In This Article
Gut Dysbiosis. It’s gone by different names in the past.
Candida overgrowth. SIBO. Parasites.
Gut dysbiosis is simply an imbalance in the microbes in your gut. Too many bugs. Not enough Bugs. The wrong kind of bugs. You get the point. Essentially your gut is out of tune. And that comes with real health consequences.
And yes, gut dysbiosis can trigger a cascade of digestive symptoms. We’ll certainly get into those. But It can also lead to and worsen blood sugar control, weight gain and a number of other chronic health issues.
In today’s article we’ll explore some of the reasons we develop gut dysbiosis. Then I’ll help you recognize the signs and symptoms. I’ll lay out some common patterns of dysbiosis I see. Finally, we’ll discuss some steps you can take if you think you may have it.
The Garden In Your Gut
Before we dive in to the topic of gut dysbiosis though, it’s important you understand our bodies’ most important ecosystem. The gut microbiome.
This is a community of microbes that live (and breathe) in the digestive tract.
Think of the gut microbiome as a garden. All gardens need good soil and a proper, balanced fertilizer. Good plant variety. Gardens don’t need weeds or harsh pesticides. When it’s taken care of it gives back. It produces food. It often provides purpose, connection and enjoyment for those tending it.
Our gut microbiome has similar needs and benefits. Like requiring an abundance of diverse, healthy microbes. Needing a variety of plants and nutrients. It provides for us. Things like nutrients and vitamins. Even mood-enhancing brain chemicals too! Believe it or not, it helps us connect with others and operate at our highest potential.
Your internal garden needs to be tended. Afterall, It’s the most important one you have!
So where can it all go wrong?
How Does Gut Dysbiosis Harm Us?
There are several reasons why unbalanced microbes are not good for us.
Perhaps the most striking reason is that gut dysbiosis causes inflammation. When the wrong type of gut bugs are thriving they produce waste that cause inflammation. This leads to damage of the gut wall. Which allows harmful bacteria and chemicals to enter the bloodstream. This promotes further inflammation in the rest of our body. Virtually any organ can be affected by dysbiosis via inflammation. This is why dysbiosis is not just a digestive problem. In fact, we see that individuals with chronic diseases like Parkinson’s disease, diabetes, and even depression often display patterns of gut dysbiosis.
Is it possible that these conditions first take hold in the gut?
What Causes Gut Dysbiosis?
Gut microbes can become unhappy and unbalanced. Just like us. Hey, It’s part of life. But it often takes a series of insults or disruptive events to become dysbiotic.
For the sake of time I have chosen to focus on three reasons why people develop gut dysbiosis. This list isn’t exhaustive but gives you a good idea of the main players.
Medications
By far the most common class of medications to directly cause gut dysbiosis are antibiotics. We’ve all had them – some of us more than we’d like to admit.
The key here is overuse of antibiotics. Ask yourself the following. Did you go through a period of time where it seemed like you took one antibiotic after another? Perhaps you had the dreaded triple or quadruple therapy for an H. pylori infection – yeah that’s not fun. If yes, were you ever directed to take a probiotic during antibiotics? If not, you most likely depleted your gut microbiome. This can leave you susceptible to a fungal dysbiosis. Fungal conditions like yeast infections and thrush are obvious examples of this.
On the flipside, did the antibiotics prescribed for your urinary tract infection actually improve your gut symptoms? This could be a sign of a bacterial overgrowth. We’ll circle back to this later.
One of the most commonly prescribed class of medications on the planet are a group called proton pump inhibitors (PPIs). They are used to treat heartburn, indigestion and stomach ulcers. These drugs can significantly change the gut landscape. Studies show long term PPI use causes significant gut dysbiosis.
Diet/Lifestyle
The standard american diet – full of of junk carbohydrates, unhealthy fats and low in fruits and veggies is a sure way of developing gut dysbiosis. These diets feed the wrong bugs. They promote inflammation and weight gain. This promotes a vicious cycle.
On the other hand, restrictive eating patterns or a history of an eating disorder like anorexia nervosa can also contribute to gut dysbiosis. Even following the low FODMAP diet for too long can lead to insufficiency dysbiosis. You’re basically starving your microbes!
Infections
Several gut infections can disrupt the gut. Most famously is the Helicobacter pylori (HP) infection. HP uses a unique strategy of attaching to our stomach lining. Once there, it reduces the production of stomach acid. This allows it to survive the harsh acidic environment. This decrease in stomach acid production likely causes dysbiosis by changing the environment certain bugs can grow in. Similar to how poor soil or the wrong fertilizer can impact your garden.
Viral infections like COVID-19 can cause sustained changes in the gut. In one study, gut dysbiosis from infection lasted for up to one year in long-haulers. Memory problems, sleep disruption and tiredness are all common symptoms in long-haulers. We see these same symptoms in gut dysbiosis. On that note, other similar syndromes like chronic fatigue, fibromyalgia and myalgic encephalomyelitis are also associated with gut dysbiosis. It all comes back to the gut!
What Are The Signs And Symptoms Of Gut Dysbiosis?
Digestive Symptoms
- Gas
- Bad breath
- Bloating
- Nausea
- Belching
- Indigestion
- Abdominal pain
- Diarrhea
- Constipation
- Heartburn
Non-Digestive Symptoms
- Poor concentration
- Poor memory
- Low mood
- Fatigue
- Poor body odor
- Joint pain & muscle aches
- Skin rashes (i.e., eczema, psoriasis)
- Weight gain
- Fatty liver
5 Signs of dysbiosis
- Symptoms begin or improve after a round of antibiotics
- Only a strict diet keeps your gut symptoms in check
- Poor blood sugar or weight control despite being careful with diet and exercise
- Probiotics make you feel worse
- Bad breath despite a clean dental check-up
Common Patterns of Dysbiosis
There are several types of dysbiosis. For simplicity, I have broken them down into three.
- Insufficiency dysbiosis – A decrease in beneficial or total bacteria (i.e.,low levels of Lactobacillus, Bifidobacterium, Akkermansia species)
- Bacterial overgrowth – Any excess bacteria in any part of the gut (e.g., SIBO). This includes “healthy” bacteria too.
- Fungal dysbiosis – AKA “yeast/candida overgrowth” (includes many other species of yeasts)
Different types will require different treatment strategies.
For example, one type of dysbiosis may require the use of antimicrobial therapies like antibiotics or herbal medicines. While one may require an increase in pre- and probiotic foods to build up the gut microbiome.
Some strategies – like the restriction of certain foods – may worsen one pattern, while benefit another. It depends on what your garden needs!
How Do I Know If I Have Gut Dysbiosis?
Testing is really the only way we can know for sure. Both direct and indirect testing methods can reveal if you have gut dysbiosis, as well as which pattern you have. The most common tests I use are listed below.
- Comprehensive Stool Analysis (Direct; Bacterial overgrowth, Insufficiency & Fungal dysbiosis)
- Breath Testing (Indirect; Bacterial overgrowth)
- Microbial Organic Acid Testing (Indirect; Bacterial overgrowth & Fungal dysbiosis)
Talk to your doctor about which test is right for you.
Final Thoughts
Dysbiosis is one of the many pillars I help patients address. It’s important to recognize that not all digestive concerns stem (solely) from dysbiosis. There are other pillars – which I’ve explored in other posts – that are equally as important at addressing.
As always, a personalized approach is best.
Enjoyed this article? Check out similar gut health topics
References:
Jackson, Matthew A., et al. “Proton pump inhibitors alter the composition of the gut microbiota.” Gut 65.5 (2016): 749-756.
Su, Qi, et al. “Post-acute COVID-19 syndrome and gut dysbiosis linger beyond 1 year after SARS-CoV-2 clearance.” Gut (2022).