What Your Gastroenterologist (Probably) Does Not Ask You…

And what oils in your diet can calm inflammation in your gut and body?

As a holistic health coach, nutrition is a big part of my wellness therapy. From professional experience, and from conversations with friends who have gastric issues, I hear how many gastroenterologists dismiss that foods we eat can play an important role in ongoing digestive troubles.

Traditional gastro tests can include an endoscope, colonoscopy or ultrasound. However, these can come back with inconclusive results, or they show gastric inflammation that is also associated with GERD (gastroesophageal reflux disease). IBS (irritable bowel syndrome) with abdominal pain and bowel changes is the most common gastrointestinal disorder today. Instead of long-term medications, herbal and homeopathic applications are helpful to modulate the hyperactive immune and inflammatory response, while addressing infections and healing a leaky gut.

There are specialized stool and saliva tests to check for chronic infections that can be associated with autoimmune diseases and a leaky gut. Conventional gastroenterologists do not do these tests, which are also not covered by insurance – and they can be very expensive.

With autoimmune diseases, one must consider structural concerns, scar tissue from surgeries, and a leaky gut where the tight border junctions of the gut are spread wider apart. A leaky gut opens the door for ANY autoimmune disease to occur.

Genetic Testing

Genetic testing can be helpful and I do use genetic testing in my practice with complex cases. Certain markers including the FUT2 gene, or histamine – connected genes, e.g. DAO, HMNT, ABP1, that can really play an important with severe gastric troubles and multiple food and chemical sensitivities. Gluten and lactose genetic markers can provide more insight with chronic digestive troubles. It is important not to treat genes, but they can be helpful markers especially with the multitude of asthma, IBS, allergies, and Autism rates were are seeing today.

Does you doctor ask the following when you discuss digestive troubles?

  1. Why is gastric distress occurring? Just treating symptoms with meds is not the right choice. Once you stop the meds, the symptoms will come back.
  2. Where does it hurt?
  3. How long has it been occurring? Days, months, or years?
  4. When did it begin?
  5. What makes you feel better?
  6. What makes you feel worse?
  7. How are daily bowel movements? (If)
  8. What stressful event was going on in your life at that time this started?
  9. How many antibiotics have you taken in your lifetime?
  10. Could a lack of stomach acid actually cause the problem?
  11. How soon after eating do your experience digestive symptoms such as gas, bloating, reflux, abdominal pain, cramping, nausea?
  12. Have you been checked for SIBO? This can be checked with a breath test in the doctor’s office. The check is for hydrogen and methane gas over a few hours. However, the test is not foolproof. Symptoms can include a myriad of digestive troubles including constipation or diarrhea, or both.
  13. Has your gallbladder been removed? It greatly affects digestion and absorption of fatty acids. It is helpful to take bile salts with larger high-fat meals.
  14. Could infections such as parasites, worms or yeast overgrowth be the main drivers of an autoimmune disease (that can occur anywhere in the body)?
  15. Did symptoms begin, and now remain, after a bad food poisoning?
  16. Or, did symptoms begin after a round of antibiotics, e.g. Cipro?
  17. Does dehydration play a role in here?
  18. Have you ever had Lyme disease or Bartonella that can infect the nervous system in the gut? This plays an important role with the transit of food and waste throughout the entire digestive tube.
  19. Do you live in a water-damaged building? Toxic mold will affect the gut.
  20. How do you handle your daily stress? Is there something that makes you sick to your stomach? The mind-body connection is very important….try discussing that with a regular gastroenterologist!

The above questions are part of a differential picture. Everything matters and I find individuals who live with chronic digestive troubles already have done tremendous research, and have seen various doctors. They are tired of taking prescribed medications that often come with horrible side effects without root cause resolution. Clients want to know why the symptoms are ongoing, especially if serious medications, such as biologics, e.g. Remicade or Humira that suppress the immune system, or steroids for inflammation, are in the picture. Nutritional therapies are very helpful, even though medical doctors will dispute this.

How can essential fatty acids impact inflammation in your gut? What your doctor does not tell you…

Essential fatty acids play a vital role in inflammatory digestive challenges. Many will say, “I eat virgin olive oil and coconut oil.” It is good, but not good enough. To temper chronic inflammation in the gut and at systemic level, we need a variety of oils.

Transfats in processed foods, fats from processed meats and commercially fed animals all contribute to increased inflammation. Commercially refined (and cheap) oils such as canola, sunflower, vegetable and corn oil all are pro-inflammatory. ‘Eating out’ or ‘ordering in’ puts us at risk of commercially refined and rancid oils that incite inflammation, cancer and cardiovascular risk in our body. Cooking at home is best, as you know exactly what is on your plate!

To temper an errant immune and inflammatory response, we need a combination of: 

  • ALA: alpha linoleic acid = unrefined omega-6 oils found in flaxseed oil. In the body it can be converted into an omega-3 source, however in its ALA form it has anti-inflammatory effects. Pumpkin seed is also in this family. Both oils are not used for cooking purposes.
  • EPA / DHA: in cod liver oil, fish oil, or the vegetarian option called krill oil from blue-green algae
  • GLA: gamma linoleic acid = unrefined omega-3 found in evening primrose, black currant seed, hemp seed and borage oil
  • And olive oil with it’s multi-health supporting oleic acid = omega-9. Avocado from the fruit is also rich in oleic acid.

Besides being anti-inflammatory, the combination of oils will also be heart, bone and brain protective, anti-cancer, and well tolerated.  If you are on blood thinning medications, consult a health professional before using therapeutic dosages.

Gallbladder and digestive function can be compromised with chronic digestive troubles.

How to make it actionable. 

As we head into spring, raw vegetable salads and shakes come back into our diet. Integrate healthy oils into your cooking; avocado, pumpkin seed oil and flaxseed oil make salads more interesting – or choose to eat the seeds! Olive oil is a staple in our homes already, and coconut is a favorite for many as it helps thyroid health too. Last night I used toasted sesame oil with my broccoli for an Asian twist. Tahini sauce is great for salad dressings or on grilled chicken.

Invest in a good cod liver or fish oil and flaxseed oil. Nordic Ice and Carlson’s are clean options that we can easily purchase at health food stores. Do keep them in the fridge to prevent them from going rancid.

Mix it up on your food plate, challenge and tantalizes your taste buds with different oils – your gut and brain will thank you too.


Rika Keck, FDN-P | NY Integrated Health

Author: Nourish, Heal, Thrive: A comprehensive and holistic approach to living with Lyme disease. 

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