Back Clinic Gut and Intestinal Health. The health of an individual’s gut determines what nutrients are absorbed along with what toxins, allergens, and microbes are kept out. It is directly linked to the health of the whole body. Intestinal health could be defined as optimal digestion, absorption, and assimilation of food. But this is a job that depends on many other factors. More than 100 million Americans have digestive problems. Two of the top-selling drugs in America are for digestive problems, and they run in the billions. There are more than 200 over-the-counter (OTC) remedies for digestive disorders. And these can and do create additional digestive problems.
If an individual’s digestion is not working properly, the first thing is to understand what is sending the gut out-of-balance in the first place.
A low-fiber, high-sugar, processed, nutrient-poor, high-calorie diet causes all the wrong bacteria and yeast to grow in the gut and damages the delicate ecosystem in your intestines.
Overuse of medications that damage the gut or block normal digestive function, i.e., acid blockers (Prilosec, Nexium, etc.), anti-inflammatory medication (aspirin, Advil, and Aleve), antibiotics, steroids, and hormones.
Undetected gluten intolerance, celiac disease, or low-grade food allergies to foods such as dairy, eggs, or corn.
Chronic low-grade infections or gut imbalances with overgrowth of bacteria in the small intestine, yeast overgrowth, parasites.
Toxins like mercury and mold toxins damage the gut.
Lack of adequate digestive enzyme function from acid-blocking medications or zinc deficiency.
Stress can alter the gut’s nervous system, cause a leaky gut, and change the normal bacteria.
Visits for intestinal disorders are among the most common trips to primary care doctors. Unfortunately, most, which also includes most doctors, do not recognize or know that digestive problems wreak havoc in the entire body. This leads to allergies, arthritis, autoimmune disease, rashes, acne, chronic fatigue, mood disorders, autism, dementia, cancer, and more. Having proper gut and intestinal health is absolutely central to your health. It is connected to everything that happens in the body.
Can individuals dealing with back pain find treatment to reduce gut pain associated with SIBO to improve body health?
Introduction
Many individuals have noticed that when it comes to improving their health and well-being, many will incorporate small changes into their daily routines. From exercising for at least 30 minutes to incorporating healthy nutritional foods into their diet, many people don’t realize that the best way to have a healthy style starts with the gut. The gut system helps the body digest food and nutrients to be transported to the body, helps regulate growth and metabolism, and provides immune support to all the organ systems. However, when harmful pathogens and environmental factors start to impact the gut, it can cause the development of harmful pathogens inside the gut system and, over time, cause overlapping risk profiles in the body. This leads to gut dysfunction and musculoskeletal issues in the individual and can cause pain and discomfort if not treated right away. Luckily, numerous ways exist to improve gut health and reduce musculoskeletal issues. Today’s article focuses on a gut issue known as SIBO, how SIBO is correlated with back pain, and what treatments can help reduce SIBO. We talk with certified associated medical providers who provide our patients’ information to assess and identify how SIBO is correlated with back pain. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of SIBO and help restore gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
What is SIBO?
How often do you feel general aches or pain in your gut or around your lower back? Do you constantly feel tired throughout the day, even after a full night’s rest? Or have you been constantly feeling constipated or bloated after eating a meal? Many of these scenarios are associated with a gut issue known as SIBO or small intestinal bacterial overgrowth. Before diving into what SIBO is, it is important to see the gut’s main function to the body. Known as the second brain of the body, the gut system is home to trillions of good bacteria that help with food digestion and protect the body from bad bacteria. When environmental factors like poor dieting, physical inactivity, or inflammatory effects affect the body, the gut’s delicate ecosystem is also affected. This can cause gut dysfunction to the body and, over time, when it is not being treated, lead to SIBO.
SIBO is the presence of excess bad bacteria in the small intestines, which causes protective barriers that help the small intestines weaken. (Sorathia et al., 2024) Additionally, SIBO can correlate with conditions as it can accompany other gut issues by stimulating the immune system. (Banaszak et al., 2023) When the immune system becomes hyperactively stimulated by SIBO, it can cause the inflammatory cytokines to mass produce and cause a ripple effect on the entire body. Since inflammation is the body’s natural response to remove harmful pathogens that cause issues, mass production of inflammatory cytokines in the gut can cause toxins and bad bacteria to enter the bloodstream and travel to different body areas to cause pain. At the same time, SIBO can disrupt the gut-brain axis, which leads to intestinal motility changes and secretion, thus causing overlapping risk profiles like back pain to affect the body. (Carter et al., 2023)
Eating Right to Feel Better- Video
How Does Back Pain Correlate With SIBO?
Now, many people are wondering how back pain is correlated with SIBO. Since SIBO causes the immune system to be hyperactive and mass-produce inflammatory cytokines to reduce the integrity and function of the gastrointestinal barrier, it can cause chronic inflammation and induce pain, which includes musculoskeletal conditions like back pain. (Hui et al., 2023) Additionally, the gut-brain axis being over-runed by SIBO and chronic inflammation being an overlapping risk factor can cause negative influences on the gut microbiome composition, and how the individual reacts to the changes can lead to abnormal bone growth and reabsorption due to the excess bacteria. (Geng et al., 2023) The excess bacteria produced by SIBO can affect intervertebral disc homeostasis and, when combined with environmental factors, can further enhance the inflammatory damage to the back muscles. (Yao et al., 2023) However, there are ways to not only reduce the back pain but also treat SIBO from causing more issues in the gut.
Treatments To Reduce SIBO
When it comes to treating SIBO, it depends on what treatment a person will be combined. The main goals for creating a treatment plan for SIBO are:
Reducing the bad bacteria
Bio-transform the gut
Preventing a relapse
Additionally, many individuals can make small changes in their routine by making dietary changes that can modify the intestinal microbiota. (Souza et al., 2022) This, in turn, helps promote gut health and replenish the nutrients while restoring the good bacteria to the gut. Regarding back pain associated with SIBO, chiropractic care can help individuals decrease or alleviate musculoskeletal symptoms by realigning the spine while massaging the muscles. This can help increase circulation while soothing the inflammatory effects caused by SIBO. Chiropractic care can be implemented as part of a person’s customizable treatment plan through a whole body approach by incorporating lifestyle changes and restoring gut health. By making these small changes with the right treatments to manage the overlapping symptoms caused by SIBO, many individuals can make these small changes to their routine to prevent SIBO from reappearing and causing issues in the body.
References
Banaszak, M., Gorna, I., Wozniak, D., Przyslawski, J., & Drzymala-Czyz, S. (2023). Association between Gut Dysbiosis and the Occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms, 11(3). https://doi.org/10.3390/microorganisms11030573
Carter, J., Bettag, J., Morfin, S., Manithody, C., Nagarapu, A., Jain, A., Nazzal, H., Prem, S., Unes, M., McHale, M., Lin, C. J., Hutchinson, C., Trello, G., Jain, A., Portz, E., Verma, A., Swiderska-Syn, M., Goldenberg, D., & Kurashima, K. (2023). Gut Microbiota Modulation of Short Bowel Syndrome and the Gut-Brain Axis. Nutrients, 15(11). https://doi.org/10.3390/nu15112581
Geng, Z., Wang, J., Chen, G., Liu, J., Lan, J., Zhang, Z., & Miao, J. (2023). Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res, 18(1), 601. https://doi.org/10.1186/s13018-023-04081-0
Hui, J., Chen, Y., Li, C., Gou, Y., Liu, Y., Zhou, R., Kang, M., Liu, C., Wang, B., Shi, P., Cheng, S., Yang, X., Pan, C., Jia, Y., Cheng, B., Liu, H., Wen, Y., & Zhang, F. (2023). Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. Adv Genet (Hoboken), 4(4), 2300192. https://doi.org/10.1002/ggn2.202300192
Souza, C., Rocha, R., & Cotrim, H. P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World J Clin Cases, 10(15), 4713-4716. https://doi.org/10.12998/wjcc.v10.i15.4713
Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. https://doi.org/10.1111/os.13626
For individuals dealing with constipation issues, can using an osmotic laxative help treat and prevent constipation?
Osmotic Laxative
Osmotic laxatives can help treat or prevent constipation by increasing the amount of water in the colon, softening stools, and making them easier to pass. Some osmotic laxatives are used for bowel preparation to help clear the colon before a colonoscopy. They are available over the counter and by prescription and can contain different active ingredients, including polyethylene glycol/PEG, lactulose, sorbitol, magnesium citrate, and magnesium hydroxides.
How They Work
Constipation occurs when stools are irregular and hard to pass, as they are usually hard and dry. An osmotic laxative helps relieve constipation by increasing the amount of fluid in the intestines. They pull water from the colon’s wall to the inside, softening stools and making them easier to pass. The term osmotic refers to the movement of fluids through a membrane with the concentration equal on both sides. In individuals with constipation problems, the concentration of water in the colon’s wall and the inside of the colon/lumen is balanced but insufficient to compensate for hard, dry stools. This is especially true of those who don’t drink enough water. Osmotic laxatives alter the balance with substances like salts, sugars, and other organic compounds to encourage water movement into the lumen.
How Are They Different?
Most laxatives are generally used for the treatment of occasional constipation. Osmotic laxatives work differently because they are used to prevent or treat chronic constipation. Other types of laxatives include:
Emollient
These are made with a surfactant called docusate.
Surfactants are substances that draw and spread fats and water.
Docusate increases the passage of water and fats into stools to soften them.
Lubricant
These are made with oily substances, like mineral oil, that help the stool slide through the intestine.
Stimulant
These laxatives relieve constipation by causing the intestines to contract and push out the stools.
Osmotic Laxatives
The common osmotic laxatives are made with different active ingredients that include:
Polyethylene Glycol – PEG
This organic compound is derived from petroleum and can be safely ingested to manage constipation.
Available over the counter.
These include Miralax and GlycoLax.
Lactulose
This is a type of sugar that is not absorbed by the intestine.
Instead, the sugar sits and ferments in the intestines, producing fatty acids that pull water into the lumen.
Available by prescription, including Cephulac, Duphalac, Kristalose, and others.
Sorbitol
This is also a non-absorbable sugar with activation similar to lactulose.
Over-the-counter and prescription versions include Arlex and GeriCare.
Magnesium Citrate
Magnesium citrate is magnesium in salt form combined with citric acid.
The salts help pull water into the lumen.
Over-the-counter versions include Citrate of Magnesia, Citroma, and LiquiPrep.
Magnesium Hydroxide
This milder form of magnesium is sold under the brand Milk of Magnesia.
Milk of Magnesia is also an antacid and is available over the counter.
Potential Side Effects
As with all medications, there can be potential side effects. Most are relatively mild and resolve independently within a few days. Common side effects include:
Abdominal cramping
Bloating
Nausea
Diarrhea
Flatulence
Overusing laxatives can cause dehydration and the loss of electrolytes like sodium, calcium, potassium, minerals the body needs to regulate heartbeat, muscle contractions, and other essential functions. (Tropini, C. et al., 2018) Consult with a healthcare provider to ensure you use any laxative correctly, whether over-the-counter or prescription. For those thinking about using osmotic laxatives, be sure to follow the dosing instructions carefully, avoid complications, and use only when needed. Individuals with chronic constipation should see a healthcare provider so that they can identify the underlying cause. Diet, exercise, and increased fluid intake can sometimes improve the condition. Others may require treatments that extend beyond the use of laxatives.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to create personalized treatment programs. We passionately focus on treating patients’ injuries and chronic pain syndromes. Using an integrated approach to improve ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers if other treatments are needed. Our goal is to relieve pain naturally by restoring health and function to the body.
Poop Testing: What? Why? and How?
References
Tropini, C., Moss, E. L., Merrill, B. D., Ng, K. M., Higginbottom, S. K., Casavant, E. P., Gonzalez, C. G., Fremin, B., Bouley, D. M., Elias, J. E., Bhatt, A. S., Huang, K. C., & Sonnenburg, J. L. (2018). Transient Osmotic Perturbation Causes Long-Term Alteration to the Gut Microbiota. Cell, 173(7), 1742–1754.e17. https://doi.org/10.1016/j.cell.2018.05.008
Emotional challenges like anxiety and depression or digestive disorders can cause individuals to experience a nervous stomach. Can knowing common symptoms, what causes them, and when to see a healthcare provider help manage the disorder?
Nervous Stomach
A nervous stomach is usually nothing to worry about, but it can happen occasionally as a reaction to a new environment, groups of people, foods, stress, and anxiety. Symptoms include indigestion, fluttering stomach/butterflies, or a gut-wrenching feeling. (Anxiety and Depression Association of America. 2023) Causes include underlying psychological and physical health conditions, certain medications, and lifestyle factors. Individuals experiencing chronic or ongoing symptoms should speak with a healthcare provider about their full range of symptoms. Treatments include medication, therapy, and lifestyle changes.
Symptoms
Nervous stomach symptoms can vary. Stress and anxiety can lead to physical symptoms, and physical symptoms may also lead to stress and anxiety. This is because the brain and gut connection communicates which hormones and neurotransmitters will be released and when. Common symptoms include: (Anxiety and Depression Association of America. 2023)
Loss of appetite
Butterflies or fluttering feeling in the stomach
Upset stomach
Indigestion
Bloating
Flatulence
Gut-wrenching feeling
Cramping
Nausea, dry heaving
Increased need to urinate or have bowel movements
Constipation
Diarrhea
Out-of-sync hunger cues
Causes
In most cases, a nervous stomach will come and go. However, it can also be caused by disorders such as anxiety disorder, depression, or gastrointestinal and digestive disorders. Brain health contributes to gut health, and vice versa. The brain is always communicating with the digestive system, and the digestive system is always sending information back to the brain. (Foster, J. A., and McVey Neufeld, K. A. 2013) (University of Chicago Medical Center, 2024) Common causes of a nervous stomach include: (Anxiety and Depression Association of America. 2023)
Over-the-counter and prescription medications can cause a nervous stomach as a side effect. This can happen when taking a single medication or more than one simultaneously. It can also occur in those with food sensitivities or other medical conditions. (Johns Hopkins Medicine, 2024) This is why consulting and updating a healthcare provider on the current list of prescribed and over-the-counter medications is important. Some meds can irritate the stomach, while others can cause constipation or diarrhea, leading to discomfort and nervous stomach symptoms. Common medications that may cause stomach side effect symptoms include: (Johns Hopkins Medicine, 2024)
NSAIDs – non-steroidal anti-inflammatory drugs such as ibuprofen can weaken the stomach lining.
Iron, antacids, and pain meds can cause constipation.
Antibiotics can cause diarrhea.
Home Treatment
Treatment depends on the severity and cause/s. An infrequently nervous stomach may benefit from over-the-counter therapies to calm it and/or lifestyle changes to reduce stress. Tips for reducing stress and anxiety include (Anxiety and Depression Association of America. 2023)
More frequent short breaks during the day
Practicing slow and deep breathing
Listening to guided meditations for stress-relief
Adding exercise to the daily routine
Realizing that stomach problems are part of anxiety and worrying about symptoms may make them worse.
Medical Treatment
Individuals may benefit from additional support treatment options with a healthcare provider (Johns Hopkins Medicine, 2024)
Antidepressant treatment for nervous stomach and/or irritable bowel syndrome.
Cognitive behavioral therapy for stress relief and learning how to manage anxiety.
Medical hypnotherapy
If symptoms are a side effect of medication or certain foods, a healthcare provider can develop an effective treatment plan that includes using another medication that is easier on the stomach or seeing a dietician.
Complications
Left untreated, a nervous stomach can contribute to further symptoms and other health problems. One study looked at the relationship between irritable bowel syndrome and certain psychiatric disorders. (Fadgyas-Stanculete, M. et al., 2014) This does not mean that a psychiatric disorder causes a nervous stomach or that a nervous stomach causes a psychiatric disorder. It is more likely that a combination of chemicals released when stressed can hurt gut health. This creates imbalances known to be risk factors for digestive disorders and conditions. (Anxiety and Depression Association of America. 2023)
Seeing a Healthcare Provider
Most nervous stomach symptoms resolve on their own. However, certain signs and symptoms can indicate that it is time to see a healthcare provider. Discuss symptoms with a healthcare provider who will order lab tests to check for underlying causes like anemia. See a healthcare provider immediately if you notice the following (University of Chicago Medical Center, 2024)
Symptoms are making work and/or normal life challenging.
Chronic or unresolved gastrointestinal issues like heartburn.
Unexplained weight reduction – losing weight without exercising or diet changes.
Blood in stool or blackish, tarry stools.
Vomiting
If there is a medical history of digestive disorders or cancers such as stomach cancer or colon cancer, this will help a healthcare provider. Depending on overall symptoms and family medical history, individuals may be referred to a gastroenterologist and/or a mental healthcare provider, like a counselor or psychiatrist. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. We work with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal health. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Root Causes of Gut Dysfunction Part 3
References
Anxiety and Depression Association of America. (2023). How to calm an anxious stomach: The brain-gut connection. Anxiety and Depression Association of America.
Triumphing Through Science, Treatment, and Education. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/how-calm-anxious-stomach-brain-gut-connection
Foster, J. A., & McVey Neufeld, K. A. (2013). Gut-brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences, 36(5), 305–312. https://doi.org/10.1016/j.tins.2013.01.005
University of Chicago Medical Center. (2024). Stress and stomach pain: When should you see a specialist? Forefront. https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/2024/january/stress-stomach-pain-when-to-see-a-doctor
Fadgyas-Stanculete, M., Buga, A. M., Popa-Wagner, A., & Dumitrascu, D. L. (2014). The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. Journal of molecular psychiatry, 2(1), 4. https://doi.org/10.1186/2049-9256-2-4
Ness-Jensen, E., & Lagergren, J. (2017). Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best practice & research. Clinical gastroenterology, 31(5), 501–508. https://doi.org/10.1016/j.bpg.2017.09.004
Johns Hopkins Medicine. (2024). Medicines and the digestive system. Health. https://www.hopkinsmedicine.org/health/conditions-and-diseases/medicines-and-the-digestive-system
Can kimchi benefit individuals trying to incorporate more fermented foods into their diet?
Kimchi
Kimchi is a flavorful and nutritious food packed with nutritious vegetables. It is high in vitamin C, vitamin A, and iron. It is made of salted, fermented vegetables and typically served as a side dish that starts with cabbage as the base. Other varieties use different vegetables, like radish, cucumber, and onion. It has minimal calories, a low carb count, zero fat, and health benefits like an abundance of probiotics from its fermentation process.
Nutrition
Kimchi is an excellent source of vitamin C and vitamin A. A typical half-cup of kimchi is 85 grams and provides the following. (U.S. Department of Agriculture. 2017)
Calories – 20
Fat – 0g
Sodium – 290 milligrams
Carbohydrates – 4 grams
Fiber – 1 grams
Sugars – 2 grams
Protein – 1 grams
Vitamin C – 18 milligrams
Iron – 1.08 milligrams
Vitamin A – 375 micrograms
Calcium – 40 milligrams
Calories
A half-cup serving provides 20 calories, about 53% of which are carbohydrates, 21% are protein, and 26% are fat.
Carbohydrates
Kimchi comprises 4 grams of carbohydrates per serving, with 1 being fiber.
However, many kimchi recipes add sweeteners, like honey or fruit juice, to balance the sourness.
More sweeteners means more carbohydrates.
Fats
Because it is primarily vegetables, it is naturally fat-free.
Protein
Kimchi isn’t exactly a protein-power player.
A half-cup serving provides just 1 gram of plant-based protein from veggies.
However, recipes that include seafood like shrimp or squid will contain higher amounts of this macronutrient.
Vitamins and Minerals
Vitamins and minerals vary depending on the vegetables used.
A Napa cabbage-based kimchi includes abundant vitamins C and K and smaller amounts of iron, calcium, copper, and potassium.
A recipe with carrots will contain significant vitamin A.
A recipe with radishes will supply folate, potassium, and riboflavin.
All varieties are made with salt, so sodium is a mineral to watch.
A half-cup serving may provide nearly 300 milligrams or 13% Daily Value of sodium.
Benefits
Kimchi is a versatile food that can provide health benefits.
Digestion
The lactic acid that ferments the cabbage also provides healthy gut bacteria.
Consuming probiotics through kimchi promotes healthy digestion and helps alleviate constipation problems. (Higashikawa, F. et al., 2010)
Compatible with Special Diets
With simple plant-based ingredients it can be suitable for specialized diets.
It suits vegan, vegetarian, low-carb, gluten-free, and dairy-free diets.
Immune System Support
The probiotics in fermented foods improve digestion and may help improve immune function.
Research has suggested that when individuals stop eating fermented foods, their immune response decreases. (Olivares, M. et al., 2006)
Researchers isolated a compound in kimchi called HDMPPA – 3-(4′-hydroxyl-3′,5′-dimethoxyphenyl) propionic acid –
and studied its interaction with inflammatory proteins.
They discovered that HDMPPA counteracted the proteins’ inflammatory effect.
It is not enough to conclude that kimchi readily reduces inflammation, but further research could help confirm its ability. (Jeong, J. W. et al., 2015)
Improve Asthma Symptoms
A study of Korean adults with asthma found that the more kimchi they consumed, the less likely they were to experience an asthma attack.
Further research is needed, but the results are promising. (Kim, H. et al., 2014)
Allergies
Commercial and home-prepared kimchi is often free of all top eight food allergens—but check ingredient labels to be sure.
Some preparations, for example, may contain fish sauce, shrimp, or shrimp paste, which are a no-go for those with a fish or shellfish allergy.
Adverse Effects
Kimchi may have adverse effects on some individuals depending on its preparation.
It could be high in sodium, which may not be recommended for individuals on a heart-healthy or sodium-restricted diet.
With high levels of probiotics, it could cause bloating or an upset stomach.
Individuals sensitive to strong flavors may not enjoy the taste.
Varieties
Traditionally, kimchi is made from cabbage, but a wide variety of vegetables can be substituted for or combined with recipes that use alternative vegetables, spices, or other additions. Some recipes include fish or meat to turn it inta a main dish. Water kimchi is a soup version served in broth. But what makes kimchi is its base of fermented vegetables.
Storage and Safety
Fermentation can be tricky when it comes to food safety. Store-bought or homemade kimchi properly canned in a sterilized jar can be kept at room temperature for up to a week after opening. Stored in the refrigerator, it will stay fresh for three to six months. The beneficial bacteria working and fermentation process is ongoing, making the taste increasingly sour and texture mushier over time. This does not mean the jar has gone bad as long as it has no odd smell or mold.
Preparation
The process is not that complex.
Select a recipe with vegetables like cabbage, radish, and carrots.
Slice the vegetables into chunks and rub with salt.
Leave the vegetables in salt; some recipes include water for several hours to allow fermentation.
Drain the excess water, then add flavoring ingredients like sweeteners and spices.
Serve as a side dish with fried rice or noodles, or make it a main course by adding fish, meat, or tofu.
Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
The Healing Diet
References
U.S. Department of Agriculture. FoodData Central. (2017). Kimchi. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/516912/nutrients
Higashikawa, F., Noda, M., Awaya, T., Nomura, K., Oku, H., & Sugiyama, M. (2010). Improvement of constipation and liver function by plant-derived lactic acid bacteria: a double-blind, randomized trial. Nutrition (Burbank, Los Angeles County, Calif.), 26(4), 367–374. https://doi.org/10.1016/j.nut.2009.05.008
Olivares, M., Paz Díaz-Ropero, M., Gómez, N., Sierra, S., Lara-Villoslada, F., Martín, R., Miguel Rodríguez, J., & Xaus, J. (2006). Dietary deprivation of fermented foods causes a fall in innate immune response. Lactic acid bacteria can counteract the immunological effect of this deprivation. The Journal of dairy research, 73(4), 492–498. https://doi.org/10.1017/S0022029906002068
National Institutes of Health Office of Dietary Supplements. (2021). Vitamin C: Fact sheet for health professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
Jeong, J. W., Choi, I. W., Jo, G. H., Kim, G. Y., Kim, J., Suh, H., Ryu, C. H., Kim, W. J., Park, K. Y., & Choi, Y. H. (2015). Anti-Inflammatory Effects of 3-(4′-Hydroxyl-3′,5′-Dimethoxyphenyl)Propionic Acid, an Active Component of Korean Cabbage Kimchi, in Lipopolysaccharide-Stimulated BV2 Microglia. Journal of medicinal food, 18(6), 677–684. https://doi.org/10.1089/jmf.2014.3275
Kim, H., Oh, S. Y., Kang, M. H., Kim, K. N., Kim, Y., & Chang, N. (2014). Association between kimchi intake and asthma in Korean adults: the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2011). Journal of medicinal food, 17(1), 172–178. https://doi.org/10.1089/jmf.2013.3013
Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?
Food Poisoning and Restoring Gut Health
Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centers for Disease Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.
Foods to Eat
After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)
Gatorade
Pedialyte
Water
Herbal tea
Chicken broth
Jello
Applesauce
Crackers
Toast
Rice
Oatmeal
Bananas
Potatoes
Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)
When Food Poisoning Is Active Foods To Avoid
During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)
Caffeinated drinks and alcohol can further dehydrate.
Greasy foods and high-fiber foods are hard to digest.
Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)
Recovery Time and Resuming Regular Diet
Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centers for Disease Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centers for Disease Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)
Recommended Gut Foods Post Stomach Virus
Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)
Beans
Onions
Tomatoes
Asparagus
Peas
Honey
Milk
Banana
Wheat, barley, rye
Garlic
Soybean
Seaweed
In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)
Pickles
Sourdough bread
Kombucha
Sauerkraut
Yogurt
Miso
Kefir
Kimchi
Tempeh
Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Learning About Food Substitutions
References
Centers for Disease Control and Prevention. (2024). Food poisoning symptoms. Retrieved from https://www.cdc.gov/foodsafety/symptoms.html
Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. https://doi.org/10.1371/journal.pone.0095534
National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Eating, diet, & nutrition for food poisoning. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/food-poisoning/eating-diet-nutrition
Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. https://doi.org/10.1093/cid/cix669
Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. https://doi.org/10.3945/ajcn.115.114769
Ohio State University. Kacie Vavrek, M., RD, CSSD Ohio State University. (2019). Foods to avoid when you have the flu. https://health.osu.edu/wellness/exercise-and-nutrition/foods-to-avoid-with-flu
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. https://doi.org/10.1002/bab.1938
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. https://doi.org/10.3390/microorganisms7010014
Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. https://doi.org/10.1002/jev2.12172
Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. https://doi.org/10.3390/foods8030092
Harvard Medical School. (2023). How to get more probiotics. https://www.health.harvard.edu/staying-healthy/how-to-get-more-probiotics
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Treatment of viral gastroenteritis. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis/treatment
For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?
Peppermint
First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.
How It Is Used
Peppermint oil can be taken as a tea or in capsule form.
Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.
For Irritable Bowel Syndrome
Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)
Peppermint extract may increase serum levels of these medications.
It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.
Pregnancy
Peppermint is not recommended for use during pregnancy or by nursing individuals.
It is unknown if it could affect a developing fetus.
It is unknown if it can affect a nursing baby.
How To Use The Herb
It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.
Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
Supplements may contain harmful ingredients or not contain the active ingredient at all.
This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.
It has the potential to worsen certain conditions and should not be used by:
Peppermint was used to treat colic in infants but is not recommended today.
The menthol in the tea may cause infants and small children to choke.
Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. https://doi.org/10.1186/s12906-018-2409-0
Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. https://doi.org/10.3399/bjgp18X699101
Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.
National Center for Complementary and Integrative Health. (2020). Peppermint oil. Retrieved from https://www.nccih.nih.gov/health/peppermint-oil#safety
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. https://doi.org/10.1007/s10620-015-3858-7
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. https://doi.org/10.1097/MCG.0b013e3182a88357
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Nutrition Fundamentals
References
University of Arizona Cooperative Extension. Hope Wilson, M. W., Patricia Zilliox. (2019). Prickly pear cactus: food of the desert. https://extension.arizona.edu/sites/extension.arizona.edu/files/pubs/az1800-2019.pdf
U.S. Department of Agriculture. FoodData Central. (2018). Nopales, cooked, without salt. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/169388/nutrients
U.S. Department of Agriculture. MyPlate. (2020-2025). Vegetables. Retrieved from https://www.myplate.gov/eat-healthy/vegetables
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. https://doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. https://doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. https://doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. https://doi.org/10.2337/dc06-2506
Centers for Disease Control and Prevention. (2022). Fiber: the carb that helps you manage diabetes. Retrieved from https://www.cdc.gov/diabetes/library/features/role-of-fiber.html
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. https://doi.org/10.1111/nmo.13986
National Institutes of Health (NIH). Office of Dietary Supplements. (2024). Calcium. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. https://doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. https://doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. https://doi.org/10.3390/nu14051008
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