7 Tips to Get to the Root of Gut Issues (by Ryan Burch)
Rye here 👋! I've had gut issues for as long as I can remember, but it wasn't until my mid 20's that I started experiencing extreme bloating and stabbing stomach aches daily, and I became desperate to get to the root! I saw multiple doctors who told me I had "IBS" (a blanket term for pretty much any gut symptom under the sun) and told me to cut out gluten, dairy and corn. I also saw a gastroenterologist who told me that it's perfectly "normal" to be constipated and bloated (adding that he has a patient who doesn't have bowel movements for 10 days) and said he could give me a prescription if I didn't want that to be the case for me (I quickly declined)...Beyond that, no other testing was suggested (except for a colonoscopy that came back normal) and I eventually realized that I'd have to keep searching for a health care practitioner that would truly listen and offer helpful action steps, including lifestyle, nutrition and stress management...which I eventually realized ONLY exists outside the western medical model (**with the exception of western AND integrative trained docs).
After 3 years of trial and error, I was FINALLY able to get to the root of my issues and relieve my symptoms naturally! So if you’re struggling with GI issues and desperate for answers, here are my top tips:
#1 – Seek out an "Integrative" or "Functional" medicine doctor in your area
*this can be in addition to your traditional doctor or gastroenterologist.
Unfortunately these doctors tend to be out of pocket, which is why I resisted seeing one for YEARS (while my symptoms raged on)…but after getting zero significant help from traditional doctors, I bit the bullet and within a few months of working with an ND, I had a diagnosis and a treatment plan that WORKED. I still see a gastroenterologist for things I can get covered by insurance (like endoscopy, ultrasound, blood test), but it's my integrative doc that helps me get to the ROOT of my issues, and explore natural approaches that provide relief.
To find an integrative doc in your area use the tool “ifm.org/functional-medicine/” or search “integrative / functional doc,” with your zip code to research doctors in your area, read reviews, etc. If specifically seeking a naturopathic doctor, you can visit the American Association of Naturopathic Physicians 'find a doc' tool, or the Institute for Natural Medicine 'find a doc' tool HERE.
#2 – Insist on Comprehensive Testing!
After I began working with an ND, we did a SIBO “breath” test, a comprehensive stool test (measuring bacteria, yeast, parasites and inflammatory markers) and a comprehensive blood panel (measuring markers for celiac antibodies, IGa, IGg and H pylori). She also reviewed "functional" ranges for every test, which means looking past the "normal" range and also addressing levels that are above or below the "normal" range, which can be a sign of an evolving health issue. NOTE: different docs have different labs they use and many of these tests require a doctor’s prescription (from either a traditional doc OR functional doc).
It turned out that I had SIBO ("Small intestinal bacterial overgrowth"), which is due to an abnormal increase in the bacterial population in the small intestine, particularly types of bacteria that aren't generally found in the digestive tract. FINALLY I had a clear diagnosis and a multi-pronged treatment plan including stress management, 3 week elimination diet, 4 week alcohol elimination, 2 weeks of an antibiotic (pretty hard to avoid if you have SIBO; I was given one that is less harsh on the gut and eliminates only bad bacteria from the small intestine), and herbs / antifungals for several months after - to keep the gut microbiome balanced and prevent SIBO recurrence.
If your traditional doctor won’t offer any tests like this, an integrative doctor will! And although it will probably be out of pocket, it will shed SO much light on what’s going on...and I can say that as much as I tried to avoid out of pocket costs, it ended up being the best investment I ever made for myself...and I wish I'd done it YEARS earlier.
Traditional doctors might suggest invasive procedures such as a colonoscopy, endoscopy, biopsy or ultrasound to identify potential markers for disease or health conditions, which may be helpful, depending on your symptoms and health history. I’ve done all of these procedures and I did feel better "ruling things out," but nothing ever came back ‘abnormal’ for me, which is why the functional lab work was the most game-changing for me. NOTE: even with insurance, these procedures can be costly (if you have not hit your deductible).
#3- Try an elimination diet
A nutritionist introduced me to the FODMAP diet and the book “IBS: Free At Last” by Patsy Catsos, MS, RDN (you can also get her elimination diet AND her amazing cookbook HERE). The book is super easy to read and provides a step by step breakdown of how to do an elimination diet to get to the root of your symptoms (can be 3-4 weeks). It also explains how certain QTYs and combinations of foods can create gut issues, and as you go through the protocol, you'll identify what works best for you (I found out gluten wasn't an issue for me, after YEARS of cutting out bread!!). I suggest buying the book and also viewing her blog / website.
NOTE: the FODMAP diet is a healing protocol for a short period of time and is not necessarily meant to be a long-term lifestyle. Some people get so attached to the diet (because they feel so much better) that they are afraid to start introducing foods back in, but this is a crucial part of the process, both in finding your triggers and having a more balanced, enjoyable diet!
#4 - Work on your eating habits / keep a journal.
Slow down, fully focus on the flavors of the meal, separate yourself from distractions, put your fork down between bites, breathe deeply and journal how you feel after eating!
Also tune into THIS podcast episode about meditation / mindfulness (including how to master the 'mindful meal' ) with Neuroscientist Ariel Garten - hosted by myself and my sis, Jess Suchan.
#5 - Consider “digestive enzymes”
Enzymes help the body break down macronutrients (carbs, proteins, and fats) into smaller molecules that we can use for energy. They can aid the digestive system in better absorbing and utilizing nutrients, making them helpful for nutrient deficiencies (commonly found in those with hormonal imbalances and conditions like Hashimotos)
Our bodies naturally produce digestive enzymes but unfortunately there are many environmental and lifestyle factors that can deplete them which is why eating enzyme rich foods and taking a supplement can be very beneficial!
If you often feel bloated, gassy or notice undigested food in your stool, this could be a sign of a sluggish digestive system and/or lacking enzymes your body needs to break down certain macros. Taking a high quality digestive enzyme before or after meals (depending on the brand) can help improve these uncomfortable symptoms, increase nutrient absorption and make harder to digest foods like restaurant meals and holiday dinners easier to process.
A couple brands we love 👇
@arrae.co (taken after a meal and clinically shown to reduce bloating by 86%)
@hilma_co dairy + gluten digestive aid (taken before a meal to reduce gas and bloating)
When choosing a digestive enzyme, be sure to pick one that is tested and research backed with natural ingredients (no preservatives, dyes or fillers)! We highly recommend bringing a bottle with you on all your holiday travels and celebrations! ✈️
#6- Consider a pre/probiotic
Ultimately, if you have moderate to severe gut issues, you should consult with your doctor for the best probiotic suggestion. However, if your issues aren't too problematic, there are a couple high quality brands that we recommend, that seem to be safe for most people. 👇
Bloating and constipation are some of the most common symptoms reported by our clients, which are hallmark signs of “estrogen dominance.”
>> Classic “estrogen dominance” refers to those with excess estrogen along with insufficient amounts of progesterone to balance estrogens' effects in the body. Generally this looks like HIGH estrogen, LOW or 'suboptimal' progesterone, and/or a LOW "pg/e2 ratio" (ratio of estrogen to progesterone) on a test report.
>> “Relative Estrogen dominance” refers to those with NORMAL or even LOW estrogen, with LOW or 'suboptimal' amounts of progesterone to balance estrogen. Generally this looks like NORMAL or LOW estrogen with LOW or 'suboptimal' progesterone, and/or a LOW "pg/e2 ratio" on a test report.
Keep in mind: not all hormone tests are created equal. One of the main reasons we are proponents of saliva hormone testing is that it captures bioavailable (“active”) hormone levels that are found in the target tissue of the body where hormones do their work! Meanwhile, standard blood tests measure TOTAL hormones, including those still bound to proteins in the bloodstream, which are inactive – and tell us very little about the symptoms that are actively being experienced (often resulting in “normal” test results, even though you KNOW your symptoms are hormonal!).
In saliva we measure FREE (active) levels of estrogen, progesterone, DHEAS, testosterone, 4 cortisols (to measure full adrenal function throughout 1 day), as well as the "PG/E2 ratio" which can pinpoint estrogen dominance, linked not only to bloating and constipation but also mood swings, PMS, weight gain, irregular/heavy/painful periods, swollen breasts and MORE!
>> Click HERE to “build your own testing + rebalancing package” (including the option to add a custom guide, a phone consultation for extra support and/or markers such as thyroid + vitamin D).
Got comments or questions on this topic? Drop em below!