GETTING REAL WITH GUT HEALTH

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Phillip Underwood
5 years ago
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THE IMPORTANCE OF YOUR HEALTH STORY Reflections Do you regularly experience any of the following: Indigestion or food repeats on you after you eat Excessive burping or belching following meals

1 THE IMPORTANCE OF YOUR HEALTH STORY Reflections Do you regularly experience any of the following: Indigestion or food repeats on you after you eat Excessive burping or belching following meals Bloating (around your belly button) after eating certain foods Discomfort, pain or cramps in your colon (lower abdominal area) Have noticed that your bowel movements change form from eating certain foods Notice you get tired after eating certain foods Experience gas production with need for release Loose bowel movements Constipation/incomplete evacuation Undigested food in your stools Score out of 10_ What is Irritable Bowel Syndrome? Disorder of gut-brain interaction (DGBI) Symptoms: Bloating, lower abdominal pain, cramping, gas, diarrhoea, constipation, mucus Lethargy, nausea, backache, depression Diagnosis: Recurrent abdominal pain on average at least 1 day/wk during the previous 3 months that is associated with 2 or more of the following: Related to defecation (improved/worsened) Associated with a change in stool frequency (increased/decreased) Associated with a change in stool form or appearance SOURCE: Schmulson, 2017

2 Associated Factors: Dysregulated gut-brain axis Heightened pain sensitivity/visceral hypersensitivity Abnormal gut motility Small intestinal bacterial overgrowth (SIBO) Low grade intestinal inflammation Psychological factors

3 bowel movement diary according to the Bristol stool scale 1 IBS-C % 25% IBS-D IBS-M 5 25% 25% IBS-U

FODMAPs Oligosaccharide fructans galactans Disaccharide Monosaccharide lactose fructose dairy apples, pears, mangoes, honey Polyols Mannitol sorbitol fructooligosaccharides wheat, garlic, leeks,

4 FODMAPs Oligosaccharide fructans galactans Disaccharide Monosaccharide lactose fructose dairy apples, pears, mangoes, honey Polyols Mannitol sorbitol fructooligosaccharides wheat, garlic, leeks, apples, onions, cabbage, lentils, chickpeas, kidney beans Symptoms Gas, Pain, Bloating, osmotic diarrhea Approach: Addresses total amount of fermentable carbohydrates Minimises intake for 6-8 weeks Re-introduction once symptoms have resolved mushrooms, apricots, artificial sweetener

5 High FODMAP foods list (not exhaustive) Dairy Fruit Vegetable Beans + lentils Grains Miscellaneous Custard Apples Broccoli Lentils Wheat Honey Milk Avocado Beetroot Legumes Rye Beer Yoghurt Apricots Cauliflower Chickpeas Barley Cider Soft cheeses Asparagus Garlic Red Kidney beans HFCS Blackberries Leek Baked beans Sorbitol Cherries Onion Soya beans Pistachios Peach Peas Pears Snow Peas Mango Sweet potato Nectarine Mushroom Prunes Watermelon Most dried fruit SOURCE: Gibson & Shepherd, 2012, Nanayakkara, 2016 Sample High FODMAP diet FRUCTANS GALACTANS LACTOSE FRUCTOSE breakfast Wheat biscuits x2, milk mid-morning Coffee with milk and apple lunch chickpeas, lettuce, peppers, beetroot & coleslaw dinner Salmon, broccoli, carrots, mushrooms & pasta POLYOLS

6 low FODMAP foods list (not exhaustive) Dairy Fruit Vegetable grains Miscellaneous Almond or rice milk Banana Bok choy Quinoa Maple syrup Grapes Capsicum Rice Sugar Honeydew Carrots Kiwis Celery Wheat free grains such as buckwheat Lemon Eggplant Lime Lettuce Melon Potatoes Mandarin Rhubarb Orange Tomatoes Passionfruit Yams Pineapple Zucchini Feta Most berries (except boysenberries & blackberries) SOURCE: Nanayakkara et al, 2016 Reintroduction after 6-8 weeks Food challenge: One FODMAP group at a time. Expect up to 2 months. Mannitol: ½ cup mushrooms Sorbitol: 2 fresh apricots Lactose: ml milk/200g yoghurt Fructose: 2 tsp honey Fructans: 1 clove of garlic or half an onion Galactans: ½ cup of lentils

7 What is driving the fermentation? Carbohydrates are providing prebiotic (food) for bacterial growth Great for good bacteria but we do not want to feed bad bacteria/yeast in the gut

8 Top Tips for IBS Try low FODMAP diet (under professional guidance). Download app The Monash University Low FODMAP Diet App ( Gluten free. Food and symptom diary (score symptoms 0 to 3). Regular meal pattern. Avoid coffee, tea, alcohol. Wind and bloating: Oats and ground flaxseeds (soluble fibre), peppermint & fennel tea. IBS-C: ½ tsp psyllium husks in 200ml water twice per day. 2 tbsp molasses & 1 tbsp coconut oil. Probiotics (ideally need to test stools to tailor probiotics). Mutaflor, IBS-D: Saccromyces Boulardii, Lactobacillus plantarum. Support the gut: Chicken broths, colostrum 2 tsp/daily, gelatin based products (BePure gut healing gummies), aloe vera juice. Meditate, yoga, diaphragmatic breathing, consider cognitive behavioral therapy, hypnotheraphy. Top tips to improve gut health Eating right for macronutrient profile (wholefood diet) Chewing-rest and digest (stress management) Apple cider vinegar Zinc taste test and vitamin D tested Fermented foods Bone broths Know your transit time Hydration Movement Gratitude

It is believed that a meal plan that includes low FODMAPs also may help ease symptoms from other health conditions, such as:

It is believed that a meal plan that includes low FODMAPs also may help ease symptoms from other health conditions, such as: If you have digestive issues, this could be why. You don't have to have IBS (Irritable Bowel Syndrome) or Colitis (a chronically inflammed colon), to experience some of these symptoms. FODMAP The acronym