16 Scientifically Proven Best IBS Supplements
Are you looking for a supplement to help with your IBS symptoms?
Well, you are in the right place!
Because today I am going to show you the 17 best IBS supplements that you may consider taking.
Are you looking for a supplement to help with your IBS symptoms?
Well, you are in the right place!
Because today I am going to show you the 17 best IBS supplements that you may consider taking.
So the question of whether probiotics cause SIBO, based on current the evidence, the answer is no.
Today I discuss how recent research shows that nonalcoholic fatty liver disease is associated to gut issue.
Susan was experiencing severe bloating, gas and diarrhea. She had been to see her GP, 3 Gastroenterologists. All her tests were normal including bloodwork, an endoscopy and a colonoscopy. No one could explain her symptoms. Like most people in her position, Susan began to look for answers on the internet. Eventually, she came across an article on a condition known as leaky gut. Her symptoms appeared to match those of leaky gut. Her question was what were best leaky gut tests.
In this article, we will cover the fundamentals basics of leaky gut, is testing for leaky gut a good idea, and the two best leaky gut tests.
A leaky gut is a popular term that describes a condition where the lining of the intestines is not functioning correctly. The correct medical term for leaky gut is increased intestinal permeability.
The intestinal lining covers a surface area of about 400 metres squared and requires about 40 per cent of the body’s energy expenditure. That is pretty extraordinary when you think that the brain needs only 20 per cent of the body’s energy expenditure.
This fact tells us that the intestinal lining is essential to our health.
The gut is a hollow tube that connects the mouth to the anus. So, everything that is inside of the gut is technically outside of the body. Therefore everything that is inside of the gut is not technically inside of the body.
Therefore anything that is in the gut to move into the body has to cross that intestinal lining. A fundamental function of the intestinal lining is to let in things that should get in and keep out things that should not stay out.
When certain conditions are present, the intestinal lining’s capability of doing that task breaks down, and then all kinds of problems can happen.
Many factors can interfere with the function of the intestinal lining including:
There are other factors which we call endogenous factors. Endogenous means they are factors that occur inside of the body that can contribute to leaky gut.
Endogenous factors include chronic inflammation, SIBO, or gut-brain axis problems
In my opinion, a leaky gut is almost always a symptom of a deep-seated underlying issue, meaning that the underlying problem comes before a leaky gut.
Causes of a leaky gut may include any of above factors that interfere with the function of the intestinal lining.
One of the critical principles of functional medicine is that we want to get to the bottom of what is causing symptoms or even manifestations of a disease. We want to remove or address those causes or triggers before we try to do anything about the symptom or the sign. The more we can get to the root of the problem, the more effective the intervention will be.
In other words, by suppressing symptoms, it is going to be less effective, and will not last for as long because we have not addressed the underlying cause.
So with intestinal permeability, if we remove the triggers that are causing leaky gut in many cases, you will not need to address intestinal permeability because it will take care of itself.
One of the astonishing things about the cells in the gut is they regenerate every two to three days. Therefore if you remove the triggers that are causing the problem, the cells will revive and the tight junctions can restore themselves, and the intestinal permeability will disappear.
Hence typically in my practice clinic, before looking at a leaky gut, I will test and treat the triggers such as food sensitivities, gut infections and stress. If the patient is still having problems that we could associate with leaky gut, at that point, I will consider testing for intestinal permeability.
If you look at the research, many different leaky gut tests have been used to define or identify intestinal permeability. Some of these are more common than others, but I am just going to mention a few different ones, and then I will tell you what I use in my practice and what I recommend.
The first is the lactulose/mannitol permeability assay. This test uses molecules, sugars, long-chain sugars called oligosaccharides, and I will explain a little bit more about that in a later.
The second test is an antigenic permeability screen. This test looks at antibodies to particular antigens like lipopolysaccharides and then also antibodies to endogenous molecules like actomyosin, occludin and zonulin. These are proteins that the body produces in the gut that help to regulate tight junction permeability, the structure of the gut and determine whether the gut is permeable or not.
The next marker that researchers sometimes use in studies is an organic acid called D-lactate or D-lactic acid. D-lactate is different from lactic acid that you may have heard about that can be high after exercise. This organic acid is a product of bacterial metabolism which is produced in the gut. Some studies have shown a correlation between high D-lactate and increased intestinal permeability.
Butyrate, which is a short-chain fatty acid, has been investigated as a potential marker for intestinal permeability. Low butyrate is a sign of leaky gut.
Finally, zonulin is a protein that regulates the tight junctions in the gut has been investigated as a marker for intestinal permeability.
In terms of clinical practice and what is readily available and has been most validated by the scientific research, the lactulose/mannitol test and the antigenic permeability screen are the two best leaky gut tests.
The lactulose/mannitol test involves measuring levels of two sugars in the urine after the patient consumes those sugars. By looking at the ratio of the two sugars in the urine you can tell you whether the gut is permeable.
The lactulose/mannitol test is available through Genova Diagnostics.
There are some shortcomings of lactulose/mannitol testing.
One of the issues is that the transport of lactulose or mannitol through the gut barrier is not actually or not necessarily an indicator of a malfunction of the intestinal tight junctions. In other words, a positive result doesn’t necessarily mean that there is intestinal permeability present.
There are a lot of variables that can influence the uptake of the sugars, like GI motility, use of medication like NSAIDs, the surface area of the intestine, gastric emptying, and mucosal blood flow so these variations can affect the result.
Another issue is that some studies have shown that only large molecules (over 5,000 daltons) can change the permeability of intestinal epithelial cells and then result in an inflammatory response in the body.
Lactulose and mannitol are below 500 daltons, which suggests that they may not be appropriate as challenge molecules for an intestinal permeability test.
There are ways to increase lactulose/mannitol testing accuracy including:
The second test for leaky gut is called the antigenic permeability screen. This test was developed by Doctor Aristo Vojdani at Cyrex Labs.
In large part, Dr Vojdani developed the test because of the shortcomings of the lactulose/mannitol test.
Doctor Vojdani wanted to create a test that would better reflect pathological permeability of the gut. So instead of using larger sugars, he decided to screen for antibodies to proteins and bacterial endotoxins, since those are the primary concern when it comes to immunoreactivity.
We know that the uptake of antigens, proteins and bacterial endotoxins, plays a significant role in the pathogenesis of a gastrointestinal and autoimmune disease.
Many studies are showing that the inappropriate transfer of proteins and endotoxins from the gut into the bloodstream initiates an inflammatory response and can contribute to autoimmune disease. This understanding explains the connection between leaky gut and autoimmune disease. Less than 10 per cent of subjects with a genetic susceptibility to autoimmune disease progress to having a clinical autoimmune disease in their lifetime. This fact suggests that environmental triggers like toxic chemicals and infections and dietary proteins are probably involved in the development of autoimmune disease.
The Antigenic Permeability Screen is a blood test. This test is only offered by one lab, Cyrex Labs, and is called Cyrex Array 2.
This test needs to be ordered by a healthcare practitioner who is registered with the Cyrex.
The test involves drawing a blood sample and then testing for antibodies to lipopolysaccharide, IgM, IgG and IgA antibodies,
In practice, for the reasons I explained above I do not check for intestinal permeability very often. Typically I tend to look at the underlying cause of intestinal permeability and address that first. So although the mannitol/lactulose and antigenic permeability screen are the best leaky gut tests, If I do a sound job with addressing the root, in most cases, the intestinal permeability will resolve on its own.
When I do test for permeability, I use the Cyrex test.
This article is not intended to provide medical advice, diagnosis or treatment.
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Biofilms are protective coatings that bacteria and fungus form to protect themselves from antibiotics and herbal treatment. Biofilms may be at the root of infections that won’t go away like Candida, fungus, H. pylori and SIBO.
Read on to learn more about biofilms, why they turn bad, how to tell if they are affecting you, common infections associated with biofilms, testing and how to treat biofilms.
Biofilms exist pretty much anywhere there are microbes and moisture. Therefore, you can find them at the bottom of the ocean. You encounter them in the mucous membranes of any animal which includes their digestive tract, lungs or even in blood vessels.
Not all biofilms are bad. In the digestive tract of humans, the friendly bacteria use biofilms to protect themselves. So some play a part in us staying healthy. So we do not want to get rid of all biofilms.
You can illustrate the different biofilms by visualising a spectrum in front of you. Going from left to right, on the left you have good biofilms and on the right the bad biofilms.
The majority of biofilms begin as good or healthy. A useful way to imagine biofilms is to use an analogy of a fence. Good biofilms are like a garden fence that keeps the healthy bacteria in and any other unwanted intruders out.
As biofilms begin to become worse, then the fence becomes higher, and it starts to hold on to unfriendly bacteria.
At this stage, biofilms are known as early phase or phase type 1 biofilms. These are unhealthy but relatively easy to eradicate.
As you become sick and rundown and you lose your good bacteria, or they get rundown, the fence becomes more like a cage. Researchers liken this to a hive community, where you can have bad bacteria, viruses, parasites, protozoans, as well as friendly bacteria.
According to Dr, there are some broad indicators that may suggest biofilms are playing a role in your health.
Certain infections are most prone to formation of biofilm including:
There is currently no easy way to test for biofilms. You can look for them through biopsy, but this is not practical or cost effective.
Diagnosis is mainly based on empirical evidence from signs and symptoms.
In most traditional diets, there are anti-biofilm things that are either part of the food or part of the additives to the food such as:
There are a number of different natural compounds or biofilm disruptors that have been found to be effective for treating biofilms.
Any natural biofilm disruptor stronger than those above are new molecules that have been developed from individual natural compounds. Examples of popular strong natural biofilm disruptor include:
There is currently no scientifically validated prescription drugs to that treat biofilms.
When using biofilm disruptors it reasonable for you to experience some acute die off symptoms. This is a good sign that the treatment is working. Biofilm disruptors open up biofilms and make your immune system aware of the pathogens inside. When this happens, you get a very aggressive immune response which can not only be uncomfortable but scary.
Although every case is different, symptoms usually resolve between one and six weeks
Intolerance symptoms occur when you react to something in the supplement or drug. People tend to react to more sulphur containing compounds such as NAC, ALA or DMPS.
Typical intolerance reactions include flushing of the skin, itching, rashes and headaches.
Die off symptoms tend to be stronger and more global than from intolerances. Die off symptoms may include multiple painful joints or whole body muscle pains.
Die off symptoms can be very unpleasant. There are however some useful strategies to help manage these symptoms.
If you want to learn more about biofilms, I recommend the following article, “Biofilms: What Have We Learned from the Research?” written by Dr Paul Anderson.
This article is not intended to provide medical advice, diagnosis or treatment.
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You will not die from SIBO, but it does lead to various complications. The main complications of SIBO include:
Read on to learn about the complications of SIBO occur in the body.
SIBO is known to cause a B12 deficiency in the scientific literature. Vitamin B12 deficiency happens in SIBO as a result of utilisation of the vitamin by bacteria. When bacteria take up the vitamin, the bacteria partly metabolise it to inactive analogues, which compete with normal vitamin B12 binding and absorption.
Symptoms of B12 deficiency may include things like neuropathy, cognitive decline, or even dementia.
There is a high prevalence of SIBO in the elderly. This fact could make you question whether the B12 deficiency seen in the elderly is related to SIBO and not just “ageing.”
SIBO can also cause fat malabsorption, which leads to a buildup of free bile acids. A build-up of bile leads to mucosal inflammation can lead to increased intestinal permeability. Increased intestinal permeability aka leaky gut can lead to autoimmunity.
Fat malabsorption can also lead to a decline in the absorption of fat-soluble vitamin including:
SIBO can lead to blunted small intestinal villi that will decrease the activity of disaccharides. Disaccharides are enzymes that are required to break down carbohydrate.
A reduction in disaccharide activity will lead to carbohydrate malabsorption. Carbohydrate malabsorption will lead to a build-up of carbohydrates in the small intestine. The bacteria in the small bowels feed on carbohydrates.
So blunted intestinal villi will lead to increase the number of bacteria so worsening the SIBO.
Bacteria digest protein. When you have too much bacteria in the upper part of the small intestine, where the protein is absorbed, then that will interfere with your absorption of protein.
While B12 deficiency is prevalent with SIBO, folate levels can often be high in SIBO because of increased synthesis of folate by small intestine bacteria.
This article is not intended to provide medical advice, diagnosis or treatment.
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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.
According to Chris Kresser, Functional Medicine and SIBO expert, three primary processes cause SIBO:
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:
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.
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.
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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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.
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.
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.
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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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.
GERD is when the contents of the stomach go up the oesophagus and into the throat. The symptoms of acid reflux include:
It is important not to ignore GERD as it may lead to chronic inflammation of the esophagus (Barrats Esophagitis) and even esophageal cancer.
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.
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.
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.
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 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.
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.
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.
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.
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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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.
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.
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.
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:
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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