Thanks to a raving fan we are going to expand on a concept of the gut and digestive disorders. With Dr. Olivia’s Joseph’s help you will discover simple ways to identify and create a solution to what’s wrong with my gut! Anywhere from SIBO, gas, bloating, acid reflux and more!
Table Of Contents
- An Introduction To SIBO: What Is Wrong With My Gut?
- What Is SIBO?
- Early Signs And Symptoms of SIBO
- Causes and Effects of SIBO
- How To Get Tested For SIBO?
- Is SIBO Curable?
- Closing Thoughts
An Introduction To SIBO: What Is Wrong With My Gut?
Dr. Bryan: All right, welcome back. We are up to episode 20 today on the Wellness Connection show. Thanks for all the great feedback and comments. Today we’re going to actually expand on a concept, or a conversation, that somebody submitted and wanted us to expand on. For some of you it may be a little bit deep, and for others of you we’re going to try to keep it real simple so that we don’t get real technical in this discussion. There’s a lot of different people that are struggling with something wrong with my gut, with digestive issues. And the subcategory of digestive issues that’s popping up left and right now is something that’s called SIBO. You may or may not have heard of it, but today I’m joined with my cohost Dr. Jason Hammond.
Dr. Jason: Hello.
Dr. Bryan: And my wife Dr. Olivia Joseph.
Dr. Olivia: Hello.
Dr. Bryan: And with Olivia’s help we’re going to expand on what actually SIBO is and what it’s doing to people, why it might be showing up, what you can do to get rid of it, how it’s affecting you, and we’re going to just have a conversation around that.
Dr. Bryan: Now if you don’t have SIBO, this is also going to be relevant to you, because look, I don’t know anybody that hasn’t at one point had to deal with some type of belly issue.
Dr. Jason: Right.
Dr. Bryan: So if you’ve had any type of belly cramps, constipation, diarrhea, or just gas or pain-
Dr. Olivia: Indigestion, acid reflux, bloating …
Dr. Bryan: Then you’re going to wanes listen to this conversation, because there’s a chance that what’s going on with these other people may also be going on with you.
What Is SIBO?
Dr. Bryan: Yeah. Let’s define SIBO to begin with.
Dr. Olivia: SIBO is short for Small Intestinal Bacterial Overgrowth, and I think that the small intestine is the most overlooked section within the digestive tract. Because forever we’ve said, “I have colon issues, I have diarrhea, constipation, acid reflux, indigestion,” but when you think about it, the small intestine is the largest part of your digestive tract, and it’s got the most important job. That’s where you absorb all of your nutrients. So when you talk about the colon, and when you talk about the stomach, it’s important, the gallbladder, pancreas, they’re important, but the small intestine is where all the magic happens.
Dr. Bryan: Where’s the small intestine found? When people are feeling and touching and pushing on their own belly, if they were going to have tenderness in the small intestine, where would that be found?
Dr. Olivia: The entire abdominal region. It covers up the most square footage. So if you literally just put your finger in your belly button, it’s everything around that. You’ve got to be really really high up for it to be stomach. Gallbladder pain’s going to be right under the right side of your rib cage. Everything in that abdominal area is going to be small intestine.
Early Signs And Symptoms of SIBO
Dr. Bryan: All right, so like I said earlier, if you’ve ever had any tenderness in the stomach, indigestion, acid reflux, bloating-
Dr. Olivia: Bloating, bloating is the biggest complaint.
Dr. Bryan: Then you’re going to want to hear this discussion around SIBO. And it means what again?
Dr. Olivia: Small intestinal bacterial overgrowth, so it’s bad bacteria. It’s not good bugs like probiotics or prebiotics, it’s bad.
Dr. Bryan: All right, whether you know this or not, all of us have bugs in our body.
Dr. Olivia: Trillions. We have more bugs in what’s wrong with my gut, in our digestive … Well in our body, you have more bugs than you have cells.
Dr. Bryan: Is microbiome the same as bugs, or is that different?
Dr. Olivia: Yes, it is. Microbiome is the balance between the good and the bad. That’s what your microbiome is.
Dr. Bryan: So really what SIBO is, and this is a newer concept to me, so I’m learning with everybody today, is when the human microbiome, or all these little mini bugs that we’re made up of inside of our intestinal tract, starts to grow wild and gets out of control, it’s kind of like taking a beautifully manicured golf course that looks perfect, and flush with all this green grass, and all of a sudden tons of weeds start showing up. There’s a fungus inside, or there’s an overgrowth of a strange bacteria that’s starting to basically manipulate the culture, and within our bellies it sounds like that’s starting to happen to a lot of people.
Microbiome overgrowth – It’s not just SIBO
Dr. Olivia: Yeah, and not just with SIBO, but you can get an overgrowth of lots of bad things. You can get a parasite, many people have had parasites. You can get fungal overgrowth, yeast overgrowth, bacterial overgrowth, so we have enough content just to talk about bacteria today, honestly, but those are all bad bugs. And they live in all of us. The reason we have bad bugs in our gut is, they protect our immune system, so when you do get exposed to things like E.coli and salmonella, there’s a little bit living in wrong with your gut so your body goes, “Hey, I know what that is, I know what to do about it.
Dr. Bryan: So just to clarify, these aren’t like ladybugs flying around, wasps, bumblebees, these are microscopic bugs.
Dr. Olivia: Yeah, little microscopic bacteria. And yeast.
Dr. Bryan: Okay. Well it sounds fun knowing that we all have bugs all over us.
Dr. Jason: Yeah.
Dr. Olivia: You wouldn’t be alive if you didn’t. That’s what protects our immune system.
Dr. Bryan: So when somebody potentially starts to get out of balance with the bugs in the microbiome, what do they usually start to begin to notice?
Initial changes when having SIBO
Dr. Olivia: The biggest frustration you’re going to hear from people is, “I’ve changed my diet. I’ve done gaps, FODMAP, gluten-free, dairy free, and I’m still having symptoms. I’ve tried probiotics, I’ve tried collagen and digestive enzymes.” When you suspect SIBO is when somebody just isn’t seeing results, because you’re focusing on the wrong thing. You’re trying to focus on all these good things, when you have too much of a bad thing. So bloating is hands-down the biggest frustration, but if you think about the amount of people who take antacids, who take Tums, who drink soda and things of that nature, throws off the acid balance in your stomach and you can’t digest food properly, so it goes into wrong with your gut undigested, it ferments, which is exactly what SIBO is.
Dr. Olivia: So how do I know if I have SIBO? Well this bacteria produces gas. It produces methane gas and hydrogen gas. So you do a breath test, just like you would do a breathalyzer. You do not test positive for a breathalyzer unless you’ve been drinking alcohol, right. Well you don’t test positive for methane and hydrogen gas unless you have a bacterial overgrowth.
Causes and Effects of SIBO
Dr. Bryan: So pause, before we go any further with the symptoms somebody might feel or even how you’d find it, how does somebody get this?
Dr. Jason: Right.
Dr. Olivia: Right, so having low stomach acid, that’s a big cause.
Dr. Bryan: Having low stomach acid comes from what?
Dr. Olivia: From, a lot of times, eating highly acidic foods, drinking soda. So your stomach gets confused. Your stomach is super acidic, so food drops in there, the acid digests it, drops out of the stomach in 30 minutes. But if you’re drinking soda your stomach goes whoa, don’t make acid, there’s already acid in there. Or you eat deep fried foods, which are very highly acidic. Tons and tons of dairy, very highly acidic. So your stomach goes, don’t make acid, there’s already acid there. So then you try to eat food and it’s not ready to digest. Taking antacids is a huge thing that people do, not realizing that there are warnings on antacids that say, “Don’t take these for too long, because it causes osteoporosis, causes anemia.” It can also cause overgrowth of bad bacteria.
Dr. Bryan: Is it safe to say that our bellies, or intestines, are kind of like a swimming pool, where you’ve got to monitor the pH?
Dr. Olivia: Yes.
Dr. Bryan: Where if it’s either too acidic or too basic, you’ve got to keep it neutral, got to get it just right? And when it gets really out of balance then-
Dr. Olivia: Right, the pool turns green and gross fungus, [crosstalk 00:08:03]
Dr. Bryan: Yeah, don’t swim.
Dr. Jason: Don’t swim!
Dr. Olivia: We got to shock the pool!
A little analogy
Dr. Jason: That’s funny. I’m hearing you talk, and there’s an idea that just came to my head, and I’m thinking the parallels between … I now see it as stomach, small intestine, large intestine. And where my mind usually goes to, I’m immediately going to exercise. So you’ve got the warmup, which serves a very specific purpose, which then allows you to go into your work set of the fitness regimen that you’re doing, which then leads into the cooldown.
Dr. Olivia: Cooldown, right.
Dr. Jason: So, you see where I’m going there.
Dr. Olivia: I do.
Dr. Jason: But if I overdo the acidicness, or I don’t allow my stomach to do its job, and to prepare the food to then go into the intestines correctly, then it’s like me going into the gym and saying, “I’m just going to go ahead and bench press my highest rep max without any warmup,” and wondering why I’m blowing out a shoulder and it takes me six months to recover from a shoulder industry.
Dr. Olivia: Right.
Dr. Jason: That’s kind of the parallel that I’m seeing from where my head is.
It’s not always the stomach
Dr. Olivia: Right. I love that you gave that analogy, because the problem’s not always the stomach. The problem can also be something like, actually within the small intestine or constipation. So if you are constipated, it’s a perfect breeding ground for bacterial overgrowth. Your waste is sitting there fermenting. When you have gas, which could be belching, burping, or gas, flatulence, when you’re bloating, that’s gas, that air is produced by bacteria. That’s how we get it. So yeah, if you don’t digest properly in the stomach that’s an issue. But if your bowels don’t move because you’re sedentary, because you don’t eat enough fiber, because you don’t drink enough water, because you have a thyroid issue, because you lack enzymes.
Dr. Jason: Because you’re stressed.
You lack some good bugs on your gut
Dr. Olivia: Right, because you don’t have enough good bugs. That’s a perfect fermentation, or breeding grounds, for bad bugs. Then you go into the colon. Well if step one and step two didn’t take place, guess what, that fecal matter is going to go into the colon and inflame it, and chronic inflammation in the colon increases your risk for colon cancer, which today, honestly, esophageal cancer, stomach cancer, colon cancer, they’re so much more common than they were 15 years ago. So we create solutions like antacids to fix one problem, but let’s be honest, when you start messing with mother nature you create more problems. So you traded one problem, acid reflux, for 15 problems. SIBO being at the root of many of them.
Dr. Bryan: I think it’s becoming well documented, more so every day, on how important a healthy wrong with my gut is to have a healthy life. Often times people look at the body as being compartmentalized, as if there’s one condition and it’s not related to the other condition, but we know now that, when we take a holistic view of how the body operates, if there’s any aspect of your digestive tract that’s beginning to fail, and is not as healthy as it should be, it’s going to have consequences or side effects on other areas of your body.
Your gut is really important
Dr. Olivia: Yeah. The gut’s like air traffic control. We stress so much the brain and the nervous system, no doubt about it, but those organ systems control everything, but something wrong with your gut really affects your quality of life, your immune system, your risk for a lot of things including autoimmune disease.
Dr. Bryan: Can I ask you this … Jason, you bring up a good point in regards to the warmup and the exercise and the cooldown, but I would venture to say that it goes beyond those three pieces, because obviously digestion starts at the month, or even the sensory, from the nose, activating all the right enzymes, so process is tip to tail, right?
Dr. Jason: Mm-hmm (affirmative).
Dr. Olivia: Yeah.
Dr. Bryan: When that digestive tract gets altered, and you do get an overgrowth of this bacteria … Is this bacteria good or bad, first of all?
Dr. Olivia: This is bad.
Dr. Bryan: Because there is good bacteria.
Dr. Olivia: Which are probiotics. And then prebiotics are a whole different category.
SIBO can cause allergies
Dr. Bryan: So when you get an overgrowth of the bad bacteria, what can happen if you ignore this?
Dr. Olivia: Okay. There’s a big connection with two things. One we’re dealing with right now, allergies. So this bacteria actually releases histamine into your body. It’s called mast cell activation syndrome, where you become hyper allergic to the environment, to foods, to things of that nature. So we’ve always said, for 15 years when I’ve lectured on what’s wrong with my gut , I’ve said you can’t change the outside environment, grass, mold, pollen, dust, those things are always constant. What you can change is your internal environment. That’s your gut, that’s where your immune system lives. So when you have this bacterial overgrowth, it’s releasing histamine. So every complaint you’re going to have about allergies comes back down to the wrong with my gut. Histamine intolerance.
SIBO can trigger autoimmune disease
Dr. Olivia: Second thing is, there’s so much research that shows SIBO can trigger autoimmune disease, which is on the rise. We’re creating these bad bugs. We’re creating them, taking antibiotics when they’re not needed, by putting antibiotics in our food sources, by spraying our produce with antifungals. It’s like, we caused the problem, not nature.
Dr. Bryan: So let’s make sure, I want to make sure that everybody understands all these words that we’re using so that it’s not just our language. And it’s not like they’re rocket science words, but some of them might be new to some people. Histamine, correct me if I’m wrong, is another way of saying high levels of inflammation, right? It’s not exact, but people, what they experience if they have high level of histamine in their body, that means all different parts of their body is starting to get inflamed, is that correct?
Dr. Olivia: Yeah, but more specific to allergies versus, like with inflammation some people think aches and pains, right?
Dr. Jason: Histamine itself, correct me if I’m wrong Liv, is a precursor to mucus formation, correct?
Dr. Olivia: It will make … Yeah, absolutely.
Dr. Jason: So basically it’s a cellular part of our body that literally, when it’s initiated, will lead to more mucus production in the body.
Dr. Olivia: Sneezing, itchy nose, watery eyes …
Dr. Jason: Right, so for someone out there listening …
Dr. Olivia: Hives, oh my gosh. Histamine’s a huge cause of that.
Dr. Jason: So as Dr. Bryan says, someone who’s listening, we’ve got to recognize that, by having the SIBO in our body, it literally is stimulating cells that create more mucus in our body, which are the allergies.
What is an autoimmune condition?
Dr. Bryan: And when you said the second part about an autoimmune condition, let’s make sure everyone’s aware of what that means. An autoimmune condition is what, by definition?
Dr. Olivia: It’s when your immune system is attacking itself. And 70% of your immune system lives in your gut, so you’ve got infection in your but, guess what it’s doing. It is ticking off your immune system, it’s constantly background irritated, constantly being inflamed. And the sucky thing about SIBO is, you could do awesome things like kombucha, bone broth, you’re making the problem worse, because those are high histamine foods. So you’re trying to do these good things, you take probiotics, well guess what, probiotics can actually feed the bad bacterial overgrowth.
Dr. Olivia: So what I’m saying is, when you do good things, guess what, you’re going to get good results. When you work out, when you eat healthy, when you have good sleep quality, awesome things happen. But when you’re doing everything right with your diet, with your supplements, “I’m doing bone broth, I’m doing probiotics, and I’m not seeing any results,” suspect SIBO. It’s so common.
The immune system gets confused
Dr. Bryan: Here’s, I guess, let’s bridge this totally together. So that golf ball that’s got the fur around it now, which is the histamine and the inflammatory response, your body looks at that as a foreign substance, and it begins to attack that. And the more that it attacks that, the more it goes into this overall attacking of whatever area is inflamed, and that leads to this autoimmune conditions.
Dr. Olivia: Yeah, the immune system just becomes confused. It says this is a foreign invader, let me attack. But then it almost gets tired. Like when you’re really super stressed out, and you snap over the smallest thing, that’s exactly what’s going on in your immune system. It’s like you’re so hyper irritated and sleep deprived and bla-bla-bla, like the smallest little thing, and boom, you explode. That’s what’s going on with mast cells and history and SIBO.
A quick recap of what causes SIBO
Dr. Jason: All right, so let me replay myself too so I can say this out loud, because every time we talk I feel like I walk away with a Ph.D in Liv-ness. So the stomach is not in a great environment, which doesn’t allow the small intestine to properly do its job correctly in breaking down food and absorbing the nutrients.
Dr. Olivia: Nutrients.
Dr. Jason: So then we have a stasis, or a slowing down of the food moving through the intestinal tract like we want, like it should. It gets stuck, and because of that, usually in the large intestine, we now have the bacteria just sitting there. Just like if we left food on the counter, if it just sat there bacteria would take it over. The bacteria takes over, and then two things happen. One, it stimulates mucus production in the form of histamine to our lungs.
Dr. Olivia: Inflammation.
Dr. Jason: Inflammation. But then it also, as Dr. Bryan said, it creates these things called mast cells, which our body doesn’t like and starts to attack, which was what we call an autoimmune disorder. Am I hearing that right?
Dr. Olivia: Yeah.
Dr. Jason: Cool.
Dr. Olivia: Those things could happen right, but sometimes it’s as simple as, it happened from an antibiotic, it happened from taking antacids for too long, it happened because you were constipated, because of X, Y, Z. So sometimes it’s anatomy, and sometimes it’s toxins. Sometimes it’s environmental. It’s not just because you have a dysfunctioning digestive system, sometimes we did it, or the environment did it.
Dr. Bryan: All right, let’s fast-forward a little bit and say it happened to you. It happened to you. You’ve been SIBO’d, right.
How To Get Tested For SIBO?
Dr. Bryan: So if this happens to you, of it it’s potentially happening, and you’re experiencing maybe some symptoms, the symptoms can be all over the board it sounds like, from autoimmunity, from allergies, to aches and pains in the belly, constipation, it could be indigestion; how does somebody start to recognize that this is happening to them. How can they actually test for it or figure out, do I have SIBO?
Dr. Olivia: Sure. It’s the least invasive test that we have for the digestive system. Because if you do an endoscopy, if you do a colonoscopy, you have to see a gastroenterologist, sometimes you have to be put under anesthesia. Here within the practice we do a ton of food sensitivity testing through blood and stool analysis. Still need blood and poop to do those tests, right.
Take a breath test for SIBO
This is literally, you order a kit, it comes to your house, you breathe into it like a breathalyzer, traps the breath in the gas, send it to the lab, and they test it for methane and hydrogen. And you get a report, boom, you tested positive or you didn’t, move on. So it’s noninvasive. You can go direct to consumer on a breath test. I refer out a lot to a gastro locally that I work with, but you can order your own SIBO breath test. Your primary will view it.
Dr. Bryan: You said a couple things. I just want to make sure I have clarity, maybe the listeners felt the same way. You said blood, poop, but then you started talking about breath tests.
Dr. Olivia: For SIBO, breath test is the golden … That’s how you test. All these other tests give you so much information, but specific to SIBO you just do a breath test.
Dr. Bryan: Got it.
Dr. Jason: Thank you, yeah, I was wondering the same thing.
Dr. Olivia: Yes, sorry.
Is SIBO Curable?
Dr. Bryan: All right, let’s just say I get my breath test back, and my breath test comes back and I’ve been SIBO’d. Is this a permanent thing, is this a fixable thing?
Dr. Olivia: Fixable.
Dr. Bryan: Can we restore it? How do we do it, what happens?
Dr. Olivia: It’s fixable. How do you treat bacteria?
Dr. Bryan: You’re asking Jay?
Dr. Jason: Uh, pushups. Burpees.
Dr. Olivia: Guys, if you had a bacterial overgrowth, what would you take?
Dr. Bryan: Antibiotic.
Dr. Olivia: Antibiotic guys, antibiotic. You need something that’s going to kill bacteria, right.
Dr. Bryan: I’m going to stop hanging out with her, she makes me feel stupid.
Dr. Olivia: No, no, no! The problem is, medically speaking, you take an antibiotic called Xifaxan, it’s $1,100 for this one dose of antibiotic.
Dr. Bryan: Holy smoke.
Dr. Olivia: And you can’t get the antibiotic unless you have a positive breath test.
Dr. Bryan: Are there not natural ways to help this?
Natural ways to cure SIBO
Dr. Olivia: There’s totally natural ways, yeah, so that’s what we do. We work on, usually in a 30 day program or protocol that we create, we’ll use the right enzyme, one that Contains hydrochloric acid, to create an acidic environment on purpose. We’ll use something that’s natural and antimicrobial. I can name a few products. If you guys do your research on it, you’re going to see they’ve been clinically tested against SIBO. So the one thing we know, when you treat SIBO naturally or through medication, the success rate is exactly the same. Like medicine doesn’t work better when it comes to SIBO. Natural or medication, they work exactly the same.
Dr. Olivia: So you treat it with some type of antibacterial again, right, we use things like Biocidin, CandiBactin, AR and BR, those are the most researched antimicrobials for SIBO. Then you do use a probiotic, but the probiotic you use is yeast, not bacteria. So you use something called Saccharomyces boulardii, or S. boulardii. It goes in and it feds on those bugs that you want to get rid of. So I call it the Pac-Man probiotic. Imagine you swallow Pac-Man and he goes in and he feeds on those white dots. That’s what S. boulardii will do. So you do that whole protocol for anywhere from 30 to 90 days, and then you retest.
Get in touch with Dr. Olivia or a medical practitioner for guidance
Dr. Bryan: Look, it’s rare that I actually will say something this bold, but I’m going to just do it, because inevitably I’m trying to think, if I had to try to fix this myself I’d be a little bit overwhelmed. If you’re concerned that you legitimately have SIBO, or you have anything wrong with your gut, and you don’t necessarily know what tests to take, or even what direction to go and you don’t want to try to be on a bunch of antibiotics and you want some help, then you got to get in touch with somebody like Olivia or a functional medicine practitioner, or somebody that actually understands this. Because for Jason and I, I guess I could speak to the two of us, if we were SIBO’d we’d be going right over to have a meeting with one of these doctors.
Dr. Jason: Yeah, exactly right.
Dr. Olivia: Yeah.
Dr. Bryan: Not that it’s rocket science, but it’s deep enough where someone can mess themself up if they’re putting in the wrong bacterias as opposed the ones that are going to help to balance out the microbiome.
Dr. Olivia: Right.
Dr. Jason: I think it just comes down to clarity. We’ve talked about it on podcasts in the past as well, as what is the end goal, how do I know? Then really just what’s the plan, as opposed to taking a bunch of different ideas, concepts, books, podcasts, whatnot, and it’s like find the expert, what do I got, and then help me, here’s the path, let’s retest. Is it fixed? Great, move on, next challenge.
There are a lot of gut disorders
Dr. Olivia: Right. That’s who taught me about SIBO, so I was trained by a functional medicine gastroenterologist who studied at a research hospital out on the west coast that was half gastros, half naturopaths. The naturopaths used the protocol I discussed, the gastros used the Xifaxan protocol. Equally effective. So I literally only refer one to two people out to this gastro a year.
Dr. Olivia: Why? Because we don’t have to. We’re successful in helping people get connected to solutions. But just like you said, when you’re clear on what you have you have a clear path of what to do. SIBO is not yeast. Yeast is not H. pylori. H. pylori is not a parasite. When you talk about the billions and trillions of bugs you have wrong with your gut, if you get it right you’re going to save time and money, and you’re going to get better results faster.
Dr. Bryan: So needless to say, there seems like there’s unlimited … Not unlimited, but there’s an awful lot of different wrong with my gut disorders.
Dr. Olivia: Oh yeah.
Dr. Bryan: There’s a lot of different gut complaints, a lot of reasons why people’s intestines don’t feel right or function right, and this just being one of them, but it’s fascinating. I learned quite a bit today, which is cool.
Dr. Jason: Yeah, me too.
Dr. Olivia: I hope everyone else did too. I hope I didn’t confuse you guys.
Closing Thoughts
Dr. Bryan: Do you have any other comments that we didn’t touch on that you think are very vital or important to hit on regarding this topic of SIBO? Or [crosstalk 00:24:47] hang out with us?
Dr. Olivia: I think that if you’re somebody like me, that’s a science and research nerd, there is so much science and research behind this, it’s not even funny. And I think back to 25 years ago when IBS wasn’t a real diagnosis. 15 years ago when fibromyalgia wasn’t a real diagnosis. Right now with SIBO, the controversy exists. What’s wrong with my gut with things like leaky gut, the controversy exists.
Dr. Olivia: I’m a scientist. I’m like guys, this is not about philosophy, this is about science. You don’t have these gases unless you have this bacterial overgrowth. When it comes to leaky wrong with my gut you don’t have elevated Zonulin or LPS unless you wrong with my gut have leaky. So why guess when you can test? I probably say that on every freaking podcast, but it’s so scientist. But we think of medicine as so scientific, and I’m not saying it’s not, but it’s definitely a one-size-fits-all approach. That’s the worst thing you could do when it comes to the gut, and that’s why we’ve been failing for 15 years.
Dr. Bryan: All right, that was great. Thank you so much. I’m just going to say, to recap this, if you wanted to go through this a little slower, if you wanted to read it, if you wanted to hear it, or if you wanted to share it, you could find it at TheWellnessConnection.com/E20, and it’s all about making sure that there’s the right bugs in the belly, and not opportunity many of the wrong bugs in the belly.
Check out our page for more of our podcasts.