Gut Health Sydney

1) Remove

We want to remove anything that could be irritating to the gut. Think of this phase as weeding the garden or putting the fire out. We also need to remove any type of gut irritant or things your gut is reacting to. Did you know your immune system can have reactions to food you ate 60 days ago? That’s why you need a specific proven process that makes discovering food sensitivities easy.

You may also have a hard time digesting certain type of carbohydrates or find meat just sits in your stomach.  Or you may have food intolerance, sensitivity or a food allergy. This phase usually involves an advanced form of elimination diet, and treatment of any parasites or known dysbiosis, SIBO or other issues.

Our long term goal for you is to be off all medication and supplements, if possible. Reflux (heartburn) medication and NSAIDs (like aspirin and ibuprofen) are known to cause digestive dysfunction. Acid suppressing medications like PPIs change your microbiome, increase the risk of SIBO, increase your risk of catching community acquired pneumonia, increase your risk of dementia and have been linked to chronic kidney disease, pancreatic cancer, increased risk of fractures and many other things. Read all about those side effects and risks of PPIs (Proton Pump Inhibitor) medications here.

Hormonal issues like excessive cortisol, the stress hormone or thyroid issues can also play havoc with your gut and need to be addressed. You can read more about hormone balancing here.

2) Replace

Depending on your health condition and symptoms, you may be lacking certain elements that are key to digestion such as stomach acid, bile and digestive enzymes.  If you’re not digesting your food properly your immune system will react to the food you eat. For example if you can’t digest protein properly the immune system thinks it is an invading pathogen and increases inflammation. If you can’t digest carbohydrate it rots, creates gas which you experience as reflux, bloating, pain and nausea. When food is sitting in your stomach too long (perhaps because you have too little stomach acid, or suffer from gastric paresis), the food also can create gas that then opens your lower oesophagael sphincter so stomach acid goes into your food pipe, causing painful reflux. If you have slow or rapid gut transit time you won’t absorb nutrients properly and toxins such as LPS will then enter the blood stream from the leaky gut (increased intestinal permeability). You also may be deficient in nutrients. Our food chain isn’t as nutritious as it used to be and you may have been on restrictive diets for many years. Part of your gut-healing plan may therefore include:

• Supplements to replace the missing elements such as betaine HCL, bile salts, and enzymes that help digest fat, lactose, carbohydrates and protein

• Foods containing nutrients that help the body produce these elements.  For instance, bitter foods can help stimulate stomach acid and digestive enzymes. 

• Foods and/or supplements to address nutrient deficiencies.  Digestive conditions can affect the absorption of nutrients such as B12, iron, calcium, magnesium and zinc.  If you have had gastric surgery in the past your gut will NOT absorb nutrients like it used to.

3) Repair

During this step we use targeted nutrients and foods that support gut-healing and long-term relief. Every patient is unique though we may use foods high in vitamins A, C, D, & E as well as the mineral zinc, foods rich in amino acids such as bone broth, supplements such as L-glutamine, collagen, aloe vera, marshmallow or slippery elm as well as high quality natural mast cell stabilising nutraceuticals like Quercetin and many others. This step is like tilling the soil so the crops can be planted.

4) Repopulate

This step may overlap with Repair. Remember, elimination diets are not forever diets. You need to reintroduce foods in the right way. Then you are left with a diverse, tasty diet that is sustainable, and that your gut can handle. One of the key things we aim to do is increase the diversity of the microbiome. This is the term for the collection of good gut bacteria, fungi, viruses and bacteriophages that play a role with immune, digestive, and metabolic health. It’s important to keep these bugs happy! Think of this step as planting new seeds in the garden. But how do you know what good bacteria you need? We use comprehensive Functional Medicine gut testing that can be very illuminating. However, you should know not all gut tests are equal. We only use 2 – one that is sent to the USA and another done in Melbourne. If you have low diversity, inadequate Short Chain Fatty Acids being made (did you know 36% of all small molecules in the blood are made by the microbiome?), suffer from leaky gut or have recurrent infections, we will use a very special probiotic. This has been shown in studies to increase diversity of the microbiome, reduces leaky gut by 60% in just 1 month and is hardy so it pushes out parasites and other nasty bugs. If your gut testing shows you don’t make enough butyrate, that means you’ll need more resistant starch in your diet, and possibly different probiotics. Firmicutes, a specific type of bacteria eats resistant starch and makes the substance our colon cells prefer as their food, butyrate! Butyrate is also an anti-cancer compound.

If you are missing a key good bacteria there are big consequences. For example Lactobacillus acidophilus modulates cannabinoid receptors and reduces abdominal pain. Serotonin levels in the blood of conventional mice are almost 3x higher than mice who’ve had their gut bacteria wiped out (“Germ Free mice”).

As much as possible we tailor this, and each other step to you, so your gut gets exactly what it needs. For example this study using 1 particular type of probiotic showed impressive results in the treatment for anxiety, but didn’t show any benefit for depression. Patients with Autoimmune diseases likewise respond well to particular strains of probiotics, that are different to the one in this study. Lactobacillus plantarum DR7 (1x109 cfu/day) for 12 weeks reduced symptoms of stress (P=0.024), anxiety (P=0.001), and total psychological scores (P=0.022) as early as 8 weeks among stressed adults compared to placebo [1]

“Our further evaluations of individual anxiety and stress items in DASS-42 confirmed that the effects of DR7 were primarily associated with a calming outcome, such as increased relaxation, improved in swallowing, reduced nervousness, touchiness and trembling attributes.”

Researchers also found that plasma cortisol levels (a stress hormone) were reduced in DR7 subjects, accompanied by reduced plasma anti-inflammatory cytokines such as interferon-γ and transforming growth factor-α, and increased plasma anti-inflammatory cytokines such as interleukin-10.

Looking For a Gut Specialist in Sydney?

When it comes to finding the right gut health specialist in Sydney, our team of experienced doctors offers expert treatment and management. Contact us now to book a consultation and experience a healthier lifestyle!

5) Rebalance

(and long term optimisation)

Our lifestyle habits have enormous influence on our digestive system and health.  During this phase, we want to address:  Stress management, Improving sleep, Moving more (or less, if necessary) and so forth. We also use Prebiotic foods – These are foods that gut bacteria love to eat, this is like fertiliser in our new garden. Freshly ground flax seed for example can be very beneficial. Likewise we may start to introduce some Probiotic foods – foods that are rich in bacteria beneficial for our digestive system. 

While this is presented as a step-wise approach, we may be working on multiple phases at the same time, or multiple body systems simultaneously. This is why at Evergreen Doctors Gut Clinic in Sydney we always create a holistic plan for our patients.  For example, if you’re only getting 4 hours of sleep a night, gut-healing by itself can only take us so far, you need to address the entire body and mind for optimal wellness.

[1] Beneficial Microbes. 2019 Apr 19;10(4):355-373. doi: 10.3920/BM2018.0135