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Posts Tagged ‘gut-brain axis’

10 signs of SIBO

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10 signs SIBO & difference between IBS and SIBO. The FODMAP diet and why it’s not for everybody. Most digestive problems like IBS are formed by lifestyle; our nutrition & our daily stress. Digestive complaints — constipation, diarrhoea, heartburn and bloating are very common.

The IBS diet

Most digestive problems like IBS and SIBO are formed by lifestyle; our nutrition and our daily stress. Digestive complaints — constipation, diarrhoea, heartburn and bloating are very common. SIBO can leave us feeling tired all the time. SIBO or IBS? (read on)…

We shouldn’t have to live with them though.


SIBO is Small Intestinal Bacterial Overgrowth. It’s often confused with IBS (Irritable Bowl Syndrome).
Dysbiosis is a microbial imbalance on or inside the body. 10 Signs of SIBO — read on…

FODMAP, GAPS paleolithic diet, pegan diet, sirtfoods, sugar free. What’s our take on these?

London Nutrition expert Susannah at The Bulgari Hotel, Knightsbridge and The Chelsea Private Clinic uses a functional approach. This can help identify between SIBO and IBS.

Digestive issues affect gut healthLondon naturopath and osteopath Susannah looks at total body wellness. Her gut health assessment links dysfunction to skin issues, stubborn belly fat, tiredness, low immunity, musculoskeletal pain, etc…
— How can you actually use this? —

SIBO test

SIBO test

10 signs of SIBO

1. Gas 2. Bloating 3. Diarrhoea 4. Abdominal pain or abdominal cramping 5. Constipation (much less common than diarrhoea) 6. Diagnosis of IBS or IBD irritable bowel syndrome or inflammatory bowel disease
7. Food intolerances such as
and more
Can we get rid of food intolerance for good? Drop us a line. How can we help answer your food intolerance questions?
8. Chronic illnesses such as: fibromyalgia : chronic fatigue syndrome : diabetes : neuromuscular disorders
autoimmune disorders
9.  Nutrient deficiencies and their associated symptoms: Vitamin B12, A, D, E, iron, other B vitamins, fat, protein and carbohydrate malabsorption.
Carbohydrate intolerance-symptoms se.g. bloating or pain or gas or fatigue after eating.
Fat malabsorption.
10. Joint pain

SIBO test

SIBO Breath Test This is the gold standard. However, it’s quite cumbersome. Individuals must fast for 12 hours, breathe into a small balloon, ingest a precise amount of sugar and repeat breath samples every 15 minutes for 3 or more hours. Abnormal breath tests also can signify pancreatic insufficiency and celiac disease.

Organix Dysbiosis Test or Urine Organic Acid Test This functional medicine lab test the urine for by-products of yeast or bacteria in the small intestine. If your small intestine is housing a yeast or bacterial overgrowth, byproducts will appear in your urine, indicating their presence. This test is much easier for patients and only requires one single urine specimen. This is the test I use most often in my clinic.

Comprehensive Stool Test This is also a functional medicine lab test looking at the flora of the large intestines.

History By listening to our patient’s history and symptoms oftentimes, this can reveal far more than any test. The question is, can we make a diagnosis of SIBO in order to effectively treat it?

SIBO diet

The goals of treatment for SIBO and IBS are In The Four Phases.

PHASE 1) correct underlying cause PHASE 2) provide the 2 PHASE plan: nutrition support to target the cause 3) Nutritional support to treat side-effects of malabsorption 4) treat bacterial overgrowth

The standard treatment for SIBO is an antibiotic called Xifaxan or Rifaximin. You may be prescribed this by a prescribing physician as part of our clinic team. Because Xifaxan isn’t well absorbed throughout the body, it mostly stays in the gut. So, it’s effective against SIBO. The antibiotic – probiotic combination is carefully considered @ Susannah Makram Clinics. The right amount of probiotic is incorporated into your FOUR PHASE treatment.

Nutrient supplementation is only effective to target your primary health concern when administered in this supervised manner.



Sibo Treatment

So now you know the 10 signs of SIBO. Generally, it’s advised to adopt a long-term diet low in carbohydrates. Specifically, refined carbohydrates. HOWEVER, Candida overgrowth is more common in those susceptible to SIBO. So we may set ourselves up for more issues with low carbohydrate diets thus.

EAT DRINK TAKE MAKE for SIBO and IBS. What it is. Personalised nutrition in the 4) phases. What it’s not: a generic FODMAP Diet or the GAPS Diet – in fact it’s not a diet at all! Functional Nutrition with Susannah is designed to be effective by its practical nature that fits into your lifestyle as well as the specially designed methodical approach it takes to heal your gut.

Child’s Environmental Allergies


Addressing your child’s environmental allergies? Allergies aren’t always easy to identify. Know if your child is prone to allergies to begin with– it’s a good start. Naturopath and Osteopath Susannah with special interests in functional nutrition answers readers of Small Magazine ‘s question:

My husband suffers from environmental allergies so we’re worried about our child developing them, too. What should we look out for? 

Susannah Makram, registered Naturopath and Osteopath answer RE: Your child’s environmental allergies

A child who sneezes or coughs a lot, who frequently develops a skin rash, hives (urticarial) or eczema (atopic dermatitis), asthma or difficulty breathing may have environmental allergies. Hives often itch or sting and can spread. Skin is red and irritated with eczema and occasionally results in small, fluid-filled bumps that may become moist and ooze, typically across the child’s extremities.

Any child may develop such allergies, and they are more common in children from families with a history of such reactions – notably, allergic reactions share a genetic link, while specific allergies do not. Studies also show a gender-specific genetic link in inherited allergies.

Allergic rhinitis, or hay fever, is the most common childhood ailment caused by allergies. Symptoms include a runny and itchy nose, sneezing, postnasal drip and nasal congestion. If you suspect your toddler has allergies, look out for itchy, watery, red eyes and chronic or recurrent ear problems.

Allergy Symptoms

Allergies and asthma often occur together. The same substances that trigger hay fever symptoms may also cause asthma signs and symptoms, such as shortness of breath, wheezing and chest tightness. This is called allergic asthma or allergy-induced asthma. Certain substances, such as pollen, dust mites and pet dander, are common triggers.

Most Common allergens

Allergies are the most common cause of chronic nasal congestion (a stuffy nose) in children. Your child’s nose may be congested to the point that he or she is breathing through their mouth, especially whilst asleep, which can lead to tiredness or irritability the next day. If nasal congestion and mouth-breathing are left untreated, they can affect the growth of teeth and the bones of the face.

Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections and decreased hearing. As a baby whose hearing is impaired for any reason while learning to talk, your toddler may develop poor speech.

The most to least common allergens: pollen, grass, dust mites, moulds and weeds, so do observe your toddler around these.

Allergy Food

Ninety per cent of food-allergic reactions are to peanuts, eggs, milk, (shell)fish, wheat, soy, tree nuts.

All allergies range in severity from minor irritation to anaphylaxis —a potentially life-threatening emergency. Anaphylaxis causes confusion, rapid heart beat/palpitations, swelling of lips, tongue, throat, bluish skin, nausea, dizziness, fainting. If you suspect that your child is suffering from allergies, make an appointment with your GP or a paediatric allergy specialist to assess the situation.

Food Intolerance Test UK

Food Intolerance Test

Food sensitivity or food intolerance: where, when, how? Common food intolerances to gluten; wheat intolerance; dairy; yeast; alcohol; histamine… Food sensitivity or food intolerance are hard to identify ourselves. HERE’S WHY…


Clients for functional nutrition in London may have lots of test results to hand. Every one of them has produced VARYING DATA. How unhelpful is that? We understand your frustration at Susannah Makram Clinics.


Allergy or Intolerance

Only about 2% of the adult population are affected. A FOOD ALLERGY is a SWIFT RESPONSE by the body’s immune system to a specific food. Reactions to food allergy are immediate by raised levels (2 hours or less)….

 food intolerance symptoms

food intolerance symptoms

Keep reading for the symptoms of food intolerance. So, they’re difficult to self diagnose. Also, food intolerance test results aren’t helpful if we don’t:

(i)    Know where the triggers can be found in our day to day diet
(ii)   How long we need to avoid the foods
(iii)  Know why we are suddenly reacting to food we ate without any problems whole our entire lives. Does this mean we have to              avoid all these food completely now forever?

That’s not all…

A recent study has shown that those who eliminated trigger foods based on food-specific IgG test results had reductions in weight, BMI body mass index, waist and hip circumference and improvements in all indicators of quality of life that were measured. Quality of life indicators include physical and emotional wellbeing, mental health, social life, pain levels and vitality.

Food Intolerance Symptoms

Food intolerance symptoms — bloating; eczema; sinus problems, lead us to ask: is the food we’re eating making us ill?      [tweetthis hidden_hashtags=”#foodintolerance”]Do you think that the foods you are eating are making you ill?[/tweetthis]
Genuine food allergy is relatively rare. Food intolerance symptoms like migraine, tiredness, bloating affect up to 45% of us. Why? 

Many Symptoms can be linked to food intolerance and they include…

Abdominal pain | Aches and pain | Acne | Bloating | Constipation | Chronic Fatigue Syndrome | Diarrhoea | Atopic Dermatitis or Eczema | Fatigue | Irritable Bowel Syndrome | Itching | Fluid Retention | Headache | Hyperactivity | Migraine | Nausea | Rashes | Rhinitis | Sinusitis | Stomach Cramps | Tension | Tiredness | Urticaria or Hives | Weight Loss/ Weight Gain

An Independent Customer Survey conducted by Allergy UK (2007), carried out on 5,286 people – the results were then divided into patient groups and the findings are summarised here:

Main Medical Condition Reported                  % of People Who Reported Moderate to High Benefit

Gastro-Intestinal  e.g. IBS, Bloating etc                                          80%
Respiratory  e.g. Asthma, Breathing Difficulties, Rhinitis           72%
Neurological  e.g. Migraine, Headaches                                        78%
Dermatological  e.g. Eczema, Acne, Psoriasis                                 76%
Musculo-Skeletal  e.g. Arthritis, Rheumatism                                64%
Psychological  e.g. Depression, ADHD, Panic Attacks                  81%
Others  e.g. Lethargy, General Feeling of Malaise                          79%


Food Intolerance Symptoms

Food Intolerance Symptoms

There are no international standards available for tests that measure food-specific IgG antibodies. The only way that a particular food specific IgG test can be shown to be valid is by carrying out clinical trials.

Benefits of Food Intolerance Testing at Susannah Makram Clinics:

| Hospital standard laboratory tests

| Utilising laboratories with over 30 years’ experience in the field of diagnostic testing

| Four tests available at Susannah Makram Clinics

| Fast turnaround of results

| Comprehensive results reported as individual food tested by name labelled as having: – Reaction, Borderline, No Reaction and  applied to be Safe, Clinical, Practical, Effective for you and your needs inside your Naturopathic Portfolio
If you’re overwhelmed by the idea of making drastic changes you’re not alone. Many tests produce false positives. Take the right test but not without seeking advice to unlock your potential – your Body Youth Code.

Pain and Gut Inflammation

As a London Osteopath offering a complete care pathway for low back pain and musculoskeletal strains and sprains we do need to include the element of nutrition for total body wellness. Chronic pain change our bodies internal environment

  1. Pain and gut inflammation – what is pain? Defining it  & Redefining it  – A gold standard method for measuring Pain does not exist in practice. There is no universally recognised unit that can, in the present day, be called into existence.
  2. Background – History of Pain – Pain Discovery – Measuring Pain – In the 1940s, a group of doctors at the University of Cornell set out to create a unit of pain intensity. Using the “dol” as a unit, the physicians created a 21-point quantitative scale. Their hot pursuit of knowledge was perhaps reflected in the means by which they gathered relevant data. They tested pain reactions on medical students and women in labor between contractions. Also, they did this by burning their subjects. Understandably, such methods were deemed controversial and “dol” never quite caught on as a unit of pain measurement. Subsequent attempts at method justification, for the sole purpose of recruiting a unit measurement of pain, did not receive the required research grants. It would seem that inflicting pain artificially, or allowing for the natural occurrence of this experience, could not morally accommodate for a study of pain that would be of significant future benefit to the suffering individual.


Consequently, the National Institute of Nursing Research reference that “Pain remains a uniquely personal experience that cannot be measured objectively.”        [tweetthis]#Pain remains a uniquely personal experience that cannot be measured objectively[/tweetthis]

  1. Two definitive categories should be used to inform the pain medicine practice of all health care professionals: Acute Pain – This can be defined as pain that lasts less than 6 weeks, or pain that is directly related to tissue damage. The pain that is experienced from a paper cut or from standing on a tack is acute pain. Pain that is felt after an operation is acute pain; it is severe, but we expect it to go away. Chronic Pain – This can be defined as pain that lasts longer than 3 months. There are at least two different types of chronic pain problems — pain that has an identifiable cause, (an injury), and pain with no longer an identifiable cause (the injury has healed). Most of chronic pain is of musculoskeletal origin.
  2.  Other terms used to describe or define pain include: Neuropathic Pain – Mechanical
    Inflammatory – Chemical (Metabolic) – Somatic – Visceral Referred & Ischaemic Pain
  3. Clinically, the most common tests to diagnose inflammation include measuring erythrocyte sedimentation rate (ESR), white blood cell count, and albumin levels (and other biomarkers) These tests are nonspecific; that is, an abnormal result might result from a condition unrelated to inflammation. Such non-specific tests do not account for IBS and SIBO for example.
  4. If you are seeking solutions by way of nutritional therapy, recognising signs and symptoms of gut health and acute, sub-acute and chronic inflammatory process, as well as being able to interpret laboratory reports thus, is unique and invaluable when it comes to getting results for healthy weight loss, unexplained fatigue etc.
  5. The principles of Naturopathy were first used by the Hippocratic School of Medicine in about 400 BC. The Greek philosopher Hippocrates believed in viewing the whole person in regards to finding a cause of disease, and using the laws of nature to induce cure. It was from this original school of thought that Naturopathy takes its principles.

Other Referenced Definitions Of Pain

Pain is what the person says it is, existing when and where the person says it does.” (McCaffery & Beebe, 1999)
Margo McCaffery is a Nurse Consultant who has published widely about pain medicine. What she is saying here is that pain is individual to the patient, the best judge of the intensity of the pain is the patient, and that the patient should be believed. This definition of pain is taught to all nursing and medical students.
The International Association for the Study of Pain (IASP) defined pain as: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (IASP, 1979)
The importance of this definition is that it includes pain that may occur without any recognised stimulus, and it also introduces recognition that pain is influenced by our emotions.
The British Pain Society have a useful glossary of medical terminology, on which pain is defined as:-
“…An emotion experienced in the brain, it is not like touch, taste, sight, smell or hearing. It is categorised into Acute pain – less than twelve weeks duration and Chronic pain – of more than twelve weeks.
Pain can be perceived as a warning of potential damage, but can also be present when no actual harm is being done to the body.”

Bad Gut Health Symptoms

Bacteria in gut

BEST SELLING PRESCRIPTION DRUGS. These drugs are changing our gut bacteria. What does this mean when we’re after good gut healthEVERY YEAR there’s a list of the top selling prescription drugs. (Read on to find out what these are).

Nutrition expert Susannah assesses gut health  our gut health reflects our overall health.

At our London clinics we find patterns in YOUR HEALTH STORY. What does this mean exactly? Gut health and gut bacteria is a topic of overwhelming interest in functional healthcare right now.


The types of bacteria in our gut are summarised here. Gut bacteria are either growing in number or dying.
Our gut microbiome depends on 1) nutrition 2)lifestyle 3) environment. READ ON for 7 SIGNS we have an UNHEALTHY GUT
Gut bacteria rely on what we’re feeding them. The good bacteria we hear about is the one we try to cultivate. More about good and bad gut bacteria and gut health probiotics can be found here.

The top 25 best selling prescription drugs

The top drugs prescribed to the world include cholesterol-lowering drugs or statins. Also, drugs for chronic pain. Top of the chronic pain list are Humira an anti-inflammatory for arthritis   and oxycontin and vicodin. These tally high for pain relief consistently. Insulin glargine injection for type 1 diabetes, metformin for type 2 diabetes and asthma medications like albuterol also rank in the top ten. Several antacids like omeprazole and other drugs for indigestion always rank high.

Research firm IMS compiles a rolling 12-month history in the US. The pharmaceutical industry publication Genetic Engineering and Biotechnology News (GEN) do as well.

Gut Health

Gut health refers to the function or dysfunction of the gastrointestinal (GI) tract.

How do we maintain gut health? Any impairment of the Gut lining can increase the risk of developing infectious, inflammatory and functional GI diseases. An example of gut lining impairment is leaky gut syndrome.

As well, impairment can increase risk of extra-intestinal diseases, such as immune-mediated and metabolic disorders. GI barrier impairment can increase risk of immune-mediated & metabolic disorders.


Bad Gut Health

Bad Gut Health

Less clear, however, is whether GI discomfort in general can also be related to GI barrier functions. In any case, methods of assessing, improving and maintaining gut health -related GI functions are of major interest in preventive medicine. It is worth looking out for your body’s bad gut health symptoms.

A healthy gut

When we feel something’s not quite right, often it’s more than just a gut feeling. As powerful as those are, our precious health calls for understanding and finding solutions. The more we know, the more we can do. Signs of an unhealthy gut are below.

  1. You have a lowered immune response. 70-80% of our immunity to infection and disease is controlled by your gut microbiota.      [tweetthis]70-80% of your immunity to infection and disease is controlled by your gut microbiota[/tweetthis]      Your immune system launches a response, resulting in inflammation. This response might include recent developments of food allergies or food intolerances that you are experiencing later on in life.


  2. You experience unexplained changes in your weight. Bowel and bladder habits are affected. E.g. IBS, digestive issues such as gas and bloating.
  3. You suffer from tiredness that is unexplained. As featured by the Mayo Clinic, studies are connecting bacteria to its effect on energy absorption. “Researchers have identified a difference in the types of bacteria found in a lean person’s gut versus those that live in the gut of someone who is obese. The amount of energy is small, but researchers wonder if over time this could be a factor in weight maintenance.”
  4. You suffer from mood swings, anxiety disorders, depression, poor memory, poor concentration, ADHD or ADD. These may be due to inflammation in the gut. The gut-brain axis explains this.
  5. You have or have had autoimmune disease. Autoimmune diseases examples are alopecia areata, Coeliac disease, RA, MS, vilitgo, Raynauds, SLE, reactive arthritis, Addison’s disease, Psoriasis etc.
  6. You have skin conditions that are recurrent. Typically your skin issues are non responsive to medication. they don’t respond well to medical grade topical solutions and treatments. Or, they are a temporary solution, until the next outbreak. An example is adult acneacne vulgaris or eczema or rosacea
  7. You have diabetes or insulin resistance. This can be affecting your fertility, whether you are male or female.

Safe, clinical, practical and effective.

Call  020 7060 3181