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Support Clients with SIBO_Final

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>> Hey there. I'm happy to be back. In this lecture, we're going to apply what you've learned about SIBO to explain how you can support clients who have this condition. We'll go over the tests they can seek out for diagnosing, what your clients can expect, and how you can support their treatment from within your scope of practice as a Health Coach. To review, SIBO stands for Small Intestinal Bacterial Overgrowth. Clients who frequently experience digestive distress, such as, bloating, gas, and nausea, may be suffering from SIBO. Often, symptoms of SIBO and irritable bowel syndrome, or IBS, are very similar. It can be one or the other or both. Doctors should always test for and rule out SIBO before diagnosis of IBS is given. When SIBO might be the cause of the client's symptoms, the first thing to do is refer them to their doctor who can order a breath test to confirm or rule out this diagnosis. Breath tests for SIBO measure hydrogen and methane, which is produced by different strains of bacteria, but not by humans. Concentrations of these gases can be measured in the breath. Therefore, significant levels of hydrogen or methane in the breath imply that bacteria is living in the upper GI tract. A client can only do a breath test with their doctor, but you can support them by educating them about the test. To prepare for the test, clients will have to follow a prep diet prescribed by their doctor. This diet can last between 2 and 48 hours and conclude with a 12-hour fast. On this diet, a client must avoid all high-fiber foods, including plants, beans, grains, dairy, condiments, herbs, and spices. This is because they'll need to specifically measure the gases produced by sugar, but not by any other types of carbohydrates. The morning of the test, a client will be instructed to fast and then drink either a glucose or lactulose formula provided by their doctor. Don't worry about memorizing this, your client's practitioner will provide all guidelines and answer all of their questions. When a client tests positive for SIBO, the goal is to support their doctor's treatment regimen to help them get their symptoms under control. There are two common approaches to addressing the overgrowth in SIBO, antibiotics and herbal antimicrobials. Typically, a traditional medical doctor will prescribe antibiotics and an alternative practitioner will utilize herbal antimicrobials. The goal with either is to kill the bacteria that have overgrown in the small intestine, thereby limiting the symptoms. This is a temporary fix however, as neither address the root cause of how the bacteria got there in the first place. The most common treatment for SIBO is an antibiotic called Rifaximin. Rifaximin is classified as an IBS drug that many practitioners also prescribe for SIBO. Like many other antibiotics, Rifaximin may succeed in killing the overgrowth, but rates of occurrence are high. If your client is taking Rifaximin, they should not be on a low FODMAP or low-carbohydrate diet during the course of their medication. I know, this may sound surprising, though it seems counter-intuitive, starved bacteria in the small intestine are actually harder to kill. They go dormant and hibernate. This is because when bacteria are stressed, they tend to go into protection mode. But when bacteria are fed all kinds of sugars and carbs, they're more vulnerable to any kind of antimicrobial treatment. They're like sitting ducks. Herbal antimicrobials also hold a lot of potential. A major study was done at John Hopkins, where an herbal antimicrobial formula was compared to Rifaximin for SIBO treatments. The herbal treatment did just as well or better in getting rid of the overgrowth. Some of the herbs and natural microbials included were lemon balm, coptis, red thyme, Indian barberry, neem, cinnamon, and oregano. Herbs are also a great alternative to those who still suffer from occurrences even after several rounds of antibiotic use. SIBO is one of those conditions where use of antibiotics is justified, but as you know, multiple rounds can have detrimental effects on the gut. If a client's experiences recurrences, they may want to consult with a naturopathic doctor to explore treatment alternatives or a functional medicine practitioner to help find the root cause of their condition. A natural herb that may help clients with SIBO is ginger root. Ginger stimulates muscle contractions and emptying of the digestive tract. It's a prokinetic. Prokinetics help stimulate movement in the GI tract by increasing the contractions in the small intestine. Because one of the main causes of SIBO is a deficient migrating motor complex, a prokinetic can be helpful in these cases. Even once the overgrowth is gone, an individual will still need to get their migrating motor complex up to par to help prevent recurrences. Both prescription and herbal prokinetics are available. Iberogast is a combination of herbs that works as a prokinetic. Remember, SIBO is a medical condition, so what you want to do here is suggest that clients talk to their doctor about taking a prokinetic rather than telling your client to take one. The goal is to empower clients with information, not insert yourself in the treatment. While doctors will provide treatment for SIBO with antibiotics or antimicrobials, there's still plenty you can do as a Health Coach to support clients with this condition. The following are a top six tips for supporting clients with SIBO. One, experiment with a low-residue diet. Once a client has completed a round of antibiotics, they may next want to try to starve out the bacteria that are left behind. This type of diet is temporary since it's very limiting and can be difficult to sustain for long periods of time. Also, starving out the bacteria in the small intestine means you'll also starve out the bacteria in the colon, which in the long-term is not ideal. In a healthy gut, complex carbs are not absorbed in the small intestine. But when bacteria find their way in there, they'll start munching on these carbs right away which causes the fermentation that produces the uncomfortable symptoms that come with SIBO. Starving out the bacteria involves limiting these fibrous foods and eating a low-residue diet. The goal is to starve out the bacteria while still feeding the body. Low-residue means eliminating anything that adds bulk or residue in the stool, such as, corn, potatoes, or plantains. A low-residue diet avoids all starchy foods, limiting a person to simple sugars, like fructose and glucose. Clients on this diet will need to temporarily cut out complex carbohydrates, including starchy vegetables, grains, beans, and any sort of prebiotics, the best guidelines to follow are those outlined in the low FODMAP diet or the specific carbohydrate diet, except all grains should be eliminated as well. Individuals with SIBO, often tend to be gluten-sensitive, so permanently eliminating or limiting gluten may be an idea for these clients to explore. Two, enjoy an abundance of healthy fats and high-quality protein. Bacteria can't digest fats or proteins, they only eat sugars. This means that individuals with SIBO can enjoy these foods without the consequences of fermentation. Your clients shouldn't overdo it on protein which can have negative effects, but if your clients eat meat, you can let them know that they can enjoy grass-fed meats, organic poultry, wild-caught fish, and eggs without painful consequence. Healthy fats, such as, olive oil, avocado oil, and coconut oil are also safe bets. It's important that clients still get the vitamins and minerals they need from vegetables however, meat alone is not a balanced diet. Leafy greens will produce the least fermentation. A meal of high-quality protein with greens cooked in a generous amount of oil is an ideal meal for many individuals who are working to overcome SIBO. Three, keep it simple. Sugar, that is. The simpler the sugar, the easier it is for humans to digest. Therefore, simple sugars have a better chance of being digested and absorbed before the bacteria get to it. Fructose and lactose, found in fruit and dairy, are hard to digest. Sugar alcohols are the hardest. Normally, in a healthy body, we advocate for slow-digesting sugars which cause less of the spike in blood sugar, but for individuals with SIBO, this translates to free lunch for the bacteria. Now this doesn't mean that we recommend eating simple table sugar. It just means that clients should know that when they do eat carbohydrates, which they can do sparingly to choose the ones that will have the least negative impact. So for example, white rice might create less problems than brown rice for persons suffering from SIBO. Four, avoid sugar alcohols. As I just mentioned, for individuals with SIBO, sugar alcohols are slow to digest and therefore, cause the most problems. Sugar alcohols are commonly found in gum and diet foods, especially sugar-free treats. Sugar alcohols can't be digested by humans, but bacteria love to eat them. This is why food and sugar alcohols cause gas. When an ingredient has "O-L" at the end of a word like, sorbitol or xylitol, it means it's a sugar alcohol. Five, approach fermented foods with caution. Fermented foods and probiotics are typically great for the maintenance of the digestive system. But while SIBO is being actively treated, they can temporarily make the situation worse. The idea is that more bacteria, even if it's good, shouldn't be thrown into the mix until the situation is under control. Fermented foods and probiotics may also create GI discomfort, but this varies from person to person. It's best to go with the principle of bio-individuality here and let clients cautiously experiment for themselves. Either way, once SIBO is under control, probiotics and fermented foods can be very healing. Six, support the migrating motor complex or MMC. Lastly, let's talk about how to help strengthen the body to prevent recurrence. The best way to do this, often means supporting digestive functions, including the MMC. This really comes down to the way we're eating. Have you ever been advised to eat or snack every couple of hours in order to sustain proper blood sugar levels? Well, the problem with this approach is it doesn't give the body any time to activate the cleaning mode of digestion. As we discussed, there are two actions that happen in the intestines, the digesting mode and the cleaning mode. If we are digesting throughout the day, this leaves little time for the MMC to do its job. Think about when you're home, when you go weeks without giving it a good clean. It starts to get dusty. Now imagine this happening inside your gut. Your clients can support the small intestine's cleaning mode by eating three meals a day, four to five hours apart, eliminating snacking, and avoiding food before bedtime. Remember, the MMC only works when the body is fasting. The growling of the stomach isn't just a signal that you're hungry, it's a sign that your internal vacuum cleaner is up and running. When food enters, the cleaning process stops. This is why it's preferable for people with SIBO to space out meals and avoid snacking. Since the most waves occur during sleep, it's best to stop eating several hours before bed. A longer fasting time is a longer cleaning time. Remember, though some people have medical conditions or bio-individual needs to eat small meals throughout the day, always consider a client's overall health and any other conditions before making the suggestion. To recap, SIBO is a medical condition that's diagnosed and treated by a doctor, clients who may have SIBO should ask their doctor for a test to confirm or rule out the diagnosis. The most popular test for diagnosing SIBO is a breath test. A blood test is also available. Once SIBO is identified, it's treated with antibiotics or an herbal antimicrobial. SIBO is difficult to treat and antibiotics may be necessary to kill the bacterial overgrowth. There are a variety of dietary recommendations you can suggest to help support clients with SIBO from within your scope of practice as a Health Coach. These include temporarily limiting fiber and complex carbohydrates, enjoying healthy fats and proteins, eliminating sugar alcohols, and approaching fermented foods with caution. Supporting the migrating motor complex by spacing out meals and eliminating snacks can be helpful for strengthening motility and preventing occurrences. Have you ever worked with the client who had SIBO? If so, be sure to visit the Facebook group page and share your experiences. This is an excellent opportunity to reflect and to learn from one another. Thank you for joining me. I look forward to discussing our next topic together. Bye for now.

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Duration: 14 minutes and 42 seconds
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Language: English
License: Dotsub - Standard License
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Views: 5
Posted by: ninaz on Mar 27, 2018

Support Clients with SIBO_Final

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