The diagnostic criteria for Irritable Bowel Syndrome is defined by intermittent or constant abdominal pain (mild or severe) for at least three months, chronic constipation or diarrhea or both, and bowel changes. You might be faced with the following type of IBS:

• IBS C – IBS with constipation
• IBS D – IBS with diarrhea
• IBS M – IBS with mixed constipation and diarrhea

When IBS is suspected, a conventional approach would be to treat constipation or diarrhea with medication. For instance, a Gastroenterologist might offer Miralax as a solution for IBS C.

As a naturopathic doctor specializing in gastroenterology, I don’t want to just leave it at “the diagnostics”. I want to look at underlying causes. With IBS, there is often an underlying condition like SIBO or Fructose Malabsorption that is causing IBS discomfort. 

We can do better than treating IBS as a chronic condition. Often by the time patients come to see me, they haven’t had stool tests or other testing for dietary and food sensitivities. Here’s how I approach these cases:

1. Search and test for underlying cause
2. Improve mucosal integrity
3. Improve function

I prepare patients for and IBS diagnosis by studying their stool and monitoring lab work to find if there are any food allergies. I look at how digestion and absorption are working. Then I assess for leaky gut and SIBO if it looks likely. Labs can tell what the cause of IBS is and help us get to the root of the individual’s IBS symptoms. 

Whether it’s mucosal lining, SIBO, or other functional issues like abdominal adhesions, or decreased motility, there are alternatives to managing symptoms with medication (even though medications are fine to use while we are figuring things out). Until we determine the underlying causes of an IBS diagnosis, there are a couple of things to consider:

First, is a dietary approach to alleviating discomfort. Try a regular meal pattern. It helps with the mechanisms in the GI tract that improve motility. Avoid large meals. Reduce fats and insoluble fiber, caffeine and gas producing foods like beans, brassicas, and, onions. Stay away from foods that contain lactose and gluten. I often suggest a Low FODMAP diet as a first step in ruling out SIBO or Fructose Malabsorption. 

Second, is the increase in movement. Exercise helps in situations with constipation. If there is a lot of pain associated with your IBS, exercise can help mitigate pain as a result of the endorphins produced. Exercise is both functional and practical medicine in the case of IBS.

IBS is a diagnosis with symptoms that mirror other illnesses, so it can be hard to understand what exactly you are dealing with. As a naturopathic doctor with expertise in gastroenterology, I can help make sense of your symptoms and help you alleviate them.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post UNDERSTANDING IBS first appeared on Pacific Northwest Integrative Medicine.

And the last time you had a bowel movement did you check it out? I mean really check it out?

People rarely take time out of their day to think about poop. But they should. It’s an important part of daily life. A lot of people are constipated and don’t even know it. Constipation occurs when there is lack of ease or discomfort in eliminating the bowels, ideally on a daily basis.

There is somewhat of a stigma involved in talking about the body’s waste. Ultimately the lack of awareness related to this important bodily function is detrimental to overall health. I would like to open up the conversation and give you a place to start if you are wondering what exactly is constipation and if you are experiencing it at this time. Then, I will give you some naturopathic solutions that are found to address underlying causes and help alleviate constipation symptoms.

Take a look at the Bristol Scale (pictured below). It is a good visual and indicator of what your poop might look like on a spectrum from constipated to having diarrhea. Conventional medical guidelines say constipation occurs if stool is harder than type 3-4 (normal bowel movements) on the Bristol Scale. If your bowel movements are occurring less than three times per week and they resemble Type 1 or 2 on the Bristol Scale – lumpy, dry, hard to pass – you might be experiencing constipation (SOURCE)

Constipation can occur in both adults and children. There can be a number of underlying issues creating constipation, here are a few (SOURCE):

• Dehydration
• Poor nutrition – especially lack of fiber
• Lack of physical activity
• Stress
• Certain medications (including antihistamines, antidepressants, antispasmodics, antacids containing aluminum, blood pressure meds, opiates, iron supplements)

If you suspect constipation, you might be wondering how to repair your bowel function and get things moving.

Conventional primary care physicians generally recommend Miralax or a stimulant laxative like Senokot.

The naturopathic approach to constipation is a little different, and there are many natural agents you can try to alleviate the root causes of constipation prior to the use of laxatives. We start with the foundations: fiber, water, movement.

1. Hydrate. Start by adding water to your nutritional intake.
2. You might add fiber bulking drinks as a next step, but naturopathic doctors most often suggest dietary fiber in the form of fresh fruit, veggies and whole grains. 
3. Try to increase the amount of time you move your body (exercise) in a day.
4. I might prescribe magnesium or high doses of vitamin C as stool softeners.
5. Depending on the situation, I might suggest motility support.
6. I also often recommend the use of a stool, such as a Squatty Potty, to rest the feet on to make bowel function easier.
7. Self-abdominal massage has been shown to help with constipation as well.

Constipation is common, and natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post GETTING YOUR POOP TOGETHER first appeared on Pacific Northwest Integrative Medicine.

There is nothing like the beginning of a school year to send the minds and bodies of our family into a tailspin. Suddenly all the little things that went by the wayside over the summer start to add up. We’ve forgotten the importance of time management and nutrition. While scheduling movement during the workday is becoming impossible.

One of the most difficult components of back-to-school season is the stress it can bring on. 

Maybe you’ve noticed your family feels a bit off right now – schedules and immune systems. It’s no wonder. You just got comfortable with summer when the urgency of fall comes knocking on your door. 

It’s the perfect time of year to recalibrate a sense of normalcy in your home. 

Let’s get back to basics. Here are some important pieces of health and wellness that are of benefit to your family – mind, body and spirit.

Use the following information to guide your decisions as you re-establish back to school routines:

SLEEP  

Natural sleep rhythms change in the summer. We are awake more hours of the day because of the presence of sunlight. Especially in the northwest. When the school year gets underway, though, we need regular sleep for. 

It’s helpful to get back into a normal sleep routine before school starts. It is good for cognitive function, immunity, and overall wellness. Sleep requirements vary from 7-10 or more hours nightly, depending on age and individual requirements.

With teenagers in the house, it can be hard to get anyone to adhere to a common sleep schedule. Teens are at the age where it’s normal for their internal clocks to be geared towards a later bedtime and wake-up time. Did you know studies show that young adults function better in schools with a late start?

One helpful thing to try is the practice of sleep hygiene. Here’s what to do: 

• at least a week before school starts, go to bed earlier
• dim lights 
• take a warm shower before bed 
• listen to calm music 
• put lavender essential oil in a diffuser by the bed 
• put technology away before entering the bedroom

MOVEMENT

Movement helps the sleep/ wake cycle and supports both cognitive function and immunity. However, movement can look different for each person depending on individual physiology. It’s not a one size fits all solution. One form of movement that can be beneficial to all humans is mindful breathing.

Try the technique called box breathing. It is a simple practice you can incorporate into your daily routine: 

Breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds, hold for 4 seconds. 

Repeat.

NUTRITION

A whole-foods, plant-based diet has the best outcomes for overall health and immunity. That doesn’t mean you have to be a vegetarian. Rethinking how you add food to your plate is a good way to start. 

The first step is to fill your plate with vegetables (avoid letting meat take up the largest part of your plate). Next, supplement your plant-based meal with lean meat or eggs for protein. Then, add in nuts, seeds, and legumes. Finally, flavor your food with healthy fats such as olive oil or avocado.

FOUNDATIONAL SUPPLEMENTS

Especially in times of transition, our bodies might need extra support to function at an optimal level. One way to add support to your regular diet is to supplement your meals with foundational nutrients. 

Here are the key supplements I recommend at this time of year:

• Probiotic – Basic gut health impacts the way all other systems in your body work. A probiotic supports healthy digestion and immunity.
• vitamin D – Especially in the Pacific Northwest, people are often low in vitamin D because of the lack of sun. Getting tested for vitamin deficiency is important because it’s possible to get too much. I will recommend a maintenance dose if you are not deficient, and a repletion dose if you are deficient.
• Multivitamin with the active form of B vitamins – B vitamins help keep our energy levels up while supporting the nervous system and stress response.
• Fish Oil – supports cognitive function and mental health.

Rhythms of life change with the seasons. During the fall, many aspects of our daily routines are in transition. Focusing on a healthy lifestyle – sleep, movement and nutrition – can improve our overall cognitive function and immunity. In addition, this healthy lifestyle is an important stress management tool which helps us deal with change in a more productive way, both mentally and physically.

Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post BACK TO SCHOOL BASICS OF HEALTH first appeared on Pacific Northwest Integrative Medicine.

Eosinophilic esophagitis (EOE) is one of those specific types of diagnoses. 

A naturopathic approach to patient care looks for the root cause of an illness in order to relieve symptoms. The treatment of EOE requires a multifaceted approach, so my goal is to work in cooperation and conjunction with a patient’s Gastroenterologist.

Are you struggling with an EOE diagnosis and you’re not sure where to turn?

Following are some frequently asked questions patients have about EOE and its diagnosis and treatment.

What is EOE?

Eosinophilic esophagitis (EOE) is an inflammation that occurs when white blood cells infiltrate the mucosal lining of the esophagus. It is found in both adults and children.

What are the symptoms of EOE?

The main symptom of EOE is an increased difficulty in swallowing. For instance, if a patient were to say that swallowing certain foods had become problematic, like bread or meat, and they needed a lot of water to get those foods down, I would suspect EOE.

What causes EOE?

As with a lot of specialty cases, it is not yet well understood how someone might develop EOE. Here are a few things that can help us pinpoint EOE as the culprit in the inflammation process:

• ALLERGENS – The most common cause for EOE are allergens. We look at basic known triggers for all people: milk, eggs, soy, wheat (avoid these) and triggers specific to an individual. 

Fish, nuts, and tree nuts are not commonly associated with EOE but are more commonly associated with the symptoms of anaphylaxis

• GER – Gastroesophageal reflux (GER) occurs when stomach contents regurgitate into the esophagus causing irritation/ inflammation to the epithelial lining. This in and of itself makes it difficult to swallow. But the damage caused to the esophagus causes the lining to be more hypersensitive to allergens and then induces EOE.

How is EOE treated?

Generally, the initial diagnosis and treatment begins with a conventional approach by a gastroenterologist. However, there are many things a naturopathic doctor can do to support diagnosis and treatment of EOE.

Conventional Approach (gastroenterologist)

• eliminate dietary triggers
• endoscopy (biopsy and analysis)
• steroid therapy
• a balloon dilation if the esophagus narrows excessively (stenosis) 

Naturopathic Approach

• allergen panel
• elemental diet – no digesting, bowel rest, nutrients in w/out processing and observation for a change without dietary triggers
• supplements that will reduce hypersensitivity
• identify other potential causes for the excessive immune response

This integration of approaches is my specialty and what many who suffer from EOE prefer. I am able to decrease inflammation and fibrosis to support the therapies offered by a GI doctor – especially mucosal lining repair as a precursor for surgery or endoscopy.

One of the pillars of naturopathic medicine is to equip you with information so that you can make the most informed decisions about your health. In fact, at the heart of naturopathic medicine is the philosophy of doctor as teacher. My intention is to empower you to participate in your own healing process.

Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post FREQUENTLY ASKED QUESTIONS ABOUT EOE first appeared on Pacific Northwest Integrative Medicine.

This age-old story is one and the same when it comes to gut permeability and the havoc it can wreak on a person’s body.

Does leaky gut cause discomfort in the GI tract or is discomfort in the GI tract causing the gut to leak?

Let’s take a closer look:

Leaky gut is not an actual diagnosis. It is a term used by doctors to describe the deterioration of the mucosal lining in the small intestine. It’s theoretical at this point even though people are developing tests to learn more about why this deterioration happens.

When the mucosal lining of the small intestine is weakened it is called intestinal permeability or hyper-permeability. It’s normal for nutrients and water to permeate the lining of the intestine – that’s how it’s supposed to work. But when the intestinal lining becomes too permeable larger waste products and toxins leak out causing adverse reactions in the body. 

One obvious side effect of leaky gut would be low level food allergies found through a food allergy panel. As allergens leave the gut and enter the blood stream they can cause a response by the immune system. Other more severe indicators of leaky gut could be chronic conditions like:

• Chron’s Disease
• Colitis
• Celiac Disease
• SIBO
• Inflammatory diseases
• Auto-immune diseases

As there are no definitive tests for leaky gut – at this time it is only a theory – we constantly assess the reliability of the intestinal lining rather than running a myriad of tests to inform our treatment plan.

If you are experiencing symptoms of leaky gut, such as:

• abdominal pain
• diarrhea
• bloating
• always hungry
• poor nutrient absorption
• don’t gain weight
• do gain weight
• water weight gain.

It may be time to look at leaky gut from a naturopathic perspective. We can always improve outcomes by treating gut permeability, even if there is no “cure” for the overall syndrome.

Naturopathic medicine is instrumental in treating the underlying causes of illnesses. In the case of leaky gut, we can do that by looking into medications, stress, nutrition, food sensitivities, alcohol, and smoking – things that might cause the mucosal lining to become more permeable. Intervening when leaky gut is suspected can also help us understand if the hyper permeability is causing the symptoms or if the symptoms are causing hyper permeability.

As a naturopathic physician with a specialty in gastroenterology, it is my goal to equip you with information so that you can make the most informed decisions about your health. In fact, at the heart of naturopathic medicine is the philosophy of doctor as teacher. My intention is to empower you to participate in your own healing process.

Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for your health care needs. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

RESOURCES:

“Leaky Gut Syndrome.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/22724-leaky-gut-syndrome#:~:text=Leaky%20gut%20syndrome%20is%20a%20theory%20that%20intestinal%20permeability%20is,letting%20toxins%20into%20your%20bloodstream.

The post GI DISCOMFORT: COULD IT BE LEAKY GUT? first appeared on Pacific Northwest Integrative Medicine.

You may be experiencing GER.

Gastroesophageal reflux, or GER, is often referred to as heartburn, acid reflux, or even indigestion (STORY).

Typically, patients who have been experiencing symptoms like these:

• Nausea in the morning
• Fowl breath
• Epigastric pain – gnawing under the breastbone
• In children – regurgitation

might start with a visit to a primary allopathic doctor in hopes of alleviating day to day discomfort.

If symptoms become persistent, a Gastroenterologist might address more chronic issues. Absent of a long-term solution, often GI doctors prescribe temporary fixes like Protein Pump Inhibitors or Acid Blockers.  

Because they are meant to be a stop gap, and not a long-term solution, often these recommendations from GI doctors could potentially cause compounding damage. It is not optimal for a patient to continue treatment using PPI or Acid Blockers for an extended period of time.

Several observational studies have linked the long-term use to uncommon but serious adverse health outcomes. Here are just a few of the potential side effects of long-term use of PPIs (Lazarus):

• hip fractures
• community acquired pneumonia
• Clostridium difficile infections.
• acute interstitial nephritis
• acute kidney injury
• chronic kidney disease
• vitamin B12 deficiency (Lam)

What if you’re treatment plan for GER has led you to this point? What do naturopathic doctors offer beyond what a Gastroenterologist would?

It’s good to know that in the short term, your allopathic doctor and Gastroenterologist are able to provide helpful treatment options. Beyond that, a naturopathic doctor is able to come alongside and offer long term options that might alleviate the need for PPI or Acid Blockers and keep your treatment plan healthy.

I work with adults and kids who may be experiencing symptoms of GER. Together we locate the CAUSE of your discomfort. Treating the cause is at least as important as addressing the symptoms.

The causes of GER can be multi-factorial, so it’s important to treat the individual, not just the illness or symptoms.

From a naturopathic perspective, here are six ways you can find relief naturally:

GOAL: Increase Motility
OPTION: Address lower esophageal motility and offer solutions to support healthy movement.

GOAL: Decrease Inflammation in the LES
OPTION: Inflammation in the LES prevents it from closing well, resulting in perpetual reflux. I will make recommendations about how to encourage the LES to close.

GOAL: Decrease Inflammation in the esophagus or stomach
OPTION: Suggest ways to decrease inflammation.

GOAL: Reduce/ eliminate H Pylori if present.
OPTION: Provide testing to determine if H Pylori is present and treatment options as an underlying condition for GER.

GOAL: Decrease dietary triggers
OPTION: Recommend dietary changes and the addition of supplementation as needed.

GOAL: Increase healthy lifestyle
OPTION: A traditional naturopathic approach would look at lifestyle choices and make suggestions for improvement to movement, nutrition, sleep, and stress management.

As a naturopathic physician with a specialty in gastroenterology, it is my goal to equip you with information so that you can make the most informed decisions about your health. In fact, at the heart of naturopathic medicine is the philosophy of doctor as teacher. My intention is to empower you to participate in your own healing process.

Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for your health care needs. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

Resources:

Lam, Jameson R et al. “Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency.” JAMA vol. 310,22 (2013): 2435-42. doi:10.1001/jama.2013.280490

Lazarus, Benjamin et al. “Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease.” JAMA internal medicine vol. 176,2 (2016): 238-46. doi:10.1001/jamainternmed.2015.7193

Story, Colleen M. “Gerd vs. Ger: What’s the Difference?” Healthline, Healthline Media, 1 June 2018, https://www.healthline.com/health/gerd/ger-or-gerd#differences.

The post GER: SIX WAYS TO FIND RELIEF NATURALLY first appeared on Pacific Northwest Integrative Medicine.