Have you heard of SIBO, aka small intestinal bacterial overgrowth? It is a digestive health condition that affects many of us, and it is often mistakenly diagnosed as “IBS” or irritable bowel syndrome.
We normally have different kinds of bacteria in the small intestine (the long squiggly bunch in the middle) and in the large intestine (the big loop on the outside). The different bacterial communities are kind of analogous to a pond and the sky — we find fish in the pond and birds in the sky but we don’t usually find fish in the sky!
What are the symptoms of SIBO?
In SIBO, the bacteria from the large intestine get into the small intestine where they just don’t belong. This can happen for a variety of reasons that I’ll get to shortly. These bacteria can then create havoc, producing gases in response to what we eat, which can cause bloating, abdominal pain, diarrhea, constipation, heartburn, nausea, and all kinds of other unpleasant digestive symptoms. SIBO is also a leading cause leaky gut (also known as intestinal permeability) which can present with a variety of symptoms around the body such as:
How is SIBO diagnosed?
There is a test for SIBO that involves collecting breath samples over several hours after drinking a sugary solution called lactulose. The testing is about $200. If the test is positive, then we obviously treat! The test results will tell us which kind of bacteria are present! The testing is important as it determines the severity of the infection and which treatment would be most effective.
Testing requires the individual to follow a limited 24-hour prep diet the day before testing, which includes:
Nothing outside of this list is permitted during the 24-hour prep diet, because anything else could feed the bacteria and we want to calm any bacteria down a bit before the big test day!
The night before the test collection, the individual must fast for 12 hours, which isn’t usually too difficult because mostly the individual is asleep! In the morning, the person is ready to start the test collection, which involves drinking the lactulose solution and providing breath samples every 20 minutes over 3 hours. Test results usually arrive about 7-10 business days after the lab has received the samples.
How is SIBO treated?
There are many approaches to treating SIBO out there, from the low FODMAP diet to the elemental diet, Cedar Sinai diet, prescription medications, herbal therapies, and more. The way I treat SIBO is a multi-phase approach:
What would be the root cause of SIBO?
Some of the potential underlying factors that can cause SIBO in the first place include:
It is important that we determine the root cause of the issue and treat it to prevent SIBO symptoms from returning again and again.
In summary, I really love testing and treating for SIBO. It’s really pretty easy, and most people see a complete resolution of their digestive symptoms, which is so, so satisfying. Most people who eventually come in and get tested for SIBO have usually been struggling with digestive symptoms for many years - sometimes up to 20 or 30 years. You can imagine how wonderful it is when these individuals feel well in their digestive system after all that suffering.
To learn more about SIBO or to discuss digestive health, please contact me or schedule an appointment.
Let's talk about symptoms.
Vaginal yeast infections are common and usually present with vaginal itching, burning, redness, and often thick or white discharge (often referred to as “cottage cheese” discharge). However, an absence of any of these symptoms doesn’t mean there isn’t a yeast infection present. Sometimes it’s just itching, for example. The way to know for sure is to get a vaginal swab for yeast through your doctor, and this can quickly confirm whether your vaginal symptoms are related to yeast. However, most people who have had a vaginal yeast infection can recognize when the symptoms come back and don’t need a test every time.
How are they treated?
Treatment of vaginal yeast infections usually includes vaginal anti-fungal creams or oral medications, conventionally speaking. But there are a host of other treatment considerations that can be incredibly useful, which I’ll get into in a moment.
What happens if a vaginal yeast infection keeps coming back?
When vaginal yeast infections are frequent, say once per year, once per month, all the time, etc, it is useful to ask my favourite question: WHY? Vaginal yeast infections are usually caused by an overgrowth of a particular yeast called Candida albicans, which is part of our natural microbiome but which can cause a lot of issues if it’s allowed to get out of control! Some of the reasons why Candida grows out of control are:
Yeast is usually kept in check by the healthy bacteria in our digestive tract and vagina. When we eliminate the healthy bacteria (by taking antibiotics, which kill both the bad bacteria and the good bacteria), yeast can flourish! If we add to this a high-sugar diet (even too much fruit), we can make matters worse! Steroid use and high blood sugar caused by diabetes can also lead to yeast growing out of control.
We might need to go deeper.
Often, and especially if vaginal yeast infections keep occurring, our best bet is to turn our attention to what’s happening in the digestive system. It is not uncommon for sufferers of vaginal yeast infections to also have symptoms of irritable bowel syndrome (IBS) like chronic bloating, gas, and loose or explosive stools. In fact, many yeast infection sufferers have been diagnosed with IBS and have accepted these symptoms as a normal fact of life. I’ve said it before and I’ll say it again — digestive symptoms like those we see in IBS are never “normal” and are always a sign that something is out of balance. People who have an overgrowth of intestinal yeast may also experience:
How is it tested?
Intestinal yeast overgrowth has traditionally been diagnosed by evaluating for yeast in the stool. These days, most conventional labs don’t offer this, but there are still many specialty labs that offer stool testing for yeast.
Ok, get to the good stuff. How do I treat this?
By treating yeast where it starts (ie. through the diet, in the blood sugar, or in the gut), we can help the microbiome get back to a healthy normal state and prevent yeast overgrowth in the vagina for good.
The treatments I use when treating frequent vaginal yeast infections are:
Treating yeast at the source usually results in:
There you have it! If you experience frequent vaginal yeast infections, please know that this is not an issue you just have to accept. Tests and treatment are available, and I love treating yeast and helping people reclaim their health.
What is Candida?
Candida refers to several species of yeast. One species, Candida albicans naturally takes up residence in our digestive tract, mouth, and vagina as part of our normal flora. In normal levels, Candida is unnoticeable by most and is relatively innocuous, but if it grows out of control, it can lead to a variety of annoying symptoms! This is when fungi becomes well, not so fun. The good news is Candida is relatively straightforward to treat!
Here are 10 signs you may have a candida overgrowth:
1. Skin Rashes and Nail Infections
Yeast has certain skin and nail manifestations that cannot be missed! Athlete’s foot, jock itch, diaper rashes, skin rashes, and acne can all be evidence of a fungal infection. Yeast on skin tends to be pink-red patches that are relatively flat, and do not produce discharges. They can be a bit scaly and may be itchy. Often these rashes will improve with the application of an anti-fungal ointment. However, don’t stop there. If you have a fungal overgrowth on the outside, it’s possible it is also happening on the inside as well.
2. Fatigue and Brain Fog
People with yeast overgrowth will frequently experience brain fog and fatigue, most likely due to inflammation caused by the yeast in the GI tract. The inflammation caused by yeast in the GI tract causes the adrenal glands to produce cortisol (our stress hormone). Over time, this can deplete the adrenal glands, leading to a state of chronic fatigue.
Additionally, candida produces toxins like acetaldehyde and gliotoxin, which can affect the nervous system, joints and muscles! It’s no wonder we frequently see brain fog and even pain syndromes like Chronic Fatigue Syndrome being linked with Candida.
3. Frequently Sick and Poor Immune Function
The chronic inflammation that can result from a yeast overgrowth in the GI tract frequently leads to a condition called leaky gut (also known as intestinal permeability). This is where the cells lining the GI tract become slightly spaced apart or “gapped," creating little micro-holes that allow pathogens, toxic metabolites and food particles to pass from the GI tract into our circulation! When this happens, our immune system cells do what they do best—attack! This constant task depletes our immune system and can make us more susceptible to other illness.
It is also noteworthy that people who are susceptible to yeast overgrowth may have an underlying immune deficiency called “selective IgA deficiency.” Selective IgA deficiency is essentially a state of low immunoglobulin A that tends to result from our genes. Having low IgA simply means that we are not as capable of fighting off infections in the first place. People with low IgA often tend to get more respiratory illness and intestinal illness than the average person.
4. Food Sensitivities and Intolerances
With leaky gut comes potential development of food sensitivities! Food particles that move from the enclosed space of our GI tract into our blood can be identified and attacked by the cells of our immune system. This frequently results in the development of food sensitivities. Often when we control both the Candida infection and correct the intestinal permeability, people will find they regain tolerance of foods.
5. Cravings for sugar and refined carbohydrates
Sugar cravings are pretty common but people who have Candida overgrowth often have intense cravings. You know who you are! These are people who can easily pack away pancakes for breakfast, donuts for lunch, pasta for dinner, and pie for desert and just want MORE. One difficulty is that as people make healthy changes to re-balance their GI flora, yeast will start to die-off and this can make sugar cravings even more intense for a while until the body has eliminated some of the harmful metabolites. Once you’re over the worst of these cravings and the yeast has died off, cravings usually reduce significantly!
6. Weight gain or inability to lose weight
It’s no surprise that eating more sugar and refined carbohydrates can lead to weight gain! Excessive amounts of refined carbohydrates in the diet are converted to fat in the body. If leaky gut is an issue, the subsequent inflammation and production of cortisol can lead to even more fat storage, often right around the abdomen!
7. Digestive symptoms like bloating, abdominal pain and loose stools
Really, we can see any variety of digestive issues with a Candida overgrowth but in my practice, I most frequently see patients who experience lots of gas and especially bloating, and frequently stools that are slightly loose or frank diarrhea. We can see alternating constipation and diarrhea, maybe hemorrhoids (from having to strain), stools that are explosive — you get it. There is a variety! Mucus and undigested food in the stool are also frequently seen. If overgrowth is severe, anal itching may also be an issue. As we work to rebalance the GI flora, we frequently see a normalization of these symptoms.
8. Hormonal imbalance
A Candida overgrowth is taxing to the liver! The liver is our headquarters for hormone production. When the liver is busy handling Candida and its metabolites, we can have hormonal imbalance as a consequence. Candida also produces estrogen-like substance, which can lead to too much estrogen in the body compared to progesterone and testosterone. Symptoms of estrogen dominance include PMS, mood swings, irregular periods, breast pain, and heavy periods.
It isn’t a stretch to imagine how having an overgrowth of a pathogen along with all its toxic metabolites can affect our mood! The metabolites from Candida can actually cross the blood brain barrier, which can have massive effects on our mood! People may experience irritability, impatience, and mood swings. These symptoms can become worse when yeast is dying off an releasing even more toxic metabolites, but as our body handles these, mood will often start to improve as well.
10. Frequent UTIs and vaginal yeast infections
Frequent vaginal yeast infections are a clear indication that you likely have an intestinal Candida overgrowth. Until this is addressed, chronic vaginal yeast infections remain a recurrent problem for many women. Symptoms of vaginal yeast infections include thick white cottage-cheese-like discharge, itching, burning, and possibly a vaginal odour of bread or beer!
Although most urinary tract infections are due to bacteria, it is also possible to have a fungal UTI, especially if yeast from a vaginal yeast infection travels up the ureters and takes residence in the urinary tract! A person who experiences frequent urinary tract infections not relieved by antibiotics may actually have a fungal UTI! Generally, antibiotics will not help a fungal infection and can actually make them worse!
If you suspect you may have a yeast overgrowth, please schedule an appointment. A yeast overgrowth is an infection that requires treatment. Don’t live in the Okanagan? No problem. I offer virtual remote consultations as well.
If you've been diagnosed with irritable bowel syndrome, or "IBS" by your general practitioner, here's a secret: there may be an underlying cause of your symptoms! What would life be like if you could go about your day without the daily bloating, heartburn, or, let's face it, embarrassingly loud and smelly bowel movements in the public washroom at work? How would that free you?
It turns out there are many underlying causes that NEED to be ruled out before a diagnosis of IBS can even be made. If your primary care doctor has not tested you for conditions like celiac disease, parasites, underlying intestinal yeast overgrowth, or food sensitivities, then my friend, there are yet stones to be unturned! EVERY person with an irritable bowel should make a visit to a naturopathic doctor! We are experts in this stuff, and we really LOVE to help people have normal, healthy poops, and flat tummies that don't hurt! To schedule a full evaluation with me in Kelowna, please phone Momentum Health at 778-484-6070 and I will be overjoyed to help you thrive!
If you’ve struggled with digestive issues, you’re not alone. Many people struggle with common symptoms such as gas, bloating, heartburn, loose stool or constipation. It’s important to talk with your medical provider about your symptoms, but sometimes simple shifts in eating patterns are the first place to start. We call these ideal eating patterns “food hygiene” and it’s not about what you eat so much as how you eat.