Tag Archives: ibs

Fibromyalgia and the Gut

Protected individual repelling bacteria and viruses show  on tablet  made in 3d software isolated on white


And yet another connection between the gut and a seemingly unrelated condition: Fibromyalgia.

Fibromyalgia describes a condition where a person experiences widespread musculoskeletal pain. Similar to IBS, a total work up is done, and if Rheumatoid Arthritis, Lupus or other diagnoses are ruled out, and there is nothing tangibly ‘wrong’, then a diagnosis of exclusion is given to explain the symptoms.  There are 18 tender points, and if 11 or more hurt for 3 months or more, that’s fibromyalgia. The symptoms of fibromyalgia don’t stop at musculoskeletal pain. They also include fatigue, brain fog, and memory issues. Fibromyalgia can begin suddenly after a trauma, surgery, infection or psychological stress, or it can come on slowly with no triggering event. There is usually a genetic predisposition.

Fibromyalgia seems to affect the way the brain processes pain. This is yet another similarity to IBS, where there are overactive pain signals, an overactive immune system and a hypersensitivity to pain.

But here is the third and most astonishing similarity: nearly all fibromyalgia patients have IBS and Small Intestinal Bacteria Overgrowth! In the case of these patients, the bacteria release toxins that get into the blood stream (b/c of damage to the GI track) and this causes the pain and sensitivity to pain.

If you have fibromyalgia, get to the root of the problem: your gut.



SIBO (pronounced see-bo) is an acronym for Small Intestinal Bacterial Overgrowth. Your colon has 100 billion bacteria per milliliter but your small intestine should have less than 100,000/ml. When too many bacteria migrate or colonize in the small intestine, SIBO develops and all hell breaks loose.

SIBO is responsible for all sorts of uncomfortable symptoms, such as gas, bloating, and diarrhea. More importantly, it causes damage to the small intestine leading to a ton of non-digestive problems as well. It is estimated that 84% of people with IBS (Irritable Bowel Syndrome) also have SIBO. Similarly, people with Crohn’s Disease and Celiac are likely to have SIBO as well.

When bacteria are in your colon (large intestine), they eat what’s left over (mostly fiber) after you have absorbed all the nutrients that your body needs. But when the bacteria in your small intestine (before your body has absorbed all that it needs), they get VIP access to your food (carbohydrates are their favorite). As described in the book Breaking the Vicious Cycle: “The presence of undigested and unabsorbed carbohydrates in the small intestine can encourage microbes to take up residence and multiply. This, in turn, may lead to the formation of products, in addition to gas, which injure the small intestine…. bacterial growth in the small intestine appears to destroy the enzymes on the intestinal cell surface preventing carbohydrate digestion and absorption and making carbohydrates available for bacteria” This is the cycle. Injury to the intestine–>impaired digestion and absorption–>bacterial overgrowth–>damage to the intestine–>impaired digestion…and so on. When the bacteria injure the intestines and impair digestion, the small intestines become less able to digest carbohydrates, leaving more for the bacteria to digest, and allowing for more bacterial multiplication. They are preventing you from digesting the very thing they need to eat.


  • Abdominal bloating and distention
  • Gas
  • Abdominal pain and discomfort
  • Diarrhea, constipation, or a mix of the two
  • Heartburn or GERD

Systemic symptoms and associated conditions:

  • Vitamin and mineral deficiencies
  • Leaky Gut (where your intestinal wall let’s things into your blood that aren’t supposed to be let in)
  • Fatigue, brain fog
  • Food sensitivities
  • Headaches/migraines
  • Mental Disorders (Autism, Depression)
  • Obesity
  • Skin problems
  • Autoimmune disorders

How does this start?

  • Insufficient stomach acid (acid kills bacteria)
  • Impaired cleansing waves (a wave of muscle contractions that sweeps the debris out of the small intestine and into the colon in between meals and at night)
  • Anatomical issue (such as having no ileocecal valve, the valve at the end of the small intestine, that keeps colon bacteria from migrating up)
  • GI infections or disease (Crohn’s or Celiac)

There are a few treatments for SIBO, antibiotics being the best. But the underlying cause might still be a problem and the SIBO will likely reoccur. There are a few diet options as treatment: The Specific Carbohydrate Diet, GAPS diet, Elemental Diet or a low FODMAP diet. Each of these manipulates the type and amount of carbohydrates in your diet to starve the bacteria.

Nutrition therapy with a Registered Dietitian (who specializes in digestive disorders) is essential. Besides being necessary to attempt one of the therapeutic diets mentioned above, nutrition is critical for:

  • Preventing the SIBO from returning
  • Correcting vitamin and mineral deficiencies
  • Healing the gut lining
  • Increasing stomach acid
  • Encouraging cleansing waves. (There are a few ways to do this, but my favorite is with lemon water)

Talk to your doctor if you suspect you have SIBO. And get a qualified Dietitian.

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Transform your IBS with FODMAPs


Irritable Bowel Syndrome is a pain in the ass! It affects approximately 15% of the population. The good news is: there is a new treatment in town.

IBS symptoms include:

  • bloating
  • gas
  • abdominal pain
  • diarrhea
  • constipation
  • alternating diarrhea and constipation.

These symptoms can also be indicative of more serious conditions such as Crohn’s Disease and Celiac Disease (autoimmune disorders that cause damage to the intestine), so a doctor needs to rule these out before a diagnosis of IBS can be concluded. If your intestines are otherwise healthy, but you routinely experience the symptoms above, then you would be diagnosed with  IBS.

Some of the possible causes of IBS:

  • A current gastrointestinal infection
  • A past gastrointestinal infection (post-infectious IBS)
  • Antibiotic use
  • One or more food sensitivities
  • Gut dysbiosis—imbalance in your gut bacteria

Each of those causes can be the result of unhealthy gut bacteria (or flora).

Not surprisingly, then, the solution to IBS is to try to change your gut flora. (Also not surprising, Crohn’s and Celiac patients have gut dysbiosis too, and therefore can also benefit from the following protocol).


FODMAPs are a group of naturally occurring sugars that are fermentable. In a healthy gut, foods with FODMAPs wouldn’t cause any symptoms. But for some people, these sugars are big trouble. They travel through your small intestine, unabsorbed, and are therefore available for your gut flora to eat. When bacteria eat FODMAPs, they release gas, which in turn leads to all those symptoms listed above.

FODMAP is an acronym that stands for:

  • F: Fermentable
  • O: Oligosaccharides (Fructans and Galactans)
  • D: Disaccharides (Lactose)
  • M: Monosaccharides (Fructose)
  • A: and
  • P: Polyols (sugar alcohols)

The list of foods that contain one or more of these FODMAPs is very long. Which means of course, that following a low FODMAP diet is pretty restrictive. But it works for 75% of people with IBS. Imagine that!

The restrictive part is only for a few weeks, and is called the elimination phase. After getting your symptoms under control and resetting your gut, you reintroduce these foods, one at a time, to see if they still produce symptoms. Some will and some won’t.

But then you’ll know what bothers your tummy. And the idea is to eat the most varied diet you can, without experiencing problems. Since there are so many foods involved and you want things to get this right the first time, this diet works best with the guidance of dietitian.


photo credit freedigitalphotos.net

Are Your Bacteria Working for You or Against You?


I wrote recently about our 100 trillion bacteria living in our gut. If all circumstances are ideal, these bacteria are good and diverse. And keep us in good health

Good healthful gut bacteria are very delicate. And harmful ones are hearty. Here are the things that change your gut bacteria for the WORSE:

  • The foods you eat
  • C-section birth
    • A woman’s body actually pours tons of protective good bacteria into the birth canal during labor so that the baby is covered during birth. These protective bacteria are the baby’s first exposure to any microbes.
  • Antibiotics
    • Even one course of antibiotics can alter the ratio. Some species are killed off completely
    • Most of the antibiotics used are in the animal industry and we are consuming them in the meat we eat.
  • GI infections
  • Chronic stress
  • Environmental Toxins
  • Low stomach acid
  • Excessive hygiene

The term for having a poor ratio of good bacteria and low diversity of microbes is gut dysbiosis.

Gut Dysbiosis is associated with:

  • IBS
  • Bloating and distention
  • Celiac
  • Crohn’s and Colitis
  • GERD
  • Some cancers
  • Obesity
  • Allergies and food sensitivities
  • Heart disease
  • Mental disorders: autism, Alzheimer’s, schizophrenia, anxiety, depression

It’s important to get your gut health back! Book an appointment today to get your gut flora in shape!