In this episode, Dr. Lisa and Dr. Toni discuss the different reasons why you could be experiencing bloating and what you can do about it. If you look and feel pregnant at the end of the day (and definitely aren’t!), it could be due to a number of different hormonal, digestive and structural issues that can happen in perimenopause.
Pressure in your stomach from weight gain or pregnancy
Diastasis recti or abdominal wall laxity
“mummy tummy”
Food intolerances or sensitivities
Visceral hypersensitivity can be stimulated by inflammation of the gut lining by foods, especially gluten, corn, dairy
Sugar alcohols especially sorbitol, less with erythritol, xylitol
Sugars like lactose or fructose
FODMAP foods
short chain carbohydrates found in many fruit, veg, legumes
Gut dysbiosis and microbiome imbalance like H. pylori and small intestinal bacterial overgrowth (SIBO)
Especially after antibiotic and antacid medication use
Low stomach acid due to eating while in stress mode or sympathetic nervous system
Low pancreatic enzymes or pancreatic issues
Gallbladder removal or issues
Slow gut motility and constipation
Hormone changes in perimenopause and premenstrually
Progesterone is a mild diuretic, so low progesterone in perimenopause can lead to more water retention
Cortisol imbalances and stress
High cortisol can lead to more water retention
Women who have experienced trauma are 50% more likely to experience IBS
Uterine Fibroids, hernias, scar tissue
Endometriosis
over 80% of women with endo experience bloating
Testing to consider:
Elimination challenge or low FODMAP diet trial
HCl challenge to test for hypochlorhydria
Food sensitivity blood test
Comprehensive Digestive Stool Analysis
SIBO breath test
H. pylori breath, blood or stool test
Liver and digestive panel blood test
Electrolyte blood test
Thyroid panel to check for potential cause of constipation
Female hormone panel with cortisol testing in saliva or urine
Endoscope with biopsy, colonscopy, laparoscopic assessment
Abdominal ultrasound
Natural approaches to address bloating include:
Start by tracking symptoms
Avoid food triggers
Fermented foods – sauerkraut, kim chi, yogurt with active bacteria
Enteric coated peppermint oil capsules or peppermint tea
Bitter vegetables and foods: artichoke, arugula, radicchio, dandelion greens
Herbs: ginger, chamomile, fennel, anise, dandelion tea (root and leaf)
Apple cider vinegar or lemon in water
Chew your food well and eat while sitting down, calm and relaxed
Avoid drinking too much water while eating
Probiotic supplementation
Antimicrobial herbs like oregano, garlic, thyme, goldenseal or prescription rifaximin if needed for SIBO or dysbiosis
Digestive and motility support like D-limonene, DGL, slippery elm, marshmallow root, melatonin
Manual visceral therapy by trained osteopath, physiotherapist, naturopathic doctor
Castor oil packs
Today’s Mama Must Have:
Dr. Toni is a big fan of having a spray bottle with water and peppermint oil on bedside table to use when hot at night
Dr. Lisa loves having her 2 minute daily cold showers and doing breath of fire and/or the Wim Hoff breathing exercise to energize her when feeling tired
What’s Else is Happening?
Dr. Toni’s next HypnoBirthing session for expecting parents looking to decrease fear and anxiety to support their natural instincts around labour and birth is happening this fall. Join her at https://www.hypnobirthingcalgary.com/register
Join Dr. Lisa’s new Meetup group Wild Woman Adventures Toronto if you want to get out in nature, connect with other women and push yourself out of your comfort zone. Activities include: sunrise/sunset SUP, tree-top trekking, a new moon workshop and more!
Dr. Lisa’s Wild Collective in Fall 2022: get on the waitlist: wildcollectivetoronto.com
We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.
You can also support us by visiting our Patreon page.
Please tell your perimenopausal mama friends about us, too!
Stay safe and healthy everyone!
Disclaimer:The information provided is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.
In this episode, Dr. Lisa and Dr. Toni are discussing a potential root cause for digestive symptoms like bloating and gas called Small Intestinal Bacterial Overgrowth, otherwise known as SIBO.
SIBO = Small Intestinal Bacterial Overgrowth
-abnormally large numbers of commensal bacteria are found in SI
-bacteria is fed by carbohydrates and produces excess amounts of gas – hydrogen, methane, hydrogen sulfide
-bacterial overgrowth interferes with proper digestion and absorption of nutrients
-gas interferes with proper bowel motility, resulting in constipation and/or diarrhea
Up to 84% of people with IBS also have SIBO, so it’s thought to be an underlying cause
Symptoms of SIBO can include:
Bloating
Gas
Abdominal pain/cramps
Constipation, diarrhea or alternating
heartburn/reflux
Nausea
Food sensitivities
Fatigue
Headaches
Joint pain
Brain fog
Malabsorption issues like anemia, chronic low ferritin (iron stores), fat soluble vitamin deficiency like vitamin D deficiency
Skin issues like eczema, rosacea
Inflammatory conditions like pancreatitis, interstitial cystitis, prostatitis
What causes SIBO?
Conditions affecting intestinal motility and damage to MMC (migrating motor complex), including thyroid issues, concussions, head injuries, chronic high blood sugar
Acute gastroenteritis from food poisoning or “stomach flu”
Use of proton pump inhibitors (PPI) acid inhibiting medications
Low stomach acid, pancreatic enzyme and bile secretion
Ileocecal valve dysfunction, resulting in reflux of colonic bacteria into small intestine
Complications of abdominal surgery, including gastric bypass for obesity and gastrectomy to treat peptic ulcers and stomach cancer, postoperative loop, stricture or fistula
How do you know if you have SIBO?
IBS symptoms get worse when you take a probiotic, especially with a prebiotic
IBS symptoms might get better after antibiotic treatment for another infection
Symptoms worse after eating more fibre – veggies like broccoli, fruit like apples
How can you test for SIBO?
Breath test = most common method of testing for SIBO
-fasting after fibre restricted eating day before
-provocation with lactulose non-absorbable sugar
-breath sample every 20 minutes over 3 hours, tested for levels of hydrogen, methane, hydrogen sulfide in the gas in the sample tube
Small intestinal aspirate culture = currently the gold standard test for bacterial overgrowth. To obtain the fluid sample, doctors pass a long, flexible tube (endoscope) down your throat and through your upper digestive tract to your small intestine. A sample of intestinal fluid is withdrawn and then tested in a laboratory for the growth of bacteria.
Possible alternative: a course of specific antibiotics to see if you’re successful in reducing your symptoms may also be a way to assess if you have SIBO
Comprehensive Approach to Addressing SIBO:
Liver and gallbladder support eg. NAC, dandelion, artichoke, beets, green tea
Herbal or specific prescription antibiotic to lower bacteria levels eg. rifaximin, specific garlic, oregano extracts, berberine, myrrh, thyme, goldenseal, enteric coated peppermint oil
Digestive support for stomach acid, pancreatic enzyme, and bile production, leaky gut eg. bitters like gentian, L-glutamine, NAG, lemon water or D-limonene, topical castor oil pack
Motility support – prescription or nutritional eg. prucalopride, ginger, 5-HTP, acetyl L-carnitine, Iberogast, spacing at least 3+ hours between eating
Elemental diet – liquid diet for at least 2 weeks to starve and kill off bacteria
Biofilm disruptors like NAC, black cumin, ALA
Today’s Mama Must-Have:
Dr. Lisa loves using apple cider vinegar before meals, as well as adding lemon and lime zest to salads, coleslaw and in water to support her digestion.
Dr. Toni is a big fan of the wet sock treatment to support immune health, especially at the first sign of a cold.
Dr. Toni’s next HypnoBirthing session for expecting parents looking to decrease fear and anxiety to support their natural instincts around labour and birth is happening this summer. Join her at https://www.hypnobirthingcalgary.com/register
Join Dr. Lisa’s new Meetup group Wild Woman Adventures Toronto if you want to get out in nature, connect with other women and push yourself out of your comfort zone. Activities include: sunrise/sunset SUP, tree-top trekking, a new moon workshop and more!
Dr. Lisa’s Wild Collective in Fall 2022: get on the waitlist: wildcollectivetoronto.com
We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.
You can also support us by visiting our Patreon page.
Please tell your perimenopausal mama friends about us, too!
Stay safe and healthy everyone!
Disclaimer:The information provided is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.
In this episode, Dr. Lisa and Dr. Toni talk about the causes and therapies for constipation in you and your kids. They discuss what is expected or ideal with respect to your bowel movements, the causes of constipation, and some tests and treatments to consider if you or your kids are experiencing constipation.
What is constipation?
Generally considered when you have less than 3 bowel movements a week, or discomfort, even you have a daily bowel movement.
As naturopathic doctors, we consider at least 1 bowel movement daily with a Type 4 rating on the Bristol stool chart to be ideal. You want your stool to sink without mucus, blood or undigested food (with the exception of corn).
What are some causes of constipation?
Not enough water
Not enough fibre from veggies and fruit
Lack of movement and proper circulation
Stress, especially in the case of irritable bowel syndrome (IBS)
Travel or another break in your routine
High intake of constipating foods: rice, toast, cooked carrots,unripe bananas
Hypothyroidism or sluggish thyroid function – see Episode 42 for more info
Reduced stomach acid, digestive enzyme and bile flow, often caused by stress and stimulation of sympathetic nervous system response
Gut bacterial imbalance
Certain medications
Allergy medication
NSAIDs like ibuprofen and opioid pain killers like Tylenol 3
Nerve damage
Hormone imbalance or PMS – constipation then possibly loose stools when your period comes is a common pattern in Traditional Chinese Medicine called Liver Overacting on Spleen
Harmful effects of constipation can include:
Discomfort, bloating, just feeling crappy
Reabsorbing toxins and hormones in your circulation
Megacolon or the abnormal dilation of the colon
Encopresis in kids, which is the uncontrollable leakage of stool
Stool testing through specialized labs, like Comprehensive Stool Analysis or GI-MAP
Small Intestinal Bowel Overgrowth (SIBO) breath test
Common treatments for constipation include:
Restoralax or Miralax, also known as Polyethylene Glycol (PEG) 3350
Adverse effects can include abdominal cramps, diarrhea, bloating, gas, nausea
Potential link to development of tremors, tics and obsessive compulsive behaviour
Contamination with small amounts of ethylene glycol and diethylene glycol
Not meant to be used daily and over the long term
The safety and efficacy of Restoralax for use in children under 18 years of age have not been established
Laxative herbs like senna
Side effects can include developing a dependence causing further constipation and other digestive disturbance, electrolyte imbalance, darkening of your intestinal tract called melanosis coli, finger clubbing, kidney inflammation
What else can you do about constipation?
You can try one or more of the following:
Increase fluid, especially pure water
8 oz (250ml) of water multiplied by age (number of years) up to 2 litres daily
Increase fibre:
Aim for 19g daily for kids 1-3 years, 25g daily for kids 4-6 years, at least 26 g and up to 31g daily for kids 9-13 years and up to 38g daily for kids over 14 years
Beans or legumes – ½ cup = 6 g fibre
Broccoli and other cooked veggies – ½ cup = 4 g fibre
Apples, pears, berries – ½ cup
Prunes or dates – see Episode 45 for more info on sugar balance
Ground flaxseed
Chia seed pudding
Support stomach acid and digestive enzyme production
Bitter foods and herbs like arugula, dandelion root/greens, artichoke, gentian
Start your kids young with small amounts!
Support gut bacteria with fermented foods or probiotic supplement and prebiotic fibre
Magnesium citrate and vitamin C provides osmotic laxative effect
Start with small amount and use only to bowel tolerance
Support proper anatomical positioning with something like Squatty Potty
Slippery elm found in powder, capsules, lozenges and teas, taken away from medications and other supplements
Other herbs and homeopathy for relaxation
Abdominal massage
Clockwise on belly
I Love You massage
Can use castor oil for extra relief from discomfort
Pelvic floor physiotherapy for kids with constipation
Dr. Toni’s breakfast bar recipe is on the show notes for Episode 32 on hot flashes.
This Week’s Mama Must Have:
Dr. Lisa is a big fan of her son’s Lunii storyteller audiobook device for screen-free entertainment.
Dr. Toni loves to have a light, easy read before bed and just read her first Bridgerton book! She highly recommends The Girl with The Make Believe Husband by Julia Quinn.
Dr. Toni’s next HypnoBirthing info session for expecting parents looking for increased calm, confidence and comfort during labour and birth is March 29th. Join her at https://www.hypnobirthingcalgary.com/register
Dr. Lisa’s Wild Mama free virtual 30-minute info session is happening on March 17th – SIGN UP HERE. Program starts on March 24th!
Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.
Please tell your perimenopausal mama friends about us, too!
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