The Top 5 Causes of Bloating | Podcast #364

Abdominal bloating occurs when the gastrointestinal (GI) tract is filled with air or gas. Most people describe bloating as feeling full, tight, or swollen abdomen. Your abdomen may also be swollen (distended), hard, and painful.

Dr. J and Evan describe that gas is the most common cause of bloating, especially after eating. Gas builds up in the digestive tract when undigested food gets broken down or when you swallow air. Everyone swallows air when they eat or drink.

On the other hand, they also talk about different components of why you may be having to bloat that you may not notice. Plus, available testing and lifestyle modifications you need.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:57  – The role of acid-pH level in the digestive system
5:01  – The link of depression and anxiety to bloating
10:02 – The benefits of probiotics and effects of stress to digestive health
18:17 – Functional medicine strategies and testing to find the root cause of bloating

Dr. Justin Marchegiani: Really excited to have a podcast today. We’re gonna be diving into a couple of different topics. The big one here is gonna be bloating – one of the big root causes of bloating. We’re gonna talk about it from a biochemical functional medicine perspective. Evan, how are you doing man? What’s going on brother? 

Evan Brand: Doing pretty well, excited to dive in and talk about gut infections. I think that’s probably the first place to start because you and I have run thousands of urinary organic acids and genetic stool tests over the years. And years ago, you know, we used to use a three-day stool test. Now, with technology improvements, we could do a one-day one sample stool test and we can uncover so much. So, I’ll just kind of riff on things. I know we like to title things just for marketing purposes and call it top five but we may go into 15 by the time we’re done because just right off the top of my head here, high gut inflammation like how calprotectin may be an issue, low pancreatic enzyme function, bacterial overgrowth, where we’re gonna measure the dysbiosis, H. pylori infections, parasites, worms, specifically Clostridia and Candida can cause a lot of issues with bloating. So, in general, I would just say any gut infection but we can break that down as much as you want to. It could be a huge cause of bloating. And, the problem is this, when you go to a conventional medical doctor or a gastroenterologist and you get some sort of bloating remedy or some sort of digestive aid, maybe an acid blocker, antispasmodic medication. Obviously, these are not addressing these infections. You could take acid blockers for the rest of your life and never clear the H. pylori that’s driving the low stomach acid which then drives the fermentation in the gut which then drives the bloating. So, I just want people to have in their heads a clear mindset of what are you taking, is it actually fixing the problem, are you just masking your symptoms. And in the case of an acid blocker, you’re actually putting yourself deeper in the hole because you’re taking low stomach acid that’s driving heartburn or an infection and you’re making it worse. 

Dr. Justin Marchegiani: 100%. So, you know, the first catalyst for good digestion is a nice low pH. That good acid pH, we need good hydrochloric acid to make that happen. So, we need essentially hydrogen ions to bind to chloride in our gut and so we need chloride from minerals. So, we need good minerals, good quality sea salt that helps make stomach acid on our own. Now, if we’re under a lot of stress and our adrenal glands are in stress overdrive, it could be cortisol high or low imbalances, as well as adrenaline issues, right? It could be high or low cortisol stress issues that could put us in a fight or flight state and that sympathetic nervous system stimulus is gonna negatively impact our body’s ability to start with making stomach acid and digestive secretions and of course that stomach acid is almost like an antimicrobial. Think of like using lemon or apple cider vinegar is a natural cleaner right. They recommend these online. You can make natural cleaners usually some kind of acid as the foundation of the formula because acids are antimicrobial and so think of acids in your intestinal tract as being antimicrobial. They also, some kind of help tighten the sphincter, the esophageal sphincter from the stomach into the esophagus. It gets tightened with good acidity and so part of the reason why we get bloating and a lot of these gases rise up to the esophagus is inadequate levels of acidity and that keeps the esophagus open and then what happens when that esophagus is open over time, the fermentation acids that occur can actually, eventually irritate the bottom of the esophagus because we didn’t have enough acids to trigger that good closure in the beginning. 

Evan Brand: Yeah. Yeah. So, then you’ll get these, what are called silent reflux issues sometimes it’s called GERD. And once again, prescription drugs are what’s the common remedy but once again it’s not the root cause. It may reduce the symptoms because if you have that backwash it’s gonna help slow the backwash down but it’s not gonna fix the sphincter so we might come in with extra betaine hydrochloric acid or if you’re extremely inflamed which is that someone can’t tolerate a low dose of it but then we could do something like apple cider vinegar with a meal sometimes bitters. I personally don’t do bitters, I just do HCl and enzymes. 

Dr. Justin Marchegiani: Yeah. We can always test it with ginger. We can always test it with an acid like lemon, lime, or apple cider vinegar, start with a teaspoon of that and mix in a couple ounces of water and then kind of work our way up from there. So, acidity is a really important first step. Of course, if we have inefficient, um, inefficient acidity levels we can almost guarantee, we’re probably gonna have poor enzyme levels and probably gonna have poor bile acid levels, right? Bile acids are important because they help break down fat and bile acids are also slightly acidic, right, in the name of bile acid and it’s also antimicrobial. So, just like we talked about the acids having an antimicrobial benefit on the HCl side, also, bile acids have an antimicrobial benefit. We see in SIBO, a hallmark of SIBO is bile aids insufficiency and so with SIBO we don’t have enough acids there on the bile side so then we have a hard time breaking down fat and then a lot of times that fat will create indigestion, petrification because it’s not being broken down. Now, when we run certain stool tests, we’ll see increases in a metabolite called steatocrit, which is a breakdown of the fat that means it’s not being broken down in the stomach. It’s coming out at higher levels which means we’re not breaking it down. So, steatocrit is a big deal because steatocrit, if we don’t have good fat digestion, we probably have some protein digestion issues, we probably have some enzyme and acid issues and we probably have, um, some gas issues, bloating issues because these things require good digestion and if they’re not being broken down well, we’re probably getting some methane or hydrogen gases kind of rising up from that.

Evan Brand: And you know, we’re taking on the subject of bloating but it’s very common that someone with these issues you’re describing, they’re also gonna have issues with energy and probably mood like anxiety and depression because you’re mentioning this issue with fat digestion, protein digestion. Now, you’re not gonna get the aminos that you need to fuel your neurotransmitter so it’s very rare that somebody’s gonna come to us and say, hey I’m just bloated and I have nothing else. Usually, along with that bloating, you’re gonna have these tangential symptoms too like anxiety, depression, fatigue, and so I encourage people, you can focus on one smoking gun like bloating as your big thing you’re coming in for but you gonna make sure you understand there’s a bigger, deeper connection to your mood issues too. So, this is the person who’s on break, uh, someone just commented about severe brain fog. We could hit that too, uh, but somebody might come in and say, hey I’m bloated and then you tease apart their case and you go, oh so you’re actually anxious too. You’re on antidepressant and an acid blocker and this happens every day, all day. So, just to clarify, number one, we hit a low stomach or we hit infections first. Number 2, low stomach acidity, you mentioned low bile in the gallbladder. Also, let’s give a shout out to people that don’t have a gallbladder, what about these poor people, they’re gonna need a lot of supplemental help for the rest of their life. And so, unfortunately, this is a very very common procedure done in the U.S., where the gallbladders are removed and so these people are gonna need some purified bile salts forever in my opinion. Well, what’s your…?

Dr. Justin Marchegiani: Absolutely! They’re definitely gonna need bile salts and some extra enzymes like lipase but again, you gotta get to the reason why that gallbladder issue even happened. Now, most people, it’s women in their 40s who have an overweight issue and so what tends to be driving, that is usually food allergens whether it’s grains or inflammatory foods but also estrogen dominance. So, if you have an imbalance in estrogen, estrogen is gonna help promote more fat storage so you obviously have more estrogen more fat storage. A lot of times you’re gonna have PMS issues too so you may be moody, irritable, um, sleep issues, uh, you could have fibrocystic issues, uh, tenderness, a lot of pain around PMS time. So, you gotta get to the root cause of that as well. So, we started out with just bloating but you can see how then this estrogen issue can affect bile levels and good bile flow because estrogen causes everything to get really stagnant and not flow well and then you’ll start having mood issues and PMS issues and maybe even fertility issues. So, you can see how you start at one point which is bloating, which is the topic of the video but then it can spiral down this other kind of tangential pathway.   

Evan Brand: Yeah. Not to mention two, let’s just say it started out with heartburn, I just want people to kind of visualize this. So, let’s say it starts out with heartburn. You go to the target and you buy Prilosec, which is over the counter acid blocker medication, you reduce your stomach acid even more but you feel some relief from the heartburn and let’s say your spouse had H. pylori, you guys pass that between each other, so now you’ve got even more reduction of stomach acid levels, you’re on the acid blocking medication. Now, you’re anxious, you’re starting to get depressed, you’re getting a bit of fatigue. As you mentioned, now, you’re getting some hormonal issues, some hormonal issues like breast tenderness or PMS or ill ability, you’ve got this dysbiosis growing in your gut so you have this bacterial infection. It could be multiple things, Strep, Staph, Klebsiella, Pseudomonas, Bordetella. And now, you’ve got beta-glucuronidase issues. Now, you’re recirculating all this estrogen. You’re creating more problems with the gallbladder. Maybe, you get the gallbladder removed. Now, you’re in really big trouble then that leads to the diet so then you read some guy on the internet who says, you need to be doing 70 – 80% vegetables. So now, you’re doing all these veggies and you’re even more bloated and you’re even more gassy and you don’t know why. So, you’re eating broccoli, you’re trying to force all these leafy greens down, a lot of vegetables. Maybe, you’re doing a lot of avocados, these higher FODMAP foods that are fermenting in the gut. This is the case where you’ve got a really, to me, the best, most beneficial thing I’ve seen for these cases, get the diet very simple, focus on good quality animal proteins and for a time being minimize your vegetables so that you can let the gut rest. 

Dr. Justin Marchegiani: Yeah. Absolutely. From a solution standpoint, yeah, good proteins, good fats and then if we’re gonna do vegetables, make sure they’re cooked steamed, sauteed, maybe use an instant pot and try to make sure they’re on the lower fermentable side. Now, that being said, next, what’s another driving factor of bloating? increase in fermentable vegetables. Now, people are hearing all kinds of things about probiotics being helpful. Well, they are. There’s a lot of good benefits to probiotics and the microbiome and the endogenous nutrients they produce. They, um, whether it’s vitamin K2, whether it’s different B vitamins, really helpful. It also produces acidity which helps keep a lot of bugs and bacteria from growing in the gut, totally helpful. Now, if you already have a lot of bacterial overgrowth and bad bugs growing, sometimes, these extra good bacteria can actually cause more bloating, more gas. And then, of course, because they’re fermentable they can also create histamine too. So, the histamine may create more brain fog or headaches, more destruction there. So, you may have more histamine symptoms, you may have motility issues because they’re producing hydrogen methane gases maybe and that may cause either diarrhea on one side or maybe more constipation on the other side, definitely possible. 

Evan Brand: Yeah. Yeah. Good call on the histamine. And so, some of these bacteria on your gut, they’re gonna be releasing histamine too. So, if you’re combining high histamine foods, you’re doing leftovers, let’s say, last night, you made a steak, you’re cooking that leftover protein. That’s gonna be higher in histamine. Combined with the histamine being produced from this bacterial overgrowth problem, yeah, you mentioned brain fog, skin flushing, rashes. So, once again, here we are talking about bloating but we’re trying to elucidate this big spider web of other symptoms that may be going on.   

Dr. Justin Marchegiani: Correct.

Evan Brand: Um, also, what about a stress component meaning someone just simply not chewing enough, they’re rushing through their meals. I think this from a mechanical perspective. If you look at your average person, I mean I saw somebody on the highway the other day, I don’t know if it was a donut, a piece of pizza, it was some kind of junk. I couldn’t tell exactly what it was but either way there’s still people trying to do makeup, scrolling on their smartphone, eating a piece of pizza, all while driving on the highway at the same time and we wonder why they have digestive problems. So, maybe we talk about the impact of not being settled when you are eating and this sort of like, this parasympathetic process that digestion is supposed to be our ancestors, they didn’t have that level of stimulation while they were trying to eat. I mean, maybe there was a wolf trying to come, get their bison killed but beyond that there wasn’t this big sympathetic stress underneath all of our meal times.   

Dr. Justin Marchegiani: Yeah. We kind of started out the video talking about the parasympathetic-sympathetic balance and how important that is because the parasympathetic is part of that rest and digest that gets the digestive secretion going. It stimulates all the blood flow into the organs, the intestines. So, of course, setting really good boundaries for your meal, you know, I recommend kind of kind of go into a meal five times or ten minutes, just kind of relax, do some deep breathing, have some appreciate, appreciation about your day, the food in front of you, you know, just whatever blessings you have in your life, just try to really get to that parasympathetic state with just good breathing in the nose, right, four to five nasal breaths in and out. Focus on whatever’s good in your life, appreciation. Whatever you have to do, whatever kind of resonating prayer to put you in that state when you just feel better and then go into that meal keep it quiet or if you want to listen to something that kind of allows you to feel good and feel rested or relaxed, that’s fine. And then, go into that meal and make sure you chew your food really well. Try to avoid a lot of hydration with the food, you know, a couple of ounces of water for swallowing some pills or digestive support is fine but try to get into that meal, like, I just had to have a good routine. Get some good hydration ahead of time, try to go into some kind of meditation or prayer for five or ten minutes ahead of time to really get that parasympathetics going and then go into your meal and really just try to chew things up pretty well too, you know, about 30 chews per bite of food on the average, kind of get your food chewed up to about an oatmeal like consistency so it’s really broken down well that’s allow the enzymes and the acids to work a lot better too. 

Evan Brand: Yeah. You know, what’s interesting is a lot of people are kind of pressure into these business meetings like with their boss or with their co-workers, there’s this like work-meeting-lunch deal where people are going out with people they probably wouldn’t associate with outside of the workplace and they’re going and eating with those people. And so, I would just tell you, if you don’t like it and that’s not your vibe, don’t do it. If you feel more comfortable, more relaxed eating by yourself, don’t do it. I mean, I remember, l had some stressful conversations over lunch and dinner tables before with people over the years and I leave feeling like I didn’t eat anything and that my mind was so focused on even if it wasn’t a negative conversation. If it was on some sort of business deal or the state of the world or something and then I’m eating. I would get up from the table. I’m like, oh crap, did I eat and I didn’t process that and it would sound maybe like unnecessary advice but I think a lot of people need to be picky of what they talk about it at the dinner table.

Dr. Justin Marchegiani: Yeah. I think anything that’s gonna keep you in that parasympathetic state is great, you know, save the more stressful things before or after and I think, also, just have good boundaries. Try to make sure you get at least 20 minutes for a meal, um, to yourself, you know, I mean, if you don’t have 20, if you can’t put 20 minutes in your schedule for you to consume some good food and put yourself in that parasympathetic state then you got some boundary issues and you got to really work on roping in your schedule and getting some control over it, at least so you have that 15-20 minute to yourself and you can really process that food well. And again, I’m not saying there won’t be some exceptions or some stressful days here or there but on average try to make sure 80 to 90% of the time, you really have control over your schedule to that degree. 

Evan Brand: One of my favorite things to do even in the wintertime here, if I’ve got blue skies. I’m taking my shirt off, I’m going to sit on my front porch where I’ve got a nice comfy front porch patio chair and that chai is warmed up by the sun so I just take my shirt off sit there barefoot and in the chair and eat my bison burger for lunch and the sunlight is a mast cell stabilizer so I noticed the sun helps me if I have any kind of food reactions, the sun will stabilize that, obviously there’s nitric oxide benefits. There’s likely some nervous system benefits circadian rhythm benefits. So, for me, if you can get fresh air on your lunch that’s great and what the heck does sunshine have to do with bloating, well, I mean there’s even some studies on sunlight improving the diversity of your gut and we’re outside all the time now. So, if you just type in like sunlight microbiome, you can read the papers on this, it’s in a microbiology journal about how exposure to the UV rays can improve the gut diversity so it’s no surprise that all these people in offices buildings all day, they got poor diversity. Obviously from other things but lack of sunshine is a negative factor for your gut health. 

Dr. Justin Marchegiani: Yep. Yeah. Absolutely. I mean, also, there’s other bugs that are out there I think we already kind of talked about H. pylori because that can affect the stomach and that can decrease, um, acid production and thus when acid production is down, we know enzyme production is also down and then that can also affect biliary function, biofunction, so we know H. pylori is a big thing. Other bugs can be problematic, right? We already mentioned SIBO, which could be a whole bunch of different bacteria that are overgrown in the small intestine that could be Citrobacter, Prevotella, Klebsiella, Pseudomonas, Morganella, right? It doesn’t really matter the actual bugs but if there’s an overgrowth there, they can definitely disrupt digestion creating different gases on the methane and hydrogen side and that can create obviously more bloat. Other parasites can cause problems too. So, we see things like Blasto, Blastocystis hominis, right? E. histo, D. fragilis, Giardia, Cryptosporidia, these are all other bugs that could be problematic. Then even things like fungal overgrowth like Candida overgrowth, whether it’s a Rhodotorula species, Albican species, these types of imbalances can cause problems. So, it’s good to test and really make sure that we look at the whole microbiome and see what’s out of balance or not and then from there food wise, I mean, of course, general refined sugar, refined grains, right? These processed foods, excess fiber, lots of raw vegetables, uh, fermentable carbohydrates, right? These things are gonna be on the list, as well. And so, we’ll kind of add those. There are a lot of different things that we have to look at so I kind of gave you the top five or six on this list. Anything else, um, Evan, you wanna add to it?

Evan Brand: Well, I would just say that if you’re coming into this conversation, you’re listening, maybe you don’t have much background and listening to people like you and I talk about functional medicine strategy. Some of this may just go right over your head. You may just tune out because you’re hearing these things which sound exotic and they sound rare, like H. pylori. I don’t have that. Giardia, what the heck is that? Blasto, though I don’t have that. You know, I just have bloating. The reality is these are very common things. The problem is the testing that’s used in the conventional gastroenterology world is very outdated and very insensitive, meaning there’s a lot of infections that go missed and even if these infections are tested for, it’s not likely that you’re gonna find an accurate result. And so, what we’re talking about, these are not rare situations, you and I, between us both, we’ve seen several thousand clients and patients across the world over the last decade and we can tell you that these issues are something we see every day, all day. So much so that in fact when I see a whole big list of infections on the stool test, I don’t get shocked by it. Yep. Uh-huh. That’s it. That’s what we’ve got. So, if you’re listening to this, you’re like, ‘man, that’s not me. I’m just bloated and tired.’ Well, there’s a reason for that. And so, I highly recommend you get tested, figure out what the heck you got, going on because if you’re not testing, you’re guessing and if you’re going and taking probiotics or random enzymes and you don’t feel better or you’re confused about what you should actually taking and not taking and you’re building up a supplement graveyard. It’s time for you to get tested and figure out what the heck you’re up against. And so, if you need help, you can reach out clinically, Dr. J is at you can reach out and do consults worldwide. So, we jump on a video call just like we’re doing here, Zoom, facetime, skype, we can look at your labs that you run at home and we can figure out what’s going on and make you – a game plan to get better. And if you need help for me, it’s Evan, and either one of us, Dr. J,,, we’re here to help you and the cool thing is you can reverse these issues and you can get to a point where you don’t even recognize your gut health. I mean, if I look back at myself even 10 years ago, I had such severe IBS. I did every diet under the sun and I made some progress but it wasn’t until I looked at my gut that I really made the magic happen. 

Dr. Justin Marchegiani: 100%. And so, just to kind of highlight a couple of things out of the gates, um, we’ll put some links below as well to some of the lab tests that we recommend, whether it’s the stool testing, whether it’s the organic acid testing which does look at bacterial and yeast metabolites. I love the organic acid because it’s very good at picking up Candida and yeast overgrowth, where a lot of times those tool testing will miss that and of course the, um, breath test will not touch any yeast overgrowth. So, it’s nice to have whether it’s stool test, whether it’s the GI map, whether it’s an organic acid, whether it’s a conventional lactulose, breath test, these are all good tests. We’ll put links down below. So, if you guys want to look at getting some of those to start out at the gates, you feel free, you can. Also, I like to compare and contrast like what we do versus the conventional gastroenterologist. So, most gastro docs, they’re just trying to rule out significant pathology, significant disease and so they may cross off the list by doing some kind of an endoscopy, which is camera down the mouth to look at inflammation in the stomach or esophagus and if they see esophagitis or gastritis, you know, what they’re going to do, they’re gonna recommend some type of PPI or Gaviscon or some type of a coding agent to kind of help reduce the inflammation but they’re not gonna really fix the root cause. Most of the time, they pull you off acids, which may be helpful in the short run but it’s forever altering your ability to break down protein or fat and it also can shift your bugs in a negative direction because now you don’t have the good acidity to keep the microbes down. You need the acidity to activate enzymes, you need the acidity to activate your bile salts. So, someone’s jumping in on the questions here saying that hey they feel better on keto but now they’re feeling more constipated. Yeah, super common because what’s happening is you’re cutting out a lot of the foods that are causing problems but you haven’t fixed your digestion, you don’t have enough acidity, enzymes, bile, there may be some bugs that are still impacting digestion and this is why being on good proteins and fats can be helpful but they also reveal weak links in your digestive chain if you’re not breaking down food well. So, just kind of getting back on the gastro doc kind of bandwagon, they’re gonna be looking at pathology inflammation in the stomach, you know, ruling out the big things like blood, um, in the ulceration in the stomach, you know, usually you’re gonna know that because you’re coughing it up but you’re seeing it in your stool. If you have irritable bowel disease symptoms like Crohn’s or ulcerative colitis, usually, you’re gonna have significant inflammation in the stomach, usually significant diarrhea, blood in the stool, they’re gonna rule that out and then what and then for the most part, once the big pathology things, ulcerations, cancer, massive amounts of inflammation are ruled out, they’re gonna typically give you like IBS diagnosis, whether it’s IBS-D for diarrhea or IBS-C for constipation and they’re gonna just manage whatever symptoms whether those symptoms are with different drugs. So, if it’s constipation, they’ll use laxatives. If it’s diarrhea, they’ll use things like Imodium or Pepto Bismol or anti-inflammatories. They’ll just modulate the symptoms with drugs and that’s it and they’re not gonna really get to the root cause. They’re gonna just try to spot the treat and then that’s where people come to us because overtime, those drugs will become less and less effective, you have more and more side effects, you’re not fixing digestion, you’re creating more nutritional deficiencies, maybe more gut permeability issues, maybe more autoimmune stuff and so these patients then come to us because they’re just tired of putting band-aids over band-aids. 

Evan Brand: Yeah. Well said. I forgot to mention the endoscopic procedure that is super common, uh, they wanted to do that on me, years ago, when I had IBS and I denied that because I even back then I had read about these infections that people were acquiring from getting scoped meaning the last person that they put the tube down, they didn’t properly clean or sanitize that so then they stick it down your throat and then you leave the hospital just to investigate and as you said, the only thing that’s gonna come out to that is they may say gastritis which is super generic. It doesn’t tell you anything about these infections and they’re not gonna give you an herbal protocol to address the infection causing the gastritis. But now, you’ve left the hospital with Clostridia or some other possibly antibiotic resistant infection that’s involved to evade the sterilizing and cleaning procedures. So, I’m all about non-invasive, accurate, functional medicine testing and that’s why we love what we do because there’s a very rare, maybe one every five years, yeah, is there a case where I’m like yeah, you need an endoscopy because there’s something crazy here.  

Dr. Justin Marchegiani: Yeah. Usually, with an endoscopy or colonoscopy which is gonna be going up the rectum to look in the colon. Usually, there’s gonna be blood in the stool, some type of significant inflammation, whether it’s excessive diarrhea, excessive inflammation, excessive blood in the stool, excessive weight loss. It has to be at the extreme ends for that to make sense. Most people just have inflammation and a lot of times the tests won’t kind of tell you enough about the root cause, they’re just gonna put you on medications to manage the symptoms and that’s where you’re kind of stuck in between. Now, a lot of my ulcerative colitis, IBD patients, they’ve already done that. Yeah, so then, it’s like all right, they’ve kind of already crossed that off their list any weird cancers, ulcers, it’s already done, they know, they’re just being managed with Lialda, Prednisone, a biologic and then it’s like, now what, right? And so, we still have to get to the root cause of that and get the immune system chilled out and figure out what stressors are there so we can get on top of that too.     

Evan Brand: Yeah. I mean, I know you and I have seen countless emails being sent to us with pictures of colons and you know different things from these scopes like hey there’s my scope results, you know, what do you have to say about it and the answer is always the same. Okay, there’s something there, let’s work on the infections. And so, uh, yeah, someone in the chat, uh, shelly said, yes that they all recommended me, every time, I go to the doctor. So, yeah, that, I mean that’s all they’ve got, they don’t have the stuff that we’re using maybe in 20 years from now you can go right down the street and get done what we’re talking about but for now you’ve got to seek out somebody like us that’s gonna be able to help you, uh, there’s one person in the chat too asking about a viral impact on the gut, it’s real. I did a whole section of that in my better belly course about that virus in the gut and so it’s definitely a big factor.   

Dr. Justin Marchegiani: Yeah, and just to kind of, uh, speak, kind of on the line here, so, um, we can, we don’t get censored, there’s certain viruses that are out there, right? There’s an ACE2 receptor site that gets impacted in these different viruses and the ACE2 receptor site, there are a lot of them in the gut and these receptor sites are really important for absorbing amino acids and so if you have any of these maybe chronic viral issues, one of the good things that you can do is actually extra free form amino acids to allow these receptor sites to absorb these amino acids easier, right? I think the free-form amino acids are already broken down. So, if you have this chronic immune stress and you’re having a hard time recovering from the immune stress adding in some additional free form amino acids can be very, very helpful on the healing side.  

Evan Brand: Yeah. I’ve seen a lot and there’s papers on this too but I’ve seen it clinically too. People post viruses that will look at their stool, there’s gut inflammation, there’s low secretory IgA, so we can see there’s been some damage and so we have been able to resolve it. So, yeah, we’ll wrap this thing up but if you al need help, please reach out clinically, we mention the websites one more time, Dr. J, that’s, me and we’re here to help you guys, so you can reach out and we’ll get to the bottom of this. 

Dr. Justin Marchegiani: And sometimes, we’ll even use some kind of an elemental diet with people that have chronic digestive issues just  because it can be hard, breaking protein and fat down and these are really good, important nutrients but sometimes we just got to break it down for them and using some kind of an elemental or a modified elemental, where maybe you make the first four to six hours of the day, really easy to process in some kind of smoothie or shake that has most of the amino acids in free form, maybe the fats more easy to process like in an MCT oil or something like that and then we use a lot of the vitamins and minerals all broken down. That could be very helpful and give the digestive system a chance to rest and some people they notice this because they just feel really good when they fast and so if you fast and you feel really good that’s excellent but you’re still not fixing the problem of getting nutrients in the system so that’s where using some kind of an elemental type of shake can be really helpful. 

Evan Brand: Yeah. Well said. Well, I’m done. I feel like we’ve covered a lot of good stuff here. 

Dr. Justin Marchegiani: Excellent. Yeah. I mean someone asked one question about flour substitutes. It just depends on where someone’s at, so flour, it’s a processed food so out of the gates, if someone wants, um, like a starch, um, I recommend maybe a greener banana, maybe yucca, cassava, maybe a Kabocha, spaghetti squash. Just look at some of the fibers, uh, non-starch, I should say, more starchy carbohydrates that are gonna be grain-free, see how you do with that. And then, if you want an actual flour, you can look at it like an arrowroot or you can look at it like a cassava is pretty good because it’s still grain-free but it’s still gonna be on the processed side. So, ideally, try to keep it grain-free so you don’t have extra gluten sensitivity connection with those.   

Evan Brand: Yeah. Definitely. That’s what I was gonna say too. Potatoes, rice, a lot of these things can still create problems for people. I’ve had many people feel like crap on some of these gluten-free breads. So, yeah, it’s still processed garbage in my opinion. 

Dr. Justin Marchegiani: Yeah. And then, someone wrote in about the, um, the onions there. Onions are very high in FODMAPs and that can be a problem and so if you head, your gut feeling a lot better and you can come back in and you’re noticing FODMAPs are creeping into your diet and causing a lot more bleeding definitely kind of, you know, rain that back in and see how much that back in and see how much that kind of brings you back to homeostasis. 

Evan Brand: Yeah. This person told, uh, they said that they’ve had similar issues with cabbage, brussels sprouts, and other similar veggies. So, yeah, I mean I would go more animal-based. See how you feel with just some meat and some berries for a little while. Maybe if you tolerate a little bit of some organic pecans, if you want to do a little bit of nuts but do like a bison burger and a handful of blueberries for lunch and see if you feel better. I suspect you will. 

Dr. Justin Marchegiani: Yeah. At least, just try, you know, cutting out the higher FODMAP foods because when you address microbes, right? You starve it on one side with restricting certain foods that can feed it, you can kill it with certain herbals and then you crowd it out with probiotics. And so, sometimes, we have to go back to the killing side and kill the microbes out a little bit more but I always just see how much the starving kind of works. Get the starving going again and then if you have to kind of return to a protocol, where we knock down the microbes with herbs, we can always do that too. 

Evan Brand: Yeah, and we’ve made these protocols a lot. It’s really fun to combine and mix and match and get the synergistic effect of this herb plus that herb. I mean, that’s where the magic really happens and there is an art to this too like you said when to cycle things on when to cycle them off, so there’s not just this one cookie cutter thing that you have to do. You really got to just work with the person. Certain herbs are used for certain parasites, certain ones we use for bacteria, certain ones we use for fungus. It depends on what you got, most of the time it’s a combination of all these bugs. 

Dr. Justin Marchegiani: Awesome. Hey, Evan, great podcast today. Hope everyone at home listening enjoyed it. Feel free to share with friends or family. Put your comments down below. Let me know what things that you guys have tried at home that have worked well or haven’t. Really appreciate the conversation. Evan, have an awesome day man. 

Evan Brand: You too, take it easy. 

Dr. Justin Marchegiani: Take care. Bye. 

Evan Brand: See you. Bye-bye. 


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The Top 7 Causes of Why You Are Bloated | Podcast #344

Stomach bloating happens when the GI tract is full of air or gas. Most people describe bloating as feeling full, tight, or swollen in the abdomen. Your abdomen may also swell (distended), be firm, and have pain. Bloating is often accompanied by pain, flatulence, constant burping, and abdominal rumbling.

In this video, however, Dr. J and Evan talk about the other causes of bloating that may be due to medical conditions. These include irritable bowel syndrome and disease, bacterial overgrowth, altered gut motility, aging and stress, and many more.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:41:  Bugs and gut infections

2:58:  Low Enzymes, acids, and bile salts

3:45:  Aging and stress

5:29:  Adrenal stress and food allergens

8:43:  Mold toxins

10:29: Low thyroid hormones

12:55:  Gut autoimmune disease

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Dr. Justin Marchegiani: And we are live! It’s Dr. J here in the house with Evan Brand. Evan, how are you doing today, my man?

Evan Brand: I’m doing well. We’re ready to talk about like, the mainstream topic. Like, sometimes, you and I, and we go into some of these nuances, that unless you’re into functional medicine or natural medicine, you may just be like, what the heck are you talking about? But  every single human being, man, woman, baby, they can already relate to bloating. So, let’s dive in. You came up with the magic number of seven. So we’re going to riff on who knows, could be 7 or 17 different causes that we see clinically from bloating. Let me start off with number one. Gut infections which if open that can of worms, we can do five to twenty infections, and then get to that magic seven number right away. But I’m just gonna go ahead and say…

Dr. Justin Marchegiani: 100 percent.

Evan Brand: Bacteria and Candida-those are probably like, two of my biggest smoking guns. I, I know parasites cause a lot of gut damage but I’ll say personally, when I had parasite infections, I don’t think I had much bloating. I think it was more of my dysbiosis, my candida problem driving the bloating than the parasites.

Dr. Justin Marchegiani: You know, when people have parasites, there’s a lot of issues happening so it’s really hard to know like, is the parasites alone the root cause why you’re having these issues. And it’s hard to know that. I mean, parasites can definitely do it because they can affect you body’s ability to generate stomach acid, and enzymes, the bile support. Obviously, they can eat a lot of these foods and they can be fermenting, and creating gases being released from them, you know, they’re pooping in their, you know, um, farting inside your intestines and creating gases and things, and obviously, they’re creating  information which then can affect digestion so parasites, we can just kind of lump bugs all the same bucket if you will. So we could say bugs, parasites, H.Pylori, fungal overgrowth-we can say small intestinal, bacterial overgrowth, or SIBO, or candida overgrowth, or fungal overgrowth. All those things kind of go in the bucket worms kind of goes in that parasite bucket as well. Anything else you want to highlight there before we go number two?

Evan Brand: Yeah, how about, uh, you can call it SIFO too. We haven’t hit that term but, just, just in case people aren’t clear on it so when we talk about fungal overgrowth. You can literally have what’s called SIFO. So this means you can have SIBO but, you can also have SIFO, and as you mentioned, it’s rare to see these things in isolation. So we’re often going to be using broad spectrum herbs, or antimicrobials, anti-fungals, antiparasitics all at once to try to knock all these down.

Dr. Justin Marchegiani: 100 percent. So regarding, um, bugs, SIBO, SIFO, and fungal overgrowth, or candida that are kind of all in the same bucket there. Uh, I would also say, diff kind of isn’t that bucket too, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Um, you know. You can almost put some of the mold, um, the colonized mold, uh, fungal critters in there as well. Some of the aspergillus and things like that potentially, they may have different root cause of why they’re there but, that’s something that should be looked at. Next thing, is um, low enzymes, low acid, low bile salts. And again, some of these things are caught like they’re connected. So like yeah, HCL, enzymes, low bile salts if we are, aren’t able to break down those foods adequately, they can ferment, they can acidify, they can create gases; and of course, those bugs on step on can also create low stomach acid, low enzyme and bile salts. So everything is kind of connected in this web here. So I would say, the digestive secretions I think would be there. I’d also throw in, maybe some lifestyle things like not chewing your food enough, and maybe drinking too much water which shifts the pH in the stomach from a two-ish to closer to a seven which water is, and those would be the things I want to highlight. What do you think?

Evan Brand: Yeah, good call. And I’ll also point out just age and stress, not chewing some of this lifestyle measures you mentioned. That could be enough to create the bloating. As we know, the infections are going to drive some of this too. So kind of like, chicken or the egg, and it is possible that just age alone by the time you’re 40, 50, 60 beyond, you’re going to be making less stomach acid and Dr. Wright’s book. He had an amazing graph in their age and stomach acid levels. So if you’re one of the lucky few that are 40, 50, 60 with no gut infections, you simply just have an aged-induced low stomach acid. Well, that’s cool but, the low stomach acid will eventually drive some sort of infection, right? Now you’ve got this fermentation and purification of the food. So even if you’re like, somehow magically clear on stool or urine, and you just have low stomach acid, it won’t be that way forever. Eventually, stuff will pop up.

Dr. Justin Marchegiani: 110 percent. Now, everything’s connected right? So of course, if we have fungal overgrowth and bacterial overgrowth, well that can affect stomach acid but, now that also can affect motility, and so if we have slower motility, right? On the faster motility side, like diarrhea and such. You know, that can really cause a little bit of bloating but tends to be more on the slower stool side because, the stool is just sitting in your intestines longer, and maybe getting compacted. Maybe it’s taking you two to three days to kind of move that stool out. That may give you a sense that you’re feeling more bloated more as well. So I would say now that the slower motility, potentially caused by the bugs, caused by the HCL, could now start to increase that feeling of bloat.

Evan Brand: Yeah. So you’re saying like, you’re literally just full of poop as opposed to the infections or releasing gases which make you feel full but that’s a different type of bloat. So that’s a good, that’s kind of a good distinction there.

Dr. Justin Marchegiani: Yeah. It could just be a combination of everything, you got a little food baby inside of you, you know.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s possible. Next, I would say adrenal stress. And so adrenal stress, the adrenals are part of the stress handling system that helps your body manage stress. Whether it’s through making adrenaline to help your body like, get the spider senses going so you can deal with that stress, uh, it could be just chronic low-grade stress where you’re making a lot of cortisol, and or you’re chronically inflamed from foods and emotional, and maybe even physical stressors, where the adrenals are just really over romped up and that’s activating the sympathetic nervous system, and so you have that see-saw, right? And sympathetic is the fight-or-flight, that’s the go-go-go, that’s the gas pedal. The break is the parasympathetic, they’re on a see-saw. So it’s hard to like, double clutch you know, and have a hit the gas and the break at the same time, so usually the sympathetics are up, the para are down. If the parasympathetic’s up, the sympathetics down, and the parasympathetic is to rest and digest. That’s the vagus nerve, right? People are like, “Oh! Gargles, sing”, right? Well, those maybe palliative things but, how about just fix the stress in your food, in your emotional life, in your physical life, work on that first. Uh, that’s going to make a huge difference and of course, gluten and processed sugar, and inflammatory foods, and foods that are nutritionally deficient can drive that kind of stress as well.

Evan Brand: Oh, yeah. Let me piggyback off that then. So you got the food-adrenal connection but how about just food connection in general? I mean, if you’ve got dairy in the system, you’ve got gluten in the system, you’re going to effect the tight junctions in the gut, so you’re going to maybe contribute to leaky gut but, also you may have some bloating from that. Now, there are enzymes, I know you and I, we manufacture some custom enzymes that things that can contain, what’s called dpp4, which is an enzyme that can help break down gluten. There’s also some allergy enzyme type formulas that we use where we can break down the occasional instance of all these types of proteins, dairy protein, and soy protein if people are getting exposed to it but, food allergies are big one, so I know you and I talk a lot about good quality meats, good quality fats, organic vegies and such but, if you haven’t got your diet boring before, I think I would go boring. I mean, look at me, I’ll do like a grass fed steak and a handful of blueberries for breakfast and I feel great. So, for me I would just recommend really, simplifying, trying to get your foods in isolation where you know, what you’re reacting to. For example, let me use my wife as a story. So, we were doing swapples which are awesome! It’s like a healthy waffle-it’s yuca, yuca-based, and she thought those were affecting her stomach but, she was also doing organic coffee, and she was doing eggs, and she was doing pastured sausage or bacon. I’m like okay, well, you got too many foods in here. We don’t know what it is. So we got down to elimination and then boom! We figured out it was the coffee affecting the gut. It wasn’t the food after all. Even the eggs which are common trigger were no problems. So I think you got to dial the food allergies, the food sensitivities, and just try to eat you food in isolation. Maybe do a food journal. Even on your phone, you could do an app, like I use Day Book a lot to take notes and you can just make a note like, :Hey! Eggs hurt my tummy today, or eggs got me bloated”, and then you can figure out what it is.

Dr. Justin Marchegiani: Absolutely! So the food component, just the inflammatory nature of that food. I think is also going to be a big one. Um, like you mentioned, I would say next, mold toxins. I know mold, uh, can do different things, whether it’s, you know, we kind of talked about it as kind of being a bug thing, which I guess it could be connected but, the problem is you may live in a moldy home. You may have things in your environment, whether maybe it’s too humid, right? And there may be a different solution for that than fixing out your bugs, clearing out the bugs in your tummy, so we may have to go about that a different way. So I guess, the mold kind of connects with the bugs but, there’s also a different solution to it. So we’ll put mold as a separate entity on that list, and that could be just too humid of a home. It could a leak in the home that was never fully remediated properly, um, it could be lack of good quality air filtration. All of those things could play out and of course, mold also is a sympathetic nervous system stressors as well.

Evan Brand: Definitely and they’re two different categories because, you can have two different situations you can be colonized for mold, meaning you’re growing in your gut and sinuses. Or you could just be a mycotoxin reservoir and some people are lucky enough to where maybe, their immune system was able to not allow the colonization or maybe the exposure of the mold was not too long-term, therefore, they’re just reservoir of mycotoxins but they’re not growing it. That’s a better situation. It makes out job easier if that is a situation, and yeah for sure, I mean, mycotoxins for me definitely affected my gut, my brain, my stool, consistency, so binders really help. So if you are having bloating but you’re having more IBS type symptoms, you know, of course bringing in the binders; we’ve done podcast on that is going to be the next step. Let’s go back to hormones per minute because yeah, I would consider you one of the best experts in hormones, and you’ve taught me over the years about hormones, and I know that PMS for a lot of women. PMS is a big deal, not only is it mood changes but, it’s bloating. So can you full us in there? What’s the hormone connection outside of cortisol to bloating.

Dr. Justin Marchegiani: Yeah. So I would say out of the gates, um, low thyroid has a string connection with affecting motility. So one of the side effects of low-thyroid hormone. Obviously, can be the conventional hair loss, cold hands, cold feet, eyebrow thinning of the outer third, maybe mood issues, maybe irritability, and obviously some of that overlaps with adrenal and female hormones and male hormones. But low-thyroid also affects motility, and so low thyroid hormone could easily affect motility. And if we slow down motility, that could easily allow more time for those foods, the ferment kind of create that food baby if you will. Just put more bulk in your tummy just make you feel a little bit more bloated and distended so it’s very possible could be playing a role in the whole situation.

Evan Brand: Okay. Well, we talked about thyroid and 90% of hypothyroid cases are hashimoto’s, so I mean, we could just say hanshimoto’s could be a cause. It’s a roundabout way. It’s a long, it’s along route to get from hanshimoto’s to bloating but, it does make sense.

Dr. Justin Marchegiani: Yep! Exactly. Um, so yeah, at this stage of the game, female hormones can plug in. Like if you have estrogen dominance, right? Lower progesterone, higher estrogen. Um, relatively speaking and just lower hormones. That can create potential things that could affect motility via stress, via sleep, and then if those things are compounded, that can create more adrenal stress. So you can kind of like, you know, it’s kind of like, it’s six degrees of bloating, right? It may not be a direct, direct indication but, it can easily, kind of dovetail two or three you know, weighs in and hit a couple of these different factors, that makes sense. So I would say some of the female hormones, um, obviously, some of the cortisol, and adrenaline, and of course the big one that we’re hitting now is the thyroid, the low-thyroid hormone. Evan Brand: Yep! Yeah.

Dr. Justin Marchegiani: Is that number five or six?

Evan Brand: Two… I don’t know. I don’t know. I think we got, we got more of those. So how about just bowel obstruction? I mean, this is not going to be a common situation but, you know, if somebody hasn’t poop in a week, and they’re listening to this podcast, I mean, you have to consider the possibility of bowel obstruction. Unfortunately, this is pretty rare but it does happen.

Dr. Justin Marchegiani: Yep! Yep. 100 percent. Um, so that can definitely happen. An again, all these things that we’re taking about would be contributing factors of that,right? So that makes a big difference on that front. Um, so we hit the enzymes, we hit the food allergens, we hit the bugs, we hit mold,

Evan Brand: That’s five.

Dr. Justin Marchegiani: We hit adrenal stress,

Evan Brand: That’s six.

Dr. Justin Marchegiani: We hit thyroid stress. That’s seven! I think we hit them all.

Evan Brand: All right.

Dr. Justin Marchegiani: Is there anything else you want to add as a bonus or value add for the listeners?

Evan Brand: Uh, yeah. So any kind of autoimmune gut stuff. So celiac, crohn’s, ulcerative colitis. Even diverticulitis in some cases could cause any and all of these issues we talked about in terms of bloating, and stomach pain, and all of that. So if you are seeing more than just bloating, you’re seeing blood in the stool, or you’re seeing  floating stool, maybe there’s fat malabsorption issue. We could go into gallbladder potential issues there as well; where we need to use some extra bile salts. So I would just say any kind autoimmune gut stuff is going to be a big one.

Dr. Justin Marchegiani: Yeah, a hundred percent. Autoimmune is gonna just create more inflammation. It’s gonna inflame the tissue to make it more raw, the more inflammation in the tissue, and the more sensitive the intestines are, the more your adrenals, and you cortisol, and your fight or flight system will totally get activated. I think it’s a really good step out of the gates here. I think we really hit a lot of good things here. So, we have food, we have low enzyme, we have low acid, we have bugs, we have mold, we have adrenal stress, right? We talked about thyroid and then the last thing we talked about is just the bowel obstruction and or the autoimmune um, gut stuff. So I think we hit seven to eight there. So a little, a little extra. So guys, if you’re listening.. go ahead.

Evan Brand: Let me, let me do the outro for you today. So today’s shorter and we want your feedback because we’ve done, I, I, lost track, I know my podcast is over 400 episodes. I know you and I have done hundreds together. So we want feedback on this. Is, is this is coming up on 15 minutes. How do you enjoy a 15 minute podcast? Is this all you need? Do you enjoy the 30-45? What do you like, because I mean, we could always go deeper but, eventually It becomes um, maybe rants or tangents. Today is just like, boom boom boom. So please, uh, go on Justin. Look up maybe his Instagram page, just in health or Justine Marchegiani. Look him up there and look up me Evan Brand and send us a message, and let us know. ‘Cause sometimes, we forget to check the reviews but yeah, send us a message maybe on Instagram. That probably the best place. We don’t use the Facebook too much because of some of the censorship going on but anyway, check us out, send us a message. Let us know what you think! Is it shorter, and sweet, and boom boom boom episode, is that good enough for you or do you want deeper dive? Let us know, and if you need help clinically, you can reach out. Justin works around the world with tons of people, thousands of people over the years, and he can run all sorts of labs to investigate these issues. So to reach out to Dr. J, and for me Evan Brand, We would love to help you, we offer intro calls too. So you can book a quick call to discuss your symptoms, your goals, see if you’re a good fit, and we can help you anywhere. So the beauty of these type of symptoms, there are root causes, it’s not a deficiency of some sort of gas x or other thing you’re going to get ate walgreens, you know, there are root causes here that you can investigate and you can reverse these symptoms.

Dr. Justin Marchegiani: 100 percent. And then in regards to the solutions here, the solutions are addressing those root cause. We can go, we can do another podcast in the top six palliative kind of solutions, but out of the gates you know, fixing the bugs, fixing the stomach acid, look at what those adrenal stressors are, getting the food right. I think those would be the big kind of the root cause foundational things today. We’re not going to go too granular into extra protocols but, just kind of more big picture stuff and we’ll do another podcast in the future where we get more into the nitty-gritty in this.

Evan Brand: Sounds good.

Dr. Justin Marchegiani: Awesome! And guys, if you want to leave us a review, or We’ll put the review link below. We really appreciate that review, really appreciate your comments below. You guys have an awesome day. We’ll talk soon.

Evan Brand: Take care now.

Dr. Justin Marchegiani: Bye!


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Benefits of a Food Elimination Diet

What are the benefits of a food elimination diet

By Dr. Justin Marchegiani

What is an Elimination Diet?

What is an Elimination Diet?

An elimination diet is an eating plan whose goal is to determine food allergies and intolerances. It is a short-term plan, usually lasting between 3-6 weeks, that allows a person to learn which foods may be causing digestive distress, skin irritation, and brain fog. In an elimination diet, certain foods are cut out of the diet for a few weeks, before being slowly reintroduced, one-by-one, in order to pinpoint troublesome foods.

What to Eliminate

 Foods To Eliminate

The law requires foods to be labeled if they contain common allergens. The eight foods identified by the FDA are:

  • Milk
  • Eggs
  • Fish (e.g., bass, flounder, cod)
  • Crustacean shellfish (e.g., crab, lobster, shrimp)
  • Tree nuts (e.g., almonds, walnuts, pecans)
  • Peanuts
  • Wheat
  • Soybeans

These eight foods constitute over 90% of allergic reactions! However, allergy tests don’t pick up on food intolerances and sensitivities.

Foods to eliminate in a food elimination diet include some of the common allergens listed above: gluten, dairy, soy, and nuts, but also encompass the common culprits of inflammation, digestion issues, and brain fog. These include nightshades (eggplant, peppers, tomatoes, and potatoes), alcohol, and processed sugar!

Click here to consult with a functional medicine doctor to diagnose and treat any food sensitivities!

Benefits of a Food Elimination Plan

Food elimination plan benefits

Eliminating sources of inflammation will allow your body to heal and can enact a plethora of positive changes within your body.

Recovery from Leaky Gut Syndrome: Leaky gut occurs when the intestinal lining becomes inflamed, which can be caused by the consumption of gluten, sugar, or other foods you are sensitive to. The inflamed gut lining allows food particles and other toxins to slip through into the bloodstream, creating more inflammation. By eliminating the foods that cause the gut to become inflamed, it is possible to break the cycle and heal your gut!

Reduce skin irritations, such as eczema and acne: Dairy and grains are two food groups which studies have shown have a strong link to acne and other skin irritations. Try cutting them out of your diet and watch your skin clear up in just a few weeks.

Prevent/treat learning and attention disorders: Studies have shown that a strict elimination diet can treat symptoms of (and in some cases defeat!) ADHD. There is promising research showing that even just avoiding artificial colors and preservatives can also lessen symptoms.

Reduce migraines: You may have heard the gut referred to as the “second brain.” In addition to all the functions, the gut is in control of, the gut actually communicates with your brain as well! An inflamed gut (due to consuming “bad” foods), can send signals to your brain signaling migraines and headaches.

Reduce bloating, diarrhea, and constipation: We’ve all experienced the feeling in our stomach after eating something we know we shouldn’t have had. Eating problem foods causes a relatively immediate stomach ache and possibly diarrhea, but regularly eating foods you are sensitive to – even unknowingly – can actually cause long term gastrointestinal distress! People who have gone on food elimination diets often say they didn’t know there was something wrong until they cut out the foods that were causing them to suffer. It’s like a weight lifted from your shoulders!

Bonus: add in a quality probiotic supplement to help your good gut bacteria rebuild!

Help heal autoimmune conditions: Food sensitivities can create and worsen autoimmune disease. Not only is it possible to stop the severity of your autoimmune disease from worsening, but it is even possible to reverse your autoimmune disease by removing inflammatory problem foods!

Starting a Food Elimination Diet

How to start a food elimination diet

If you suffer from digestive distress, skin breakouts, rashes, or suspect you might have a food allergy or intolerance, an elimination diet is always a good idea. The antibodies your immune system makes when it reacts to a problematic food you’ve eaten take about 3 weeks to dissipate; imagine feeling like a whole new person in only 3 weeks!

A food elimination diet generally last between 3-6 weeks, and can focus on one or two specific foods, or it can target a wide range of foods. For a preview of what an elimination diet looks like, and when to add foods back in, check out our post outlining what you can eat and when you should reintroduce foods.

Consult with a healthcare professional to determine your best plan of action!


Bloating and gas solutions from extra protein and fat intake

bloating and gas solutionsBy Dr. Justin Marchegiani

Today’s talk is going to be on gas and bloating from increasing proteins and fats in your diet. I see this quite frequently with patients in my clinic where patients have come to me. They’re on the standard American diet, a lot of processed carbs, a lot of grains. That kind of 60, 15, 20—60-70% carbohydrates, lower amounts of fats and moderate amount of proteins.

And now, we are changing their diet around by reducing a lot of the inflammatory foods, the grains, the refined sugar, the inflammatory omega 6 fats. We are pulling them out and shifting it. We are increasing good fats and maybe some more good protein to stabilize blood sugar. And guess what happens? They start getting bloaty and gassy. Now what does that mean? So let’s break down some of the digestive physiology. Let’s go through what it could potentially mean and some interventions and treatment options.


Get expert advice on how to get rid of bloating and gas from a functional medicine doctor by clicking HERE!

Bloating and gas from fats and proteins

Let’s give you some contextual value of what the physiology is doing so it makes sense. So we have our stomach and kind of laid it out, left or right. Typically the intestines are all kind of mushed up in this spaghetti goose. Protein digestion primarily happens in the stomach. What does that mean? So if we start giving someone more protein, more high-quality protein, whether it’s grass-fed meat, maybe omega 3 rich, you know, wild Alaskan sockeye salmon, maybe a clean collagen powder, that protein—well, maybe not the powder per se; but the real animal whole food proteins, they get digested in the stomach.


The Digestive Process

digestive process


Step one is when hydrochloric acid is produced. Hydrochloric acid activates certain enzymes from the stomach that kicks off the cascade for protein digestion. Step two is this acidic chime. This nice low pH of about 2-2.5, gets released into the small intestine and from here, what happens is we have our organs involved—imagine this being our gallbladder (GB) and then this is our pancreas. Based on the acidity, they actually shoot over some bile salts and some enzymes, multiple enzymes—lipase, trypsin, chymotrypsin.

In the gallbladder, we have various bile salts and that’s going to kick off fat digestion. But again there’s still going to be some protein digestion happening in the small intestine as well. This is because we do have other proteolytic enzymes coming out from the pancreas such as trypsin and chymotrypsin. So you can see protein digestion here. Fat and protein digestion is here.

Small Intestine

Now again, this is the first part of the small intestine. So this is the small intestine down here and these are the different parts: the duodenum, the jejunum, and the ileum. And again, we need nice acidity coming in here. So here are the three parts. A lot of the nutrients gets reabsorbed in the small intestine and if we don’t break it down at step one or step 2, then we’re going to have problems here.


Here’s our colon here as well. And again, what typically happens here is nutrients are all extracted here and then what happens here we have electrolytes get re-uptaken along with different fluids as well. So we have electrolytes met various minerals and then fluids. We have proteins, fats and proteins, and electrolytes and fluids. And we have different processes that can go wrong that can create dysfunction.

Digestion Issues

Now let’s talk about what can happen. So over here with the stomach, we can easily have acid reflux and heartburn if we’re not breaking down our protein correctly. Again, the nice acidity tightens up this esophageal sphincter up there. So nice acidity closes that up tight and prevents acids from rising up. We have to make sure we break it down. And so we reflux to that esophageal sphincter to close it up so that acid won’t come back up.

Same thing down here in the small intestine. If we don’t create a whole bunch of these enzymes to break down these foods, we’re going to have more fermentation, putrefaction and rancidification. Rancidification are fats going bad. Fermentation is going to be carbohydrates getting a whole bunch of gases being fed on by the bacteria being created, and then putrefaction is the proteins rotting.

If we don’t have this happen correctly here, a whole bunch of gas, a whole bunch of bloating will happen. We have our  ileocecal valve acting as a two-way street, so we have either bad bacteria from here going this way, or bacteria going the other way. So if we have bad bacteria, it can go back and forth and create more gas, more bloating, more flatulence, and more intestinal disruption. The bloating, the gas, the discomfort, the indigestion, feeling is like there’s a brick in your tummy.


Acid reflux, burping, bloat

With stomach issues, one of the first things we notice is burping, belching. Excessive gas is here because food is not being broken down properly. Now more fats and proteins do a couple of things. They put more stress on your digestive system. So let’s say you have this much hydrochloric acid and enzymes in your stomach to digest much protein and fat; if we start increasing protein and fat because your digestive physiology is not going to be enough to start creating an indigestion of protein down here, then it will give rise to acid reflux, maybe the burping, the belching and the bloat.


And then same thing happens down here; if we don’t knock over this domino correctly, let’s say it falls and misses, the second domino is not going to fall correctly either. So we’re going to have maldigestion of more fats and more proteins, and this can create more gas in the intestines, more bloating, more gas.

Fermentation, Putrefaction, Rancidifcation

We may start even to see with the fermentation, putrefaction and rancidification lower in the intestines. We may even start seeing more flatulence, too. And a good gauge is if your flatulence is kind of foul-smelling, that’s more methane. Methane gases tend to drive more constipation. Hydrogen gases tend to be more air like you don’t have the foul odor as much. But again, those are just general rules of the game there.

Constipation or Diarrhea

And then again, you can see here with the colon, we could have either constipation or diarrhea from the colon. Again if we have excess hydrogen gas, we can have more diarrhea, excess methane gas more constipation, or we can have a combination of the two, an alternate back and forth. So you can see here, each step is really important – Protein, protein and fat, reabsorbing electrolytes and fluid.

Lab Testing

lab testing

Now we can do different lab testing to look at the function each step along the way. So in the stomach, we may look at glucose testing or we may look at various H. pylori test or dysbiotic bacteria test to look for things that could be causing protein to maldigest in the stomach.

With fats and proteins in the small intestine, we may look at SIBO testing, like a lactulose breath test which can be effective at looking at the hydrogen and methane gases. Of course, different highly functioning stool—highly specialized stool tests that maybe look at DNA or stool antigens of various infections like parasites, bacteria, Klebsiella, Citrobacter, fungal overgrowth. Also, the different types of critters and worms can be effectively looked at with this type of testing.

And again, infections can affect any step along the way and if you have an infection up higher, guess what? It’s going to cause the domino of top to fall off track and then all the other dominoes below will be off kilter. So again, issues up top can cause issues to spill down to the next and so on.


Treatment Options

treatment options


Well, obviously diet is going to be important. So if we draw our 3 macronutrient dials—these are our dials here. So we have carbs, proteins and fats. Imagine we can control our little dials or we have levers. Either one to help get your mind wrapped around it, we would just dial down the proteins and fats just for the time being. We also work on supporting digestive secretions, HCL enzymes, bile salts to help break down these foods in the stomach. So that’s a really good start.

We may even look at certain diet options, too. Even FODMAP approaches or specific carbohydrate approaches where we cut down these Fermentable, Oligo-, Di-, Mono-saccharides and Polyols—the specific fermentable sugars in the diet. We may even look at cutting out phenols and salicylates, and even peeling and/or really mashing and cooking our vegetables well, and even avoiding raw veggies, too.

Click here now to get treated for any digestive issues by a functional medicine doctor!


We treat the various infections that come up and we also may have, depending on how long the problems have been happening, malabsorption. And the longer it’s been happening, the more nutrients get malabsorbed. Part of what’s important in the stomach and hydrochloric acid is it helps to ionize minerals. That allows minerals to get into the bloodstream and to go where they need to go, so they can be absorbed and utilized.

So we can easily have mineral issues and minerals are so important because zinc helps make hydrofluoric acid. If we are low in zinc, that can affect our body’s ability to make more hydrochloric acid. It also affects sex hormone levels. If we have low sex hormones and the more inflamed we are, that will cause inability to repair.

Also if we can’t break down proteins, it will affect other factors, too, since proteins become our neurotransmitters. It helps how we feel, control the reward centers like dopamine and serotonin. It also becomes the precursor to sleep hormones like melatonin. And you can see, if your sleep starts going and your mood starts going, and then we lose the ability to break down high-quality cholesterol in our diet that’s the building block to a lot of our hormones, we now start having poor sleep, poor sex hormones, poor mood. We also have PMS, we have brain fog, and we don’t have the building blocks to help our body repair.

So you can see digestive issues can really start to make this whole thing spiral out of control.

Try some of the things I already mentioned earlier in the video. If that’s not working, click on screen so you can schedule a consult with myself. We can dig in a little bit deeper and help you get to the next step of what could be going on under the hood, so to speak. And then also click on the subscribe button. We have more videos coming your way, lots of great solutions to your everyday health challenges.

Healthy Digestion! How Much Fat and Protein Should I Be Eating?

Healthy Digestion How Much Fat and Protein Should I Eat

By Dr. Justin Marchegiani

How much fat do I need?

Your body has specific feedback loops that are intimately tied with satiety (feeling full). It’s interesting to know that fat and protein produce specific neurochemicals that make you feel full. Some of these neurochemicals are known as peptide YY, adiponectin, leptin, Ghrelin and CCK. These chemicals have an intimate feedback loop to the appetite centers of our brain. If you eat too many of these foods you will start to feel nauseous.

If you think back to some of the famous Pringles commercials of the 1990’s where they would say, “Once you pop, you can’t stop!” Or just think back to your college days, how many times do you remember eating a whole pizza to yourself ? It’s very easy to eat foods in excess that don’t produce a neurochemical signal to your brain telling you you’re full. The food industry knows this, and that is one of the reasons why they’ve taken most fats out of the food and added refined sugar and artificial sweeteners in their place. it’s wrong to even refer to these items as food, as Michael Pollan poetically puts it, they are more like “Edible food like substances.”

When you wake up in the middle of the night craving something;  do you find your self craving a grass fed steak with asparagus? Or are you craving some potato chips and Häagen-Dazs ice cream? You’ll find the underlying denominator in all these cravings is refined sugar and high glycemic carbohydrates.

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How much protein do I need?

How Much Protein I Need

My personal recommendations are 0.5 to 1 g per pound of body weight.  Many people convolute this formula using kilogram conversions and refer to lean body mass, in my opinion this just makes it more confusing. In general the recommendations above are adequate and nearly everyone can calculate their needs within just a few seconds.

Therefore a 200 pound man would need anywhere between 100 g of protein to 200 g protein depending on activity level and particular goals. If this person were training and trying to increase their muscle mass I would recommend staying at the 1 g side.

Strength coaches such as Charles Poliquinn even go as far to recommend 2 g per pound of body-weight. For your average everyday person 0.7 grams per pound is a safe starting place, you’ll find it’s probably far more than what you’re eating currently.

The only individuals that need to worry about their protein consumption are people who have kidney damage or kidney disease. Proteins do not create kidney damage on a healthy kidney,  but if your kidney is already impaired, the extra glomular filtration may be to much for the kidney to handle. Adding extra fats into your diet have a net neutral effect and can be a good alternative if you have kidney damage.

Many people ask about the acid load of protein.  As long as you eat enough high quality vegetable and fruit emphasis on the vegetables, the alkalinity created from the vegetables will be more than enough to balance out the acidity of the meat proteins. The most acidic proteins are soy, grains, casein and egg whites; all other whole animal proteins provide an adequate amount of phosporus which will help neutralize it from it’s calcium leaching effects.

I recommend starting off your day with the first 30 to 60 minutes consuming at least 30 g of protein. Below are different food choices and their protein amount per 4 ounces. FYI the palm of your hand is about 3 ounces, so something slightly bigger than your palm is a good estimate.

Beef- 32 gms. Lamb- 30.2 gms.

Turkey- 32.6 gms. Chicken- 33.8 gms.

Calf liver- 24.5 gms. Venison- 34.3 gms.

Salmon- 29 gms. Scallops- 23 gms.

Shrimp- 23.7 gms. Cod- 26 gms.

Tuna – 34 gms. Sardines- 22.7 gms.

*Tofu- 9.2 gms. Egg- (1) 6 gms.

*Lentils- 1cup 17.9 gms. *Dried peas- ½ cup 6 gms

*Cottage cheese- ½ cup 14 gms. *Yogurt- 1 cup 12.9 gms.

*Kidney Bean- 1 cup 15.4 gms. *Pinto Beans- 1 cup 14 gms.

*Lima Beans- 1 cup 14.7 gms. *Black Beans- 1 cup 15.2 gms.

*Garbanzo- 1 cup 14.5 gms. *Navy Bean-1 cup 15.8 gms.

Walnuts- ¼ cup 3.81 gms. Almonds- ¼ cup 7.62 gms.

Cashews- ¼ cup 5.24 gms. Almond Butter- 2 TBSP. 7 gms.

Cashew Butter- 2 TBSP 5 gms.

*Please keep in mind that beans are two thirds starch. So for every 1 g of protein you get from beans (legumes) you end up consuming 2 g of starchy carbohydrate. This is one of the main reasons why I don’t like legumes or beans as a quality protein source.  I also don’t recommend getting your protein from dairy sources like cottage cheese and yogurt.  The casein proteins in these foods can create inflammation and stress the immune system.  These dairy foods in their raw form are far superior to their pasteurized, homogenize and refined alternatives.

What do I do if eating all this protein and fat is causing me digestive problems?

Causes Digestive Problems

Your stomachs main job is to digest protein. It does this by producing HCl and pepsin which help decrease the pH in your stomach. As the acidity in the stomach decreases, this provides a more favorable environment to help break down protein. As the acidic chyme (pre-broken down protein and food in the stomach) are released into the small intestine, this signals a release of bile from the gallbladder and pancreatic enzymes from the pancreas. The bile from the gallbladder is an emulsifying agent which helps break down this newly entered fat in the small intestine. If the chyme from the stomach is not acidic it will not trigger a release of bile when it enters the small intestine.

As you can see there’s an intricate domino effect occurring in our digestion processes. Healthy digestion in the stomach is the first domino that needs to fall. This domino then triggers healthy digestion in the small intestine. The next domino that falls is healthy absorption of these broken down nutrients in the small intestine and healthy bacterial fermentation and re-absorption of electrolytes in the large intestine.  if one Domino doesn’t fall they can mess up the whole chain!

If you have a digestive problem the first thing I would recommend is supporting your body with hydrochloric acid, enzymes, pancreatic support and bile salts. This greatly aids in your body’s digestive abilities, which helps you to break down, utilize and assimilate all of the great food your putting your body. if your digestion is impaired it’s common to have bloating, gas, stomach burning or Gerd, belching, nausea and skin problems.

Some individuals have a gastrointestinal infection ranging from a parasite, bacteria (H-Pylori is a common one), fungus or viruses.  it’s important to mention  that everyone is entitled to having more than one infection, the more infections you have, the longer the recovery time.

If adding in digestive support doesn’t do the trick you should be screened for an infection either way. The goal isn’t to use natural supplements to cover up symptoms, the goal is to get to the underlying cause of the problem.

The last thing you want to do is use any type of proton pump inhibitors or acid blockers to fix the problem. This may help some of the symptoms in the beginning, but in the long run you are opening yourself up to major problems!

If you need help figuring out your diet and getting your digestion back on track, feel free and schedule a complimentary consultation by clicking here. This will at least give you the opportunity figure out the next steps you need to take to help improve your health!

The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.