In this conversation, The doctors discusses the implications of long-term use of Proton Pump Inhibitors (PPIs), their efficacy, risks, and the importance of tapering off these medications. The discussion covers the physiological effects of PPIs, the necessity of addressing underlying causes of reflux, and the potential for natural and herbal alternatives to support patients in tapering off PPIs. The conversation emphasizes the importance of patient education and the need for a gradual approach to discontinuing PPIs to avoid rebound symptoms.

Takeaways

• PPIs are effective for short-term use but not for long-term.
• Tapering off PPIs should take three to six months.
• Natural alternatives can help manage reflux symptoms.
• Melatonin can improve lower esophageal sphincter function.
• Nutrient deficiencies are a risk with long-term PPI use.
• DGL has been shown to improve quality of life in patients.
• Patient education is crucial in managing PPI use.
• Underlying causes of reflux should be addressed.
• Herbal remedies can provide additional support during tapering.
• A gradual tapering process is essential to avoid rebound symptoms.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠

In this conversation, Dr. Ilana Gurevich discusses a complex case involving a patient with scleroderma who experienced chronic diarrhea. The discussion covers the patient's journey, the challenges of treatment, and the surprising outcomes related to fertility and pregnancy. Dr. Sand emphasizes the role of nitazoxanide in managing the patient's symptoms and the considerations for treatment during pregnancy.

• The patient had chronic diarrhea due to scleroderma.
• Nitazoxanide was used as a treatment for Giardia.
• Standard treatments like metronidazole had failed for the patient.
• The patient unexpectedly became pregnant after treatment.
• Managing diarrhea during pregnancy poses unique challenges.
• Functional medicine approaches can provide alternative solutions.
• Probiotics and dietary changes were attempted but were ineffective.
• Nitazoxanide is considered safe during pregnancy.
• The patient's symptoms improved significantly with treatment.
• The case highlights the importance of individualized patient care.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

This conversation delves into the gastrointestinal issues that arise during pregnancy, focusing on common problems such as morning sickness, reflux, constipation, and hemorrhoids. The speakers share personal experiences and professional insights on effective remedies, including acupuncture, dietary adjustments, and the importance of hydration. They emphasize the need for pregnant individuals to be proactive about their digestive health and provide practical tips for managing symptoms throughout pregnancy.

• GI issues are common in pregnancy and can be severe.
• Morning sickness often lasts beyond the morning hours.
• Acupuncture can provide significant relief for nausea.
• Dietary changes, including ginger and protein intake, are crucial.
• Reflux is exacerbated by hormonal changes and physical space constraints.
• Constipation can worsen nausea and should be addressed promptly.
• Hydration is essential due to increased blood volume during pregnancy.
• Pelvic floor health is important to prevent complications during childbirth.
• Papaya enzymes are effective for digestive issues in pregnant women.
• The first bowel movement postpartum can be particularly challenging.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠

In this conversation, Dr. Ami Kapadia discusses the complex relationship between Candida and allergies, emphasizing that many patients may not just have a fungal overgrowth but could also be experiencing an allergic reaction to Candida. The discussion covers the importance of understanding Candida as a commensal organism, the connection between allergies and Candida, testing methods for diagnosis, and treatment options including sublingual immunotherapy. The conversation also touches on the role of the immune system, the impact of diet, and the connection between heavy metals and Candida.

Takeaways

• Candida can be an allergen, not just an infection.
• Terminology in medicine is crucial for patient understanding.
• Allergic predisposition can lead to Candida allergies.
• Testing for Candida allergies often requires allergist involvement.
• Sublingual immunotherapy can be effective for Candida allergies.
• The immune system's response to Candida is complex.
• Chronic conditions may complicate Candida treatment.
• Diet plays a significant role in managing Candida.
• Heavy metals may influence Candida overgrowth.
• A thorough patient history is essential for effective treatment.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠
• ⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠

Treatment strategies for different varieties of SIBO.

A continuation of our burning SIBO questions.

Topics for part two:

• Most effective treatment strategies for methane and hydrogen SIBO
• Making sense of hydrogen sulfide SIBO,
• Dr. Gurevich's favorite herbal treatment options
• How and why to support patients through the dreaded elemental diet. 

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

Pathology and testing for SIBO.

Dr. Gurevich leads us in a discussion about small intestinal bacterial overgrowth (SIBO).  We discuss pathology and underlying causes of SIBO as well as SIBO testing options.  In this episode we also discuss SIBO and the microbiome, parasites and protozoa effecting the microbiome, endometriosis, gastroparesis, adhesions and SIBO.  There is also discussion about testing including breath testing and the IBS smart test.  We also look at a variety of treatment options including visceral massage and others.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

Botanical and medications for management of fungal overgrowth.

Dr's Sand, Kapadia and Gurevich continue their discussion on SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us through more details in a discussion of fungal overgrowth in the GI tract. 

Topics covered in this episode:

• Botanical and medication treatment options for SIFO
• Gluten sensitivity and candida
• Sugar and candida
• The mold yeast elimination diet
• MCAS

Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: ⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠

Patient course on SIFO:  ⁠https://drkapadia.teachable.com/p/sifo-in-integrative-course-for-patient-education⁠

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

How fungal overgrowth changes the intestinal tract.

Dr's Sand, Kapadia and Gurevich continue their discussion on SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us through more details in a discussion of fungal overgrowth in the GI tract. 

Topics covered in this episode: SIFO treatment, foundations of GI health, stress the gut and limbic system retraining, dietary changes and SIFO, nutrient deficiencies in SIFO, acid suppression and SIFO, medications and botanicals in treatment of SIFO

Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: ⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠

Patient course on SIFO:  ⁠https://drkapadia.teachable.com/p/sifo-in-integrative-course-for-patient-education⁠

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

Testing and Treatment

Dr's Sand, Kapadia and Gurevich do a deep dive into SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us in a discussion of fungal overgrowth in the GI tract. 

Topics covered: Symptoms Testing and Treatment of SIFO, Organic Acid Testing, Stool Testing, Protozoa, tongue coating, association with allergies, MCAS, skin, Vulvovaginitis and candidiasis, IBS, IBD and SIFO, Biofilm and SIFO

Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: 

⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

In this conversation, Dr. Rebecca Sand discusses a complex case of a 34-year-old female patient suffering from bloating, constipation, and other gastrointestinal issues. The discussion covers the patient's medical history, diagnostic tests, treatment strategies, and the exploration of potential underlying conditions such as SIBO and endometriosis. The conversation emphasizes the importance of a comprehensive approach to diagnosing and treating digestive health issues, particularly in women.takeaways

• The patient had a long history of gastrointestinal issues starting from childhood.
• Initial treatments included dietary changes and medications, which were not effective.
• Lab results indicated significant nutritional deficiencies, particularly low ferritin and B12 levels.
• SIBO was diagnosed and treated with herbal remedies, leading to some improvement.
• Endometriosis was identified as a potential underlying condition contributing to symptoms.
• Management strategies included dietary adjustments, nutritional supplementation, and lifestyle changes.
• The importance of addressing inflammation in the treatment of digestive issues was highlighted.
• Regular monitoring of symptoms and lab results is crucial for effective treatment.
• Walking and physical activity were emphasized as beneficial for digestive health.
• Understanding gynecologic conditions is essential in managing women's health issues.

👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠

• ⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

• ⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠
• ⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM

• ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠