Good morning, everybody.

Today we're joined by Marilia Shimon, a registered nutritional

therapist specializing in gut health, specifically IBS and SIBO.

Marilia has an interesting story, which we'll touch on shortly and hold

certifications from both the Institute of Functional Medicine and Monash University.

Marilia, thanks for being here.

Can you tell us a little more about yourself and how you

ended up in alternative GI care?

Thank you for having me.

Uh, so it was through my own health journey.

I was a proud owner of an iron stomach.

I could eat and drink whatever I wanted.

And indigestion was not part of my vocabulary, uh, until I had

an episode of food poisoning and everything changed literally overnight.

And I've spent good seven years jumping from doctor to doctor.

running all sorts of tests that all came back normal, which

is unfortunately very common.

And I just couldn't, couldn't really get to the root cause of my problem.

I was told that my symptoms were due to IBS, but they kept getting

progressively worse year after year.

And I was just like, how is it possible that they keep

getting worse if it's just IBS?

And by saying just IBS, I'm not underestimating the, uh, the

consequences of having IBS, you know, obviously it's, it's a burden.

It's not a, an easy condition to navigate, but my symptoms really were

drastically getting worse year after year.

So I thought there is something else to it.

And I realized that the food poisoning from the beginning, I understood

the food poisoning was the initial trigger for my digestive symptoms,

given I had none before that.

And it was then through my own research trying to connect the pieces that I

came across SIBO and how for poisoning a bacterial infection can lead to that,

uh, and then everything made sense.

Of course.

And how did your, uh, symptoms present initially from a, from an idea standpoint?

Was a lot of sort of pain, distention, bloating, those sorts of things or?

Yeah, so lots of distention, bloating.

I went from being able to eat absolutely everything to not being

able to eat pretty much anything.

Whatever I ate was, was causing me problems.

So like multiple food intolerances, I had acid reflux, indigestion,

distention, all of those really terrible symptoms that unfortunately

a lot of people are experiencing.

Yeah, I think that's just all too common again in society where we

are sort of just faced with not only large levels of, uh, of toxins in

the environment, but also just foods that trigger these, these gut issues.

I know today we're going to be touching heavily on SIBO.

That's our discussion point.

But before we carry on, can we just quickly sort of break down the

difference between IBS and SIBO?

I think a lot of people sort of see them as one thing, but obviously,

and to some extent they are, but there's quite a discrepancy.

There's, could you just sort of break down the difference between them?

So they are both.

Uh, similar conditions and they can coexist.

Symptoms are very similar in the sense of like they have

bloating, abdominal distention, they can have either constipation,

diarrhea, or a combination of both.

But the main symptom to keep in mind that defers them is abdominal pain.

So in IBS, we must have abdominal pain in order to fit

the criteria of IBS diagnosis.

And in SIBO, we don't really have that.

So I would say that's the main thing to keep an eye on.

And, you know, with that abdominal pain comes visceral hypersensitivity, which

is a hallmark symptom of IBS, which means you have an overly sensitive gut.

So you feel, you know, what my clients usually say is like, you

feel like that there's another person living inside your body.

If that makes sense, that your gut has a life of its own, which

it does, obviously, but you shouldn't be feeling that 24 seven.

And in IBS with visceral hypersensitivity, you do have that.

gut brain brain gut brain connection much more highlighted.

Okay.

And then, uh, by extension, what is SIBO?

How would you define SIBO?

And if you are sitting on somebody next to a plane and they asked you what you did.

But how would you define what SIBO is?

So SIBO stands for small intestinal bacterial overgrowth, and it

means exactly what the name suggests.

There is an overgrowth of bacteria in the small intestine.

And we shouldn't have that many bacteria in that part of the intestines because

that's where we break down food and there is absorption of nutrients and all.

So essentially, it's not an infection, it's just an overgrowth of bacteria

in the wrong place in the gut.

We should have large amounts of bacteria in the large intestine,

but not in the small intestine.

Yeah, I think that's what people will often sometimes sort of refer to

when they are talking to about dysbiosis.

So would you almost say that SIBO is a form of dysbiosis then?

Yeah, some, some, uh, experts do say that it's a form of dysbiosis,

is a disorder of the whole GI ecosystem.

So I think there are different ways of, you know, explaining it.

But yeah, dysbiosis is definitely one of them.

And

I know we'll begin on the treatment in a shortly and bear

with me, but, uh, to just give the listener a bit more of a background,

there are various types of SIBO.

Can you sort of elucidate the different types and how they

maybe present differently?

Yeah, of course.

So as of now, we know that there are three types, hydrogen dominant SIBO,

methane dominant and hydrogen sulfide.

So the hydrogen dominant one has.

Uh, presents the symptoms like bloating and diarrhea, or sometimes it could

be a bit of constipation as well.

The methane, it's predominantly bloating and constipation.

And the hydrogen sulfide is bloating and more severe diarrhea than the hydrogen.

So they all have bloating in common, but then it's more like,

is it on the constipation side?

Is it on the mixed side or is it on the diarrhea side?

Fair enough.

And then I suppose the, the golden question is, and it's obviously a

fairly long answer and it depends on the individual, but is there sort of

a common cause of these conditions, these sorts of SIBO types of conditions

in general, or are they all as unique as the individual in question?

Yeah, so I think the most important thing to understand

is that SIBO is not a root cause.

It's a result of impaired gut motility.

So as the gut slows down in the movement of the gut slows

down, it can allow bacteria to overgrow in the small intestine.

Why that happens?

We know that the physiological underlying causes are dysfunction of

the migrating motor complex, which are the cleaning waves, you know,

or the housekeeping of the gut.

And why that happens?

There are different reasons.

We know that the most common cause of MMC dysfunction is food poisoning.

So got a stomach bug.

Typical story.

Like mine was able to eat everything.

Got a stomach bug overnight.

Things kind of changed and then after a few months got things

got progressively worse and then that's because you developed SIBO.

But there are other, other underlying causes as well.

It can be structural issues, scarring from surgery, diabetes,

or even it could be side effect of medications that slow down the gut.

Okay, and that being peristalsis that the MCC is affecting, is that correct?

Yeah, it's it's the movement.

It's actually affecting the MMC and like upper digestive, not just peristalsis.

Okay, so it's sort of going from a sort of a neurological

level all the way down to the gut.

Yeah, that's

interesting that I did not know and I suppose this would be a perfect

segue to talk about how generally you start working with patients and

how you start treating individuals.

There are a lot of ways of doing this, but what is your sort of main modality

when you start talking about when you have somebody who obviously comes to you with.

These digestive complaints, and obviously they also present, uh, in other words,

brain fog, aching joints, a lot of very broad, non specific complaints.

How do you go about sort of breaking that down and then working with an

individual from, from the beginning?

So the most important thing always is to rule out

medical conditions, right?

That's the first thing.

So you want to see your GP or a specialist and rule out

things like Crohn's, ulcerative colitis, celiac disease and all.

So you've done all that.

That's usually the top three things that they will investigate.

That's all clear.

Most likely they will tell you then it's IBS because you know, with IBS, we don't

have a test, but we have that criteria that we follow tick some of the boxes.

Okay.

IBS off you go.

But then we know that there is more to it, right?

Now, we know that 30 to 80 percent of IBS can be SIBO.

So then next step in what I usually do is, okay, have you tested for SIBO?

So that's how we start.

Most of the time it comes back positive, but obviously you need

to rule out other things as well.

So lactose intolerance is so common, but not tested and it could be that

that's As simple as that, you know, you just have a lactose intolerance.

Are you using, uh,

sorry to interrupt, but are you using breath testing predominantly

to test for, for CV or various, uh, different breath tests?

Yes, predominantly breath test.

If you look at the research, that's what's being used as well.

So, you know, at the moment, I think that's the best tool we have.

So as I was saying, like, you need to think about other things like food

intolerances, histamine intolerance, lactose intolerance, fructose intolerance.

You just obviously need to correlate the symptoms.

But then if we have a positive, uh, SIBO breath test and they correlate with the

symptoms that the client is experiencing, we then need to tackle that either

liaising with, with their, uh, GP, you know, in, in order to get antibiotics,

or then we go down antimicrobial route, uh, herbal antibiotics essentially.

Do you find, uh, slight tangent, do you find food

sensitivity testing to be accurate?

There, there are lots of different panels out there.

Uh, companies like Cyrex tend to test not only IGE, but IGA as well, I believe.

Whereas others just, and I think I've got this right, just test IGE.

So you sort of get these false positives with a lot of food testing services.

Uh, do you think they're effective or is ultimately just an elimination diet?

sort of the way to go in trying to determine what food triggers

you may or may not have.

Well, so we know the gold standard is the elimination diet, right?

So that's, that's what I do.

And it is.

It is boring, it requires commitment, patience, time, but there's no

other way, so that's the way I go.

Fair enough.

And then speaking of elimination diets, do you have a preferred one?

Do you sort of just stick your plans purely on meat and tell them to get on

with it, or do you just, do you remove certain potentially triggering food

groups like FODMAPs or carbohydrates?

Uh, what's the, sort of the lowest common denominator for you there?

Yeah.

So I'm trained on the use of the low FODMAP diet with Monash University.

And that's usually really what I do because there's so much scientific

evidence to back up the low FODMAP diet.

We know that up to 75 percent of individuals feel better

on a low FODMAP diet, but it.

It is a diet that requires guidance.

You know, it's not as simple as, okay, here's a food of a list of foods you

can eat and food that you cannot eat.

It's really not like that.

It's much more about portion control than yes or no.

Uh, so that's usually the route I take is, is the low FODMAP diet.

Can you just explain what the low FODMAP diet is?

I can never get the acronym right, but, uh, it is, it's basically, and

I'll obviously get you explain it.

Removing certain, excuse me, fermentable foods from the diet.

Is that correct?

Yeah, so you're removing essentially, not removing, you're lowering

the intake of fermentable carbohydrates.

FODMAP stands for fermentable oligosaccharides, desaccharides,

monosaccharides, and polios.

And exactly, these are fermentable carbohydrates in everyone's gut.

But as we were talking earlier, the gut of IBS is overly sensitive.

So that fermentation causes a lot of discomfort, you know, in the connection

of the gut with the gut and the brain.

Uh, so you're just lowering that intake to see if symptoms get better as well.

And as I said, 75 percent of, of individuals do have

a positive result with that.

That's interesting.

So it's not necessarily completely removing that food, but it's, it's about

sort of just lowering the quantity.

Is that correct?

Exactly.

Yeah.

So as I said earlier, it's not about eat this, don't eat that.

It's about how much you're eating of those specific fault maps in the meal.

Uh, and if you're, you know, making sure you're not fault map stacking.

So for example, if you're a person that snacks a lot and you're just

grazing throughout the day and you're just adding those fault maps,

you know, on top of each other.

And then obviously towards the end of the day, you're super bloated, super

distended because you didn't have.

that break that your digestive system needs in order to, to break down food,

the food that you ate previously.

So it is really much about.

Okay.

And then with an elimination diet, such as the FODMAP diet,

you often have to then obviously, well, not often, you have to then

reintroduce foods at a certain point.

Obviously people can't just live on these diets.

Um, well, I mean they can, but then we end up with more issues later.

Not

ideal.

Definitely

not.

How are you then reintroducing foods in a patient or in an individual

with these, with these issues?

Yeah.

So it's, it's very systematic.

You, um, You choose one fault map at a time.

So we have six fault maps.

You choose one at a time and then you reintroduce them

over a period of three days.

You assess symptoms day one, you're fine, you move on to portion of day two.

And then if you feel fine, you move on to portion of day three.

If at day two, you already feel that your symptoms are, are already starting to come

back, you then don't move on to day three and you'll find your threshold and your

trigger of that, of, of those fault maps.

So it's, it's time consuming, as I said earlier, you know, any

elimination diet is, you need to reintroduce step by step and then

find what works for you, what doesn't.

But if you do all of them, you know, Within eight weeks, you can get it done.

And I always say to my clients, if you do it, eight weeks are going to pass.

If you don't do it, eight weeks are going to pass.

So you might as well get over it.

Yeah, of course.

And when you're sort of reintroducing foods, do you find any sort of,

uh, concurrent issues with maybe things like oxalates, uh, obviously

things like a raspberries, a high in oxalates, I believe.

Sweet potatoes as well.

Do you ever find that when you're reintroducing Specific foods that you

will sort of hit a a plateau where maybe there is another a food insensitivity

That's oil not food insensitivity.

Excuse me a plant Antinutrient in this for us in this case is causing an issue

I don't see that often or the one the one thing I see people react

the most is Fructone which is one of the fault maps And that is found in things

like garlic, onion, leeks, and that is by far, and the research also backs this

up, the one that most people react to.

So they may be able to reintroduce all the other FODMAPs fine, but perhaps

the fructan is the one that they need to kind of manage in smaller portions.

Okay, fair enough.

And what do you think about this cheating using FODMAPs,

uh, FODMAP digesting enzymes?

Uh, do you think those have a place or are they just not

really dealing with the issue?

I think they have a place.

I mean, they, they are heavily backed by scientific evidence as well.

The ones that are in the market, they have their own research.

And I definitely think there is a place, you know, especially like if you're

traveling, if you're eating out and you know, you, why not have that support?

Okay.

So I suppose you can have your cake and eat it.

Maybe it's not ideal all the time.

Yeah.

I mean, exactly.

But you don't, you don't want to be used, be using those enzymes all

the time because essentially you are breaking down that fiber that you want

to be digested by gut bacteria, right?

In the large intestine.

So if you're using that fiber every, uh, that enzyme every day, you're

not really getting the benefit of that, of that dietary fiber, but

yes, you can have the cake and eat it too in certain occasions for sure.

And speaking of enzymes, uh, what do you think about the

use of things like betaine HCL?

Not necessarily only to support the digestive process, but

also to sort of offset the development of further dysbiosis.

Yeah.

In conditions such as candida, quite often there is an argument to be made

about increasing stomach acid by way of betaine HCL supplementation to sort

of just support that digestive process and to help keep that bacteria at bay.

Do you have any thoughts there?

Is it something you ever use at all, perhaps?

Yeah.

I do use with, uh, especially my CBO clients a lot.

We know that we see, but there is, uh, an issue also with stomach acid

production and stomach acid is like the first line of defense, right?

It's everything that we're putting in our mouths is the connection of the

external world with our internal world.

So we need to have that.

protective barrier and the stomach acid is there to kill any, you know, opportunistic

bacteria, pathogens, so on and so forth.

So we know that we see, but we also need to support that.

So I do use that as part of my protocols.

Okay.

And one more question on digestion and I promise you we'll move on, but

just regarding

histamine, obviously when There are, there's an imbalance in histamine levels.

You're going to have higher or lower levels of stomach acid.

I suppose one might say that by addressing the root cause of, uh,

the SIBO you, that you would then rectify the underlying histamine issue.

But do you ever sort of go after maybe a histamine or an MCAS issue

directly, uh, trying to sort of lower or increase histamine levels

to, to thereby support digestion?

Yeah.

And I see, I see his feminine tolerance a lot with, as a consequence of SIBO.

So it's, as you said, it's about understanding the underlying cause,

what it is that it's causing that.

And then I think you kind of need to, you need to assess what is more urgent,

let's say, you know, so if you have a client, if I have a client with.

SIBO and histamine intolerance, and the histamine intolerance seems to be the

thing that is driving, you know, the rashes, this, all the skin symptoms and

potentially also diarrhea, then I go first on a low, put them on a low histamine

diet to bring the symptoms, you know, calm it down, let's say, and then tackle

SIBO, but it is a step by step process.

Perfect.

Understood.

Right.

One more question about diet.

And this is a selfish question because this was where my body of research

and my academic background was in.

But ketogenic diets, what do you think about them in terms of their ability

to sort of maybe help to modulate the symptoms of some of these issues?

Obviously you, you, with the ketogenic diet, you're not necessarily

getting rid of the FODMAPs.

But just by reducing the carbohydrate burden on the body, is that ever

an effective strategy or is it sort of really only sort of dealing

with one third of the problem?

I don't really implement the ketogenic diet simply because the research

shows that it's actually one of the most detrimental diets for the gut microbiome.

So it's not, it's not something I work with.

I do understand it has its place, you know, for different conditions,

but it's not something that I, I, I practice in my clinic.

Okay, perfect.

Understood.

I'll stop preaching about that one then.

All right, so moving on to sorts of Treatment modalities beyond just diet.

What else are you using?

Things like probiotics, antimicrobials, et cetera.

Yeah.

Uh, so yes, antimicrobials, definitely using that.

So I always discuss with my clients that they have two options, right?

So if we're tackling seabird, they can go down the antibiotic route, refluxamine.

but they can also go down the herbal supplementation.

So I present both, we discuss and, you know, let them decide

what it is that they want to do.

Uh, if they want to, to go down the, the herbal route, then yes, uh, using

a combination of of herbs, allicin, berberine, oregano oil, anine.

Always have a biofilm disruptor there as well.

Uh, and then, you know, combining those herbs for about four to six

weeks and, and see how symptoms get better, retest, see where we are at,

do we need more, what do we do next.

And just to clarify rifampicin, rifampicin is an antibiotic that

doesn't pass into the bloodstream.

It just works in the gastrointestinal tract.

Is that correct?

Yes.

So 99 percent of the absorption is in the, in the GI tract.

So absolutely.

Okay.

Um, then regarding the antimicrobials again, how are

you recycling them specifically?

Do you find that people become tolerant to these compounds pretty quickly?

Uh, do you have some that you prefer?

Um, how do you, uh, treat somebody with, well, a patient

with, with these, uh, compounds?

Yeah.

So I find that most of them are well tolerated, apart from allicin.

Allicin is definitely the one that most people react to.

Uh, and then it's really about, okay, let's say there's an ideal.

that you should be taking, but you know, if that doesn't work for you

and it's actually giving you more symptoms than results, then you

need to find whatever works for you.

So if it is, you know, one capsule a day, or if it's the whole, the

full dosage, but every other day.

So we, we really need to work with each individual and

find out what works for them.

But I find that all the others are very well tolerated apart from the allicin.

And the issue with allicin being the prebiotic fiber

that then triggers the, uh,

Yeah.

Potentially.

Yes.

Oh, okay.

And it is, it is quite difficult to digest as well.

It can be a bit, it can be a bit heavy and also it depends, you know,

so like if you take it before a meal or after a meal that all these

things can also make a difference.

Is that sort of, and allicin obviously just for

people is garlic extract.

Is that correct?

It's the active ingredient in garlic.

Yeah, and usually the fault map is removed, you know,

through this process, but still some people cannot tolerate it.

It could be for other reasons, different compounds.

Okay.

And use of probiotics, specifically things like Saccharomyces boulardii?

Yeah, I do use it a lot.

I think there's a lot of, you know, as we know, there's a lot of research

for Trevor's diarrhea and, and the use of Saccharomyces boulardii.

So that is one I use.

I use quite often, especially when I am dealing with clients that have

like post infectious IBS slash SIBO.

And other classes of probiotics, do you find that they are effective

or do you really just sort of rely on Saccharomyces specifically?

Yeah, no, I do use some lactobacillus, Bifidobacteria.

There is also some research, you know, the research with SIBO

and probiotics is very limited.

So there's a lot that we know about IBS, but not specifically SIBO.

But it is also a matter of trial and error, you know, that there is the

research and you know what to use.

But again, does that work for that person?

Great.

It doesn't work.

Okay, let's do something else.

So I also use sport, sport based probiotics sometimes and I find

that they are very well tolerated.

Okay, perfect.

And when looking at probiotics, like specifically the A lot has been made

in recent, well, definitely in recent years about working with specific species

beyond just the strain and, and just for the listeners, probiotics are broken

down at a high level into the genus, so sort of the, the overarching family,

then specific species, and then specific strains, I hope we got that right, and

for the most part, the literature that I've looked at seems to indicate that

the species is where it's Is what you need to focus on as a clinician, but

then you get a lot of companies that start marketing specific strains of

specific species, uh, as being the go to.

Do you find this to have any merit in your experience or is it again just

work at the species level enough?

I think the strains, the strains level is, is becoming very predominant

and we'll see more and more of like, you know That specific strain that has been

researched for that specific thing or that one for that other thing So definitely

it's uh, it's something I keep in mind.

Okay, so it is taking hold.

That's interesting Moving on, I'd love to get some feedback.

Well, I'd love to pick your brain about some specific questions.

Let's call them rapid fire questions.

Yeah.

Olympic system retraining.

It's been made quite popular again in recent months or in recent, in recent

years, programs like the Gupta method.

I believe there are a few in the States and one in Australia called DN DNRS.

What do you think about limbic system retraining

specifically for, for gut issues?

I think it's really important.

We know just like the low FODMAP diet has a lot of scientific evidence.

There's also scientific evidence for things like yoga, meditation,

gut directed hypnotherapy.

These are all things that can help with symptoms, with GI symptoms.

So, you know, I mentioned before 75 percent of the individuals respond

to a low FODMAP diet, but then there is the other part that doesn't.

And then we start to consider, okay, so how about yoga, meditation, hypnotherapy,

all of those things can also help.

So they definitely have a place.

And, you know, it's like every health condition, that's what I believe at

least is a combination of factors, right?

That will make a difference.

It's not like one thing will solve the problem is, is the whole toolkit.

Okay.

Next one, vagal nerve stimulation.

A lot of these devices on the market, like the Sense8 and the Apollo, I suppose

they're working on a similar level to the limbic system retraining, but have

you ever utilized those in your practice?

What do you think of those?

Okay.

So I do recommend to clients and I think the main reason

is because nowadays most of us really struggle with doing nothing, you

know, telling someone to sit down for 10 minutes and literally do nothing,

not watch TV, not scroll the phone.

It's, it's a challenge.

So I find that these devices kind of make them feel that they're

doing something while they're doing nothing, if that makes sense.

So that, that's mostly when I, I recommend, you know, if I feel that

the client does have some difficulty in just like relaxing and taking

10 minutes to switch off, I'm like, okay, how about you get this device?

Because at least you, you feel that, you know, you're doing something while

you're relaxing at the same time.

But other than that, I just tell them to gargle twice a day, like strong.

Vibrations.

Could you just discuss what the vagus nerve is and why potentially

it could be an issue in people with vagus nerve dysregulation could be

an issue in people with IBS and SIBO?

Yeah.

So we know that the vagus nerve is what connects the gut and the brain, right?

And it's this two way communication pathway.

And it is.

This connection is so intense where the brain sends messages to the gut,

the gut sends messages to the brain.

Actually the gut sends more messages to the brain than the brain to the gut.

And there can be a dysfunction, like chronic stress can, can create a

dysfunction in this communication and then lead to digestive symptoms.

But also this biosis in the gut can interrupt this communication and create

health problems, mental health problems.

So things like depression and anxiety, we know that, you know, there is

a big correlation between a gut dysbiosis and depressive symptoms.

So that's where this nerve it's engages in this to in this way

in the communication between them

Yeah And the way I understand it when you sort of activate the the

vagus nerve you are activating the the parasympathetic Sympathetic branch of the

nervous system and by doing so you start to lower levels of stress hormones like

cortisol adrenaline all of these Chemicals in the body that drive stress that then

drive the production of molecules such as cytokines that just increase inflammation.

And then you get this sort of, you fall into this vicious

cycle where the body's inflamed.

It's, which then triggers the vagus nerve, which then triggers

release of these chemicals.

And it's very hard to get out of.

And again, uh, from my view of the literature, there does seem to be some.

It is to show that by stimulating the vagus nerve, you can help get it out of

this loop and then allow the body to heal.

Yeah, at a high level, that seems to be how these devices work.

And yeah, again, there does seem to be a fair amount of clinical efficacy for them.

Yeah.

And as you said, it's about activating the parasympathetic nervous system, right?

And we know that that's the rest and digest and you need to be in

the rest and digest mode in order to be able to digest, break down

food properly and avoid bloating, distention and digestive symptoms.

So it definitely, I'm sure the devices have a place, you know,

and however, whatever works for the person, you know, and if the device

is the thing that works, why not?

Of course.

Next one.

This one is probably, yeah, it's going to raise some eyebrows.

Uh, the carnivore diets.

Uh, do you like it?

Do you not like it?

I mean, for me, it's a hard no.

And I, I get that, you know, I, I started eating a carnivore diet

and all my GI symptoms disappeared.

Yeah.

Obviously you removed the triggers, right?

It's as simple as that, but you didn't really, yeah, you,

you didn't really address the underlying cause of the problem.

So if you bring the foods back, you're actually potentially going

to feel even worse because you depleted your gut from fiber.

The diversity of gut bacteria is definitely lower, and then you're

going to be able to tolerate even less foods than, than before.

So it is a hard no for me.

Fair enough.

Another contentious topic.

Prebiotics.

There seems to be this divisive line in the functional GI

community about prebiotics.

Some practitioners swear by them, others run a mile from them.

We sort of touched on this earlier that, uh, at least initially there

may not be the best intervention, but what are your thoughts on prebiotics?

Yeah, so obviously like prebiotics are amazing because

they are essentially feeding our beneficial gut bacteria, right?

And I think the main problem why There is confusion is because we are, we are

talking about two different things.

We're talking about people that are just looking to improve their gut

health, but they don't have GI issues.

And then people that have GI issues, and the advice is just

not the same for these two groups.

Uh, if you know, like prebiotics are found in things like garlic, onions, leeks.

And if I tell a SIBO client or an IBS client, yeah, you know, go

ahead and eat garlic onion leeks.

they're going to feel terrible.

So who are we trying to help here?

You know, so if it's generalized good health advice, prebiotics, yes.

Amazing.

Go for it.

But if you have SIBO, like this is not going to be a good idea unless

you have dealt with the sequel.

So.

You know, the most common ones are like inulin, FOS.

I definitely stay away from those, depending on the profile of the client.

Talking about IBS, SIBO clients, then they don't usually tolerate those well.

But I do like PHGG, partially hydrolyzed guar gum.

I find it very well tolerated.

Uh, we know it's, uh, like low FODMAP, you know, there are even

some in the market that are certified low FODMAP by Monash University.

So I do use that a lot and actually there is one clinical trial that showed

that the combination of rifaximin with PHEG to be more effective than

rifaximin alone in eradicating SIBO.

So it definitely has, has its place.

So ultimately context matters when it comes to as with everything.

Exactly.

Perfect.

We've covered a lot and I want to be respectful of your time.

As we sort of draw to an end, what, if we could summarize this in its entirety,

what five tips would you give to somebody wanting to improve their gut health?

And I know that's like saying how long is a piece of string, but if

you were to just, uh, and it's like one of the, on one of those desiring

questions, what would you take with you?

But just broadly speaking.

Yeah.

So I'm going to say.

what I would do to improve gut health in, in the scenario of my clients.

Okay.

So in the, in that context, the generalized advice, we know eat a,

uh, plant rich diet, you know, colors, dietary fiber, probiotics, prebiotics, but

that doesn't really suit my, my people.

So I'm going to focus on that.

I would say number one, which is It may sound silly, but it's minimize the risk

of catching a stomach bug because that can, it can be life changing, you know,

and we don't really understand that because no one is really talking about it.

So that will be the one, the the first thing.

The second thing would be minimize the intake of unnecessary antibiotics.

Obviously they are important, they have a time and place, but as I

said, unnecessary because we know that they are essentially a bomb.

If you're dealing with symptoms, understand what's causing them.

I always think that symptoms are signs that something isn't right.

So don't ignore them and look for the, the, the, why, you know, ask why you

are experiencing symptoms, address the underlying cause of the problem.

And work with a specialist to overcome dietary restrictions, you know, because

at the end, that's what you really want.

You want to be able to eat a variety of foods,

definitely something.

I mean, yeah, those words are ones to live by for sure.

Okay.

Final question.

Uh, taking everything into account that you've, that you've learned over the

years, uh, how do you live your life?

Uh, and there'll definitely be some overlap with the previous answer.

I'm sure But how are you optimizing your day to day lifestyle, uh, sort

of based on these sort of functional medicine philosophies that we discussed

to sort of, yeah, live your best life?

So I truly think it's about nailing the basics, you know, and to be

very, very cliche health is well for me.

I lost my health and I know it's, you know, it doesn't matter what you have.

If you don't have your health, it's absolutely pointless.

So for me, it's really about nailing the foundations.

And as I said before, as well, it is multifactorial.

It's not, I will do this one thing that is going to be the solution,

but it's a combination of things.

Thanks.

It does require discipline because, you know, it's much easier to not think

about all the things that you need to do to achieve long term health.

Uh, but I prioritize sleep.

I make sure my meals are balanced, that I get enough color on my

plate, protein, dietary fiber.

I exercise daily.

I do strength training, cardio exercises, and then I also try to rest and have fun.

Marilia, that is amazing advice, and I think Yes, there's

definitely something that I need to sort of take on board as well.

Where can people find you if they want to work with you?

Yeah, so they can find me, uh, online on my website,

which is gutfulnessnutrition.

com or Instagram and my handle is gutfulnessnutrition.

Perfect.

We'll be sure to link to all of those in the show notes as well.

Marilia, thank you so much for your time.

We really appreciate it and we'll have to do this again soon.

Absolutely.

Thank you, Rob.