Is over-eating the primary cause of Leaky Gas?carbohydrate malabsorption maldigestion GERD low carb overeating reduced stomach acid gas flatulence bacterial overgrowth Low FODMAP and low starch
Posted 27 February 2015 - 05:48 AM
Most of us overeat but don't realise we're going it. This link gives an easy to read explanation of how overeating can lead to carbohydrate maldigestion, IBS and GERD.
The single biggest cause of indigestion is overeating. We tend to talk about IBS rather than indigestion but they're really the same thing. I didn't know I over-ate until my daughter told me.
Chronic over-eating is believed to dilute stomach acid, as too much food overloads the digestive system. Stomach acid stimulates the release of pancreatic enzymes. If you regularly overeat, your stomach acid will be depleted, enzymes responsible for digestion won't be secreted and carbohydrates won't be digested properly.
The fermentation of carbohydrate that doesn't get digested results in gas. This helps to explain why the gas in Leaky Gas is so chronic.
Complete evacuation will only work so far. There is always stool in the colon. If you regularly overeat and malabsorb your carbohydrates, then all stool will be somewhat gassy from the action of the bacteria. Every time you eat peristalsis will move stool further down into the colon. This is why so many of us experience gas every time we eat.
According to this site:
"... 30g of carbohydrate that escapes absorption in a day could produce more than 10,000 mL (ten litres) of gas"
This might help to explain why low FODMAP and low starch diets alone might only have limited success. The maldigestion itself stems from overeating, not from FODMAPs or starches. These high carb foods will aggravate the problem because these are the preferred food for bacteria, but carbs don't cause IBS. People generally eat high FODMAPs and high starch foods without any problems. Something had to happen to change us from normal people with a normal digestion to malabsorbers. I can trace when my IBS symptoms started and it would have been early teens, when I started eating badly, as most teens do.
It's quite possible that fermenting food residue in the colon makes it more difficult to evacuate. Excess gas can get trapped in the colon and this could possibly trap stool. This has been my experience anyway. The less gas the previous day the easier and quicker evacuation tends to be.
It's difficult to get rid of a bacterial overgrowth once you have it. A SIBO specific diet which combines both Specific Carbohydrate diet and the low FODMAP diet should help assuming you can tolerate the extra fibre from vegetables. The main thing is to stop overeating. Try grazing, with several smaller meals throughout the day.
Posted 27 February 2015 - 06:14 AM
thanks for your post, Tummyrumbles.
about grazing--and i'm not meaning to argue here--far from it. it's just that i keep reading articles that mention the importance of the migrating motor complex in the small intestine--the cleansing housekeeper waves-- as far as SIBO is concerned. and that how grazing may increase the risk of developing bacterial overgrowth and can also cause SIBO relapses after successful treatment.
and that meal timing is important as far as SIBO is concerned--spacing meals 4-5 hours apart, avoid snacking..
i remember we discussed that here, too.
and like i said, i'm not trying to argue here. it's just that it all seems very tricky. maybe it's one of those YMMV sort of things--we each have to find out what works best for us.
these are just my own thoughts. for expert medical advice please contact a health care professional.
Posted 27 February 2015 - 06:58 AM
Well, that's not embarrassing! Good on you Annie for being on the ball. Yes that was my post. Symptoms have been much reduced since going low starch and eating more veges but I still had gas creeping up in the afternoons and I couldn't understand why this was. The complete evacuation worked but only up to a point. Around midday the gas would gradually start up again and grow in intensity. I've only had a few days where there was no gas at all. You might remember one of those posts and how excited I was as I thought I'd solved my LG (and I remember your kind reply). I only ate a few jaffles the previous day and I couldn't understand why this worked so well, with wheat being a problem food and all. Now I understand what happened. It wasn't the food itself that was important, it was the fact that there wasn't much of it. I have GERD as well and I believe these issues are all related. This IBS is so confusing and I really shouldn't have posted studies that didn't relate personally to me. From now on I'll only post studies that back up my personal experiences. I have found that the gas is very much reduced if I don't overfill my stomach at mealtimes, so yes this contradicts the MMC theory. In fact, grazing results in much quicker evacuations and I think for the reasons outlined above. I hope everyone tries this as I really do believe overeating might be the underlying cause of malabsorption and gas.
Posted 27 February 2015 - 07:17 AM
oh no, please---i certainly didn't mean to embarrass you--not my intention at all.
i actually found that earlier post of yours quite helpful. you always research things so carefully and it's so helpful that you share your research with us.
i'm glad you found grazing to be helpful. yes, it is exciting when we finally find something that helps us! congratulations!
thanks, as always, for sharing.
these are just my own thoughts. for expert medical advice please contact a health care professional.
Posted 27 February 2015 - 04:18 PM
At the moment I am but I'm not sure they make a difference. The ones I take only have 2 bacterial types anyway. I believe I have bacterial overgrowth so probiotics might not be a good idea if it's SIBO.
Posted 01 March 2015 - 12:12 PM
I think i might have sibo too and have read that soil based organisms are more suitable than d- lactated probiotics. But i dont really have the science / knowlegde to know if those claims are true. what do you think of it?
Posted 01 March 2015 - 03:08 PM
The one I'm taking is a well-known one over here, Inner Health Plus and only has 2 types acidopholus and bifidobacterium. I've found no changes. If you want to try a probiotic VLS # 3 has a good reputation but as far as I know is only available online. If you do have SIBO some people think that probiotics, yoghurt etc aren't a good idea because the problem is an overgrowth where bacteria don't belong, in the small intestine, so it doesn't matter which bacteria you add, in that sense they're all bad. If a soil based bacteria is more effective / natural then these populations will grow in the small intestine, because whatever you did in the first place to get SIBO, chances are you're still doing it. I can't find much information on bacterial overgrowth in the large colon, where it might be a different story where bad bacteria might overtake the good bacteria. I suspect I've got SIBO because of all the throat gurgling and unusual burping I do and I have elements of GERD as well so I won't be continuing with them once the bottle is finished. I found that stopping overeating meant that I could go a whole day with no gas at all but that's after complete evacuation. The only problem is all food can cause gas for me because the overgrowth is still there. A lot of people claim success with a low carb diet and this is what I need to do. I have a problem with will-power and this makes it hard.
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Posted 01 March 2015 - 03:35 PM
However, I believe I do need some type of fiber for bulking and maybe to help bind things together, maybe to help get more out at once. For me, brown rice seems to help but I don't want to eat it everyday, especially since I have heard that rice can be high in lead. I have heard of red rice, and I guess another kind, black rice, is expected to become popular and they are supposedly lower in lead. I don't tolerate psyllium, and once tried acacia and they made me feel worse.
I did just start taking Jarrow Saccharomyces Boulardii with MOS. MOS is a prebiotic and those are usually an absolute no-no if you have bacterial overgrowth or gas problems, but this one supposedly helps prevent bacteria from adhering. I am one week in with it. It did back me up pretty bad at first but that seems to be getting better. I did have brown rice the past couple of days and I didn't have incomplete evacuation for a change. I have eaten brown rice before which did help move things through but it still took several trips. I tend more towards diarrhea than constipation, although in my teens I had constipation.
So while they do recommend low-carb, low-residue foods to avoid feeding bacterial overgrowth, it is also important to keep things moving. For me, that means some type of fiber like brown rice. I am experimenting with herbal antibiotics as well. Haven't tried Lauricidin yet but depending on how the Jarrow Saccharomyces Boulardii with MOS works, that is next on my list.
Posted 01 March 2015 - 04:43 PM
"So while they do recommend low-carb, low-residue foods to avoid feeding bacterial overgrowth, it is also important to keep things moving."
Yes I agree, this is the hardest thing for IBS. The good foods that move things along also cause gas. Rice is high in arsenic and contains phytates that inhibit enzymes that digest food. Rice is an anti-diarrheal which means it can cause constipation for some. Brown rice has more arsenic and phytates than white rice but does have more fibre. Black rice or wild rice is a grass and a pseudo-grain but might not be as toxic as rice. I've found the best food is veges but it's a real balancing act. Just enough to move things along but not too much to cause irritation or excess gas.
Posted 01 March 2015 - 05:22 PM
You are right about the arsenic in rice which is why I would hesitate to eat it everyday. I think the black rice is different from the wild rice- I just read about it recently. It hasn't really become popular yet but is expected to. Besides the rice, popcorn also is somewhat helpful for bulk. However, I read that if someone has SIBO due to a faulty illeocecal valve, popcorn isn't recommended.
So while it is good to be aware of the general guidelines- like the Fodmaps- we still have to tailor our diets individually based on what we can tolerate. I think I was already avoiding a lot of Fodmaps before the guidelines came out, just based on my reactions over the decades. And with SIBO,I wonder if there would be differences depending on whether you are hydrogen or methane predominant or a combination of both. Supposedly I have no methane, only hydrogen.
Then there is the recommendation that Annie mentioned about meal spacing since the small intestine apparently can't move things forward while it is digesting food. To do this, one needs filling foods to avoid hunger in between. Let's face it, the non-starch vegetables are not the most satiating for very long, and too much protein can be constipating, even for some of us who are diarrhea predominant. Again comes trying to find the correct balance.
One other complication is that if we avoid some foods for a long time that we stop making enzymes to digest it. So there can be instances where foods that bothered you at one time wouldn't necessarily bother you now but you would have to begin eating it in small amounts regularly to find out. I haven't had much luck with digestive enzyme supplements, except for one that helps with both gluten and casein. Also a couple that I take on the occasions where I eat legumes, although I don't think I handle the fiber in them very well so only dare to eat them when I will be home the next day.
Posted 02 March 2015 - 07:18 AM
That's interesting that if you stop eating a food you stop making the enzymes for it. That makes sense I guess. The migrating motor complex theory can confuse things too. If you do have SIBO you're supposed to have long fasts because the MMC is delayed but this is just theory. Did the person who wrote that actually have SIBO and did they find that long fasts helped them? This is the problem, that all these studies that say such and such will help IBS is more wishful thinking than anything else.Long fasts mean you're more likely to overeat when you do eat because you're so hungry and I think this might have caused my IBS as it's the only thing I can think of that I've constantly been doing since a teenager. I don't put on weight (I lost fat cells when a baby from a bad gastro episode, according to my mum) so overeating is easy to do. The downside is that if the calories aren't being digested properly they just turn to gas which is much worse. I'd like to know why we all start out normal and end up with IBS. It's can't just be starches and FODMAPs and alcohol because normal people have all these with no problems. I gave up alcohol 20 years ago and milk about 10 years ago, which leaves starches and FODMAPs. These might be problem foods for normal people too but they don't have chronic gas from them that lasts all day and night. I miss baked beans and lentils bacon and onion fry but I do the same as you and have these on a Saturday when I'm home on Sunday. Yes it's tough. Non-starchy veges aren't very satisfying and I don't like the idea of filling up on meat and fat. I think boiling and mashing your high starch veges might be the best way to eat these. Have you tried cauliflower au gratin? It's delicious. I boil the cauliflower for a few minutes only, as I don't like it watery, and put some mayo on it with a sprinkle of mustard, then grated cheese on top then into the oven for about half an hour. It causes gas but then what doesn't cause gas. If you can tolerate some high starch foods you might like oven baked sweet potato chips, they're very addictive.
Posted 02 March 2015 - 10:19 PM
Another thing about eating. Many experts say that digestion begins before we even start eating. I suppose that means we start salivating in anticipation of a meal. I wonder if this part is affected by whether we really like what we are about to eat. If so, I know that I will likely never salivate over a bland salad the same way I would a good pizza, thus another possible problem with all the diet restrictions.Makes me sympathetic towards children who have to choke down healthy foods they can't stand the taste of!
Posted 03 March 2015 - 03:19 PM
I have a lot of respect for Dr Pimentel as he was probably the first doctor to find a physical cause for IBS, that's assuming IBS is SIBO. I'm convinced IBS is some sort of bacterial imbalance and SIBO makes more sense than anything else, but still doesn't explain how we got the IBS in the first place. That's a good point about digestion. I don't really enjoy salad veges at all but I'm eating more of them now in the hope they speed up the colon generally and help to move the bad stuff out. If you find a food distasteful this has to affect digestion as the brain is involved in these processes. I'm hoping that small camera technology can be improved so they can have a look inside the colon and see what's actually going on. I think incomplete evacuation might have a lot to do with it. The food residue from incomplete digestion could be causing bacterial growth as this food should have been digested in the small intestine. Instead it's feeding bacteria and causing gas as well. It's possible that pockets of this gas can form in the colon and block stool and this could be why so many of us have broken mushy BMs. Some people here claim they now have perfect BMs from probiotics, diet change or whatever but I'm not sure what their initial problem was. I don't understand how probiotics would solve malabsorption say from overeating as the problem is that overeating dilutes stomach acid so the food just isn't being digested properly. Adding more bacteria to the mix doesn't seem to be a solution to me because you're still left with a lot of food residue, a lot of bacteria and a lot of gas. If you don't overeat though, you're back to square 1 again, trying to find out the cause of the malabsorption. Can you post if you find out any new theories about SIBO? I had a look at Dr Siebecker's website but it seems you have to pay to access these.
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Posted 03 March 2015 - 04:56 PM
The information on Dr Siebecker's siboinfo.com page is pretty limited. There is an option to sign up for free newsletters which I did and it seems like you get more information. I just got one the other day and it has a lot of articles you can view for free- not the seminars she has done which you do have to pay for. I also signed up on the Underground Wellness site. A guy named Sean Croxton does interviews that you can listen to. He did a series of free online interviews last fall called the 'Digestion Sessions' with several health experts over a period of several days. There was an option to purchase them but there was no charge to view them during that time. He had previously done what was called the 'Thyroid Summit' which I didn't know about or see. Thyroid problems can be another contributing factor to digestive issues and there is a lot of debate about how that is being diagnosed and treated. My mother and sister are both hypothyroid and are on medication for it. My thyroid tests showed that I was on the lower end of normal so no treatment recommended but from what I've read, the usual medication for that, Synthroid, has come under question. Trying to read and sort out information on thyroid problems is just about as complicated as trying to figure out digestive problems.
Another good site is Chris Kresser. Quite a lot of information there, usually along with several reader comments/discussions. Main problem with all of this is having the time to read or view them. There was also some sessions by a Donna Gates recently called the 'Healthy Gut Summit'. Unfortunately I didn't have much time to view most of them, but one annoying thing was that she is a big fan of fermented foods and kept bringing those up. There was one session on biofilms that I would have liked to have listened to but didn't have time. Biofilms might be one reason for antibiotic resistance and the difficulty in eradicating things like SIBO because they protect the bacteria. They are essentially like the plaque that we get in our mouths which can lead to gum disease. In fact, on the news today there was a story about someone in Silicon Valley, California who has come up with an expensive toothpaste that he claims treats dental-related plaque very well. As for SIBO, not all of the experts are on board with the biofilm theory but then again when new ideas emerge, there usually is a lot of initial resistance to them from the experts.
I did briefly try a product that supposedly breaks down biofilms, called Interfase Plus, but didn't tolerate it well enough to stick with it- made my cramps, gas and loose stools worse. It may have been a case of things getting worse before they get better but I couldn't stick it out. So for now I just started Jarrow's Saccharomyces Boulaardii with MOS, and continue to rotate various herbal antibotics like Berberine (which is supposedly good for hydrogen which my breath test showed), some Oregano Oil, allicin, olive leaf, and occasional peppermint oil capsules. I also take ginger capsules with every meal since it is supposed to be good for digestion as well as nausea which I do get from time to time.
Yes- the probiotics idea is confusing. If there is indeed bacterial overgrowth in the small intestine- where normally there is supposedly very little bacteria- then taking them orally would theorectically only add insult to injury. As Dr Pimental said, SIBO isn't about what kind of bacteria it is, but it doesn't belong in the small intestine. However, whether we have SIBO or not, our large intestines may indeed need some probiotic supplementation. This is where the fecal transplant idea makes sense, in that it puts the bacteria where it is needed, besides possibly providing strains and a balance that haven't been identified.
Posted 04 March 2015 - 04:45 AM
Chris Kresser is great isn't he? I got my link from his website in my opening post. He explains things well without under or over explaining. Biofilms still seem to be contentious issue with some claiming these don't exist. Yes it's a big question - probiotics or not? If you have bacterial dysbiosis in the colon then just about any probiotics would help, if they take up residence there and grow - and has it been proved in studies that they do actually this? I know there have been studies of VSL #3 but these seem mainly subjective with people saying they feel a lot better. We need really tiny cameras that can see down to bacteria level and see whether the probiotics actually take hold or not. Probiotics aren't all that expensive but I don't like feeling silly and being ripped off. If you have SIBO then no, that seems to be the situation but how do we know which one we've got or even if it is bacterial imbalance causing the IBS? Testing isn't all that accurate and I know people here have posted they've gone on the antibiotics course but the SIBO returns in a couple of weeks. Motility is a big factor too. It could be that lazy habits can make a colon permanently sluggish and maybe this too encourages bacterial growth. I think diet is the answer but the diet is so hard! I can eat salad all day at work but come late afternoon I would gnaw someone's arm off if I couldn't get a hamburger. (I shouldn't be saying this here - you didn't really read that). I'm persevering with the salads and as many veges as I can take but trying to space everything out.
Posted 04 March 2015 - 10:08 PM
I heard that Dr Pimentel was working on a blood test for IBS that checks for something called vinculin antibodies. Not sure what this would do as far as helping with treatment. All I can find on it now is that it might change how IBS is diagnosed- that it would no longer be a diagnosis of exclusion like it is now. Will have to wait for more information to come out.
I thought this was interesting. It made me think of carrageenan, which I think might be a type of seaweed, that is used as a thickening agent in some foods. I have heard that it is very irritating to the GI tract and should be avoided. I read that on Dr Andrew Weil's site- another place I visit for information and subscribe for free emails.
Posted 05 March 2015 - 07:13 AM
What an interesting idea about a bacteria bank! Is such a thing possible? It would be very expensive to maintain I guess and to test all the cultures, and you'd have to keep the bacteria fed. It would be interesting to see what happens with a Bali belly curry! Did you think of that yourself or did you see it somewhere? The trouble with a project like that is that bacteria aren't isolated and the way the colon works everything is interconnected - brain, enzymes, neurons etc which is why IBS is so hard to solve. This raises an interesting question. My daughter and her partner both ate out and had food poisoning with vomiting and diarrhea. When they recovered a few days later he was totally fine, but she had diarrhea after meals for a few weeks. I got her onto the low FODMAP diet and she came good, although maybe she would have anyway. But why did she get IBS-D, even if only temporarily, and he didn't? This is the thing about IBS I don't get. All the additives in food for instance, antibiotics, alcohol, starches, FODMAPs - all of us are exposed to these things but it's still only a percentage of people that get IBS. A person can drive themselves crazy trying to figure it out and I just don't think it's possible. I think we have a genetic weakness but that could be any gene, anywhere and there's probably several genes all over the place that could potentially lead to IBS. They did a study where they thought they isolated "the IBS gene" and found a drug to block activating this gene. Only trouble was the drug caused heart palpitations and other complications. I'm really over the studies. I've been reading on some of the probiotics studies and the doctors send the patients letters asking them if they feel better. The controls are free to choose their own diets. How scientific is that? Of course you're going to stop eating hot dogs and hamburgers while you're on the study, just because of the novelty of it. As soon as it's over it's back to your normal lifestyle. If they're going to seriously test things like probiotics have people eating the same diet over a week, some days with probiotics and some without. The thing with probiotics too is that most digesting is over by the time the carbohydrate gets to the colon to feed the bacteria, that's assuming it's not SIBO. Carbohydrate digestion doesn't usually involve bacteria until most of it is digested anyway. No-one fully digests FODMAPs and resistant starch but the small amount of gas doesn't seem to bother normal people or maybe they just get rid of it straight away. With us it seems to get blocked in the colon, causing motility issues / constipation / diarrhea and maybe this is due to genes, who knows. So if you are a carbohydrate malabsorber probiotics aren't really going to do anything as the damage is done already. For whatever reason the digestive enzymes couldn't do their job.
I hope you keep us posted with the news you're getting from the websites. I hadn't heard of carrageenan but our food standards allow it over here. I notice it's in almond milk which I don't drink thank goodness.
Posted 08 March 2015 - 07:41 PM
The bacteria bank was my idea- just was comparing it to a blood transfusion. I was thinking that maybe the bacteria could be frozen but don't know if it could survive that way. I do think it would be interesting to track any changes periodically and if it corresponded to the development of digestive symptoms then it would give the bacteria theory more validity. But again, it could still be only one factor for a symptom, part of a cumulative effect.
Posted 09 March 2015 - 04:51 AM
Airplane, I think I've cured my IBS! I've been going low starch the last few days and I've had straight days at work with only one small fluff after lettuce. I can't remember ever going a whole day at work with little to no gas, unless I ate very little the previous day.
I've been grazing on salads all day at work, starting about 12 and finishing about 3. Lettuce, carrot, tomato, cheese, 2 eggs. When I get home I have meat and veges, banana (very ripe) & yoghurt.
My first night on low starch I had pork hock soup with well-cooked potato, pumpkin & carrot and well-cooked broccoli. There wouldn't have been much starch in the potato as I cooked it so long. The second night for dinner I had hamburger with lettuce instead of a roll, but everything else: fried onions, lettuce, tomato, beetroot. The third night fish in coconut milk, cauliflower au gratin and mushrooms fried in butter. I was actually very full.
I hope you try this diet. I'm going to post in the diet section a starches and fodmaps list so you can print it out.
Thanks for letting me know about Dr Pimentel's vinculin tests - that really helped my understanding of IBS causes. I found a lot of related information here:
Give the low starch diet another go because this is definitely the cure. But yes, complete evacuation is all-important and you just have to stay there until you've finished. The last 3 days evacuation has been about half an hour, but it used to be 4 hours.