Guest blog post by: Dr. Robynne Chutkan
Dysbiosis is a state of bacterial imbalance within the community of trillions of microbes that live in and on our bodies known as the microbiome. Dysbiosis results in overgrowth of harmful species and under-representation of “good bacteria”—it’s also a major cause of bloating that affects millions of people. Why are our microbes so out of whack? There are lots of reasons, but here are the 4 main culprits:
- The widespread use of antibiotics, not just those prescribed for humans, but the large amounts given to some commercially raised animals that can end up in our food.
- The prevalence of acid-suppressing drugs and other medications that change the pH of the digestive tract and disrupt bacterial balance is another major cause of dysbiosis and bloating.
- The Western diet, which encourages growth of the wrong type of bacteria in your gut and includes too much sugar, fat, and processed carbohydrates, can send bad bacteria into a feeding frenzy, leading to an imbalanced microbiome.
- Not eating enough fiber encourages dysbiosis, too. Most Americans only eat about half the recommended 25 to 35 grams of fiber daily, which can negatively affect both the amount and diversity of bacterial species present. Certain types of dietary fiber are what we call prebiotics: non-digestible foods that encourage the growth of beneficial species and are a crucial part of restoring balance when dysbiosis is present.
Dysbiosis doesn’t just cause bloating; it’s the root cause of many of our modern plagues such as autoimmune diseases, allergies, asthma, obesity, and even cancer. The diagnosis of dysbiosis can be elusive—breath and stool tests are only helpful around 50 percent of the time—and a close look at lifestyle habits and personal history is often the best way to make a diagnosis of dysbiosis.
It’s helpful to have a checklist of risk factors for dysbiosis that can help you identify whether it might be the cause of your bloating. Here are some things to consider:
- Have you taken antibiotics more than four times per year or for longer than two weeks at a time?
- Have you been on birth control pills or hormone replacement therapy in the last five years?
- Have you taken corticosteroids such as prednisone or cortisone for longer than two weeks at a time?
- Have you been on acid-suppressive therapy with proton pump inhibitors or histamine blockers (H2 blockers) for more than a month at a time?
- Do you take ibuprofen, aspirin, or other NSAIDs regularly?
- When you were growing up, were you a picky eater who rarely ate green vegetables?
- Have you consumed large amounts of sugar and starchy foods?
- Do you drink more than ten alcoholic beverages per week?
- Do you drink one or more sodas or diet sodas daily?
I recommend a three-pronged approach to eradicating dysbiosis that involves avoidance, encouragement, and repopulation.
- Avoid medications, foods, and other substances that contribute to the problem, including: acid suppressors, alcohol, antibiotics, artificial sweeteners, birth control pills, hormone replacement therapy, NSAIDs, steroids, and foods high in sugar and fat.
- Encourage the growth of good bacteria by consuming foods with prebiotic ingredients that can increase the population of essential gut bacteria, including inulin, a naturally occurring carbohydrate found in plants such as artichokes, chicory, and jicama. Oats, dandelion greens, garlic, leeks, onions, and asparagus, also contain prebiotics, especially when consumed raw. Fermented foods, such as sauerkraut, cabbage, and kefir contribute to the growth of good bacteria and provide live bacteria themselves as a result of the fermentation process.
- Repopulate the gut with large amounts of live bacteria in the form of a robust probiotic. Probiotics are live strains of bacteria that can be taken in pill, powder, or liquid form. They aren’t considered drugs, so they’re not regulated or tested for safety or efficacy, and sometimes marketing can masquerade as science on the various Internet sites that sell them. You may have to do some research to find out which particular type may be best for you.
Identifying and remediating the cause of your bacterial imbalance is an essential step in getting rid of your bloating. The three-pronged approach I outlined might take some time before results are apparent, but it offers the possibility of a real cure. If you have severe dysbiosis, rehabilitating your gut flora may take months or even years. Your microbiome wasn’t built in a day—it took an entire lifetime. Rehabilitating it is a gradual process, but with the right approach, tangible improvements can almost always be made.
Dr. Chutkan is the author of Gutbliss, The Microbiome Solution, and The Bloat Cure. Educated at Yale and Columbia, she’s been on the faculty at Georgetown Hospital since 1997. In 2004 she founded the Digestive Center for Women, an integrative gastroenterology practice that incorporates nutritional optimization, biofeedback, and stress reduction as part of the therapeutic approach to digestive disorders. An avid runner, snowboarder, and yogi, she is passionate about helping her patients live not just longer, but better lives. Tweet to her at @DrChutkan