Interview with Diane & Liz on the Balanced Bites Podcast about All Things Digestion | Chris Kresser

Interview with Diane & Liz on the Balanced Bites Podcast about All Things Digestion

by Chris Kresser

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On Wednesday the 19th I’ll be on the excellent new Balanced Bites podcast with Diane Sanfilippo of Balanced Bites and Liz Wolfe of Cave Girl Eats to discuss digestive health. Topics covered will include:

  • Small intestinal bacterial overgrowth (SIBO)
  • Gut pathogens
  • Maintaining healthy gut flora
  • The best nutritional approaches for gut healing

Leave your questions in the comments section before the end of the day on Thursday (the 13th).

Diane and Liz have a great show. If your eyes start to glaze over when people (like me) start rambling about the finer points of scientific studies and physiological mechanisms, but you love practical, down-to-earth discussion about Paleo food and nutrition, their podcast is for you. Check it out!

  1. Hi Chris,

    Can you give me the information on the infant Pro-biotic you recommended on your talk of digestion on the Healthy bitespodcast? I had a c-section 3 weeks ago due to my baby being in a transverse position and his vitals decreasing with each contraction..I am breast feeding but would like to look into supplementing with the pro-biotic you recommended. Thanks for your time!


  2. Hey Chris,

    I’ve been a fan since your first appearence on Robb’s podcast. Been on a relatively low carb paleo diet since 03-10. Im a type 1 diabetic and have managed to lose 65 lbs. The problem is Im a 30 year old male 5’7 and now weigh about 130 lbs on a good day. I want to gain about 15 lbs but I have several issues. First is that my cholesterol is extremely high TC is over 300 so Im afraid to add more fat or protein to my diet. On your podcast with Dr Deans you seemed to indicate a TC level in the mid 200 as optimal for longevity. Second Ive tried adding carbs and fat to my diet but have generally been met with bloating and really bad pain as well as higher flucuations in BS. I had an endoscope done 6 months ago (no celiacs although I was already paleo for a year) and it seems to have started a lot of my problems as I get dizzy now when I eat too much (especially carbs.) I was a Crossfitter for two years but stopped after the endiscopy due to feelin weak and tired. I first thought it was the reason I couldn’t gain weight but after 4 months of just walking I’m still dropping weight and fast. I’ve lost 10 lbs since I stopped. I feel stuck in a box I can’t get out of.



  3. Per recent results from a Genova Diagnostics CDSA/P test, I am not digesting fats (long chain fatty acids at 29.7 mg/g, phospholipids at 10.5 mg/g and total fecal fat at 43.9 mg/g). Can you comment on what causes a person to stop digesting fats (as opposed to digesting protein and carbohydrates which I appear to be digesting adequately)? How can you treat fat malabsorption? Is this a condition that can be resolved/cured with the proper treatment? Do you recommend a paleo diet (which as you know encourages a higher consumption of good fats) for someone with fat malabsorption issues? Or should fat intake be limited? Is it also problematic to supplement with fish oils if I am not digesting fats? I have been diligently trying to adhere to a paleo diet for the past 8 months, but it has not been very successful. I have actually ended up gaining weight rather than loosing weight and I always feel very bloated (even when taking good quality probiotics and digestive enzymes) which I did not usually feel on a gluten-free but higher carbohydrate and lower fat diet. I imagine this is because on the paleo diet I have significantly increased my fat intake (avocados, nuts, nut butter, olive oil, coconut oil, bacon, etc). I would be very interested in any thoughts you have on this issue.

    Many thanks!


  4. I feel your pain Kaitlyn, I was doing well on paleo diet but tried to heal my Crohns once and for all with GAPS. Im doing it for about a year now but honestly still haven’t progressed comfortably past the intro stage. My overall health is way worse now than before GAPS with more allergies and sensitivies now. Its frustrating alright…
    I think the extreme low carb/low calorie nature of Gaps intro, if done for too long (which I did) can starve the already comprimised beneficial bacteria, fry the adrenals and take a big toll on the liver.
    From having learned the hard way, my advice is to only start the GAPS protocol conjunction with a practitioner who’s familiar with it and comfortable tweaking it!
    Keep up the good work Chris, appriciate your efforts!…’there’s more to life than health’!

  5. Does healing your gut remove IgG mediated food intolerances to otherwise “normal” paleo friendly foods or do you have to avoid the foods for a given time before re-introducing them?

  6. I find that fruit, nuts, and chocolate trigger acne. Eating very low carb and intermittent fasting kept the acne down, but caused other problems, so I have added “safe starches” as per PHD. I tolerate them well for the most part, though my acne flares are worse then when VLC. Paul Jaminet thought my sensitivities might be evidence of a small bowel dysbiosis, and suggested trying a detox agent. Activated charcoal seems to work very well at keeping the acne at bay.

    In your opinion, is the effectiveness of the activated charcoal evidence for a small bowel dysbiosis? If so, what strategy would you recommend to resolve it?

    (Background: I’ve had health issues for many years, chronic sinus infections throughout youth, acne since teens, IBD in 20’s. Went on SCD in 2004 which solved sinus infections and greatly improved gut symptoms. Added rice back into diet without much issue. Went very low carb paleo in 2010 which significantly improved acne, but caused terrible body odor. Added safe starches as per PHD and seem to tolerate them well.)

  7. My food is not digesting. I have been following a Paleo diet since January and I have very little gas and distention, but I continue to have diarrhea three to four times a day. I take a dietary enzyme and supplement with probiotics. I avoid nuts and raw veggies as this makes it worse. I try to eat well-cooked veggies and meat as the staple of my diet. I eat no grains. The food often comes out looking exactly like it went down, only in smaller pieces. Please help, I have had diarrhea on and off for almost 15 years. BTW, I also have hypothyroidism. I have a history of anemia, but that has been cured with the Paleo diet, so I know that I am absorbing more nutrients that I was pre-Paleo, but I would just like to have a normal bm each day instead of what I am dealing with now. Paleo has cured my stinky gas and cramping, but not the diarrhea. Thanks Chris and Balanced Bites for tackling this not so glamorous issue.

  8. I’ve been following your recommended diet for about 1 1/2 years now. Started GAPS Intro 4 months ago but can’t comfortably move on to Full GAPS. I feel like I have more constipation and bloating problems as I’m purposefully trying to heal my gut flora than I ever did before starting GAPS. How is that possible?! Pretty frustrating. My husband has been eating the same as me and also can’t move to Full GAPS. He now has persistant bloating and diarrhea but never had either before GAPS. (We both consume plenty of fermented foods, Bio-Kult, and fermented cod liver oil. I take magnesium supplements each day to try to prevent the constipation but my husband does not use magnesium since his digestion tips the other way.) Are all of these symptoms just part of a long healing process or is something else going on?

  9. I believe I have dysbiosis due to all my symptoms (bloating, pain, nausea, lack of appetite, brain fog, etc), and I’ve been taking probiotics for years without any improvement in my symptoms. I’ve tried many different brands that work for many people, but haven’t worked for me. However, recently I read that most of the bacteria in our gut is from the Bacteroides family, which isn’t in probiotics, with lactobacillus and bifidobacteria making up only a small percent of the total bacteria in the gut. I also read that having too much bifidobacteria from probiotics in the small intestine can cause problems since they’re supposed to be in higher amounts in the colon instead. I would like to know how to increase the good bacteria in my gut and decrease the bad, besides just reduce carbs, which I’ve done already. I have no wheat or dairy in my diet and eat a relatively healthy diet with a good amount of fat in it. I also would like to know if there’s something that modulates the immune system that you would recommend to reduce the inflammation that causes this brain fog. Thanks.

  10. Hey. I suffer from chronic fatigue syndrome. I am house bound 90 percent of the time. I follow a paleo type diet I guess you could say or an evolutionary correct diet of organic vegetables mostly non starch apart from sweet potato, grass fed lamb, chicken, seafood and eggs, coconut oil and milk, bone broths etc. I do not go to the toilet generally unless I take oxypowder which my naturopath told me I must use. I do also take very high does vitamin c and moderate magnesium but these do not make alot of difference bowel movement wise to get things moving. What are your thoughts on oxypowder by GHC? Can the oxygen wipe out good bacteria? They claim not, I am suss. The company promises no dependance will occur with this product. Also can severe hormone imbalances cause constipation and digestive issues ie: low progesterone, no oestradiol production, low oestrone etc? high night time cortisol? I try to eat more glutinous meats, marrow etc over high muscle meats as recommended in GAPS diet. I use Dr ohiras OMX-100, Symbion, Syntol and make my own coconut kefir. Cheers, Amy

  11. I’m very interested in reading your upcoming series on iron excess and how it relates to glucose intolerance. I am aware of some individuals who have donated blood to manage high iron levels and ended up sick afterwards. Can you address why this may have happened? Is there any way of knowing ahead of time whether or not one with high iron would be at risk for an adverse reaction to a blood donation?

  12. Just want to second Nancy’s question re: the dental – digestive connection. I’m very curious about your opinion on that as well.

  13. What do you have to say on the topic of a “dental – digestive” connection? For example, could toxins from anarobic bacteria from root canals, implants, cavitations, or bacteria from low grade, chronic, dental infections or heavy metal toxicity or reactivities be experienced as digestive issues? The mouth, being part of the digestive system, it would seem, that dental work would influence what happens down stream, so to speak. Any thoughts? Thanks.

  14. I have Bristol Type 1 stools. I eat sweet potatoes, collard greens, kale, and drink kombucha daily. I also eat dairy, red meat and alot of healthy fats. Why am I always constipated and why do I always need coffee to stimulate a BM? I quit coffee for along time and my body didn’t sort out the constipation on its own. Is it the heavy creams, meats and fats slowing motility? Would digestive enzymes help and why? Please go in depth on the subject of Bristol Type 1 stools, it’s much appreciated.

  15. I’ve been VLC for 2+ years. Just started to experiment with veggies in my diet. I’ve noticed no ill effects with sweet potatoes, but I with cruciferous veggies like broccoli and cauliflower I have. Not major issues or pain, just lower gut gas. What do you suggest I do? Normally it wouldn’t be that big of a deal because it mainly shows up around night time — but my girlfriend is actually suggesting I go back to carnivore. Never thought I’d hear that.


  16. I too get bloating and/or pain after eating ANY FOOD. Looking forward to the podcast. Hoping to hear something that I can apply immediately.

    • I second Talayna’s comment, except that I notice the bloating more after a mid-day meal than I do in the morning (which is usually eaten after working out) or in the evening (when I am more relaxed and usually going to bed shortly afterward anyway). I supplement with probiotics and HCl at each meal, but the bloating that occurs after lunch makes for a long afternoon. This seems to occur regardless of what I eat.

  17. Hello,

    Do you have any information about the effectiveness or implications of sublingual food allergy drops (the kind taken under the tongue)? My integrative MD is having me take them for a long list of food allergies that I’ve developed from leaky gut, and I’m beginning to wonder if I should even have the cocoa and casein in the drops (I fulfill all of the criteria that Datis Kharrazian outlines in his thyroid book for autoimmune thyroid disorder, but my doctor attributes all symptoms to mercury poisoning and wants me to start chelation as soon as my gut has healed. I am gluten intolerant and so there is not any wheat in the drops).

    Thank you.

  18. 1) Can you discuss Gallbladder/gallstones issues in relation to gut health? I have had major gallbladder/liver issues which greatly diminish my guts ability to process fats and proteins, which makes healing my gut with paleo/gaps style diets extremely difficult!I have done so much in the last few years to remove stones (with liver flushes) & support fat digestion (with diet, tonics, herbs, enzymes, etc), and although I have certainly had some improvement, I still struggle with this challenging and painful problem.

    2) Can you discuss solutions for severe and chronic constipation? What supplements/herbs are safe to take long-term? Is there hope for recovery even after 10 years of chronic constipation? Eating a paleo/gaps diet haven’t solved the issue & I understand that lack of bile flow because of my gallbladder issues contribute. But I simply cannot have a bowel movement without using something to stimulate it: magnesium, high dose Vit. C, laxative herbs, etc… And it has been this way for many, many years now, even though I am only 31 years old. It has unfortunately lead to anal fissures and hemorrhoids as well. I relate with Allison’s above comment, having tried many different protocols without success.

    3) What are your thoughts on the theory about parasites/bacteria/worms/etc actually being a healthy part of our gut flora, and that part of why we may be so susceptible to the symptoms of these little bugs is that we are “too sanitary.” Some people in the Raw Paleo groups discuss using “High Meat” as well as raw meat, eggs and dairy to help “re-instate” all sorts of bacteria (e-coli, salmonella, etc) in the gut, supposedly supporting our guts & immune systems in the long run.

    4) Why do think food sensitivities come and go? I had problems with dairy in the past and stayed off of it. Then re-introduced it slowly on GAPS using raw kefir and then raw cheeses, tolerating them very well for over year, until suddenly a month ago I started developing mucus and flem every time I eat dairy, no matter if it’s cheese or kefir, goat or cow.

    5) Lastly, my dear friend is struggling with terrible health problems. She has been on GAPS for 2 + years strictly, but nothing seemed to help her SIBO. She has had much pain, gas & bloating with eating, plus a terrible extended abdomen almost all the time, even when decreasing fiber on GAPS. She tried high-dose pro-biotics, raw yogurt, reducing sugars, etc. She began having what we thought were gallbladder attacks and had to juice fast for 1-4 weeks at a time, regularly, not able to tolerate eating any food at all. She did many liver flushes removing stones which helped only some. She has the worst case of Environmental Illness I have ever seen, unable to enter most stores or peoples houses & not able to use a even a land line because of EMF sensitivity. Now finally, after a couple months of eating literally only raw fish, a few raw veggies and raw coconut oil her abdomen distention has miraculously disappeared, but she is now severely underweight and unable to gain weight or add back other foods without a set-back. Can you help?!

    Thank You So Much Chris!!

  19. I am a competitive strength endurance athlete and have been eating strict Paleo for the past 2 years. Since I can remember, I have alternated from bouts of constipation to very loose stools. About a year ago I worked with an FDN who treated me for the parasite toxoplasma; while on the protocol I also completed a series of colonics. Since then, my overall digestion has improved, however it’s still nothing to write home about. In the past two months I have started on a food rotation plan and anti-fungal diet –I am seeing some improvement in digestion/elimination, however nothing consistent. I sleep in a pitch-black room, drink plenty of water and have manageable stress levels. Do you have any ideas on what I can do?

  20. After I had my son 2 years ago, I lost all the baby weight and then just kept losing weight. I realized everything that I ate was going right through me. I went and saw a Naturopathic doctor who did some test and found out I had low stomach enzymes to digest anything, probably from my very Type A personality. She put me on some supplements (and I added meditation and yoga for stress reduction) and after about 6 months of going gluten and mostly dairy free I was feeling much better. Since then I don’t take any supplements and I’ve lead a pretty much paleo life, with only white rice as far as grains go. However, more recently I’m finding I’m having the opposite problem, where I get “backed up” and crampy/gassy. The foods haven’t really changed. I think my weight is fine and holding steady but I would like to have better digestion as I know that’s important to grow a healthy baby (we are thinking about baby #2 : )). I get light headed if I don’t eat enough food but I worry that eating a lot of food is what is causing all the gas. Any ideas on foods that are easy to digest and will keep me from getting lightheaded/being hungry all the time. Also, thought I should mention that I get pretty intense sweet cravings after I eat, even if it’s a huge meal.

    Love both podcasts and the Healthy Baby Code – all God sends for sure : )

  21. If Cyrex testing shows cross-reactivity to dairy – is it ok take probiotics with trace amounts of dairy? Also – what about colostrum? Thanks!

  22. oh yes, did a stool sample test for bacteria and worms and turned out I had none, but when I collected the sample noticed there was totally non-digested fibers from sweet potato in the stool… (fibers looked exactly the same as when mashing a boiled sweet potatoe although not orange, of course)

  23. my problem is bloating from carbs.

    Was apparently only breastfed for a few weeks, then brought up on a delicious diet based on white bread, meats and ice cream. Also a lot of cookies and candy always available.
    Never really got fat but was far from fit or slim. (Did not do any sports)

    Around age 20-23 gained some weight and started to be embarrased by noisy stomach and bloating.

    Then for the following ten years I went completely overboard with diet, always eating out, and drinking beer every day and finally got properly fat enough so the bloating really didnt show anymore.

    At 33 or so slimmed down with weight watchers, then switched to LCHF/Paleo to maintain weight and actually maintains weight even a few kg less today, than during calorie counting.

    Then I became bored with the low carb eating a couple of years ago, and switched to a PerfectHealthDiet style diet. (Carbs from rice, potato, and, ehrm, croissants)

    So now at 41 I finally know how to eat healthily, but the bloating is back. It doesnt really make much sound, but it looks like a beer belly although my bmi is ok.

    Switching to a VLC diet solves the problem, but I am fed up with eating so much fat all the time… also quite fond of ricenoodles and potatoes…

    Is there a solution?

  24. I too suffer from constipation. Bristol Type 1 or either no sensation at all to go to the bathroom. Can vary between 5-6 bristol bowel movements a week which are incredibly strained or 2-3 bowel movments a week where it almost feels like there is nothing there to get out and usually just small shapes are released. I am thinking it has something to do with bile production. Occassionaly I will get diarrhea which I welcome because A LOT is passed and though its exhausting, I feel cleaned out. I take magnesium but just seems like water is passed and small, intermittent passing of sand like bowel. But not much substance to it. Have experimented with vit c 2-3g a day, didnt notice a difference. Am following GAPS and have been for 2-3 weeks. Tried the carrot juice cod liver protocol no success. I have been paleo for over a year. Will sometimes go a week with regular bowel movements, only one a day but that will last a week and wont see one for months at a time. Last time I felt regular was a week in May. Im sure at this point its at least somewhat psychological as I expect nothing in terms of bowel movements. Having started using enemas to get some relief, but again, just seems like water. Taking probiotics, thought it was FODMAPS but onions and garlic do not bother me. Went to the hospital last month with what felt like a gallbladder attack. Am waiting to get an ultrasound. Unfortunately have a very unsupportive doc. Also, low DHEA, no period for the last 8 months. Sedentary for now to help natural boost DHEA levels. Eat around 1300-1600 calories a day. Female, 24, 115lbs.

  25. Hello to Chris and the Balanced Bites Podcast,

    I’ve been recently diagnosed with Coeliac disease after experiencing consistent intestinal pain for the last 15 years. Since diagnosis, I have used real, whole foods, fish oil and probiotics to heal my gut, and bring my Transglutaminase Antibody; tTGA level back to negative. Next comes the hard part, the maintenance. It has been 6 months since diagnosis and my gut and brain seem to be in discordance. For the first time in my life I’ve started to experience depression or what I assume is depression and a disengagement with my surroundings. Recently, I started introducing some raw dairy back into my diet along with WAPF prepared grains and legumes, and fruit. I need help. Nothing seems to agree with me any longer; not the vegetables, the fruit, meat, grains, fats, coconut, nor dairy. I experience distention and discomfort habitually and would like suggestions on how to move forward. I’m an active engaged person; I teach a couple days a week, bike, practice yoga and meditation and paint.
    Thank you for your help and recommendations.

  26. Hi! I have been following the PHD (Perfect Health Diet) for some time. I added 50 mcg of Ioderol as a result of a limited thyroid test with B3, B6 and selenium. I take Vit C 2000 x 2 and DHA. The initial use of Ioderal was great; now my stomach is constantly nauseous (or is that acid production??) I started chewing Rolaids this weekend. Am I not getting enough fats? I am at a loss on what to do…

    Thank you!

  27. I have been experiencing a type 1 bowel movement on the Bristol Stool Chart (pellet stool) for quite a while. Regular and no pain but with a bloating sensation after meals and low energy. I am trying hard to find out the problem but no answers so far. I am a healthy freak. I don’t eat anything that my grand-grand mother doesn’t recognize as food. I am not eating gluten grains. I drink kefir daily. I exercise daily, doing strength training and yoga. I even ride my bicycle to work for 1 hour every single day. Does this has to do with some unconscious stress?

  28. I have been following Paleo Diet since Feb. 2011. Lost 25lbs. Doing Crossfit, Yoga and hiking. I was laid off from a desk job in June and got a physical job in Sept. as a stock person, at 54 yrs young. After one month on the job, had to quit, do to severe knee pain and recommendation from my Chiropractor. After a week off the job, still with joint pain, still eating the same, I now have smelly gas. Would like some Paleo foods that help joint pain and decrease the gas. Thank you for the help in advance!

  29. Hi Chris,

    I’m curious why and how a person develops a sensitivity to FODMAPs foods and if there is any way you can “heal” it or if one just has to avoid those problem causing foods forever. For me, apples and onions cause a lot of digestion pain. These are foods I’ve been eating since I was a baby.

    Thanks, Chris!

    • I second this question – and a related one is – is there any connection between SIBO and sensitivity to FODMAPS foods – can SIBO cause FODMAPs intolerance?

  30. 1.Thoughts on using bovine colostrum for healing leaky gut and candida.
    2.Can strengthening the immune system alone take care of parasite issues?
    3. Thoughts on the controversy of using probiotics with bifidus when SIBO is an issue.
    Thank you!

  31. I hav been diagnosed with Chronic Gastritis, I also have GERD. The gastritis symptoms came on about 2 years after I has surgery for Crohn’s (Crohn’s since ’84).
    I was given ALOT of antibiotics before surgery due to some complications. Surgery itself went fine.

    It was 2 1/2 years after the surgery I had an endoscopy which showed, along with the chronic gastritis had H.pylori. I was then treated with 2 antibiotics. Though the H.pylori infection is gone, the symptoms stay at mild to moderate levels.

    I have tried a PPI, Pepcid, Pepcid plus Carafate suspension. The symptoms don’t go away.
    I don’t eat any of the foods said to irritate the condition. I do eat chicken, about once a week & fish about 2 times a week, eggs several times a week. Other that that I eat mostly whole grains, tofu, veggies, some fruit and ground or soaked nuts or nut milk I make myself. Everything is organic. Some of is home grown, as are the eggs, which are from our chickens.
    Any suggestions for some one on my situation? Thank you in advance for any information for can provide.

  32. how can i boost my HCl production?
    From what i understand we all lose the ability to make enough as we age and a lack of it is at the root of all sorts of issues – excess gas, bloating, general belly discomfort after eating, candida overgrowth, recurrent UTIs (e-coli doesn’t get wiped out in the stomach as it should).
    have i understood right?
    and if so is there an alternative to lifelong supplementation?
    I know it’s a good idea not to drink loads of water whilst eating (not just cos i might choke 😉 but could low level, chronic dehydration have an effect on stomach acid production?

  33. I’ve been trying to follow a paleo diet since I got a bad GI virus in July here in PA (didn’t take any antibiotics, just waited it out), and now my stomach is not the same. I get cramping/pain/bloating after eating ANY FOOD (meat, veggies, fruits, white or whole grains, fats, both together or alone). I followed a paleo diet with just veggies and meat for 2 weeks and felt like I had knives in my intestines. The only thing that I can digest without incident is freshly made veggie juice. I take a probiotic 2x day with meals. NOTE: drinking red wine with any food relieves ALL my symptoms! Please help– I’m slowly losing my daily life and need to go back to digesting at least some foods again!

    • Hi Emm, I decided to reply to your comment because my brother has been experiencing almost identical symptoms as you described for several months now, with little relief. He is at the stage of accepting that there is nothing more he can do to resolve his problem, but hopefully you heal before you reach that stage. First of all I would make an appointment with a good alternative/natural health practitioner like Chris if you can find one and afford it. Get as much clinical testing done as possible before you make changes to your lifestyle, because if you don’t you are just guessing. I am not a licensed health practitioner, but IMO the most critical tests for you to have done would be a stool sample, HCl production, and then if you don’t learn anything from those tests, barium x-ray of the small intestine and colon to rule out any structural problems. I recommend supplementing with HCl tablets or Apple Cider Vinegar or Lemon Juice with every meal (whichever you prefer) and digestive enzymes, assuming you are not already. Without providing an exhaustive list of supplements and/or foods to take to remedy your problem, the one food I suggest you consume every day is coconut oil, preferably 3 tablespoons per day. The lauric acid in it kills whatever pathogen I suspect is causing or contributing to your digestive problems as effectively as any other compound I know of, plus it should be easy for you to consume. Lastly, I have read some information suggesting that the large numbers of bifidobacteria in most probiotic supplements may cause or worsen SIBO (small intestine bacterial overgrowth), so it couldn’t hurt to stop taking the probiotic and consume fermented foods instead Again I am not a licensed health practitioner but my brother and I have probably studied how to remedy digestive disorders naturally as much as the typical health practitioner. Feel free to email me if you want more information about this subject.

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