Stress, Dysbiosis and compromised Small Intestine

How many ailments are caused by Chronic Stress? 

How many were listed and identified in previous articles in my newsletters? 

Today, I read a very interesting article and interview with Dr Allison Siebecker, ND, and Dr Steven Sandberg-Lewis, ND: 
"Bacteria are normally kept at low levels in the [Small Intestine] SI (<100 thousand/mL) by bactericidal GI secretions, the migrating motor complex (MMC) which sweeps it clean between meals and at night, as well as the Ileocecal valve, which prevents backflow.  Conversely the [Large Intestine] LI is meant to have a large bacterial population (100 billion/mL) where they perform helpful activities.  If the normal SI protections are compromised by factors such as acute GI infection, GI surgery, disease or chronic stress, overgrowth can and does occur.
   SIBO wreaks havoc, causing mucosal damage, increased permeability, deconjugation of Bile, bacterial consumption of nutrients and accumulation of bacterial acids and gas. Common GI symptoms include bloating, abdominal pain, diarrhoea, constipation (or both), heartburn and nausea. Common systemic symtpoms include food sensitivities, headache, joint pain, and respiratory, skin, brain and mood symptoms. Malabsorption signs include steatorrhoea and anemia (microcytic or macrocytic)."

It is now identified that Small Intestine Bacterial Overgrowth (SIBO) may play a role in the development of IBS.   

But what is SIBO?

It is defined as "an abnormally high number and/or type of bacteria in the small bowel. The small intestine, comprising the Duodenum, Jejunum, and Ileum, sits between the stomach and the large intestine, and is where the bulk of absorption of nutrients from food takes place. Compared to the colon, it has relatively few commensal bacteria species. When overgrowth occurs, it is typically bacteria "migrating" from the colon: [...] species that ferment carbohydrate and play a role in the development of the symptoms characteristic of SIBO - including bloating, flatulence, discomfort and changes in the stool form." writes Ben brown, ND, in the article 'Functional Medicine Masterclass' published in the IHCAN, The Practice and Science of Natural Medicine Magazine (June 2017), adding: "SIBO is also associated with chronic diarrhoea, steatorrhoea [excess fat in the stools], and pale stool, due to dilution of bile pigment in a large volume of stool. Perhaps not surprisingly, SIBO can mimic symptoms of Irritable Bowel Syndrome [IBS], and case-control studies have generally found a higher prevalence of SIBO among patients with IBS 919% to 37%) compared to healthy controls (0% to 12%). This association is important clinically, because treating SIBO may relieve symptoms consistent with IBS.
"Several Intestinal as well as extra-intestinal disease association with SIBO have been described, including Inflammatory Bowel Diseases [IBD], gastroparesis [delayed gastric emptying], chronic diarrhoea, treatment refractory coeliac disease, chronic pancreatitis, erosive esophagitis, hepatic encephalopathy, rosacea, chronic urticaria, fibromyalgia, restless leg syndrome, rheumatoid arthritis, hypothyroidism, obesity, subclinical atherosclerosis, deep vein thrombosis, Parkinson's disease, and multiple sclerosis.
"Risk factors for the development of SIBO include anatomical changes, alterations in motility, reduced pH, and immunological factors. Examples of anatomical changes include small-bowel obstruction, small-bowel diverticula, and postsurgical anatomical alterations. Changes in motility may be primary (i.e. gastroparesis), or secondary to conditions such as Parkinson's, hypothyroidism or diabetes mellitus. Alterations in pH are linked to hypochlorhydria, proton pump inhibitor use, and advanced age. And immunological factors include IgA deficiency, combines variable immunodeficiency, and human immunodeficient virus."

You probably remember how stress can affect our fragile microbiome, especially symbiotic bacteria living in our gut, more specifically in our bowel, breaking down the food that our digestive system is not able to digest, and producing by-product such as B vitamins and other key compounds. Several metres long, our Small Intestine has a vital role to extract nutrients from the food we eat. Not only the food we choose to eat is therefore of the utmost importance, but the state of our digestive system is also the result of that choice, of the lifestyle we choose to lead, and the way we choose to respond to stressful events.
Nutrient-dense foods assure our body receives the building blocks necessary for energy, but also for constant healing and repair, and immunity against the environment (pollution, dust, fumes, household chemicals, etc.) and pathogenic microbes entering our digestive system.

How to keep a healthy digestive system?

- Always choose wholesome foods (unprocessed, unrefined, etc.)
- Minimise the ingestion of toxicants (pesticides, herbicides, food additives and preservatives, etc.)
- Chew each mouthful,
- Keep stomach juices at optimal levels,   
- Promote digestive enzyme action,
- Promote liver detoxification and the flow of bile, 
- Drink enough water (preferably between meals),
- Ingest both soluble and insoluble fibre, 
- Regular physical activities,
- Bowel movement (1-3 times per day),
-  Avoid sugar as much as possible (feed the wrong kind of bacteria),
- Avoid Gluten, and grains as often as possible (to reduce irritation to gut wall),
- Avoid Lectins and Phytates (to reduce inflammation to gut wall),
- Avoid Coffee and Caffeine-laden products, 
- Avoid dairy products, especially mass-produced cow's milk,
- Avoid stress, and reduce your response to stress,

Because we are not all happy farmers or living in the countryside, the choice of the food we eat may, somewhat, be restricted. It also appears from customer surveys and trends that people most often buy the same food over and over again, restricting the array of ingredients used in meal preparations. This means that many people do not consume a wide enough variation of antioxidants, and most-probably chose less nutrient-dense foods. 

On the long term, a lower intake of antioxidants and a regular consumption of foods known to cause intolerances, allergies, or reactions in the digestive tract, may all contribute to inflammation in the gut and to an imbalance in symbiotic microflora. If left unchecked, this will lead to systemic inflammation, to an entire array of symptoms, and in some cases SIBO.