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Naturopathic

What is SIBO?

SIBO is a chronic bacterial infection of the small intestine and is considered to be an underlying cause of many cases of IBS.  The infection involves bacteria being able to colonize the small intestine – an area of the GI tract that normally has relatively low amounts of bacteria.

How does it happen?

The most common cause of SIBO occurs after a bout of gastroenteritis (aka stomach flu/food poisoning/traveller’s diarrhea) and is known as post-infectious IBS. A process occurs in which the immune system begins to attack specific neuromuscular cells within the small intestine that control the Migrating Motor Complex. The MMC is a series of contractions that clear out the small intestine of food remnants, bacteria, and digestive secretions. A damaged or weakened MMC can allow bacteria to stick around the SI and colonize the area.  

Other causes can include abdominal adhesions from past surgeries of inflammatory conditions, ileocecal valve dysfunction, and others.  

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Why is SIBO important? 

SIBO symptoms can have a significant effect on the quality of life. In addition, SIBO can lead to nutrient deficiencies due to malabsorption and contribute to intestinal permeability (aka leaky gut).   

SIBO questionnaire:

The more “yes” answers and the more severe and frequent symptoms mean a higher suspicion of SIBO. 

  • Alternating diarrhea and constipation? 
  • Chronic Constipation? 
  • Chronic diarrhea? 
  • Heartburn? Belching after meals? 
  • Bloating that is worse after meals or gets worse throughout the day?
  • Foul-smelling gas?
  • Celiac disease or gluten sensitivity but symptoms remain despite gluten avoidance? 
  • Digestive issues since a bout of gastroenteritis/food poisoning/traveller’s diarrhea?
  • Do digestive symptoms improve with the use of antibiotics?
  • Are digestive symptoms worse with fibre or probiotics?
  • Lactose or fructose intolerance? 
  • Chronic B12 or iron deficiency? 
  • Multiple food sensitivities?

Healthcare with Heart

SIX08 Health’s integrated, multidisciplinary team enables us to provide comprehensive and individualized care to our patients.

Ryan Nakama

Dr. Ryan Nakama – BSC, ND

Doctor of Naturopathic Medicine

Focus Areas: Digestive health, women’s health, pain management, energy and performance optimization. 

Dr. Ryan Nakama works to remove obstacles to health, including pain and mobility issues, in order to help patients obtain, maintain, or regain the life they want to live.

Dr. Nakama is skilled in the use of clinical nutrition, herbal medicine, and lifestyle counselling, with additional advanced training in prolotherapy, regenerative injection therapy, and intravenous (IV) nutritional therapy.

In addition to self-directed research Dr. Nakama regularly attends conferences and workshops in order to stay up to date on the latest research and clinical expertise in the areas of naturopathic medicine and patient care.

Regenerative Injection Therapy (RIT) FAQ

What is Regenerative Injection Therapy?

Regenerative Injection Therapy (RIT) involves injecting substances into areas of pain or damage in order to promote repair and healing in the body. Multiple techniques are often used in conjunction to address the various aspects involved in specific pain or injury in order to achieve a broad treatment benefit. Prolotherapy is possibly the best know form of RIT and is aimed at promoting the repair of soft tissues that contribute to many types of musculoskeletal pain.  

What types of pain can RIT treat? 

RIT and Prolotherapy can be useful in many types of joint pain, especially those related to joint instability and ligament laxity. This includes rotator cuff injuries, knee pain, low back and SI pain, sciatica, recurrent joint dislocations, ankle and wrist pain and more. 

How does prolotherapy work?  

Prolotherapy comes from the term “proli” as in proliferate or “to grow”. Injecting a solution – the proliferate – into injured tissues initiates a local immune and inflammatory response that is responsible for healing. New blood vessels form, nutrients and oxygen arrive, damaged tissue is removed and over time new tissue is laid down and restructured creating a stronger end product. Strengthening and tightening the injured structures allows the muscles to relax and pain signals to shut off. NPT appears to work by blocking specific pain receptors and allowing anti-inflammatory mediators to be released. Because the same nerves that supply the deep structures also supply the surface structures, superficial injections may be used to affect the deeper nerves.

How do ligaments and tendons cause pain?  

Ligaments are connective tissue fibres that attach across a joint to stabilize it. Tendons are made up of similar material and are the bridges or endpoints of muscles that attach them to the bone. So, tendons and muscles move joints and ligaments to stabilize them. But what happens when the ligaments get loose – either from a traumatic injury or repetitive use – and can’t perform their job? Nerve fibres in the damaged ligaments send out pain signals to the brain. Subconscious reflex mechanisms cause surrounding muscles to tighten in an attempt to stabilize the joint. Muscle tension and the mal-aligned bony structures can also irritate or compress nerves resulting in chronic pain signalling. This attempted but inadequate compensation leads to structural changes, chronic pain, and further instability. 

Why are ligaments and tendons so hard to heal? 

Think back to any anatomy diagram you’ve seen – with the red muscles and white or grey ligaments and tendons. It’s the same way in the body. Muscles are red because they have a rich blood supply while the white structures have very little. It is because of this poor blood supply that ligaments and tendons are notoriously poor healers. They often just don’t receive enough oxygen and nutrients that are required for healing. This is why even if you’ve done “all the right things” some injuries may not have healed completely or properly.

Is Regenerative Injection Therapy (RIT) for me? 

RIT is not a cure for all types of pain. Nor does it always eliminate 100% of one’s pain. It is, however, very good at addressing pain due to joint and ligament instability, neurogenic pain, and muscle tension. Because multiple systems are ultimately connected – the knee bones connected to the hipbone – and a problem in one area can actually present itself in another it takes a skilled practitioner to determine the underlying cause. While many injuries or pain may respond to physiotherapy or chiropractic, those due to chronic or traumatic injury where the tendons, ligaments or joint capsules are weakened, or where chronic pain signals stuck “on” may require the structural cause to be addressed. RIT techniques truly get to the root cause in these cases.

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