Episode 14: Why Your Gut Isn’t Breaking Down Food Properly
H. pylori, Functional Dyspepsia & Chronic Bloating
Have you ever felt painfully full after just a few bites of food? Do you struggle with bloating, upper abdominal discomfort, nausea, burping, or the sensation that food simply sits in your stomach for hours?
In this episode of Team Gut Girls, Dr. Whitney Baxter, ND, Dr. Christina Carew, ND, and Dr. Dominique Vanier, ND unpack one of the most misunderstood digestive conditions: functional dyspepsia.
You’ll learn why chronic digestive symptoms can persist even when blood work, imaging, and endoscopy results come back normal. The doctors explore the important role of H. pylori infection, how dyspepsia differs from acid reflux, why bloating occurs, and what the latest research says about the gut-brain connection.
They also break down common myths about H. pylori testing, discuss the pros and cons of proton pump inhibitors (PPIs), explain when symptoms may signal something more serious, and share practical strategies to help you better understand your digestive health.
If you’ve been told “everything looks normal” but still experience digestive symptoms, this episode will help you understand what’s happening and what questions to ask next.
Because Better Gut Health Changes Everything.
WHAT YOU’LL LEARN:
• What dyspepsia actually is and why it’s often misunderstood
• Common symptoms including bloating, nausea, early fullness, and stomach pain
• The difference between organic and functional dyspepsia
• How H. pylori can contribute to digestive symptoms
• Why blood testing for H. pylori isn’t always enough
• What functional dyspepsia means when tests appear normal
• The connection between IBS and functional dyspepsia
• Risks and benefits of long-term PPI use
• Diet, lifestyle, and gut-brain strategies that may help
• Important red flags that require medical attention
00:00 Why Your Gut Isn’t Breaking Food Down Properly
01:01 Dyspepsia Symptoms Intro
02:23 Organic Causes and H Pylori
03:50 Functional Dyspepsia Explained
06:09 Myth Busting H Pylori Testing
11:11 Stress Ulcers and Treatment Debate
17:10 Normal Endoscopy Still Symptoms
18:58 Why Dyspepsia Causes Bloating
24:02 Testing Algorithm and Next Steps
26:51 PPIs Benefits and Long Term Risks
30:08 DIY Strategies Food Herbs Brain Gut
38:31 Tracking Questions and Red Flags
42:07 Final Recap and Takeaways
Links to Other Episodes
Episode 5 Disorders of Gut-Brain Interaction
14 Why Your Gut Isn’t Breaking Food Down Properly
Dr. Christina Carew, ND: Welcome to another episode of Team Gut Girls, where your favorite naturopathic gastroenterology gut-focused doctors, come together to dispel myths and help you to understand what your, doctor and the internet is telling you. I’m Dr. Christina Carew, I’m joined by Dr. Whitney Baxter and Dr. Dominique Vanier.
And today we’re going to talk about…
Dr. Whitney Baxter, ND: Something if you’ve ever felt uncomfortably full after a few bites of food. You might have felt like this before, it’s quite common. Felt like food just sits in your stomach or you’re having some, higher abdominal pain, bloating, burper- burping or nausea, maybe some burning.
This episode is for you. Today we’re talking all about a gut connection called dyspepsia and a bacterium called H. pylori [00:02:00]
Dr. Dominique Vanier, ND: okay, so these clusters of symptoms is referred to as what we collectively call dyspepsia. And one of the things that makes dyspepsia confusing is that it’s not actually a diagnosis.
You wanna think of it more like a collection of symptoms. but there’s actually an exception to this that we will go over pretty thoroughly in this episode. Functional dyspepsia is a real diagnosis.
Organic Causes and H Pylori
Dr. Dominique Vanier, ND: So let’s talk about when someone develops dyspepsia. The next question is, why? And sometimes there is an identifiable cause.
We call this organic dyspepsia. so we think about, organic dyspepsia, this is where we start when we’re trying to determine what’s going on with somebody, and we’re gonna look for things like stomach ulcers, if they are on certain medications that have led to these symptoms, gastric or even esophageal cancer.
And one of the most common causes worldwide, which we are really diving into deep today, is Helicobacter pylori, or H. pylori. [00:03:00] And like Whitney just mentioned earlier, this is a bacterium that lives in the stomach, and in some people it causes inflammation of the stomach lining, and that’s where we see all these symptoms.
It’s really due to this level of inflammation that’s happening. So we’ll see things like upper abdominal pain, burning, nausea, indigestion. And because it’s such an important cause of dyspepsia, current guidelines will recommend testing for H. pylori pretty much right away when patients present with these symptoms
Dr. Christina Carew, ND: Okay. So if someone tests positive for H. pylori, we have our answer. It’s this whole reason why we have upper abdominal pain, bloating- … burning, right. it’s super simple, and our episode is now over, so we can- We can go home. so some- this is where, it’s a little bit nuanced. So sometimes yes, but, it does get interesting.
Functional Dyspepsia Explained
Dr. Dominique Vanier, ND: So many people with dyspepsia symptoms test negative for H. pylori. They may have gone on to have, an endoscopy, which is the scope that goes through the mouth into the stomach into the [00:04:00] upper part of the small intestine, and that can be normal. They don’t have any obvious structural explanation for why they feel the way they do, but they still have symptoms, and that’s where functional dyspepsia comes in.
So it’s not a structural issue, it’s a functional issue. And we’ve talked a lot about other functional digestive issues on other episodes. But functional dyspepsia is what we call dyspepsia symptoms that really can’t be explained by anything else, other conditions that are, that we have already worked up for.
So interestingly, this functional dyspepsia counts for up to 80% of dyspepsia cases in clinical practice. So today’s episode, we’re really trying to have a goal of helping you make sense of your symptoms. We’re talking about when there may be an identifiable cause, such as H. pylori. Now, number two, why many people continue to have symptoms even when testing is normal, and what functional dyspepsia actually means.
So if you’re [00:05:00] listening and you’ve ever been told, “All your tests are normal, everything’s good. You look fine,” but you are downing Pepto-Bismol like it is your job. You’re sneaking into the boardroom by yourself and drinking Pepto-Bismol. This is the one for you. And before we get into a bit of myth-busting, s- segments on, H.
pylori, dyspepsia, functional dyspepsia, I wanna be really clear on what functional dyspepsia is. And so clinically, we do define it in a certain way. It’s when somebody has one or more of the following bothersome digestive symptoms. So they may have this uncomfortable fullness right after they eat. They may feel, an early satisfaction or early satiety.
They may or may not have this upper abdominal pain, and they may or may not have upper abdominal burning. So they can have one, they can have all. and also it’s important that we have, done a full workup and ruled out other causes. Okay, so with that introduction, let’s [00:06:00] go into some myths and misconceptions, and I’ll pass it to you guys.
We’re gonna talk a little bit about H. pylori and functional dyspepsia and where they overlap.
Myth Busting H Pylori Testing
Dr. Christina Carew, ND: Okay, so First myth: A blood test is the best way to test for H. pylori. And so this one’s actually interesting. I actually did a deep dive on this topic because I was really curious. where I live and where Dr. Dominique lives, it’s very common that we’ll see the medical doctors run an H.
pylori blood test. but this is actually really rare. It’s actually not run almost anywhere else in the country or in any other country. and so depending on where you’re living, this may not even have been given to you as an option, but perhaps presented by ChatGPT. And the one thing about the blood test is it measures antibodies, and so an antibody says, “Has my body seen this [00:07:00] infection ever?”
it doesn’t necessarily mean that it is today. It doesn’t mean that it was, nine days ago or nine months ago. it just says that, my body has seen this infection at some point in time, and it, recalls seeing it because we’re getting this pattern that’s showing up in the blood. And so the way that this blood test is sometimes used in practice is that people will be like, if you’ve never been treated for it before and this test is positive, you may as well be treated now.”
And so that may or may not be the best option for someone, to pursue because the treatment for H. pylori, if you’ve ever had it, is pretty invasive. So it’s a lot of antibiotics. It’s for a long two-week period of time. Most people feel terrible on them. and it doesn’t always get rid of your symptoms.
So keep that in mind. So the preference is actually, a stool antigen test or a urea breath test. So those can still be performed at the same labs. Depending on [00:08:00] where you live, sometimes those are covered under your health coverage, but not always. So it depends on where you are. typically, if someone in my practice shows up with a positive blood test, I’ll send them for the breath test just to make sure before we, give you a whack of antibiotics.
and so sometimes another way that it can be diagnosed is in an endoscopy. So an endoscopy is a camera that goes down into your esophagus and into the, stomach, and it’s actually looking for evidence of this bacteria inside the stomach lining, so they do a biopsy for it. and it’s not really a perfect testing method because when we think about the stomach…
So our skin on our body, we can have a rash on our elbow, and if someone looks at our knee, then it’s not necessarily gonna help us. And so the stomach is if you took your comforter and pushed it all together into the size of a hot water bottle, and then you try to look at it and [00:09:00] be like, “Oh, is there something in there?”
It’s not always the greatest way to be able to visually see something. Sometimes it’s really obvious. It’s, in a part of the stomach that’s easily locatable. but not always. And so these other tests which rely on making a gas or seeing a bacteria in the stool are a little bit more reliable ’cause they actually don’t care, like, where someone looked in the stomach lining.
And none of them are perfect. They do re- require you to either do the breath test correctly, get the stool antigen in the sample that it’s there, or look in the right spot for the endoscopy. don’t be alarmed if you get a negative but still feel like you might have it. It may just not be…
It’s not a perfect test. but, if someone is, already taking medication like PPIs to prevent some of that heartburn, antibiotics, the Pepto-Bismol that Dr. Dominique talked to, about earlier, that may also be [00:10:00] another reason why sometimes we see false testing, either in breath, stool, or endoscopy testing.
So just keep in mind there are lots of ways. There’s also, sometimes there’s these, stool antigen markers on these private stool lab tests, and just to be, like, conscious of those aren’t necessarily similarly not detecting an active infection. They may have been detecting a past infection. And so you always want to be sure that the symptoms that you’re having are aligned with an active infection before you atom bomb your insides with a whole bunch of antibiotics, ’cause it may or may not help
Dr. Dominique Vanier, ND: I, it’s interesting.
That’s a good point there. I once had a patient where she was taking really high levels of ginger and a few other herbs, and, she went for an endoscopy because she had all the symptoms for H. pylori, and it came back like she had a normal endoscopy, but she actually was infected. It just, it came up as a false negative.
[00:11:00] So important, right? These tests are not perfect, although they’re all pretty good. other myths, that we know of about dyspepsia or H. pylori
Stress Ulcers and Treatment Debate
Dr. Whitney Baxter, ND: I’ll get into a myth, all about stress, ’cause we love talking about stress and how it impacts our gut. So a myth is stress can cause stomach ulcers, which cause dyspepsia, so all of those symptoms, the burning, the early fullness.
Everyday physiological stress does not directly cause peptic ulcers in most people. The most dominant causes are H. pylori infection and actually NSAID use. So like Advil, these anti-inflammatories that people take for pain for whatever reason. But roughly 16 to 31% of ulcers have neither H. pylori or NSAID use as an identifiable cause, suggesting [00:12:00] other co-factors, potentially stress, must contribute in some patients.
So there is this group of people that this could be going on. As we’ve talked about a number of times, stress is not good for our gut. It just doesn’t allow it to fully function and digest properly, so we’re often left with undigested foods or improper release of stomach acids, digestive enzymes, poor movement or motility.
It may not be the primary cause of your stomach ulcer, but it will exacerbate this functional dyspepsia
Dr. Christina Carew, ND: Okay, myth three. This one’s a biggie. So if I’m H. pylori positive, but I don’t have the symptoms that we talked about earlier, like the burning sensation in the stomach or stomach pain, you should not treat it. And so this is really a, great debate. There’s a consensus paper that was done in Asia that talked about how, some, Asian countries like Korea actually [00:13:00] test all people who are 18 years of age, and if they’re positive for H.
pylori, then they treat them for it because they actually see long-term it reduces the amount of stomach cancers they have in their population. Wow. And a pretty high prevalence of stomach cancer in that population as people aging, so this is like a preventative public kind of health endeavor. we know that about 50 to– 30 to 50% of people that have H.
pylori are actually not symptomatic or not symptomatic in this like traditional way where we’re seeing it. sometimes there’s some like weird things that come up. I have a patient that was positive for H. pylori and had a weird skin rash. That was their only symptom. But once they were treated for H.
pylori, skin rash went away. So that was like kinda unusual. sometimes people will have constipation from H. pylori, which is kinda interesting. We don’t always see that ’cause it’s a bit higher up. But remember that like our gut is all connected, and so a signal in one place that’s disrupted can make everything kinda [00:14:00] change.
we do know from the current research that about 2 to 6% incre- or you have a 2 to 6% increased fold chance, meaning like doubling, to tr- to six times. I don’t even know what six times is. Hextupling? I’m sure I made that up. At risk of gastric cancer if, if you have a positive H. pylori infection, whether you have symptoms or not.
And so you are increasing your risk of gastric cancer without it. And we know that gastric cancer, if anyone’s had anyone in their lives that had it, is really hard to get rid of, and the incidence of, death is pretty high. and so if, if we are able to treat it, and there is some, a large RCT that looked at, 22 years after someone was treated for H.
pylori, what was their chance of getting gastric cancer, and it was reduced by 50%. So not perfect, [00:15:00] but certainly still helpful. And so our guidelines in North America currently say if someone is positive for H. pylori, they should be treated with antibiotics. So a long way around of saying if you’re positive, even without symptoms, you should consider getting treatment because it has some long-term effects that might be really worthwhile
Dr. Whitney Baxter, ND: And people are often afraid of antibiotics, right?
they don’t want to take them if they feel good. Like, why would I take it if I didn’t even know I had this? But using these numbers and the risks, and just breaking it down for people, yeah, this is a really hard protocol. I want you to try to get to at least 10 days. I’m gonna check in with you, and we, just go for it.
And it’s hard, but people have had to buy, because there’s quadruple therapy. There’s lots of medications going on. But, Monday to Sunday, daily medication things, just to keep it easy, don’t think about [00:16:00] it, just do your best. So just, supporting our patients through this protocol is sometimes the best that we can do
Dr. Dominique Vanier, ND: And I think a, good role that naturopathic doctors play there, ’cause, f- at least in Ontario, th- all of those medications are out of our scope, but it’s the education part, and I’ve certainly talked to quite a few patients where one of those…
one of the medications in the quadruple therapy is a proton pump inhibitor, which is an acid reducer, and that’s there for an important reason. it actually brings out the bacterium in its more act- like it’s more, active, phase, we’ll call it, so that it makes the antibiotics more effective.
So if somebody’s on it, we don’t wanna just take three of the four, right? We wanna make sure we’re doing the full protocol if possible.
Dr. Christina Carew, ND: And we wanna make sure that they do probiotics. Yeah. And there’s some research around some other things that, naturopathic care might include, lactobacillus or NAC or bile openers that may actually make the antibiotics work a bit better.
Yes. So there could be some things that could be [00:17:00] additive, that may actually improve someone’s outcome of getting rid of it the first time.
Dr. Dominique Vanier, ND: Yes. Yeah, so many other supportive roles there.
Normal Endoscopy Still Symptoms
Dr. Dominique Vanier, ND: okay, so myth four is my endoscopy was normal, so therefore I don’t have dyspepsia. And somebody, let’s say that they’ve, done the, H.
pylori test and that’s negative, and at some point they’re sent for the scope that we referred to earlier, and this is where it’s a little bit confusing. So an endoscopy is gonna rule out any of those primary causes of dyspepsia, like the ones we’ve discussed, H. pylori, stomach ulcer, et cetera. You wanna think of it like those are the organic primary causes.
But if somebody’s endoscopy is normal, it can mean that they have this functional dyspepsia, and that is a disorder of gut-brain interaction. So we’ve talked extensively about disorders of gut-brain interaction in, I believe, episode five on this podcast, and people most commonly know, DGBIs, or disorders of gut-brain interaction, [00:18:00] as it relates to irritable bowel syndrome.
Functional dyspepsia also follows under that umbrella. So when somebody has dysfunctional dyspepsia, it means that they have all the symptoms like burning, bloating, stomach pain, and it’s partially due to a miswiring between the way the brain communicates with the digestive tract. Now, what’s also interesting is somebody can have a normal endoscopy, they may have dyspepsia symptoms, but they actually have gastroparesis, which is a totally different condition, and we have a whole episode on that as well, and, Dr.
Christina has spoken extensively about that in presentations to some of our colleagues. And that’s where our, stomach empties too slowly into the small intestine. So the point of this myth is that if your scope is normal, it doesn’t necessarily mean that all, is normal. It could mean that we have a functional condition happening.
Okay, let’s maybe dive into a bit more of the insight and education piece for the listeners.
Why Dyspepsia Causes Bloating
Dr. Dominique Vanier, ND: So I wanna [00:19:00] talk about why functional dyspepsia actually causes bloating. This whole series is on bloating, so we wanna figure out, like, why somebody would present with bloating. And, each one of us is gonna discuss what’s really going on in the body.
So I’ll start off. There’s actually no single mechanism that explains why somebody would have bloating when they have a diagnosis of dyspepsia, but there’s multiple things happening, and we wanna think of it in these, six key areas. So area one would be when somebody has functional dyspepsia, they have something called impaired gastric accommodation, and this is where the stomach is normally supposed to relax when we eat food.
But in this population of people, the stomach basically does the opposite, so it doesn’t appropriately accommodate the food that we eat during a meal, and that can lead to a few other things like this increased buildup of pressure, this early satiety, and a few other symptoms. [00:20:00] What are some other mechanisms going on?
Dr. Whitney Baxter, ND: So we’ve talked about this a lot before, too, but there’s… So it’s not accommodating, but then it’s not emptying effectively, so delayed gastric emptying. So this means that the stomach contents, so all that food that you just ate and it mashed up, is just going to sit there for longer. So you’re gonna get those signals back up to your brain that you’re full.
it makes sense that you could feel some bloating there. The resulting prolonged gastric distension, so this, physical pouching out, produces the bloating, the pros- postprandial fullness, so early fullness after you eat, and then early satiety
Dr. Christina Carew, ND: There’s, visceral hypersensitivity. So that’s when we have a normal amount of gas, food, or distension, but it can be still felt as painful or uncomfortable [00:21:00] even though it’s not exaggerated.
And so part of this, actually relates to our episode on mast cells. So mast cells are at the end of the nerve bundles. They create more sensation and turn on the fire alarms of things that are, making our body perceive things as a threat that may not be a threat, but they feel like that.
And so that sometimes is where we get some of the pain and discomfort from. And then, that leads into that is duodenal inflammation. So there’s inflammation inside the small intestine where the eosinophils and the mast cells, these sort of contributors to, sensation live. They … That inflammation can be seen as a contributor to functional dyspepsia.
and one of the things that when we have more inflammation, we have more leaky gut, so we actually talk about that in episode 11. and so you’re now [00:22:00] starting to see how, like, all of these conditions are becoming more difficult to, pull apart from each other because there is so much overlap in what causes what
Dr. Whitney Baxter, ND: And that’s where things like visceral hypersensitivity and this, low-grade inflammation, these are consistent through all the disorders of gut-brain interaction.
So we can start to treat these foundations for people, make, a huge jump, hopefully, in progress just to start to see some shifts and feeling better, instead of, “Oh, we don’t know what this is. It must be just a functional, must be IBS, or must be functional dyspepsia.” So there’s actually concrete things that the research is showing that we can do, which is always exciting.
So next, another piece we’ve talked about already in this episode, and almost every episode, is gut-brain axis dysregulation. So again, this is explained best by thinking there’s a miswiring between the brain and the gut. So they’re just yelling at each other [00:23:00] inappropriately, that there’s pain, we need to bloat now.
there’s something moving through our gut that’s normal, even though it might not be at all.
Dr. Dominique Vanier, ND: Yeah. And the last point, and of course, it, again, like Dr. Whitney said, everything just weaves into each other because one area will definitely affect the other. But we can see issues with peristalsis.
And so sometimes, but not always, that’s impaired in functional dyspepsia, and that’s gonna affect the speed at which things move from the stomach to the small intestine. It impacts motility, and then we’re more likely to see gas and bloating. And we did reference an important point before, which is interestingly, it’s up to 60% of people who have functional dyspepsia will have IBS.
So we can see, this overlap of bloating happening from, lower digestion and upper digestion. And if possible, we wanna be able to tease it apart, ’cause the treatment protocols are a little bit different sometimes for both. But for some people, they may actually have multiple conditions happening, which leads to some [00:24:00] bloating.
Testing Algorithm and Next Steps
Dr. Whitney Baxter, ND: So- Okay, let’s talk about how to approach this for people. There’s a testing algorithm, which is sometimes nice for us to see in the naturopathic medical world. We can, talk you through next steps and what to expect, whether you’re going mostly through the conventional system, because we cannot refer for imaging or scopes.
so for dyspepsia, an important point is that the endoscopy is the gatekeeper. So whatever happens with that endoscopy, what that result is, that’s going to diagnose all types of dyspepsia, and then you’ll know your next steps
Dr. Dominique Vanier, ND: And I did a presentation on this a little bit recently because it’s really that scope.
And so again, it’s out of the scope of naturopathic doctors, at least in Ontario. But when the decision is made by somebody’s family doctor or even gastroenterologist to do an endoscopy, it tends to be based on a few different things. But the guidelines from 2017 for [00:25:00] both Canada and the US do say that it has to do with age, typically, at least as, as a starting point.
And so somebody who is above 60 and has these dyspepsia symptoms is much more likely to be sent for an endoscopy versus somebody who is under 60. And the majority of people will automatically be tested for H. pylori. And again, we talked a little bit earlier about, what that first testing may look like.
Still sometimes it’s a blood test, but sometimes a stool test and sometimes a breath test. And if this is negative, then they will typically be given an empiric trial of a proton pump inhibitor, and that’s the main acid blocking medication. So again, they haven’t had a scope yet. they’ve been given a medication first to see if they respond to it.
If they still have burning stomach pain, bloating, et cetera, only at that point are they often referred for an endoscopy. And there’s certainly exceptions to this, right? If somebody has like a strong [00:26:00] family history of gastric cancer or if they’re like in a, in an area that has a higher rate of gastric cancer, that may change the decision-making process.
But what I think is important here is that symptoms alone cannot distinguish organic dyspepsia from the functional dyspepsia, which is again, more of a disorder of gut-brain interaction. And that’s where the endoscopy comes in, but not everybody gets a scope. And so some patients sit in this like diagnostic dilemma, we’ll call it, where we think that they have a functional condition, but we can’t say for certain.
We’re gonna treat, we’re gonna treat it though like they do anyway let’s maybe go into, when people are recommended a PPI and how that looks and the timeline there, and I’ll pass it to Christina for that in terms of what happens when somebody is given a PPI.
Dr. Christina Carew, ND: Yeah.
PPIs Benefits and Long Term Risks
Dr. Christina Carew, ND: So as Dr. Dominique referred to, sometimes you’re given a PPI, so they might…
They usually end in azole, lansoprazole, [00:27:00] pep- pantoprazole. they are usually in this, PPI family, which is a proton pump inhibitor. Sometimes if you have an allergic reaction or are not sensitive to those, you may be given an H2RA, which is a histamine 2 receptor antagonist. both of them are designed to lower the stomach acid in hopes that whatever is contributing to the symptoms, when the stomach acid is lower, just has an opportunity to heal.
So think of it as like a rest for your digestive system in some ways, where your body has this opportunity to heal because it’s not being irritated by the acid. and it should be a temporary measure. So most of the packaging instructions say, use this for up to three months. and what ends up happening, lots of times with pe- patients that come into our practice might have been on them for twenty-five years or thirty years.
and [00:28:00] is that an appropriate use of the medication, and what are some of the outcomes? We know that there are some other, things that we need to worry about from a, long-term care use. so certainly they have been associated with, increased fracture risk, increased risk of C.
difficile, low magnesium, renal disease, bone issues. certainly because we’re reducing the amount of absorption from our food because that acid isn’t breaking it down as well, we might be missing some of the nutrients. And often, once you’re on one of these medications, people forget to go back and check for those things.
And so that would be one important thing that you can advocate for yourself about. And there aren’t really guidelines around when to discontinue it. And so Often I actually have a, physician who’s a patient who came in one day and slid across this, pa- piece of paper, and there’s 25 medications on it.
And [00:29:00] I was like, “It looks like you got it all figured out.” And he’s “I don’t even know how to get off any of these.” And so I would say, we’re really good at understanding when patients need to be on something or trial something, but we’re not really good at knowing how to take them off. And there are some, pharmacists that can help with that.
There are some other practitioners that can help with that. But, typically coming off a medication, depending on what kind of medication it is, very different than going on it. So sometimes it’s, reducing the dose, sometimes it’s discontinuing altogether, sometimes it’s changing to different medications.
So don’t try to do this on your own. but, there may be some benefit in trying to come off of it. It doesn’t mean that all those symptoms are suddenly going to come back if they were gone. it may actually have resolved itself, and you’re just continuing to take the medication without really a need for it
Dr. Dominique Vanier, ND: Yeah, the de-prescription conversation I think is starting to happen a [00:30:00] little bit more, but if, it’s possible that somebody has an exit plan when they start a medication, then that’s important too, right? Yeah.
DIY Strategies Food Herbs Brain Gut
Dr. Dominique Vanier, ND: Okay, let’s maybe talk a little bit about some practical takeaways, some accessible, things that, the listeners can possibly DIY at home or at least be more mindful of regarding symptoms and what they’re eating.
we wanna keep in mind, though, that, functional dyspepsia is heterogeneous, and what we mean by that is no two people are gonna look exactly the same that have functional dyspepsia. So something that’s gonna work well for somebody may not work as well for the next or vice versa. so it’s really important to work with, your practitioner, naturopathic doctor, and find the right plan that fits for you.
But let’s dive into maybe some food, pain, and then brain-gut therapy. So we’ll start with, we’ll start with food.
Dr. Christina Carew, ND: So food can be challenging, right? We’ve talked previously about taking all the foods out of the diet and then being mindful [00:31:00] of, the fear of putting them back in, and so we always want to be careful around that.
And there are some sort of, universal things that are often told to people who are having dyspepsia symptoms, stop citrus or stop coffee or don’t have tomatoes. And, sometimes I would say that people come back in and they’re like, I’ve never tried that again ’cause someone told me to take it out.”
And back to our discussion earlier, I think that was in episode four, that, being mindful of how a food makes you feel is really important, but not excluding everything because, we’re both missing things that we might get some nutrition from, but also maybe missing things that we just enjoy.
And so food should be about eating and, not… and about having good time eating and not just, literally being stressed out about eating. So there are some dietary changes in this case that may, help. sometimes being mindful of [00:32:00] if you are taking that, medication that lowers the stomach acid, that may make some foods feel more triggering at a time because they’re not breaking down as well.
also being mindful of, other medications that you’re taking that may also exaggerate that. And tracking your diet as a starting point without taking anything out can be a great way to just see if there’s any commonality, and sometimes it’s actually something super underlying. So it might just be, foods with more fat in it, not that it is eggs or potato chips or avocado that’s making the issue.
It’s just in general, if I eat more fat, I have more difficulty with nausea, bloating, fullness, pain. and so if we can identify a food category like that, then we may also have a food category solution. And so we know that if we have better bile, if our body is able to break down fats a little bit better [00:33:00] by sometimes partnering them with other foods, we may see that the body’s actually able to eat those things.
It may be actually a volume piece as well, like how much of that are you eating? So if you’re on a keto diet, it’s very different than if you’re, adding it as part of your meal. and we do know that some things like FODMAPs have been studied to improve functional dyspepsia symptoms. Challenge, again, is that when we take all of that fiber out, then, we can actually slow down the transit system, which may make the bloating worse, but some of the other symptoms better.
And so always being mindful that tracking your food, can be helpful, but nothing’s ever an absolute, and nothing’s ever absolutely the same for every person
Dr. Whitney Baxter, ND: Okay, so let’s talk about some things that are going to help that stomach empty more effectively, and then decrease the pain. So again, like Dr. Christina alluded to, really working with your practitioner so we can hear, your history. [00:34:00] What’s making it worse? What have you tried? What are your symptoms?
Because some things, though they’ve been studied to help, for example, ginger, it’s great. It helps the movement of the gut. It, increases gastric emptying, so that stomach emptying. It’s an anti-inflammatory. It’s used in pain. But it could trigger some, burning or some discomfort. So just really working with your practitioner.
Maybe you do a little test dose, make sure it’s not flaring anything up. and then peppermint too. There are, like, enteric-coated peppermint capsules that can be really, great. They’re, they really relieve pain in many DGDIs. so I like those. And then probiotics. They can promote our ecosystem of microbiota and that gut-brain modulation, which may reduce hel- reduce the pain and visceral hypersensitivity just from that, microinflammatory standpoint along the gut mucosa [00:35:00]
Dr. Dominique Vanier, ND: Yeah, there’s so many other great herbs that can definitely help.
And then, but also sometimes, they don’t, right? Or sometimes they help in one area and then, for example, people that have concurrent reflux may be aggravated by peppermint. So again, important to work with your person who knows what they’re doing. another important takeaway that we’ve talked a lot about is the brain-gut connection.
And so there’s many well-researched therapies in this area, and that can… You wanna think of it like that can dampen some of these pain signals that are being sent to the brain from the gut. so things like gut-directed hypnotherapy has a lot more research behind it now than it did even five, 10 years ago.
Cognitive behavioral therapy. I know we’ve talked pretty extensively about diaphragmatic breathing and how that is supportive for the nervous system. And again, it’s about the central nervous system aspect or mechanism behind s- the pain in some people with functional dyspepsia. So often with, with, the recommended treatment [00:36:00] plans is, is really working on how the brain communicates the gut is, part of it for, at least for some people.
And then like we mentioned earlier, we wanna talk about whether there’s anything else going on, like a lower and upper digestive condition. So for some people with dyspepsia, they’re also gonna have that concurrent irritable bowel syndrome. And if they’re experiencing constipation as part of their IBS is that actually may worsen functional dyspepsia.
So important to figure out, do we need to move the bowels even a little bit better to see improvement higher up? Okay.
Dr. Christina Carew, ND: I would also, add to this is like hiatal hernia. So hiatal hernia can present like functional dyspepsia, where we’re getting symptoms, and sometimes it’s really challenging because in a hiatal hernia, the diaphragm is supposed to keep, the lower es- the esophagus from, and the stomach from, bunching up together essentially.
So it’s like a, level or a [00:37:00] shelf that keeps the stomach below the surface. And if the hole that the esophagus goes through is, overstretched, then the stomach can come through the hole And so why that sometimes is hard to diagnose is ’cause on a gastro exam, like an endoscopy, it may not be happening right at that moment.
And so it’s, like a thing that happens over time. It’s like running and you pull your, hamstring, and then you finally get into the physio and you’re like, “Wow, it actually feels okay today.” It’s like those things can shift and change. It’s not that you can’t have that whole overstretch where the, s- the stomach is coming up through the, it- up through the diaphragm.
It’s just like when you’re lying down under anesthetic on a table, it may actually not show up. And so some of these might be things where you do need to see an osteopathic practitioner, a physiotherapist, someone who can see you maybe quickly and also in those moments where you’re [00:38:00] getting some of the symptoms, because there could be some functional pieces behind it that we didn’t discuss here that may be contributing to the symptoms.
and so this isn’t, the only thing that might be happening if you have dyspepsia symptoms, so keep that in mind
Dr. Dominique Vanier, ND: The gut can be like the Wild West for some people because they can have a hiatal hernia, and they can have no symptoms at all. So yeah, it’s, this is where the testing and the workup is important.
Tracking Questions and Red Flags
Dr. Dominique Vanier, ND: And so on that note is when we are talking about this with our practitioner, let’s say somebody’s had, chronic symptoms that we’ve discussed earlier, and they’re really looking for help on this, is what are some kind of key takeaways that they can use, or what are some points that they can bring to their practitioner?
And even before they have that meeting, I think tracking is really important. So this is helpful for your practitioner because it shows that you’ve been collecting some data for a certain amount of time. So for example, [00:39:00] paying attention to whether there’s early meal fullness, whether somebody’s having pain or burning, and is that happening independent of meals?
Is it happening with meals? And also noting what makes it better or worse, and that would be paying attention to food, if it’s exacerbated by stress, if you went on vacation and you felt better, if you felt worse, things like that.
Dr. Whitney Baxter, ND: It helps you to really understand when things are starting to feel better too, right?
if there are subtle changes after, oh, you, I notice I have a lot of high fat foods. I didn’t think of that before, and I started this treatment, and that’s getting a bit better. So these subtle things that you can track really help just document, progress. So here are some questions that you can ask your practitioner, some more specific things.
So have we ruled out H. pylori, and what test did we do? So just a reminder, there’s the serum or the blood test, the breath test, and the stool test. [00:40:00] So they’re not all perfect, but we tend to lean towards the breath test and the stool test. If the PPI isn’t working, that proton pump inhibitor, what are my next options?
Should I try something to speed up the gut, so prokinetics, neuromodulators? So those are things like anti-anxiety medications that we’re using at a lower dose to help that pain, that gut-brain interaction. Is there anything I should try to remove in my diet? How long should I be on this medication before we reassess?
It’s really asking clear what is the plan, what is the taper up and the taper off. Is there a role for dietary changes? Is my stress contributing, or are there any supplements that have research in my case? And then finally, should I see a gastroenterologist, or can this be managed in primary care?
Dr. Christina Carew, ND: And then making sure you tell your practitioner if there are any, red flags. So red flags are [00:41:00] things like weight loss, vomiting, trouble with swallowing, not able to eat, even once a day because you’re finding that it’s, too irritating, so sometimes people will go on extended fasts, like making sure you’re telling someone that.
if there’s any blood in your, in your spit or vomit or anything that’s coming up from a… blood coming out, where it shouldn’t be perspective. Any family cancer history, any kind of issue with, pain or discomfort in the throat or the esophagus area, that may trigger some more urgent care.
And what we’ll do is actually put a lot of these into a handout that you can, download off, teamgutgirls.com, and then that way you can use that to track and bring into your, physician so that you have some more information, and you feel a little more empowered to be able [00:42:00] to, find out what’s going on and why.
Dr. Dominique Vanier, ND: We have so many great resources.
Final Recap and Takeaways
Dr. Dominique Vanier, ND: So let’s wrap up this episode. I wanna leave listeners with two quick recaps. Number one, if someone has stomach pain, early fullness, burning, and other upper digestive symptoms, we wanna rule out whether it’s caused by something else like H. pylori or if it’s, a functional issue.
So it’s not a structural issue, it’s a functional issue. And point number two being regarding the functional dyspepsia, you cannot fully treat the gut without treating the brain, and you cannot fully treat the brain without treating the gut. We wanna look at the whole thing as basically one system because they are so intertwined and impact each other.
So thank you for joining us today on another episode of Team Gut Girls, because better gut health changes everything
Be the first to comment!