Nikki Hawkes

Medical Herbalist & IBS specialist

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Gut health and digestion

SIBO: why it’s important to consider the possible causes

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SIBO describes a translocation of bacteria from the large intestine to the small intestine

I see a lot of information about SIBO on websites and social media, especially in relation to giving advice on how to cope with the symptoms.

Symptoms

Common symptoms of SIBO include:

  • bloating
  • nausea or vomiting
  • diarrhoea
  • fatigue
  • weight loss
  • joint pain
  • skin problems
  • depression
  • malnutrition

Yet many of these symptoms are the same as for other conditions. So its not always straightforward to know if you have SIBO or something else, just from symptoms.

This is one reason it is a good idea to get advice from a qualified professional rather than from friends on social media. What helps one person with SIBO is not necessarily going to be the right thing for someone else.

You could perhaps get a test from your doctor or another health professional. If that test is positive, your doctor might consider a course of antibiotics appropriate. Yet, SIBO often returns after a course of antibiotics, so this is not a long term solution for most people.

But, more importantly we should consider that if the test for SIBO is positive – what is the underlying cause of the SIBO? Because some of the underlying conditions that result in symptoms of SIBO can be serious.

Causes

Here are some of the underlying causes of SIBO:

  • Medications such as antacids and proton pump inhibitors
  • Low stomach acid
  • History of traumatic head injury
  • Chronic diabetes or chronic pancreatitis
  • Early neurodegenerative disease such as Parkinson’s disease
  • Intestinal disease such as coeliac disease
  • Other causes of damage or scarring to the intestinal wall, such as radiation therapy or surgery
  • Immune system deficiency such as HIV
  • Hypothyroidism

The best diet for SIBO

The low FODMAP is often suggested as the best diet for SIBO, and I agree this is a great place to start. The low FODMAP diet can really help to reduce symptoms. On the other hand, in some cases it could be very important to consider what the underlying cause of those symptoms is. Particularly because the low FODMAP diet is not recommended for most people in the long term.

If you think you have SIBO:

  • Consider having testing, either through your doctor or privately
  • Consider a trial of the low FODMAP diet to reduce symptoms
  • Work with a qualified practitioner such as a qualified medical herbalist to determine what the underlying cause could be

How herbal medicines work from a modern perspective

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As a herbalist, part of my work involves the need to keep up with current research. Actually, as a bit of a science geek, it is a part I really enjoy. And especially I have to admit that it is very satisfying when published research supports years of traditional herbal use. Particularly when previous unfavourable scientific theories about herbs are shown to be incorrect. Now scientists are realising that the gut microbiome can transform herbal constituents into new compounds. So, we are seeing research that explains how herbal medicines work from a modern perspective.

With the rise of research into the gut microbiome scientists are finding that the gut microbiome has important roles that were previously unknown. One of these roles is the conversion of herbal constituents that scientists believed to be inert. And these new compounds are often powerful remedies that the body can use.

Of course, herbalists have known all along that herbal medicines can provide powerful healing benefits. But, in some cases, there may not have been a known mechanism of medicine action. Now, with the new understanding of the effects of the gut microbiome, we are learning how at least some of these amazing remedies can have powerful effects on the body. Sometimes benefits that were previously dismissed by the scientific community. So, once again we find that science supports what people have known for centuries.

But is there even more to it?

However, taking this one step further, with this new understanding of the microbiome, there is an explanation of why some herbs, and indeed some prescribed drugs do not work for everyone.

Every person has a unique gut microbiome, a bit like a fingerprint. This uniqueness can now explain the importance of a healthy gut environment and a wide diversity of microbial species. After all, if a person does not have the particular species of microbe that is able to convert a herb (or drug) into the active medicinal components then the herb (or drug) may not work for that person.

So, this new understanding of how herbal medicines work underlines the fact that good gut health is a key component for maintaining and improving health in general.

The role of ageing in gut health and osteoarthritis

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Osteoarthritis is a progressive and degenerative joint disease. It causes a great deal of pain and disability for millions of people. It commonly affects older people and we used to think it was caused by wear and tear. But, scientists now think there might be other causes. One such cause involves a link between gut health and osteoarthritis. I will explain how. [Read more…] about The role of ageing in gut health and osteoarthritis

Can a leaky gut make you ill?

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As a practitioner that uses functional medicine principles it is clear to me that to improve the health of someone with a complex, chronic condition, factors that contribute to the progression or the severity of that condition must be addressed. We might start by optimising lifestyle factors, such as diet, quality of sleep, type of exercise, stress management, and so on. But, how well someone digests their food has a key role in any functional medicine assessment, especially in relation to how gut health might be linked to overall health and vitality.

There are thousands of research studies that support the importance of good gut health. This article is about the findings of one of these studies, a 2018 systematic review about the association between a leaky gut and disease.

See What can go wrong with the digestive system?

[Read more…] about Can a leaky gut make you ill?

Some reasons a low FODMAP diet may not work for IBS

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Research shows that if you have irritable bowel syndrome, eating a diet low in FODMAPs is likely to reduce your symptoms. I discuss what FODMAPs are and how they help IBS here.

Briefly a low FODMAP diet restricts foods that contain certain types of carbohydrates, specifically fermentable carbohydrates. However, though a low FODMAP diet is certainly a useful tool to help manage the symptoms of irritable bowel syndrome, it is not a cure for this complex condition. In fact, research shows that the low FODMAP diet only helps around 60 to 80% of people with IBS.

There are several reasons that a low FODMAP diet may not be entirely successful in relieving symptoms. To uncover the underlying factors can entail a bit of detective work, with careful consideration of the individual circumstances that might be responsible. [Read more…] about Some reasons a low FODMAP diet may not work for IBS

Does ginger protect against stomach ulcers?

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Ginger is a well known pungent, culinary spice, but it also has remarkable health-promoting properties. For instance, I’ve previously written about the use of ginger for easing painful periods and preventing menstrual migraines. But, ginger offers much more than pain relief. In this scientific review in the Royal Society of Chemistry Journal: Food and Function, researchers discuss the potential ability of ginger to protect against stomach ulcer.

The culinary and medicinal part of ginger is the rhizome, often described as a root, but actually an underground plant stem. Thought to have it’s origins in northern India, the remedy is now grown in many parts of the world. No doubt, at least partly due to its valuable contribution to several systems of traditional herbal medicine, including Chinese, Ayurvedic, Unani, Arabic, Greek and Roman. [Read more…] about Does ginger protect against stomach ulcers?

Home remedies for heartburn

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Heartburn is a symptom of GORD or gastro-oesophageal reflux disease, also known as GERD. This burning sensation is due to liquid from the stomach rising up the gullet or oesophagus. Which can also leave a nasty taste in the mouth. This can be an occasional nuisance or it can be a severe and lifelong problem. So, it’s good to know a few simple home remedies for heartburn.

It is important to be aware that over the long term GORD can cause complications. These include ulcers in the stomach and oesophagus. Or, even a narrowing of the oesophagus, causing difficulty swallowing. These complications need more medical care than simple remedies can provide. Yet, if your symptoms are occasional or mild, research has shown that simple home remedies for heartburn may really help. [Read more…] about Home remedies for heartburn

Food as medicine to prevent chronic disease

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Given the regularity of food related news headlines, and especially those that seem to contradict ‘last week’s news’, it’s perhaps not surprising that many people are unsure about what they should believe. What should we eat to improve our health or even prevent chronic disease? Low fat or low carb? What about grains or gluten? Are eggs okay, or not? It can be very confusing.

According to research the healthiest way to eat is the Mediterranean type diet. One aspect of this type of diet is the abundance of fruits and vegetables it supplies. These contain a wide variety of nutrients and fibre.

It appears the fibre could be more important than was once thought. Not just an inert substance easing the passage of stools. But, food for the microscopic organisms living in our gut, that have a huge potential to influence our health. [Read more…] about Food as medicine to prevent chronic disease

Reduce your IBS symptoms with a low FODMAPs diet

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Irritable bowel syndrome (IBS) is a common condition of the gastrointestinal tract, and many people say that food either triggers or exacerbate their IBS symptoms. Yet, there is considerable evidence that making a change to a diet low in FODMAPs can help to reduce these symptoms.

IBS is a functional condition, meaning that there are no structural changes to the gut, but that does not mean that the symptoms are not real. The main symptoms of IBS are abdominal pain, bloating and a feeling of distension, with an altered bowel habit that is not explained by other causes. This might entail abnormal stool frequency, stool form, or passage of the stool through the gut.

If you suspect you have IBS it is important to be checked out by a doctor. This is because there are other conditions that may have similar symptoms and these should be ruled out before a diagnosis of IBS can be given. [Read more…] about Reduce your IBS symptoms with a low FODMAPs diet

How to soothe irritable bowel syndrome with a hot oil poultice

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A 2015 German study tested the use of hot oil poultices on people with irritable bowel syndrome. They found that using a hot oil poultice appeared to be a safe and effective method of reducing pain related to IBS. The researchers also reported that although the most benefit was likely to due to the application of heat, their patients said that they received the highest level of benefit from using the hot caraway oil poultice, rather than a heated poultice made from olive oil alone.

Caraway is a culinary spice used to flavour a variety of vegetable dishes, breads, cakes and biscuits. Like many spices it also has medicinal properties. For instance, caraway has antispasmodic and carminative properties, and therefore might reduce abdominal pain, spasms and bloating.

Irritable bowel syndrome is characterised by a number of symptoms, including abdominal pain and spasms, bloating or distension and altered bowel habit. [Read more…] about How to soothe irritable bowel syndrome with a hot oil poultice