This is the second in a three-part series. In the first installment, we took a closer look at the digestive system, its role in maintaining your health, and the importance of digestive enzyme. In this installment, we will examine the role of the billions of bacteria in your gut and what happens when that system gets out of balance – a condition known as dysbiosis. In the third part of the series, we will examine a condition called Leaky Gut Syndrome, which is to blame for many skin condition and food allergies and sensitivities.

Did you know that there are more bacteria in our intestinal tract than there are cells in our entire body? That’s over one hundred trillion organisms with a collective weight of about four pounds – roughly the size of our liver. The amazing thing about this internal ecosystem is that is that when these various bacteria exist in the proper balance, they provide tremendous benefits to our body.

Our intestinal flora plays an important role in our ability to fight infectious disease, providing a front defense in our elaborate immune system. A normal microbial flora also manufactures many vitamins in our foods and bodies, including the B-complex vitamins and vitamins A and K, and increase the bioavailability of essential minerals like calcium and magnesium. They also aid directly in the digestive process, digesting lactose, breaking down proteins into amino acids, and helping to regulate peristalsis (see Part 1 in this series) and regular bowel movements. Our beneficial gut flora also plays a role in normalization of serum cholesterol and triglycerides and breaking down and rebuilding hormones that help to reduce inflammation.

Now keep in mind that these many benefits are only realized when all is right in our gut. Unfortunately, achieving and maintaining balance in our intestinal environment is no simple task. Under circumstances of chronic stress, poor diet, a compromised immune system, or the use of antibiotics, the harmful bacteria can begin to outnumber the beneficial bacteria in the gut. This creates and imbalance referred to as dysbiosis. If this dysbiosis persists undetected or untreated, we can experience indigestion, malabsorption, constipation, diarrhea, skin disorders, yeast infections, irritable bowel syndrome, and even cancer and other chronic diseases. So you can see how important maintaining an optimal bacterial environment in your gut is for not only for proper digestion, but for your overall health.

Let’s continue this discussion by identifying the different types of intestinal bacteria, the factors that lead to dysbiosis and how to identify this condition, and how to restore and maintain an ideal gut flora.

There are over 400 types of bacteria in our digestive systems, each with many types of strains. Most of these bacteria are anaerobic, meaning they do not need oxygen to survive. The rest are aerobic, which do need oxygen for survival, and another hybrid type, which produces lactic acid and can be either aerobic or anaerobic. If you recall from the first article in this series, we learned that the digestive tract consists of four main sections: the mouth, stomach, small intestine, and large intestine or colon. While most of us are familiar with the presence of bacteria in the mouth, numbering in the billions, few are aware that many of these are beneficial bacteria – “the good guys” — that help in controlling the number of “bad guys” that survive the trip into our stomach. By contrast, the stomach is less conducive to bacteria because of its higher acid content. We saw the exception to this rule as described in the first article of this series in people who produce insufficient stomach acid (hypochlorhydria) due to old age or chronic stress, which can promote harmful bacteria like h. pylori – the stomach ulcer bug. The small intestine harbors many billions of bacteria, the most commonly known of which is the lactobacillus acidophilus. The colon harbors many trillions more, the most common of which is the bifidobacteria. These two types of bacteria are considered beneficial and are commonly referred to as “probiotics”.

You might wonder where all these little buggers come from? Well up until birth, we receive predigested food from our mothers and have a sterile digestive tract. We receive our first does of bacteria (good and bad) at birth. The trip down the birth canal initiates us into this world and then we receive additional doses in breast milk and formula and when we suck on nipples, fingers, toes and whatever else we can get our mouths on. And then, whenever we breathe in or touch anything microbes enter our body through our skin and mucous membranes. So as you can see, it is virtually impossible to avoid colonizing some harmful bacteria with the beneficial bacteria. The problem arises when the bad begin to outnumber the good, and this can happen in these early stages of development.

The first sign of the bad outnumbering the good is when a baby becomes irritable, colicky, develops gas pains or diaper rash. This could be a result of the mother’s lack of sufficient probiotics. If the baby is not receiving enough probiotics from the mother’s breast milk or from its formula, it is at an immediate disadvantage. As we get older, we no longer have our mothers to blame or even to protect us from overexposure to the bad guys and we typically throw off the balance even more by eating unwashed or undercooked foods and forgetting to wash our hands before eating, not to mention the microbes we pick up from other human beings through kissing or sharing food and drink. And as mentioned earlier, the intestinal environment can be made even less conducive to the survival of beneficial flora under conditions of chronic stress, a compromised immune system, the use of antibiotics, or a poor diet. Just as a diet high in refined sugars and processed foods can compromise our enzyme production, it can create an unfriendly environment for probiotics.

By far the most common form of dysbiosis is candidiasis, a form of yeast overgrowth or fungal infection. There are many forms of yeast and some proliferate more easily than others. Since yeast is fungal in nature, they tend to thrive on sugar and fermented foods like alcohol and vinegar. Yeast is present in everyone and generally controlled by our beneficial flora. However, a diet high in refined sugars or alcohol can over time lead to an overgrowth of intestinal yeast and more serious health problems. Another major cause of this condition is repeated use of antibiotics. This is because most antibiotics are designed to kill both harmful and beneficial bacteria, but are essentially innocuous against yeast and other fungal organisms. The most common type of yeast that leads to candidiasis is candida albicans.

Initially, candidiasis may be accompanied by recurrent vaginal yeast infections, skin rashes, itchy eyes, sinusitis, and thrush or coated tongue. If left untreated, candidiasis can cause abdominal bloating, anxiety, constipation, diarrhea, depression, environmental sensitivities, food allergies, fatigue, brain fog, insomnia, PMS, ringing in the ears (tinitus), feeling worse on damp days or in moldy places, recurring bladder infections, and mood swings. There is a growing number of rheumatologists who believe that candidiasis is a root cause of chronic fatigue and fibromyalgia. Many naturopathic physicians believe that prolonged candidiasis can lead to even more serious illnesses like heart disease and cancer.

Part of the problem here is that conventional medicine fails to recognize candidiasis as a systemic condition. Abraham Hoffer, M.D., a pioneer in the use of nutritional therapies for the treatment of psychological disorders, estimated that up to one third of the population is affected by candidiasis. Even among physicians who acknowledge candidiasis as a legitimate health condition, the typical response is to administer an antifungal drug and leave it at that. The problem with this approach is that, while it may kill off the active yeast organisms that are currently causing the problem, when the patient stops taking the drug the spores that were unaffected by the drug then mature into their full fungal form. Oftentimes, the yeast can be so ingrained in the tissues and organs that it would take months of drug treatment to make a significant difference.

The most effective and efficient way to deal with any form of dysbiosis is by attacking it from all fronts. But first you must acknowledge dysbiosis as an imbalance within your system — a disease condition. To put this into the proper perspective, think of a cold, a flu, or any of the many conditions mentioned above as merely symptoms of this underlying condition. As these symptoms may come and go, often without any targeted effort on your part, the underlying condition remains. This is why the symptoms typically reoccur, sometimes quite frequently and at varying intensities. In other words, the underlying condition – the dysbiosis — will not simply correct itself without some concerted effort on your part.

If you are unsure as to whether you currently have dysbiosis, there are diagnostic tests you can undergo. Perhaps the most accurate and reliable method is a Comprehensive Stool Analysis. This can be done by ordering a CSA kit through your health care practitioner and collecting stool samples (typically over a 3-day period) and sending them off to the lab for analysis. What you get back is a comprehensive report identifying and detailing the microbial makeup of the bacteria in your colon. The report will typically include descriptions of any harmful bacteria (pathogens) along with profiles of the herbal or pharmaceutical items that are most commonly effective at dealing with the alleged invaders.

While the CSA is a quick and effective way to verify the existence of dysbiosis, these tests can be rather expensive, especially if your physician has not recommended the test for coverage by your health insurance. However, there is certainly nothing preventing you from treating suspected dysbiosis even without a confirmed diagnosis. Since the foundation of any treatment plan for this condition consists of improving the quality of your diet and taking nutritional supplements to improve your digestion and enhance your immune system, you will only get healthier in the process. If you have been experiencing some of the symptoms mentioned above for some time and they go away after making these nutritional and lifestyle changes, there’s your diagnosis. If you are someone who needs help with identifying the symptoms of dysbiosis, some health practitioners actually use a questionnaire that designed for this specific purpose. These can be extremely effective at identifying patterns of symptoms associated with dysbiosis. There are even special questionnaires for candidiasis.

Regardless of our method of diagnosis, you need a comprehensive game plan for treating dysbiosis and restoring normal gut flora. Here is a list of proven steps:

1. Hit the bad guys head-on with a powerful herbal compound. Since herbs are essentially drugs, you do not want to start taking them without some guidance from a health professional who has experience in working with them, like a nutritional consultant or herbalist. The purpose of this approach is to knock out the most active offenders first and make it easier for your immune system to deal with the rest – to level the playing field so to speak.

2. Adhere to a strict diet consisting of whole, natural foods, including plenty of meat proteins, and eliminating all forms of refined sugar and alcohol and limiting processed foods. Eating a healthier diet will make it easier for your digestive system to handle its main job while trying to reestablish a normal gut flora. Studies have shown that there is a marked drop in T-cell production after ingesting refined sugars. Focusing on taking in adequate protein will provide a boost for the immune system.

3. Supplement with probiotics. As described above, probiotics are the beneficial bacteria in your gut. Since dysbiosis represents a deficiency in the good guys, it is important to replenish their numbers with a good probiotic supplement. These probiotic bacteria also ferment the dietary fiber, producing short-chained fatty acids that are essential for maintaining the health and integrity of the colon. While these organisms occur naturally in cultured foods like yogurt and cottage cheese, it is not wise to rely on these foods as your sole source of probiotics because of their relatively high sugar content in the form of lactose. However, the bacteria commonly used to make yogurt — Lactobacillus bulgaricus and L. thermophilus – can be found along with other probiotics in most probiotic supplements. Probiotic supplements come in many forms (freeze-dried, tablets, powders, liquid, etc.) and vary greatly in quality. The most effective products tend to be in live cultures contained in capsule form. Because they are live cultures, they must be kept refrigerated. At the minimum, a good quality probiotic may include L. acidophilus, L. bifidum (or bifidobacteria infantis for children), L. bulgaricus and L. thermophilus. A typical dose per capsule will be one billion microbes of each species. This should be taken two to three times per day, preferably first thing in the morning and at bedtime.

4. Supplement with digestive enzymes and betaine HCL during meals. As mentioned earlier, a state of dysbiosis is almost always accompanied by a deficiency in digestive enzymes and/or stomach acid. It is during this time that your digestive system needs a little extra help from the outside so that you can digest, absorb and assimilate the nutrients from your foods that your immune system so desperately needs.

5. Boost your immune system with phytonutrients, herbs, and antioxidants. Phytonutrients are prevalent in fresh vegetables and fruits like spinach, grapes, apples, parsley, swiss chard, broccoli, asparagus, squash, etc. Juicing your vegetables can be an effective way of getting these nutrients in a more concentrated dose. Fresh wheat grass is loaded with oxygen-rich chlorophyll, which promotes beneficial flora and supports liver function. Supplementing with proven immune enhancers like vitamin C, vitamin A, echinacea, zinc, astragalus, goldenseal, pau d’arco, and grapefruit seed extract is also recommended. There are many products that have a combination of many or all of these substances.

6. Take fiber supplements in between meals. Most of us do not get the recommended 25-30 grams of dietary fiber per day. Dietary fiber is essential for proper elimination of harmful microbes and other toxins in our bodies. As the bad guys are dying off from the other methods being used here, they must be eliminated through your stool. Ideally, you want a supplement that contains both soluble fiber (such as guar gum or apple pectin) and insoluble fiber (such as cellulose). These are best taken with plenty of water between meals so as not to inhibit the absorption of other key nutrients.

7. Manage stress through daily, mindful practice. Since stress has such a tremendous negative impact on your immune system, it is important to do whatever you can to minimize it. Engaging in mindful practices like conscious breathing, meditation, or yoga relaxes the entire body and mind and has been clinically shown to release anti-stress hormones. These practices also increase oxygen throughout your body, which creates an unfavorable environment for harmful bacteria.

The length of time you want to be on such a program depends largely on the persistence of your symptoms. Ideally, should continue the supplemental regimen for at least two weeks after the symptoms subside. In order to prevent reinfection, the dietary and lifestyle practices should be continued until they become a permanent part of your lifestyle.

If you suspect that your problem is candidiasis, based on the relevant symptoms listed above, then the most important aspect of your program is eliminating all sugars, alcohol and fermented foods. You may also want to take an herbal compound or drug that is specifically an anti-fungal agent. Consult with your pharmacist or nutritional consultant about this. As mentioned above, candidiasis is unique in that it tends to reappear after treatment is concluded. The amount of time it will take to eliminate candidiasis will range from one to six months, depending on the extent of the overgrowth and the compliance of the individual to his program. Even after the problem is under control, care must be taken to avoid a relapse by being more mindful of sugar intake, chronic stress, and use of antibiotics. Some people are naturally more susceptible to reinfection because of genetics, chronic stress, or hypoglycemia. These people must constantly be mindful of these causative factors and take special care to keep the little buggers under control.

Most people will find that once they have restored balance to their gut flora all of their nagging health problems, even the ones they have lived with most of their lives, seem to disappear. The only reason this approach is not more widely used is because it takes a fair amount of attention and practice. It is not the typical quick-fix approach that people and even many health care professionals prefer. However, balancing your gut flora is one of the most effective and responsible ways to restore and maintain good health.

Look for next month’s issue when we examine a condition called Leaky Gut Syndrome, which is to blame for many skin condition and food allergies and sensitivities.