Simple Gut ReSet
Establish the root cause.
After thorough case taking, including symptoms, lifestyle, health and dietary history, one of the first things I do for many of my clients is to order a microbiome stool test. This fast tracks our work together as it helps me to deliver a more targeted strategy, depending on specific gut imbalances. I utilise state of the art functional laboratory testing, which looks at the health of the microbiome using DNA technology to analyse the bacterial, fungal and viral communities of the gastrointestinal tract.
This information allows us to get the results we are looking for quicker and more efficiently. More here.
A personalised protocol will be developed after I have gathered more information from you and we have the results of this test, with a plan to go forward for the first phase of the programme.
This part of the protocol consists of a nutritional strategy, including example meal plans and recipes, often with nutritional and herbal supplements, and lifestyle recommendations.
Depending on the severity of your symptoms, it may be recommended to follow a simplified low FODMAP diet (or modified low FODMAP diet) for the first 2 - 6 weeks of the programme. The aim is to remove anything from the diet that might ferment in the intestines, thus allowing the inflammatory response in the gut to reduce, before the next stages of the protocol can take effect.
FODMAPs are Fermentable, Oligo-saccharides, Disaccharides, Monosaccharides and Polyols, or short-chain fermentable carbohydrates (1).
75% of IBS sufferers find relief from following a low FODMAP diet, however, it's important not to follow the elimination phase of the diet for more than 6 weeks, in order to minimise any potential nutrient deficiencies. This is because FODMAPs are specific carbohydrates and fibres that feed our gut microbiome. It was designed as a short-term strategy to help determine which foods may be triggering your IBS symptoms.
It's a 3-step diet which entails the low FODMAP elimination phase (2 - 6 weeks), followed by a re-introduction phase, and finally the personalisation phase.
The full low FODMAP diet can be very difficult to follow, as it restricts so many foods. And it's likely that you don't need to follow such a restrictive diet, especially if you already know which foods are aggravating your health problems. I prefer to keep it simple, and only remove the foods that we know are causing an issue. The idea is to maintain a diet with as much diversity as possible, so as to keep the microbiome healthy, by feeding it with the nutrients it requires.
And this usually includes high FODMAP or high fibre foods, therefore the reason why it is only a short-term therapeutic strategy.
I will also be addressing other possible root causes of your IBS, including looking at your lifestyle, stressors, and ensuring maximum digestive capability by incorporating mindful eating practices.
Physical movement and exercise is key to a healthy life, equally as important as a healthy diet. Studies show that sedentary behaviours are a major risk factor for chronic health problems such as cardiovascular disease and metabolic syndrome (which includes diabetes, insulin resistance and obesity). Furthermore, exercise is a potentially effective and feasible treatment for IBS (2). Therefore, getting active is a necessary part of this programme.
While physical movement is crucial, it's important not to overdose on exercise, therefore finding a balanced approach is essential. Too much exercise can be equally as damaging to our health as too little, and it's important to find the right amount and the right type of exercise that works for you. We are all individual, and some of us need more than others.
What's important is to be aware that too much physical exercise can be extremely taxing to our adrenal glands, and for some people, can lead to extreme fatigue and burn out.
For many people, a restorative yoga practice can be all that is needed (3), alongside plenty of walking. While others may need to include high-intensity interval training, running and/or weight training.
Even a quick 10-minute walk can help to reduce bloating and flatulence associated with IBS.
This part of the plan involves how we manage our stress and looks at ways to encourage relaxation, rest, and good sleep, which is crucial for good health.
The 'fight or flight' stress response is designed as a short-term response to an emergency or a stressful situation, and it stimulates the adrenal glands to secrete stress hormones, cortisol and adrenalin. Life in the 21st century exposes us to chronic overstimulation of the adrenal glands, which ultimately may lead to inflammation in the body, digestive distress, weight gain, low mood and poor sleep, among other symptoms.
The central nervous system is composed of the sympathetic nervous system (fight or flight) and the parasympathetic nervous (rest and digest). These two systems don’t occur at the same time, and ideally, we need to flip between them at different times of the day. However, we can all too easily get stuck in the sympathetic nervous state. We must encourage calming activities so that our bodies can rest and digest. Mindful eating practices are important to stimulate the vagus nerve and the parasympathetic nervous system, so that our digestive system can function effectively.
This is because the vagus nerve is the main component of the parasympathetic nervous system, and its' stimulation improves gastric acid (stomach acid) secretions and gut motility. Besides using mindful eating practices, some other ways to stimulate the vagus nerve include yoga (4), meditation, acupuncture, massage, cold water therapy and spending time in nature or green spaces.
Once we have done the work of removing problematic stimuli and established other root causes of your IBS, we can put it all together into a personalised long-term maintenance plan.
It's important that you avoid your triggers, and maintain your new healthy diet and lifestyle habits to continue to feel well.
The small changes that you have made up to now will become your new habits. It takes time and commitment to establish new healthy habits and routines, so don't be too hard on yourself if you find yourself repeating your old behaviours.
If you fail at something, then just try again, you will get there eventually.
The key to success is finding a balance between the 4 steps: Nourish, Move, Restore and Maintain. Once you've experienced the benefits, it's hard to go back!
**As mentioned on the previous page, if your symptoms are persisting, we can look at the possibility of small intestinal bacterial overgrowth (SIBO) as being an underlying factor.
SIBO is a condition where there is an accumulation of bacteria in the small intestine. This overgrowth of bacteria, which should normally reside in the large intestine, can interfere with our normal digestion and the absorption of our food and nutrients. These bacteria consume our food and then produce gas within our small intestine. This gas can cause abdominal bloating, pain, constipation, diarrhoea, belching and/or flatulence (5).
The main symptoms of SIBO are the same as Irritable Bowel Syndrome (IBS) and can only be detected by the use of specific breath testing, as opposed to stool testing. However, a microbiome stool test may show indicators that a SIBO breath test is warranted.
Breath testing measures hydrogen and methane gases produced by the bacteria. A sugary solution of either lactulose, glucose or fructose (or all 3) is consumed after a 1 or 2 day preparatory diet and then several breath samples are taken over a short period of time.
The results of this test can help your practitioner to determine the types and amounts of gas present. This is important to know because there are differing protocols for the
removal of the bacteria, which usually consists of specific antimicrobial herbs, specific prebiotics and probiotics, nutritional supplements, and a change in the diet.
* Further testing and sessions would incur an additional fee.