Nirala Jacobi:

Welcome back to part two of the SIBO Doctor podcast, and let's jump right back into it. So there's always a lot of talk about the vagus nerve. Vagus nerve is the great wanderer cranial nerve number 10, right?

Maree Chilton:

That's right.

Nirala Jacobi:

Yeah. And it enervates large parts of the digestive tract. And so when we talk about vagal toning, for those of you who are unfamiliar with it, it can mean just training that nerve to do its job again. And there are different techniques, but what are your favorite techniques Marie to tell patients to tone their vagus nerve?

Maree Chilton:

I like things that are easy like gargling, because you can combine it with washing teeth. Humming. You can do humming anywhere. The most obvious would be breathing. And then it's about the way you breathe. What we're trying to do is there's two parts of breathing. There's the breath in, which is actually a sympathetic. Sympathetic is the accelerator and vagus is the break. And so sympathetic makes us a little bit more stressed. Parasympathetic vagus nerve makes us rest and digest. So when we breathe in, we create a little stress response and when we breathe out, we increase rest and digest basically. So if you want to encourage that, if you breathe out longer than what you breathe in for. So it can be as simple as say breathe in for a count of four, breathe out for a count of six if you can do that or breathe in for however long you can breathe in for comfortably.

Because there's hundreds of different breathing techniques, and I find that people come in and say, "Oh yeah, I'm doing the six, seven, eight. So I breathe in for six, hold for seven, breathe out for eight. And I go, "Why do you do that?" "Oh, because I saw it on the internet and it's supposed to make a difference." Well, that's all good and fine. And I'll often say to them, "Can you actually hold your breath that long?" And sometimes they can't. Sometimes they create a stress response by doing that.

So what I've found over the last couple of years is that I've gone more into understanding more about breath and how we breathe to understand the vagal response. Because when I test for vagal tone, I'm looking at the back of the throat and the ability of someone to say the word R and have the back of the throat ... So if I look into the mouth and I look at the back of the throat and we have a little dangly bit called the uvula, and I want to see that someone can do that 10 times and go ... I'm going to say, "Ah, ah, ah, ah." And what I want to see with the uvula is that it actually elevates up and it can do-

Nirala Jacobi:

And symmetrically, right? So you want a symmetrical rise of the uvula.

Maree Chilton:

That's right. And I want to see it continuous. So for the 10, I want to see that you can do it for 10. And so now, when I look in people's mouths, one, I can't see the uvula anymore. So we've got so much dysfunction of mouths, airway, tongue function, tonsillar tissue, collapse in the back of the throat that it's really hard to even see into the back of people's mouths now. There's poor tongue tone, because tongues are sitting so far into the floor of the mouth that you can't see the back of the throat. And then when I ask people to actually make the sound ... So anyone can do that in front of a mirror and have a look and see, will it rise symmetrically and can you do it continuously?

Often, when I have someone that has a vagal issue, they might be able to do it once or twice, that can't continue to do it. So that gives people an opportunity to go, "Ah, do I need to work with my vagal tone?" So that's not the exercise. That is the test to sort of see-

Nirala Jacobi:

Assessment. Yeah.

Maree Chilton:

And you can do a self-assessment of that. And so then you can see, right, can I gargle or hum, something that's easy to do to make a difference to see, can I improve the tone of the vagus nerve and increase the way it fires off to actually go back to the brain and talk to the brain? So breathing would have to be my favorite vagal exercise, but good quality breathing. And if you don't understand what that means, then like these days, there's so many things online that you can have a look at, but gargling and humming.

Nirala Jacobi:

Yeah. And I think circling back to one of the first things you talked about is that people are a lot more dysregulated these days. And what I mean by that is there's so many different aspects to modern living that affect our function, the function of our body. And we are just more suppressed I would say. There's a lot of things that suppress our function, whether it's toxins in our food supply, the stress of our daily living and then just the stress of living in the 21st century with lots of different stressors in our life. And so people just become very entrenched in their whatever pathology they have. And it just gets more and more difficult to see the type of responses that we would have seen 20, 30, 40 years ago in somebody, whether that's chiropractic medicine or naturopathic. Specifically with hydrotherapy, there were a lot of conversations with hydrotherapist that said it used to be just two, three treatments, and now it takes 50 treatments before you really start to shift somebody into health and wellness.

And so this is more or less just an encouragement for people to understand that. So don't think that you've tried it for a week and it didn't work. This kind of breathing or you've tried something for a week and it didn't work, it's not long enough these days. You need to give something a little bit more of a time. And I think also picking something that really speaks to you rather than it being a chore, really doing something that you derive pleasure from like yoga or relaxing or whatever that may be for you. Just give it a bit more time is my message.

Maree Chilton:

Yes. I would agree with that. And I would say these days that you have to probably give it about three months structurally now to see that you can make changes. And if I think of that from a red blood cell, it takes about three months for a red blood cell to go through its whole life cycle and approximately that it can take about that much time to change the way the body is functioning to give us to change fluid and inflammation and get nutrition and tone the system a little bit more.

Nirala Jacobi:

Before we talk about where people can find different therapies and things like that, I wanted just to touch base on the emotional aspects and you alluded to it a little bit, but practitioners like Bessel van der Kolk, there's a lot of talk about trauma. And he wrote a book called The Body Keeps The Score and just about how people hold trauma in their body. And I just wanted to get your observations and thoughts about that.

Maree Chilton:

Yeah, well, that's a big topic, isn't it?

Nirala Jacobi:

It is. And I just sprang it on you and you did talk about it a little. I just wanted to know if you wanted to elaborate a bit more specifically about yeah, trauma. Maybe we already talked about it because we talked about how stress affects different functions, but yeah, trauma is such a specific thing.

Maree Chilton:

Yes. Look, it's probably got a couple of ... it's about how the brain processes that information and therefore it can take a little bit of time to reregulate the system when there is trauma and also the ability to have enough awareness around, again, breathing because breathing is the way that we connect to our body.

Nirala Jacobi:

I know it always sounds so simple and it is, but it is magic when it really starts to work, I think, and everything gets oxygenated and stuff, but all right. Did you want to say any more about that?

Maree Chilton:

Oh look, it's not a big topic, it's ... and each of the organs holds trauma different ways and yeah, I really do think it comes down to that awareness. But I also think the way we can help trauma, particularly when people don't want to necessarily directly look at trauma is by helping the body to work more efficiently. It allows the trauma to be released. And if you can allow yourself to sit, and again, I think that's where it can take time to allow these patterns that in that subconscious part of our brain we don't even know that the resting tone. And when I think about it, I think trauma changes the tone of our nervous system. So a way of thinking about that would be having it like a dimmer switch, and trauma can suppress that dimmer switch and lower the tone and deregulate the nervous system from a flattening of the nervous system. And it can also make us hypervigilant and oversensitive to it as well. And it's becoming aware. So it can be either and of that seesaw and it can also fluctuate between. And we can also be paralyzed into the freeze phase so we can have fight or flight and that freeze phase. And I think that's where trauma sits in that as well.

And again, the joy of the nervous system is by working with the body, we don't always have to talk about what's going on, because we can be connecting to the body and allowing it to release. And when I'm treating the body, I'm treating how the body presents to me on the day via ... for me, I have an indicator system that I work with. And so I don't have to go specifically, you might say, "Oh, I've got a shoulder problem." But I'm not going to the shoulder, I'm going to the body and treating what the body shows me. So I think that's where you can treat trauma.

Nirala Jacobi:

That's such a big topic and I'm sure that there are a lot of questions that I'll think of later on today, but in closing or as we sort of wrap up, I wanted to get your take on, if somebody's listening to this and they have either no person that they're working with or they're working with somebody who just cracks their necks and backs but is not really getting permanent relief, what are your suggestions on finding somebody that ... what different modalities, how do you go about finding somebody to work with? I know it's difficult because some people just don't live in an area that is well supplied with a lot of different practitioners. But sometimes you get lucky. You're 45 minutes away from me. So I think you and I talked about, don't be afraid to leave your little enclave of 10 mile radius. Just think broader and experiment with different practitioners would be my thought.

Maree Chilton:

That's right. I think there's two things to that. It used to be people had skill sets that could encompass a whole lot of different things. So you could go to one practitioner for many different problems. I think these days it's become very much more specific and people are treating like they treat fascia or they treat the viscera or they treat your knee or your foot. And I think that's the hard part is trying to identify which part of this needs to work to go, who do you go to? Also, don't be afraid to have multiple practitioners, but ask them to communicate with each other. I think sometimes they need to be able to talk to each other.

For me, I always look at the strategy of the control system, the brain, the nervous system first. And I go, is it working? Is the system coordinated? Is it balanced? Because if it's not, then all the other bits aren't going to work. So I like to start there and physios can do that work. Osteos can do that work, osteopaths. Craniosacral people can do that work. Chiropractors can do that work. Cranial osteopaths can do that work, but I suppose it's having that conversation to go, what are we treating? We're trying to treat the whole picture to that.

The other thing is also having a sense of yourself, of going, "Did I get my digestive issue because I had dysentery when I traveled in Egypt or has this something that's progressed over a long period of time? I'm now 60 years of age. I started life with birth trauma. I have had braces. I've had teeth removed. I've had a history of tonsillitis. I've had antibiotics all my life. I broke my leg. I've got recurrent shoulder pain. I have a scoliosis in the spine, and I've had appendicitis. I've had that removed. I've had cesarean." The more things that go on for you, you have to look at your history and go, "The more things that are going on in my life, chances are the more people that I might need to be able to find where that root cause is coming back to."

And that's where I think sometimes we need to get pain control. We need to try to control our pain and symptoms so that we can have some comfort to then be able to go, "How do I rehabilitate my system to be able to make it stronger so that I'm functional, so that I have energy, that I can eat effectively, I can exercise appropriately, I can have good quality sleep and my mood and motivation are appropriate for myself?"

Nirala Jacobi:

Great advice. And for those of you listening who are motivated to go work with somebody, I'd say, "Yeah, just take that advice of maybe experimenting with different types of practitioners, because I'm a big believer in somebody who may respond to acupuncture may not respond to chiropractic medicine." So it's like different types of people actually resonate with different types of modalities I find, and sometimes chiropractic might not be the right thing, but it might be a good starting point or osteopathic or those modalities that Marie just mentioned. And experiment and see what you resonate with and take charge of ... or realize that what you're feeling or what you're experiencing right now is just a whole combination of different bodily functions that you might actually get relief with not being on a specific diet, you might actually get relief from some structural and physical therapies.

I'm not saying that you shouldn't be on a specific diet if you need to be. But I see a lot of people that have suffered needlessly in some cases, of course not in all cases, but in some cases, where they were really totally believing that they had, for example, SIBO. I mean, I'm the SIBO doctor so I see a lot of people that have been treated for SIBO, think they have SIBO and continue to think they have recurring SIBO. And so one of my jobs is to really help them see that whether or not that's true and to guide them in the right directions to find other type of help, if that's indicated. And I find that really rewarding because it's actually not the problem. You have a lot of structural issues that need to be addressed.

And I think conversations like what we had just now really help to educate people that there's more to it than just that one experience of bloating, for example. That there could be lots of other contributing factors. And maybe the stress is not just that you can't sleep at night, but it's really restricting your breathing, which is causing you to have a lot of digestive symptoms. So it's just another way of thinking much ... not so linear, but more in a 3d way about how your body functions. So I really appreciate our conversation about that.

Maree Chilton:

Yes. We have to be our own health detectives.

Nirala Jacobi:

Yes, yes. Very much so.

Maree Chilton:

And understand our own health history a little bit more.

Nirala Jacobi:

Yes. And like what I'm working with you and I mean, this goes way back almost 50 years ago some of the things that I'm experiencing. And it's very empowering and also enlightening. Wow. My body held stuff for that long. So that's why I want to invite people to continue to explore with their health journey. If they feel stuck, then find different type of practitioner that might shed some more light into your patterns and in how you're holding stuff in your body.

Maree Chilton:

Yes. I totally agree.

Nirala Jacobi:

Well, Marie, it's been so wonderful talking to you. Thank you so much. Today's a public holiday in Australia, so I really appreciate you taking your time out of your day today. And do you have anything else in closing you'd like to add?

Maree Chilton:

Yeah. Just be your own health detective. I think it's really important that we understand our history of how we start life and how we progress through life with things that happen to us so that we can then be in the driver's seat to seeing the changes we want to see and not feeling a victim to our symptoms.

Nirala Jacobi:

Well said. And Marie's details will be in the show notes. She lives in a small town in New South Wales. So hopefully you're not going to be totally inundated with requests for seeing you, but your details will be in the show notes of this podcast. Marie, it's been very illuminating. Thank you so much for taking the time to speak with me today. And I will see you later on this week.

Maree Chilton:

Thank you, Nirala. It's been great.

Speaker 3:

Thank you for listening to the SIBO Doctor Podcast. We hope you find the information in this episode useful in the treatment of your SIBO patients. Thanks to our sponsors, sibotest.com, a breath testing service with easy online ordering. Thanks again for listening.