Terms like FODMAP, SIBO and IBS may not have been in our vocabulary just a few short years ago. However, our evolving understanding of our digestive system and its pivotal role in health, immune response, gene expression and disease has brought awareness and expanded opportunity to better address chronic conditions and increase the quality of everyday life.
One in seven people have digestive issues, and while that number is substantial on its own, it may not include those with symptoms not typically associated with digestion and gut health. Issues like brain fog, fatigue, autoimmune conditions, anxiety, depression, poor sleep, chronic aches and joint pain, headaches and food allergies can all be symptoms and indicators of poor gut health.
We are composed of more microbes than human cells, with the majority of those microbes found within the digestive tract. The diversity and composition of microbes can determine our health and gene expression. For every one message from the brain to the gut, there are nine messages from the gut to the brain. Gut microbiota determines the messaging to the brain—whether to turn inflammation up or down, and whether to increase or decrease repair of organs and tissue. It is no wonder that the gut microbiome is being called the second brain. Antibiotics, factory farming, environmental toxins, mental and emotional stress, and poor diet all contribute to the issues.
“For a long time, we shied away from language around the digestive system with most unwilling to talk about gas, bloating, diarrhea, constipation, etc.,” says Kristen Bentson, DC, MS, IFMCP, of Bethlehem. “For a significant part of the population, it has meant suffering in silence with no real answers.”
In college, Bentson found herself with serious health issues, having a constellation of symptoms, including gastrointestinal issues, fainting, fatigue and pain. Traveling from doctor to doctor, she was left with more questions than answers. Her symptoms were so significant that she took a year off from school to find out what was happening and how she could fix it. She quickly realized that she needed to be an active participant in her own healing. In addition to an invaluable GI doctor, she found key support in her healing through chiropractic and functional medicine. It would prove to be a guiding force in redirecting her own career into those two professions. After her second child, she had severe reactions to food, which had her dive deeper into gastrointestinal health and a low-FODMAP diet.
What is Low-FODMAP?
FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are certain sugars that may be difficult for the small intestines to digest. This can cause cramping, gas, bloating and gastric distress. A low-FODMAP diet is a short-term, temporary elimination diet that gives the gut a break and a reset. The eliminated foods are slowly and methodically reintroduced one at a time to see what may still be causing the distress. This temporary plan can be especially helpful for those experiencing IBS (irritable bowel syndrome) and SIBO (small intestine bacterial overgrowth).
Bentson's own journey, combined with hearing so many women being told “nothing is wrong,” “it's all in your head” or “you just have to live with it,” provided the impetus for her writing her book: The Cool Girl's Guide to the FODMAP Diet. A low-FODMAP diet isn't limited by gender, nor is it meant to permanently remove all the foods on the list.
It is rather a systematic approach to properly identify sources of irritation. It is important to understand that what we are eating has a direct impact on our health and that there are solutions, but it does take work.
Seeking Help
A key question Bentson asks when working with someone is: Are you really ready to make lifestyle changes and are you willing to work to get to the root of things? As she likes to say, “There is not a pill for every ill.” As a functional medicine practitioner, Bentson takes a comprehensive and systematic approach through clinical testing, lifestyle changes and a whole-foods approach in finding the root of the issues and the dietary match that works for each individual.
Food is information for the body and, as such, can help turn on and off genetic expression. Just because a food may be deemed healthy does not mean it will be healthy for your body. The same applies to supplements. Some supplements could be working for you and against others, despite what an “influencer” may say. Bringing in a functional medicine doctor to work with you alongside your allopathic doctor may provide the guidance and knowledge needed to help you discern the underlying issue and the imbalance causing your symptoms as well as help you navigate a path to effectively rebalance your systems.
Smart Practices for a Healthy Microbiome
Even if you don't have obvious digestive health issues, maintaining a healthy microbiome is key in maintaining good health and preventing the expression of disease. Bentson reminds us to keep it simple and consistent. “First, remember that the best foods don't have food labels; focus your food approach on getting a wide variety of brightly colored, unlabeled and unprocessed whole foods,” she says. “Next, if the foods you're eating do have a label, read the list of ingredients and avoid added sugar, numbers (like red dye #40 or polysorbate #80) and chemicals.”
Bentson notes that cutting back on and ultimately eliminating alcohol may be one of the best decisions you can make for gut health and overall health. Look to incorporate nutrient-dense foods, prebiotic fiber and polyphenols. These include things like artichokes, ground flax seeds, raw fermented sauerkraut, blueberries, green tea, fresh herbs and unsweetened yogurt.
Promoting diversity in your microbiome can also benefit from seeking diversity in your foods and food sources. It is easy to get stuck in the same few vegetables as well as shopping at the same stores. Step outside your normal routine, incorporate different fruits and vegetables and provide more diverse phytonutrients. Sourcing from farmers' markets and various stores can mean different regions, different soil conditions and differing micronutrients.
Minding your food is one aspect, minding how you eat is another. It is a basic yet most-often-bypassed strategy to improve your digestion. The expression “drink your food and chew your water” is indicative of how we should be eating. Simply taking the time to truly chew your food until it is liquid allows for the proper enzymatic breakdown from our saliva to take place. Swallowing after just six or eight chews puts more stress on the rest of the digestive tract, reduces nutrient absorption and can increase bloating and gas. Chewing your food fully helps you slow down, provides greater satiety and can encourage relaxation when eating.
Our digestive system is very sensitive to stress. Bentson encourages everyone to have specific, routine stress-transforming strategies in place. This can include breathing practices, gentle exercise, prayer, time in nature, listening to calm music and sipping an adaptogenic tea like tulsi. In addition to emotional stress, environmental stressors like mold, environmental toxins, chemicals and pesticides can be contributing to poor gut health.
Just like minding the soil in a healthy garden, minding the health and diversity of your microbiome is foundational to all aspects of your own health. Paying attention to your body's signals, being an active participant as well as finding trusted, knowledgeable guidance can help you to flourish.
Published as "Living Well" in the June 2022 edition of Lehigh Valley Style magazine.
