Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (53 page)

Infants

1.
Does your baby have severe intermittent colic?

2.
Does your baby persistently bang his or her head against the crib?

3.
Is your baby a chronic crier?

4.
Does your baby show a blotchy rash around the perianal area?

INTERPRETATION OF QUESTIONNAIRE

If you answered “yes” to more than 40 items, you are at high risk for parasites.

If you answered “yes” to more than 30 items, you are at moderate risk for parasites.

If you answered “yes” to more than 20 items, you are at risk.

If you are not exhibiting any overt symptoms now, remember that many parasitic infections can be dormant and then spring to life when you least expect them. Be aware that symptoms that come and go may still point to an underlying parasitic infection because of reproductive cycles. The various developmental stages of parasites often produce a variety of metabolic toxins and mechanical irritations in several areas of the body—for example, pinworms can stimulate asthmatic attacks because of their movement into the upper respiratory tract.

Source: Used with permission from Ann Louise Gittleman,
Guess What Came to Dinner?
Garden City Park, NY: Avery Publishing Group, 1993.

Organic acid urine testing provides a noninvasive window into how well your metabolism is working. Organic acids are formed as by-products of cellular metabolism, digestion of food, and by the metabolism of the gut microbes such as bacteria and yeast. I consider this test to be a general functional medicine screening and use it often. What comes out in our urine can give profound information about nutritional and immunological factors, including fatty acid metabolism, neurotransmitter metabolism, carbohydrate metabolism, oxidative damage, energy production, detoxification status, B-complex sufficiency, dysbiosis, methylation abilities, and inflammatory reactions. This is probably the best test for determining whether candidiasis is present. You can obtain this type of testing from Great Plains Lab, Genova Diagnostics Lab, Metametrix Lab, and others. It’s a simple urine test, done at home and mailed back to the lab for analysis.

This test differs from the comprehensive digestive stool analysis in that it tests for dysbiosis of the small rather than the large intestine. According to Pimentel 78 percent of people with IBS or fibromyalgia, and many with restless leg syndrome and chronic fatigue syndrome, have small intestinal bacterial overgrowth (SIBO). The SIBO test measures breath levels of hydrogen or methane to determine whether there is a bacterial infection in the small intestine. Small bowel overgrowth occurs when bacteria in the large intestine travel to the small intestine. To perform the test, you drink either a lactulose or a glucose drink and collect breath samples. Hydrogen is produced when lactulose or glucose comes in contact with the gut flora. A significant rise in hydrogen levels indicates SIBO. This test is currently available at large teaching hospitals, from gastroenterologists, through functional medicine labs, and at
http://www.mybreathtestkit.com
.

The method that has rapidly become the recognized standard for intestinal permeability testing is the mannitol and lactulose test. Mannitol and lactulose are two types of water-soluble sugar molecules that our bodies cannot metabolize or use and are absorbed into the bloodstream at different rates due to their different sizes. Mannitol is easily absorbed into cells by people with healthy digestion, while lactulose has such a large molecular size that it is only slightly absorbed. A healthy test shows high levels of mannitol and low levels of lactulose. If large amounts of mannitol and lactulose are present, it indicates a leaky gut condition. If low levels of both sugars are found, it indicates general malabsorption of all nutrients. Low mannitol levels with high lactulose levels have been found in people with celiac disease, Crohn’s disease, and ulcerative colitis. Your doctor can give you a test kit to collect urine samples. After collecting a random urine sample, you drink a mannitol/lactulose mixture and collect urine for six hours. The samples are then sent to the laboratory. This test is often done in conjunction with a CDSA or a parasitology test.

Although this is a terrific test, I rarely use it because it doesn’t tell me why someone has the problem. I’d rather do stool testing and food sensitivity and environmental testing to discover the cause rather than just verify that increased permeability is occurring. Nonetheless, it can be useful to help monitor what’s going on.

Proteins are chains of amino acids put together. The average adult has about 22 pounds of protein in his or her body. These proteins are used structurally, as enzymes, and as neurotransmitters, and they are in every cell in our bodies. Using either blood or urine testing, you can determine whether your body is able to break down food and cellular proteins into usable amino acids. If levels are low, first look at food intake of protein. Are you actually eating enough of it? Typically we need about ½ gram of protein for each pound of our body weight. Surprisingly, I often discover low amino acids in people who have low energy, in children and adults who are “failing to thrive,” and in people with emotional, behavioral, learning, and mood disorders, even in people who are eating enough protein. Correcting this requires a two-point approach: first, giving free amino acids and easy-to-digest proteins from foods or medical foods, and second, trying to find the underlying mechanism for the malabsorption.

Often we eat the wrong balance of fats, and fats can modulate mood and inflammation. Testing for essential and nonessential fatty acids can be done through either standard blood testing or by a finger-prick blood test. Surprisingly, in people who have been taking fish oils for a long time, we often see people who have terrific levels of omega-3 fatty acids but low levels of beneficial omega-6 fatty acids. It’s the balance of total fats in our diet that creates health and reduces inflammation.

The indican test, or Obermeyer test, is a urine test that looks for the presence of indoles in your urine. The level of indican (a type of indole) found in urine gives information about how well you metabolize protein. People with poor digestive function, malabsorption, dysbiosis, gluten problems, and putrefaction of foods have high indican levels. Indican testing is an inexpensive, noninvasive way to screen for faulty digestion. The test won’t identify where the problem begins, but it can be used to monitor whether digestion is an issue and how well the treatment plan is working. This test isn’t done that often, even though it’s a simple in-office test, because the chemicals are toxic.

There are two ways to test yourself for lactose intolerance: You can do a home elimination or you can do a breath test. Both are detailed in this section.

This self-test requires eliminating all dairy products from your diet for 10 to 14 days. Obvious dairy sources are milk, yogurt, cheese, ice cream, creamed soups, frozen yogurt, powdered milk, and whipped cream. Less obvious sources are bakery items, cookies, hot dogs, lunchmeats, milk chocolate, most nondairy creamers, pancakes, protein-powder drinks, ranch dressing, and anything containing casein, caseinate, lactose, sodium caseinate, or whey. If you’re not sure what’s in a food, avoid it during the testing period. It’s probably easiest to prepare all of your food at home and go to work or school with a bag lunch during the test. If you eat at a restaurant or at a friend’s home for a meal, be specific about what you eat.

If lactose intolerance is causing your problems, you will probably notice that your symptoms have changed significantly and that reintroduction of dairy products triggers a return of symptoms. Most people with lactose intolerance can tolerate small amounts of dairy products or specific dairy products. I, personally, don’t drink milk but do well with kefir and raw milk cheeses.

This simple, noninvasive, doctor-ordered test determines whether lactose intolerance is causing a digestive problem and/or contributing to another health problem. This test is ideal for people who have difficulty completing the self-test described above or are confused about their findings. First, you breathe into a bag to supply a baseline sample; then you drink a small amount of a lactose solution. You then breathe into a different bag, and finally, lab technicians measure the amounts of hydrogen and methane gas exhaled in both samples.

A normal hydrogen level is 10 parts per million (ppm), whereas levels of 20 ppm or more are commonly found in people with lactose intolerance. Normal methane levels are 0–7 ppm, and an increase of 12 ppm or more between the two samples indicates lactose intolerance, even if one’s hydrogen production is normal. Measuring both methane and hydrogen considerably decreases the likelihood of a false result. Antibiotics, enemas, and laxative use are common reasons for false negative results, which occur 5 percent of the time. This test has a few false positive results, which are generally caused by eating high-fiber foods beforehand, exposure to cigarette smoke,
or sleeping during testing. This test is available from gastroenterologists, or at
http://www.mybreathtestkit.com
.

Diagnosis of fructose intolerance is done with hydrogen breath testing and is very similar to the test for lactose intolerance. Instead of drinking a lactose solution, you’ll be given a fructose drink. To get the best results, eat a low-carbohydrate, low-fiber, non-dairy meal the night before, such as a piece of chicken or fish with a nice salad. Avoid fruit, fruit juice, soft drinks, beer, wine, and sweetened teas 24 hours prior to the test. This test can be ordered through any gastroenterologist or online or at
http://www.mybreathtestkit.com
.

You can find secretory IgA (sIgA) levels in stool, saliva, and blood; sIgA is an immunoglobulin antibody found in saliva, throughout the digestive tract, and in mucous secretions throughout the body. It provides our first line of defense against bacteria, food residue, fungus, parasites, and viruses. (It is explained more fully in
Chapter 9
, “Fire in the Gut.”) By sitting on mucous membranes, sIgA prevents invaders from attaching to them and neutralizes them.

High levels indicate that your immune system is dealing with some stressor, such as an infection or high levels of stress. Low levels indicate that you’ve been fighting the stressor for such a long time that your body can’t mount a response.

The Heidelberg capsule test is a radiotelemetry test for functional hydrochloric acid (HCl) levels. It is a simple, effective technique to determine how much HCl your stomach is producing.

In this test, you swallow an encapsulated radio transmitter that’s about the size of a B-complex vitamin; the device measures the resting pH of the stomach and also the stomach’s pH when administered baking soda, which is very alkaline. Then, by observing how quickly the stomach returns to an acidic condition after the baking
soda challenges, the physician can determine whether or not your stomach produces adequate HCl. Unfortunately, this test is not widely available.

Many of us have low hydrochloric acid levels. This opens us up to small intestinal bacterial overgrowth, fungal and parasitic infections, poor digestion of protein, and poor absorption of minerals. There is a simple way to test to see if you have enough HCl. However, please read the precautions carefully before doing this experiment.

You are taking acid. Too much will burn your stomach.
Stop
taking with any discomfort.