Nick | Gut Health

A big reason people don’t fully resolve their digestive issues is that they never truly find the root cause of them.

Here are common issues people deal with today and what I’ve often see as the root cause contributors to them.

THREAD 

I’ve worked with nearly 200 people to resolve digestive issues, many of which spent years trying without success. Almost all struggled so long because, despite their significant effort, they hadn't identified the true causes. 

Finding and addressing this is THE key to making sustainable progress.

Effort alone won’t fix health issues if you’re focused on the wrong things. It’s important to not only find the main issues present, but also all factors involved and contributing to it. 

In this post, I’ll cover common issues I’ve seen and the overlooked contributors.

1. Pathogens

This is a common cause of people’s poor digestion, bloating, inflammation and leaky gut. 

While our bodies have defenses like stomach acid and immune cells, modern lifestyles and certain health issues can weaken these, allowing harmful bacteria, yeast and parasites to accumulate.

Disrupted bile flow, low acid and slow motility (ex: from hypothyroid) create favorable conditions for pathogens to flourish. 

Liver stress, conditions like IBD and nutrient deficiencies (zinc, B12) can often contribute to these issues too.
https://pubmed.ncbi.nlm.nih.gov/25319735/

Stress, mycotoxins, heavy metals and other immune-suppressing factors can block the body’s defenses against pathogens.

Poor metabolic health, high blood sugar and disrupted digestion can feed pathogens and make resolving the issue very tough.

https://pubmed.ncbi.nlm.nih.gov/24476707/

Antibiotics and PPIs are major contributors. Antibiotics can kill beneficial bacteria, disrupting balance that helps prevent overgrowth and promoting resistance due to overuse or misuse. PPIs weaken one of our main defenses against pathogens: acid.

Regular use of these fuels overgrowth for many people.
https://pubmed.ncbi.nlm.nih.gov/23270866/

Aside from these, there are other more obvious contributors that can directly impact the microbiome and inhibit our defenses against pathogens.

This includes things like inflammatory foods, processed food & supplement additives, pesticides, alcohol, poor sleep and sedentary lifestyle.

If you’re addressing SIBO or overgrowths like Candida or H. pylori by only focusing on antimicrobials, lasting relief is unlikely. 

While exposure alone can cause overgrowth, in most cases, other underlying health issues or diet &amp; lifestyle contributors play a significant role.

2. Leaky gut

The gut lining faces constant threats today. Within the gut, pathogens and microbiome imbalances disrupt short-chain fatty acid production, which is crucial for the lining. 

These stimulate mucus secretion and maintain tight junctions, both essential for keeping things intact.

Nutrient deficiencies can significantly weaken the gut lining. 

Functions like mucus production, immune defenses, tight junctions, and cell turnover rely on nutrients like vitamin A, zinc, glutamine, fiber, vitamin D, vitamin C, and magnesium to maintain a healthy and functional gut barrier.
https://pubmed.ncbi.nlm.nih.gov/24755435/

Certain food and supplement additives, like titanium dioxide and silicon dioxide, can cause inflammation, oxidative stress and increased intestinal permeability. 

Emulsifiers, artificial sweeteners, and preservatives also harm the gut lining, disrupting nutrient absorption and damaging gut health.

https://gut.bmj.com/content/66/7/1216

Seed oils, heavy metals, mycotoxins, pesticides, and other toxins contribute to leaky gut by driving inflammation, causing oxidative stress and damaging epithelial cells. 

They also disrupt microbiome balance, suppress the immune system, and indirectly weaken the gut lining, amplifying the damage.

https://pubmed.ncbi.nlm.nih.gov/36919486/

Circadian disruptions, stress and NSAIDs are common contributors to leaky gut too. 

Circadian disruptions and high cortisol can affect tight junction proteins, mucus secretion, microbiome balance and inflammation. NSAIDs damage epithelial cells directly and reduce mucus by inhibiting COX-1 enzymes.

https://pubmed.ncbi.nlm.nih.gov/29221664/

Most advice for leaky gut focuses on supplements like glutamine or zinc. While helpful, they often only address part of the issue. 

If factors like circadian disruptions or mycotoxins persist, zonulin levels may temporarily drop but will likely rebound, leaving you reliant on supplements.

3. Inflammatory bowel disease

The exact causes of IBD are still not well understood and treatments usually fail to achieve lasting remission. Many people with IBD also have issues like dysbiosis, leaky gut, SIBO, low stomach acid, enzyme insufficiency, bile disruptions or nutrient deficiencies that can contribute to flare ups and prevent remission if overlooked.

Another major issue with IBD is that diet and lifestyle issues are major contributors to it, yet they are almost never discussed.

This incomplete approach is a big reason why IBD rates continue to rise and why 50% of people with it don't get into remission.

I’ve dealt with colitis myself and helped clients with Crohn’s and colitis achieve sustainable remission without meds. 

In every case, other factors were driving flare-ups. Once these were identified and resolved, flare ups stopped along with the need for immunosuppressants.

There are many studies outlining clear links between leaky gut and IBD. Some suggest it has a role in the development, others suggesting it predicts the onset of IBD.

Leaky gut allows harmful substances into the bloodstream, often triggering systemic inflammation and autoimmunity. It’s also linked to celiac, diabetes, arthritis and MS.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9628915/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4637104/

SIBO and dysbiosis can worsen IBD by triggering inflammation, releasing toxins, and damaging the gut lining. Common issues like low stomach acid, enzyme insufficiency and bile dysfunction often lead to malabsorption of nutrients, disrupting digestion, microbiome balance and detoxification while increasing inflammation too. 

If issues like these are present, addressing them will be key to managing IBD effectively.

https://pubmed.ncbi.nlm.nih.gov/22993202/

Diet is also key for managing IBD, but generic advice like "go low FODMAP" often misses the mark. 

Most with IBD have other issues, so tailoring the diet to address these is crucial, such as adjusting carbs for SIBO or fats with bile disruptions.

Lifestyle factors like circadian disruptions, high stress, sedentary lifestyle and poor sleep are crucial with IBD. 

Enzymes, immunity, motility and just about every digestive process are governed by circadian rhythms. Excessive levels of stress can directly trigger inflammation and microbiome imbalances. Overlooking these issues makes controlling IBD much harder.

https://pubmed.ncbi.nlm.nih.gov/30615844/

4. Reflux

Lasting relief from reflux is rare, with most relying on PPIs that suppress symptoms but don’t solve the problem. 

Many with reflux actually have low stomach acid, and while PPIs might ease symptoms, they can worsen the issue. Even with high acid, they don’t address why it’s high.

https://pubmed.ncbi.nlm.nih.gov/16011666/

Reflux often results from stomach pressure pushing acid into the esophagus. produces excess gas that can create this pressure.

Digestive disruptions, like low enzymes, bile, or acid, contribute to over fermentation and gas production, worsening the issue. As can slowed motility commonly from neurotransmitter issues, hypothyroid or microbiome imbalances.

https://pubmed.ncbi.nlm.nih.gov/12671885/

Malfunctioning digestive muscles, including the lower esophageal sphincter, pyloric sphincter, diaphragm or stomach muscles, can contribute to reflux, allowing acid to move upward. 

Hiatal hernias, vagus nerve issues, inflammation, stress, smoking, hormonal imbalances, nutrient deficiencies and pressure build-up are common factors.

5. IBS

IBS is one of the most diagnosed digestive conditions, yet its diagnosis, understanding and management are deeply flawed.

Misdiagnosis is rampant, and many cases labeled as IBS often have underlying issues that are overlooked, leading to ineffective treatment.

IBS is a symptom-based diagnosis, not identified through specific tests. It requires recurring abdominal pain/discomfort at least once a week for 3 months, linked to 2 of these: defecation, stool frequency changes, or stool appearance changes.

There are often no tests done to rule out other conditions.

https://theromefoundation.org/rome-iv/rome-iv-criteria/

The issue with IBS is that its symptoms overlap with many other problems. Without testing, symptoms are labeled as IBS, even if another condition is the true cause.

This leads to misdiagnosis, allowing the real issue to go unchecked, potentially causing serious damage over time.

Pathogen overgrowth, like SIBO, is often misdiagnosed as IBS since it causes key IBS symptoms like bloating, gas, diarrhea, constipation and stool changes.

Many studies show high SIBO rates in IBS patients, with one finding 78% had positive breath tests and another showing 84%.

https://journals.lww.com/ajg/abstract/2003/02000/Normalization_of_Lactulose_Breath_Testing.35.aspx

https://www.sciencedirect.com/science/article/abs/pii/S0002927000021614

IBS and leaky gut are also closely aligned. Many people with IBS experience food sensitivities, which is a common side effect of leaky gut due to partially digested food particles entering the bloodstream.

Bloating, gas, constipation, diarrhea and brain fog are also common symptoms shared between these two diagnoses.

IBD and IBS also share symptoms like gut-brain disruption and motility issues, microbiome imbalances, fatigue and food sensitivities. 

While IBD often includes severe signs like blood or mucus in stool, milder cases may mainly present with bowel changes, bloating, and gas, resembling IBS.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4245306/