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Gas, Bloating and Tummy Aches, Oh My!

Gas, Bloating and Tummy Aches, Oh My!

by Dr Cory Tichauer

Does this title sound like a familiar topic to you?  Do you feel like your quality of life is always teetering around the question of “what can I eat” or “will there be a bathroom”?  Is gas, bloating, diarrhea or constipation a recurring theme in your life?  If you can identify with any of these questions, there are a number of ways that you can detect and remove the source of your problem. 

Long blamed as an outcome of too much stress, research has shown that functional digestive problems can actually be due to a number of possible reasons.   These include poor diet, food sensitivities, digestive insufficiency, autoimmune or inflammatory reactions, infection or dysbiosis, neuromuscular problems with motility and SIBO.  Each of these concerns can be identified through a relatively small number of tests which themselves can be more easily narrowed down though a good medical history!

Taking an honest assessment of your diet can help you to understand whether it is time for a change.   While we all cheat to some degree, meals high in refined carbohydrates (white flour) and sugar contribute to inflammation and bacterial imbalance in the digestive tract.   Doing a blood test for antibody-based immune reactions to specific foods can also help identify reactions that may be contributing to your problem.  If you are motivated now, the gold standard is still to eliminate the primary reactive foods, which include gluten, soy, dairy, eggs, peanuts and corn, from your diet for 8 weeks. 

If you rely on taking antacids or proton-pump inhibitors or have needed to take these medications for prolonged periods of time, you should consider whether digestive insufficiency may be a problem.   Did you know that heart burn can often be due to having too little stomach acid?   Likewise, poor production of certain pancreatic enzymes or lack of healthy bile production can impair the digestion of carbohydrates and fat, leading to bloating, discomfort and bowel irregularity.   Working with a clinician experienced in functional medicine can help to identify these issues through testing or a therapeutic trial.

If you recall that your problems go back to a specific time in your life or a food poisoning incident, you may need to consider the possibility that you’ve been colonized by some opportunistic bug, like Candida, salmonella or strep, or you may have developed an inflammatory immune reaction.   Stool testing and/or urine testing of organic acids can help to identify potential problems.   High levels of inflammation can be further investigated to rule out inflammatory bowel diseases like Chrohn’s and Ulcerative Colitis.  Other markers can show problems around “leaky gut”, loss of immune tolerance to normal flora and a lack of normal digestive function.

Encompassing many of these symptoms, Small Intestinal Bacterial Overgrowth (SIBO) is a condition caused from having bacteria, normally found in the colon, growing in the small intestine.   Basically, it’s a problem with good bacteria growing where they don’t belong!   Due to variants in the types of bacteria and the gases each produce, this condition can cause either diarrhea or constipation.  Both problems affect the neuromuscular function of the intestines, known as the migrating motor complex, and need to be addressed uniquely through a combination of diet change, medication and nutritional support.   SIBO is most commonly diagnosed through a relatively inexpensive lactulose or glucose breath test.  If this is a concern, dietary programs such as the Low-FODMAP, Specific Carbohydrate and GAPS Diet have all been shown beneficial in helping to treat the problem, as well as identifying a reason to further investigate.

Good recommendations all around include eating organic when possible (avoid the “dirty dozen”), spacing meals by at least 4 hours, and fasting 12 hours between dinner and breakfast the next day.   Chewing slowly, avoiding distraction when eating, reducing stress, taking probiotics and/or eating fermented foods and minimizing gluten, sugar and dairy will also provide benefit to digestion, body contour and overall well being.


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