Larry Langdon
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Gastrointestinal Issues with Lyme Disease

Gastrointestinal Issues with Lyme Disease

Lyme can cause long-term damage to our digestive organs in addition to disturbing the natural equilibrium of our stomachs. Adrenal gland deficit is unexpectedly common in patients with Lyme disease. When the infection takes its toll on the gut, the body produces less hydrochloric acid. Thus, the pancreas stops making the necessary digestion enzymes, resulting in undigested food particles spilling into the circulation and causing more inflammation. Patients with Lyme disease frequently report having a leaky gut. Because of abnormalities in the gut microbiota, poisons and bacteria can "leak" through the intestinal wall. This disorder can persist and worsen over time, causing the patient to experience a new set of symptoms.

Our gut is responsible for 80% of our immunological activity. Furthermore, it contains 70% of our lymphocytes, making it the first line of defense against any invading pathogens. Our systems have a significantly lower fighting chance against invading microorganisms if the stomach is weakened. Furthermore, intestinal issues might generate new symptoms, increasing the effect of Lyme and stymying the patient's natural defenses. All of this is debilitating, so you may imagine how frequently Lyme disease is misdiagnosed. Because of the wide range of symptoms it causes in patients and its uncanny ability to imitate other chronic diseases like fibromyalgia or multiple sclerosis, it's known as “the great imitator.”

Despite gastrointestinal symptoms are unexpectedly common in acute Lyme disease, they are frequently overlooked by doctors when making a Lyme disease diagnosis. In one study of 314 patients with acute Lyme disease, 23% of patients reported anorexia or a loss of appetite (not to be confused with anorexia nervosa, an eating problem), 17% had nausea, 10% had vomiting, 8% had abdominal discomfort, and 2% had diarrhea. The influence of persistent Lyme disease on gut health and gastrointestinal symptoms is less well recognized.

Lyme disease and antibiotic treatment both have the potential to disturb the gut flora, resulting in symptoms and compromised immune function. Dysbiosis, or an imbalance between "good" and "bad" microbes in the stomach, was detected in patients with Lyme disease who had received antibiotic treatment, according to an intriguing study.

Certain bacteria, such as Bartonella, can induce various gut symptoms when transmitted with Borrelia burgdorferi. Bartonella henselae, for example, can cause intestinal irritation.

Unbalances caused by Lyme disease infection or therapy, if left untreated, can cause symptoms ranging from brain fog to joint discomfort. They can also limit nutritional absorption and whole-body nutrient status, as well as create systemic inflammation. Thus, addressing Lyme disease gastrointestinal concerns is critical for recovery.


What are the gastrointestinal symptoms of Lyme disease?

Gastrointestinal symptoms are uncommon in acute Lyme illness, but nausea, vomiting, heartburn, and stomach discomfort might occur. Constipation, gas/bloating, and stomach discomfort are more likely in those with chronic or late-stage Lyme disease. Lyme bacteria can infect the gastrointestinal tract directly, resulting in inflammation and digestive problems. As a result, gut difficulties can lead to immunological dysregulation, making you more susceptible to infections. Whether digestive troubles are a result of Lyme disease or increased susceptibility to chronic infections, addressing the underlying concerns is critical to restoring health more quickly and efficiently.

Early research revealed that 5%-13% of individuals with acute Lyme disease experience gastrointestinal symptoms, such as lack of appetite, nausea, vomiting, and abdominal pain (dubbed "gastro Lyme"). Chronic Lyme illness, on the other hand, might cause gastrointestinal problems.


Symptoms of chronic Lyme disease in the gastrointestinal tract include the following:

  • Nausea is a typical symptom of Lyme disease, especially chronic nausea and nausea after eating. Nausea can be caused by a malfunction of the autonomic nervous system, which is the part of the nervous system that controls automatic body functions like heartbeat and digestion. Borrelia burgdorferi has been linked to problems with the autonomic nervous system. In some people with Lyme disease, nausea is accompanied by vomiting.
  • Lyme-induced gut paralysis can manifest itself in the stomach, a disease known as "gastroparesis." It can also occur in the small intestine, which can lead to small intestinal bacterial overgrowth (SIBO). While the etiology of dysmotility (muscle weakness in the digestive tract) in Lyme disease is unknown, it may be due to nerve inflammation produced by direct invasion of Borrelia burgdorferi in nerve cells.
  • Diarrhea can be caused by antibiotic treatment or the infection itself in Lyme disease. People with vector-borne diseases other than Lyme disease, such as ehrlichiosis, tick-borne relapsing fever, and Rocky Mountain spotted fever, have a higher rate of diarrhea.
  • Constipation can be caused by Lyme disease gut paralysis or changes in the gut microbiota caused by antibiotic treatment for the condition.
  • Lyme disease is known to produce abdominal pain, which is thought to be caused by the effects of the infection on the nerves that innervate the gut. Lyme disease can also produce hepatomegaly (liver enlargement) and splenomegaly (spleen enlargement), both of which cause abdominal pain.
  • Food sensitivities and allergies: In clinical nutrition practice, new-onset food allergies and sensitivities are frequently observed among patients with Lyme disease. These allergies and sensitivities may result from immunological dysfunction caused by Lyme disease or gut imbalances caused by infection and antibiotic treatment. According to research, gut imbalances can cause food allergies and sensitivities, implying that gut healing may be essential for reducing or eliminating these symptoms.


Lyme disease and Candida

Lyme disease has been shown to impair immunological function. This immunosuppression may make the body more vulnerable to additional infections or colonization by microbes that are normally kept in check inside the body, such as Candida albicans, an opportunistic yeast.

Antibiotic treatment is often necessary for patients with Lyme disease, but it is not without hazards. Candida overgrowth is one of these hazards, which can occur when antibiotic treatment kills the probiotic bacteria in the gut that normally keep Candida at bay. Antibiotic treatment is linked to a decrease in the beneficial gut bacteria's synthesis of antimicrobial chemicals called "short-chain fatty acids," or SCFA. Reduced levels of SCFA are linked to increased colonization of Candida albicans in the gut.

Candida overgrowth is increased by eating a diet high in refined carbohydrates and sugars, such as bread, pasta, and cereal, because Candida loves to eat processed carbs.

Candida overgrowth caused by Lyme disease might cause the following symptoms, including gastrointestinal symptoms:

  • Oral thrush is a white coating on the tongue or in spots throughout the mouth.
  • Yeast infections in the vaginal area
  • Low carbohydrate tolerance, which includes grains, legumes, fruits, and starchy vegetables
  • Bloating that persists
  • Sensitivities to foods
  • Dry, scaly skin, psoriasis, and fungal toenails are examples of skin diseases.
  • Sensitivity to oxalate: Oxalates can be found in various plant foods, including spinach and beets. Intriguingly, some fungi, such as Candida, may create oxalate-like compounds. When a Candida overgrowth occurs in the stomach, the surge of oxalate-like compounds produced by these organisms might overwhelm the body's ability to process them, causing people to react to oxalate-containing foods. In the end, controlling Candida overgrowth is critical to alleviating oxalate sensitivity.


Leaky gut syndrome with Lyme disease

Small intestine hyperpermeability, often known as leaky gut syndrome, occurs when the gaps between the cells lining the small intestine are expanded. This permits bacteria and food particles to enter the bloodstream, causing the immune system to release inflammatory cytokines in response. The outer layer of bacteria that enters the bloodstream contains fat and lipopolysaccharide, a carbohydrate that triggers the immune system's response. Increased intestinal permeability can be caused by food allergies, alcoholism, stress, infections, toxicants, some drugs, and mast cell activation syndrome (MCAS). Food proteins move through the inflamed small intestine into the bloodstream, causing an antibody reaction, which leads to an increase in food allergies.


Lyme disease causes constipation

According to estimates, constipation affects up to 25% of the world's population. Constipation is not only unpleasant and can interfere with daily activities but also puts people at risk of developing more serious health problems. What about those who are doing "everything right" to avoid constipation, such as drinking lots of water, eating plenty of fiber, and exercising on a regular basis, but still have constipation?

Constipation has been dubbed "Bell's palsy of the gut" with Lyme disease. The nerves that innervate the intestines can be damaged, similar to the facial paralysis that can occur with Lyme disease, producing a reduction in the muscular wave of contractions that normally moves the contents of the intestines downstream. Because the underlying cause of their constipation was never recognized, patients wind up using magnesium, Dulcolax, or other laxative drugs for long periods. Nerve dysfunction can occur anywhere in the digestive tract, including the esophagus, resulting in swallowing difficulties.

When constipation or trouble swallowing is caused by Lyme disease-related nervous system dysfunction, treating the infection also improves nerve signaling. Prokinetic drugs promote bowel movement while also acting as "physical therapy" for the large intestine by enhancing the activity of intestinal muscular contractions.


Bacterial overgrowth in the small intestine (SIBO)

In one gastrointestinal practice that examined patients for Lyme disease, the prevalence of SIBO was as high as 81%.

The small intestine has very few microbes in a healthy state. SIBO, on the other hand, is characterized by an overgrowth of bacteria in the small intestine, which results in various symptoms. Bacteria can enter the small intestine through the mouth or by migrating from the large intestine. The ileocecal valve, located at the intersection of the small and large intestines, prevents the contents of the large intestine from entering the small intestine. When the ileocecal valve fails, bacteria might enter the small intestine. Bacterial overgrowth in the small intestine can also be caused by antibiotics and excessive sugar consumption.

IBS-like symptoms of gas or bloating, stomach discomfort, diarrhea, or constipation or both are the most prevalent SIBO symptoms. SIBO occurs when abundant bacteria in the small intestine ferment food and create gases. Bacterial overgrowth in the small intestine also causes poor nutrient absorption, which can lead to fatigue, low iron, and vitamin B12 deficiency. SIBO can induce leaky gut syndrome and its related symptoms because it causes inflammation in the small intestine.

After 3 hours of taking lactulose, a lactulose breath test collects gas from the breath every 20 minutes. The bacteria will digest the lactulose and generate methane, hydrogen, or hydrogen sulfide if there are too many bacteria in the small intestine because of SIBO. SIBO is defined as an increase in any of these gases in the small intestine.

Antibiotics or herbal regimens that have been shown to be effective against the bacteria that cause the gas are used to treat SIBO. SIBO can also be treated with probiotics, specific diets, and motility medications.


Mast cell activation syndrome in Lyme disease and digestive symptoms

The immune system that surrounds the digestive tract is primed by bacterial overgrowth in the small intestine combined with the inflammation generated by leaky gut. Mast cells are immune cells that are found where the "outside world" meets the inside of the body, including the skin, lungs, and gastrointestinal tract.

Mast cells release histamine and other chemical mediators when they are activated by a range of triggers. Mast cells are more likely to release their contents into MCAS, resulting in various symptoms. Nausea and heartburn are the most prevalent digestive symptoms in MCAS, but abdominal discomfort, diarrhea, and constipation can all occur. MCAS can cause systemic symptoms, so if intestinal dysfunction is causing MCAS, it needs to be addressed.



The Lyme disease bacteria can attack any organ or tissue in the body because it is a systemic illness. Lyme disease and its associated infections cause gastrointestinal symptoms because of inflammation, nerve damage, and mitochondrial dysfunction. These digestive symptoms or diseases may appear on their own, but if systemic symptoms are present or the digestive illnesses are difficult to cure, Lyme disease should be suspected. Furthermore, by lowering intestinal-mediated immune dysregulation, addressing digestive diseases enhances the success of Lyme disease treatment.