SIBO, LEAKY GUT - Mold Illness Made Simple Online …...SIBO & LG –WHY SO COMMON IN CIRS? Bauche D., Marie, JC. (2017). Transforming growth factor β: a master Regulator of the gut

DR. SANDEEP GUPTA

DR. FARSHID SAM RAHBAR

SIBO, LEAKY GUT& MOLD ILLNESS

MSH

TGFb

VIP

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medical condition

mold illnessS IM P L EMADE

DR. SANDEEP GUPTA

• Medical degree from The University of Queensland (1999)

• Hospital Intensive care for 5 years

• Private holistic practice for 10 years on Sunshine Coast, Lotus Holistic Medicine, and

Sydney (3-4 times per year)

• Skype consults worldwide

• 1st non-US doctor to become certified in Shoemaker Protocol (2014)

• Author of Surviving Mould Down Under paper (2014)

• Co-author of Physicians Consensus Statement with Dr. Ackerley, Dr. Berndtson, Dr. Rapaport,

Dr. McMahon and Dr. Shoemaker (2015)

• Website: www.LotusHolisticMedicine.com.au


DR. FARSHID SAM RAHBAR

• Board certified gastroenterologist practicing in Los Angeles, CA, USA

• Attended University of Tehran (Iran) and completed residency at St. Mary’s Hospital,

Rochester, NY

• Fellowship Gastroenterology and nutrition, Loma Linda University, CA

• Certified with:

– American Board of Internal Medicine, American Board of Gastroenterology, American Board of

Integrative Holistic Medicine, A4M and more

• ILADS board member and educational committee member

• Website: www.LaIntegrativeGI.com


WHAT IS CIRS (CHRONIC INFL AMMATORY RESPONSE SYNDROME)?

Biotoxinexposure

• Biotoxins & inflammagensfrom water-damaged building or Lyme/stealth infections

Immune, gene, brain

• Defect in antigen presentation means toxins stay in body causing chronic inflammation that leads to gene dysregulation and brain changes

CIRS

• Multi-system, multi-symptom illness develops even if removed from WDB or infection eradicated


WHAT IS SIBO & LEAKY GUT (LG)?


Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Fungal Overgrowth (SIFO)

Leaky Gut (intestinal permeability)

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Cyre

xlab

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ries

Intestinal barrier damage - mechanisms

• Damage to intestinal cells (enterocytes)

• Damage to tight junctions

• Intestinal cell “drop out”(Extrusion)

SIBO/SIFO

• Bacteria and/or fungi, that may be

normally abundant in the large intestine

flow into small intestine

can alternate

Immune &

Neurological

IBS


Restless Leg

Chronic fatigue

Chronic pain

Joint pain

Rosacea

Other

Iron (anemia)

B12

Weight loss

Malnutrition

Risk Factors

Food poisoning

Reduced stomach acid / PPI

Reduced motility

Altered small bowel

Bloating after meals

Nausea/vomiting

Chronic diarrhea

Chronic constipation

GERD / reflux

Gluten intolerance

Lactose intolerance

Multiple food sensitivities

Foul gas/wind

Bile reflux

SIBO & LG – SYMPTOMS/CONDITIONS

Alcoholism

Celiac disease

IBD

H.pylori

Nerve damage

Drugs (e.g. opiates)


SIBO & LG – TESTING

Ghoshal, U. (2011). How to interpret hydrogen breath tests

SIBO Breath Testing Intestinal Permeability

Further Gut testing

Giliadin/gluten antibodies (Cyrex)

Food IgG panels

Occludin/Zonulin, LPS

Secretory IgA

Parasites / Microbiota (dysbiosis)

Organic Acids

CIRS testing

MSH, VIP

TGF-β, C4a

Leptin

MMP9


SIBO & LG – WHY SO COMMON IN CIRS?

Bauche D., Marie, JC. (2017). Transforming growth factor β: a

master Regulator of the gut microbiota and immune cell interactions

Low MSH, VIP

- Key anti-inflammatory, immune modulatory and anti-microbial hormones in CIRS

- Low levels allow inflammation and pathogens to increase in gut

- Low levels (may) reduce gut motility

High TGF-β, IL-6 and other cytokines

- High TGF-β plus other cytokines (IL-6) shift gut towards inflammation(Th17 : Treg balance)

- Microbiota may also increase TGF-β

- If high enough autoimmunity starts to develop

Pro-inflammatory State

- Inflammation continues to fuel the fire of CIRS

- Perpetuates & exacerbates SIBO, leaky gut

- Multiple food sensitivities


SIBO & LG – NASAL INFECTION CONNECTION

• Bacteria e.g Multiple Antibiotic Resistant Coagulase Neg Staph (MARCoNS) drip down into gut

MARCoNS

• Antibiotic nasal sprays may drip down into gut and alter gut microbiota

• Possible alternatives:

• EDTA/colloidal silver

• XyliFos/LoxaSperse (Xylitol)

Nasal Sprays


SIBO –TREATMENTS

Rifaximin

Hydrogen predominant

Rifaximin plus neomycin or tinidazole

Methane predominant

Antifungals

SIFO

Berberine

Allicin (garlic)

Oregano oil

Olive leaf

Artemisian

Protectagen(Cat’s Claw)

Herbs

Monolaurin

Bioflim disruptors

Other

Pharmaceutical

Natural


LEAKY GUT –TREATMENTS

- activates CIC-2- pro-kinetic

Lubriprostone

PentaDecaPeptide

- Naturally occurring peptide- Heals intestinal lining and joints

BPC 157

Pharmaceutical & Peptides

Berberine

Quercetin

Plant based antioxidants

Betaine HCL

Digestive Enzymes

Herbs & Stomach Restore

Glutamine

Zinc Carnosine

Amino Acids

Vitamins/minerals (IV, liposomal, liquid)

Omega 3s

Other

Natural

Enck

et al (2

016). Irritab

le B

ow

el Syn

dro

me

SIBO & LG – MORE TREATMENTS


Lifestyle

Pro-kinetic agents

Other Treatments

Diets

•Exercise

•Stress reduction (meditation)

•Adequate sleep

•Fun activities

•Reglan (metoclopramide)

•Motilum (domperidone)

•Ginger

•Other herbs

•Pre/Probiotics (cautiously with SIBO)

•Spore probiotics

•Turmeric / Curcumin

•Low Dose Naltrexone

•Ozone therapy

•Gluten/casein free

•Low FODMAP

•Elimination

•Paleo (AIP) / GAPS / Elemental

MOLD ILLNESS MADE SIMPLE – ONLINE COURSE


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Questions and Answers


SIBO, LEAKY GUT - Mold Illness Made Simple Online …...SIBO & LG –WHY SO COMMON IN CIRS? Bauche D., Marie, JC. (2017). Transforming growth factor β: a master Regulator of the gut

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