Got bloat? Three tests to help identify digestive problems -

Up until a few years ago I had a stomach of steal; not like a six-pack, I mean my digestion! In my 20’s I could eat whatever I wanted with no stomach distress at all (that I can remember, do any of us really remember our 20’s?)…But as I’ve gotten older, my digestion does not work as well. I find myself with odd bowel movements, stomach bloat and/or a stomachache after a lot of meals. As someone who thinks they eat very healthy, knows a lot about the gut and what causes symptoms; I’ve had a hard time being my own patient. I don’t know about you, but I have a hard time making a change without significant motivation or data to make me do it. So because a wise professor once told me, “if you can’t get your client to be able to enjoy a hotdog and a beer once in awhile you haven’t done your job” (and I can’t! I get a stomachache or look like I’m 6 months pregnant) I’ve decided to figure out what’s going on in my body.

There are a few ways you can approach your symptoms:

Go to the Dr. and get medication, probably a protein pump inhibitor (antacid) to mask the indigestion. I understand wanting to eliminate the symptoms and the pain, but you aren’t figuring out what’s causing the stomach distress; you are just covering it up. PPI’s will not heal your body and long-term there can be some serious side effects.

Do an elimination diet. These are great and I highly recommend for most people. It’s a good way to see if you feel better when not eating certain foods (honestly this may help 95% of you!), and then when you add them back in one at a time you can gage how you feel. I have seen this help a lot of people. But if you get to a point where you can’t pinpoint a particular food(s) or you just feel crappy most of the time no matter what you eat, there are other options. (Favorite elimination diets below)

Get some tests! In functional medicine, we look at the whole body and how everything is connected. Indigestion or heartburn is not just a disease to be dealt with by giving it a drug; it’s often a symptom of something else. In functional medicine we look at your whole history to figure out how you got there and what we can change to make the symptom go away. For me I’m guessing lifelong food sensitivities, Advil use, long distance running and genetics have contributed to my weakened gut in my 40’s and so I am going to work with a practioner, do some tests and figure our whats going on in there.

If you are having severe pain please go see a gastronoligist. Most functional medicine doctors will refer you for a scope if they feel you need it. But for most cases of heartburn, Gastoesphageal Reflux Disease (GERD), Irritable Bowel Syndrome (IBS), bloating, abnormal flatulence and burping, undigested food in your stool, diarrhea and constipation a functional medicine practioner can you help you figure out whats going on. Remember if you have problems in your gut, you probably have other symptoms that are impacting the quality of your life as you may not be absorbing basic nutrients properly!

These are the tests I am doing:

– A hydrogen breath test (HBT): (I am doing Bacterial Overgrowth by Genova $185). This will test for abnormal growth of bacteria in the intestine. Symptoms you may be experiencing are abdominal pain, bloating, gas, belching, constipation and/or diarrhea. An HBT draws from the fact that there is not a source for hydrogen gas in our bodies other than the bacterial metabolism of carbohydrate. In this test after fasting for 12 hours and eating a low fiber diet the day or two before (chicken and white rice) the concentration of hydrogen (and sometimes methane) is measured in your exhaled breath for 1-2 hours after drinking a solution of some sort of sugar (usually lactulose). If you have defective sugar absorption, the unabsorbed sugars are available in the colon for bacterial fermentation. In SIBO (small intestine bacterial overgrowth) the bacteria migrates to the small intestine gaining access to the malabsorbed sugar causing your symptoms and hydrogen gas to be present in the collected breathe.

There can be false positives, it is important to work with an experienced practioner that can look at other factors/tests to confirm your diagnosis.

Treatment will include an antibiotic called riaximin, botanical antimicrobials and a SIBO diet protocol; there are certain foods and additives that exasperate this problem. I will list some resources at the bottom if you want to do some additional reading.

To order this test click here

– A stool test. Yes you heard me right. You poop in a cup, scoop some of it out, mix it in a test tube with some liquid and ship it off to a lab. If you can stomach that part, you can find out a whole host of things that are going on inside of your body! I am doing the GI effects by Genova and the Diagnostic Solutions GI-Map (both around $130) they tell slightly different things, you probably do not need both so discuss with your practitioner. Stool tests can help diagnose conditions affecting the digestive tract. They look for parasites, yeast and bacteria that can cause infection. Inflammatory markers and stool PH, which when low can show poor absorption of carbohydrate and fat or if high can indicate inflammation. It can look at your gut mucosal barrier integrity (leaky gut) and short-chain fatty acids. Poor nutrient absorption can be identified by looking for fecal fat, which can diagnose celiac, cystic fibrosis and pancreatitis and/or lack of enzymes, which can affect pancreatic function. A trained practitioner can analyze all of this and help you design a protocol to improve your gut health.

To order this test click here

– An Amino Acid test (Ion 40 with Amino Acids and Vitamin K, Genova $220)

This is a lab that will measure essential vitamins, minerals, amino acids, and fatty acids and to see if your body has the adequate reserve of these nutrients to meet the demands you body has as well as support your tissues needs. Markers are identified where there are special needs or dangers. If you have had a DNA test and have any genetic mutations (I did 23 and me and had some mutations. 23 and me is a DNA test like Ancesteralize me that reports back information on your ancestry, wellness, carrier status and traits based on your DNA from saliva) this test can help show whether these mutations will actually affect you. Just because you have a mutation does not mean it is actually doing anything in your body. This test can help identify whether the nutrients affected by these mutation are indeed low or compromised. Things such as dietary protein adequacy, gastrointestinal dysfunction, kidney function, inflammation, detoxification impairment, cardiovascular disease, neurological dysfunction, and metabolism problems are a few other things that can be indentified on this test.

To order this test click here

To summarize:

There are many things that can affect gut health. Because 70-80% of your immune system resides in your gut, symptoms of digestive distress can indicate that things are off in your body. Even symptoms that seem unrelated such as depression, fatigue, low concentration and pain could indicate poor gut health. I am choosing not to treat my digestive symptoms with a drug that may or may not work, cover the underlying cause and have substantial side effects, I am attempting to use functional medicine testing to identify the root cause of my problems. Working with a qualified practitioner can help identify areas that need to be addressed. Improvement in gut health will help to heal a whole host of problems in the body.

If you have been to more that one Doctor for chronic illness and cannot seem to find relief, I highly recommend first trying an elimination diet (Remove gluten dairy and sugar from your diet for at least 2-4 weeks)

My favorite elimination diets:

http://whole30.com

http://21daysugardetox.com

http://drhyman.com/10dd-course

http://jjvirgin.com/programs/

http://lyngenet.com

If you have tried changing your diet or you have not had success with diet alone here are my favorite resources:

To find a Functional Medicine practitioner to run these tests, go here: https://www.functionalmedicine.org/practitioner_search.aspx?id=117

To read about Gut health:

http://my.chriskresser.com/ebook/gut-health/?_ga=1.109802501.165779949.1418771164

To read about SIBO:

https://chriskresser.com/sibo-what-causes-it-and-why-its-so-hard-to-treat/