People often ask me what the difference is between celiac disease and gluten or wheat intolerance/sensitivity. It is a good question, and can be confusing, so I would like to give some basic information regarding the difference. Of course, if this is something you are struggling with and need support, please make an appointment to see me, and we can discuss what might be appropriate for your particular situation.

Celiac disease and gluten or wheat intolerance are both conditions that can cause digestive problems after eating wheat. The reaction can be in response to gluten, a protein found in wheat, rye, and barley, or to the carbohydrates found in wheat, called fructans. However, they are distinct conditions with different causes, symptoms, and treatments.

Celiac disease is an autoimmune disease. This means that when someone with celiac disease eats gluten, their immune system makes antibodies against a part of the protein, which it then mistakes for a similar protein in the GI tract, and it attacks the lining of the small intestine. Eventually, this can lead to severe nutritional deficiencies, and associated problems such as anemia and osteoporosis. The treatment for celiac disease requires following a gluten-free diet for life. This means avoiding foods such as bread, pasta, cereal, and beer. Some people can be so sensitive that they must also avoid cross contamination from gluten, including using dedicated gluten free cookware and food prep surfaces. Some people may also need to replete nutrient deficiencies. Celiac disease can present with a variety of symptoms, including:

• Weight loss
• Diarrhea
• bloating
• abdominal pain
• fatigue
• blood in the stool

So then, how is wheat or gluten intolerance/sensitivity different? While they also involve a poor response to wheat, they are not autoimmune diseases. As mentioned, the sensitivity or intolerance can occur in response to either the protein gluten, or the carbohydrate fructans. Non-celiac gluten sensitivity can also involve an antibody response, but it is not an autoimmune response. (The antibodies are against the gluten only, not against the GI tract). A wheat sensitivity in response to the fructans, involves poor digestion and absorption of these carbohydrates. People with these types of sensitivities can experience symptoms similar to celiac disease, although are usually less severe, and don’t usually include blood in the stool, but can include:

• bloating
• abdominal pain
• diarrhea
• gas

People with gluten or wheat intolerance may initially benefit from following a restrictive diet, and later be able to add wheat back to their diets.  The only way to know for sure if you are dealing with Celiac disease or gluten/ wheat intolerance is to be examined and tested by a doctor for a diagnosis. I am a naturopathic doctor specializing in gastroenterology, and in a unique position to help you alleviate your symptoms from a whole person perspective. I perform a variety of functional diagnostic panels to get to the root of your discomfort, and also have specific nutritional protocols for you to follow based on your individual situation. Although restrictive diets are required in some cases, I believe they should be used judiciously and in cooperation with your medical team.

Natural medicine can work very well to improve GI health. 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.

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Inflammatory bowel disease (IBD) is a chronic condition that affects the gastrointestinal (GI) tract.

Here are five important things you should know about IBD:

1. IBD affects millions of people worldwide: IBD is a global health issue, with an estimated 3 million people affected in the United States alone. The condition is found in people of all ages, although it is most commonly diagnosed in young adults between the ages of 15 and 35. (SOURCE)
2. There are two types of IBD: Crohn’s disease and ulcerative colitis, and both can cause severe symptoms that significantly impact a person’s quality of life. Both are considered to be auto-immune diseases, which occur with an overactive immune system. Crohn’s disease can affect any part of the GI tract, from the mouth to the anus, but most commonly affects the small intestine and the beginning of the large intestine. It can cause inflammation that penetrates the full thickness of the intestinal wall and can result in a variety of symptoms such as abdominal pain, diarrhea, fatigue, weight loss, and malnutrition. Ulcerative colitis, on the other hand, affects the large intestine and the rectum. It causes inflammation that disrupts the inner lining of the intestinal wall and can lead to symptoms such as abdominal pain, bloody diarrhea, and urgency to have a bowel movement.
3. In order to rule out IBD, you must be able to rule out both Crohn’s Disease and ulcerative colitis. When IBD is suspected, diagnostic work up should include both a colonoscopy and an upper endoscopy.
4. While there is currently no cure for IBD, advances in medical treatment options have significantly improved the outlook for people with the condition. Medications such as steroids, other prescription anti-inflammatories, and biologics can help reduce inflammation and suppress immune system flare-ups. (SOURCE)
5. In addition, lifestyle changes can help manage symptoms of IBD, such as certain dietary approaches, including the SCD, IBD-AID, or elemental diets, avoiding trigger foods, staying hydrated, and managing stress can help improve symptoms and quality of life for people with IBD. Complementary and alternative therapies such as probiotics, omega 3 fatty acids from fish oil, acupuncture, and herbal supplements – such as Curcumin, and Boswellia – may also be helpful for some people. (SOURCE)

It’s important to remember that with IBD, treatment is not all or nothing. Often patients come to me hoping to avoid taking prescription medications. Natural therapies work better for some patients than others. For instance, those with mild to moderate IBD have a better chance of disease control with nutritional interventions and supplementation. Those with moderate to severe IBD might require medication, in addition, to achieve successful remission. It’s important for people with IBD to work closely with their healthcare team to develop a personalized treatment plan that addresses their unique needs and goals.

As a naturopathic doctor specializing in gastroenterology, I use laboratory measures and clinical presentation to monitor and determine response to treatment. This can be helpful to determine whether we need to modify protocols to reach the most beneficial outcome for each individual.

Natural medicine can work very well to improve outcomes in IBD. 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 FIVE THINGS TO KNOW ABOUT IBD first appeared on Pacific Northwest Integrative Medicine.

I’m not one for New Year’s resolutions, they are hard to stick to. Instead, setting life goals and intentions that can actually be obtained are more helpful. Especially after the health scape of the last few years, it’s important to take care of the issues that we’ve put on the back burner.

In the new year, consider getting in touch with your body and revisiting the health needs you have been ignoring. For instance, I have patients who have had diarrhea for years. Years. We have spent so much time in survival mode, it’s time to thrive.

If you are someone who has been experiencing chronic GI issues it is long past time to get it checked out. Ask yourself the following questions:

• Have I had intermittent GI pain?
• Alternating diarrhea/ constipation?
• Acid reflux?
• Bloating or gas?
• Unexplained, ongoing nausea?

Rather than pushing past the pain and guessing why you continue to have these symptoms, take the time to look into it deeper. I can help decipher what’s going on with your body through testing and by offering dietary modifications that will alleviate discomfort.

The big goal should be restoring normal function to your GI tract, your body and your everyday life. Don’t set a resolution this year; instead follow through on your intention to take care of yourself and to be well.

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 STARTING THE NEW YEAR WITH INTENTION first appeared on Pacific Northwest Integrative Medicine.

Often times rather than narrowing down information to achieve diagnosis, independent investigation adds a level of complexity to the issues at hand. It can be hard deciphering the nuances of the symptoms on your own.

Commonly, people who have diarrhea, gas, or bloating start by googling their symptoms and begin to modify nutrition based on perceived food sensitivities. They might suffer through discomfort, pain, or worse – long term damage – by merely managing symptoms. Not understanding the root of the problem, the symptoms of IBS and IBD may appear similar but in reality, the treatments are very different.

IBS is a functional issue; chronic symptoms that develop into a syndrome affecting the body’s systems. As the symptoms of IBS are alleviated, the function of the body can be restored and maintained.

IBD, on the other hand, is a pathological issue causing inflammation of tissues in the GI tract. It is a disease rather than a syndrome, often manifesting as Chron’s Disease or Ulcerative Colitis. As such, there’s more of an algorithm to the treatment of IBD than IBS.

If you have IBD and treat the symptoms, they might alleviate to some degree but won’t go away. There are three red flags that we look at when differentiating IBD from IBS:

• Blood in the stool (usually diarrhea)
• Weight Loss
• Fatigue

It’s important to get a definitive diagnosis if you suspect IBD and better to rule out the other (IBS). Rather than gathering and deciphering the information on your own, it’s useful to have someone help you narrow down what you’re dealing with.

As a naturopathic doctor with a specialty in gastroenterology, I will recommend specific labs that make the distinction between an IBS or IBD diagnosis definitive. For instance, I can perform basic blood work and stool studies, but if IBD is suspected I will refer you to a GI doctor for endoscopy and/ or colonoscopy to rule it out. The definitive diagnosis is achieved through tissue biopsy. I will partner with you by offering a more educated distinction between IBS and IBD than you would be able to correlate independently.

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 THE DISTINCTION BETWEEN IBS AND IBD 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.

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.