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3 Primary Causes of SIBO - Dominick Hussey

3 Primary Causes of SIBO

The causes of SIBO or Small Intestinal Bacterial Overgrowth and how it develops is not entirely clear, and it’s still somewhat debatable. SIBO begin when there is a disruption in the mechanisms that control the number of bacteria that live in the small intestine. There are at least seven risk factors that are potential causes for that disruption.

  • Structural or anatomic issues, for example, after surgery, if there was damage to nerves that enervate the small intestine, or patients with Cystic Fibrosis
  • Motility disorders, so dysfunction of the migrating motor complex
  • Irritable bowel syndrome
  • Metabolic diseases like diabetes
  • Low stomach acid
  • Age
  • Organ system dysfunction
  • Medications

The 3 Primary Causes of SIBO

According to Chris Kresser, Functional Medicine and SIBO expert, three primary processes cause SIBO:

  • Low gastric acid secretion
  • Small intestine dysmotility
  • Disrupted microbiota

Low gastric acid secretion

Stomach acid suppresses the growth of ingested bacteria, which would limit bacteria in the upper small intestine. For this reason, hypochlorhydria, or low stomach acid, is a primary risk factor for SIBO.

Low stomach acid can develop:

  • When H. pylori bacteria are present
  • With chronic stress
  • As a consequence of ageing

There are also drugs that inhibit acid secretion, like histamine type 2 receptor blockers, and Proton Pump Inhibitors, both of which are used to treat heartburn and GERD.

If a person has heartburn and they take these acid-suppressing drugs for a significant period, it reduces stomach acid it may predispose them to develop SIBO.

Small intestine dysmotility

The next primary of the causes of SIBO is impaired intestinal motility or dysfunction of the migrating motor complex (MMC). The MMC sweeps residual debris through the gastrointestinal tract so abnormalities in the MMC may predispose to the development of SIBO.

Disrupted microbiota

The third of the primary causes of SIBO is a disrupted gut microbiome, but there is less research on this proving a direct cause. There are however several lines of evidence that support an association.

One is that it’s well-established that antibiotic use can lead to disrupted gut microbiome and in turn SIBO.

Celiac disease also leads to a disrupted gut microbiome, and there’s a definite connection between celiac and SIBO.

Disrupted gut microbiome has been shown to cause dysfunction of the ileocecal valve, and we know that dysfunction of the ileocecal valve can lead to translocation of bacteria that should stay in the large intestine into the small intestine, which is one of the principal ways that SIBO develops.



This article is not intended to provide medical advice, diagnosis or treatment.

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What is the Correct Definition of SIBO - dominick Husey

What is the Correct Definition of SIBO?

There are several different definitions of small intestinal bacterial overgrowth (SIBO). Part of the challenge of dealing with it is that there isn’t even really a consensus on how to define it. On the simplest level, it indicates the presence of excessive bacteria in the small intestine. But what is the correct definition of SIBO?

In this article, I discuss the different ways parameters or measures scientists have explored (at the time of writing) to find a correct definition of SIBO.

The Number of Bacteria

A more specific definition of SIBO is where the number of bacteria in the small intestine exceeding 105 to 106 organisms per millilitre. Usually, there should be less than 103 organisms per millilitre found in the upper small intestine, and the majority would be gram-positive. But this specific definition of SIBO relies on endoscopy, which is one of the two test methods used to detect SIBO, but it’s the least frequently used. In fact, I can not think of any Functional Medicine practitioner, that is using endoscopy to diagnose SIBO, so it’s not that helpful of a definition for our practical perspective.

The Type of Bacteria

In addition to the absolute number of bacteria in the small intestine, the type of flora also plays a role in the signs and symptoms of SIBO. The predominant bacteria metabolize bile salts to unconjugated or insoluble compounds, and that can cause fat malabsorption or bile acid diarrhea.

Microorganisms that preferentially metabolize carbohydrates to short-chain fatty acids in a gas can cause bloating without diarrhea. Whereas gram-negative bacteria that are overgrown in the small intestine like Klebsiella can produce toxins that damage the mucosa and interfere with nutrient absorption.

This explains why people with SIBO can have such a wide range of symptoms. It depends on which type of bacteria is overgrown in the small intestine. Again using the type of bacteria found in the small intestine to define SIBO relies on endoscopy.

Measuring Gases

The two main ways of testing for SIBO is through an endoscopy of the small intestine and a lactulose breath test. As mentioned above the former method is not practical. The breath test measures the quantity of hydrogen of methane produced in the small intestine. This method is relatively straightforward but there is no consensus on how to interpret the results. This lack of consensus makes it difficult to establish a firm definition based on the results of a breath test.


So what does this mean? There are three possible measures you could use to define SIBO: the number of bacteria, the type of bacteria and the gases produced in the small intestine. Using any of these measures to establish a correct definition is made difficult because of the limitation of the two main testing measures. It is my observation that currently, the majority of Functional Medicine practitioners (including myself) use the more practical breath test results to diagnose SIBO.



This article is not intended to provide medical advice, diagnosis or treatment.

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3 Overlooked Causes of GERD - Dominick Hussey - Functional Medicine

3 Overlooked Causes of GERD

According to the Canadian Society of Intestinal Research, 13% of Canadians suffer from Gastroesophageal Reflux Disease (GERD). This figure may be much higher because of the vast majority of people that experience GERD self-medicate. But what are the causes of GERD? Read on to learn more about this common disease and three overlooked causes of GERD.

What is Gastroesophageal Reflux Disease (GERD)?

GERD is when the contents of the stomach go up the oesophagus and into the throat.  The symptoms of acid reflux include:

  • Acidic taste in the mouth
  • Burning pain in the chest
  • Vomiting
  • Breathing problems
  • A chronic cough
  • Chronic laryngitis
  • Erosion of the teeth in longstanding issues

It is important not to ignore GERD as it may lead to chronic inflammation of the esophagus (Barrats Esophagitis) and even esophageal cancer.

What are the medical causes of GERD?

Medical textbooks describe the cause of GERD as a dysfunction of the lower esophagal sphincter that usually prevents the stomach acid from travelling from the stomach and up to the esophagus.

The medical treatment for sphincter dysfunction is surgery known as a Fundoplication. Surgeons wrap the upper part of the stomach around the lower part of the esophageal sphincter.

Like medication, the use of surgery is trying to treat symptoms and is not resolving the underlying causes of GERD.

What are Underlying Causes of GERD?

When looking for the cause of any health issue, it is best to take a simple step by step approach. This approach means looking for the most straightforward reason first.

1. Think of Diet First

If you suffer from any digestive issue including GERD then looking at your diet is an excellent first step.

Following an elimination diet, whereby most food allergens are removed, is an excellent place to start. Most elimination diets exclude wheat, dairy, spicy foods and nightshade vegetables.

Examples of elimination diest include:

The underlying cause of GERD may be Irritable Bowel Syndrome. Their symptoms are very similar. A low fodmap diet has been shown in clinical trials to help symptoms of IBS.

2. Dysbiosis

If the elimination diet does not give 100% relief, then the next consideration is dybiosis. Dybiosis is an imbalance or overgrowth of bacteria that live in the gut. Two types of dybiosis are associated with GERD.

H.pylori Overgrowth

H.pylori is a type of bacteria that live in the stomach and have been shown to be a cause of stomach ulcers. If someone has GERD and an overgrowth of H.pylori then it would seem reasonable to treat the H.pylori.

You can test for H.pylori using a stool, breath and blood test. Using a combination of all three tests ensures a more accurate diagnosis.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO can often be the underlying cause of IBS. It, therefore, makes sense that the treatment of SIBO may also help GERD.

SIBO can cause increased gas pressure in the small intestine and the stomach. This gas pressure may be one the mechanism by which SIBO causes GERD.

Reduced intestinal motility is associated with SIBO and may also contribute to GERD.

Testing for SIBO is achieved via a lactulose breath test.

Treatment of SIBO is a combination of a low fodmap diet, herbal antimicrobials and prokinetic supplements.

Prokinetics help with gut motility. Iberogast, a prokinetic, has been shown to relieve symptoms of heartburn and reflux. Another useful prokinetic supplement is Motilpro.

3. Increased Stomach Acid

If both dietary and dybiosis interventions do not give 100% relief, then the cause of GERD could be due to excess stomach acid.

The symptoms of high and low stomach acid often overlap however excess stomach typically occurs in younger people.

If younger people report a gnawing-type stomach pain or any family or personal history of gastritis or ulcers, there is a likelihood they are having issues with high stomach acid.

Treatment of increased stomach acid

In some cases, it may be necessary to use a take a short-term course of acid lowering medication.

Alternative treatments for increased stomach acid include a combination of Melatonin, B Vitamins, Betaine and Methionine.

Alternative treatments are not recommended for long-term use.

In Summary

Many Canadians suffer from GERD. The medical treatment of GERD is surgery.

3 often overlooked causes of GERD include diet, dybiosis and increased stomach acid.

If you think you have GERD then looking into these overlooked causes in a simple step by step approach may resolve your problems.



This article is not intended to provide medical advice, diagnosis or treatment.

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How Do Probiotics Work For Constipation and Gas - Dominick Hussey

How Do Probiotics Work For Constipation and Gas?

There is a growing body of evidence showing that probiotics help digestive symptoms. This evidence has anecdotal, clinical and research origins. But how do probiotics work?

One popular theory is that probiotics repopulate the gut. Scientific research has not currently proved this argument.

Another hypothesis is that probiotics help to rebalance the friendly bacteria by killing the harmful microbes.

Read on to learn about a recently published research study that shows how probiotics work for constipation and gas.

A recent study published in the PLOS One journal has shown that probiotics can help reduce gas and improve constipation by decreasing certain “unfriendly” bacteria in the gut. These unwanted bacteria included Citrobacter, Klebsiella and Methanobrevibacter.

The researchers recruited 21 healthy adults. Each adult took a probiotic mixture. The composition of the mix included five strains of Lactobacilli and two strains of Bifidobacteria. Each adult received the combination once a day for 60 days.

What the study found

At the end of the study, the researchers found that there was a significant reduction in the numbers of Citrobacter, Klebsiella and Methanobrevibacter bacteria. This decrease in bacteria coincided with a decline in gas and constipation.

More specifically the researchers were able to show that there was a direct association between the reduction in abundance of Methanobrevibacter, the decrease in flatulence (for all the adults) and a decline in constipation (for women only).

This finding is not a surprise as there is a close correlation between Methanobrevibacter species and constipation and the production of methane gas.

A frequently overlooked ability of probiotics is their antibacterial effect. Probiotics can produce antibacterial and antifungal peptides (chemicals) that help reduce bacterial overgrowth in the gut.

How Probiotics Work For Constipation and Gas

The researchers concluded that the probiotics work for constipation and gas through their antibacterial effect which led to the reduction in the unfriendly bacteria.

There have been many studies like this one that show that taking probiotics may help reduce digestive symptoms. These studies have used different types of probiotic species.

As well as Lactobacillus and Bifidobacterium there are two other classes of probiotics including Saccharomyces boulardii and Soil Based Probiotics.

Does it matter which probiotics you use?

The simple answer is no, but it does matter which particular probiotic supplements you buy.

When choosing a probiotic supplement, you should consider the following:

  • Make sure you purchase a high-quality scientifically tested product that is safe.
  • Be wary of marketing that claims that a product can help with specific symptoms.

If you do decide to take a probiotic, then listen to how your body reacts and ignore any purported claims. If you don’t feel any improvement or your symptoms worsen, stop that supplement and move on to the next.


This article is not intended to provide medical advice, diagnosis or treatment.

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Dysbiosis- #1 Overlooked Cause of Weight Gain - Dominick Hussey

Dysbiosis – #1 Overlooked Cause of Weight Gain

According to Statscan one in four adult Canadians are obese or carry excess weight. For some of these people, the cause of their weight gain is due to diet and lifestyle. For others, the reason seems less obvious. They eat well and do a right amount of exercise but still the pounds roll on. Some of these people visit their family physician for a medical explanation. Their doctor checks their thyroid but after testing that everything appears normal. Read on to learn about the #1 overlooked cause of weight gain that may be stopping you lose those unwanted pounds.

Dysbiosis – The Cause of Weight Gain for Susan

Susan, 44, came to me complaining of bloating, constipation, abdominal pain and weight gain. The digestive symptoms began one year previously shortly after a round of antibiotics. Her doctor gave the antibiotics for a chest infection. Susan had never before had digestive issues and so being health conscious went back to her doctor. Her doctor said that she was reacting to the antibiotics, which would resolve itself and in the meantime prescribed Laxaday (a laxative) for constipation and acetaminophen for the pain.

Susan took the medication for a month, but each time she tried to stop them her symptoms returned. Again she went back to her doctor who suggested she may have irritable bowel syndrome (IBS) and referred her to Gastroenterologist (GI) consultant for a proper diagnosis. After waiting two months for her appointment, she spent 10 minutes with the GI consultant who agreed with the diagnosis and advised her to manage her symptoms with her current medication. During the same consultation, Susan asked the consultant about some recent weight gain. She had put on 10 pounds in a month. The consultant replied that it was not their area of expertise and told her to ask her family physician.

Keen to find answers she went back to her doctor for an explanation for her weight gain. She told her doctor that her mother had a low thyroid and wondered whether that might be causing her weight gain. Her doctor agreed and sent her for blood work, but the results came back as normal.

For the next seven months, Susan put on another 20 pounds despite being careful with her calorie intake and increasing her exercise. Nothing would help, and she was becoming depressed about her weight. It was at this point after speaking to a friend who was a client of mine that she came to me for a functional medicine consultation.

As a functional medicine practitioner, I am trained to take a very in-depth case history and spend a long time (45 minutes) listening to our client’s story. This process allows me the best opportunity to identify the root cause of my client’s health issues.

After hearing Susan’s story, I told her that the cause of her weight gain might be the result of her poor digestion. More specifically I was suspicious she had dysbiosis.

Dysbiosis is an imbalance of bacteria that live in your intestines.

Research on Weight Gain and Dysbiosis

There is a growing amount of scientific evidence that there is an association between the makeup of the microbiota and weight gain. In studies of twins who were both lean and obese, researchers found that the thinner twin had a much more diverse microbiota compared to the fat twin.

The fact that we associate microbiota diversity with weight gain does not mean one affect the other – cause and effect. To demonstrate cause and effect researchers devised a novel experiment where they bred two same bacteria-free mice. Then they populated their guts with bacteria collected from obese women and their lean twin sister. The mice ate the same diet in equal amounts, yet the animals that received bacteria from an obese twin grew heavier and had more body fat than mice with microbes from a thin twin. As expected, the obese mice also had a less diverse community of bacteria in the gut.

In my practice, the #1 cause of dysbiosis is from medication most commonly antibiotics but also birth control medicine.

Dysbiosis is present in certain gut infections including small intestinal bacterial overgrowth (SIBO), candida and parasites.

To identify the cause Susan did a breath test for SIBO and a stool test to look for candida and parasites.

Susan was positive for SIBO.

To treat the SIBO, I put Susan on low FODMAP diet and various antimicrobial supplements to help balance and reduce her bacteria.

After two weeks, Susan reported 90 percent improvement in her digestive symptoms. After four weeks, she had lost 8 pounds. After ten weeks she had lost a further 10 pounds.

After 15 weeks her SIBO was gone (after retesting), and she was back to her healthy weight.

Susan was, of course, was thrilled and at the same time was amazed how treating her digestion had reversed her weight gain.


This article is not intended to provide medical advice, diagnosis or treatment.

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5 Supplements To Reduce The Christmas Dinner Bloat - Dominick Hussey

5 Supplements To Help Reduce The Christmas Dinner Bloat

Have you ever felt bloated and sleepy after Christmas dinner?

As a young lad after eating my grandmothers Christmas dinner, I would look like I had swallowed a soccer ball and would soon be sound asleep on the sofa.

Dial forward some 45 years after learning I have celiac disease I can understand why young body reacted in such a way to a meal full of wheat.

My solution is simple I just avoid wheat and can then sit comfortably on the sofa and watch the Christmas day movie without falling asleep.

Have you felt bloated after Christmas dinners?  Do want to avoid the same experience this year? If you do feel bloated, read on to learn more about which supplements I recommend.

Supplements to reduce the Christmas dinner bloat

Increase your stomach acid production

One of the most common reasons for bloating after eating is due to a lack of acid production in the stomach. Stomach acid helps break down protein-rich foods such as turkey. If you have low stomach acid, then the turkey will not be broken down sufficiently and will cause bloating. Reduced stomach acid related bloating occurs 5-10 minutes after eating.

To help increase stomach acid production, I suggest the following supplements:

  1. Braggs Organic Apple Cider Vinegar – take one tablespoon in some warm water 5-10 minutes before eating.
  2. St Francis Canadian Bitters – take one teaspoon 5-10 minutes before eating.
  3. Betaine HCL capsules – take one capsule during the meal.

Stimulate Digestive Enzymes

Digestive enzymes are mainly produced by the pancreas and by the cells that line your small intestine. These enzymes help to break down your food’s macronutrients such as protein into micronutrients such as amino acids. If you have reduced enzymes and foods are left in their macronutrient form this can lead to inflammation and bloating. This inflammation and resulting bloating can be much worse if you have a sensitivity to a particular food protein such as gluten or casein. Pancreatic deficiency bloating becomes apparent 30 minutes after eating.

To help increase production of pancreatic enzymes, I suggest the following supplements:

Reduce Gas Production from Small Intestinal Bacterial Overgrowth

Small Intestinal Bacterial Overgrowth or SIBO is condition occurs when bacteria that normally live in the large intestine overgrow onto the small intestine. A common symptom of SIBO is bloating that occurs roughly 30 minutes after eating. I find SIBO in the vast majority of my clients with or without digestive symptoms such as bloating.

To help reduce bloating from SIBO, I suggest the following supplement:

What supplements should I take?

If you are unsure what supplements to take, I suggest the following:

Determine when your bloating starts after eating. If it starts 5-10 minutes after eating, then you probably have inadequate stomach acid. I would then begin with the apple cider vinegar.

If the bloating starts later, then consider starting with the Bitters. If the bloating continues, then try the probiotics.



This article is not intended to provide medical advice, diagnosis or treatment.

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Does IBS Cause Lower Back Pain?

Does IBS Cause Lower Back Pain?

In my practice, clients with a primary presenting symptom of lower back pain often also report having irritable bowel syndrome (IBS) symptoms such as bloating, constipation, diarrhoea and gas. To the client, these two conditions appear unrelated. But are they? Does IBS cause lower back pain?

Research has found that IBS is associated unrelated extra-intestinal symptoms including Chronic Fatigue Syndrome, depression and Fibromyalgia.

Association of symptoms means that they usually appear together. It does not mean that one condition may cause the other.

For example, just because many of my clients with lower back pain also have IBS does not mean that the latter caused the former.

To say that one condition causes another you would have to observe that by treating one the other also resolves. In this article, I will outline a client case study whose back pain and IBS symptoms resolved on a low FODMAP diet.

Meet Kelly

Kelly 35, is a yoga teacher working in downtown Ottawa.

While participating in a yoga class, I was also attending I noticed that she avoided doing any postures that involved twisting. After the class, I asked whether Kelly suffered from lower back pain.

She said she did.

Kelly explained that the pain had started some four weeks previously. She had been receiving chiropractic care with a limited reduction in symptoms.

I indicated that if physical symptoms do not respond to physical therapy, then there is often an underlying condition that is driving the problem. I suggested that she come for a consultation with me so that I could assess her back pain and what might be causing it.

A week later she came for an initial consultation, and I took a full medical history.

As well as suffering from the lower back pain she also complained of digestive symptoms including abdominal discomfort, bloating, diarrhoea and gas. She had experienced these symptoms since she was a teenager. She had tried removing gluten from her diet to help her symptoms (which it did) but said that it was socially too stressful to maintain the diet.

On examination, I identified that her muscles were hypertonic or tight and a couple of the primary muscles that support her lower back were not functioning very well.

I explained to Kelly that in my experience over tight and poorly functioning muscles are often a cause and sign of low-grade inflammation. Furthermore, this inflammation often stems from problems in your digestion.

Some years previously Kelly was referred by her family to a Gastroenterologist about her digestive symptoms and was diagnosed as having IBS.

Recent research has found that approximately 80% of people with IBS have a condition called Small Intestinal Bacterial Overgrowth or SIBO.

SIBO is a condition where your friendly bacteria that normally live in your large bowel overgrow into your small intestine. One of the functions of the friendly bacteria is to breakdown fermentable carbohydrates known as FODMAPs.

When this process occurs in the small bowel, it can lead to a build of gases causing the symptoms of bloating, constipation and diarrhoea but also inflammation that can spread throughout the body.

Research has also shown that a low FODMAP diet can help reduce symptoms of IBS.

With this information in mind, I explained to Kelly that I thought that her poor digestive health might be causing her back pain and suggested that she try following a low FODMAP diet for two weeks.

Due to her experience of following diets, she was a little anxious but said she would think about it. I said that was, of course, her decision and to do what she could manage without getting too stressed.

Two weeks later at our follow up appointment she said that on reflection she had decided to embrace the diet fully. Furthermore, she reported significant improvement in both her digestive symptoms and lower back pain.

Interestingly she noticed that when on one occasion she veered away from the diet she observed the following day her lower back symptoms were worse.


Based on the clinical outcome, we could assume that Kelly’s back pain was the result of her IBS.

Can we expect that everyone with lower back pain and IBS will have the same outcome? The answer, of course, is no.

To make that conclusion we would have to carry out a much larger study.

That being said changing one’s diet is a relatively low-risk therapeutic intervention compared to for example long-term use of anti-inflammatory medication.

If you do suffer from lower back pain that has not responded to physical treatment and at the same time suffer with IBS symptoms following a 2-week low Fodmap diet would be a safe option.


This article in not intended to provide medical advice, diagnosis or treatment.

Now I’d like to hear from you. Do you suffer from lower back pain and IBS? Have you tried a low FODMAP diet? Let us know in the comments below.


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7 Little Known Warning Signs That You Have SIBO

7 Little Known Warning Signs That You May Have SIBO

SIBO or Small Intestinal Bacterial Overgrowth is characterised, as the name implies, by excessive bacteria in the small intestine.

Typical symptoms of SIBO include bloating, gas and constipation and or diarrhoea.

If you thought that not having any of these symptoms meant you do not have SIBO, think again.

There is a growing amount of evidence to show that SIBO can manifest with symptoms both inside and outside of the gut. Read on to find out more about some of the little-known signs and symptoms of SIBO that I observe every day in my practice.

Do you Burp after meals?

The majority of your friendly bacteria or microbiota should reside in your large intestine. Your small intestine should be virtually sterile.

One of the main occupations of the microbiota is to breakdown fermentable carbohydrates and produce valuable nutrients for your body as well as gases.

When SIBO occurs your microbiota overgrows from your large intestine to your small intestine. The microbiota that now lives in your small intestine continues to feed on these carbohydrates and produce gases.

These gases become partially trapped in the small intestine leading to the typical bloating and gas.  These gases are expelled upwards causing burping.

So, if you find yourself burping a lot especially after eating, this could be a symptom of SIBO.

Do you experience Fibromyalgia symptoms?

Fibromyalgia symptoms include chronic muscle pain and stiffness, especially across the upper back, neck and shoulders. There has been growing evidence of a link between Fibromyalgia and SIBO two studies published in the Annals of Rheumatic Disease, researchers from the Cedars-Sinai Medical Center found a direct association between subjects with fibromyalgia and SIBO. (1) (2)

Do you get Interstitial cystitis?

Interstitial cystitis (IC) is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. A large number of people who suffer from IC have SIBO. In a study published in Digestive Diseases and Sciences, researchers found 81% of 21 subjects with IC tested positive for SIBO. (3)

Are You Lactose Intolerance?

People with lactose intolerance are unable to completely digest lactose. Lactose is a sugar found in milk. A small but significant amount of people with a lactose intolerance also has SIBO. In a study published in the Saudia Arabia Journal of Gastroenterology, researchers found that 18% of subjects with IBS were also lactose intolerant. (4)

Do you have chronic low Iron and or B12?

You may have SIBO if you suffer from chronic low B12 or iron that does not increase with supplementation. It is thought that the bacteria that have overgrown into the small intestine take up nutrients such as B12 and iron before they can be absorbed. (5)

Do you suffer from Restless Legs?

Restless legs syndrome (RLS) is a condition in which you have an uncontrollable urge to move your legs. It typically occurs in the evenings while you’re sitting or when you first lie down to go to bed. Recent research has found a strong association between IBS and RLS. In a study published in 2012, researchers found that 25% of people with RLS suffered from SIBO compared to 6.5% of controls. (6)

Do you have Diabetes?

If you have been diagnosed diabetes and suffer from digestive symptoms then you may have SIBO. A recent study observed that SIBO was present in 43% of diabetic patients with chronic diarrhea, and 75% had a positive change in their symptoms after being treated with antibiotics. (7)


If you suffer from any of the above conditions with or without other digestive symptoms then I suggest that it worth looking into the possibility you have SIBO.

SIBO is diagnosed using a Lactulose breath test.


This article in not intended to provide medical advice, diagnosis or treatment.

Now I’d like to hear from you. Do you suffer from any of the above conditions? Have you heard of SIBO? Let us know in the comments below.


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What diet is best for IBS

How to choose the best diet for IBS?

Is there a best diet for IBS? The answer is: it depends.

The actual cause of IBS, short for irritable bowel syndrome,  is unknown although there have been numerous factors associated with it including food sensitivities, epigenetics, nutritional deficiencies, genetics and psychological stress. (1)

In my clinical experience, there is never one single cause for a condition it always a blend of factors.

The food we eat can often be a common constituent of this blend but deciding which foods are triggering your IBS symptoms can be confusing.

Read on to learn about the most clinically and scientifically valid diets for IBS and how to work out the best diet for you.

Diets for IBS

There are various of diets that have been shown either clinically or through scientific research to help with symptoms of IBS. In this next section, I will briefly outline each of these diets, beginning with the simplest.

A Gluten Free Diet

Gluten is a protein found in the protective casing around all grains. The most well known and most toxic glutens include:

  • Wheat gluten.
  • Barley gluten.
  • Rye gluten.
Other less well known but potentially harmful glutens are found in Spelt, Kamut, farro and durum.
If you suspect that gluten may be triggering your IBS symptoms, it is crucial that when following a gluten free diet you exclude all the above grains.

It is a well known scientific fact that gluten is associated with IBS. (2) A gluten-free diet has also been shown to help with IBS symptoms. (3)


FODMAP is an acronym, for a group of carbohydrates, which stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These carbohydrates are found in various foods and alcohols including:

  • Oligosaccharides –Fructans and Galacto-oligosaccharides found in wheat, rye, barley, onions, leek, shallots, garlic, legumes, lentils, artichokes, and chicory.
  • Disaccharides – Lactose found in dairy products.
  • Monosaccharides – Fructose found in honey, mango, watermelon, apples, pears, and high fructose corn syrup.
  • Polyols – Alcohols found in Apples, pears, apricots, nectarines, plums, cauliflower, products (e.g., gums & confectionery) sweetened with artificial sweeteners such as sorbitol known as polyols.

To download a more comprehensive list of FODMAP foods, please click here.

The low FODMAP diet has been shown to help IBS symptoms in several high-level clinical trials significantly. (4, 5)

FODMAPs are broken down by our friendly bacteria that normally reside in our large bowel.

In a significant percentage of people with IBS, these bacteria overgrow into the small intestine, known as small intestinal bacterial overgrowth or SIBO.

When the bacteria break down FODMAPs in the small intestine, they produce an excess of gases. These gases cause the symptoms of bloating and altered bowel function.

The diet is thought to help symptoms by starving the bacteria of FODMAPs.

It is important to see this diet as a short term measure to get symptoms under control since there concerns about the future health of the bacteria in the large bowel.

A Low Histamine Diet

Histamine is a compound produced by your immune system when it encounters an allergen.

Histamine Intolerance occurs where there is an excess production of histamine. Histamine intolerance has been associated with the development and severity of IBS. (6)

Histamine is found naturally in various foods and food additives.

In my clinical experience, I have observed IBS symptoms improve when clients have followed a diet low in histamine foods. A present there have no clinical trials to show that a low histamine diet helps with IBS.

A brief list of high histamine foods includes:

  • Leftover meats and fish
  • Processed or smoked meats
  • Fermented foods such as sauerkraut and kefir
  • Aged Cheeses and meats
  • Tomatoes and Avocados

To download a more comprehensive list of high histamine foods, please click here.

How to choose the best diet for IBS

If you suffer from IBS and are confused by which of the above diets to follow I suggest taking a simple step by step approach.

Begin by putting yourself on a gluten-free diet for at least two weeks. If your symptoms totally disappear, then you have your answer.

If your symptoms only partially improve, I suggest starting the low FODMAP and following that for another two weeks.

If your symptoms significantly improve, then this would strongly suggest that you may have SIBO. In such case, I recommend that you seek out a health professional, such as a Functional Medicine Practitioner or Naturopathic Doctor, that has experience in diagnosing and treating SIBO.

If your symptoms only partially improve, I suggest moving to a low histamine low FODMAP diet for another two weeks. If your symptoms significantly improve, then this is also a strong indication of SIBO.

To download a more comprehensive list of Low FODMAP Histamine Diet, please click here.

If your symptoms do not improve on the Low FODMAP Histamine diet, I strongly recommend you go to your doctor and ask to be referred to a GI specialist for further investigation including a colonoscopy.


This article in not intended to provide medical advice, diagnosis or treatment.

Now I’d like to hear from you. Do you suffer from IBS? Have you been confused about what diet to try? Do you have any other suggestions that have worked well for you? Let us know in the comments below.


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Diarrhea: Everything you need to know

If you live in Ottawa and you suffer from Diarrhea you are not alone. Each year, 4.5 billion people contract diarrhea worldwide. This blog will help you understand what are the common causes and how you might help your symptoms.

Your stool is typically composed of three-quarters water and one-quarter solid matter. With diarrhea, the moisture content is, of course, higher. Diarrhea is a symptom of an underlying condition. Determining the cause is essential for finding the right solutions to correcting the problem. Most diarrhea resolves itself when the cause is addressed. The loose stools are a way that the body can expel something it doesn’t need or is otherwise toxic.


  1. Loose or watery bowel movements.
  2. More bowel movements per day than normal (1-3x per day is normal).
  3. Urgency with elimination.
  4. Cramping or discomfort in the abdomen.
  5. Undigested food in stool.
  6. Fatigue and brain fog.

Common Causes

  1. Food allergies or sensitivities
  2. Lactose intolerance
  3. Sugar intolerance
  4. Leaky gut/damaged mucosal lining of the intestines
  5. Impaired digestion and absorption
  6. Trouble digesting fats
  7. Parasites
  8. SIBO
  9. Prescription drug use
  10. Antibiotics
  11. Lack of“good” bacteria nth gut
  12. Stress or anxiety
  13. Excessive magnesium or vitamin C
  14. Viral infection
  15. Food poisoning

Note: If diarrhea is or becomes chronic, check with a physician as malnutrition can ensue.

Treatment of Acute diarrhea

If you develop acute diarrhea, the following suggestions may be helpful for controlling your symptoms.

  1. Recline on your back with a pillow under knees
  2. Place a hot water bottle on a towel over the abdomen
  3. Drink plenty of fluids to avoid dehydration
  4. Try green juices, coconut kefiran tea
  5. Avoid dairy, fat, sugar and excess meat

Treatment of Chronic diarrhea

Dietary modification

If you have experienced diarrhea or loose stools for more than 2-3 weeks, then you have chronic diarrhea. This is the most common type I see in my practice. When considering any digestive symptom, I always look first to whether what you are eating is causing your symptoms. Below is a list of the diets that I consider in ascending degrees of complexity:

  1. Remove all Gluten, Dairy and Sugar-containing foods.
  2. Institute of Functional Medicine Elimination Diet: Remove all gluten, dairy, corn, soya, red meat, shellfish, and peanuts.
  3. Paleo Diet: Remove all grains, dairy, and legumes.
  4. Paleo Autoimmune diet: Paleo diet less eggs, nightshade vegetables, nuts and seeds.


In my practice, supplements are used as a supplementary measure alongside dietary modifications. Below is a list of common supplements I use in my practice when treating diarrhea.

  1. Soil-based probiotics
  2. L-glutamine
  3. Aloe vera juice (2-4oz)
  4. Increasing amounts of ground flaxseed
  5. Deglycyrrhizinated licorice (DGL)
  6. Psyllium husk
  7. Bentonite clay
  8. Zinc
  9. Digestive enzymes
  10. Ox bile if fat digestion is an issue

Functional Testing

If dietary modification and supplementation do not resolve symptoms, then I look to lab testing to uncover the root of symptoms. Below is a list of the most common tests I use in my practice.

  1. IgG food sensitivity testing
  2. Comprehensive Stool Analysis Test for Candida and Parasites
  3. Organic Acids Test for yeast, metabolic and overgrowth concerns
  4. Small Intestinal Bacterial Overgrowth (SIBO) Lactulose breath test
  5. Lactose Breath Test (or just remove dairy!)

If you have any questions about this article either post them in the comments section below or email using the form on my contact page.


This article in not intended to provide medical advice, diagnosis or treatment.