Hindgut Acidosis

The Lactic Acid/Dysbiosis (SIBO)/Leaky Gut Cascade


Introducing Lactic Acid - the equine hindgut's worst enemy





Content

  1. A case study
  2. Hindgut acidosis
  3. Meet lactic-acid bacteria
  4. Pectins
  5. Colic risk
  6. Should we be saying No to Haylage?
  7. That swollen sheath?
  8. It can all start from birth - the foal's microbiome
  9. Supporting naturally ...


1. A case study

Without question, hindgut-related issues are right up there at the top of all my client emails, and all the more so with our recent understanding of the connection between a disrupted hindgut biome and the multi-detoxification disorder known as Cryptopyrroluria, nickname KPU, which relates to the gut:liver:kidneys pathway. There's no doubt that everything is connected inside that inner engine.


As the saying goes, "Everything starts with the gut," and rightly so. In the medical practice that I follow - Functional Medicine, the gut system is right at the top of what's known as the 7-Interconnected-Systems - meet Interconnected-System No. 1 - Assimilation (digestion, absorption, microbiome).


I'm going to start with a client's story - agreed that this was an extreme case so if you get to the end of the page and think in horror that this is nothing like your horse (!), keep an open mind as this was a classic case of the symptoms going unnoticed over a 5-year period so he got to an extreme place. This lovely chap's gut system was in bits, and he was badly suffering from a slow deterioration over the previous 5-years. As well as his hindgut acidosis he also had both squamous and glandular (pyloric) stomach ulcers, plus the bit in the middle - his small intestine (SI) was also pretty well shot for good measure with acidic bloat and gas, which meant there was something leaky going on down there.


All the clues indicated significant hindgut dysbiosis, which had led to SIBO (Small Intestinal Bacterial Overload) which as we know, if left untreated inflames the very fragile SI wall membrane and breaks it open, leading to leaky gut and putrefactive toxic matter leaking into the bloodstream. This then sends the immune system into overdrive trying to manage all these toxins in the blood, and can then triggers a cascade of autoimmune responses with body-wide pain and inflammation. For the record, this is no different to us humans.


Like so many of our 4-legged clients, this boy was yet another case of a whole-body-connection syndrome - there were just too many related symptoms and too many connecting factors over his timeline of ‘issues’, so let's start at the beginning of his story.


5-years ago ...

... he’d had sarcoid surgery with the accompanying - and clearly necessary - vet meds. The downside was that these would have disrupted his gut biome and triggered internal stress on his metabolism overall. And let’s not forget that sarcoids are all about a deviously clever and deeply embedded stealth virus at sub-cellular tissue level, so we also had an exhausted immune system which had been working overtime trying to fight it. Hence his overall recovery from the surgery took much longer than expected, compounding on that internal state of stress his body was already experiencing.


2-years later ...

... and he was now girthy with belly pain, and he felt slow and unbalanced, a classic sign of impaired digestion meaning poor nutrient absorption causing fatigued body chemistry, again deep down at sub-cellular mitochondrial level. No surprise as his SI's ability to assimilate all the nutrients (carbs/proteins/fats/minerals) was disrupted, as was his hindgut fibre digestion. And lest we forget, a horse is nothing more, and nothing less than a hindgut fibre-fermenter, with that fermentation process producing the vital metabolites for ATP, the horse's main energy source. Mess with the hindgut's fibre fermenters, and you mess with everything.


Within 2-years of his sarcoid surgery, he was in a mess, because the gut biome is literally the body’s CPU. I'm not disputing that antibiotics weren't necessary following his surgery, but studies now show that no organism, whether human or horse, fully recovers their gut function after a course of antibiotics.


Back to the timeline and from hereon this boy’s internal engine started to deteriorate. He was chronically stressed, so now his nervous system was involved. His fight/flight system was now triggered so he had the survival hormones, cortisol and adrenalin, on autopilot having taken control of the cockpit. And when this happens, cortisol's role (as the stress-managing hormone) is responsible for shutting down energy-sapping body functions in order to get all the blood supply to the where it's needed to stay alive, i.e. usually the muscles so they can run fast from a perceived threat.


Thing is, one of those energy-sapping functions is ... digestion. I mean, who needs digestion when you’re running from a tiger ... And when digestion shuts down, well … nuff said. And another of cortisol's role in fight/flight mode? Flooding the body with acid so when the tiger takes a bite, we don't taste so good. So not only was his body now running on adrenalin and in fight/flight, but cortisol had shut down the gut and drenched his body with acid. This boy's whole inner engine was now well and truly in trouble.


Early 2020 ...

... and his sheath was now permanently swollen, and it definitely wasn’t a bean. Two vets later and give them their dues, they were close.  One said ‘fatty tissue’, another said ‘muscoskeletal due to muscle pain’, but neither could explain to our client why this was happening, and neither provided a solution other than anti-inflammatories (more pharma meds). Our client's osteo suggested 'ulcers', and here was more of that whole-body connection because what causes glandular/pyloric ulcers? Our old nemesis - stress.


Here’s the 'How'. The stomach/foregut’s stress-related ulcers are located in the back of the stomach by the pyloric sphincter - this is the opening from the stomach to the small intestine, and well protected from the stomach acid by a lovely thick layer of protective gel-like mucus. But - when there’s a permanently switched-on fight/flight response due to a now chronic stressed state, the gastric mucus membrane becomes much less well-supplied with blood than usual (because cortisol's diverting the blood supply), which means it stops producing enough of that vital, protective mucus layer.


This means the stomach acid can then infiltrate what's left of the now thinner protective layer and damage the gastric wall membrane, causing red-hot inflammation alongside a heap of red-raw pain, which in turn causes even less protective mucus. So, this self-compounding cycle intensifies the stress and pain, creating even more stress.


So back to this boy, and the vet now prescribed an acid-blocking drug (one of the 'zoles'), aka a PPI (proton pump inhibitor) to switch off the acid. I shall now try and be really polite and not let my potty mouth go off on one, but shall we just say that for those of you who know me, you'll know this particular pharma drug type turns me into seething middle-aged, fire-breathing She-Devil.


Frustrates the, er, 'heck' out of me that PPIs are the vets’ go-to for ulcers as they’re So Fricking Gut Damaging, but there we go … I could go into the reasons here as to why they’re so bad but it would make this page 12-ft longer than it’s going to be already. Suffice to say it’s all covered on the Ulcers' page if you want to really depress yourself with what really happens when horses are fed this  pharma drug.


No surprise, this poor chap got significantly worse.


I’ll now slightly digress and chip in that boy was also a bit lame, so he'd also had 4 steroid injections, all around the same time. And yes he deteriorated further. His gut was already in meltdown, his hindgut biome was shot, and he had zero immunity. His liver was already exhausted at having to biotransform (metabolise) all the pharma drugs' toxic residue, as well as life's general toxins, and understandably his body was ready to throw in the towel. Frankly I’m surprised he didn’t go into toxic shock - I’ve had many clients who have. Oh, and did I mention that by now he also had squamous ulcers and had lost his appetite? This poor boy was on the final slippery slope to meltdown.


You’ll probably not be surprised to hear that by now this chap was also clearly showing his discomfort. His original ‘girthy’ had now progressed to biting, ears back at everything, lots of swinging back glaring at his right side and cow-kicking underneath his belly for good measure. So now we can bring the hindgut back into the conversation because the hindgut – the large intestine - sits definitively on the right side of the horse’s barrel so this is where all the pain is. And when there's pain in the hindgut, there's now hindgut acidosis.


2. Hindgut acidosis

You see a horse swinging his head down his right side to his flanks, usually ears back and nipping at himself? Hindgut acidosis. You see a horse cow-kicking under his belly on the right side? Hindgut acidosis. A horse biting you, and not a love nibble? Hindgut acidosis. And I speak from experience – our MacAttack, so named because when I first met him his only job in the world was to bite me hard and mean it - had long-term hindgut acidosis. I didn’t know this when I adopted him 5-years ago, but he came to me with a buffet of major issues so no surprise that they all manifested themselves in many ways while we cleaned him up.


When we finally fitted the last piece in the MacAttack jigsaw in 2021 (KPU), we knew we’d got it right because he literally stopped biting overnight. Now when he stalks me in the field it’s to say Hi and have a face rub; now I can grab rug straps under his belly without risking losing an arm - or at the very least an arterial bleed - from his previously well-aimed cow-kick.


Put simply, hindgut acidosis sucks because it burns so it hurts – and not just for the horse but the human who happens to be nearby. 😉


Meanwhile, back to our client's horse ...


Forward to Spring 2021 ...

... and this poor chap then tipped himself over the edge - he broke through a fence to a grass strip and binged his socks off. Cue faecal water/diarrhoea.


3. Meet lactic-acid bacteria

Now we're going to introduce lactic-acid (LA) bacteria into the whole sorry scenario, because lactic-acid (LA) is the hindgut's worst enemy, and at the root of all things hindgut acidosis.


The one thing we need to avoid is the risk of LA bacteria arriving in the hindgut, but it'll get there if the front end of the gut system, the stomach/foregut, is out of whack with ulcers/pain/inflammation, and especially if PPIs have been prescribed because they shut the stomach acid production to Off, so there's no disinfecting wash of what's been eaten which means anything and everything passes border control.


These LA bacteria come in naturally from the forage a horse eats anyway, especially if they're fed haylage (because grass ferments courtesy of  LA bacteria), but the stomach acid usually deals with them before they pass into the small intestine. However, if we've got a disrupted gut system, and especially if a PPI has been prescribed, there's no acid to kill them off, so they sneak on through into the small intestine and Boom! The No.1 enemy of the equine GI tract has now invaded, and trust me when I say it'll wreak havoc as they multiply in their gazillions by the second like all bacteria do.


Welcome to the lactic-acid effect. These LA bacteria ferment sugar and starch, so with all that sugar from our boy's grass binge the LA bacteria had gone to heaven and back! Thing is, if there's one place where fermentation isn't meant to happen, it's the small intestine. Belly bloat? Fermentation. And the more sugar the horse ingests, the more these LA bacteria multiply, overpowering and killing off the beneficial gut microbes. So now we have dysbiosis.


It gets worse. The waste from all these LA bacteria gorging on all that sugar is lactic acid - they literally burp it out. This is badbadnotgood, and definitely isn't welcome in either the small or large intestine because firstly, it lowers the pH value to sour – remember, the intestinal environment should remain as sterile, pH-neutral. Also, remember, fermenting shouldn't happen in the small intestine - only enzymatic digestion - because fermenting creates gas, and the SI doesn’t cope with any kind of gas as it’s a very thin tube with no room for gas bloat, so it feels like it's being blown up like a balloon. So, we now have an ever-expanding gas bloat where it doesn’t belong, and it’s very, very uncomfortable.


Meanwhile, the expanding, sour, acidic environment inflames and what gives is the fragile intestinal wall. Meet leaky gut, through which that putrefactive digesta now leaks into the bloodstream. Now cue a runaway immune system trying desperately to fan the flames of a body feeling like it's on fire; if left unattended, so begins a buffet of autoimmune syndromes.


Now let's introduce pectins.


Pectins

One of the main culprits that causes lactic acid in the hindgut is pectins, which are a plant's cellular building material, a naturally occurring structural carbohydrate, aka 'starch'. And where do we find a huge concentration of pectins? Our neon-green leafy grass ... Those leaf blades are full of pectins, because the leaf is a critical part of the grass's growth phase, to grow into a mature stemmy grass and seed head - spring grass is very rich in pectin because it's literally the new young leaves of new, growing grass.


Thing is, as a forage feed for horses, they're totally inappropriate because those young growing grass leaves have absolutely no cellulose fibre that the hindgut fibre-fermenters ferment - cellulose fibre is only found in the mature grass stems, i.e. hay or long grass, aka standing hay, hence why hay is the best forage we can give our horses.


Small amounts of pectin are always going to be present in a horse's diet, because it's a plant's natural building material for leaves, flowers and similarly soft-elastic parts of plants. However, if a horse consumes them, pectins are primarily consumed by gut microbes that prefer an acidic intestinal environment, i.e. lactic-acid bacteria, and if the diet is overly high in pectins, they produce high levels of acid waste (lactic acid).


This is where it all starts to go wrong - an acidic pH value in the large intestine should be avoided at all costs, since the important cellulose-degrading hindgut biome need an absolute neutral pH environment. If it becomes too acidic, these vital microbes die off, which in the long term not only means that the horse can no longer utilise its hay properly, but also triggers the risk of laminitis, colic or cryptopyrroluria (KPU).


See our separate Pectins page for the full story. Oh, and yes - apples and carrots contain pectins too ☹


NB - It's easy to be confused into thinking pectins are good for the gut because this our human gut biome need pectins. However, we have a very different gut biome family than the horse - unlike the horse, us humans naturally have lacto-xxx bacteria in our gut biome. Look at any human probiotic label and you'll see a host of lactobacillus on the list, including lactobacillus acidophilus. If we don’t have enough pectins in our daily ration, our own gut bacteria start attacking our gut wall, so the saying "An apple a day keeps the doctor away" is absolutely right for us humans, because pectins feed our human gut biome and prevent leaky gut.


Meanwhile, back to our client's boy who was now in a ton of trouble after his grass binge, all due to that overload of grass pectin hitting his hindgut and creating a belly-full of pH-lowering, lactic-acid, courtesy of his resident unfriendly lactic-acid bacteria which had turned his GI tract into a red-raw, sour burn.


Another well-known equine pectin-offender is beet - sorry to all the beet lovers but it's true, and I get your frustration because I used to be a beet lover years ago until I learned the facts. Previously thought of as a beneficial fibre feed, beet is actually anything but. Like grass and apple pectin (often found in many horse feeds/gut supplements), beet is full of fructose (25%) and pectin-rich. The alleged 'molasses-free' equivalent may be lower in sugar but still contains up to 7% residual sugar in the pulp, and is still pectin-rich. And still promoted as safe for laminitics ...


Colic risk

Just as an aside, the digestion of all starches and those grass sugars (along with proteins/fats) is all meant to be dealt with in the SI, but if the digestive function/biome of the small intestine is out of kilter, starch and sugar will reach the hindgut, meet lactic acid bacteria and get fermented into lactic acid. So there's double-bubble for your money. This can lead to a colic risk.


The general transition time of food digestion in the small intestine is relatively short, so if the SI function has been disrupted with SIBO, there will be large undigested starch and protein particles due to the short digestion time to digest those larger molecules. Hence they end up in the large intestine, where they can impact and can lead to colic. So, it’s always good to be mindful of starch levels in feed when a horse’s gut function is compromised. The more complex the starch is, the more chance it’ll end up in the hindgut, and we really, really want to avoid this.


Should we be saying no to Haylage?

Now to haylage, and I know I don't need to tell you that haylage is fermented grass, but a quick reminder as to what causes fermentation. Yep - bacteria. LA bacteria. The equine gut's no.1 enemy. So it could be said that haylage is probably the worst forage we can feed to our horses.


Just the same as it happens in the gut, the fermentation process of grass to haylage lowers the pH so makes it more acidic – my connie's gut (Murphy) literally turns into a projectile, high-pressure faecal water spray within just a few hours of eating haylage.


For more info, there’s a separate page here on the website explaining why haylage should be avoided when we're talking hindgut health.


That swollen sheath?

Now back to earlier, and remember that swollen sheath? One vet saying ‘fatty tissue’, and the other saying ‘muscoskeletal due to 'muscle pain’. Again, this has a connecting factor to LA, so the vets were close, but didn’t quite make the connection.


LA can cause the skelelal soft-tissue, i.e. ligaments, tendons and muscles, to feel as if they’re ‘on fire.’ Why? Because when we have dysbiosis/SIBO causing leaky gut, the LA leaks through the permeable gut membrane (leaky gut) into the bloodstream, along with the toxic digesta.


The body's natural detox organs, the liver/kidneys, don't know what to do with these particualr toxins so they're sent back into the bloodstream to be stored in, of all places, the connective soft tissue - yes we're talking tendons/ligaments/muscles, where they create their own acidic inflammation and damage the sub-cellular structure. The reason some vets think it’s ‘fatty tissue’ is because the inflammation can look as if the horse is putting on weight, but it’s actually the lymphatic system sending its fluid – lymph – to the inflammation to urgently try to degrade the LA.

Many clients also mention those 
orbital pads above the eyes - some people think what looks like swollen pads above the eyes are fat; others think it’s Cushing’s. The good news is that they’re not fat – there’s no tissue here for fat cells to grow in; nor are they Cushing’s related. Anatomically there’s a lot of connective tissue and facia here, so as before it’s more likely lymph.

Long and short, these are perfect indicators that there's significant metabolism disorder.


This can all start from birth - the foal's microbiome

Another factor is the horse’s history - we rarely know what’s gone before with our horse unless we bred them. When a foal is born they don't have an established microbiome - their tiny gut system is beautifully sterile, so the gut microbes need to get into the hindgut to establish their biome, and a foal does this by eating their mother's faeces, a process known as coprophagia.


The first 4-5 months is crucial for the foal – by eating mum's faeces the foal naturally colonises its hindgut's fibre-fermenting microbes (that reside in the hindgut's cecum, home to the trillions of gut biome colonies). Disturb this process or wean too early, and the foal will end up with lifelong digestive and metabolic problems due to a poorly created gut biome. If you give a foal antibiotics, or feed it haylage, this will also disturb the process of the microbes learning to live in the young gut. See our Creating the foal's microbiome page.


The integrity of the foal's biome also completely depends on how the mother was raised from a foal, and how she's been fed/how healthy her own biome is, i.e. if she was fed haylage or antibiotics at any time. If so, and therefore by default, if the dam has LA bacteria in her hindgut, the foal’s immune system will acknowledge the LA bacteria from their mother’s faeces as ‘normal’, making LA bacteria accepted as a lifelong resident. 


In other words, if the dam has the wrong microbes, this will be passed on through the generations.


This will dramatically affect a horse's future ability to ferment cellulose fibre in their hindgut, which will have the direct effect of dramatically affecting the horse’s energy. In these cases, it’s essential to change the feed regime to 24/7 hay which will create a hostile environment for the gut-damaging microbes by starving them of their beloved sugar; this will then allow the beneficial microbes to recolonise and outgrow the bad bugs.


This is sadly so widespread these days as so many breeders are feeding haylage to their foals - already we’re seeing foals with metabolic problems, i.e. sweet itch at the age 2. Totally a human made problem.


Pulling this together

Basically, feed a horse wrong and it creates the wrong microbes which are passed on through the generations. For the last 20-30 years, most scientific research has been focused just on the small intestine, yet the crucial fibre-digesting takes place in the hindgut. Scientists are now realising they’ve strongly neglected the hindgut but are now realising that a healthy hindgut = a healthy metabolism.


The last decade has been the decade of human microbiome research, discovering the connection to so many human-related gut conditions, i.e. IBS, Crones, Celiac, gluten intolerance and so on., so research has intensified and interest has grown – it’s now known that the gut biome manipulates everything.


The good news is that as a result, there’s now more research happening on the equine microbiome with the first publications now coming out, and the early realisation that so many horses have disrupted biomes at the root cause of many metabolic disturbances, especially in the IR lami-prone horse resulting in colic, faecal water syndromes, trapped gas – all signs of dysbiosis in hindgut.


A disturbed hindgut biome is also now thought to be behind the relatively unknown, yet now widespread, multi-metabolic detoxification disorder, Cryptopyrroluria, aka KPU, which is very much connected to many autoimmune syndromes such as sweet itch, pollen allergies, mallenders/sallenders, plus so many more syndromes, which the latest research now shows also have their root in a disturbed microbiome. For so many horses this ultimately could well have started with the foal not able to to colonise their cecum microbes appropriately.


See our KPU page for the full story, and to see if it resonates with what's going on with your horse.


5. Supporting naturally ...

So, there we have it - enough of the Carol-ramble, and let’s pull this all together. So, what to do? No question - we Alleviate, Detox, and Fortify. Generally you'll be looking at something along the lines of the following, and yes it may seem complex as the support kit is multifaceted.

Don't panic though! If it all seems like a minefield, we also do the whole kit as one of our one-stop-shop COMBO Collections in our Gut shop page - see our SIBO COMBO in the link below.

Meanwhile here's the process deconstructed for you:


  1. First up, we may to get some immediate pain and stress alleviation going - there's always pain when there's acidosis so it’s a minimum 2-week course of our DuoBute. If a horse is showing signs of chronic stress as well, we suggest a 1-month/1kg course of our StressTonic. Feed these together for a couple of days in a p.m. feed to start taking the edge off, then we start the hindgut regeneration.
  2. In an a.m. feed it's a a 1-month/1kg course of our SiboCARE alongside our GutAminos (which start reconnecting the leaky gut damage to the intestinal membrane). It's also adviseable to feed Spirulina for around 2-weeks to help deacidify the hindgut environment and mop up mycotoxins.
  3. NB - if you think your horse is a KPU candidate, you'll need to add in the P5P as well, to reset the liver biotransformation function. You'll see all this explained in our KPU page.
  4. Once the SiboCARE is finished, we now tone the liver/kidneys/lymphatics function with a 1-month/1kg course of our LKLCARE.


Thereafter?


  1. We recommended our BiomeTonic, aka the well-known 'oily herbs' which support the intestinal environment, creating a friendly home for the welcome gut microbes to thrive, while not being so friendly for the pathogen microbes. Some horses seem to need it permanently; others (like our MacAttack) did well on it being fed every couple of months for a couple of weeks - it's very much horses for courses so your horse will no doubt tell you.
  2. Our WildFed mix is also useful to feed occasionally to add valuable roughage nutrient diversity to the diet. You can either add to the feedbowl or sprinkle a handful over hay every other day or so.
  3. Finally, we look at fortifying the diet, dumping the junk feeds for feeds made from multi-species grass forage, i..e a cob or chaff, and getting as much quality hay going through the hindgut, while closing the nutrient gap with forage-balanced minerals - see our EquiVita/VitaComplete range.


Back to our client's horse where this poor boy's entire gut system was in meltdown, his whole body felt like it was on fire, and his sheath and inside legs were swollen from lactic-acid storage in his soft-tissue cells.


There was no question that we needed to reset him back to his natural state by stabilising his pain and stress, and getting him off the ultra-processed feedbags by switching up his diet/forage management to species-appropriate, aka grass forage, and getting him off the neon-green grass blades and onto hay.


Once stabilised, it was then all about cleaning him up from the inside-out with the above programme. Our client is completely onboard - she's already got the protocol underway, and removed the offending feedbags from his feedbowl. As for grazing on grass? I think you know the answer to that! He’s been switched to hay, more hay, and nothing but lovely hay 24/7/365 😉.


Here’s wishing this lovely chap a happier and certainly a more comfy, pain-free, stress-free, healthy future.


SHOP - Gut Gut System main page

See what our clients are saying

11.12.23 - SiboCARE / GutAminos Hi Carol, just to say, what fantastic results so early on with the SiboCARE and GutAminos. She loves the taste but all symptoms have improved no end...also she is much calmer in herself, which is such a relief to see. All of your advice has been a godsend in what has been a worry, so thank you so much. MH

28.8.23 - SIBO COMBO
Hi Carol, an update on Sid the mini shetland - he came off the antibiotic, bute, steroids and my, he really came back to life - chasing his stable mate and just racing round the school for the joy of it – he was showing more energy than ever before. Mid June he went onto BiomeTonic. During this time he has not only grown he has also put on much needed weight. He is a transformed pony and is better than we hoped he might ever get to. I want to say a big thankyou to you for your advice.

3.6.23 - SIBO COMBO

Hi Carol, I thought I would update you with my boys progression. I rode him last week and he was the ‘sparkliest’ he has been for years. He was happy and not spooky and trotted up a hill (I’ve not done that in years). I am able to ride him now 5 times a week with no problem. He has not had any mud fever this winter, his mallanders/sallanders have almost gone, his hooves look in great shape and his overall coat condition looks fantastic! He's now out by night with a muzzle and in by day with hay. IStill a way to go - there's still a bit of bloat and round the belly but he has a flat bum (no heart shape) and no more cresty neck. Natalie & Dewi

2.2.23 - SiboCARE / GutAminos Hex is doing very well, like a different horse. Feels bright and not kicking out when saddle goes on. Obviously feeling much better, I feel his stride is longer using his hind legs more easily, Many thanks so pleased he is brighter and more comfortable, Best wishes, Felicity

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