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Gastrointestinal Disorders

Gastrointestinal conditions are extremely widespread. A recent study found that nearly two thirds of the US population suffers from at least one type of GI symptom per week. We have tremendous success in treating this issues because we know that by balancing the microbiome and its billions of bacteria, that we're going to eliminate these uncomfortable symptoms.

Gastrointestinal conditions encompass a wide range of disorders. It’s estimated that over 10% of the US population suffers from GI issues, and if you’re over 65, that number jumps to 35%. One study concluded that nearly two thirds of the US population suffers from at least one type of GI symptom per week and GI symptoms account for nearly 100 million ambulatory visits annually. 

What are the most common types of GI conditions?

Irritable Bowel Syndrome (IBS):

IBS is characterized by a number of symptoms including abdominal pain, gas, bloating, nausea, as well as constipation or diarrhea. It is the most common gastrointestinal (GI) disorder. Many people are diagnosed with IBS when all other potential conditions are ruled out.

IBS is often accompanied by depression or anxiety, as there is a link between the gut and the brain, known as the “gut-brain axis.” The enteric nervous system is located in the gut, and it is responsible for regulating digestion. A dysfunction of the enteric nervous system is a common factor in people suffering from IBS.

What causes IBS?

  • Dysfunction of the microbiome.

  • Food allergies and sensitivities are a common factor in IBS. According to one study, at least two-thirds of all IBS patients suffered from at least one food intolerance. Gluten and dairy are the most common offenders. 

  • An unhealthy diet, particularly one high in sugar, refined carbohydrates and processed foods is also a common trigger for IBS, which is one of the reasons why it is so prevalent in the United States. 

Why do so many people suffer without resolving these symptoms?

Most physicians, including gastroenterologists, take a narrow view of digestive or gut-related issues. They focus on symptoms and medicate superficial problems instead of looking at the underlying root causes that lead to gut dysfunction. Many members of the medical community fail to recognize how gut and specifically the microbiome plays a vital role in nearly every physiological process. And, imbalances in the gut microbiome can result in many symptoms - not all GI-related -  including headaches, acne, fatigue, and even depression

What are the most common types of GI conditions?

Inflammatory bowel disease (IBD) includes conditions which cause long-term inflammation in the digestive tract. It is considered to be a type of autoimmune disease. 

The two main diseases that fall in this category are:

  • Crohn’s disease involves inflammation throughout the digestive tract, including the large and small intestines. The damage often happens in patches rather than affecting the entire tract. However, it can impact multiple layers of tissue in the intestines.

  • Ulcerative colitis impacts just the large intestine (colon). The damaged tissue usually affects the entire colon in a continuous stretch, causing colon pain and inflammation. It can also cause symptoms in the rectum.

It is estimated that about 1.6 million Americans suffer from inflammatory bowel diseases.

Inflammatory bowel disease encompasses a wide range of symptoms, including:

  • Diarrhea for a long period of time

  • Alternating bouts of constipation and diarrhea

  • Belly pain

  • Cramping

  • Gas / Bloating

  • Bleeding from the rectum or blood in your stools

  • Poor appetite

  • Unintended weight loss

  • Fatigue or lack of energy

  • Fever

  • Depression and/or anxiety 

  • Brain fog / loss of mental clarity

Small Intestinal Bacterial Overgrowth (SIBO):

Our gut microbiome contains trillions of bacteria, crucial to our digestive and overall health. However, issues arise when we have an imbalance or an overgrowth of bacteria. The challenge with SIBO is that it has similar symptoms to other GI conditions. It is common for people who have had SIBO in the past to have a recurrence.

The small intestine is where most of our digestion takes place and nutrients are absorbed. When we have an improper balance of bacteria or an overgrowth, this can result in a malabsorption of nutrients. The bacteria itself can actually digest the nutrients itself, resulting in some of the common symptoms we see like gas and bloating.

Common SIBO Symptoms:

  • Nausea

  • Gas/bloating

  • Diarrhea

  • Vomiting

  • Malnutrition

  • Weight loss

  • Joint pain

  • Fatigue

  • Rashes/eczema/rosacea. acne

  • Depression

  • Asthma

Gastroesophageal Reflux Disease (GERD) / Heartburn:

Although related, acid reflux and gastroesophageal reflux disease (GERD) are not the same thing. Acid reflux is the backward flow of stomach acid into the esophagus, with the most common symptom being heartburn. Left untreated acid reflux can progress to GERD, a more severe and chronic form of reflux. The most common symptom of GERD is frequent heartburn, experienced two or more times per week. Other symptoms can include regurgitation of food or sour liquid, difficulty swallowing, coughing, wheezing, and chest pain, especially while lying down at night.

However, more research suggests that chronic inflammation is another contributing factor for GERD. Inflammation not only contributes to tissue damage in the esophagus, but is also tied to many other forms of digestive distress. Inflammation is a common root cause for a number of chronic health conditions, therefore it is not uncommon for people with digestive dysfunction to suffer from several different inflammatory-related conditions. 

It is estimated that 20% of Americans suffer from GERD. Many experts believe that the alarmingly high prevalence of GERD is a direct result of eating a highly processed diet. Up to 40% of Americans experience GERD-related symptoms at least monthly, and 10-20% experience GERD symptoms almost daily.

What can trigger this underlying inflammation which can lead to GERD?

  • A poor diet

  • Poor gut health, or leaky gut syndrome

  • Food allergies or sensitivities

  • Excess physical or emotional stress

  • A sedentary lifestyle

  • Being overweight or obese

  • Smoking cigarettes, alcohol abuse or drug use

  • Taking immune-suppressing medications

  • Environmental toxins

  • Certain medications like NSAIDs, overuse of antibiotics and antacids/other acid blocking medications

Issues with Conventional Treatments:

The most common medical approach for acid reflux and GERD is to medicate symptoms, rather than address the underlying cause of the condition. These medications might temporarily improve the symptoms but can cause other unintended consequences and even make the situation worse.

Common Medications include:

  • Antacids, such as Tums, Maalox, Mylanta, and Rolaids

  • H2 acid blockers, such as Tagamet, Pepcid, and Zantac

  • Proton pump inhibitors (PPIs), such as Prilosec, Prevacid and Nexium.

Once prescribed, most doctors recommend staying on them for years or even permanently. Unfortunately, chronic use of these medications can disrupt the gut microbiome, which can lead to inflammation, an altered immune response, as well as the increased risk of other chronic conditions. Long-term use of PPIs may even change the pH level in your stomach, thereby blocking some of your body’s natural ability to absorb key nutrients.

Leaky Gut Syndrome:

In a properly functioning digestive system, the lining of our intestinal tract includes tight junctions or microscopic openings, which allow water and nutrients to pass through into the bloodstream, while keeping harmful substances from escaping. The rate of this passing is called “intestinal permeability.”

Leaky gut results from damage to the lining of the GI tract, which thereby allows bacteria, undigested food particles and other toxins to enter the bloodstream. It refers to an increase in permeability of the intestinal lining, which could play a role in a variety of GI disorders.

What causes Leaky Gut Syndrome?

Damage to the lining of GI tract is often due to chronic inflammation and a persistent immune response, which can be triggered by several factors, including:

  • Poor diet

  • Overuse of antibiotics and other medications which disrupt the gut microbiome.

  • Infections

  • Autoimmune conditions

  • Stress

  • Other health conditions like diabetes and undiagnosed low thyroid function

 

As with many GI conditions, the root cause of this dysfunction is often tied back to the microbiome and as like other GI conditions, there is a strong link between the gut and the brain. The gut and the brain are interconnected; the bacteria send messages back and forth. Most patients with leaky gut also suffer from anxiety, memory loss, fatigue, or other brain issues. We’ve now identified IBIB (“Irritable Bowel Irritable Brain”) as the two systems are interconnected.

Treating Leaky Gut Syndrome requires addressing not only the gut dysfunction, but the impact on the brain, as well.

When we treat one, we treat the other.

Celiac Disease:

Celiac disease results in an immune reaction to eating gluten, which is a protein commonly found in wheat, barley, and rye. If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this inflammatory reaction damages the lining of the intestines, which prevents it from properly absorbing some nutrients. Overtime, this can also lead to Leaky Gut Syndrome. Intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications if left untreated. 

There's no cure for celiac disease. However, following a strict gluten-free diet can help manage symptoms and prevent further damage. Additionally, there are a number of therapeutic options which can promote intestinal healing and even reverse the damage.

 

Although many people have gluten sensitivities, Celiac Disease is substantially less common.  An estimated 1 in 133 Americans, or about 1% of the population, has celiac disease.

Food Sensitivities:

Unlike some allergies, food sensitivities and intolerances are not life-threatening. However, they can be very problematic for those affected. Intolerances to certain foods can result in a variety of symptoms such as gas, bloating, diarrhea, skin rashes, eczema or skin breakouts, fatigue, brain fog, dark circles under the eyes, frequent nasal congestion, as well as aches and joint pain. 

Many of these symptoms are attributable to the immune response to the food. Food sensitivities are extremely common and seem to be on the rise. It is estimated that about 30% of the U.S. population suffers from food sensitivities, however there are likely millions more who go undiagnosed. Common food sensitivities include:
 

  • Gluten

  • Dairy

  • Soy

  • Corn

  • Shellfish

  • Eggs

  • Peanuts

  • Tree Nuts

  • Caffeine

Other Non-Specific GI Symptoms (i.e., gas, bloating, etc.):

In addition to the above, many people experience regular bouts of various digestive dysfunction and symptoms, without explanation.

Targeted Testing Approach:

There are a number of tests that can aid with assessing GI function, as well as the overall health of the microbiome. Some examples include:

  • Food Sensitivities Testing to identify specific which food(s) may be triggering your symptoms.

  • GI Map Test which can identify key markers of inflammation and intestinal wall integrity, as well as imbalance in the composition of the bacteria in the gut microbiome.

  • SIBO Breath Test which evaluates and identifies bacterial overgrowth.

Treatment Approach:

The focus of all our treatment protocols is to not only relieve the symptoms, but to identify and address the underlying cause of the dysfunction. Dr. Kellman’s approach combines a variety of modalities to provide a comprehensive and customized treatment plan to meet your specific needs and it may include some of the following:

Peptide Therapy:

Peptides are small proteins, which are comprised of short chains of amino acids. These compounds are naturally produced by the body as signaling molecules used to stimulate hormone production, to prompt an immune response which helps the body to fight against bacteria, viruses, and other diseases, as well as to initiate the healing of damaged tissue. 

We use these peptides to treat a wide variety of conditions, including GI conditions. One of the most commonly used is BPC-157. BPC stands for body protection compound. The body naturally produces BPCs, primarily in the gut and the stomach and they function to protect and heal the digestive tract. Therefore, it is particularly useful in the treatment of gastrointestinal conditions, as it promotes healing of the gut. BPC-157 is administered as a troche, which is a medicinal lozenge, which is held in the mouth between the cheek and the gum and allowed to fully dissolve. BPC-157 is naturally anti-inflammatory, helps to alleviate pain and is very effective at combating leaky gut, gastrointestinal cramping, as well as the treatment of Crohn’s Disease.

Herb Nootropics and Targeted Probiotics:

The use of herb nootropics, specific strains of probiotics, as well as other nutraceuticals are another tool we use to address GI conditions. 

  • Probiotics, both from food sources as well as supplementation, are essential to healing and balancing the gut microbiome - but using the right strains of probiotics is critical. We use a targeted set of probiotic strains that are specifically beneficial to patients dealing with autoimmune conditions.

  •  Saccharomyces boulardi is a non-populating type of yeast, which is naturally anti-inflammatory, promotes intestinal microbiome balance,  and protects and repairs damaged intestinal mucosa, commonly seen in people with “leaky gut,” as well as helping to restore short-chained fatty acids (SCFA) balance in the gut, namely butyrate. SCFAs are crucial to gut health and in the treatment of autoimmune conditions. The main food component that impacts the gut microbiome composition and activity is fiber. The bacteria in our gut ferment this fiber, resulting in the production of SCFAs which fuel them, namely, acetate, propionate, and butyrate, which have recognized health-promoting activities, such as anti-inflammatory and immune-regulatory functions. Butyrate is the main energy source for colonocytes, the cells which make up your gut lining. Higher levels of butyrate in the gut also help to boost antioxidant levels, which protect against free radicals. All of these things protect the GI tract, improve digestion, as well as reduce overall inflammation. Saccharomyces boulardi also aids in boosting butyrate levels in the gut, promoting further healing.

  • Other supplements and natural compounds that can also aid in symptoms, such as the use of deglycyrrhizinated licorice (DGL), an alternative therapy that may help ease acid reflux symptoms or various combinations of herbs and botanicals to address gas and bloating. 

Dr. Kellman formulates a customized supplement protocol to fit each patient’s specific and individual needs.

Diet and Lifestyle:

As with most chronic conditions, including healing the gut microbiome, reducing inflammation and improving digestive function is crucial to healing and dietary changes are an essential part of our whole-body approach to overall health and wellness. 

Dr. Kellman’s Microbiome Diet is not only naturally anti-inflammatory, but also includes supportive, functional foods that balance the microbiome and heal the gut, which is the root cause for many conditions. The plan also excludes foods which commonly trigger food sensitivities. Diets and lifestyle changes are specifically tailored to the condition you are dealing with.

 

Whether you have already been diagnosed with a GI condition or suspect you may be suffering from one, the Kellman Wellness Center is here to help you to take the reins on your road to recovery. Contact us at 212-717-1118 to learn more about these effective treatment options or to schedule an initial consultation.

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