As Hippocrates once said, “all disease begins in the gut”. At The Natural Nutritionist, we believe the equal and opposite to be true, which is that all good health begins in the gut. It’s for this reason we place such emphasis on digestive health in the clinic.
Less than optimal digestive health can present in more ways than one, including digestive discomfort, inconsistent bowel motions, nutrient deficiency, food intolerance, low energy, low mood, brain fog, compromised immune functions and inflammatory conditions such as autoimmune and cardiovascular disease.
The root cause for many of these presentations can vary from medically diagnosed conditions such as coeliac disease, irritable bowel disease (IBD), bowel cancer and Helicobacter Pylori (H Pylori) to the more subtle parasitic infections, bacterial imbalance (dysbiosis), yeast and mould overgrowths, suppressed immune function and food intolerances. Given your goal should always be to ‘address root cause’ ensuring all the necessary testing has been done is critical. Here we share a few simple steps for gut health testing.
Step 1: Assess for ‘Red Flags’
If signs of digestive ill-health are present, take note of whether they’re accompanied with recognised ‘red flags’. Red flags include blood in the stool, waking at night to pass a bowel motion, family history of bowel cancer, recurrent vomiting, persistent diarrhoea and accompanying fever, unexplained anaemia and age of onset (presentation of symptoms over the age of 50 is considered a red flag).
If red flags are present, one or more of following tests should be carried out with the guidance of a health professional:
- Faecal calprotectin: a stool test where the optimal result is less than 50 ug/g and anything more suggests the presence of inflammation and possibly irritable bowel disease (IBD).
- Faecal occult blood: a stool test where the optimal result would be negative, and a positive result may indicate anything from cancer to polyps and haemorrhoids.
- HLA DQ2 & HLA DQ8 gene testing: a blood test where the results could indicate the genetic potential for coeliac disease. Over 99% of people affected by coeliac disease have the HLA DQ2, HLA DQ8 or parts of these genes but only 1 in 40 who have the genes will develop coeliac disease.
- Coeliac serology: a blood test measuring the antibody levels (IgA anti-tTg and endomysial antibodies) where elevated levels are indicative (but not diagnostic) for coeliac disease. Gluten must be consumed for 6 weeks prior to testing for an accurate result.
- Full blood examination (FBE): a blood test used to assess markers of immune health and red blood cell health such as haemoglobin, MCV and WCC. Less than optimal levels may indicate inflammation, increased intestinal permeability, poor nutrient absorption or the potential for coeliac disease
- C-Reactive Protein (CRP): a blood test used to detect inflammation where the goal is less than 1 mg/L.
- Nutritional markers including iron studies and zinc: a blood test where less than optimal levels may indicate inflammation, increased intestinal permeability, poor nutrient absorption or the potential for coeliac disease.
Should any of the results appear outside of the ideal it’s important you work with a trained health professional, or team of health professionals, to treat accordingly. In many cases, progressing to step 2 is warranted.
Step 2: Functional Testing
Carrying out functional digestive health testing is warranted in cases where red flags aren’t present, and a targeted approach is needed – as we always say ‘test don’t guess’. Where red flags are present, and the individual is ready for further assessment, functional testing can form a very useful part of the longer-term treatment strategy.
There are many tests on the market, ranging in both cost and clinical relevance so I highly recommend working with a trained and experienced professional to firstly determine which test is most relevant as well as how to treat the results.
In our clinic there are three tests most used, and they include:
1. The Complete Microbiome Map or GI-MAP:
This stool test assesses immune and digestive markers including calprotectin, coeliac antibodies, occult blood and sIGA. It provides a microbiome analysis with particular attention on the microbes that cause disease or that disrupt normal microbial balance contributing to illness and symptomology. It also screens for parasites, fungi and virus.
It’s a comprehensive test relevant to those with medically diagnosed IBS or IBD and any of the signs of digestive discomfort listed above. Review a sample report here.
A simple stool smear sample, MetaBiome is a comprehensive gut microbiome test which provides a complete picture of the microbes in the gut as well as their functional potential. It’s an incredibly detailed test, using the most up to date technology and relevant data. You can learn more about it here.
This test is most relevant for those with diagnosed IBD, coeliac disease, a past history of bowl cancer, autoimmune conditions, chemical sensitivity, mood disorders and/or metabolic disease or risk factors.
3. SIBO Breath Testing:
A breath test used to gain understanding of the bacterial load within the small intestine. This test is most relevant in those not presenting with red flags but who are presenting with significant post meal bloating, inconsistent bowel motions, FODMAP intolerance, nutrient deficiencies and many other symptoms. You can learn more about SIBO here.
We hope this clarifies your next steps to optimise your gut health and find the root cause for your “red flags”. If you’re in need of support with either or both of the steps above the team at The Natural Nutritionist would love to be your guide. Please book a complimentary 15-minute chat here to discuss this further.