GI Guide

A food allergy is an immediate response you get every time you eat a certain food, i.e., break out in hives every time you eat shellfish. By the time we're adults most of us have figured out our food allergies. Food sensitivities involve a different part of the immune system. They can be dose-dependent, meaning you are able to eat a little of the food and be ok, but eating more than a certain amount causes symptoms. Food-sensitivity reactions can show up 2–3 days later, making it harder to identify the culprit.

No, you can have something called “non-celiac gluten sensitivity.” This means that you may have symptoms similar to those with celiac disease but don’t meet the diagnostic criteria. Gluten sensitivity shares many symptoms with celiac disease but people with non-celiac gluten sensitivity can have many non-GI related symptoms, such as headache, “brain fog,” joint pain, numbness in the legs and arms, skin rashes, eczema, and mood and behavioral imbalances. Symptoms typically appear hours or days after gluten has been eaten.

IBS is a diagnosis made, generally by a gastroenterologist, when all other GI conditions have been ruled out and you are still suffering from diarrhea, constipation, bloating, gas, and abdominal pain. Sometimes you may be prescribed medications to manage symptoms or told to follow a special diet. However, IBS usually has one or several underlying causes, including food sensitivities (gluten and dairy are common), low stomach acidity, parasites, or a condition called Small Intestinal Bacterial Overgrowth (SIBO). Research shows that up to 80% of IBS cases are actually SIBO.

Depending on the root cause, there can be some common food triggers. But working with a dietitian or functional medicine practitioner can help fine-tune which dietary changes need to be made for the best results. Removing gluten, dairy, and some foods that are high in fermentable fibers — like cauliflower, asparagus, garlic, onion, and apples — may help relieve some of the symptoms. However, for full resolution, the underlying cause must be addressed first. 

Depending on what the cause is it may or may not. If stress or anxiety is triggering GI issues, then through mindfulness techniques it may resolve on its own. However, if it is a food trigger or gut bacteria imbalance, interventions must be implemented to bring the GI tract back into balance, and until the triggers are removed you will likely continue to struggle with some level of discomfort. The good news is that as long as all other severe medical diagnoses have been ruled out by your doctor, IBS symptoms can usually be managed with nutritional and supplemental interventions.

To increase your chances of falling pregnant, you need to create an environment that will support a new life. Reducing inflammation is key. When choosing foods, eat as many organic fruits and veggies as possible, ideally limiting fruit to no more than 2 servings a day, and consuming 8–10 servings of veggies daily. Meats should be organic and pasture-raised/grass-fed whenever possible as this will decrease your exposure to inflammatory fats and chemicals. Eating enough fat is important — get fats from healthy sources like avocados, nuts, seeds, olive oil, and fatty fish — 2-3 tbsp per meal is a good start.

Yes, highly refined sugars and carbohydrates should be limited or avoided when trying to get pregnant. The blood-sugar balance will influence your hormonal balance, so avoid foods such as white-bread products, pastries, cookies, cakes, candy, sodas, juices, jams/jellies, white rice, and pastas. You should also avoid highly processed foods that have a lot of fillers, food colorings, and added preservatives — if you can’t pronounce the ingredient or know what it is, put the product back on the shelf.

Most often, infertility has its roots in one or more of these areas:

• digestive function and gut health
• detoxification
• blood-sugar and insulin imbalances 
• adrenal health or stress management

Inflammation and oxidative stress underlies these 4 areas so working holistically to optimize them will lower the body’s overall inflammation, maximizing chances of conception. Nutrition is key because every single area depends on nutrients. Typically when I formulate a specific plan for you, we’ll first want to address gut health, detoxification and blood sugar because focusing on these areas will improve egg and sperm quality, balance hormones, increase chances of implantation and embryo development, reduce the risk of miscarriage, and optimize birth outcomes.

SIBO stands for Small Intestinal Bacterial Overgrowth. It’s not an infection or an overgrowth of pathogenic bacteria, but of normal bacteria in the wrong spot. In a normally functioning digestive tract, the bulk of bacteria reside in the colon, the rest of the GI tract is relatively sterile. When there’s a motility issue, for any number of reasons, that prevents bacteria from being moved through the GI tract, then you can get a stagnation or backflow of bacteria into the small intestine, causing an overgrowth. This leads to gas, bloating, distension, abdominal pain, diarrhea, constipation, reflux, and nausea.

SIBO can have many causes but most commonly can be from an episode of food poisoning. Other causes of SIBO can be from abdominal surgeries, underfunctioning thyroid, long-standing diabetes, stomach-acid suppressing medications (PPIs), overuse of pain medications or opioids, head injuries, liver disorders, and motility disorders (like Parkinsons, gastroparesis, etc).

The best way to test for SIBO is by doing a SIBO breath test. This involves drinking a fermentable sugar solution so that the bacteria will ferment and give off either hydrogen or methane gas. If there are bacteria present in the small intestine then the breath test will capture a rise in these gases as the bacteria produce them as a result of their fermentation. Currently, MDs and GI doctors can order tests, but there are several labs that allow RDs to order the breath testing.

SIBO eradication and management involves a comprehensive approach, including herbal supplements and/or prescription antibiotics along with dietary modifications and specific probiotics and digestive support. While SIBO does have a high relapse rate, with proper management and interventions, along with a maintenance protocol to prevent it from coming back, symptoms and discomfort can be greatly reduced. Sometimes manual manipulation such as visceral manipulation techniques can help resolve adhesions and scar tissue which will make the eradication of SIBO more effective.

We have over 100 trillion bacteria inside of us, about 10x as many human cells in the body. So we’re made up more of bacteria than we are human if you think about it. All these bacteria serve a purpose, and every different type of bacteria has a different role — supporting our immune function, making vitamins, regulating our bowel movements, digesting food, and some research suggests helping with weight control, among others. So, supporting our bacteria via the food we eat and not overusing antibiotics are important.

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. Basically, these are short-chain fibers that our body does not digest, and instead of being absorbed into your bloodstream, they reach the far end of your intestine where most of your gut bacteria reside.

Your gut bacteria then ferment or “eat” them, producing gases and causing digestive symptoms in some people. These fibers also draw liquid into your intestine which can cause diarrhea and bloating.

Yes, stress has a big impact on the GI tract. It can shut down motility and cause constipation, or speed it up and cause diarrhea and cramping. This is because stress affects the main nerve in our body that regulates GI motility, the vagus nerve. Stress also changes the balance of our good bacteria and can lead to imbalances that negatively affect our health.

It is important that you have at least 1–2 complete bowel movements every day, but up to 3 or 4 can be normal as long as it is not loose or runny. The stool should be soft in consistency and look like logs or snakes, not small pellets.