Hello, friends!
Let me start by saying that if you’ve ever struggled with gut issues, I get it. Truly, deeply, from the depths of my… well, gut. I’ve been there—bloated, uncomfortable, and Googling things like “why does my stomach hate me?” at 2 a.m; I'm being facetious. Actually, I signed up for functional medicine school and studied diligently for about 2.5 years. It was the first time I learned about gut health as the foundation of health.
Nurse practitioner school, like any modern medical or physician assistant school, teaches to give medication to mask symptoms, spends about an hour one day of class stating the basics of how lifestyle changes are important (such as a mediterranean diet and 150 minutes of exercise in a week), and we are taught many of these conditions are 'chronic.' Minimal discussion on the why component of lifestyle change and what these changes do physiologically. I had learned these medications should solve my issue and those of my patients, however, the medications are typically not a cure. Suffice to say, allopathic interventions failed me and were ineffective for my numerous gastrointestinal conditions. This experience began while in Tennessee and followed me to Oregon, Idaho, and Washington.
If you are wondering why I am writing this blog post, personal as it is, so I am. I never imagined discussing such topics, nor seeking to specialize in this area of medicine. We are taught to maintain a professional decorum and not talk about ourselves with patients. I find complete abstention from this with my own clinicians (physicians and nurse practitioners) results in a sterile, unsympathetic environment; It is a disservice to patients who often feel unheard, ignored, and misunderstood. Yes, the focus is on YOU, the patient, but we are all human and connection may be the most valuable thing we have.
My goal here is to be somewhat relatable with you, "Sufferer of Gastric Woes," and let you know I empathize with you as a clinician and patient. In my studies from a Bachelors in Biology to a Master of Science in Nursing to a Doctorate in Nursing Practice, I learned foundational knowledge, but certifying in functional medicine and moving to the naturopathic realm truly aided in my healing. This is my abridged, personal journey through the Small Intestinal Bacterial Overgrowth (SIBO), candida overgrowth, and intestinal permeability.
Small Intestinal Bacterial Overgrowth
SIBO, or Small Intestinal Bacterial Overgrowth, was my first introduction to the world of gut drama. Imagine nearly every food you eat resulting in either bloating, diarrhea, constipation, insufferable abdominal pain, and a disdain for cooking shows you once watched. What’s worse, I learned that the health foods I’d been eating (broccoli, cabbage, etc) were essentially fueling the bacteria that had decided to set up camp in my small intestine. Garlic is supposed to help, but an allergy prevents its use for me. I was vegan for six years and steadily declining in health. Total protein levels in my comprehensive metabolic panel were low and despite being thin, I was becoming metabolically unhealthy with elevated liver enzymes and high cholesterol. I ate every vegetable that should be helping me was not a daily potato chip, french fry vegan.
Diagnosis was key here—after some strategic functional testing, I finally knew what I was dealing with. I learned in training about SIBO and the various manifestations. Depending on the type treatment may differ. I was treated with metronidazole and rifaximin, but had other healing or lifestyle changes resulting in persistent of the condition. Clostridium overgrowth, a clostridium species that is not the clostridium difficile you hear about as an opportunistic infection in hospital patients, causing abdominal symptoms and resulting in nearly absent vitamin c levels.
The treatment? A combination of herbal antibiotics and dietary changes. But....it's a bit more complicated.
Candida Overgrowth
Candida, a naturally occurring yeast, is harmless in small amounts and generally considered endemic to the human microbiome. Unchecked, it will consume any sugar or carbohydrate you consume and multiply. For me, candida manifested as chronic fatigue, memory deficits, sugar cravings (I consider chocolate a food group), and recurrent skin conditions. A significant issue with candida as well as bacterial overgrowths is that they can form biofilms, wherein the organisms pack together and resist medication therapies. People develop vaginal candidiasis or oral candidiasis. The CDC estimates 25,000 people die annually from candidemia, a systemic blood fungal infection. Fungi are ubiquitous, as is Candida. And some individuals suffer from candida overgrowth for years.
Treating it required a combination of herbal antifungals, probiotics, dietary change, commitment, and will power. Even traditional medication was needed in my case. But, there's more.
Enhanced Intestinal Permeability
Next up was enhanced intestinal permeability, or “leaky gut,” which sounds made up. Specific lab testing can help direct this diagnosis, however, it can be deduced from symptomatology and other lab markers. We have written other blogs on this topic and I spoke about it at a nurse practitioner conference this year. The gut lining becomes too porous, letting things through that shouldn’t be there like bacterial toxins. Life stressors, food choices, overt or stealth gut infections, and medications all worsen this dynamic. For me, this meant food sensitivities, brain fog, and feeling tired even after a night’s sleep. The unfortunate part is that food sensitivities are an immune system response to proteins in the foods you eat regularly and thus perpetuate the porosity of the gut lining via continued inflammation. People will steadily reduce the foods they eat to next to none. Eating 2-3 foods is not particularly enjoyable for anyone, but this occurs in severe cases.
What's more, the endotoxins from clostridium overgrowth and candida overgrowth were worsening this condition and a cycle developed: Eat a food, worsen the overgrowth, develop a food sensitivity, switch foods, develop a sensitivity, and perpetuate the overgrowth.
To repair the gut lining, inflammation reduction is necessary. Step one? Stop the damage. I recommend stopping all gluten (wheat, gluten containing grains), dairy (there can be cross reactivity), processed foods, sugar, reduce stressors (these worsen leaky gut, and medications that cause an insult (NSAIDs, steroids etc). Step two? Rebuild. Supplements like L-glutamine, collagen, bone broth, mucilaginous herbs, and probiotics (often a trifecta of lactobacillus species, saccharomyces boulardii (beneficial yeast), and certain bacillus species). Fasting can be integral to healing as well, because the gut needs time to heal. All five steps are outlined in this blog.
Why This Journey Matters to You
I share this not to scare you off carbohydrates (except wheat and maybe all grains if you have an autoimmune condition or honestly any chronic condition at all) or make you second-guess your conventional medicine clinician, but to let you know I’ve been in your shoes. Gut health issues can feel isolating and confusing. But here’s the good news: you don’t have to navigate it alone.
As someone who’s been through it I can empathize with what you’re going through. Whether it’s diagnosing the root cause of your symptoms, finding the right treatments, or simply reassuring you that it’s okay to be upset you are giving up a favorite food, we're here for you. As with many things in life, this is a journey. It takes strength, resolve, time, guidance, and the right resources.
Let’s Tackle Gut Health Together
My personal experience has fueled my passion for helping others heal optimize their gut health. If you’ve been struggling with bloating, fatigue, food sensitivities, or just feel like your gut is staging a rebellion, we can help. Together, we can identify what’s going on, create a plan to fix it, and get you feeling better. In the interim, check out our Wellness Guide for comprehensive lifestyle recommendations and our Cookbook to follow the same paleo recipes we do.
Brendan
DNP, AGPCNP, ACHPN, AFMC
Kommentare