Several years ago I had a 38 year old woman we’ll call “Lisa” come to see me at the naturopathic clinic I was working at because of moderate depression. She could still function ok, but her mood was very low, her sleep was poor and she sometimes suffered from anxiety attacks as well. She kept saying she didn’t have a “reason” to be depressed, that there was “nothing wrong” with her life. She made a good living doing work she enjoyed as a vet, had a loving partner, lots of friends and family support and led an active lifestyle with plenty of hobbies outdoors. But for the last 6 months, she was feeling more and more down, and just couldn’t shake these blues.

We took a thorough case history and I noticed a few non-specific gut symptoms, such as bloating and indigestion after she ate, and mild constipation. She had had several courses of antibiotics the winter before for a chest infection, and a history of occasional thrush and urinary tract infections. I began to suspect her gut could be a hidden driver behind her low mood, and ordered a couple of tests. Sure enough, her tests came back practically off the charts for dysbiosis/SIBO (small intestinal bacterial overgrowth) and after putting her on a 6-week gut healing protocol, her annoying gut symptoms disappeared – along with her depression and anxiety.

What is Gut Dysfunction and How Do I Know If I Have It?

Gut dysfunction in naturopathic or functional medical terms can refer to a range of GI issues, but most commonly it refers to dysbiosis or SIBO (small intestinal bacterial overgrowth) and intestinal permeability (“leaky-gut” syndrome) which can cause systemic inflammation, a key driver behind many different health conditions including poor mental health.

Dysbiosis refers to an excess of “bad” bacteria in the small intestine that can interfere with nutrient absorption, vitamin production and can release lipopolysaccharide, a potent endotoxin that can trigger the immune system and cause inflammation. Intestinal permeability refers to the tight junctions between intestinal cells becoming less cohesive, resulting in poorly or incompletely digested food particles and toxins “leaking” into the bloodstream, again causing wide-spread inflammation.

The confusing thing is these “gut problems” don’t necessarily produce gut symptoms, but can manifest differently from person to person in things such as sinus problems, skin conditions, hypothyroidism, chronic fatigue and pain syndromes and often auto-immune disease, as well as depression, anxiety and even schizophrenia. The only way to know for sure if you have them is to get tested through a naturopath or functional medicine practitioner.

The 2 tests I most commonly use are a simple breath test for SIBO which can measure specific gases released by pathogenic bacteria, and also a comprehensive stool analysis that can show many other factors, such as parasites, fungal and bacterial overgrowth, and overall intestinal health and immune markers.

How Did I End Up With Gut Dysfynction In The First Place?

There are many factors that can cause gut dysfunction, and it’s usually a combination of several. Underlying food intolerance is a big one, gluten in particular can be a major cause of intestinal permeability in many people, not just coeliac patients. Diets high in sugar and refined carbs can feed pathogenic bacteria and result in dysbiosis, as can regular use of antacid medications and antibiotics. Modern diets are generally lower in fermented foods and healthy “prebiotic” fibre, so many people are not replenishing their guts with good bacteria. But even stress and poor sleep can affect gut function, there’s an intricate bi-directional relationship between the gut and the nervous system – notice how if you are nervous or anxious you can usually feel it in your tummy immediately!

How Does Gut Dysfunction Affect Mental Health?

How Can We Improve Our Gut Health (And Thus Mental Health!)?