Testing For The Root Cause Of Your Digestive Problems

This article originally appeared on Healevate.

Nothing says good morning quite like pooping into a toilet hat and transferring part of that specimen, using a spoon, into a test tube. While this might sound a little gross on the surface, it can tell you a lot about your health.

The condition of your gut and how well you can absorb, utilize, and eliminate nutrients represents the foundation of health in your body. Digestive symptoms manifest as anything from brain fog, fatigue and acne, to diarrhea, gas, and bloating. The symptoms are vast and can be confusing, so clearly knowing what you’re looking for helps.

Symptoms of Digestive Problems

Understanding your symptoms can be a useful guide for choosing the correct test.

GI: Gas, bloating, belching, stomach pain, constipation, diarrhea, undigested food particles or fat in stool, gurgling in stomach, acid reflux, malabsorption, cankers, altered motility or gastroparesis, and food sensitivities or allergies.
Immune: Allergies, asthma, chronic sinus infections, frequent infections such as urinary tract infections, Candida overgrowth, and autoimmune conditions.
Liver: Poor detoxification, recirculation of toxins and hormones from bacterial deconjugation, increased or decreased bile production, and pain under the lower right ribs.
Skin: Itching, hives, acne, rosacea, rashes, eczema, psoriasis, and dermatitis.
Musculoskeletal: Joint pain, muscle pain, and fibromyalgia.
Brain and Mood: Headache, fatigue, neuropathy, brain fog, inability to focus, irritability, anxiety, depression, ADD/ADHD, lack of coordination or balance, and poor memory.
Hormones: Fatigue, poor temperature control, weight gain or weight loss, poor sleep quality, food cravings, poor blood sugar regulation, and hormone imbalances.

Which Test Do I Choose for Digestive Problems?

Choosing digestive tests can be a daunting task, especially when the symptoms seem to be coming from everywhere in your body. Starting off with the basics and expanding from there is always a good way to proceed when doing any testing.

The first thing to consider is if the symptoms suggest an acute infection, such as parasites or food poisoning. If this is the case, then testing to identify the organism is best. This usually involves a stool test and/or blood testing.

If your symptoms are chronic or more vague, then approaching tests with a broader scope can more easily pinpoint the root causes (there are often many). Dysbiosis, malabsorption, nutrient depletion, and GI dysfunctions like increased or decreased transit time often occur together.

When using this approach, the first goal is to identify and eliminate all pathogens, because if they’re present, you’ll have dysbiosis. Next, identifying the composition of the gut flora and checking immune and gut function will help direct treatment in the healing and rebuilding phases.

Occasionally, things don’t go like you want them to and further testing is warranted. Some companies offer specialty tests for food sensitivities or allergies (like celiac), detoxification, specific toxin testing, and hidden infections. We’ll get to these types of tests later on.

Digestive Testing

General tests can be completed by lab companies such as LabCorp or Quest, as well as specialty labs:

  • Stool testing (1- or 3-day)
  • Serum blood testing for infections such as bacteria or yeast
  • Antibody or antigen testing for certain bacteria, yeast, or viral infections

Functional tests are more in-depth than standard digestive tests. They’re provided by specialty labs and often require a practitioner to request them for you:

  • Organic acids dysbiosis profile
  • Comprehensive digestive stool analysis (CDSA)
  • Intestinal permeability
  • Lactose intolerance breath testing
  • SIBO (small intestinal bacterial overgrowth) breath testing

Stool Testing

Stool testing is just what it sounds like—an examination of your stool for good and bad organisms, toxins, and the presence of blood.

Typically, stool tests incorporate a stool culture of common bacteria, microscopic analysis for yeast, fungi, parasites, and blood cells, and sometimes testing for toxins that organisms excrete, such as the Shiga toxins (E. coli) or Clostridium difficile toxins A and B.

Additionally, most of the functional/specialty labs do antibody tests for hard-to-identify organisms, such as Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica, and Helicobacter pylori as a part of their normal stool testing.

One of the big differences is that some labs offer one-day tests while others offer three-day tests. The benefit to three days’ worth of samples is that there’s a greater chance of identifying elusive GI organisms.

That’s not the whole story, though. While most labs rely on traditional methods to identify organisms, some labs offer PCR-based testing, which means they’re using DNA to identify and only require one sample.

Standard stool testing is offered by traditional lab companies. Expanded stool testing is offered by specialty labs such as BioHealth Laboratory, Genova Diagnostics, and Doctor’s Data. DRG Laboratory offers PCR-based stool testing.

Serum Testing for Infections

Serum testing requires a blood draw, and the sample will be used to identify any organisms in your bloodstream. This may happen if you’ve had a systemic illness that may have spread from another area, such as the digestive or urinary tracts.

Bacteria, yeast, and other fungi are often identified in this manner. Yeast is especially important to consider here, because it’s opportunistic and will go beyond the limits of the GI tract in people with compromised immune function or co-infections.

This test is most likely to be conducted through a standard lab, at a hospital, or through your doctor’s office. It’s not something offered through specialty labs.

Antibody or Antigen Testing for Infections

Antibody testing is similar to serum testing in that it offers another means of identifying sometimes hard-to-locate organisms. Antibody testing can be done on blood or stool. When you have an infection, your body mounts an immune attack and creates antibodies against that specific organism’s antigen (the protein your body identifies as foreign).

Antibody tests measure your body’s immune response to an organism. This type of testing lets you know that there was an organism present at some moment in time, but it won’t necessarily tell you if it’s active, since antibodies can remain elevated even after the intruder is eliminated.

Similarly, antigen testing can identify the presence of an organism. Performing a stool antigen test for H. pylori is a preferred method, as it’s less invasive than other methods and is both sensitive and specific for active infection.

Antibody and antigen testing can be run through standard labs, as well as via BioHealth Laboratory, Genova Diagnostics, Doctor’s Data, and DRG Laboratory.

Organic Acids Dysbiosis Profile

Urinary organic acids measure the byproducts of your metabolic processes. Specifically, it’s measuring the metabolites produced by the bacteria and yeast living in your gut. This is a simple and non-invasive test, since it requires only a urine sample.

Intestinal bacterial overgrowth and yeast infections will cause elevated metabolites, and they’re also useful in assessing carbohydrate and protein malabsorption.

Urinary organic acid testing is available through Great Plains Laboratories and Genova Diagnostics.

Comprehensive Digestive Stool Analysis (CDSA)

Comprehensive digestive stool analysis is another way to evaluate the health of the GI tract. Using microbial growth-based cultures, biochemical assays, and microscopic evaluation, this thorough test assesses the status of beneficial and pathogenic microorganisms, including aerobic and anaerobic bacteria, yeast, and parasites. Specific analysis includes:

  • Identification of pathogenic bacteria, parasites, and fungi, and levels of beneficial bacteria
  • Protein, carbohydrate, and fat absorption via elastase and chymotrypsin levels, as well as the presence of meat and vegetable fibers and fats
  • Inflammatory markers including lactoferrin, lysozyme, eosinophil protein x, calprotectin, and the presence of mucus or blood cells
  • Immune function via sIgA levels (secretory IgA)

Many of these markers can also be tested as smaller profiles or individual tests. The full test is offered by Genova Diagnostics and Doctor’s Data, while DRG Laboratories can do a pared-down version with their stool PCR testing.

Intestinal Permeability Testing

This test provides a method for verifying the presence of increased intestinal permeability, also called leaky gut. Leaky gut allows food particles, toxins, and products of dysbiosis to enter the bloodstream, where an immune response mounts and inflammation is produced. It’s implicated in many conditions, from IBS to autoimmunity.

One version of the test, the Lactulose-Mannitol test, requires you to drink a solution of the sugars lactulose and mannitol. The degree of permeability is assessed by the amount of sugar recovered in urine.

An updated version of permeability testing called Intestinal Antigenic Permeability Screening assesses IgA, IgM, and IgG antibody reactions to bacterial endotoxins (LPS) that have entered the bloodstream. It also measures the tight junction proteins zonulin and occludin that break down in leaky gut, as well as a cell structure component called actomyosin. This test may more specifically show the route of gut barrier damage.

Genova Diagnostics and Doctor’s Data offer Lactulose-Mannitol testing. Cyrex Labs has the Array 2: Intestinal Antigenic Permeability Screening.

Lactose Intolerance Breath Testing

Lactose intolerance is one of the most common food intolerances in the US. Consumption of dairy that causes gas, bloating, diarrhea, and abdominal pain is an indication for this type of test. Inability to break down the dairy sugar lactose because of a lack of the digestive enzyme lactase or intestinal irritation results in lactose malabsorption and digestive symptoms.

This test requires you to drink a lactose solution and then take breath samples over a period of several hours. It measures the amount of hydrogen and methane produced when undigested and absorbed lactose is fermented by gut bacteria.

Genova Diagnostics offers this test.

SIBO Breath Testing

Small intestinal bacterial overgrowth (SIBO) occurs when large amounts of bacteria are present in the small intestine, where there are normally very few. The small intestine is where absorption largely takes place, so there’s little need of bacteria.

The symptoms are similar to lactose intolerance, because the bacteria are fermenting undigested foods (especially carbohydrates) and producing methane or hydrogen. Bloating, gas, abdominal pain, diarrhea, and constipation are classic symptoms.

During this test, you consume solution of glucose or lactulose, and then breath samples are taken over a period of 2-3 hours. The test measures the amount of hydrogen and methane produced when undigested and unabsorbed lactose is fermented by gut bacteria. High methane is associated with constipation, and high hydrogen levels correlate with diarrhea.

Genova Diagnostic and Commonwealth Labs both offer this test.

Summary

There’s certainly no shortage of digestive testing for you to explore. If you don’t get answers from basic tests, perhaps it could be time to consider more functional testing. Many of the tests referenced above can be ordered through Direct Labs, and can shed much light on the root causes of your health symptoms- and like G.I. Joe used to say, knowing is half the battle.

Save

How to Test for Hidden Food Allergies or Sensitivities

This article originally appeared on Healevate.

If you’re experiencing a variety of health symptoms and have no known food allergies or sensitivities, you might wonder why you’d need to test yourself for them. You may believe that simply cleaning up your diet and eliminating soda, baked goods, sugar, and processed foods is enough. And while that’s certainly a good start, it’s not nearly enough to eliminate the immune and inflammatory processes that food reactions can cause.

Since eating is such an automatic process for most of us, we never stop to consider whether the symptoms we’re experiencing are related to food unless the reaction occurs while we’re actually eating or very soon thereafter.

If you have brain fog, fatigue, congestion, rashes, joint pain, or headaches, there’s a pretty good chance that your body is reacting to something you’re eating.

For many people, food is the most inflammatory substance they encounter on a daily basis. Because we eat multiple times a day, and because we’re creatures of habit, we tend to consume the same things, giving the immune system the opportunity to react.

Food sensitivities and allergies cause many symptoms, especially if you have a leaky gut. Any symptoms of inflammation or autoimmunity can point to food intolerances, so the list is vast.

Symptoms of Food Allergies and Sensitivities

The symptoms of food intolerance can manifest quickly, as with a swollen tongue or anaphylaxis, but quite often the symptoms are delayed. This makes them hard to pick up on, as well as attribute to a certain food.

Immune/inflammation: Allergies, asthma, runny nose, post nasal drip, unresolved infections, autoimmunity, swelling, wheezing, coughing, anaphylaxis, throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, GERD (acid reflux), IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), canker sores.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, insomnia.

Nerves: Tingling, pins and needles, numbness, paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating.

Musculoskeletal: Joint and muscle pain, muscle weakness, fibromyalgia.

Liver: Poor detoxification, chemical sensitivity.

Cardiovascular: Low blood pressure, rapid heart rate, palpitations.

The First Food Allergy or Sensitivity Test To Perform

The first method of screening isn’t a lab test at all. It’s an elimination diet. Eliminating the most common sources of food intolerances is a great way to find out if you have an issue.

Removing gluten, dairy, corn, soy, eggs, and nuts from your diet for 4 weeks, then adding them back one single food (not food group) at a time over a period of 3 days should tell you whether your body is reacting to something.

If you have a known autoimmune condition, you may also want to include the nightshade vegetables, such as tomatoes, potatoes, sweet and hot peppers, eggplant, and spices made from these, as well as gluten cross-reactive foods like coffee, chocolate, and the gluten-free grains.

If any of the previously mentioned symptoms appear during that 72-hour window, you should avoid that food for at least 6 months to give your immune system a break and let the inflammation go down.

This method can you help you to identify the source of your food troubles, but for some, reactions can occur to even the healthiest foods, such as blueberries or spinach, especially if they have a leaky gut. To further complicate matters, not only do the foods themselves cause a response, but the additives, colorings and gum resins (binders used in gluten-free foods) do as well. This is where testing can be valuable.

Food Allergies vs Food Sensitivities

Food allergies and sensitivities are very different issues. A food allergy occurs when the immune system identifies a food as a foreign substance and attacks it. This response occurs on a spectrum and can be anything from a swollen tongue to anaphylaxis, which is a potentially life-threatening reaction.

Food allergies are tested by measuring antibodies in the blood against particular foods. IgE and IgG are commonly measured. If you have an obvious response to a food, you can confirm it with this type of testing.

Food sensitivities are the more common and elusive form of food intolerance. They’re more vague than allergies and are considered to be any toxic or inflammatory response to food. Quite often they’re mediated by a lack of enzymes, stomach acid, and/or a leaky gut. Celiac disease is a perfect example, where a severe intolerance to gluten causes the destruction of the surface of the small intestine.

Testing for food sensitivities offers a variety of options; antibody and mediator release testing (MRT) are two of the better ones available. No matter what test you choose, be aware that if you have a leaky gut, there’s a good chance you’ll be reacting to many of the foods you eat.

Food Allergy and Sensitivity Tests

There are several types of testing available for identifying food allergies and sensitivities. IgE testing represents the true food allergy test. IgG testing can also identify allergies, but more commonly, it shows delayed sensitivity reactions. The rest of the testing options are for intolerances or sensitivities only.

  • IgE antibody test
  • IgG and IgA antibody test
  • Gluten and gluten cross-reactivity tests
  • MRT test

IgE Antibody Testing for Food Allergies

Antibodies are produced when your body mounts an immune attack on a substance it has identified as foreign, which in this case is food. It creates antibodies against specific proteins (antigens) in that food. Antibody tests measure your body’s immune response to a particular substance or organism.

There are several categories of antibodies. IgE antibodies are created when your body has a true allergic response to a substance, which is why traditional food allergy testing analyzes antibody levels in the blood. An IgE allergy is considered a fixed allergy in that it will almost always provoke an immune response when the food is consumed. This type of food allergy elicits an immediate response.

This test can be completed by traditional labs such as LabCorp or Quest, as well as the specialty lab companies Alletess Medical Laboratory and Great Plains Laboratory. IgE testing can easily be ordered online through Direct Labs.

IgG and IgA Antibody Testing for Food Allergies and Sensitivities

In spite of having an allergy, you can still yield a negative IgE test result. This is why it’s important to test IgG levels as well. IgG antibodies measure a delayed hypersensitivity reaction, which can take up to 72 hours to occur. These are the more difficult reactions to link to a particular food, so testing can be helpful here. IgG antibodies are the most prevalent antibodies in systemic circulation and are the most common form of immune-mediated food responses.

While some IgG responses represent true allergies, most are hypersensitivities or intolerances. Similarly, IgA antibodies also represent delayed hypersensitivities. They can take many hours or days to occur and operate in a low-and-slow manner.

Traditional labs such as LabCorp or Quest will offer this test. Genova Diagnostics offers an IgG test. Alletess Medical Laboratory offers stand-alone IgG testing, combined IgG and IgE testing, and IgA testing. Cyrex Laboratories offers the Array 10: Multiple Food Reactivity Screen that measures IgG and IgA levels. The Array 10 tests raw and cooked foods, additives, gum resins, and brewed beverages.

All of these IgG and IgA tests can be ordered online through Direct Labs.

Gluten and Gluten Cross-Reactivity Tests

If you suspect that you’re sensitive to gluten, or even have full-blown celiac disease, testing is an important piece of the puzzle. Gluten testing involves analyzing the IgG and IgA response to various components of the gluten molecule, including several gliadins, glutenins, gluteomorphins (made during the digestion of gliadin), and the intestinal enzyme transglutaminase. It’s important to note that you must consume gluten for this test to be as accurate as possible.

Once you confirm gluten intolerance or celiac disease, completing gluten cross-reactivity testing is helpful, since these foods elicit the same response from the immune system as gluten does. This means that they contain similar protein sequences as the gluten molecule (molecular mimicry). Milk, whey, chocolate, coffee, soy, potatoes, corn, eggs, and most gluten-free grains (including rice) are considered cross-reactive.

Conventional lab companies offer gluten testing and the Array 4: Gluten Associated Cross-Reactive Foods test. This test can be ordered online through Direct Labs.

Mediator Response Test (MRT)

The MRT utilizes different technology than antibody testing. It quantifies the inflammatory response to specific foods and additives. Mediator release refers to the inflammatory chemicals that are liberated from your cells in response to a sensitizing food.

Instead of measuring antibody production, this test measures your white blood cells’ chemical response to a food. It gauges the cells’ change in volume, which comes from the release of inflammatory chemicals such as histamine and cytokines. A non-reactive food will produce no change, while a reactive food will produce an increase or decrease in cell volume.

This is a blood test and is only offered by Oxford BioMedical Technologies.

The Bottom Line on Food Allergy and Sensitivity Tests

Start with the basics and conduct an elimination diet. That alone will give you new information to work with. From there, spend money only on the testing that could reveal new information that would alter your approach to food. If you’re already 100% gluten-free and are avoiding all cross-reactive foods as well, then gluten testing would be a waste of time and money.

So be smart and be proactive. Discovering hidden food allergies or sensitivities could make a huge difference in your day to day health.

Save

Save