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I find that more and more people are aware of the importance of a balanced gut microbiome these days. The good bugs in your gut influence things like your immune system, hormone detoxification, metabolism, nutrient absorption, mood, skin health, levels of inflammation, reaction to food, oxidative stress, and more.

But did you know that antibiotics aren’t the only medication that can affect the bacteria in your gut, and in fact aren’t the biggest culprit for upsetting the balance.

I have gone knees deep in a research paper to find for you what medications will influence your very important microbiome. There are several commonly used medications which will potentially have a negative impact.

The main ones that were found to have an impact are:

• Proton pump inhibitors (PPIs) were one of the most notable drugs that influenced the bacteria, influencing multiple pathways, especially increasing the Streptococcus parasanguinis bacteria and affecting many pathways of bacteria’s ability to help our digestion of carbohydrates and fat
• Metformin seems to correlate with an increase of Escherichia coli, but also appeared to show an increase in the metabolic function of the microbiome, which may contribute to its effect.
• Antibiotics decreased overall Bifidobacterium levels
• Laxatives also affected multiple bacteria but were correlated with higher levels of  Alistipes and Bacteroides bacteria groups and a decrease in bacteria that digest starches

And to a lesser degree:

• SSRI antidepressants
• Oral steroids increased Methanobrevibacter smithii in those with inflammatory bowel disease. This is a bacteria which influences metabolism which could potentially explain the weight gain frequently observed in oral steroid users.
• Anti-androgen oral contraceptives
• Vitamin D and calcium supplements
• Levothyroxine use was associated with an increase of Actinomyces group

The analysis explored a multiple of different papers which examined the different microbiome associated with different medication use and found these patterns. In many instances it was thought that the microbiome changes are a result of the medications, however it is possible that when certain over growth or undergrowth of certain bacteria was present that this could be responsible for the condition that prompted that medications prescription in the first place. Given the majority of the conditions included things like constipation, reflux, inflammation and mood disorders, it makes sense as these conditions can be affected by an imbalance in your gut bacteria.

Overview of the number of associated microbial features.

Reducing the damage

While some of these correlations may not be the fault of the medication but just a reflection of the nature of the disease, it is still notable that many medications to disrupt our microbiome. In some instances, there are important reasons for taking medications, in which case you need to take steps to ensure you’re supporting your gut microbiome.

Feeding your good bacteria is one of the most important steps, and this is achieved by eating foods rich in prebiotics. Plant foods are the most notable source of this, and the bigger variety you can have, the better.

Including fermented food such as saurkraut, kimchi, kefir and kombucha and yoghurts can introduce some bacteria, but it isn’t always guaranteed that they will bring the type of bacteria you need to replace. If you tolerate these foods (people with histamine intolerance or SIBO may find them problematic) then it’s certainly beneficial to include them.

Probiotic supplementation can be very valuable, however the important thing to remember is that you need to choose a strain of probiotics that meets your aims.

Nutrients that support gut health lining include glutamine, n-acetyl-glucosamine, lysine, glycine and proline.

In some cases, it may be worthwhile discussing with your health practitioner whether there are alternatives to these medications. While natural medicines will not be as powerful as conventional medicines, in some conditions they can provide a very satisfying effect, reducing the need for medications.

Photo by Adam Nieścioruk on Unsplash

Herbs for the Gut

Herbal medicines can soothe the digestive system beautifully, and for conditions such as GORD (reflux) they can reduce the requirements for these medications.

For reflux: consider herbs such as Marshmallow root, Ribwort, Meadowsweet, Licorice (avoid if you have high blood pressure) and Dandelion root.

For reducing inflammation in the gut: A tablet containing herbs such as Boswellia and Turmeric can be particularly beneficial.

For sluggish bowels: a regular brew of Dandelion root, Ginger, Licorice, Yellow Dock and Cinnamon can help to get things moving.

References

Vich Vila A, Collij V, Sanna S, Sinha T, Imhann F, Bourgonje AR, Mujagic Z, Jonkers DMAE, Masclee AAM, Fu J, Kurilshikov A, Wijmenga C, Zhernakova A, Weersma RK. Impact of commonly used drugs on the composition and metabolic function of the gut microbiota. Nat Commun. 2020 Jan 17;11(1):362. doi: 10.1038/s41467-019-14177-z. PMID: 31953381

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Health & Wellbeing Podcast #29

Pelvic floor tightness, pelvic floor dysfunction, or hypertonicity of the vagina is when the muscles of the pelvic floor are too tight. This can cause pelvic pain for women that just doesn’t seem to make sense. They might experience pain during intercourse (dyspareunia or vaginismus), pain in relation to going to the toilet (1s and 2s), IBS and period pain that doesn’t get better with other treatment. These issues can be due to a tightness in one of the muscles of the pelvic floor, something which a women’s physiotherapist is able to help with.

Most women are well aware that the muscles of the pelvic floor can get weak, but tightness of these muscles is something that hardly anyone knows is even an issue. I didn’t appreciate how much this can be a problem until I attended the Endometriosis symposium and learnt about the connection between tight pelvic floor muscles and chronic inflammatory conditions of the pelvis. Since then I have been in awe about how much this issue can affect women, but moreso how little awareness of this is out there. Learning about this issue was a light-bulb moment for me and I hope that this podcast can be as eye opening for you.

In this episode I chat with women’s physio Brooke Hile about all things related to pelvic hypertonicity.

Listen on the Soundcloud website here or in the embedded player below.

Want to subscribe to get podcasts automatically? You can do that here:

iPhone   Stitcher   Youtube   Soundcloud

Get in Contact with Brooke:

Instagram @thingsdownthere
https://www.herhealthphysiotherapy.com.au

The post Pelvic Floor Tightness/Hypertonicity – Podcast #29 appeared first on Alison Mitchell Naturopath.

This interview was recorded a few months ago, and you can hear my boy making very cute little chirps in the background (I was nursing him on my lap while I was being interviewed).

In this podcast you will learn:

• Why gut health is so important
• The connection between gut health and acne/skin
• Why & how gut health and anxiety (and depression) can be linked
• Common symptoms of poor gut health
• The difference between IBS and leaky gut (intestinal permeability) syndrome
• What your tongue and nails can tell you about your gut health
• How you can eat and breakdown food, but not absorb it so well (and what to do about it)
• What a healthy gut diet plan looks like (which might be different to what you think!
• What to do when you feel certain foods upset your gut
• The difference between prebiotics and probiotics and why you need both and where to find them
• Whether it’s necessary to buy probiotics
• What to look for in a probiotic if you’re going to buy them
• Gut health supplements demystified 
• How to restore healthy gut flora if it’s out of whack
• Why and how colonic irrigation can destroy your gut forever
• Naturopath’s top tips for good gut health

So far I’ve had great feedback on this, so have a listen and tell me what you think in the comment box below!

You can find the original post here.

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It is estimated that one-fifth of the population believe that they have a food intolerance. If you’re reading this article, you’re probably one of them. If you can’t quite put you finger on what food isn’t agreeing with you, then it’s time to get clued up.

In this article you can read about the difference between food intolerances and food allergies, plus 5 common causes that you can investigate, and practical tips to help manage your allergy or intolerance.

Want to learn more? You can read the full article here: http://casadekarma.com.au/the-ultimate-guide-to-food-allergies-intolerances/

The post The Ultimate Guide to Food Allergies and Intolerances appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #3

If you have been following me for a while you probably know that I love to talk about digestive health and the importance of gut health for overall wellbeing. I was very excited to have the opportunity to talk about all things digestion (and of course poo) with my fellow naturopath, the beautiful Hayley Stockbridge.

Hayley practices at Manly on Sydney’s Northern Beaches and in Stanmore in Sydney’s Inner West. Her major focus is always educating her patients to live healthier and happier lives. She treats women, men and children of all ages and a wide variety of health issues such as weight loss, digestive problems, anxiety/stress, fertility, hormone imbalances, food intolerances and headaches.

You can also connect with Hayley on Facebook and Instagram.

We answered a few digestion questions in this podcast which was lots of fun, I would love for people to keep submitting questions for future podcasts. You can submit them in the comments section below, on my facebook page or via the contact form.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

Podcast Breakdown

3:57 What is a normal bowel movement?

6:50 Question 1: I’ve had GORD ever since I can remember, I’m on Nexium and I take metamucil. I still get the occasional bit of reflux but mostly it’s controlled with the medication. I don’t want to stay on it because I don’t want to rely of a medication. I also get diarrhoea every week or so that’s watery, explosive and smelly and really urgent and uncomfortable, and I’m frequently bloated. Is any of this connected and what do you suggest I do about it?

9:05 Diet for reflux, food intolerances.

9:40 The importance of easing of PPI medications slowly.

11:00 Reflux often due to a structural/mechanical issue, but this doesn’t mean you’re doomed.

12:50 Testing and avenues to look at for assessing causes of reflux, most common food triggers of reflux.

14:15 Question 2: I feel bloated and grumpy whenever I eat bread, but my GP said I’m not celiac so I can eat as much wheat as I want. I don’t get it though, why am I getting these feelings if I’m ok with bread?

15:00 Non celiac gluten intolerance including fructose mal-absorption

18:34 The general overconsumption of wheat and gluten containing foods and the issues with processing of wheat

22:40 It’s advisable to rule out celiac disease, as knowing this will determine how much gluten you can tolerate.

24:00 Sourdough may be an option for people sensitive to wheat as the fermentation breaks down some of the gluten and gliadin

25:45 Gluten free products are not always better for you

26:45 Experiment to find out what foods work best for you

27:55 Question 3: Help for constipation please! I have been taking movicol for about 5 yrs now. I go to the toilet once a day, but if i don’t take movicol I go once a week. I don’t like relying on it, but I don’t know what else I can do. Hayley and I discuss some common approaches to supporting constipation and diet for good bowel movements.

30:29 Papaya vs Pawpaw

33:00 Probiotics

34:40 Apple cider vinegar benefits

36:00 Dandelion coffee/tea

37:00 Manual work for constipation

37:25 The importance of exercise for healthy bowel movements

38:57 Toilet time – make time each morning to train your bowels to go at that time, and don’t suppress the urge to go when you need to.

39:50 Our yoga efforts.

41:00 Question 4: My 4 year old daughter frequently complains of stomach pains, I’m always at the doctors with her trying to find out what it is but they can’t find anything. It can be really upsetting for her, and sometimes she’s doubled up and crying with the pain. We eat well, but she always has a runny nose and this stomach pain is very concerning. She started preschool last year and seems to get sick all the time, I’m worried about how she’ll go at school with this stomach pain. She used to go to the toilet every 3-4 days, and even though this is considered normal the doctors gave her parachoc to try and help in case this is causing the pain, now she does go to the toilet easily (although it’s very lose) . Is there anything else I can do for her?

46:00 Infant massage for stomach pain

47:15 Our favourite digestion herbs

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When your gut controls your mood: the gut-brain axis

From as early as the 1930’s, scientists were beginning to understand that the health of our digestive system could influence our mood.  The state of our intestinal lining and the balance of bacteria within our digestive system have a major role to play in the production of our neurotransmitters: chemical transmitters that tell our brain whether we should be feeling such ways as happy, sad, agitated, or calm.  But even though the research in this area sky-rocketed in the last decade and continues to grow every day, the concept of our gut-brain connection isn’t very well known.

The gut is linked to the brain

Did you know – When you were just starting to grow in your Mumma’s womb, your brain and your digestive system developed from the same lump of tissue.  During this process of dividing up cells (embryogenesis) this lump of tissue divides and forms our central nervous system and our enteric nervous system (this is the nervous system of our gut – sometimes called the second brain).  These two are connected by an important ‘wire’ – our vagus nerve.  This development can help us understand why there are so many similar chemicals and receptors in both our brain and our digestive system, for instance serotonin.

Gut bugs and your mood

As soon as you’re born, bacterial colonies start to develop in your digestive system.  Within the first few days, the bacteria starts sending messages to the nervous system and can actually determine our nervous system ‘set point’ long term (1).

When the balance of our gut bacteria (collectively referred to as the microbiome) is affected, this can affect your mood.  Studies have found that the microbiome can have a major impact on stress levels and anxiety (2).  In fact, by treating imbalances in our microbiota, it is possible to support a wide range of mental health disorders (3), (4), (5), (6), (7).

The second brain

The nerves in your digestive system are constantly speaking to your central nervous system.  If your gut is irritated for some reason – say you’ve eaten something that you’re intolerant to (like gluten, for example), you’ve generally got a bad diet, there’s an imbalance in your microbiome (that’s your collective gut bacteria, remember) or you’ve got an infection – this can create an inflammatory reaction and will certainly make you irritated as well.  We know that depression is both associated with, and worsened by inflammation.  This inflammation in the brain can be driven by inflammation in the gut, which can be caused by intestinal permeability (leaky gut) and bacterial imbalances (dysbiosis).  Treating leaky gut can help reduce the severity of depression (4), (8), (9), (10), (11).

Neurotransmitters in our gut

Serotonin is produced in large amounts in our digestive system.  In people with Irritable Bowel Syndrome (IBS) there is too much serotonin in their digestive system.  This is why antidepressants known as SSRI (selective serotonin reuptake inhibitors) can improve the symptoms of IBS: these act by reducing the amount of serotonin taken into cells in the rest of our body which allows more to get into the brain.  However anti-depressants can affect the gut negatively as well, because if you weren’t making enough serotonin in the gut in the first place, you’d end up with even lower levels in the digestive tract and so it can become irritated, affectively you’ll get a depressed gut (12), (13).

A vicious cycle

When your gut is upset, you feel upset.  But stress can affect your digestive system just as much as it affects your mood.  It can impair the secretion of digestive acids, slow down the motility of the gut, allows the unfriendly bacteria to grow, reduces your friendly bacteria and exacerbates intestinal permeability (leaky gut) (14), (8).  This is a recipe for an unhappy digestive system, and as you know this can then go on to send more messages to your brain: so you can see how the cycle continues.

People with gut problems are more likely to experience anxiety and depression.  Some studies have found a high proportion of anxiety in those with gut conditions such as Irritable Bowel Syndrome(IBS), Crohn’s disease and coeliac disease (15), (16), (17).

Helping the gut-brain axis.

By treating digestive problems, sealing leaky gut and balancing your microbiome it is possible to help with conditions such as anxiety and depression, and there’s even research showing the benefits of treating the gut in conditions like chronic fatigue syndrome, schizophrenia and autism (10), (18), (11).  Probiotics are one of your major tools when it comes to treating the gut, but it’s a good idea to consult with a health practitioner to make sure you’re getting the right type, and also to get a good gut healing treatment program to go along with it ⁽¹⁹⁾, (4), (9).

Related articles:

• Probiotic stress busters: http://www.naturopathnsw.com.au/probiotic-stress-busters
• Depression starts in the gut?:  http://www.naturopathnsw.com.au/depression-begins-in-the-gut
• What is Dysbiosis: http://www.naturopathnsw.com.au/what-is-dysbiosis
• Fermented foods (foods to stop bloating and farting): http://www.naturopathnsw.com.au/foods-to-stop-bloating-and-farting-fermented-foods
• Enhance your health with probiotics: http://www.naturopathnsw.com.au/enhance-your-health-with-probiotics
• The benefits of soaking and sprouting: http://www.naturopathnsw.com.au/the-benefits-of-soaking-and-sprouting-plus-a-sprouted-chickpea-hummus-recipe

Works Cited

The post A Gut Feeling appeared first on Alison Mitchell Naturopath.

The human body is made up of a diverse colony of micro-organisms that live predominately in the mucous membranes of our gut.  The adult intestine contains 300 to 500 different species of bacteria, with 30 to 40 species comprising up to 99% of the total population.

There exists a balance of good and bad bacteria.  In healthy people the good bacteria outweighs the bad.  The most common forms of micro-flora that exist in our gut include:

• Bacteroides
• Bifidobacterium (good)
• Eubacterium
• Clostridium
• Lactobacillus (good)
• Fusobacterium
• Various anaerobic gram-positive cocci

Medical scientists are now acknowledging gut dysbiosis as a phenomenon in disease. A recently published definition of dysbiosis was: a breakdown in the balance between protective versus harmful intestinal bacteria

Our good gut bacterium has several functions.

• To grow and proliferate
• Energy salvage (fermentation of non-digestible dietary contents and endogenous mucus) and production of Short Chain Fatty Acids (SCFA)
• Production of some vitamins, e.g. K and B12
• Synthesis of amino acids from ammonia or urea
• Control of epithelial cell proliferation and differentiation
• Metabolism and enterohepatic circulation of xenobiotics
• Immune system development and regulation
• Pro/anticarcinogenesis
• Resistance to infection – crowding out pathogenic organisms
• Prevention of bacterial translocation
• Control of ion concentration and absorption
• Control of colonic motility and transit time
• Control of colonic pH

What causes Dysbiosis?

When there is an imbalance of good to bad bacteria, dysbiosis is the result.  This can occur from many factors such as:

• Antibiotic use
• Contraceptives (the Pill)
• Steroids
• Altered gastric secretion
• Spastic colitis
• Constipation
• Diarrhoea
• Radiation
• Diet including sulphur, excessive protein, excess refined carbohydrates, lack of fibre, excess fat
• Decreased immune status (especially low secretory IgA)

Why is Dysbiosis bad?

The good bacteria in the stomach are very important for our guts immune health and to protect against invading bacteria.  Bowel flora play an important role in our ability to fight infectious disease, providing a front line in our immune defence, provide a passive mechanism to prevent infection, and produce many vitamins – Vitamin B12 and Vitamin K. Acid-producing lactobacilli and bifidobacteria increase the bioavailability of minerals, which require acid for absorption–calcium, copper, iron, magnesium, manganese. Without a healthy colony of bowel flora, we cannot expect robust health and wellbeing.

There are many health conditions associated with dysbiosis.  Recent research has revealed that dysbiosis is strongly linked with all chronic gastrointestinal, inflammatory and autoimmune diseases.  It may also be very important in conditions such as fatigue, poor immunity, cancer and allergies.

The breakdown products of gut bacteria (endotoxins) are involved in immune reactions.  High endotoxins are associated with chronic diseases such as psoriasis, pancreatitis, SLE (lupus) and liver disease.

The more minor symptoms of dysbiosis include bloating, flatulence, nausea, bad breath, vomiting and diarrhoea and/or constipation.

How do I know if I have Dysbiosis?

A test is available in naturopathic consultations which can assess the presence of bad bacteria in the gut.  This test is called the ‘Urinary Indican Test’ or ‘Obermayer test’.  It is performed by mixing a urine sample with two reagents and assessing the colour change according to a chart.

Dysbiotic bacteria in the intestine produce a chemical called indole.  A portion of this is reabsorbed and metabolised to a indoxyl sulfate (or indican) which is then excreted in the urine where is can be assessed by this test.

The test takes approximately 10 minutes and costs $16.50.

The night before the test is performed ensure that you consume some protein and also avoid alcohol and iodine containing foods and supplements as these may give a false positive.

UPDATE: This test is no longer available.

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