Treatment for cancer, including surgery, radiotherapy and chemotherapy, not to mention commonly prescribed drugs such as antibiotics, NSAID’s and Proton Pump Inhibitors such as Omeprazole can all take their toll on the gut. Whilst chemotherapy targets cancer cells, it also kills healthy cells, such as the epithelial cells that line our gastrointestinal tract. Because healthy cells are caught in the crossfire, many women find they are not only fighting cancer but battling a long list of digestive side effects. These side effects, such as abdominal pain, cramping, flatulence, nausea, vomiting, diarrhoea, constipation or mucositis put a strain on the gut and also put a strain on the immune system. Some women find that the symptoms can be debilitating and this can reduce adherence to cancer treatments.
Our gut is full of bacteria, most of which have a positive effect on our health, but when these bacteria become imbalanced, they make it easier for less friendly bugs to take over, which can lead to something called dysbiosis. One of the side effects of dysbiosis is that your gut microbiome doesn’t produce enough nutrients, especially short-chain fatty acids which help maintain the gut lining. When the gut lining is compromised, this can increase intestinal permeability, which means that unwanted bacteria, toxins, food compounds and viruses can enter the bloodstream and cause a myriad of health problems.
There is also the risk of Small Intestinal Bacterial Overgrowth (SIBO) which is where bacteria begin to grow and overpopulate the small intestine (they are meant to predominantly reside in the large intestine). The small intestine is responsible for extracting most of the energy and nutrients from your food. This bacterial overgrowth leads to excess production of methane or hydrogen gasses. These gases influence the cells of the intestinal lining, causing bloating, abdominal pain, flatulence, diarrhoea, and/or constipation. SIBO interferes with the digestion and absorption of the nutrients in our food which can lead to vitamin and mineral deficiencies.
Gut health and brain health go hand in hand as they are constantly communicating with each other via the gut brain axis. This axis is a bidirectional line of communication that links parts of the brain with intestinal function. Think of the terms “gut feeling” or “sick to my stomach,” or maybe you have had “butterflies” in your stomach – this is your gut brain axis communicating. Bacteria in the gut is impaired with cancer treatments, and so is the brain, “chemo brain” is a common side effect of treatment. Your gut microbiome is important for regulating serotonin levels in the body (serotonin influences mood). In a clinical trial anxiety scores improved by 55 percent when supplemental probiotics was given, thus once again showing the important connection between a healthy gut and a healthy brain.
We know that our guts need diversity and variety and we know that a well-functioning gut is a critical player in the maintenance of our health – not just our gut health but the health of all of our body systems. It is important to remember that although treatments can have a significant effect on the gut, our bodies are resilient and, given the right tools, have the ability to repair and rebalance.
So what can you do to support your gut?
Firstly I recommend that you work with a nutritional therapist who specialises in cancer. You are unique, as is your gut bacteria which can be as unique as your fingerprints. Because you are unique, there is no single solution that is suitable for everyone. Your individual circumstances, stage of disease and current treatment, along with your symptoms and health history are important to ensure that any support given is specific to you and does not interfere with your current treatment: Starting right now, here are a few things you can do.
- Eat prebiotic rich foods. Probiotics have long been promoted to improve gut health, but prebiotics also are important because they feed your gut bacteria. Prebiotic-rich foods include asparagus, chicory, Jerusalem artichokes, leeks, garlic, onions, underripe bananas, apples, dandelion greens, raw cacao and flaxseeds. These are all fibrous foods, if you increase fibre in your diet, you need to increase water as the fibre acts like a sponge in your gut and lots of fibre + too little water = constipation.
- Eat fermented foods. These foods help promote healthy gut bacteria. Fermented foods include yogurt, kimchi, sauerkraut and kefir. If you are buying kimchi, sauerkraut or other fermented foods, you want to look for unpasteurised versions as pasteurisation will destroy the bacteria in the food.
- Expand your menu. Your gut has a diverse collection of bacteria. To encourage diverse growth of bacteria, we need to eat a diverse range of foods. Aim to eat 10 different vegetables each day.
Whilst the above recommendations will all support good gut health, you may need to do this in conjunction with a more therapeutic approach. Eating some sauerkraut for many people is just not going to be enough on its own, although it can be a good start. Wherever you are in treatment, whether you are just starting, have started or have finished your treatment, contact me to help you optimize your gut health and in turn your overall health. Remember, look after your gut and it will look after you.