SIBO and GERD/GORD with Dr Steven Sandberg-Lewis

In today’s episode, Dr Nirala Jacobi is in conversation with
renowned SIBO specialist, Naturopathic Gastroenterologist and
Professor, Dr Steven Sandberg-Lewis.


 


Dr Sandberg-Lewis is a highly regarded and well known
naturopathic physician. He has been a professor at the National
University of Naturopathic Medicine (NUNM) since 1985, in
Portland, Oregon.  Dr Sandberg-Lewis has a part-time
clinical practice and is the author of several Townsend Letter
award-winning articles, and of the medical textbook ‘Functional
Gastroenterology: Assessing and Addressing the Causes of
Functional Gastrointestinal Disorders’.  He
has also been named one of the Top Docs in Portland Oregon in
2014.


 


Topics discussed include:


How are proton pump inhibitors (PPI) related to SIBO?

How the 3 main secretions at the upper gate of the small
intestine are bacteriostatic, and how hypochlorhydria and PPI use
can support SIBO development.

Heidelberg testing and Weakly Acid Reflux.

How alkaline reflux can trigger the same symptoms as acid
reflux.

Loss of stomach mucosa in the absence of the acidic trigger.

Atrophic gastritis - what is it and how common is it?

Is reflux after meals normal?

Esophagitis - what causes it and what is it?

The role of alkaline saliva in bathing the esophagus to help
neutralise acid that may come up.

Leaky mucosa in the stomach, the connection to PPIs, and the
link to food intolerances and allergies.

Dilated intercellular spaces (DIS) in the oesophagus and
superficial nerve irritation in the oesophagus.

Do we use the same leaky gut healers for the upper gut - the
stomach and DIS?

Dry mouth as a symptom of anxiety and sympathetic dominance,
and the importance of relaxation in prompting saliva to bathe the
oesophagus.

Dr SSL and Dr Jacobi use therapies including glutamine, zinc
carnosine, n-acetyl glucosamine, gamma oryzanol, quercetin, and
demulcents to help heal DIS.

If a client has slight Barrett’s or erosive esophagitis and
is put on lifelong PPIs, is this the appropriate course of action
to support?

How do we slowly wean people off PPIs?

Sliding hiatal hernia and the possible cause of reflux.

What is the difference between hiatal hernia syndrome and an
actual hiatal hernia?

Advanced diabetes and issues related to autonomic neuropathy,
such as silent reflux.

Laryngopharyngeal reflux, the typical symptoms to look out
for, and conditions it is linked to.

Enlarged tonsils and the connection to laryngopharyngeal
reflux.

How do we test for low stomach acid?

Riddler’s reflex point for stomach acid.

Pectoralis major test for hypochlorhydria.

Heidelberg test.



Bile Reflux - what causes it?

Dysplasia and cancer of the lower oesophagus and the theory
linking these conditions to duodenal gastroesophageal reflux.

What treatment can we do for Bile Reflux?

The importance of endorphins and enkephalins in the
contraction of the sphincters in the body.

Chapman’s reflex point to improve the tone of the pylorus
(taught by Dr SSL in the GI practicum in November)

Nutrients to help to heal Barrett’s and prevent cancer
include selenium, turmeric, green tea catechins, anthocyanidins
(found in berries and colourful fruits and vegetables).

Top causes of reflux to pay attention to besides SIBO:

Hiatal hernia

Hiatal hernia syndrome

Pancreatic insufficiency

Spasmodic diaphragm

Anxiety, or conditions that decrease client’s saliva or
makes saliva more acidic (eg sjogren’s, elderly)



Digestive Support for lack of saliva production

Use zanthoxylum (prickly ash) - 1-2 drops on the tongue,
and/or bitters as a digestive stimulant.

Pilocarpine lozenges



What is Dr SSL’s opinion on methane and PPI use - being there
there is potential for PPI users to have less methane output, and
conversely for Hydrochloric Acid (HCl) users to have increased
methane production.

What is the appropriate dose of HCl for patients and should
we use capsules or tablets?

The combination use of bitters plus HCl.

Rebound hyperacidity - why can it occur after taking PPIs?

Buteyko breathing for upper digestive symptoms.



 


Resources


GI Practicum in Australia on 10th-11th of November 2018

Reserve your spot



Healing Leaky Gut, stomach, and DIS

Dr SSL and Dr Jacobi use therapies including glutamine,
zinc carnosine, n-acetyl glucosamine, gamma oryzanol,
quercetin, and demulcents.



Dr Steven Sandberg-Lewis

Medical textbook - Functional Gastroenterology: Assessing
and Addressing the Causes of Functional Gastrointestinal
Disorders by Dr Steven Sandberg-Lewis



Mim Beim

Buteyko breathing for upper digestive symptoms