It’s time for another gut health post! My infatuation with this topic continues on. This time, we’re going to be covering the topic of dysbiosis. Or, in other words, bacterial imbalance. We’ll define what this looks like, the symptoms you might be experiencing from it, and what you can do to alleviate them. Of course, this is by no means medical advice or diagnosis, this is just general information for you to tuck away and use when working with a qualified health practitioner. So, with that little disclaimer out of the way, let’s get right to it!

Dysbiosis 101

Going back to my introductory post on the microbiome (the Forgotten System), our gut is home to trillions of bacteria, along with varying degrees of yeasts and parasites. Some of these residents are good and others are bad. Or rather, opportunistic. The predominant strains or types of bacteria keep these opportunists from taking over so long as they remain in charge. However, when the opportunity arises, the opportunists can quickly multiply and take over, much like an alien invasion in a science fiction movie. The overabundance of parasites, yeasts (i.e., candida albicans), or bacteria (strep, E. Coli, H. Pylori) is more often than not the primary type of dysbiosis. But there are others to look out for. For instance, having too diversity or abundance of bacteria can lead to problems as well. While this is not a normal situation, there are times when a person will take a comprehensive stool analysis and given the results of low bacterial diversity. (In which case they’d have to closely work to improve it with the help of a doctor.) But with this sort of “deficiency” or “undergrowth” of bacteria comes an inefficient microbiome that is vulnerable to fostering those opportunistic bad guys I mentioned before down the line.

A third and emerging type of dysbiosis has to do with an overgrowth of microbes occurring in the wrong place. This can be in the stomach (in the case of H. Pylori) or in the small intestine. With the latter, this is known as SIBO, or small intestinal bacterial overgrowth, in which there is an overwhelming number of bacteria in the small intestine, which normally doesn’t house as many bacteria compared to the large intestines or colon. (As a side note, you can also get SIFO- small intestinal fungal overgrowth- but that’s a very rare occurrence and is not as common as SIBO.)

OK, so we know what dysbiosis is, what exactly leads to it? It’s one thing to identify the initial cause- too many or too few microbes, dislocation of microbes- it’s another to figure out what was rooted at the source to begin with.
Here is just a short list of possibilities. Know that in many cases there’s a web of imbalances and symptoms that need a broader approach when it comes to figuring out what’s going on with the body and what can be done to restore it back to health. (Basically, in tough, complicated cases, you’re often faced with a “chicken or the egg” sort of situation.)

But here’s the lowdown on general causes behind dysbiosis:

• Infection (traveling, poor sanitation, water, pools or rivers)
• Food poisoning or Stomach Flus
• Chemical exposure (unwashed produce may contain trace amounts of pesticides)
• Frequent use of antibiotics
• Medications (prescription and/or over the counter)
• Diet (processed foods, refined grains, and sugars, preservatives, etc.)
• Alcoholism
• Overuse of probiotic supplements (i.e., taking 100+ billion CFUs nonstop day after day; unless you have an underlying condition and are receiving medical supervision, there’s really no need to go overboard, lest you risk having an enormous quantity of bacteria in your gut that can soon migrate up to the small intestine where they shouldn’t be and cause dysbiosis in the form of SIBO)
• Chronic stress and anxiety (at an extreme rate- abusive household, toxic work environment, mental health disorders)
• Bad dental hygiene (encourages the proliferation and migration of opportunistic bacteria in the mouth)

Signs & Symptoms of Dysbiosis

Not sure if you’ve got an imbalance? Keep track of the following signs and symptoms. If more than a couple tends to occur, you may want to consider scheduling an appointment with the doc!

• A growing laundry list of food intolerances (especially to foods you never had any problems with)
• Irregular bowels (i.e., constipation, diarrhea, or alternating between the two; must be occurring for more than a few weeks)
• Trouble urinating
• Vaginal and/or rectal itching (also includes infections)
• Constant, extreme bloating (i.e., not a tiny “food baby” after a big meal- I’m talking looking like you’re nine months pregnant after having even just a little bit of food!)
• Indigestion, nausea, heartburn, or GERD
• Skin problems, such as acne, rosacea, psoriasis, or eczema
• Food malabsorption (floating stools or steatorrhea, light-colored or green stools, undigested pieces of food in stool, foul-smelling stools)
• Offensive body odor, bad breath, and gas (enough to the point where no amount of Gas-X, mints or deodorant can mask the problem)
• Chronic fatigue
• Joint pain
• Unexplainable anxiety or depression

Dysbiosis: The Next Step

After taking into account all of the symptoms I listed above, you may want to go and get checked out if the problems don’t resolve within a week or two. Sometimes, you could just be under a minor infection or bug that can resolve itself on its own. But when the problems become severe to the point that your quality of life is compromised, then you should definitely get help. From there, your healthcare provider may perform one or a multitude of tests to get to the bottom of things. These tests include a urine or organic acids test, comprehensive digestive stool analysis (CDSA), or hydrogen breath test (for SIBO). In tougher cases, they’ll have you undergo either a tissue biopsy of the affected area of infection, an endoscopy, or a colonoscopy. While these are all invasive procedures, they serve as a means to an end in order to give the most accurate diagnosis possible (and thus most effective treatment).
Once you’ve received the proper diagnosis, the next course of action is to treat the underlying cause of the dysbiosis. Most likely you’ll be prescribed an antibiotic or antifungal to treat the infection (more holistic practitioners tend to lean towards herbal treatments).

What YOU Can Do Today

Whether you’ve successfully eradicated the infection or would like to avoid dysbiosis altogether, the name of the game is PREVENTION. There’s no way I can tell you what to do if you have dysbiosis, but I can offer some key lifestyle practices to help keep it from taking place. You’ve seen me write about them before, but they bear repeating:

• Eating a whole foods diet tailored to your bio-individuality: So, whether that’s keto, vegetarian, vegan, or omnivore, find what works for you. And avoid the processed, sugary junk that will make those opportunists go crazy!
• Include probiotic-rich fermented foods and prebiotic fiber to feed and fortify the good bacteria in your gut.
• Regularly brush and floss your teeth to prevent oral infections. Bonus: Chew your food!
• Learn to manage stress before IT manages YOU.
• Put a limit to the amount of alcohol you drink- too much can definitely do a number on your microbiome if you’re not too careful. (Read about my Gut Hack if you’re going out for a drink tonight!)
• Consider supplementing with collagen to maintain a healthy, happy gut. If it’s not within your budget, consider sipping on some bone broth on the regular!
• Pay close attention to your poop. Yes, I said the “p” word. Poop! Pay attention to the size, color, shape, and smell if you suspect any imbalances in your gut. Anything that looks off and doesn’t change within a week or so should warrant a friendly chat with the doc.

Lastly, I recommend doing a short Gut Reset every so often. This is meant to be done for a few days as a means to make things easier on your digestion and give it somewhat of a break. I cover things more in detail in that post, but in a nutshell, you’re simply doing things like fasting, avoiding exotic, complicated meals, and going for simple things like soups, smoothies, and teas. It’s a really nice way to support your gut as well as prevent any imbalances. After all, everyone deserves a break, so why not your gut?

Further Reading and Sources:

[1] https://www.healthline.com/health/digestive-health/dysbiosis#prevention
[2] https://blumhealthmd.com/2017/06/17/what-is-dysbiosis/
[3] http://www.thegoodgut.org/what-is-gut-dysbiosis-how-is-it-caused/
[4] https://www.sciencedirect.com/topics/medicine-and-dentistry/dysbiosis
[5] https://www.integrativepractitioner.com/topics/the-microbiome/6-causes-of-dysbiosis-of-the-gut-microbiota
[6] https://www.ncbi.nlm.nih.gov/pubmed/15253677