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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 in our stomachs. Adrenal gland deficit is unexpectedly common in Lyme disease patients; when the infection takes its toll on the gut, the body produces less hydrochloric acid. This causes the pancreas to become unmotivated to create the necessary digestion enzymes, resulting in undigested food particles spilling into the circulation, where they cause more inflammation. Lyme disease patients frequently report having a leaky gut. Due to abnormalities in the gut microbiota, poisons and bacteria are able to "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 defence against any invading pathogens. Our systems have significantly less of a fighting chance against invading microorganisms if the stomach is weakened. Furthermore, intestinal issues might generate new symptoms, increasing the impact of Lyme and stymying the patient's natural defences. All of this is debilitating, but it's much more so when you consider 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 MS, it's known as The Great Imitator.

If you suspect you've contracted Lyme disease and are through the acute stage, the first step is to see a Lyme-aware doctor who can run the necessary tests and make an accurate diagnosis. Although chronic Lyme disease is far more difficult to treat than acute Lyme disease, there are ways out. Antibiotics are used to treat infection symptoms, while natural supplements are used to treat inflammation and gut-related disorders, in addition to nutritional therapy. When it comes to battling chronic Lyme disease, the first step is always a good diagnosis, despite the fact that it's a much longer path.

Despite the fact that 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 percent of patients reported anorexia, or a loss of appetite (not to be confused with anorexia nervosa, an eating problem), 17 percent had nausea, ten percent had vomiting, eight percent had abdominal discomfort, and two percent had diarrhoea. (2) The influence of persistent Lyme disease on gut health and gastrointestinal symptoms is less well recognised.

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 Lyme disease patients who had received antibiotic treatment, according to an intriguing study.

Certain bacteria, such as Bartonella, can induce a variety of 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 increasing susceptibility to chronic infections, addressing the underlying concerns is critical to restoring health more quickly and efficiently.

Early research revealed that 5-13 percent 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:

  • 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 nerve system. (ref) In some people with Lyme disease, nausea is accompanied with vomiting.
  • Lyme-induced gut paralysis can manifest itself in the stomach, a disease known as "gastroparesis." (ref) It can also happen in the small intestine, which can lead to SIBO (small intestinal bacterial overgrowth). While the aetiology of dysmotility (muscle weakness in the digestive tract) in Lyme disease is unknown, it may be due to nerve inflammation produced by Borrelia burgdorferi's direct invasion of 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 greater rate of diarrhoea.
  • 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 infection's effects 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 my clinical nutrition practise, I frequently observe new-onset food allergies and sensitivities among my Lyme disease patients. 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 colonisation by microbes that are normally kept in check inside the body, such as Candida albicans, an opportunistic yeast.

Antibiotic treatment is often necessary for Lyme disease patients, but it is not without hazards. Candida overgrowth is one of these dangers, 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 beneficial gut bacteria's synthesis of antimicrobial chemicals called "short-chain fatty acids," or SCFA. Reduced levels of this SCFA are linked to increased Candida albicans colonisation 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 which include 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 a variety of 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 grow 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 (LPS), a carbohydrate that triggers the immune system's response. Increased intestinal permeability can be caused by food allergies, drunkenness, 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.

Leaky gut syndrome causes systemic inflammation, which causes fatigue, headaches, joint pain, ADHD, brain fog, and autoimmune diseases. Because inflammation causes many of the symptoms of Lyme disease, appropriately treating leaky gut syndrome (if present) is critical to lowering the systemic inflammatory burden.


Lyme Disease Constipation

Constipation affects up to 25% of the world's population, according to estimates. Constipation is not only unpleasant and can interfere with daily activities, but it also puts people at risk for 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 fibre, 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 recognised, patients wind up using magnesium, Dulcolax, or other laxative drugs for long periods of time. Nerve dysfunction can occur anywhere in the digestive tract, including the oesophagus, resulting in swallowing difficulties.

When constipation or trouble swallowing is caused by Lyme disease-related nervous system dysfunction, treating the infection also improves nerve signalling. 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 (Small intestine bacterial overgrowth - SIBO)

Small intestine bacterial overgrowth is likely the most prevalent gastrointestinal illness associated with Lyme disease and other tickborne diseases (SIBO). SIBO is thought to affect 60-70 percent of Lyme disease patients. In one gastrointestinal clinic that examined patients for Lyme disease, the prevalence of SIBO was as high as 81 percent. SIBO is the cause of 60-70 percent of IBS, according to research. This is encouraging because SIBO can be successfully treated, resulting in IBS remission.

In one GI practise that examined patients for Lyme disease, the prevalence of SIBO was as high as 81 percent.

The small intestine has very few microbes in a healthy state. SIBO, on the other hand, is characterised by an overgrowth of bacteria in the small intestine, which results in a variety of symptoms. Bacteria can enter the small intestine through the mouth or through migration 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/bloating, stomach discomfort, diarrhoea or constipation, or both, are the most prevalent SIBO symptoms. SIBO occurs when abundant bacteria in the small intestine ferment food and create gases, resulting in these symptoms. 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 (LBT) collects gas from the breath every 20 minutes. The bacteria will digest the lactulose and generate methane, hydrogen, or hydrogen sulphide if there are too many bacteria in the small intestine due to 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 near the point where the "outside world" meets the inside of the body. These areas include 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 in MCAS, resulting in a variety of symptoms. Nausea and heartburn are the most prevalent digestive symptoms in MCAS, but abdominal discomfort, diarrhoea, and constipation can all occur. MCAS can cause systemic symptoms, thus if intestinal dysfunction is causing MCAS, it needs to be addressed.



The Lyme disease bacteria can attack any organ or tissue in the body since Lyme disease is a systemic illness. Lyme disease and its associated infections cause gastrointestinal symptoms due to 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.