacteria within the gastrointestinal tract. This is most evident when chronic IBS symptoms begin following acute gastroenteritis due to exposure to a pathogen. The introduction of a pathogenic microbe can create both the acute symptoms associated with acute gastroenteritis, such as vomiting, diarrhea, and fever, while creating a long-term shift in gut motility that sets the stage for chronic IBS.  

Alterations to the microbiome also appear to underlie the two main categories of IBS: diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C). IBS-D has been associated with increased levels of hydrogen-producing bacteria, while IBS-C has been associated with increased levels of methane-producing bacteria; both of these microbial imbalances are collectively known as small intestinal bacterial overgrowth (SIBO).

Does IBS = SIBO?

The gold standard for diagnosing SIBO is small intestinal aspirate, though it is rarely used clinically. Instead, lactulose breath tests are utilized to measure both hydrogen and methane levels; these measurements are indicative of bacterial levels within the small intestine. Research values vary but indicate that anywhere from 33-78% of patients diagnosed with IBS actually test positive for hydrogen and/or methane SIBO.  There is now a trio-smart test that also tests for sulfate gas.  An additional study of patients who tested positive for SIBO found a 7-8 fold increase in both Escherichia/Shigella and Klebsiella bacteria compared to non-SIBO patients.  An additional study in patients with IBS-like symptoms showed roughly 25% of them had an excessive number of fungal organisms within the small intestine, known as small intestinal fungal overgrowth or SIFO.   Recently, a large-scale study at Cedars Sinai has identified elevations of a third gas, hydrogen sulfide, in cases of IBS-D, indicating elevation in hydrogen sulfide-producing bacteria as both an additional type of SIBO, and another possible root cause of IBS.  Several therapeutic trials that aimed to treat gut microbes with antibiotics have shown favorable improvements in IBS-symptoms, further supporting the theory that microbial imbalances play a key role in the development of IBS.

All of this research indicates that for a huge percentage of IBS-sufferers, microbial imbalances, either in levels and/or locations of bacteria (as in SIBO) or fungi (SIFO), or a combination of both, are largely to blame for their symptoms. These findings are essential in providing relief for IBS patients, as these complex imbalances in the microbiome will not be corrected simply by following the typical treatment recommendations for IBS, such as stress management, increased fiber intake, laxatives or anti-diarrheals, or pain medications. 

IBS: A Way Forward To Healing

The diagnosis of IBS simply labels the symptoms as a syndrome, without providing any answers as to why a patient may be experiencing those symptoms. Without a root cause, it is difficult to provide the correct treatment methods. But with a correct diagnosis, the correct treatment methods can be applied.

Depending on symptomatology, it may also be helpful to test for Celiac disease, lactose intolerance, and food sensitivities, in addition to completing imaging to evaluate for inflammatory bowel disease such Crohn’s or Ulcerative colitis. While we have yet to gain access to testing methods for SIFO or hydrogen-sulfide SIBO, a comprehensive stool analysis can provide insight into the body’s ability to breakdown and absorb nutrients, as well as the health of the gut microbiome.  It is through these testing methods that specific imbalances in the gut can be identified; once they are identified, targeted treatments can be applied. For patients previously diagnosed with IBS, particularly if they have seen no resolution in their symptoms following the standard IBS treatment methods, identifying the root cause of their symptoms can be life-changing.

At Blum Center for Health, our team of practitioners and health coaches can work with you to heal your digestive distress. Whether you have an existing condition, are experiencing symptoms, or simply want to prevent future complications we are here to support you on the journey. Book an appointment by calling 914.652.7800.  

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The Power of Visceral Manipulation: Improving Digestive Function

Guest post by Dr. Miho Urisaka, PT, DPT, OCS

Many patients who come to see me for low back pain often have underlying chronic digestive issues that contribute to their musculoskeletal pain. I often use visceral manipulation to the mesentery as a technique that can help reduce their low back pain as well as alleviate symptoms of digestive dysfunction. 

The mesentery is a sheet of tissue that attaches the stomach and intestines to the abdominal wall. It is also responsible for providing blood supply and nerve innervation to these organs. When the mesentery becomes restricted, it can cause tension in the organs it attaches to, leading to symptoms such as bloating, constipation, and abdominal pain.

Visceral manipulation is a gentle manual therapy technique that aims to release these restrictions and improve the mobility of the organs. The technique involves the therapist using their hands to gently move and manipulate the organs and surrounding tissue. This can help to break up adhesions and scar tissue, which can cause the organs to become stuck in one position. By improving the mobility of the organs, blood flow and nerve function can be restored, leading to a reduction in symptoms.

Visceral manipulation can also be used to help improve the function of the gut by encouraging the movement of food through the intestines. This is known as peristalsis, and it is important for maintaining regular bowel movements.

Lifestyle changes such as regular exercise, stress management and a healthy diet can also be beneficial for improving digestive function. Nutritional therapy can help to address underlying causes of digestive dysfunction, such as nutrient deficiencies or food sensitivities. Visceral manipulation can help to support these changes by improving the function of the gut and allowing for better absorption of nutrients.

A comprehensive approach that includes both nutritional therapy and visceral manipulation can provide the best results for digestive issues. It can help to reduce symptoms, improve the function of the gut and support the body’s ability to absorb nutrients, and overall, improve the results of nutritional therapy. If you are experiencing symptoms of digestive dysfunction, it may be worth incorporating visceral manipulation as part of your treatment plan.

 

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Book an appointment with Miho who sees patients on select days at Blum Center for Health.

Contact info:

Orthopedic Movement Physical Therapy

info@omptny.com

212-695-2769

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Constipation Issues? Here are 4 Tips to Get You Going

Do you struggle with constipation? You’re not alone. Constipation is the most common gastrointestinal complaint, resulting in 2.5 million doctor visits annually.

Constipation is frustrating, painful and can be connected to other health issues either as a cause or as a symptom. It can create bloating, irritability, lack of appetite, incontinence and even vomiting.

People often ask, “How often should I poop a week?” Well, that’s a great question! 

You should be pooping every day – ideally, twice a day. Yes, seriously. I know, I know, it’s not what your internist said. But, here’s the thing: Going to the bathroom daily is a sign of a healthy digestive tract and critical to your overall health. 

Think about it this way: When you poop, your body is eliminating waste. Waste! Do you really want waste sitting in your large intestines for days on end? Absolutely not. 

Plus, it’s important to recognize that your ever-important liver flushes out toxins housed in your body, and disposes of them into your intestines. If you’re not pooping daily, then all those toxins get reabsorbed into your body. Not good. 

You are considered constipated if you experience: 

  • Straining during a bowel movement
  • Hard, dry stools or stools like pellets or balls
  • Incomplete evacuation, meaning you don’t feel like you’ve passed the entire stool
  • Less than one normal formed, soft stool daily

There are many factors that contribute to constipation. Some are lifestyle, some are medical. Let’s take a look …

Lifestyle causes of constipation and what you can do about it: 

Diet! We always start with diet: Eat more fiber. The average person eats less than 15 grams a fiber a day, yet your body requires optimally in the range of 30-40 grams a day, depending on your size. Vegetables, legumes, fruits and whole grains like oats, brown rice and quinoa will help add “bulk” to your stools (with the added benefit of feeding your gut microbiome.) Here’s an easy way to add 5 grams of fiber a day to your diet: Fiber Blend

Drink more fluid – you need fluid to help pass a bowel movement. Aim to drink half your body weight in ounces. If you weigh 150 pounds, for example, you’ll want to drink about 75 ounces of liquid – water, herbal teas, mineral water. Coffee and other caffeinated drinks don’t count. They are dehydrating and may be contributing to your constipation. And remember, as you add more fiber, you must add more liquid!

Move more – Exercise helps constipation by lowering the time it takes food to move through the large intestine. By moving through quickly, water doesn’t get reabsorbed from the stool, thus helping keep it soft and moving easily. 

Reduce stress – Stress hormones affect your gut which can lead to constipation. There are lots of ways to reduce stress, such as yoga, meditation, gentle exercise, journaling, Qi Gong and Tai Chi. Try them all and find the best fit for you. 

Go to the bathroom when you need to go to the bathroom – chronically suppressing the urge to poop can lead to constipation. 

Stop using laxatives – laxatives decrease your colon’s ability to contract and they can actually worsen constipation.

But, sometimes we all need a little help.

Here are 4 simple ways to “get you going”:

Try our constipation recipe – Mix together 1 cup pure applesauce, 1 cup prune juice and 1 cup cooked oat bran – start with 2 tablespoons and add an additional tablespoon until you reach the point of regularity.

Take a probiotic – According to research, probiotics have been shown to  increase “gut transit time” by 12.4 hours, increase the number of weekly bowel movements by 1.3, and help soften stools, making them easier to pass. Bifidobacterium and Lactobacillus positively affect constipation. Our Probiotics is a blend of 7 strains of Lactobacillus and 4 strains of Bifidobacterium. Score!

Magnesium – One of the first lines of defense I typically recommend is adding magnesium citrate at bedtime. Magnesium citrate not only pulls fluid into the colon making easier to poop, but magnesium helps many sleep better and have less muscle pain.  Start with 200mg and titrate up to 500mg nightly. Here’s my Magnesium Go-To. 

Vitamin C – High dose Vitamin C (4-6 grams/day) can cause diarrhea, therefore, taking Vitamin C in amounts just below bowel tolerance (gas, bloating or diarrhea) can definitely improve bowel movements and regularity. Start slow with 3000 mg spread throughout the day. Then, every 2-3 days add another 1,000 mg. Once stools loosen up, maintain the dose that works for you. Plus, it’s an important antioxidant! Our Vitamin C fits the bill. 

While lifestyle goes a long way in alleviating constipation, the root cause of constipation may be medical. It’s important to address the root cause of constipation. If you make the lifestyle changes but continue to need daily supplement support to poop, it’s time to take a deeper look under the hood. 

Medical causes of constipation and what to do about it …

  • Dybiosis and Small Intestinal Bacterial Overgrowth – an imbalance in the gut microbiome or an overgrowth of bacteria in the small intestine are often implicated in chronic constipation. Besides constipation you might be experiencing gas, bloating, burping and/or reflux. 
  • Food sensitivities – certain foods are known to cause constipation, such as gluten, diary, corn, soy and eggs. 
  • Autoimmune disorders, such as Hashimoto’s and Celiac Disease.
  • Nutrient deficiencies – often associated with the first three medical causes of constipation listed here, nutrient deficiencies, such as Vitamin C, Magnesium and Fiber can contribute to difficult stooling. 
  • Too many antacids, and too much calcium and iron in supplements – are well-known instigators of constipation.
  • Toxins, such as lead and mercury, are an oft-overlooked source of constipation. 
  • Neurological conditions, like Parkinson’s Disease or Multiple Sclerosis.
  • Prescription medications, such as antidepressants or painkillers.

 

The best thing you can do for yourself is work with a functional medicine practitioner. We take a Whole Body approach, working with you to understand how all your symptoms are connected. We use “food as medicine,” assess your gut microbiome and your detox pathways. We can run the appropriate functional medicine tests based on your symptoms, if warranted. As a certified Functional Medicine Coach I can help lead the way. Click here set up an appointment, or learn more.

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. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

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5 Ways to Protect Your Gut in the Summer

Warmth, water, mountains, family, friends … summer means fun in the sun. But, what could be more annoying than an uptick in gut symptoms – particularly gas and bloating? No one likes to feel uncomfortable in their summer clothes.

Perhaps you can relate to this: I recently went on vacation. By the end of my time away I felt pretty good in the morning, but by dinnertime bloating was making me feel (and look) like I was pregnant.

What gives? Well, a bit of alcohol and eating more of the foods I generally avoid, added up in a negative way. And even though it wasn’t excessive, it impacted my gut in a relatively short amount of time.

If this resonates with you, don’t despair. In 10 quick days, you can reverse course. More about that in a moment. Can’t wait? Join Me

In the meantime, here’s what you can do to support your gut for the rest of the summer…

5 WAYS TO PROTECT YOUR GUT IN THE SUMMER: 

→ RETHINK ALCOHOL – Summer typically equals an increase in cocktails. Get clear: How many drinks are you consuming daily. If you’re in good health, and at low risk for cancer, then alcohol in moderation is likely okay. What is moderation? A few social drinks a week. There’s no need to drink every day, afterall. Plan for them — wait for the rooftop get-together or the weekend summertime bash. And If you’re a beer drinker, switch! Beer contains gluten and can be bloating if you’re sensitive to it. Have you considered a mocktail? Take a look at my Blueberry Lime “Margarita” recipe. 

→ GET YOUR SLEEP – Long, summer days with evenings out often lead to burning the candle at both ends. When your sleep suffers, so does your gut. And don’t forget, many of your summer activities affect the quality of your sleep: drinking alcohol, consuming sugar, eating foods that don’t serve you, and even travel and activity stress can all cause sleep disturbances. And, sleep disturbances and stressors suppress your immune system, making you vulnerable to infections. Get your zzzzz’s!

→ SUPPORT YOUR GUT WITH APPROPRIATE SUPPLEMENTS – Now is not the time to leave your gut-loving supplements behind. In fact, now is the time to be vigilant. If you’re indulging in alcohol, eating foods that you generally avoid, you’ll want to make sure you’re protecting your gut microbiome and gut lining as best you can. My summer go-to’s are:

→ Probiotics – support and influence the bacteria that live in your digestive tract. Use a well-rounded, multi-strain product, and since it’s summer, opt for a shelf-stable, heat-resistant probiotic like this one: my favorite summer probiotic. 

→ L-Glutamine – this important amino acid will help support the integrity your digestive tract lining by shoring tight junctions and helping to prevent a leaky gut. You want this why? Because about 80% of your immune system lives in your digestive tract and your gut lining is imperative to keeping out invaders, such as viruses (yep, like COVID). Oh, and it’s relevant to add: Alcohol consumption puts your optimal gut health at risk. Alcohol can, in fact, increase gut permeability. Here’s the the L-Glutamine I use. 

→ EAT SUMMERY GUT-LOVING FOODS – Summer produce is here! Take advantage of it while you can. Make sure half of the food you eat everyday comes in the form of produce. Eat the rainbow – all the different colors offer a range of necessary phytonutrients. Plus, the fiber found in produce provides much needed food for your gut microbiome. Also consider adding some kimchi, sauerkraut and low-sugar kombucha. Some of my favorite summer foods are: berries (love them all!), herbs like basil and mint, as well as broccoli, cucumbers, snap peas, green beans, watermelon and peaches. 

→ REMEMBER TO HYDRATE & REPLACE ELECTROLYTES – Hydrate, hydrate, hydrate. You might think eight glasses of water is enough. Actually, the proper amount of fluid is half your body weight in ounces. So if you weigh 150 pounds, you’re aiming to consume 75 ounces of liquid. And for every hour you’re outside, add another 16 ounces of water. Yes, really. Since it’s hot and you’re likely sweating, you might consider adding electrolytes to your day. Many of my clients like Nuun. My personal fave is Ultima.  

Which brings me back to what you can do right now about summer bloating and digestive discomfort  … Join me for the 10-Day Summer ReBoot! We’ll bring down the bloat and make the remainder of your summer gut-happy. Learn More Now

Happy summer!

 

 

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. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

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9 Telltale Signs Your Gut Needs Attention

“The whole world is suffering from this COVID-19 pandemic,” microbiologist Heenam Stanley Kim said, “but what people do not realize is that the pandemic of damaged gut microbiomes is far more serious now.” 

We are now learning that there is a strong connection between your gut microbiome and your vulnerability to develop the disease known as COVID-19, and the severity of symptoms you experience. And perhaps, most importantly, we are learning that after you have COVID, your prior gut issues can increase your risk for developing autoimmunity, or for having a flare of your existing autoimmune condition. 

You see, your gut microbiome — which includes all the bacteria and yeast that normally live in your digestive tract — keeps your immune system healthy and your intestinal lining strong.  But if you develop a condition called dysbiosis — an overgrowth of bad bacteria, yeast, parasites or other microbes like viruses — you then have an increased risk of damage to your intestinal lining, something called Leaky Gut Syndrome. If the integrity of your gut lining is “leaky,” pathogens, such as COVID-19, can cross over from the gut and gain access to your body and your immune system. Because your gut health is so important, and to support you especially right now, we are running a 10-Day HealMyGut Group Coaching Program beginning October 22nd –> More Info

Remember, your gut (which includes your stomach, and your small and large intestines) is your first line of defense, and research shows us more and more every day that your gut microbiome communicates with every system and organ in your body — your cardiovascular, endocrine, respiratory, nervous, urinary and reproductive systems. Your gut is connected to your brain and mood. It’s even connected to your skin, hair and nails. 

I hope by now you can see why all of us at Blum Center for Health, and in the world of Functional Medicine, believe that The Number One thing you can do this spring for your health….is….take care of your gut microbiome!

Here are 9 Telltale Signs Your Gut Needs Attention

  • You have had COVID-19, or you are afraid to get very sick from COVID-19 
  • Have heartburn, reflux, IBS, diarrhea or constipation
  • Are frequently getting sick
  • Have fatigue or brain fog
  • Are feeling puffy or inflamed
  • Have inflammatory conditions like arthritis, autoimmune, heart disease, obesity or diabetes
  • Have food sensitivities or reactions to food
  • Have mood issues, such as depression and anxiety
  • Have difficulty losing weight

Let’s talk about the many different types of gut issues.  If you have gas or bloating after you eat, or if you experience constipation and/or loose stools, or any type of intestinal discomfort, this means that you have a problem with how your gut is functioning. If you go to a conventional doctor they will commonly diagnose you with irritable bowel syndrome, or IBS. But, this diagnosis doesn’t tell you why you’re having this problem, and they’ll likely prescribe medication to control the symptoms, which by the way only makes the imbalance worse in the long run. 

Here are three tips to heal your gut, which will not only treat your symptoms, but address the underlying problem.  And keep your immune system happy, too.

  • For your digestive symptoms, find out whether or not you’ve got food sensitivities, which could be causing the problem. Problematic foods are typically gluten, dairy and corn. The food you eat is the number one influencer on your gut bacteria.  One way to figure it out is to follow a functional medicine elimination food plan. In fact, this will be the basis of our 10-Day HealMyGut Group Coaching Program beginning October 22nd –> More Info
  • Help balance your gut microbiome with supplements: 1) We use herbal antimicrobials to help remove or “prune” the undesirables living in your gut 2) l-glutamine to help shore up the lining of your small and large intestines and treat leaky gut and 3) probiotics (good gut bacteria as a supplement) to help influence the gut ecosystem and immune system.  Depending on the severity of your gut symptoms, you may also need digestive enzymes.
  • Reduce stress by learning resiliency techniques. Stress is the 2nd biggest influencer on the microbiome – in a bad way.  We suggest learning strategies for relaxation that work for you, as this will help heal and protect you from developing dysbiosis and leaky gut. 

If this sounds like just the plan you need, consider joining me for our 10-Day HealMyGut Group Coaching Program. We’ll do this together, as a group, and I will be with you every step of the way! >>> Check it out<<<

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Common Probiotic Myths Debunked

The amount of information found online about probiotics can be mind boggling. Search “should I take probiotics,” for instance, and you’ll likely close your browser none the wiser. There’s a lot of credible information, and there’s equally loads of erroneous information, including “experts” who have extrapolated data from research studies and made umbrella statements that are just plain … wrong.

For instance, many people believe that probiotics are like seeds that plant themselves in the gut and that they are supposed to grow and flourish. In fact, studies show that most probiotics pass through our digestive tract in about 6 weeks. Bloggers, experts and the media picked up this information and, suddenly, a buzz was created that probiotics were useless. This is not true!

Here’s what we know: 

Over 100 trillion microbes live in your digestive tract. Most of them are “good” bacteria, but there’s always some “bad” bacteria that live in your gut ecosystem (like weeds in your inner garden), always looking for an opportunity to overgrow and cause an imbalance. 

There are about 500 different strains of these microbes (estimates range from 300-1000) and when you take probiotics, you are ingesting just a few of the strains that have been well studied and found to be beneficial to your health.  You can eat probiotic foods, such as cultured (yogurt) food or fermented vegetables (kimchi, sauerkraut), or you can take a probiotic supplement, with many different types that vary by the dose and the number of strains that they contain. 

What’s most important is that you think about probiotics as influencers on your gut ecosystem.  While you take them, they are exerting a tremendous influence without needing them to “plant and grow”.  Here’s what we know.

How Probiotics Help You

GUT

Many studies have shown that taking probiotics can alleviate myriad gastrointestinal symptoms, including reducing bloat, gas, diarrhea, and constipation.  While the exact mechanism for how they do this has still to be completely worked out, we do know that probiotics help improve the overall balance of the good:bad bacteria, and help heal the intestinal lining.  This really matters because a damaged microbiome can give rise to many chronic health conditions, including inflammatory and autoimmune diseases, mental health issues, obesity, increased infections and lowered resistance to viruses. 

Here’s the good news:  If you have a “leaky”gut (increased permeability of the digestive tract lining), or dysbiosis (too many bad bacteria), probiotic supplements can help restore your gut barrier as they are passing through.  They can also help improve the number and function of your own good gut bacteria, and inhibit the growth of the “bad” bacteria. This ability to influence the overall health and functioning of your gut highlights why taking probiotics helps so many people, and why probiotic foods have been around for hundreds of years in many different cultures around the world.  Pretty important stuff, right?

INFLAMMATION

Probiotics also play a huge role in helping treat inflammatory conditions like arthritis, and immune system imbalances like autoimmune disease. Think of any condition with -itis at the end — gastritis, colitis, bursitis, diverticulitis, rhinitis, dermatitis — these are all inflammatory conditions. Many of these conditions are related to a damaged microbiome, and leaky gut, where microbes and toxins are leaking through the digestive tract lining into the bloodstream. Yeah, not good, as this triggers a system-wide immune response … inflammation. 

Susan Blum, MD, reports in her latest book, Healing Arthritis, that researchers have studied the use of probiotic supplements to treat the dysbiosis (overgrowth of “bad” bacteria) of inflammatory arthritis and found that probiotics improve symptoms in arthritis sufferers. Generally speaking, when it comes to arthritis, probiotics are thought to improve all the functions of your own good flora, including helping T regulator immune cells work better and live longer, turning off inflammation and repairing the gut lining and tight junctions. Because probiotics help treat a leaky gut, and because of the gut-arthritis connection, it follows that they would also treat systemic inflammation and arthritis, and they do!  

Probiotics help reduce inflammation by helping the immune system block pro-inflammatory responses that trigger inflammation over time. In other words, probiotics are a must for any one who has an inflammatory condition, and are beneficial for anyone trying to keep inflammation at bay. 

IMMUNITY

Did you know that the majority of your immune system resides in your gut? In fact, about 80% of your immune system lives in your digestive tract. With your gut playing such an important role in your body’s ability to defend itself against infection, it’s imperative that your gut microbiome be in tip-top shape. 

Your immune system has an innate response and an adaptive response. Innate immunity is an immediate inflammatory response — a signal that your body needs to defend itself from an invader, such as an allergen. Adaptive immunity takes longer to come to fruition. It is the body’s way of developing antibodies to pathogens — for example this is the way a vaccination works. When you consume probiotics, you are directly tuning up your gut-immune system, because the probiotics “talk” to your immune cells as they are passing through.  This is like arming your gut to protect you from foreign invaders!

CHOLESTEROL

Studies show that certain probiotics, particularly Lactobacilli, can help reduce cholesterol. They do this by preventing cholesterol from being absorbed, as well by helping to break it down. Evidently, probiotics can bind with cholesterol in the intestines to block it from being absorbed, and they also influence the metabolism of bile acids, which then affects the way that your body metabolizes fat and cholesterol.

MENTAL HEALTH

You’ve likely heard of the Gut-Brain Axis — meaning that neurotransmitters not only reside in your brain, but also live in your gut, and they communicate with one another. Take care of your gut, and you take care of your brain.

In fact, researchers recently found that probiotics improved psychiatric disorder-related behaviors including anxiety, depression, autism spectrum disorder, obsessive-compulsive disorder, and memory abilities, including spatial and non-spatial memory.

Probiotics help your mood and your functioning? Pardon the pun, but this is a no-brainer.

ANTIBIOTICS

Probiotics can also help offset the bacterial imbalance caused by taking antibiotics. Antibiotics kill good bacteria along with the harmful ones, often leading to gas, cramping or diarrhea. These side effects often drive patients to the pharmacy in search of an appropriate probiotic.

What’s perhaps more important, and lesser known, is that frequent or extended use of antibiotics can lead to leaky gut and is implicated as an underlying root cause of autoimmune disease. 

Research demonstrates that probiotics strains can act as adjuncts to antibiotic therapy by reducing side effects, protecting the digestive tract lining from leaky gut and they can actually improve antibiotic function.

ORAL HEALTH

Flossing and brushing aren’t the only ways to care for your mouth. Emerging research is demonstrating that the microbiome of the mouth benefits from probiotics. From preventing plaque to fighting bad breath and reducing gingivitis, and even to preventing oral cancer, probiotics are proving to be good for the mouth, too! Pucker up with confidence!

SKIN

Who doesn’t want clear skin? People predisposed to skin conditions, such as acne, eczema or rosacea, tend to flare when their gut microbiome is out of balance. It is well documented that probiotics help prevent and treat skin diseases including eczema, atopic dermatitis, acne, allergic inflammation, skin hypersensitivity, wound protection and even UV-induced skin damage.

Which Probiotic Strains to Take

Look at probiotics and you might be wondering, “How the heck do I know which one to choose?” Great question. 

General recommendations call for ingesting 1 to 25 billion colony-forming units (CFUs) daily. To put these guidelines into perspective, most store-bought probiotic yogurts only contain about 1 billion CFUs per serving. 

We are now learning that perhaps different strains are effective for different health issues, but research has a long way to go until we can choose a specific strain for a specific condition.  Case in point: Studies performed in inflammatory bowel disease suggest that high doses of combinations of different probiotic strains are more effective in decreasing inflammation and maintaining patients in remission than a single probiotic strain. This is one of the reasons that we always recommend multi strain formulas.  

For this reason at Blum Center for Health we recommend 25 billion CFUs to best support your gut microbiome. Ours is a hypoallergenic blend of 12 certified probiotic species — a complete spectrum of microorganisms. And, it’s on sale right now!  Learn More Here

Ready to improve your gut and improve your health? A probiotic is a great place to start.

 

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.

 

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Should You Take Probiotics?

Probiotics are living bacteria normally found in the human digestive tract that are usually ingested to improve the quality and quantity of the gut’s beneficial bacteria. One of the goals of taking a probiotic is to shift the population of gut bacteria toward one that is more healing and low inflammatory. But most people don’t know that probiotics do a lot more than just influence the population of the microbes that live in your gut.

Many studies have shown that probiotics can repair a leaky gut, reduce intestinal permeability and help increase the production of butyrate (a short chain fatty acid made by good gut flora that is very good for us).  In their role as influencers on the gut microbiome, probiotics have been found to specifically reduce proinflammatory bacteria such as Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Streptococcus viridans, Bacteroides fragilis, Bacteroides uniformis, and Clostridium ramosum. When these and other potentially harmful bacteria are present in high amounts, they create a pro-inflammatory, leaky gut causing condition called dysbiosis. (1)  The term dysbiosis was introduced over a century ago by the Nobel Prize laureate Elie Metchnikoff, who used it to describe a disruption of the normal balance of the bacteria in the gut and then proposed using yogurt with active bacterial cultures to improve both the gut and human health.(2)

Probiotics have gotten bad press recently because many people believe that probiotics are like seeds that plant themselves in the gut and that they are supposed to grow there and flourish.  When studies recently showed that probiotics in fact pass through us in about 6 weeks, the buzz was that people shouldn’t bother taking them. This absolutely is not true, because probiotics exert their influence without needing to plant and grow.  They help improve the whole ecosystem of the gut and also have a huge role to play in helping treat inflammation like arthritis, and immune system imbalances like autoimmune disease.

For example, researchers have studied the use of probiotic supplements to treat the dysbiosis of inflammatory arthritis and found that probiotics improve symptoms in arthritis sufferers.  Generally speaking, when it comes to arthritis, probiotics are thought to improve all the functions of your good flora, including helping T regulator immune cells work better and live longer, turning off inflammation and repairing the gut lining and tight junctions.  Because probiotics help treat a leaky gut, and because of the gut-arthritis connection, it follows that they would also treat systemic inflammation and arthritis, and they do!  

The bottom line? The strains researched in arthritis with the most evidence for an anti-inflammatory effect are Lactobacilli:  casei, acidophilus, reuteri, rhamnosus GG and salivarius. There is also good evidence for Bifidobacterium bifidum.  Bifidobacterium infantis, E coli nissle, and Lactobacillus plantarum were found to improve tight junctions and heal leaky gut, even if they weren’t studied for their effects specifically on arthritis. This data tells me that a multi-strain formula that includes as many of these as possible, with a priority given to those that have been studied in arthritis patients, is best when using probiotics to reduce inflammation.

If you have arthritis or any inflammatory condition, taking a probiotic is a great place to start.  But to treat dysbiosis, functional medicine offers a more complete approach that includes an herbal program to clean the “weeds” out of the garden.  The HealMyGut program can be done by itself, or as part of the Arthritis Challenge.  

And finally, I leave you with a brief suggestion for choosing a probiotic.  This can be confusing! I prefer to use a multi strain formula that has as many anti-inflammatory strains as I can find.  I love Klaire Labs, because they have been around as long as I’ve been practicing Functional Medicine (almost 2 decades!) and I know they work since I have been using them all this time.  My favorite product is Therbiotic complete, because it includes all the above strains. That’s why I use this for my private label BCH! PURCHASE HERE

Klaire Labs Therbiotic Complete: 12 strains

  •      Lactobacillus rhamnosus
  •      Bifidobacterium bifidum
  •      Lactobacillus acidophilus
  •      Lactobacillus casei
  •      Lactobacillus plantarum
  •      Lactobacillus salivarius
  •      Bifidobacterium longum
  •      Streptococcus thermophilus
  •      Lactobacillus bulgaricus
  •      Lactobacillus paracasei
  •      Bifidobacterium lactis
  •      Bifidobacterium breve

 

[1]  Parian A, Limketkai B, Shah N, Mullin G. Nutraceutical Supplements for Inflammatory Bowel Disease. Nutrition in Clinical Practice. 2015. Vol 30, Number 4. 551-558.

[2] Zeng MY, Inohara N and Nunez G. Mechanism of inflammation-driven bacterial dysbiosis in the gut.  Mucosal Immunology. Online publication 24 August 2016. doi:10.1038/mi.2016.75

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Is Summer Eating Making you Feel Heavy, Bloated and Blah?

Summer is full of fun — parties, BBQ’s, cocktails — and about midway through July many people feel heavy, bloated and blah. It’s an easy time of the year to slowly, or for some, not so slowly, slide back into old ways.

For some, (like me!) you have a hamburger bun and three days later think, “Well, I had a hamburger bun and nothing happened so I’ll eat another one today.” Before you know it hamburger buns and white bread become the norm.

Or, for some, you eat the hamburger bun,  feel like a complete failure and go right back to your old way of eating.

(By the way, this is exactly why we created the 10-Day HealMyGut Summer Reboot for the month of July. We know how hard it is to stay on track and this will reset your system and make the rest of the summer easy as pie. Learn more and get the limited time offer)

Here’s the good news: It is possible to navigate summer eating fun AND stay on track with health goals.

The trick is to rewire the way we think about summer eating and to understand that making healthy choices begins WAY BEFORE the actual event.

Think about it: How possible is it to show up at your best friend’s BBQ — full of hot dogs, hamburgers, potato chips, cold slaw, macaroni salad, cheeses, charcuterie, baguette, beer, cocktails, and pie — and think that you will only eat salad? Not likely! In fact, I would say impossible.

Besides, what fun would a BBQ be if you only ate salad?

On the other end of the spectrum, who wants to over-indulge on everything and then feel crappy physically and feel crappy about themselves?

The great news is that there is a way to find a middle ground to enjoy these food events, and even indulge, without a food hangover, shame, guilt and defeat.

10 Ways to Enjoy Summer Eating Without the Side Dish of Guilt

  1. Eat throughout the day — This goes for everyday, of course, but this is particularly problematic during the summer. Many people skip meals, or skimp on meals, thinking they will “save up” for the event —this backfires every single time. We end up eating more then we would have had we nourished and fueled our body during the day. When we skimp on nourishment our blood sugar drops and our body goes into starvation mode. We end up not only over-eating, but also eating foods we probably would not have found so tempting.
  2. Stock Your Fridge with seasonal foods and partake in extra servings of fruit and veggies leading up to the event. I find it helpful to have an extra smoothie or a green juice. Not only is it nourishing but it serves as a reminder that you are committed to treating your body with love and care.
  3. Exercise first thing in the morning — even if it’s just a walk. It revs your metabolism, reinforces healthy habits and sets a healthy tone to the day.
  4. Visualize yourself at the event — Let’s say you know you are going to a beach wedding in two weeks. Don’t wait until the last minute and start fretting about food. Every morning sit silently and envision yourself at the reception. Visualize yourself having fun, feeling great in your clothes. Visualize yourself being choosy when you take hors doerves. See yourself asking for fish and filling your plate with healthy, delicious food. See yourself having just a few bites of cake with a generous helping of berries. In other words … PRIME YOUR BRAIN!
  5. Plan in advance, Part 1: — Going to a BBQ and not sure what the pitfalls will be? Call or email your friend and ask what she/he will be serving.
  6. Plan in advance, Part 2: — Ensure there will be something you like to eat? BRING IT!
  7. Place everything you eat ON A PLATE — Eating mindlessly out of the potato chip bowl is a recipe for disaster.
  8. Plan for alcohol in advance — Planning on two drinks? Sip slowly and drink a full glass of water between drinks. Pace yourself and drink with awareness.
  9. Be aware of your surroundings — Are you eating because you are choosing to eat OR are you eating because you are mirroring someone else’s eating?
  10. Walk away! — If you feel like you are unhappy with the choices you are making …. walk away. Cognitive psychology demonstrates that when we change our environment we disrupt the behavior and can change the behavior in that moment. For instance, can’t stay out of the potato chip bowl? Grab a friend and go for a walk.

Lastly, have fun! Summertime is all about fun. Wear sunscreen, stay hydrated and eat all the summer produce you can before it’s gone — watermelon, peaches, berries, green beans, sugar snap peas — load up before it’s sweet potato time!

Looking for a quick way to reset the gut? Try our HealMyGut Summer Reboot to bring your intestinal flora to a state of robust health and diversity. Relief is on the way! Get Our Special Summer Reboot

 

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. You can learn more about coaching with Melissa Here

 

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What is Dysbiosis – and What You Can Do About It

Dysbiosis is like having weeds in your gut garden

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 Dysbiosis 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

 

Check out my FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

 

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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.