Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (37 page)

Fermentation dysbiosis:
We don’t form gas; the bacteria in our gut do. They eat our carbohydrates, and the by-products of fermentation create gas. Eating sugar, fruit, beer, wine, starchy vegetables, and grains makes this worse. Typically a low-carbohydrate diet helps bring this back into balance. Think about implementing a low-carbohydrate type of diet such as Atkins, Anti-Fungal Diet, Specific Carbohydrate Diet (SCD), or Gut and Psychology Syndrome (GAPS) diet. (You can read more about these diets in
Chapter 13
.) Fermentation dysbiosis is typically coupled with bacterial and fungal dysbiosis.

Bacterial overgrowth dysbiosis:
Bacteria may move (translocate) from the colon into the small intestine, or they may grow in the small intestine due to low levels of hydrochloric acid. People experience this often as gas and bloating, diarrhea, discomfort, and sometimes constipation. Bacterial overgrowth is often coupled with fermentation dysbiosis. Common types include Clostridium difficile, H. pylori, infectious E. coli, and Clostridium perfringens. Think about implementing an Atkins, Specific Carbohydrate, or GAPS diet. (See “Small Intestinal Bacterial Overgrowth” and “Helicobacter Pylori” in
Chapter 8
.)

Fungal dysbiosis:
We normally have a fair number of Candida species, a diploid fungus in the yeast family, in our natural microbiome. Antibiotics, stress, sugar, steroids, and other medications can give them the opportunity to quickly grow, causing a myriad of ill effects. True to dysbiosis, these yeasts can colonize on skin (athlete’s food, eczema, psoriasis), in the vagina, in the small intestine, in the nose (some chronic sinusitis), on the scalp (seborrhea, cradle cap), and elsewhere in the body. They are always coupled with fermentation dysbiosis. In fact, in rare people Candida manufacture enough alcohol to make people drunk. (See “Candida: The Masquerader” in
Chapter 8
.)

Parasitic dysbiosis:
Many people have amoebas, fluke, cysts, other protozoa, and other parasites. (See “Parasites” in
Chapter 8
.)

Immune-inflammatory dysbiosis:
Microbes produce toxins that affect the immune system by suppressing it. For example, gliotoxin is produced by Candida albicans. This leads to inflammation in the mucosal tissues of the small intestinal lumen. This inflammation can lead to leaky gut and malabsorption.
It can also set the stage for hypersensitivity-allergic dysbiosis in people who are susceptible.

Hypersensitivity-allergic dysbiosis:
Some people have an exaggerated immune response to otherwise “normal” yeast and bacteria due to their genetic predisposition. Our body initially reacts to a microbe of some sort, but the antibodies formed to fight it are what set off autoimmune reactions. This is called gene mimicry. Ankylosing spondylitis, rheumatoid arthritis, reactive arthritis, Reiter’s syndrome, and psoriatic arthritis also fall into this category. Other people may experience acne, IBS, eczema, or psoriasis. These people often have food intolerances, leaky gut, and environmental sensitivities as well. Replacing probiotic bacteria, avoiding foods that you are sensitive to, and repairing the intestinal mucosa are essential.

While there are many causes of dysbiosis, we generally bring it on ourselves. Constant high levels of stress, use of antacids and proton-pump inhibitors, exposure to manufactured chemicals, poor food choices, gluten sensitivity, chronic constipation, oral contraceptives, gastric surgery including gastric bypass surgery, and use of antibiotics and painkillers all change the healthy balance of the digestive tract.

The most common cause of dysbiosis is the use of antibiotics, which change the balance of intestinal microbes. Not terribly specific, antibiotics simultaneously kill both harmful and helpful bacteria throughout our digestive system, mouth, vagina, and skin, leaving the territory to bacteria, parasites, viruses, and yeasts that are resistant to the antibiotic that was used. In a healthy gut, parasites may be present in small numbers and not cause symptoms, but if allowed to flourish they can cause diarrhea, illness, and weight loss. Most people can recover fairly easily from a single round of antibiotics, but even those with strong constitutions may have trouble regaining balance from repeated use of antibiotic drugs. I’ve worked with many clients whose doctors bounce them between antibiotic, antifungal, and antiparasitic drugs. Many feel better after a regimen like this, but some feel worse than before they began.

These medications are designed to block hydrochloric acid production in the stomach. This acid acts as a first line of defense against microbes that come in as guests with our food. When blocked, our defense is gone.

These microbes produce toxins that cause symptoms. The bacteria form chemicals that are poisonous to the cells around them and to the person they live in. A wide variety of substances are produced, including amines, ammonia, hydrogen sulfide, indoles, phenols, and secondary bile acids. These substances may hurt the intestinal lining directly by damaging the brush border and become absorbed into the bloodstream, causing system-wide effects. Initially, our body rushes white blood cells to the injured tissue to eat up the bacteria and carry away the debris via the lymphatic system. Cytokines and other inflammation markers rush to the scene. If all is in balance, the infection will soon go away. But if our immune system is overwhelmed, the dysbiosis will continue and we will eventually experience pain, discomfort, and leaky membranes.

Poor diet also contributes to dysbiosis. High-fat, high-protein diets and low-fiber diets can contribute to dysbiosis because these diets slow down bowel motility. A diet high in fat, sugar, and processed foods may not have enough nutrients to optimally nourish the body or repair and maintain the digestive organs. The nutrients most likely to be lacking are the antioxidants (vitamins C and E, beta-carotene, coenzyme Q10, glutathione, selenium, the sulfur amino acids, and zinc), the B-complex vitamins, calcium, essential fatty acids, and magnesium.

Poor ileocecal valve function can contribute to dysbiosis. The valve’s job is to keep waste matter in the colon from mixing with the useful material that is still being digested and absorbed in the small intestine. When this valve is stuck, either open or closed, dysbiotic problems can occur. Chiropractors can adjust the ileocecal valve to alleviate this problem.

This list offers the most common tests that are used to assess whether you have dysbiosis. You can find more detailed information on functional testing in
Chapter 11
.

Crook’s yeast questionnaire (for candida and fungal infection)

Comprehensive stool testing