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Chris
Hello and welcome to the ending Body Burn Out Show, where your hosts, Chris and Filly co-founders of multi award winning Functional Medicine Practice, serving busy people with energy mood and got issues well.
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Filly
Busyness, overworking, addictive doing and perfectionism might be the norm. It's not normal and it's a major contributor to health issues.
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Chris
Our goal with this show is to give you a holistic route root cause approach to healing your body so that you don't have to continue doctor or diet hopping or popping a gazillion supplements hoping something might stick.
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Filly
So get ready to heal your body, get your spot back deeply, connect with yourself and step into the life of your dreams. Let's dive in. Hello. It is Filly here on the ending Body Burnout show. I am so excited to bring you today's episode with Dr. Neurology Kobi Now, this woman is amazing. She is a wealth of knowledge of all things, or small intestinal bacterial overgrowth.
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Filly
Quite a few years ago, when I started practising in functional medicine, I felt like there was a missing link in what I was doing in terms of gut health, doing a lot of comprehensive stool tests and looking at the large intestines and pathogens and leaky gut. But I found that there was some some clients who had really tricky health issues that weren't getting better with my usual methods.
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Filly
And so that's where I came across CBO and Dr. Nirala Jacobi. So she's known as the CBC doctor here in Australia and oh my gosh, did all her courses, all her certifications had some one on one mentor sessions with her. And she has been a huge part in our practice and especially how we treat certain health conditions, including CBD.
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Filly
So just as a a recap or a bio about Dr. Nirala Jacobi, So she's a natural plastic doctor, an internationally recognised expert on small intestinal bacterial overgrowth or SIBO. She is the creator of the SIBO Biphasic Diet, a resource that has helped tens of thousands of SIBOs sufferers, Iran around the world. And if you've worked with us, you have seen that this is a protocol that we use when treating Zebo.
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Filly
Dr. Jacobi is the host of the CBD Doctor podcast and the founder of the SIBO Doctor, an online educational platform that includes a practitioner certification program. She's also the medical director of SIBO Test, providing innovative testing options for SIBO and IBS. Dr. Jacobi is known for her systemic and effective approach to diagnosing and treating SIBO and other functional digestive disorders.
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Filly
Having received her naturopathy doctorate in 1998 from the esteemed BA star, I think I pronounced that right. University in Seattle, Washington. She brings more than two decades of clinical experience and expertise to her patient clinic, the Byram Clinic. So without further ado, let's jump into today's episode. Okay, So, so excited to have Dr. Neurology Kobi on our podcast today.
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Filly
Fangirl here, As I said in the intro, she has been a pivotal mentor in our own practice, especially in regards to gut health and treating SIBO. So let's dive in. How did you become a leading expert in gastrointestinal health and what got you into specialise in this area?
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Dr Nirala
Well, first of all, thanks for inviting me onto your podcast, Filipa. It's really nice to chat with a colleague who has herself so much knowledge in this field. So basically, you know, I was a natural doctor in America, primary care physician role in Montana, and basically I treated a lot of digestive disorders because people have, you know, crappy diets.
00;04;36;26 - 00;05;03;01
Dr Nirala
They have a lot of antibiotic use. And so we're very familiar with this type of presentation where somebody just has digestive issues. And so I always love that that side of naturopathic medicine because we believe the gut is the root of the treat, right? Without a healthy digestive system, we really can't be healthy. And so we see a lot of systemic illness actually arise out of digestive conditions.
00;05;03;03 - 00;05;35;07
Dr Nirala
But I've never heard of SIBO until I actually went to a conference in 2011 and a couple of colleagues had raised this topic and it was like a light bulb went off in my mind and it was like, this is the missing link of people that are just not improving with the things we do to help them overcome IBS and dyspepsia and reflux and gas and bloating and all the rest of it that we know about SIBO and as a as a major cause of IBS.
00;05;35;14 - 00;06;10;23
Dr Nirala
And they were improving with these very well thought out protocols. So I just dove into the research and, and also started testing my patients and I wasn't satisfied with how the testing was done. So I started my own testing company here and that's been going for about ten years now. And basically I found that it's just one of those really it can be very complex, but it can be very simple, but it can also be very complex.
00;06;10;23 - 00;06;28;12
Dr Nirala
And you and I have had conversations about how complex it can be and how many faces it can it can have. So but yeah, so it's been about ten years and I feel like I have a really good grasp of what SIBO is now.
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Filly
MM Yes, I had some sessions with you where I'm like, Oh my gosh, Tricky client. I've done all the things What now? And the things that you would just roll off that I hadn't even thought about. Oh my. This lady nurse says stuff it.
00;06;46;18 - 00;07;18;21
Dr Nirala
Well, you know her school of hard knocks and like I've been in practice for 25 years and you just have to think laterally and and as you know, there's so many different, different aspects to what we do. And the more we learn about different stuff, like the genomics stuff, for example, that was a whole piece that I had to learn myself to really understand what kind of genomic contribution was could, could mean that somebody has a hard time overcoming SIBO, for example.
00;07;18;24 - 00;07;23;11
Dr Nirala
So that was also I was learning along the way, you know. Yeah, a lot of it.
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Filly
Yeah. Yeah. So our podcast is dedicated to helping busy people who often have the patterns of overdoing high achieving perfectionism, people placing in their body burn out. Do you see a link between this type of people or like the behavioural patterns that they have and gut disorders?
00;07;43;26 - 00;08;35;23
Dr Nirala
Absolutely, yeah. That goes without saying. With SIBO specifically, I have to say it's usually the people that have a hard time over coming Siebel. It's not so much the underlying cause of Siebel that somebody has a lot of stress and that causes Siebel. It's not usually it can be a definitely a participating issue that entrenches somebody in chronic Siebel, but Siebel has very specific underlying causes, and sometimes, yes, if somebody has really sort of massive, massive, massive stress for many years, that can affect it to a level where it's possible that it can affect the upper gut motility, But just standard stress that we see day to day will definitely affect digestive disorders, but not
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Dr Nirala
necessarily cause Siebel. I hope I was clear.
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Filly
Yeah, it's kind of like it can affect the things that then can lead to savoury. So especially with the digestive organs not being able to produce stomach acid and yeah, a lot of produce out of biology kind of shut down those things. And what about with motility? So for people who don't know what that is, can you explain what that is?
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Filly
And then DC like is there a bit of a nervous system or stress link with motility?
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Dr Nirala
Sure. So I'm I'm, I'm kind of unsure if you if your audience actually knows what SIBO is. I'm sure you've had other podcasts about it to be.
00;09;15;22 - 00;09;22;09
Filly
Yes, I have talked about it. But how about just in case someone this is the first time they've ever listened to it.
00;09;22;09 - 00;09;57;19
Dr Nirala
Actually, someone just sent me a photo of it was, I think it was Who Wants to Be a Millionaire? It was actually a question. I saw that an Australian wants to be a millionaire. You know what is SIBO? So it was pretty funny. It's coming into the into the vernacular, but basically SIBO is a it's a condition where bacteria that are normally in very small amounts in the in the intestinal tract or in the small intestine are overgrown and that's a problem because this is where we absorb our nutrients while we digest our food and absorb our nutrients.
00;09;57;21 - 00;10;23;04
Dr Nirala
And this area is so vital for our wellbeing that there are lots of different checks and balances in place from the body to ensure bacteria don't overgrow. So you mentioned stomach acid. We make healthy amounts of stomach acid to digest our or to start the process of unravelling proteins and breaking them down into peptides and pancreatic enzymes further this process.
00;10;23;04 - 00;11;15;02
Dr Nirala
And then we also have bile that's secreted from the gallbladder to help them calcify fats. And all of this is also these digestive juices are very bacteria's static, so they prevent bacterial overgrowth. But then we also have a very strong motility wave in the small intestine that's sort of imperceptible to us for the most part. Sometimes when your stomach is really growling because you're hungry, that's actually the migrating motor complex, which is part of the enteric nervous system, and it is a sort of cleansing wave that ensures that the small intestine is kept relatively free of bacteria and it sweeps up the food and along with it any sort of bacterial massive bacterial overgrowth for
00;11;15;02 - 00;11;48;24
Dr Nirala
the most part. So those are the primary checks and balances that that exist to prevent bacterial overgrowth. But when you have a situation that like, for example, a case of food poisoning has happened to to you, and that that can actually damage the migrating motor complex because it induces an autoimmune response that then damages this cleansing wave. And so even though your bowel movements may not be affected, you may still have some problem with motility.
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Dr Nirala
And as you mentioned, there are also other conditions that can affect the motility of the upper gut. And that's a major sort of category of what causes Siebel.
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Filly
Mm hmm. Well, while our on that topic, what are some other ways that motility can become damaged?
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Dr Nirala
Well, independent of the migrating motor complex, we also have vagal dysfunction. And certainly you have you have probably talked a lot about this on your podcast because it is very in vogue to talk and to mention the vagus nerve because it is so important for our digestive tract. So for your listeners, you've heard you've probably talked about the fight or flight syndrome or response, I should say, where we have a the autonomic nervous system that regulates how we respond to perceive threats.
00;12;43;20 - 00;13;07;26
Dr Nirala
And the sympathetic nervous system is also known as the fight or flight. And then you have the rest and digest, which is the parasympathetic nervous system response. And the parasympathetic nervous system is very much related to the digestive processes, as the name implies. An integral part of that is the vagus nerve, which integrates many organs along the way, along the ways.
00;13;07;28 - 00;13;33;20
Dr Nirala
So it's, you know, when you have mass of stress that can definitely affect the autonomic nervous system and the vagus nerve itself, which which is considered the main highway between the gut and the brain, also known as the gut brain axis. So there's a lot there that's not necessarily just related to motility, but other other factors as well.
00;13;33;23 - 00;13;42;00
Filly
Yeah. And then also surgery. So I find that a lot of women who have had endometriosis often also.
00;13;42;01 - 00;14;11;25
Dr Nirala
So that's yeah, so that's the other category of underlying causes. So in my mind there are four main categories of underlying causes. One is the motility aspect which, which sort of covers the migrating motor complex. So damage to that, whether that's like I said, through food poisoning or other types of infections that can also cause that. And then you have the gut brain problem or the vagal issues and the high stress and mould issues, right?
00;14;11;25 - 00;14;37;08
Dr Nirala
So mould toxins can actually affect motility because mycotoxins exert a certain toxicity to what we call the my enteric flexes, which is part of the entire nervous system and people that have chronic mould exposure very often have have SIBO that you can't really treat until you've treated the mould. I don't know if you found that, but I certainly have experienced that a lot.
00;14;37;08 - 00;15;09;19
Dr Nirala
And so and then the other category is structural issues, which is includes endometriosis, it includes any sort of surgery, whether that's caesarian or gallbladder removal or appendix appendectomy or any of these very routine abdominal surgery surgeries can actually cause scar tissue and affects how how food moves through the digestive tract, not because of scar tissue inside the digestive tract, but inside the abdominal cavity.
00;15;09;19 - 00;15;36;17
Dr Nirala
That then creates sort of barriers to proper movement through through the gasps. And then the force category, small medications that also affect mostly motility in the gut. So all in each category has several different conditions, as you know, that that has to be sort of ruled out. Another big one with mortality, for example, is hypothyroid, hypothyroidism.
00;15;36;19 - 00;15;39;22
Filly
Yeah, yeah. And hypermobility to.
00;15;39;25 - 00;15;41;17
Dr Nirala
Yes it's.
00;15;41;19 - 00;15;42;13
Filly
Yeah.
00;15;42;15 - 00;15;59;21
Dr Nirala
It has also the the structural problem. So we see much less motility because of the, the loss of connective tissue in the gut wall. So there are lots of different reasons why it's not as easy as just killing bacteria. Right.
00;15;59;22 - 00;16;08;25
Filly
It'd be great, wouldn't it. Just like take these antibiotics are herbs and done or elemental diets? Probably not that easy. Just do the elemental diet.
00;16;08;28 - 00;16;11;02
Dr Nirala
Right? Right.
00;16;11;04 - 00;16;21;09
Filly
We might touch on that sort of stuff in a second, but what are some really common symptoms then that you see? We'd say buyer.
00;16;21;12 - 00;16;44;17
Dr Nirala
So, you know, I see the really complex cases because I that's, that's what I do. People have already seen other practitioners and yes, they were, they had SIBO and they're still symptomatic and or they're not clearing Siebel. There's lots of different reasons why I see people. So my little group of people that I see is very probably different.
00;16;44;17 - 00;17;12;17
Dr Nirala
But for the most part, I'd say generally speaking, you see all the classic IBS symptoms, right? And IBS can be different for different people, but generally speaking, we have a lot of gas and bloating. Oftentimes there's also abdominal pain, which is known as visceral hypersensitivity, which is very classic. With IBS. And because remember that that cirrhosis is actually a a subset of IBS.
00;17;12;19 - 00;17;38;05
Dr Nirala
And then we also have bowel changes very often, not always. Sometimes people do have normal stools, but it's either a diarrhoea pattern or a more constipation pattern. So and then you have other types of symptoms that can also be related to Ciba. But not everyone has that like excessive belching or reflux or you know, those would be probably the primary ones.
00;17;38;05 - 00;17;56;23
Dr Nirala
There's, there's, I've seen so many different things be related to Zebo and clear up rashes for example or acne rosacea, a restless leg syndrome, fibromyalgia all those things are or conditions are often also seen be comorbid with Siebel.
00;17;56;26 - 00;18;18;27
Filly
Yeah, actually the worst Seabury test in terms of the levels of the gases on the test that I've ever seen. This lady had no gut symptoms at all, and she just had quite a few food sensitivities and rosacea. And that was kind of her thing that, oh goodness, we worked on her got and all sorts of things, but quite a while.
00;18;18;27 - 00;18;43;10
Filly
And while things got better, it didn't resolve. And I never really in my mind, I'm like, Oh, she doesn't have bloating, There's no digestive system symptoms. That's why, you know, we didn't do CIBA testing right at the start. But then by the end of it, it's like, let's just test CBT, let's just rule it out. And sure enough, super high amounts of hydrogen methane gas is insane.
00;18;43;12 - 00;19;02;24
Dr Nirala
Yeah. And sometimes that can happen, you know, that people are sort of very minimal with their symptoms and there's it's kind of it's a bit baffling when that happens. But sometimes I've had patients like that to that, that they've had this so long that that's the normal for them.
00;19;02;27 - 00;19;16;22
Filly
Right. Yeah, yeah, yeah. So actually when you do do the gut work and clear the ceiba and it's like oh wow, I actually didn't realise that I don't have to feel distended all the time. This, that was abnormal how I was feeling.
00;19;16;24 - 00;19;17;21
Dr Nirala
Right.
00;19;17;24 - 00;19;39;17
Filly
So testing them because you have, you mentioned earlier that you created your own way of testing Zebo because you were finding that the usual conventional or not even the conventional functional medicine way wasn't quite cutting it. Can you talk about that? Because there are quite a few different ways of testing savoury, right.
00;19;39;17 - 00;20;10;24
Dr Nirala
So, so by the gold standards in terms of in-office testing, I would say is is the lateral breath test, which is pretty standard now, you know, and you can get it definitely from different labs that that do a decent job that's but back in back ten years ago I just didn't see a lot of the reference ranges that I wanted And the timing was, you know, I want a three hour breast test, not a two hour breath test.
00;20;10;27 - 00;20;42;22
Dr Nirala
So that's why I kind of just forged ahead and purchased the machines and all of that. But but basically it's it's still the actual breath test. Nothing has changed over the last ten years with that. And we still only measure hydrogen and methane. There is a third gas that is produced by the bacteria. If fusarium or diesel for Vibrio is present in the small intestine, and that's called hydrogen sulphide and we are not able to test that.
00;20;42;22 - 00;21;12;12
Dr Nirala
There's actually just one lab in America that offers that, which is, you know, it's kind of I always want to have have way more labs that offer that before my confidence level goes up in a particular test. So anyway, so that's that's still there but you can have lactose breath test, glucose breath testing and fruit up. These are all different substrates that are slightly different fermented.
00;21;12;12 - 00;21;37;19
Dr Nirala
So sometimes when you have a negative lactose breath test, it's often helpful to follow up with a different substrate sugar to see if you have bacteria that maybe don't ferment like Charles. But for the most part it's it's most people do ferment channels, I'd say. And then there are companies that tout blood testing and stool testing. There is no stool test for Siebel.
00;21;37;19 - 00;22;03;06
Dr Nirala
And that's because we have no way of accessing the small the small intestinal bacteria through a stool test. The stool just is representative of what's happening in the large intestine. And I know that there are a lot of people that extrapolate from that because we know that the bacteria that produce hydrogen mainly are Klebsiella and E coli. And we see that all the time, right on a stool test all the time.
00;22;03;09 - 00;22;26;26
Dr Nirala
That doesn't mean it's in the small intestine. So I think there's a lot of people, practitioners are taking a lot of liberty when they're when they're diagnosing patients like that, because it's a really distinct and discreet condition that is very, very different from large intestinal dysbiosis because it does a lot more damage right in the in a small intestine.
00;22;26;26 - 00;22;49;19
Dr Nirala
So that's that. And there is a new blood test that is just looking at antibodies to bacterial complexes. And, you know, to be honest, I, I, I'm waiting to hear just to talk to some of the scientists at that lab. But I really don't know how that can actually diagnose or differentiate between SIBO and leaky gut. Right. Yeah.
00;22;49;26 - 00;23;11;25
Dr Nirala
All you're doing is you testing for immune responses to bacteria. Well, yeah, it could be. That was six months ago. Or it could be it was a year ago. So and it could be that it was leaky gut, unrelated. Could have been because of coeliac disease or so. So I'm still really I'm a bit cautious with my optimism about that test.
00;23;11;27 - 00;23;40;07
Filly
Mm. I think that's what I love to say. You have a lot of courses on your website, the cyber doctor, and because it can get confusing, confusing, especially if you're a new practitioner and you open up a catalogue of all the lab tests that you could do and, and even the gut side of things as well. I thought maybe it was you mentioned on the course or maybe I was hearing it somewhere else.
00;23;40;07 - 00;23;57;01
Filly
But some people were also trying to diagnose say you are using an organic acid urine test, right where there's a panel there that looks at, you know, your flora and that sort of stuff. And if that's high, then some people were like, Oh, yeah, you've got SIBO, but that doesn't really work.
00;23;57;04 - 00;24;29;19
Dr Nirala
No, because first of all, an organic acid test only looks at your own organic response like responses to what's happening in your body. There's not location specific at all, right? They're looking at bacterial markers and you have, you know, in in the entirety of your digestive tract, you have trillions of organisms. So it's very difficult to pinpoint location and possible to pinpoint location with the hip uric acid and all those different markers on the bacterial section of a organic acid test.
00;24;29;21 - 00;24;48;28
Filly
Yeah, Yeah. Okay. Treatment, obviously, you know, that's could be a very long conversation, but generally speaking, what are the different ways that you teach practitioners and in your clinic in terms of when it comes to treatment?
00;24;49;00 - 00;25;25;16
Dr Nirala
Yeah. And this is sort of my sweet spot because I worked it out for over the years that it's best in my experience, it's best to do it in a sort of a really highly organised approach where you support the digestive process a little bit before you actually introduce antimicrobials. And what I mean by that is because it's a bacterial overgrowth, a lot of people are just given antimicrobials and or antibiotics which are effective of, of, you know, for the most part.
00;25;25;18 - 00;26;08;12
Dr Nirala
But when you understand that SIBO causes freshwater damage. Right, and leaky gut, meaning that the enzymes that do that last crucial part of digestion are often damaged. Oftentimes we see histamine intolerance and other types of food intolerances as as a result of Siebel. And we see detoxification impairments because of continued LPs absorption or endotoxin because of this situation of e colon klebsiella, a gram negative, and to just drop antibiotics or antimicrobials often works.
00;26;08;12 - 00;26;39;29
Dr Nirala
Don't get me wrong, but my approach has been a lot more to support digestion and to remove fermentable a little while and then people are really primed for antimicrobials without much of the die offs and sort of inflammatory response that can happen when you kill too many bacteria at once. So that's why I created the biphasic diet protocol, which basically divides it the whole treatment into two phases.
00;26;40;01 - 00;26;55;18
Dr Nirala
And I find that really very, very successful. But of course. C But a lot of times when people it's just a simple, you know, I don't know if you see those people anymore because I don't see the simple symbols, right? So maybe there are there still is responsible.
00;26;55;19 - 00;26;56;14
Filly
Easy words out.
00;26;56;18 - 00;27;26;09
Dr Nirala
There that may Yeah. Most of the time for me it's it's been a you know Siebel and this and that and neurological symptoms and you know insomnia and blah blah blah blah blah. And so people need a lot more support in that area. But yeah, for the most part, treatment consists of going on a low-fodmap diet, if I can put it in a nutshell, right.
00;27;26;09 - 00;28;04;12
Dr Nirala
So low fodmap diet, which means a low fermentable carbohydrate diet, then you can have a choice of either antibiotics and typically that antibiotic is rifaximin. If your hydrogen is high, a lot of doctors here in Australia don't like to prescribe neomycin because of the auto toxicity. So I often combine the rifaximin with alli med or Alli Max, which is a type of garlic extract that helps with killing methane and then there's different herbs for killing hydrogen as well.
00;28;04;12 - 00;28;36;19
Dr Nirala
And then I always, depending on what other symptoms people have, I do peripheral support as well. And then when people are completed, I usually test again because I like to know that it's completely clear. And then if they if I've determined that their cause of SIBO was from a damage to the motility aspect, then I add in a pro kinetic, which is either a conventional pro kinetic or a herbal pro kinetic which aims to reset the upper gut motility.
00;28;36;19 - 00;28;49;17
Dr Nirala
So these are substances like ginger or artichoke or a number of other things I use to to help with and normalising the the motility in the small intestine.
00;28;49;19 - 00;28;54;14
Filly
Yeah. Yeah. Awesome elemental diet as well.
00;28;54;17 - 00;29;25;07
Dr Nirala
Yeah I do. You know I'm it's it's harder to talk people into into the elemental than I do that mostly with really high gases and people that have failed other treatments. So the elemental diet is not like a whey protein or pea protein kind of formula. It's it's free form amino acids and glucose and and basically fat like some sort of oily medium chain triglycerides or something like that.
00;29;25;07 - 00;29;45;12
Dr Nirala
So it's a it's almost like a pre digested formula that's also really great for peripheral support for people that have really inflamed digestive tract because it gets very easily absorbed. So people with a Crohn's flare or ulcerative colitis flare can do well with that as well.
00;29;45;14 - 00;29;55;14
Filly
Yeah, I know, I attempted it for myself when I was treating my own gut stuff. I lasted ten days.
00;29;55;16 - 00;29;57;22
Dr Nirala
That's pretty good.
00;29;57;25 - 00;30;02;14
Filly
All right. Maybe it was 12, but then I retested and luckily this aivi it was clear.
00;30;02;16 - 00;30;05;17
Dr Nirala
Yeah, it was all work, right? Yeah.
00;30;05;17 - 00;30;21;11
Filly
So if there is, you don't know the elemental diet is a kind of like a medicated, formulated shake, nutritional shake. And you don't eat any food for two weeks and you just only having those shakes, something that.
00;30;21;11 - 00;30;40;10
Dr Nirala
Works. It was for the most part, it does work, which is always baffling to me that it works. But yeah, because the idea is that it's so highly absorbable that nutrients are absorbed before they can reach the bacteria in the small intestine. And so you're essentially starving them for two or three weeks.
00;30;40;12 - 00;31;02;00
Filly
Yeah, Yeah. And sometimes I'm surprised too, when I'm presenting the different options of like, oh, you know, these are the ways we can treat SIBO. Sometimes there are people who are like, Hell, yeah, I'll do the shakes. I don't have to worry about cooking all these foods like the savoury diet can be tricky for people as well, especially if they don't love cooking, right?
00;31;02;04 - 00;31;07;14
Filly
They find it quite overwhelming. So sometimes that option is actually quite helpful for people.
00;31;07;16 - 00;31;11;05
Dr Nirala
Yeah. No, absolutely, completely agree.
00;31;11;08 - 00;31;40;24
Filly
Okay, so do you see so in our practice, because we take a very holistic approach to healing body burn out, including looking at metaphysical root causes of, you know, trauma which can cause a trauma brain loop happening in the body nervous system, dysregulation. And a lot of the times there's unconscious core self-limiting beliefs kind of stuck in the unconscious state, just regulating the nervous system.
00;31;40;26 - 00;32;01;06
Filly
Have you ever seen these, especially like you mentioned, do you get a lot of the tricky patients? Yeah. Have you come to a point where you've done all the physical stuff and all, all the protocols and still someone's body is sending them some pretty strong signals by the gut?
00;32;01;09 - 00;32;42;15
Dr Nirala
So I don't wait until I've exhausted every possible anti-microbial before I address this issue with them, because it's pretty for me, it's pretty obvious when somebody has limbic system activation and, you know, I make that early on in my appointments. I address that and I recommend different types of therapies for people that I think are in this chronic state of activation, which is really I think it's probably more relevant today than it was even ten or 15 years ago or 20 years ago, 25 when I started it.
00;32;42;15 - 00;33;22;05
Dr Nirala
It's people have a certain baseline activation now I find that and what I mean by that is external stressors like either finances or climate change or whatever it may be. It can trigger people and pass out old trauma and ways of being. And limbic system activation can happen because of perpetual trauma and this or perpetual basically activation. And so it's just that pattern that gets reactivated where people are just very much in a sympathetic state, sympathetic nervous system.
00;33;22;05 - 00;33;54;26
Dr Nirala
State. So the fight or flight and that can absolutely make it so that it's very difficult to, uh, to eradicate SIBO quickly. And so these are other people, like I mentioned before, that it's very slow going and we have to put a lot of focus on. I often recommend things like hypnotherapy, the Nerva app, deep breathing Gupta program, brain retraining or DNR.
00;33;55;01 - 00;34;23;04
Dr Nirala
So lots of different types of therapy depending on where they're at to really start connecting the the stress to their digestive system. And I think that's been really helpful, especially when people are really activated and have a lot of much more deep seated like cars and cars is just phenomenal with with addressing with the Gupta program, for example.
00;34;23;06 - 00;34;37;19
Dr Nirala
So I do that much more. I have that conversation much more early on in our appointments now than just going through. Like for me, just reading bacteria is not even the fun part. You know, that's that's really.
00;34;37;22 - 00;34;38;07
Filly
Easy.
00;34;38;09 - 00;35;10;11
Dr Nirala
To do. That's just part of it. But really, you know, a lot of people have have this rigidity in the solar plexus when they have this limbic system activation a lot of the time or trauma activation. And that part is very often connected also to the fascia, to the brain, to the diaphragm, to breathing. If you're not breathing deeply and you're always too shallow breathing when you are very stressed, this is what happens when you're not really utilising your diaphragm.
00;35;10;11 - 00;35;33;27
Dr Nirala
That can just get sort of stuck in this shallow breathing pattern that then, you know, the lungs are meant to be massaging the transverse colon. So there is also that mechanical motility that's that's missing from all this. So there's a lot to be said about people that are in a state of chronic stress or trauma, reactivation and all of that.
00;35;33;27 - 00;35;51;01
Dr Nirala
And luckily, we now have a language to to speak about this and to address it and to recommend different things to people like somatic experiencing and different types of trauma work that I find are so profound and powerful.
00;35;51;04 - 00;35;59;04
Filly
Yeah. Why do you think that? You said that you see it more now than what you did say 20 years ago?
00;35;59;06 - 00;36;19;14
Dr Nirala
Maybe I just I'm older, you know, I'm more aware of. Yeah, I think so. And I was I think like, you know, when you when you first start your own practice and you're, you know, I was always a very driven person and I could really see that part of that was out of trying to get my own safety.
00;36;19;15 - 00;36;37;15
Dr Nirala
You know, a lot of people just want to they're very driven for to be recognised as something. But for me it was always about finding my own safety. And as you get older, that's the beauty of getting older. You know, for me I love getting older because I have so much more of an understanding of my own patterns.
00;36;37;15 - 00;37;04;18
Dr Nirala
And so seeing, seeing that and I had a lot of digestive issues, you know, now that I'm much more, I can actually see it a lot more in people. And I also think that we live in a much more stressed out world these days. You know, if you look at what just happened in in Europe over the summers with the fires and now, you know, like it's just it's just relentless, the bad news.
00;37;04;20 - 00;37;26;06
Dr Nirala
And so I think it really has. And then COVID happened and the lockdowns and and now the you know, the economy, there's just always something that seems to be really affecting people on a different level. And the got will always be the getting the short end of the stick, so to speak. Yeah. Well when stress is high.
00;37;26;09 - 00;37;52;19
Filly
Poor little guts. But it is it's like the big stuff happening in the world. Although rationally we can be like, it's okay, it's fine, you know, inflation rising or whatever. But that ingrained part of us, that's always our amygdala, like the survival brain, it can like for some people they in getting that chronic fight flight state and Vermont should be able to switch out of on their own.
00;37;52;22 - 00;38;22;11
Dr Nirala
Yeah and a lot of it has to do with safety right. So the whole limbic system, including the amygdala, it's all about my safe in this world, Right. And so this is how we also know, for example, that adverse childhood events. Right. Have have a way of almost in imprinting onto the microbiome people with with adverse childhood events are much more likely to experience IBS and so forth.
00;38;22;11 - 00;38;36;04
Dr Nirala
And so people with adverse childhood events then meet the stresses of more modern life. And that pattern just keeps continuing. Um, yeah, Yeah. So I've seen that a lot.
00;38;36;06 - 00;38;43;23
Filly
It is nice getting older. I'm almost hitting on 40 and I love my late thirties and I think forties is just going to be even better.
00;38;43;27 - 00;38;47;15
Dr Nirala
Oh my God, just wait till you get to be 50. Oh, it's the best.
00;38;47;17 - 00;38;50;14
Filly
It's like loose and free.
00;38;50;16 - 00;38;58;25
Dr Nirala
Well, I like that. That's never been my problem. But that's more just more at ease within yourself. And that's what I like, you know?
00;38;58;26 - 00;39;21;04
Filly
I love it. So cool. Thank you so much for coming on our podcast. It's been awesome. I know that our listeners are going to get so much out of what you've just covered today about SIBO and Health, and if anyone wants to find out more about Dr. Nirala and his, she's got so many things, so many also things that as a CEO.
00;39;21;04 - 00;39;25;28
Filly
Dr. Tor.com for practitioners, you have heaps of courses.
00;39;26;02 - 00;39;52;26
Dr Nirala
Yeah, Yep. So thanks for that. I have. So if you go to the CMO, Doctor Dotcom, there is a course for practitioners called this Siebel Mastery Course, which is very, very, very extensive. A certificate program. And then for four patients or Siebel sufferers, I have something called the Siebel Success Plan that includes to get through the see the biphasic diet.
00;39;52;26 - 00;40;21;15
Dr Nirala
And, you know, I add in lots of different home treatments and hydrotherapy treatments and all kinds of different things that you can do to improve your symptoms whilst you're going through the protocol. And then I have different free resources and stuff. So it's a really good informational site also for people if they want to check it out. And then I have a podcast also that deals with all things Siebel that I've been doing for about almost seven years now.
00;40;21;15 - 00;40;23;24
Filly
Wow, it's been that long.
00;40;23;26 - 00;40;24;18
Dr Nirala
Yeah.
00;40;24;21 - 00;40;45;08
Filly
Yeah, it's awesome. Podcast is awesome. You have amazing experts from all over the world coming on and talking about different areas of SEO and how everything is connected. Also great free resources. So we were talking about the underlying causes of save. I see. Have the what cause my savoury questionnaire which we use in our practice.
00;40;45;11 - 00;40;46;18
Dr Nirala
Great, fantastic.
00;40;46;22 - 00;41;00;25
Filly
And so many very helpful diet. So the save our biphasic diet histamine like light salicylates. Yep. We use all those and people can grab them off your website.
00;41;00;28 - 00;41;02;17
Dr Nirala
Yeah. Great. Yeah.
00;41;02;17 - 00;41;02;29
Filly
All right.
00;41;02;29 - 00;41;05;19
Dr Nirala
Yeah, yeah. That's, that's a good resource for them.
00;41;05;22 - 00;41;07;15
Filly
Thank you so much.
00;41;07;17 - 00;41;22;21
Dr Nirala
It's been a pleasure. I'll see you around the track somewhere at one of the conferences. Yes. All right.
00;41;22;23 - 00;41;31;25
Filly
Thank you so much for listening. We so appreciate you. If you'd like to give us extra smiles, drop us a review and spread the love. By sharing this episode.
00;41;31;27 - 00;41;49;27
Chris
You can also write your own state of burnout and the root Cause contributors by taking out ending body burnout assessment on our website. And if you're interested in learning about our group one on one ending Body Burn, our programs should as a DM via Instagram or Facebook have the best day ever.
