Stress, Dysbiosis and Compromised Intestinal Integrity
Updated 24/04/2023 (previously published 26/20/2018)
How many ailments are caused by Chronic Stress?
If you signed up to receive our newsletter, you may have discovered our series on stress and the impact of stress on the gut and almost any system in the body.
By now, you know that the answer to the question above is: The list is endless!
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.
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 in the #IHCAN 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."
What are the solutions?
You probably remember from previous articles and newsletters that stress can affect your gut (and oral) microbiome, specifically symbiotic bacteria that are responsible for breaking down the food that you cannot and producing by-products such as B vitamins and other key compounds like short-chain fatty acids, the most important being butyrate.
Several metres long, our Small Intestine has a vital role to extract nutrients from the food we eat and facilitating their absorption. Not only the food we choose to eat is, therefore, of the utmost importance to support our energy and health, 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 protection against the environment (e.g., pollutants/toxicants, mould/mycotoxins, 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.), including plenty of vegetables and fruits
Minimise the ingestion of toxicants (pesticides, herbicides, food additives and preservatives, etc.) by choosing organic or Demeter-certified food (Biodynamic)
Mark a pause before taking the first bite to break your state from hyperactivity to a complete state of relaxation (essential to ignite digestive capabilities)
Take the time to eat. Chew each mouthful thoroughly
Keep stomach juices at optimal levels (stress suppresses the release of stomach acid and the intrinsic factor, essential chaperone to carry/protect vitamin B12 until its absorption in the bowel — you may, therefore, benefit from supplementing with betaine or HCl and digestive enzymes of you suffer from acid reflux or indigestion)
Promote digestive enzyme action (enzymatic processes required the building blocks for their synthesis but also a multitude of cofactors, such as magnesium, zinc, and many more. Again, a balanced and nutritious diet is of the utmost importance. Also note that enzymes belong to a group of protein complexes and, therefore, their function can be affected by increased body temperature and inflammation (e.g., fever, infections, etc.)
Promote liver detoxification and the flow of bile. Think cholagogues and choleretics, gastrointestinal agents that stimulate the flow of bile into the duodenum (cholagogues) or stimulate the production of bile by the liver (choleretic)
Keep well-hydrated — preferably between meals (drinking too much liquid with. a meal can dilute your food and make the work of enzymes that much harder)
Increase your consumption of dietary fibre — both soluble and insoluble fibre
Daily physical activity
The combination of physical activity, hydration and dietary fibre should help regulate bowel movement (from 1 to 3 times per day), which is essential to prevent stagnation in the intestines, reduce gut problems (e.g., flatulence, distention, discomfort and potential pain) and the risk of SIBO.
Avoid all types of sugar as much as possible (feed the wrong kind of bacteria and fuel inflammatory reactions),
Avoid gluten and grains as often as possible (to reduce irritation to the gut wall. Gluten causes the gut to be leaky in 100% of people consuming it)
Avoid lectins and phytic acid. These are considered anti-nutrients, and a regular, large intake can lead to deficiencies in certain minerals. They may also inflame the intestinal wall. Both of these phenomena are made worse by stress. Reduce your stress and the impact of stress on your health before consuming large amounts of food containing lectins and phytic acid
Avoid coffee and caffeine-containing foods and drinks.
Avoid dairy products, especially conventional mass-produced cow's milk and plant-based milk, which often contain a long list of pro-inflammatory additives. Ideally, make your own using activated nuts or grains, such as oats.
Avoid stress, and reduce your response to stress. Develop gratefulness and become more mindful. Live in the moment and take control of your thoughts and the narrative.
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 choose less nutrient-dense foods and foods void of fibre.
On the long term, a lower intake of antioxidants and dietary fibre 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 and generate an entire array of symptoms, and in some cases SIBO. All of which can be precipitated by chronic stress…