What is dysbiosis and how can our diet and lifestyle affect it?
In my last bowel post I wrote about how a low-FODMAP diet can affect bowel health both positively and negatively when you suffer from dysbiosis or SIBO (you can find the post here). In this post, we take a deeper look at the benefits of a healthy intestinal microbiome and the causes of just unbalanced intestinal flora (dysbiosis / SIBO).
Did you know that we are made up of more microorganisms than human cells? In fact, we have billions of microorganisms just in the digestive tract, including bacteria, protozoa, fungi, viruses and archaea. Together, these are called our microflora. Gerard Mullin, associate professor of medicine at John Hopkins University, refers to the intestinal flora as a “garden”, a magnificent orchard with a single-celled life. Some organisms are good, like bees and pollinators, and others can cause health problems just like the ear canal that can destroy entire flower beds.
Benefits of a healthy gut microbiome
The biological diversity of the intestine refers to the number of different living organisms we have in our intestines. Researchers have begun to understand how this complex ecosystem, also known as our “second brain”, affects everything from digestion to the immune system, absorption of nutrients, weight gain and even the effects of certain drugs.
A healthy microbiome is symbiotic and contributes many health benefits to the human world. A healthy intestinal flora helps prevent chronic inflammation, protects against allergies and hypersensitivity, produces short-chain fatty acids, vitamins and enzymes, and helps maintain an intact intestinal mucosa and proper pH in the colon. Healthy intestinal bacteria prevents the excess growth of pathogens and parasites, protects the body against infections, and can positively affect mood, cognition, brain health, sleep as well as minimize the risk of chronic diseases. When you read all this, you want nothing more than to be able to give a gold medal to your microbiome, but unfortunately the reality doesn’t look like this for many of us.
As nutrition therapists, we are interested in both the amount and variety of bacteria / microbes in our digestive systems. Microbial diversity is crucial for a healthy gut, body and brain (I have written about this a couple of times before, including here and here). Dysbiosis is a medical term that describes changes in the microbiome that can adversely affect health. Purna Kashyap, a gastroenterologist and microbiome researcher at the Mayo Clinic in Minnesota, studies dysbiosis and describes it as “a disorder of the microbial community that has a clear detrimental effect on values.” SIBO is a common type of dysbiosis that is characterized by a bacterial infection in the small intestine and which can cause constipation, diarrhea, bloating, gas, cramps and pain.
SIBO can be caused by several different reasons where the bacterial infection comes from two directions. Either they can come from the north, ie from the stomach, or from the south, ie from the large intestine. If I may be a little nerdy, the latter refers to a movement of colon bacteria through the ileocecal arch, a sphincter muscle that connects the small intestine. This can cause IBS symptoms and even malabsorption. Some doctors and nutritionists think that it should be called SIMO (small intestinal microbial overgrowth), because many different organisms can grow in the small intestine, not just bacteria. In most cases, SIBO / SIMO is caused by an overgrowth of various colon bacteria / microbes.
The following factors may contribute to dysbiosis
- Low hydrochloric acid (stomach acid), which allows microbes to colonize the small intestine from the north. Gastric acid is essential for a healthy digestion as it can kill uninvited guests. Some health conditions and medications reduce stomach acid.
- Opening of the ileocecal arch. The ileocecal arch acts as a trapdoor that opens for food to pass from the small intestine to the large intestine and then closes quickly again – if it works properly. A dysfunctional ileocecal arch can remain open for too long, cramp, or get stuck in an open position, allowing colon microbes to easily translocate and colonize the small intestine. Every time you eat something that causes bloating, there is a risk that the ileocele calf will leak, causing reflux and translocation of colon bacteria to the north. Another IBS complication in about 1/3 of those suffering from IBS diarrhea is caused by bile acid malabsorption, a condition that most doctors miss. Bile acid should be absorbed in the small intestine, but when the ileocele is open, the bile acid is absorbed into the large intestine and causes irritation and diarrhea.
- Biofilm – simply put, a biofilm is a colony of different microorganisms that together form a protective film. The microorganisms under a biofilm cooperate, which makes them strong and it can be extremely difficult to treat and get rid of them. Studies show that C. difficile, a bacterium that can be very harmful in large quantities, creates a protective biofilm that makes it resistant to antibiotic treatment. This is just one example of many.
- Various triggers, such as alcohol, certain drinks, food, stress, sugars, and medications, can contribute to both Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) where dysbiosis is common.
- Constipation / sluggish stomach caused by health conditions such as fibromyalgia, hypothyroidism, stress, anxiety, medications, aging and incorrect diet can lead to the intestine working more slowly, which contributes to increased fermentation in the intestine. This may cause bloating that exacerbates SIBO / SIMO (see section 2).
The third and final post of this bowel series will be more about constipation, sluggish stomach and diet so keep an eye out for it!
All Nordic Wellth nutritionists work according to the same model. We have developed well-developed guidelines to ensure that all consultations maintain the same high standard, regardless of which therapist you go to. In addition to solid university education from England, all therapists are coached by me so that our thinking in the consultation process is homogeneous. This way of working has been very successful for our clients. With us, you are in good hands, so if you suffer from chronic symptoms, just book an appointment no matter where in the country you live.
Live well, be well!
This is a guest post. Any opinions expressed are the writer’s own.