Healing Your Gut:
The Role of Gut Microbes in IBS and Bloating
Let's take two of the most common problems for which patients are often told
there is no cure: bloating and irritable bowel syndrome (IBS). If you are one of
those people who complains of stomach bloating, chances are high you
have already seen a specialist. Most likely you were told that there really was
nothing wrong based on the routine blood tests. Similarly if you suffered from
irritable bowel syndrome and a generally loose tummy, you received nothing
more than ineffective advice to improve your diet and control stress.
© Copyright 2014
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In fact if you suffer from any
gastrointestinal complaint
that your doctor has not
been able to isolate and
identify using conventional
diagnostics, you are one of
the patients who needs a
different type of evaluation
to get to the source of the
problem and to fix it.
Complaints such as bloating
and IBS are indicative of
functional disturbances in the
gastrointestinal tract caused
by a multiplicity of factors.
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Routine diagnostic tests
designed to detect
inflammation or virulent
pathogenic activity cannot
provide needed information
on how well the gut is
performing. Inefficient,
imbalanced and disturbed
gastrointestinal function is at
the root of the most common
complaints for which patients
often do not receive the right
kind of intervention. This is
because traditional medical
practice does not use
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advanced testing that is
designed to detect blocks in
the function of metabolic
processes and
gastrointestinal function.
Healing Your Gut
So the starting point for helping patients with gastrointestinal complaints, where standard
treatment has failed, is the identification of markers in stool, urine and blood samples for functional
fitness of the gut. Stomach acid levels, pancreatic enzymes, bacterial populations, parasite
burden, food absorption and retention capability are the key factors that need to be evaluated.
Only a few specialized laboratories offer GI function tests. We use Metametrix of USA through
Dubai-based Diagnostika Medlabs to enable us the use of these advanced evaluations.
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Importance of Stomach Acid
For proper gastrointestinal function,
adequate stomach acid production is
essential. Many people mistakenly believe
that stomach acid is harmful and do plenty
to make the gut environment less acidic. This
is a huge mistake. Unscientific advice to
reduce stomach acid or alkalinize it without
evidence for why it should be done creates
a perfect setting for bacteria, yeast, fungal
and parasite overgrowth. The right levels of
stomach acid are not only important for
basic digestive function but are a natural
protective barrier against microbial
overpopulation. One of the findings we often
see in patients is the body's increased
production of stomach acid in response to
pathogenic bacteria or parasites. This is a
natural defense and the acidic environment
makes it harder for disease causing bacteria
to thrive. Taking antacids without first
establishing the level of acid in the stomach
through testing can create more problems
than it solves in the long run. Complaints of
acidity must be assessed from multiple
perspectives instead of reflexively treating
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with anta-acids and proton-pump inhibitors.
Differentiating elevated stomach acid levels
caused in response to the presence of
pathogenic agents and stomach acids
levels that are purely organic in nature
makes for a safer and better treatment. If
there is inadequate pancreatic enzyme
release, stomach acid levels will stay
elevated because pancreatic enzymes
provide a buffer against the acid.
Paradoxically in some cases what appears
to be an acid reflux from too much stomach
acid can actually be result of too little
stomach acid. There are patients whose
antacid treatment does not produce the
expected results; they may very well be
suffering from inadequate stomach acid
production. Dr Alexander Bralley who
pioneered advanced
gastrointestinal testing
says that symptoms
of low stomach
acid easily resemble
those of excess and
may end up being
treated wrongly.
Healing Your Gut
At XY Clinics we follow a protocol
called ‘the four R’ aimed at:
o removing anything that negatively affects intestinal health
o replacing with the right enzymes
and supplements
o re-inoculating with pre and pro-biotics
o repairing the mucosal lining of the
intestinal tract so that the immune barrier protection is robust.
A careful evaluation of dietary influences can give a clue to this and the problem can be
corrected by supplementation aimed at aiding stomach acid production. When stomach acid
production is inadequate it leads to a reduced ability to extract and absorb essential metals and
minerals. Iron, zinc and B12 are just some of these. People who say they like to eat meat but
complain of not being to digest it well improve when stomach acid is boosted along with a
supplementation of iron and B12 under the supervision of a nutritionally qualified medical
practitioner. The common complaint of bloating is often addressed when stomach acid levels are
brought to optimum levels. Reduced immune function or complaints of low energy and fatigue
when a person seems to be eating a healthy diet and there are no other causes could be the
result of not extracting and absorbing essential and trace elements because of low stomach acid
levels. People who believe maintaining an alkaline or low stomach acid environment should be
aware that chronic hypochlorhydria or low stomach acid level is an open invitation for microbial
population over growth and pathogenic bacterial infections in the long term.
Our Microbial Friends and Enemies
Our view of the vast number of gut microbes is
changing as sophisticated studies aided by
advances in the laboratory testing begin to
show just how important microbial ecology is to
human health. This is an area that has
traditionally been neglected. Considering that
we have 10 times more microbes than cells in
our body, it is now becoming apparent that our
health depends pretty much on a fine balance
among the great number of microbes. When
the microbial eco-system in the gut is disturbed,
symptoms of ill health ranging from bloating,
irritable bowel and constipation to gut-linked
headaches show up. The widespread use of
antibiotics coupled with poor nutrition can
destroy useful microbial masses. Contact us for your appointment now.
www.xyclinics.com
Healing Your Gut
When an imbalance between beneficial and
harmful bacteria occurs and there is unregulated
growth, it is called dysbiosis. If dysbiosis develops,
then even the normally beneficial bacteria can
become a problem because their growth is
beyond what is optimally needed. A good
example is L-Acidophilus which is a beneficial
bacterium and which many people take in the
form of probiotic supplements. In individuals whose
stomach acid levels are low, L-acidophilus can
overgrow especially when the diet is rich in refined
carbohydrates. If you have suffered from bloating,
low energy or irritability and you suspect that it has
something to do with your gut function, you could
be right. Just like taking vitamins and minerals
without laboratory evidence for their consumption
could be bad, taking probiotics indiscriminately
without a reason for their use could actually lead to
complications in the long term. The estimated 400
microbial species in the human gut need to be
kept in fine balance. Since dietary habits such as
low fiber food, the use of antibiotics and antacids
can cause dramatic alterations in the microbial
balance, gastrointestinal complaints that have not
responded to standard therapy should be
investigated from the perspective of bacterial,
yeast, fungal and parasite levels.
About 400 bacterial species play a role in
health and disease; the beneficial bacteria
are called predominant. These are most
important and critical to our health. Either
because of poor diet including low fiber or
use of antibiotics, these highly beneficial
predominant bacterial populations can
shrink. Measuring the levels of the good
bacteria is essential before attempting to
improve gastrointestinal health. Just as gut
issues show up when the good bacteria
levels fall, problems develop when their
population goes too high. The trick is
ensuring the right balance. If a person
suffers from constipation chronically, a
suspect cause could be undesirably high
levels of the predominant bacteria. Some
of the other symptoms of overpopulation
are cramping, bloating and flatulence.
Yeast or parasite infections can also cause
altered balance of the bacteria.
XY Clinics Dubai: Jumeirah, Al Wasl Road, No. 992, P.O. Box: 345013. Telephone: +971-4-3807554 Email: [email protected]
XY Clinics Bangalore: Genlabs Healthcare Pvt Ltd. Kasturingar Main Road, Bangalore – 560 043 Telephone: +91-80-25458516 Email: [email protected]
XY Clinics Lucknow: D.R. Building, Era’s Lucknow Medical College&Hospital, Sarfarajganj, Hardoi Road – 226003 Telephone: +91-522-3201150 Email: [email protected]
Healing Your Gut
Bacterial Baddies
There are bacteria that are really bad. Among these are Helicobacter pylori (H. Pylori) and
Clostridium species. For every 10 patients we test, we see a 30 to 40% H. pylori infection rate. H.
Pylori causes peptic ulcers and increases the risk of some types of cancers, therefore identifying
infection and deciding on appropriate therapy can help reduce future risk. In response to the
presence of H. pylori, the stomach turns acidic to make it difficult for the bacterium to populate.
While excess stomach acid secretion is harmful in itself, the ammonia produced by the bacterium
can do significant damage to the intestinal wall and to some cells. If an individual's capacity for
clearing the rising levels of ammonia is sub-optimal, symptoms including tiredness, fatigue,
irritability and nausea can develop. Not every individual who gets H. Pylori shows peptic ulcers
and other gastro-related disease states, thus most people carrying it do not even get tested. In
diabetic patients whose kidney function is already challenged, additional ammonia produced by
H. Pylori will make the matters worse.
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In some H. Pylori patients, the stomach acid
levels show up as low and PH as high. It is an
indication that the normal defense
mechanisms have failed and H. Pylori is
thriving. When the stomach does not have
sufficient stomach acid, it creates an
environment that is quite hospitable for other
pathogenic bacteria as well. Moreover basic
nutrient extraction and absorption become a
problem. Protein digestion becomes a
challenge. In treating H. Pylori, clinicians give
a class of drugs called proton pump
inhibitors. These drugs block or reduce
stomach acid production. One reason for the
re-emergence of H. Pylori in a significant
number of patients could be the
unwarranted targeting of stomach acid. If H.
Pylori overwhelms the body's natural defense
system and has thrived, it would lead to a
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very alkaline, low stomach acid level. A
common breath test done to detect H. Pylori
is not 100% accurate and may be picking up
the H. Pylori presence in only those patients
who show signs of greater ammonia
production. Indeed according to the Finnish
biotech company, BioHit, which specializes in
H. Pylori tests in blood and biopsy samples,
nearly 30% of breath tests for H. Pylori could
be false negative. H. Pylori infection can go
undetected with a breath test in those
individuals who respond to the infection with
a higher acid load but without presenting any
clinical issues. We have seen this in a number
of cases and the detection was possible only
when using advanced tests. Because patients
are not tested for stomach acid/PH levels,
several conditions arising from lack of
adequate stomach acid levels go
Healing Your Gut
The Parasite Poison
Testing for the presence of parasites is helpful
in treating conditions whose cause is difficult
to identify with invasive procedures. Parasites
can enter the body through water and food.
Even swimming pools can be a source of
parasites such as Cryptosporidium. If you
have suffered from diarrhea, abdominal
pain, fatigue or nausea and the treatment
recommended by your doctor has not
resolved the problem, you could be carrying
a parasite infection that has gone
undetected and untreated. Some parasite
infections will remain asymptomatic or cause
symptoms every now and then. Most
laboratories do not offer parasitology testing
and thus patients do not get the help they
need.
Leaky Gut
The lining of the intestinal tract is coated with mucosal cells. The muscoa acts as a protective
barrier against the passage of disease-causing molecules. Several factors can cause a weakening
and loosening of tight junctions between a particular type of intestinal cell. When this happens,
the gut becomes permeable and a condition called leaky gut or intestinal permeability develops.
In leaky gut, the natural barriers against entry of unwanted substances through the intestinal lining
fail and unfriendly toxins and foreign agents enter the liver. If the leaky gut is not addressed, the
increased demand for detoxification can overwhelm the liver's capacity to carry out the
cleansing functions. Increased sensitivity to some foods is a result of the leaky gut. Gluten-caused
inflammatory response becomes heightened. Confirming leaky gut by measuring the passage of
large molecules through the loosed junctions requires a special test called Lactulose-Mannitol
Intestinal Permeability available from Diagnostika Medlabs at Dubai Biotechnology Park. The
repairing and healing process can take months and the patient will need both dietary and gut-
friendly non-drug products.
Stress and Gut Health
Our first line of defense against harmful
microbes is through an immune-enhancing
product called Secretory IgA. This
immunoglobulin inactivates disease-causing
pathogens and allergens by acting on
them. Secretory IgA levels rise when there is
stress. However in the event of chronic stress,
the body's ability to produce Secretory IgA
goes down. Depressed Secretory IgA levels
contribute to reduced immune barrier
function. Because patients do not get
evaluated for stress issues in a standard
clinic visit, the real cause of their problems
goes undetected and attended. Addressing
the stress issues and providing support to the
adrenal glands will help improve gut health
and slowly restore Secretory IgA levels.
Healing Your Gut
Food Intolerance Testing: Is It Valid?
From the time food intolerance testing was introduced, experts have rarely agreed. Most
gastroenterologists dismiss the scientific validity of food intolerance. While food allergy (IgE)
testing is accepted as indisputably valid, food intolerance testing (IgG) is considered dubious
by a large majority of gastroenterologists. When individuals are told that they have intolerance
to dozens of foods, the validity of such findings comes into question. The health care
practitioner whether he is a doctor or a dietician who recommends intolerance testing should
be in a position to show how the suspect foods are clinically linked to the complaints of the
patient. Failure to provide a relationship between the so-called intolerant foods and clinical
symptoms leaves open the question of validity of the test. Users of intolerance testing are simply
told that they are intolerant without being provided an explanation of why or where the
intolerance comes from.
Some people report feeling better after removing certain foods from their diet. Our own surveys
of such patients indicate that most often the benefit is linked to removal of carbohydrates.
Frequently this happens to be wheat. Food intolerance testing can cost as much as Dh2500.
From a common sense perspective, all that an intolerance test tells you is that it is time to rotate
your diet. Intolerance by definition is temporary and eating from a wide variety of foods, and
eating whole foods usually works quite well. Any food intolerance has an underlying cause. It is
far more advisable to have your gastrointestinal function assessed comprehensively than to rely
on questionable food intolerance testing. If you believe you must do it, please make sure that
the tests offer something called IgG subclass 4 as testing for total IgG gives many false positives.
If your intolerance test shows you have a problem with 20 or 30 foods, you should ask yourself if
it makes sense. On the other hand assessing your gastrointestinal function may help pinpoint
why you may not feel great when eating some foods.
Healing Your Gut
All of us have species of bacteria in our gut that act on compounds from phenol-rich foods such
as berries, cherries, onion, tomato and artichoke. If the level of bacteria that act on these foods is
higher than desired, you may not feel so well eating them. In this case the underlying cause to
possible intolerance is the overgrowth of the phenol-metabolizing bacteria. Controlling the level of
the bacteria resolves the problem.
Similarly if you don't feel good when you eat meat products, it may
be because you do not have sufficient availability of acid and
enzymes needed to break down the protein in the meat. Again
identifying the real cause is better than removing meat products
from your diet for a few weeks only to find that the problem has not
been solved.
If you have high levels of the common yeast Candida, you will not feel great when you eat sugary
foods and carbohydrates as Candida pretty much thrives on these. Or if you have increased
histamine activity, you may report sensitivity to several foods. In this case you may be suffering
more from histamine intolerance than food intolerance.
Are You Really Wheat Intolerant?
In recent years, the number of people taking themselves off of wheat
products has been increasing. Using a food intolerance test to remove
gluten from your diet may not be a good idea even if you felt better
after the removal of wheat or rye products. If you think you have a problem with gluten, there are
two ways you can confirm this beyond doubt. Tests such as deamidated gliadin antibodies and
tissue transglutaminase can provide confirmation of inability to tolerate gluten. These are tests that
were developed to check for risk of celiac disease. Another option is to do a saliva-based genetic
test that shows whether you carry a mutation in two genes called HLA-DQ2 and HLA-DQ8.
Is it really food intolerance?
For more information or to book an appointment, contact us at www.xyclinics.com