Gut Balance in PFAPA/PFS – The Small Intestines

In every child (and nearly every adult) I have seen with PFAPA, PFS, autoimmunity or other disorders there is small intestine imbalance. Our microbiome (all microbes on and in our body) have their own world happening. When they are out of balance, we get disorder and disease. And that INCLUDES PFAPA, PFS, and autoimmunity. This imbalance (along with other parts of the digestive tract) is one of the 3 direct causes of these disorders. Breakdown in the biome or immune system that lies within this area is what leads us to this repetitive problem.

Excerpt from my Book …

What do we know about small intestine imbalance?

“The small intestine is a complicated place. It has a lot of functions. It finishes digestion, and then it helps with absorption of these minerals into the body for use. It also contains an entire biome of microbes that are both harmful if in too many, and helpful in balance. Most of the immune system lies within the intestines and digestive system. That is correct – read that again – THE MAJORITY OF THE IMMUNE SYSTEM resides inside of the intestines and digestive system. There are components that come from other locations in our body, however, most of our protection and reaction comes from this location. This is why this book is VERY focused on proper nutrition, digestive support and environmental detox. 

Unfortunately with improper balance in the northern parts of digestion it leaves the small intestines to try to process larger particles of food, but it can’t. This leaves aggravated villi and lining inside, and that creates openings where particles of food, or germs escape from inside the tract to enter into the body. This is where things really start to fall apart. These particles then get coded for removal and they go through the detox and removal, OR they get incorrectly labelled and our own tissues are identified as targets (autoimmunity).

There are many many digestive disorders that come from improper balance in the intestines including Celiac, IBS, colitis, gastritis and more. 

The Roll of Antibiotics – If your child has ever taken antibiotics they have most certainly had a loss in microbes from their intestines. But this lack of microbes over time without repopulation can be very detrimental to the immune system and your child’s PFAPA episodes and condition. Other medications can also be damaging inside the intestines as well. 

Note: Thinking “Oh my kid only had antibiotics a few times by a few years of age so it’s fine” is incorrect. If you or your child have been treated with antibiotics ever you have lost beneficial microbes.

Our goal is to keep the intestines sealed, and in good working order with great microbe balance. This will help us work toward symptom or episode control with PFAPA. 

What are a few signs that something might be out of balance in the small intestines:

Bloating 1-2 hours after a meal

Food allergies

Sinus congestion – stuffy head

Crave bread or noodles

Dairy sensitivities

Gluten or grain sensitivities

Asthma, sinus infections, stuffy noses (constant)

Alternating constipation/diarrhea

– End of excerpt

What can you do about this at home?


The first place to start is with a whole food diet. This means DITCHING THE PROCESSED packages, boxes and bags. It means paying attention to common allergens like wheat and gluten. Pay attention – just because a packages says gluten free does NOT mean it is healthy – check out this to learn more.

Learn more about what is processed, and why we should avoid it by going to my other blog here. Wondering about how to make real/whole food work for kids? Check this out. Just need some tips on cooking and how to get started with real food? Check this out.


This means a lot of vegetables, plenty of fruit, high quality fish and seafood, and occasional grass fed beef and pastured chicken. Be sure to have as many clean fermented foods as you can. This type of variety naturally populates your gut and biome.

Plant matter also helps to heal the intestinal walls and mucus layer which is where your immune system is located! Choosing beef only once a week or less is important for the MICROBES. It’s not about fat or anything like that (as long as you are choosing grass fed and finished and organic when possible). With too much beef the microbes get out of balance in a negative way.

Need help in choosing the right variety and quality of foods? Check out this piece.

PROBIOTICS (with help)

Probiotics with probiotics can help a lot BUT you need THE RIGHT strains. Every company has different quality, some are pointless because they are so poor the microbes will be dead before they even reach the intestines. This is where it is important to work with a practitioner. They can get you the best quality, as well as the appropriate strains in the product to address your specific needs and imbalances.

It is especially important to choose something that has a variety of strains, as well as no fillers and junk in the product. A lot of kids products are full of additives, dyes and sugars. Some pretty bad stuff to be honest. Finding a nutraceutical brand from a practitioner is the way to go.

Your digestive tract relies on more than just these things however, and other imbalances in vitamins, minerals and areas of the system can be contributors to imbalance. It’s NOT ALL about the intestines. Even if you think your child’s digestion is normal – if they have immune system dysfunction there is an imbalance that needs addressing. Start with these things above, and get in touch with me for a FREE consult. Let’s see what we can do for your family.