Healing Your Gut:

The Role of Gut Microbes in IBS and Bloating

Let's take two of the most common problems for which patients are often told

there is no cure: bloating and irritable bowel syndrome (IBS). If you are one of

those people who complains of stomach bloating, chances are high you

have already seen a specialist. Most likely you were told that there really was

nothing wrong based on the routine blood tests. Similarly if you suffered from

irritable bowel syndrome and a generally loose tummy, you received nothing

more than ineffective advice to improve your diet and control stress.

© Copyright 2014

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In fact if you suffer from any

gastrointestinal complaint

that your doctor has not

been able to isolate and

identify using conventional

diagnostics, you are one of

the patients who needs a

different type of evaluation

to get to the source of the

problem and to fix it.

Complaints such as bloating

and IBS are indicative of

functional disturbances in the

gastrointestinal tract caused

by a multiplicity of factors.

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Routine diagnostic tests

designed to detect

inflammation or virulent

pathogenic activity cannot

provide needed information

on how well the gut is

performing. Inefficient,

imbalanced and disturbed

gastrointestinal function is at

the root of the most common

complaints for which patients

often do not receive the right

kind of intervention. This is

because traditional medical

practice does not use

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advanced testing that is

designed to detect blocks in

the function of metabolic

processes and

gastrointestinal function.

Healing Your Gut

So the starting point for helping patients with gastrointestinal complaints, where standard

treatment has failed, is the identification of markers in stool, urine and blood samples for functional

fitness of the gut. Stomach acid levels, pancreatic enzymes, bacterial populations, parasite

burden, food absorption and retention capability are the key factors that need to be evaluated.

Only a few specialized laboratories offer GI function tests. We use Metametrix of USA through

Dubai-based Diagnostika Medlabs to enable us the use of these advanced evaluations.

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Importance of Stomach Acid

For proper gastrointestinal function,

adequate stomach acid production is

essential. Many people mistakenly believe

that stomach acid is harmful and do plenty

to make the gut environment less acidic. This

is a huge mistake. Unscientific advice to

reduce stomach acid or alkalinize it without

evidence for why it should be done creates

a perfect setting for bacteria, yeast, fungal

and parasite overgrowth. The right levels of

stomach acid are not only important for

basic digestive function but are a natural

protective barrier against microbial

overpopulation. One of the findings we often

see in patients is the body's increased

production of stomach acid in response to

pathogenic bacteria or parasites. This is a

natural defense and the acidic environment

makes it harder for disease causing bacteria

to thrive. Taking antacids without first

establishing the level of acid in the stomach

through testing can create more problems

than it solves in the long run. Complaints of

acidity must be assessed from multiple

perspectives instead of reflexively treating

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with anta-acids and proton-pump inhibitors.

Differentiating elevated stomach acid levels

caused in response to the presence of

pathogenic agents and stomach acids

levels that are purely organic in nature

makes for a safer and better treatment. If

there is inadequate pancreatic enzyme

release, stomach acid levels will stay

elevated because pancreatic enzymes

provide a buffer against the acid.

Paradoxically in some cases what appears

to be an acid reflux from too much stomach

acid can actually be result of too little

stomach acid. There are patients whose

antacid treatment does not produce the

expected results; they may very well be

suffering from inadequate stomach acid

production. Dr Alexander Bralley who

pioneered advanced

gastrointestinal testing

says that symptoms

of low stomach

acid easily resemble

those of excess and

may end up being

treated wrongly.

Healing Your Gut

At XY Clinics we follow a protocol

called ‘the four R’ aimed at:

o removing anything that negatively affects intestinal health

o replacing with the right enzymes

and supplements

o re-inoculating with pre and pro-biotics

o repairing the mucosal lining of the

intestinal tract so that the immune barrier protection is robust.

A careful evaluation of dietary influences can give a clue to this and the problem can be

corrected by supplementation aimed at aiding stomach acid production. When stomach acid

production is inadequate it leads to a reduced ability to extract and absorb essential metals and

minerals. Iron, zinc and B12 are just some of these. People who say they like to eat meat but

complain of not being to digest it well improve when stomach acid is boosted along with a

supplementation of iron and B12 under the supervision of a nutritionally qualified medical

practitioner. The common complaint of bloating is often addressed when stomach acid levels are

brought to optimum levels. Reduced immune function or complaints of low energy and fatigue

when a person seems to be eating a healthy diet and there are no other causes could be the

result of not extracting and absorbing essential and trace elements because of low stomach acid

levels. People who believe maintaining an alkaline or low stomach acid environment should be

aware that chronic hypochlorhydria or low stomach acid level is an open invitation for microbial

population over growth and pathogenic bacterial infections in the long term.

Our Microbial Friends and Enemies

Our view of the vast number of gut microbes is

changing as sophisticated studies aided by

advances in the laboratory testing begin to

show just how important microbial ecology is to

human health. This is an area that has

traditionally been neglected. Considering that

we have 10 times more microbes than cells in

our body, it is now becoming apparent that our

health depends pretty much on a fine balance

among the great number of microbes. When

the microbial eco-system in the gut is disturbed,

symptoms of ill health ranging from bloating,

irritable bowel and constipation to gut-linked

headaches show up. The widespread use of

antibiotics coupled with poor nutrition can

destroy useful microbial masses. Contact us for your appointment now.

www.xyclinics.com

Healing Your Gut

When an imbalance between beneficial and

harmful bacteria occurs and there is unregulated

growth, it is called dysbiosis. If dysbiosis develops,

then even the normally beneficial bacteria can

become a problem because their growth is

beyond what is optimally needed. A good

example is L-Acidophilus which is a beneficial

bacterium and which many people take in the

form of probiotic supplements. In individuals whose

stomach acid levels are low, L-acidophilus can

overgrow especially when the diet is rich in refined

carbohydrates. If you have suffered from bloating,

low energy or irritability and you suspect that it has

something to do with your gut function, you could

be right. Just like taking vitamins and minerals

without laboratory evidence for their consumption

could be bad, taking probiotics indiscriminately

without a reason for their use could actually lead to

complications in the long term. The estimated 400

microbial species in the human gut need to be

kept in fine balance. Since dietary habits such as

low fiber food, the use of antibiotics and antacids

can cause dramatic alterations in the microbial

balance, gastrointestinal complaints that have not

responded to standard therapy should be

investigated from the perspective of bacterial,

yeast, fungal and parasite levels.

About 400 bacterial species play a role in

health and disease; the beneficial bacteria

are called predominant. These are most

important and critical to our health. Either

because of poor diet including low fiber or

use of antibiotics, these highly beneficial

predominant bacterial populations can

shrink. Measuring the levels of the good

bacteria is essential before attempting to

improve gastrointestinal health. Just as gut

issues show up when the good bacteria

levels fall, problems develop when their

population goes too high. The trick is

ensuring the right balance. If a person

suffers from constipation chronically, a

suspect cause could be undesirably high

levels of the predominant bacteria. Some

of the other symptoms of overpopulation

are cramping, bloating and flatulence.

Yeast or parasite infections can also cause

altered balance of the bacteria.

XY Clinics Dubai: Jumeirah, Al Wasl Road, No. 992, P.O. Box: 345013. Telephone: +971-4-3807554 Email: info@xyclinics.com

XY Clinics Bangalore: Genlabs Healthcare Pvt Ltd. Kasturingar Main Road, Bangalore – 560 043 Telephone: +91-80-25458516 Email: info@xyclinics.com

XY Clinics Lucknow: D.R. Building, Era’s Lucknow Medical College&Hospital, Sarfarajganj, Hardoi Road – 226003 Telephone: +91-522-3201150 Email: xyclinicslko@gmail.com

Healing Your Gut

Bacterial Baddies

There are bacteria that are really bad. Among these are Helicobacter pylori (H. Pylori) and

Clostridium species. For every 10 patients we test, we see a 30 to 40% H. pylori infection rate. H.

Pylori causes peptic ulcers and increases the risk of some types of cancers, therefore identifying

infection and deciding on appropriate therapy can help reduce future risk. In response to the

presence of H. pylori, the stomach turns acidic to make it difficult for the bacterium to populate.

While excess stomach acid secretion is harmful in itself, the ammonia produced by the bacterium

can do significant damage to the intestinal wall and to some cells. If an individual's capacity for

clearing the rising levels of ammonia is sub-optimal, symptoms including tiredness, fatigue,

irritability and nausea can develop. Not every individual who gets H. Pylori shows peptic ulcers

and other gastro-related disease states, thus most people carrying it do not even get tested. In

diabetic patients whose kidney function is already challenged, additional ammonia produced by

H. Pylori will make the matters worse.

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In some H. Pylori patients, the stomach acid

levels show up as low and PH as high. It is an

indication that the normal defense

mechanisms have failed and H. Pylori is

thriving. When the stomach does not have

sufficient stomach acid, it creates an

environment that is quite hospitable for other

pathogenic bacteria as well. Moreover basic

nutrient extraction and absorption become a

problem. Protein digestion becomes a

challenge. In treating H. Pylori, clinicians give

a class of drugs called proton pump

inhibitors. These drugs block or reduce

stomach acid production. One reason for the

re-emergence of H. Pylori in a significant

number of patients could be the

unwarranted targeting of stomach acid. If H.

Pylori overwhelms the body's natural defense

system and has thrived, it would lead to a

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very alkaline, low stomach acid level. A

common breath test done to detect H. Pylori

is not 100% accurate and may be picking up

the H. Pylori presence in only those patients

who show signs of greater ammonia

production. Indeed according to the Finnish

biotech company, BioHit, which specializes in

H. Pylori tests in blood and biopsy samples,

nearly 30% of breath tests for H. Pylori could

be false negative. H. Pylori infection can go

undetected with a breath test in those

individuals who respond to the infection with

a higher acid load but without presenting any

clinical issues. We have seen this in a number

of cases and the detection was possible only

when using advanced tests. Because patients

are not tested for stomach acid/PH levels,

several conditions arising from lack of

adequate stomach acid levels go

Healing Your Gut

The Parasite Poison

Testing for the presence of parasites is helpful

in treating conditions whose cause is difficult

to identify with invasive procedures. Parasites

can enter the body through water and food.

Even swimming pools can be a source of

parasites such as Cryptosporidium. If you

have suffered from diarrhea, abdominal

pain, fatigue or nausea and the treatment

recommended by your doctor has not

resolved the problem, you could be carrying

a parasite infection that has gone

undetected and untreated. Some parasite

infections will remain asymptomatic or cause

symptoms every now and then. Most

laboratories do not offer parasitology testing

and thus patients do not get the help they

need.

Leaky Gut

The lining of the intestinal tract is coated with mucosal cells. The muscoa acts as a protective

barrier against the passage of disease-causing molecules. Several factors can cause a weakening

and loosening of tight junctions between a particular type of intestinal cell. When this happens,

the gut becomes permeable and a condition called leaky gut or intestinal permeability develops.

In leaky gut, the natural barriers against entry of unwanted substances through the intestinal lining

fail and unfriendly toxins and foreign agents enter the liver. If the leaky gut is not addressed, the

increased demand for detoxification can overwhelm the liver's capacity to carry out the

cleansing functions. Increased sensitivity to some foods is a result of the leaky gut. Gluten-caused

inflammatory response becomes heightened. Confirming leaky gut by measuring the passage of

large molecules through the loosed junctions requires a special test called Lactulose-Mannitol

Intestinal Permeability available from Diagnostika Medlabs at Dubai Biotechnology Park. The

repairing and healing process can take months and the patient will need both dietary and gut-

friendly non-drug products.

Stress and Gut Health

Our first line of defense against harmful

microbes is through an immune-enhancing

product called Secretory IgA. This

immunoglobulin inactivates disease-causing

pathogens and allergens by acting on

them. Secretory IgA levels rise when there is

stress. However in the event of chronic stress,

the body's ability to produce Secretory IgA

goes down. Depressed Secretory IgA levels

contribute to reduced immune barrier

function. Because patients do not get

evaluated for stress issues in a standard

clinic visit, the real cause of their problems

goes undetected and attended. Addressing

the stress issues and providing support to the

adrenal glands will help improve gut health

and slowly restore Secretory IgA levels.

Healing Your Gut

Food Intolerance Testing: Is It Valid?

From the time food intolerance testing was introduced, experts have rarely agreed. Most

gastroenterologists dismiss the scientific validity of food intolerance. While food allergy (IgE)

testing is accepted as indisputably valid, food intolerance testing (IgG) is considered dubious

by a large majority of gastroenterologists. When individuals are told that they have intolerance

to dozens of foods, the validity of such findings comes into question. The health care

practitioner whether he is a doctor or a dietician who recommends intolerance testing should

be in a position to show how the suspect foods are clinically linked to the complaints of the

patient. Failure to provide a relationship between the so-called intolerant foods and clinical

symptoms leaves open the question of validity of the test. Users of intolerance testing are simply

told that they are intolerant without being provided an explanation of why or where the

intolerance comes from.

Some people report feeling better after removing certain foods from their diet. Our own surveys

of such patients indicate that most often the benefit is linked to removal of carbohydrates.

Frequently this happens to be wheat. Food intolerance testing can cost as much as Dh2500.

From a common sense perspective, all that an intolerance test tells you is that it is time to rotate

your diet. Intolerance by definition is temporary and eating from a wide variety of foods, and

eating whole foods usually works quite well. Any food intolerance has an underlying cause. It is

far more advisable to have your gastrointestinal function assessed comprehensively than to rely

on questionable food intolerance testing. If you believe you must do it, please make sure that

the tests offer something called IgG subclass 4 as testing for total IgG gives many false positives.

If your intolerance test shows you have a problem with 20 or 30 foods, you should ask yourself if

it makes sense. On the other hand assessing your gastrointestinal function may help pinpoint

why you may not feel great when eating some foods.

Healing Your Gut

All of us have species of bacteria in our gut that act on compounds from phenol-rich foods such

as berries, cherries, onion, tomato and artichoke. If the level of bacteria that act on these foods is

higher than desired, you may not feel so well eating them. In this case the underlying cause to

possible intolerance is the overgrowth of the phenol-metabolizing bacteria. Controlling the level of

the bacteria resolves the problem.

Similarly if you don't feel good when you eat meat products, it may

be because you do not have sufficient availability of acid and

enzymes needed to break down the protein in the meat. Again

identifying the real cause is better than removing meat products

from your diet for a few weeks only to find that the problem has not

been solved.

If you have high levels of the common yeast Candida, you will not feel great when you eat sugary

foods and carbohydrates as Candida pretty much thrives on these. Or if you have increased

histamine activity, you may report sensitivity to several foods. In this case you may be suffering

more from histamine intolerance than food intolerance.

Are You Really Wheat Intolerant?

In recent years, the number of people taking themselves off of wheat

products has been increasing. Using a food intolerance test to remove

gluten from your diet may not be a good idea even if you felt better

after the removal of wheat or rye products. If you think you have a problem with gluten, there are

two ways you can confirm this beyond doubt. Tests such as deamidated gliadin antibodies and

tissue transglutaminase can provide confirmation of inability to tolerate gluten. These are tests that

were developed to check for risk of celiac disease. Another option is to do a saliva-based genetic

test that shows whether you carry a mutation in two genes called HLA-DQ2 and HLA-DQ8.

Is it really food intolerance?

For more information or to book an appointment, contact us at www.xyclinics.com