Today, I have an incredible guest. She is Katie Morra, MS, RD, LDN, a functional medicine RD and nutritionist in Bethesda, MD, and the founder of the Gut Honest Truth podcast. I am stoked to have her on. So, let’s dive in.
Table of Contents
Katie Morra’s Story
Katie Morra is a registered dietitian and a certified functional medicine practitioner. She also has her own podcast on iTunes and Spotify. Her specialty is treating the gut. She grew up in an all-healthcare family with the dentist, the pharmacists, the psychiatrists, the psychologists, etc in her immediate family.
She went to school to become a psychologist, but when she applied to grad school, she interviewed and shadowed people and got bored. Then she shadowed some dietitians and functional medicine dietitians. She had the privilege of shadowing at Mark Hyman’s office.
That’s the first time she was fully captivated with everything going on. That’s the point that lead her to where she is now. She went back to school to become an RD, and went to the Institute for Functional Medicine. The first course she did was the Gut Module and it was meant to be – this is how she figured out what she wanted to do.
Irritable Bowel Syndrome (IBS)
Lacey likes to call IBS a BS diagnosis, and Katie tends to call it a trashcan diagnosis where they don’t know what is actually wrong with you. It’s a valid diagnosis to a degree, but it doesn’t get to the root cause to address why you have these symptoms.
Common symptoms of IBS:
- Change in bowels, diarrhea, constipation, loose stools
It afflicts at least 15% of the world-wide population. This is sort of diagnosed after somebody goes through G.I. and they see a gastroenterologist who runs an endoscopy, colonoscopy, lactose intolerance test, and Celiac test. If all of these tests come back negative, you get the IBS sticker slapped on you.
Main 5 categories of root causes of IBS:
- Chronic stress
- Gut infections (bacterial, parasitic, yeast)
- Digestive output (low stomach acid, bile, or enzymes)
- Food sensitivities and allergies
- Thyroid and hormone balance
The Importance of Stomach Acid
Katie always tell her patients and clients that the top two things that cause chronic illness are: chronic stress and low stomach acid.
Low stomach acid is the conductor of digestion and your first line of defense towards everything. You put things in your mouth all day long, eating bacteria and more. They should get killed off when they enter your super-acidic stomach and have no chance of making it into your small and large intestine to infect it. When you have low acid, you don’t have that first line of defense anymore. This lowers your immunity and your ability to kill things that can make their home in your gut.
Stomach acid is also a trigger to all downstream digestion – stimulating production of pancreatic enzymes and bile. Without the proper signaling, you won’t produce anything as adequately as you should. Then you will struggle with digesting proteins, carbs, and fats and you won’t get your micronutrients.
Many people who have low stomach acid will present like they have high stomach acid (hyperchlorhydria) with reflux, GERD, or ulcerations in the stomach. They will be told to take something like TUMS or a proton-pump inhibitor (PPI) to shut down acid production – but this is the completely wrong thing to do in most cases.
The 5 overarching topics above interact with each other. If you have chronic stress where you’re in a bad relationship or you hate your job, overtime you will be leading yourself to low stomach acid. Or, if you have hypothyroidism, that leads to low stomach acid. It becomes a vicious cycle because you can’t digest and absorb nutrients which contributes to hypothyroidism.
Trying to manage these issues yourself is very difficult, it is important to test, don’t guess. There are many conditions that have overlapping symptoms, so testing is important so you know how to treat the issue because you do not treat all gut conditions the same way.
Best ways people can test for stomach acid
Baking soda test: take 1/4 tsp fresh baking soda in warm water, drink it first thing in the morning after you wake up and drink it. Wait to see how long it takes for you to start belching. If it is past 5 minutes – then stomach acid may be low.
Betaine hydrochloric acid challenge: (**should only be done under supervision, never open the capsule because it will burn your esophagus**) you take one capsule before a protein meal for each meal of the day, and up the dose until you start to feel discomfort. In a way, this is a slap to the stomach to start producing stomach acid again. Katie usually stops at 6 capsules since it is a lot of acid.
Heidelberg Test: swallow a capsule and they tether it with a string or you poop it out. It tests how long your body takes to re-acidify after drinking a bicarb substance. The outcome at the end of this is to take HCl, and it is an expensive test, so it isn’t really available to most people.
Why does H. pylori cause health chaos?
H. pylori is common in over 50% of the population worldwide, and can be transferred by saliva. Katie treats couples a lot, and it usually is passing through the family.
Common symptoms of H. pylori:
- Loss of appetite
- A Lot of burping and bloating
- Struggle to gain weight
- Nausea and pain hours after eating
- Undigested food in stool
- Heartburn and reflux
- Bad breath, dry mouth
The relationship of H. pylori to Candida
H. pylori has a best friend called Candida. Candida occurs naturally in the gut as a yeast, but can become overgrown. Candida can be categorized as SIFO when it is concentrated in the small intestine. You can also have Candida in other places in the body causing fungal acne, dermatitis on your scalp, yeast infections, UTIs.
Candida and H. pylori are best friends. Katie thinks it may have to do with the biofilm that they form together. It is like a brick wall built around different things in the gut. Once you pop the biofilms or your immune system becomes out of whack, many times the hidden infections come out which you didn’t know you had. This is why many times you can get worse before you get better.
For testing both candida and H. pylori, you can do a GI Map. For H. pylori you can also do a biopsy, endoscopy, or breath test. These are all different mechanisms of testing. Also, H. pylori can infect other places in the body, it isn’t just a gut issue.
What does Katie see most in her practice?
Katie mostly sees H. pylori, but she also sees a lot of SIBO (small intestine bacterial overgrowth).
The top contributors to SIBO:
- Digestive output
- Slowed motility
- Intestinal adhesions (scar tissue from surgery, or the way you hold your stress, the way you sit, genetics, C-sections). It is important to work with a myofascial release practitioner to release and break down the scar tissue to improve gut motility.
- Medications (PPIs, acid reducers, morphine, codeine, and levothyroxine is actually the #1 contributor)
- Food-borne illness (can cause autoimmune SIBO)
SIBO and gluten are the top 2 causes of leaky gut (intestinal permeability).
Katie’s top 3 tips for maintaining a healthy gut
- Limit stress and practice stress management
- Chew well
- Test your stomach acid every 6 months-1 year
Katie Morra’s Info: