The Gut-Brain Connection - A BIG Piece of the Puzzle

A few questions for you first - Is bloating your most prominent digestive symptom? Do your IBS symptoms worsen during periods of stress? Do you feel bloated with a certain food one day, but not another day? Do you get bloated even from water? Yes is a common answer I hear but it does not typically indicate any serious damage to the gut, or that you most definitively have SIBO. It could actually be a misfiring of signals from your gut to your brain and back…aka a gut-brain connection issue (or a disorder of gut-brain interaction - DGBI).

Bloating & Distension are Different:

Abdominal bloating and distension are 2 of the most commonly reported GI symptoms. For some they can be chronic and very uncomfortable, but for other it may be infrequent.

But there is a difference between bloating and distension! They can occur together or independently. To get technical, abdominal bloating is the subjective sensation of excess intestinal gas, but without obvious visible abdominal distension. People with bloating may feel a sense of fullness or discomfort. Abdominal distension is the objective physical manifestation of an increase in abdominal girth (aka “looking 6 months pregnant” for some). Unfortunately, because of how the health care system categorizes IBS, the differentiation is not regarded, but it can be very helpful to determine the cause of your IBS.

If you have bloating and/or distension but regular bowel movements, or if you have explored celiac testing, the lowFODMAP diet or SIBO testing and you still have bloating, it would be helpful to explore the idea of a disorder of gut-brain interaction (DGBI).

It's Not "Just in Your Head":

It’s important to understand that a DGBI is not "just in your head." While the brain and gut communicate closely, the symptoms are real and need proper management - these are gut conditions that can be affected by stress and mental health. But they are not just stress and mental health.

Think of your gut as a house and a DGBI as a highly sensitive fire alarm system. Normally, the fire alarm only goes off when there is an actual fire, alerting you to real danger. However, in DGBI, this fire alarm system is malfunctioning. It’s hypersensitive and can be triggered by everyday activities like cooking or lighting a candle, causing unnecessary panic and stress. Just as you would need to fix a malfunctioning fire alarm, DGBI requires a tailored approach to manage the symptoms and improve your quality of life.

What can help?

There are several things we need to explore in order to calm this hypersensitivity and correct a DGBI. Everyone in unique of course so unraveling the trigger and make the correction does need an individual approach. Do we need to start with correcting any imbalance of gut bacteria? Or does daily stress and anxiety have a bigger impact on your gut symptoms. These are things I love to explore with people.

The Foodie's Guide to Gluten-Free

I WISH these were gluten free…

As a practitioner that sees a lot of gut health issues, and conditions associated with it, it is likely that I will ask you go try going gluten free. I do this, not because I am trying to be the stereotypical Naturopath portrayed in movies, or because you are celiac, but because it can truly have a negative effect on some people’s health if there is a sensitivity. No, it doesn’t effect everyone, or at least everyone the same, but for those with a more chronic condition that they are seeking help with, it is a great place to start. There is research that shows gluten can increase zonulin in the gut, which I’ve spoken about before, which causes a more “leaky gut.” Gluten can cause different reactions, including the obvious bloating and cramping, to swelling, headaches and fatigue.

Gluten-What?

What the heck is gluten though? Gluten is the protein in certain grains, including wheat, spelt, kamut, rye and barley. It is what makes it stick together well. It is not in oats, millet, buckwheat, corn, rice, quinoa, sorghum. In years past, trying to find gluten free bread that didn’t crumble immediately was almost impossible! Luckily now there are so many great options to choose from. I am creating a guide for those patients of mine that need some guidance, but also all those out there wondering whether this is something they should try for their health. (Hint…if you are asking yourself that, you should probably try it!) Halifax has a few less options than bigger cities, so let me know if there are other favourites I may not know about.

My Gluten-free Tips

1. My number 1 tip for going gluten free is to not worry so much about replacing every type of gluten product you have. You can do a lot with a lettuce wrap, sweet potato, cauliflower or bed of rice. Try a burger on a lettuce wrap, or seasoned ground meat in romaine. Or even sloppy joes in a roasted sweet potato. You will end up buying less gluten free products and eating more whole foods :)

2. Bob’s Red Mill is my go-to for gluten free flours for baking. No more complicated recipes needed with a binding agent such as xanthum gum, since their blends are all ready to go and come out tasting great!

3. Eating out when you are gluten free has become easier as well (except for brunch…that’s still hard for me sometimes!). A lot of restaurants have gluten free options or substitutes so all you need to do is ask. A go to for me is just their meat/fish, potato and veggie dish. There is usually always something like that.

Favourite Gluten Free Products

• Baking Flour: Bob’s Red Mill 1:1 Baking Flour - the best baking flour I find. It works so well for mostly anything you are baking. (blue bag better than red bag as you need to add the xanthum gum to the latter)

• Oats: Regular oats - Unless you are celiac, you can use regular oat flakes. These are a go to for me for quick pre-made breakfasts and snacks. I love my oats!

• Pasta: Cantelli or Barilla gluten free pastas are good grocery store brand options. GoGo Quinoa Pastas are sometimes available and a good option. Kids also tend to like the 100% legume pastas you can find now (eg. Chickapea pasta), which provide a good source of fibre. Be careful with this though if you are sensitive to beans or bloat with too much fibre.

• Crackers: Blue Diamond Artisan Nut-Thins/Almond crackers, Mary’s crackers are great options as well as several options at Costco that are great. Breton even has gluten free crackers in the regular cracker section.

• Bagel: O’Doughs Thins - Found at Superstore in the freezer section. They are delicious with a little peanut butter for a quick breakfast if you are craving more carbs (but not with the calories - bonus!). Their sandwich buns are pretty good as well. Little Northern Bakehouse has good bagels as well.

• English Muffins: Glutino brand - I’m not a big english muffin gal but I’ve been told these are a go to for some people.

• Bread: This one is a toss up depending on what you are looking for. Some options are - Little Northern Bakehouse Gluten Free bread is apparently really good, especially their Honey Oat Bread; Promise brand from Sobeys; Costco Gluten free bread (comes in a pack of 2 loafs); fresh bread at the market (look around, you may find a gem). Glutino and Udi’s are best for making stuffings etc, since they are still a bit crumbly.

• Burger buns: O’Dough Hamburger Buns - I discovered these in the summer and I was very impressed! If you aren’t going for the lettuce bun, try these. There are many other options in the freezer sections.

• Wraps: Superstore has its own wrap that is decent; Sobeys carries ones that aren’t frozen in the health food section. Some can get expensive so look around.

• Pizza: Sabatassos Gluten-free Pizzas - Since I can’t eat dairy, these came highly recommended by a great source. Found at Costco and they are apparently amazing! Lots of other options now at your local grocery store.

There you have it, some great options for those of us that are gluten free! I promise it isn’t so bad. I love to cook and I’ve made out alright 😉

Any favourite products of yours I’m missing here? Let me know!

In health & happiness,

Dr. Karen