5 Things You Need to Know About Coffee Enemas

Picture of coffee beans on a white backgroundWith the spring equinox coming up on the 20th March 2019, there is no better time of the forthcoming year to cleanse the liver. Coffee enemas are a simple and effective way to do this.

How do coffee enemas work?

Coffee enemas have been around as early as the 1800s. Studies done in the 1920s showed various therapeutic effects from coffee enemas. Max Gerson, founder of the Gerson Therapy, further studied the effects of coffee enemas and used them as part of his treatment programmes.

When a litre of coffee solution is introduced into the colon it passes through the colon wall into the system of blood vessels that take blood from the intestines to the liver, the portal system, as opposed to passing through the whole digestive system. This is the reason why I personally do not recommend coffee colonics, but only enemas.

Various compounds in the coffee have specific effects. For example, the palmitic acid that coffee contains, increases glutathione S-transferase, an enzyme critical in quenching free radicals and the master-antioxidant used by our liver to detoxify toxins, by 700%! Free radicals can cause damage to our cells and our DNA.

The coffee also causes the bile ducts to dilate so that more toxins can be excreted through bile into the intestines for exit out of the body. At the same time the theophylline and theobromine in the coffee cause dilation of the blood vessels, allowing more blood to pass through the system for filtering by the liver.

How will I feel after a coffee enema?

Most people report increased mental clarity and energy after a coffee enema. They can also help to normalise bowel movements, particularly if you suffer from constipation, contrary to many people’s fears that using enemas will make the bowels weaker. The fluid actually increases peristalsis, the movement in the gastrointestinal system that aids the movement of substances through and, in the case of unwanted or indigestible substances, out of the body.

However, coffee enemas are not suitable for everyone (see below) and certainly if you feel wired or jittery afterwards with as little as a teaspoon of coffee then it would be wise to try the alternatives suggested below instead.

How to make your coffee enema solution

Organic Ground Coffee

Coffee enemas should be done with organic ground coffee and never instant coffee! I would suggest starting low with a teaspoon if you are sensitive to coffee or you have anxiety or adrenal fatigue and see how you get on. If you have no health issues and don’t fall into the category of people who shouldn’t do a coffee enema listed below, then you can start with a heaped dessertspoon of ground coffee. You can slowly increase up to as much as 3 tablespoons if there are no adverse reactions.

  • Place the coffee in a non-aluminium pan with two pints of filtered water. The filtered water is essential, as tap or plastic bottled water will introduce more toxins into the system.
  • Bring the mixture to a boil and allow it to boil for 3 minutes, then simmer for another 15 minutes.
  • Strain the solution through a stainless steel fine meshed sieve or through unbleached coffee filter paper and allow it to cool to body temperature.
  • Top up to 1 litre with some body temperature filtered water and place in your enema kit.

If you are pushed for time and don’t have time to let the mixture cool down, you can just use half a pint of liquid in your pan and top it up to make a litre of body temperature water with a mixture of cold and boiling filtered water.

Open the tap at the end of your enema kit over a sink or toilet and let the fluid run through the tube until you have fluid with no gaps all the way along the tube – the gaps are air bubbles, which should be got rid of as they make the enema difficult to administer. You can help the process by squeezing the top of the tube where it meets the bag. Close the tap as soon as you have released the air bubbles.

Picture of an enema kit and its components on a white background

It’s a good idea to add about 10 oral magnesium drops or a magnesium citrate capsule opened up into the solution, stirring well. Coffee enemas can cause a loss of electrolytes so this helps to re-balance things. Ideally a pint of freshly made green juice a day (unless you have digestive issues) can be a great way to re-balance those electrolytes, as it floods the body with potassium. It is also preferable to do a coffee enema in the morning as the caffeine can affect sleep.

How to administer a coffee enema

Grab a thick folded down to place underneath your bottom and lie down somewhere comfortable within quick and easy reach of a toilet. Some people like to do enemas in the bath as they find that the heat enables them to retain the solution. I find that slightly pulling apart with both hands on my lower abdomen helps me to retain the enema. Others find that lying on their right side with their legs pulled up slightly can help them to retain. Then hold the enema for 15 minutes and release it into the toilet. It will help you to retain it if you have had a bowel movement beforehand or flushed out your colon with a water flush enema beforehand, using one to two pints of body temperature filtered water and allowing it to be expelled as soon as the urge to defecate comes.

Coffee enemas are not suitable for everyone

Enemas of any description should not be used during pregnancy. Some people are very sensitive to caffeine.

Some people have a genetic variation which means they cannot detoxify caffeine efficiently. Other people, particularly people with adrenal fatigue / M.E., can find coffee enemas too stimulating.

Coffee enemas would also be contraindicated with diarrhoea; heart, kidney or respiratory failure; inflammatory bowel diseases; removal of part of the colon or intestines; high blood pressure and post-surgery unless under supervision from a qualified naturopathic nutritionist.

Whilst absorption of caffeine is minimal with a coffee enema in comparison to drinking caffeine, there is still some absorption taking place.

It’s also important to make sure you are well hydrated, i.e. you are drinking 4 pints a day of still, pure water – read my blog on hydration for more information on the best way to get yourself hydrated. Coffee enemas can be quite dehydrating on the body so are really not a good idea until you have your hydration levels up.

If you are unsure how you react to coffee, start very slowly with a teaspoon of coffee in your coffee solution. If you react ok to this, you can then start to slowly increase a teaspoon at a time.

If you find that you cannot tolerate the caffeine because it makes you feel wired, gives you palpitations or causes shallow breathing or a feeling of anxiety, then you can try an enema solution with 2 level teaspoons of choline bitartrate powder instead of caffeine. This is also good for cleansing the liver but does so in a much gentler way.

The other option, as long as you do not have Coeliac disease, is wheatgrass powder. Ensure the wheatgrass powder is pure and organic and start slowly with a ¼ tsp in your enema solution. Wheatgrass enemas are harder to hold onto because they are so detoxifying.

The microbiome

More and more studies are emerging about “the microbiome”.  This is the community of microbes that live inside us.  We have microbiomes on our skin, in our gut, vagina, mouth and nose. Practically any cavity inside us can have microbes inhabiting there.

We have about 10x as many microbes living inside us, or on us, than we have human cells (and we have approximately 75 trillion cells)!  This indicates the idea that we should be scared of microbes or bacteria is a little outdated.

Probiotics

The growing interest in particularly the gut microbiome has led to multiple probiotics coming onto the market.  The supermarkets are filled with “gut friendly” bacteria-laden yoghurt.

Is taking care of that ecosystem inside us as simple as swallowing a probiotic every day or eating some yoghurt?

Well, unfortunately, the answer is no!

Probiotics and fermented foods cannot repopulate your bowel flora – as they only stay in the system temporarily.  It’s the prebiotics that feed the microbes and can ensure the survival & flourishing of the ones we want in our systems.   

What are probiotics?

According to WHO, probiotics are “live organisms which when administered in adequate amounts, confer a health benefit on the host.”  However, the cultures we get in supermarket yoghurts cannot survive the pasteurisation process that those yoghurts go through.

In order for a yoghurt to be considered a probiotic food it must contain live cultures.  Whilst it is true that raw yoghurt can contain live cultures, again these effects are only temporary.

Therefore, using probiotics and fermented foods has to be done alongside eating prebiotic, bacteria-feeding foods or supplements to really be effective.

The most well researched prebiotic supplements are lactulose, fos and gos. However, research around acacia gum and partially hydrolysed guar gum is also emerging.

What are prebiotics? Prebiotic foods include what we call “FODMAPs” which are highly fermentable carbohydrates. These include whole foods like whole grains, nuts, seeds, onions, garlic and brightly coloured organic veggies.

However, these foods and supplements are often poorly tolerated with people with SIBO and IBS. Therefore, working on the IBS is essential so that someone can then work on building their gut microbiome. 

Probiotic quality

We are beginning to see that throwing multiple strain probiotic supplements, is not necessarily an effective strategy.

It’s about getting the right person for the job because different probiotic strains have different therapeutic qualities.  For example, Lactobacillus Rhamnosus GG, has been shown to help cell growth in the intestines and enhance the protection of the gut wall.

Some probiotics act as anti-microbials against pathogenic (disease-causing) micro-organisms and positively affect our immunity. Furthermore, they produce beneficial compounds in the gut, have anti-inflammatory effects, speed up or slow down gut transit time, and even alter our brain chemistry and metabolism!

So, how do you know that you are getting the right probiotic for the job?

Do your research! We’ve all done it, myself included, purchased a supplement because we’ve read somewhere that “probiotics are good”.  But, this is not an effective approach.  

Probiotic dosing

Importantly, dosing is about getting the right amount of intake. Unless research shows lesser doses of a particular probiotic to be effective, the general rule of thumb is that a single strain should contain at least 10 billion CFU to be effective.

Consequently, each strain within multi-strain probiotics should contain at least 10 billion CFU.  Many people don’t think about particular strains or dosages of a probiotic, so it’s a good point to remember.   

Furthermore, we have many different species of bacteria living within us.  Stool testing can show which species we have and diversity is the key. We’ve all heard of lactobacillus and Bifidobacterium, but research is showing that these aren’t the only two species that can have significant impacts upon someone’s health.

Akermansia muciniphila and faecalbacterium prausnitzii, the new kids on the block in terms of research, have been shown to be protective against leaky gut and inflammation and to be good indicators of increased microbial diversity in the gut.

In conclusion, certain prebiotics feed certain species of bacteria, so by knowing what exists within us we can target our food choices more specifically to increase certain populations.   

Fermented foods.

Fermented foods can also help feed the populations in the gut.  They cannot specifically colonise in the way that probiotics can, but they can certainly be used to increase the growth and diversity of beneficial bacteria in our microbiome.

Good choices include raw sauerkraut, raw kimchi, tempeh, miso and kefir.  Heat can destroy the bacteria, so add your choices to your food at the end of cooking instead of heating them up within the food, and ensure that your kimchi and sauerkraut are raw and unpasteurised! 

Finally, each microbiome, whether it be skin, gut, oral or vaginal, is drastically different so we can’t take a one size fits all approach.  Suffice to say that the vaginal microbiome is essential for urinary tract health and reducing fungal or bacterial infections.

The oral microbiome is a whole article in itself!  And our skin microbiome, which is there to provide us with protection, has taken a real bashing from the new age of antibacterial wipes and sprays that plague our supermarket shelves! 

Key takeaways

So, what are the key takeaways? Emerging research is showing how important certain microbes that live on and inside of us are for overall health.

But, eating supermarket yoghurt and taking probiotics with no actual goal in mind with no idea of what each particular strain does and whether it contains a therapeutic dose, is not going to make much of an impact on increasing your microbial diversity.

Stool testing, which can be ordered through a naturopathic nutritionist, will give you a much better idea of the health of your gut microbiome and your overall gut health.

Once armed with that information, your practitioner can help you choose the right probiotics and prebiotics for the job by looking at the research, mixed with some raw unpasteurised fermented foods and by adding onions, garlic and eating around 14 different coloured whole foods a day!     

References 

Aureli, P., A. Fiore, et al. (2010). “National survey outcomes on commercial probiotic food supplements in Italy.” Int. J Food   
Bao, Y., Y. Zhang, et al. (2010). “Screening of potential probiotic properties of Lactobacillus fermentum   
Cao, Y., Shen, J., & Ran, Z. H. (2014). Association between Faecalibacterium prausnitzii Reduction and Inflammatory Bowel Disease: A Meta-Analysis and Systematic Review of the Literature. Gastroenterology research and practice, 2014, 872725.  
Carlson, J., Erickson, J., Lloyd, B., Slavin, J. (2018). ‘Health Effects and Sources of Prebiotic Dietary Fiber.’ Current Developments in Nutrition, Volume 2, Issue 3.    
Hawrelak, J. A. (2013). Probiotics. Textbook of Natural Medicine.  
Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., … & Calder, P. C. (2014). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology, 11(8), 506.   
Huebner, J., R. L. Wehling, et al. (2007). “Functional activity of commercial prebiotics.” International Dairy Journal.  
Kristensen, N. B., Bryrup, T., Allin, K. H., Nielsen, T., Hansen, T. H., & Pedersen, O. (2016). Alterations in fecal microbiota composition by probiotic supplementation in healthy adults: a systematic review of randomized controlled trials. Genome medicine, 8(1), 52.   
Miquel, S. et al. (2013). Faecalibacterium prausnitzii and human intestinal health. Current opinion in microbiology, 16(3), 255-261. 
Mohammedsaeed, W., McBain, A. J., Cruickshank, S. M., & O’Neill, C. A. (2014). Lactobacillus rhamnosus GG inhibits the toxic effects of Staphylococcus aureus on epidermal keratinocytes. Applied and environmental microbiology, 80(18), 5773-81.   
Naito, Y., Uchiyama, K., & Takagi, T. (2018). A next-generation beneficial microbe: Akkermansia muciniphila. Journal of clinical biochemistry and nutrition, 63(1), 33-35.   
Patel, S., & Goyal, A. (2012). The current trends and future perspectives of prebiotics research: a review. 3 Biotech, 2(2), 115–125.  
Rao, R. K., & Samak, G. (2013). Protection and Restitution of Gut Barrier by Probiotics: Nutritional and Clinical Implications. Current nutrition and food science, 9(2), 99-107. 
Reid, G. (2006). Probiotics to prevent the need for, and augment the use of, antibiotics. The Canadian journal of infectious diseases & medical microbiology. 17(5), 291-5.

Genetic Testing – What is Epigenetics and Why Should We Care?

What are genes? 

So back to classroom biology!  We inherit 23 chromosomes from our father and 23 from our mother.  These chromosomes act as storehouses for our DNA, which contain our 23,000 or so genes.  Each gene codes for the production of a particular protein within the body.  Those proteins have important functions.

An example of this is the gene that codes for the production of the enzyme that degrades our stress hormones when the stressor has passed.

Another example is the gene that codes to produce the enzyme that helps us make nitric oxide to keep our blood vessels pliable.  Or the gene that codes for the break down homocysteine, which research suggests is implicated in cardiovascular disease. 

The DNA that makes up our genes contains sequences but, as we are all different, so are our genes and we can have variations in those sequences.  These variations are called single nucleotide polymorphisms or SNPs (pronounced “snips”) for short! So when you hear people say they have this gene or that gene, they have a genetic variation.   

The new paradigm shift in the way science looks at genes 

Nutrigenomics looks at how a particular gene variant is behaving and how we can change that behaviour with certain nutrients.  This is an exciting and emerging field of science which is starting to show us that our genes are not our destiny.

Even more exciting is the field of epigenetics.  Research suggests that we can switch the expression (or behaviour) of our genes on or off through the environment we give them to live in, i.e. our internal environment.  In other words, our diet and our lifestyle can influence whether a particular gene variant is going to be damaging to us or not.   

I have a particular gene variant – what should I do? 

Those of you who know a little about this field may have already done some genetic testing and may have found out that you have certain SNPs.  But the trick is not to look at a particular SNP in isolation.  We need to consider the body as a whole, what other conditions someone might have, what medications they might be on and of course how these genes interact with each other.

Treating a particular SNP with a particular supplement is not a holistic approach and in some cases can actually do more harm than good.  For example, treating an MTFHR variant with methylfolate may be prudent in one individual but may have a completely different effect on someone else with the same variant.     

Is genetic testing for me or not? 

Picture of lab technician testing samplesMany people are terrified to find out whether they have a particular gene variant as certain gene variants can indicate a higher risk of certain diseases.

However, the scientific field of epigenetics is now showing that by upregulating or downregulating certain genes through diet and lifestyle, we can change the way they behave.

So knowing that certain foods or lifestyle factors such as sleep, exercise and stress reduction can influence whether or not that particular gene variant expresses itself can be incredibly empowering and motivate us to change the way we approach what we ingest or how we live our lives for the better.

Genetic testing puts you back in control

Epigenetics puts us in the driver’s seat as opposed to the outdated model of thinking that taught us that our genes are our destiny, something which we fall prey to and can do nothing about.   

Personally, I’d rather know if I had a gene that put me at a higher risk of heart disease if I ate a higher fat diet, for example, so that I could change my diet.

Example: The ketogenic diet

The ketogenic diet has been shown in research to have positive neurological effects, having been used as an effective treatment for epilepsy since the 1920s.  However, if I knew I had a gene that meant I was at higher risk of cholesterol, then I wouldn’t embark on a high fat ketogenic diet.   

But genetic testing really shouldn’t take the place of making diet and lifestyle changes, which lay the foundations for health and wellbeing.  The next step would be functional lab testing and genetic testing would really be the last stage, enabling some fine-tuning of a nutritional and lifestyle programme.   

Key message

So, the key message here is that we have more autonomy over our genes than we think. We have the ability to influence gene expression through our dietary and lifestyle choices.

And whilst it is well worth getting some testing done to establish what gene variants you have in order to prevent potentially chronic illness in the future, we still need to work on those lifestyle factors regardless of whether we have good genes or not, as our lifestyle factors can, as Dr Ben Lynch, N.D. says, “dirty” our genes! 

References  

Alegría-Torres, J. A., Baccarelli, A., & Bollati, V. (2011). ‘Epigenetics and lifestyle.’ Epigenomics, 3(3), 267-77. 
Barañano, K. W., & Hartman, A. L. (2008). The ketogenic diet: uses in epilepsy and other neurologic illnesses. Current treatment options in neurology, 10(6), 410-9. 
Bouchard-Mercier, A., Paradis, A. M., Rudkowska, I., Lemieux, S., Couture, P., & Vohl, M. C. (2013). ‘Associations between dietary patterns and gene expression profiles of healthy men and women: a cross-sectional study.’ Nutrition journal. 
Deans, C., & Maggert, K. A. (2015). ‘What do you mean, “epigenetic”?’ Genetics, 199(4), 887-96. 
Ganguly, P., & Alam, S. F. (2015). ‘Role of homocysteine in the development of cardiovascular disease.’ Nutrition journal, 14, 6.  
Hardy, T. M., & Tollefsbol, T. O. (2011). ‘Epigenetic diet: impact on the epigenome and cancer.’ Epigenomics, 3(4), 503-18. 
Imam, M. U., & Ismail, M. (2017). ‘The Impact of Traditional Food and Lifestyle Behavior on Epigenetic Burden of Chronic Disease.’ Global Challenges, 1(8), 1700043. 
Institut Pasteur .(2015). “Our epigenome is influenced by our habitat and lifestyle.” ScienceDaily.  

IBS Symptoms and Treatment – Could You Have SIBO?

Picture of woman holding her stomach with red area of inflammation radiating from underneath her handsCould I have undiagnosed IBS?

Prevalence and Symptoms of IBS

Statistics show that approximately 2 in 10 people in the UK have IBS.  Many more people are thought to have IBS who have either not been diagnosed correctly or haven’t consulted a GP for a diagnosis. Many people think that IBS symptoms such as constipation, loose stools, going to the toilet less than once a day, wind or bloating is normal.

In terms of a healthy bowel movement, the gold standard is 2 to 3 times a day and doesn’t leave any marks on the toilet bowel or even on the toilet paper!  Can you honestly say your stools are like that?

Common Treatments for IBS

IBS is commonly “treated” with medications such as Moviprol to relieve constipation or Immodium to stop diarrhoea. Proton Pump Inhibitors such as Omeprazole and Lansoprazole are prescribed to relieve symptoms of acid reflux and heartburn. All of which have side effects.

So, we are going to take a look at the side effects of using such medications. However, please consult a qualified health professional before making any decisions about medications.

Effects of Moviprol: Picture of multicoloured medications

If you are taking Moviprol, have a look at the sodium content in it.  It is very high and the wrong sort of sodium in the wrong sort of amounts can affect our cell health, blood pressure and heart health.

Effects of Immodium:

When we have loose stools, there is a reason the body is trying to eliminate so rapidly.  We need to find out the reason, whether it is excess toxicity trying to escape or rapid transit time due to stress.

If we just ‘fix’ the symptom, then where will that toxicity go if we are stopping it from coming out?  It goes deeper, where it can store itself in joints such as in arthritis, extra tissue such as endometriosis, or, even worse, in organs.

Effects of Omeprazole / Lanzoprazole and the Question of Stomach Acid Production:

Numerous research studies have indicated the dangers of Proton Pump Inhibitors.  There have been links made in various studies between PPIs and an increase in mortality, stomach cancer and even neurological conditions such as dementia.  Whilst I’m not suggesting you stop taking medication without talking to your GP, it does raise concerns that you might not have been aware of.

Not only do these medications have concerns surrounding their long term effects, but also stop a vital function of the body – they decrease the production of acid in the stomach.  “But I’ve got acid heartburn”, I hear you say, “so why would I not want to decrease the production of stomach acid?”

Diagrammatic illustration of an open lower oesophageal sphincter allowing acid to backflow into the eosophagus, causing GERDStomach acid purposes

Well to answer that question, let’s look at the main purposes of stomach acid production:

  • The production of stomach acid actually triggers the tightening of the lower oesophageal sphincter, which prevents stomach acid from rising up into the oesophagus.  So causes of acid reflux can actually include too little stomach acid. Conversely the treatment often dished out like sweets for acid reflux is the very thing that can cause reflux in the first place!
  • Secondly, it is produced to break down proteins so that we can use them to regenerate our bodies.  So when people don’t produce enough stomach acid, they can have impaired protein digestion and are not able to use the protein they take in to maintain optimum physical function.  Instead it putrifies in the large intestine, causing toxicity.
  • Thirdly, stomach acid has the effect of killing of any unwanted bacteria and prevents it from accumulating in the small intestines, a major cause of 60% plus of IBS cases!

Whilst some people do produce too much stomach acid, the majority of people actually produce too little. This is usually after use of antacids such as Gaviscon or PPIs.

I can hear you saying, well that’s all well and good Bee, but the symptoms of IBS are horrendous so what do I do?  Well don’t worry, there are lots of natural alternatives. Most importantly naturopathic nutrition looks at addressing the root cause. So let’s take a look at some possible root causes of IBS. Our main focus is on the biggest known cause of IBS, SIBO.

Causes of IBS

SIBO

Research suggests that one of the biggest causes of IBS could be something you have never even heard of! Diagram illustrating the anatomy of the lower digestive tractSIBO – small intestinal bacterial overgrowth.  Studies have shown that 60-84% of people with IBS actually have something called SIBO which is causing their IBS symptoms?

But what is it?  And is it curable?  Well, we are supposed to have an abundance of certain bacteria in our large intestine, but not in our small intestine.  SIBO is where bacteria have overgrown backwards into the small intestine.

Causes of SIBO

Poor gut motility

Poor gut motility is when food and bacteria aren’t being swept down through your digestive tract effectively.  Gut motility is controlled by something called the migrating motor complex (MMC for short).

The functioning of the MMC can be impaired by illnesses such as gastroenteritis (gastric flu) or a severe bout of food poisoning (24 hrs or more). I can also be impaired by infections such as Lyme Disease or mould toxicity, and even an impact that has knocked or shaken the head.  This is not as easy to address and may warrant ongoing treatment with natural prokinetics to keep everything moving through.

Poor digestion

Picture of a man with his head in his hands looking stressedAs discussed above, low stomach acid is obviously one cause.  Other causes include impaired production of digestive enzymes, impaired production of bile and low secretory IgA which acts as an immune defence in the gut.

Causes can even be as simple as drinking with or close to meals (which dilutes your digestive juices). Or not chewing your food properly and eating whilst distracted (by our phones or the TV). Eating on the go, or eating under stress or whilst upset or angry can also cause poor digestion.

Stress shuts down our digestive system. With so many people under constant chronic stress, it is affecting their digestion all the time.  Taking time to do some deep breathing or anything that calms you before every meal, helps switch your body into rest and digest mode.

Obstructions and abdominal adhesions

Adhesions are scar tissue that form after surgery, a perforated appendix or a haemorrhage.  Obstructions can be caused by conditions such as endometriosis, diverticulitis and superior mesenteric artery syndrome.

Medications and stimulants

We have already discussed the dangers of anti-diarrhoea medications and PPIs above. Other medications such as opiates, narcotics, antispasmodics and even trycyclic antidepressants such as amitriptyline can all cause poor gut motility, as can cigarette and cannabis use.

For some people SIBO can reoccur throughout their life, depending on the cause, but for others it can be cured by addressing the route cause.

How Do I Know If I have SIBO

Consult a SIBO practitioner like myself who can carry out primarily a 3 hour lactulose breath test, possibly Lab technician assessing lab test resultsfollowed by a glucose test as well if necessary.  It is important that the test is a 3 hour test and that it tests for both methane and hydrogen.

Methane & hydrogen are emitted by bacteria in the small intestine, before you have had chance to absorb your food. Causing the symptoms of wind, bloating, stomach cramps, iron deficiency, B vitamin deficiency, fatigue, etc!  But a word of warning… There is a third gas, called hydrogen sulphide, that doesn’t show up on a standard test.

Hydrogen Sulphide

Leading expert in the field, Dr Mark Pimental, has recently developed a test for Hydrogen Sulphide SIBO. Unfortunately, at the time of writing this article, it is not yet available in the UK.

If however you have a flat line across the whole of your 3 hour breath test, it is possible that this is not in fact a negative breath test for SIBO, but in fact a positive indicator that you have hydrogen sulphide SIBO. So if you have previously been tested, as I was, and told that the test is negative because you had a flat line but you are still symptomatic, you may in fact need treating for Hydrogen Sulphide SIBO.  A trained SIBO practitioner should be able to help you interpret the test and give you some indication of how long treatment might take.

I also order a stool test for my clients to see what possible causes of SIBO may exist.  Lab tests I use include GI Effects from Genova Diagnostics and GI Map, depending on someone’s signs and symptoms.

Natural treatments for SIBO

The natural treatment for SIBO that I prescribe to my clients is herbal antimicrobials to kill off the excess bacteria, Picture of medicinal herbsof a particular type and dosage.  These should always be taken under supervision.

I also prescribe a 2 phase diet which can virtually eliminate symptoms within a couple of weeks in some people.  However, this diet is not meant as a long-term strategy.  We need to fix the cause, as opposed to just managing the symptoms with diet.

Phase 2 diet

The diet works by eliminating / reducing a group of fermentable carbohydrates called FODMAPs.  Designed by one of the leading experts in the field, Nirala Jacobi, adapted from Alison Siebecker’s SIBO Specific Diet, the diet is specifically targeted at starving the bacteria to help with their elimination.  It has also been designed to be as varied as possible, because restricting any food groups can cause disruption to the gut microbiome, the community of “normal” bacteria that are supposed to live in our large intestine and modulate our immune system, help us detoxify effectively, produce vitamins and in short keep us healthy.

If someone has Hydrogen Sulphide SIBO I tailor the diet, as hydrogen sulphide producing bacteria will thrive on different foods to hydrogen and methane producers.

Meal spacing

Other strategies I employ include meal spacing, i.e. eating with four to five hour gaps in between. This can help the MMC to sweep excess bacteria out, so regular grazing can also be problematic.

I also, depending on someone’s stool test results, address any digestive issues with specific enzymes, address any leaky gut, inflammation or lowered gut immunity and assess whether someone needs to take hydrochloric acid in the form of Betaine HCl.  I would also prescribe a prokinetic to ensure that motility is working as well as possible and possibly also a biofilm disruptor, as bacteria are known to create a biofilm around themselves to protect themselves.

There are also many natural treatments for symptoms such as bloating, reflux, constipation and diarrhoea.  Take a look at www.siboinfo.com  for more info.

Microbiome restoration

I end my treatment with microbiome restoration, as the antimicrobials, although natural, and the restricted diet, Gut bacteriado to some extent alter the gut microbiome.  This can be done through prebiotic supplements and including prebiotic rich foods in the diet, but has to be done at the end of treatment, as it can otherwise make someone very symptomatic.

Probiotics, fermented foods, yoghurts such as Yakult, etc will not on their own be enough to recolonize our gut bacteria.  Those bacteria need to keep being fed prebiotic foods in order to grow, thrive and survive.

Other Causes of IBS

Other causes of IBS can include;

  • parasitic infections (almost impossible to pick up unless you use PCR testing to test for DNA and standard tests throw up a lot of false negatives)
  • Coeliac disease (which your GP can test you for as long as you are still eating gluten)
  • Non-coeliac gluten sensitivity (don’t think if you are not coeliac that gluten is fine as this could be you!)
  • Disease causing bacteria such as Klebsiella Pneumoniae that produce endotoxins (linked with endometriosis in some cases), any of the individual causes of SIBO on their own
  • Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis)
  • Removal of gallbladder or part of the bowel
  • Diverticulitis
  • Candida or other fungal overgrowth
  • Food intolerances
  • Salicylate or oxalate sensitivity
  • Histamine intolerance
  • Disrupted gut flora
  • Or simply a poor diet.

I shall be diving deeper into some of these other causes in future articles.

Often removing highly inflammatory foods such as dairy, gluten and sugar can have a huge impact on someone’s digestion.  Again, testing as part of my six step programme instead of guessing, can often get to the route cause of any of these, together with hydration, supplementation, lifestyle changes, clearing up the diet and detoxification.

If you would like help with any digestive issues, contact me for a free 15 minute chat to find out how I can help you.

References

Bharucha, A. E., Seide, B. M., Zinsmeister, A. R., & Melton, L. J. (2007). Insights into normal and disordered bowel habits from bowel diaries. The American journal of gastroenterology103(3), 692-8.
Bures, J., Cyrany, J., Kohoutova, D., Förstl, M., Rejchrt, S., Kvetina, J., Vorisek, V., … Kopacova, M. (2010). Small intestinal bacterial overgrowth syndrome. World journal of gastroenterology16(24), 2978-90.
Ghoshal, U. C., Shukla, R., & Ghoshal, U. (2017). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and liver11(2), 196-208.
Thomson, A. B., Sauve, M. D., Kassam, N., & Kamitakahara, H. (2010). Safety of the long-term use of proton pump inhibitors. World journal of gastroenterology16(19), 2323-30.

Treating IBS Course

We can run a course for you covering IBS, the causes and how to relieve the symptoms.

Contact me to get some more information on the courses/ workshops that I can run for you.

The Ketogenic Diet – What is it and How Does it Work?

The Ketogenic Diet – Not Just About Weight Loss

Picture of good fats and meatYou may have heard about the ketogenic diet and the success that many people have had using it to safely lose weight.

But what is it and does it have other benefits other than weight loss?

Let’s explore….

History

The ketogenic diet has actually been around since the 1920s. It was originally used in treating epileptic seizures, very effectively in fact.  It is known for improving mitochondrial function and cognitive function.

How it Works

The aim of the ketogenic diet is to get the cells of the body to start burning fat for fuel in the form of ketones instead of glucose.  The diet is based on keeping carbohydrate intake at 10% or under of your diet, which amounts to 30 grams max of carbs a day.  And, contrary to popular belief, protein is not a huge part of the diet, at only 20% of your daily food intake.

Things to Note

Good Fats

It is fat, and when I say fat I mean “good” fat, that makes up the majority of the diet, at around 70% of your daily Picture of avocado, nuts, oils and olivesintake of food.  Healthy fats include coconut oil, cold pressed organic oils (in dark glass bottles as the light can turn them rancid), nuts, seeds, coconut, olives, avocado, organic butter and ghee, to name just a few options.

There are a number of things to watch out for, however.  Firstly, if someone’s liver is struggling to process the amount of toxins they are ingesting on a daily basis or if there is stored toxicity in the body, as is the case with many health conditions, then a good detoxification programme to open up the bowels and liver and see that waste out is essential and would include things such as castor oil packing, psyllium husks, lecithin, soaked seeds or even enemas to ensure that the liver is able to break down the fat that is being consumed.

Hydration

Another important factor is that the person needs to ensure they are getting adequate hydration on a daily basis A picture of flowing water(read my article on water for further info) and also that they are taking in electrolytes (which can be helped by taking a pinch of Celtic sea salt or Himalayan salt before each glass of water).  Coconut water and energy drinks are not a great way to take in electrolytes as the sugar in them will almost certainly take you out of ketosis.

Another thing to be aware of is that long-term ketosis can affect your hormones so it is wise, especially for women in the run up to menstruation, to employ “carb cycling”, which involves increasing the amount of carbs around a period and then taking them back down again for the rest of your cycle.

Fasting

Intermittent fasting is also an important part of the ketogenic diet, which can mean fasting for 12 hours at first.  However, if someone is struggling with adrenal fatigue or low energy then this should be done more incrementally. Preferably this would be done with some guidance and a programme tailored at supporting mitochondrial function at the same time. Mitochondrial function is essential for those with conditions such as M.E. (aka Chronic Fatigue Syndrome) and Fibromyalgia.

Exogenous ketones can help someone get into ketosis more easily and avoid what is known as the “keto flu” when used in conjunction with the other advice above, the keto flu being flu-like symptoms that can occur as part of the adaptation process of switching from using glucose to burning fat for energy.

A diet as low in carbohydrates as the ketogenic diet is not advised for pregnant or breastfeeding women, nor children. This is because they need a higher intake of carbohydrates.

Other Health Benefits

Nutritional ketosis is very different to keto acidosis, which is a dangerous condition, and so should not be confused. Picture of a brain encased in a lightbulbNutritional ketosis is highly anti-inflammatory and there is research out there to show that it improves cognitive ability which gives it the potential to help neurological conditions such as Parkinsons or Alzheimers, helps balance blood sugar in both type I (with guidance) and type II diabetes and can even protect against cancers.  So it is so much more than just a weight loss diet.

If you want to know more about the ketogenic diet and whether you can use it to improve physical or mental performance, reduce inflammation, lose weight or you want to find out how it can help your particular health condition, please contact me to arrange a free and informal 15 minute chat.

References

Barañano, K. W., & Hartman, A. L. (2008). The ketogenic diet: uses in epilepsy and other neurologic illnesses. Current treatment options in neurology10(6), 410-9.

Hallböök, T., Ji, S., Maudsley, S., & Martin, B. (2011). The effects of the ketogenic diet on behavior and cognition. Epilepsy research100(3), 304-9.

Miller et al. (2018). Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health.

Rogovik, A. L., & Goldman, R. D. (2010). Ketogenic diet for treatment of epilepsy. Canadian family physician Medecin de famille canadien56(6), 540-2.