In recent years, the public’s awareness of gastrointestinal problems and the microbiome have skyrocketed. An increasing understanding of the link between the gut and overall wellness has been a boon to the food and supplement industry, some of which have been based on evidence, while others are a bit more questionable.
Irritable Bowel Syndrome
IBS is classified as either IBS-C (constipation dominant), IBS-D (diarrhea dominant), IBS-M (mixed constipation and diarrhea), or IBS-U (unspecified with symptoms not clearly fitting into any other categories). Symptoms of IBS other than constipation and diarrhea include:
- Abdominal pain
- Urgent defecation
- Urinary frequency
- Severe menstrual symptoms
- Fat or mucus in the stool
Leaky Gut Syndrome
The cells that line your intestines are tightly connected to avoid the leakage of toxins and harmful bacteria out of your body, while preserving nutrient absorption. In some people, this barrier loses its integrity. This can happen because of genetic susceptibility to leaky bowel syndrome that is then triggered by changes in the gut bacteria caused by a poor diet or some medications, possibly including NSAIDs such as Advil and Motrin and the proton pump inhibitors used to treat GERD, among others. It is possible that environmental triggers such as mercury and air pollution are to blame for some of the damage to the gut lining. Certain food additives such as emulsifiers, and an excess of salt and sugar might also contribute to a leaky gut. Once the toxins or harmful bacteria leak into your bloodstream, inflammation develops and can cause other health problems, possibly including:
- Food allergies
- Seasonal allergies
- Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
- Celiac disease
- Multiple sclerosis
- Nonalcoholic fatty liver disease
- Inflammatory breast cancer
- Chronic fatigue syndrome
Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is more common in older adults and among those with certain preexisting conditions, including diabetes, celiac disease, Crohn’s disease, cirrhosis, cystic fibrosis, chronic pancreatitis, and scleroderma. The use of narcotics is also implicated in the development of SIBO. Symptoms are very similar to those of IBS and include:
- Abdominal pain
- Fecal urgency
- Weight loss
Individuals with SIBO are at a higher risk of nutritional deficiencies, including fat-soluble vitamins (vitamins A, D, E, K), iron, and vitamin B12.
Worth a Try
Increasing fiber intake is the most important thing you can do to improve your diet in terms of gastrointestinal wellbeing. Individuals who eat a higher fiber diet enjoy the benefits of having a higher number of bacterial species. Taking a fiber supplement won’t do the trick, though. You need to get a wide variety of types of fiber from different foods, such as beans and green vegetables.
Fermented foods such as sauerkraut, kimchi, yogurt, and kefir are rich in probiotics that support a healthy gut. If you notice an increase in bloating or other problems when you introduce more of these foods into your diet, ease off for a while. Some experts recommend avoiding fermented food if you have both SIBO and IBS.
Small and frequent meals are especially helpful for people experiencing symptoms from IBS. Eating small amounts every three to four hours has helped with symptom relief among people used to eating three large meals a day.
Avoidance of sugar alcohols is important for individuals suffering from an overabundance of gas or experiencing diarrhea. The following should be avoided:
Omega-3 fatty acids found in oily fish such as salmon and tuna, nuts and seeds, and plant oils can help relieve the inflammation linked to gastrointestinal problems.
Avoidance of large amounts of caffeine and alcohol has proven to reduce pain and bloating for some people substantially.
Exercise seems to improve gut health in various ways, including an increase in the diversity of the microbiome (the more types of good bacteria present in your intestines, the better). As most athletes know, exercise prevents constipation and keeps you regular. Exercise is also anti-inflammatory and increases butyrate, which protects intestinal cells.
Ginger has been beneficial to individuals experiencing GI problems like nausea, bloating, or flatulence. Ginger appears to speed up gastric emptying and has long been known to help with motion sickness and other causes of nausea. Be careful not to overdo it, though! Too much ginger can cause heartburn and diarrhea in some people.
Slippery elm is a traditional Native American remedy that comes from the inner bark of a tree and is commonly dried and used in capsules, teas, and tinctures used to soothe the mucous membranes lining the esophagus, stomach, and intestinal membranes. The antioxidants in slippery elm also help to relieve inflammatory bowel conditions. Always talk to your doctor before adding any herbal supplements to your regimen. Because slippery elm coats the digestive tract, it could potentially slow the absorption of other medications or herbs and should be separated from other herbs or drugs by at least two hours.
L-glutamine is an amino acid naturally found in the GI tract and promotes the growth of intestinal cells, thereby repairing the lining of the gut that has become compromised in people with leaky gut syndrome.
The Low FODMAP diet is a fairly complicated diet that I usually reserve for patients with irritable bowel syndrome symptoms that are severe enough to affect their quality of life negatively. FODMAPS are fermentable oligo-, di-, and monosaccharides and polyols. These sugars are found in various foods such as beans, milk, specific fruits and vegetables, and wheat. Instead of being absorbed, these small carbohydrates are fermented by gut microbes, leading to excess gas, bloating, and diarrhea. After being on a low FODMAP diet for two to four weeks, you can slowly reintroduce some high FODMAP foods into your eating plan and see how they affect your body.
Peppermint is used as a smooth muscle relaxant and, in clinical trials, alleviates irritable bowel syndrome (IBS) symptoms. Peppermint oil also reduces abdominal pain by targeting specific pain receptors. Uncoated peppermint oil can cause reflux, so enteric-coated peppermint capsules are the way to go.
The Gut and Psychology Syndrome Diet (GAPS) eliminates a vast list of foods and recommends adding bone broth and probiotic-rich foods to the diet. Proponents of the diet state that it will treat leaky gut syndrome, depression, and ADHD. However, there is no research to back it up.
The only people who are likely to be helped by a gluten-free diet are those who have been formally diagnosed with celiac disease or gluten intolerance.
Detoxes to clean your gut are unnecessary and can be quite dangerous. Your lungs, kidneys, colon, lymphatic system, and liver are your body’s detoxification system. There is no evidence that changing your diet will release toxins built up in your organs and fatty tissues.