There is an enormous number of bacteria that grow in the colon but many people don’t realize that bacteria can also grow in the Small Bowel. The lower end of the small bowel is where the most bacterial growth is found and this can be problematic.

If there is an overgrowth of bacteria present in the small bowel, they feast on contents that come down the pipeline. The more undigested foods that hit the small bowel the more there is for bacteria to nourish on. This is why it is so important that you ensure you are digesting your food.

Digestion actually starts in the mouth. When you take the time to cook your food and smell the aromas your body begins digestion by secreting enzymes (salivary amalyase) in your saliva, this is the first step of chemical digestion of carbohydrates. This is the first issue with fast food, your body is not primed for digestion. Next cells of your stomach called parietal cells secrete HCl and the chief cells secrete pepsinogen and gastric lipase. If you are stressed, eating on the go, on your phone and not eating with other human beings chances are you are not producing enough of the critical enzymes to break down your food. This is why I recommend consuming Digestive Enzymes or Betaine HCl with Pepsin to help out. Not only will you not properly digest your food which in itself creates gas and bloating but if you do not have enough acid in your stomach dysbiosis may develop.

In addition to digestive juices, bile production is critically important to keep bacteria from growing in the small intestine. 

If you think removing the gallbladder is no big deal… think again!

Did you know bile (produce in the liver and stored in the gallbladder) not only is important for absorbing fats but also for regulating the bacteria in your small intestines?

If you do not have adequate bile, you are at increased risk for bacteria growing in the small intestine and developing a condition called SIBO or small intestine bacterial overgrowth (bacteria should not be in the small intestine)

The key to getting rid of SIBO the goal is to stop feeding the bacteria and support adequate bile production.

The classic “SIBO-safe” diet (per Dr. Allison Siebecker, et al.) consisting of:
• animal protein (eggs, fish, seafood, poultry, beef) ** Because vegan and vegetarians are often deficient in choline
• lactose-free dairy (aged cheese, 24-hour yogurt, heavy cream) *** I would remove dairy
• healthy fats (coconut oil, EVOO, butter)
• low-FODMAP vegetables
• low-FODMAP fruits (including bananas, berries, oranges, pineapple)
• nuts and seeds (small servings)
• treats: dark chocolate, peanut butter
• rarely: low-FODMAP starches (potatoes, rice, gluten-free bread/crackers)

Does this look familiar? Looks like a paleo, low-moderate carb diet to me (as long as you don’t overconsume the fruit). For people who report better digestion, and less bloating and pain on my program or a keto diet this may be why!

Now, how do we support someone who has a gallbladder but might be concerns of SIBO (gas, bloating, pain, constipation, diarrhea)?

It’s simple, ensure they are consuming dark leafy greens! Leafy greens support methylation. Methylation is required for lots of reactions in our body but lets look at one for now. When choline (found in meat proteins) is methylated it becomes phosphatidylcholine. As it turns out you need phosphatidylcholine for proper bile production.

Gallbladder problems are more likely in those whose methylation is compromised. This is where testing genetic SNPs come into play. If you have methylation issues you may want to supplement with active folate (5MTHF). Please don’t consume vitamins that contain folic acid (synthetic folate). If you have gallbladder issues one underlying reason they may have developed is due to these methylation deficits, so what can you do? Consume dark leafy greens too!

Last note is the synthetic form of B9 is called folic acid. It is found in processed foods and unfortunately in our grains (bread, cereal, cornmeal, flour, pasta, rice, other grains) and prenatal vitamins. The synthetic folic acid binds to receptors on your cells and blocks natural folate from binding. Even if you are consuming foods like leafy green vegetables and you think you are getting enough folate, it will likely be struggling to get into cells. Without enough methylfolate you risk methylation deficiencies. In short synthetic folic acid blocks methylation.

If you are looking to supplement with folate choose methylfolate, if the bottle says folic acid throw it away. In addition, if you have known methylation issues I would highly recommend a paleo style diet which will remove the grains mentioned above which are “enriched” with folic acid.

Now if you are struggling with gas and bloating in general and your gallbladder is functioning optimally, then the focus should be on the TYPES of foods you are consuming. 

# 1. Focus on Protein & Fat:

When you consume protein and fats there is little growth of bacteria and as a result little gas production. The Standard North American Diet which is typically high carb provides fuel for the rapidly growing bacteria and they actually ferment the carbs creating gas. To combat this consume a lower carbohydrate diet focusing on complex carbs.

Overgrowth of this carb loving bacteria is called small intestine bacterial overgrowth or SIBO. The gas created increases pressure and may cause the acid of the stomach to regurgitate into the esophagus.

Often times a low carb diet can improve symptoms of GERD because fewer carbs for the bacteria to ferment. But use caution because when the bacteria die, they may release a toxin creating flu-like symptoms. This “die off” reaction may create flu-like symptoms when you start a low carb or intermittent fasting plan.

Here are some other tips to help deal with GERD as well as general gas and bloating.

• Exercise & Weight loss
• Establish mealtime routine and be calm at meals
• Cook gas-producing foods like broccoli, cabbage, and beans in seaweed granules *** Has anyone tired this? I just learned about this one.

Aggravating factors
• Over-eating
• Coffee
• Tobacco
• Spicy foods e.g. cayenne, ginger, fennel

• Increase soluble fiber e.g. Gugar Gum: helps protect the mucosa
• Elimination diet: start with gluten & dairy

Herbal Therapy
• Gentian aka Gentiana lutea: will increase the tone of the lower esophageal sphincter. This is the sphincter or doorway that should prevent the contents of the stomach from coming back up into the esophagus
• Marshmallow aka. Althea officinalis, Fennel, Slippery Elm aka. Ulmus rubra – demulcent
• Chamomile tea aka. Matricaria recutita – decrease inflammation, increase healing

• Deglycyrrhizinated licorice: helps to heal the lining of the digestive tract **caution may increase blood pressure.
• Digestive enzymes: provide your body with the enzymes to help break down food.