Uncovering Digestive and Chronic Illness

Not feeling well? Unfortunately it can difficult to find a quick answer. Every system in your body is interrelated and current medical science still has a long way to go in studying the key to long-term health and what makes a healthy gut microbiome. Before changing your diet on a whim here are some ideas to help you communicate with your doctor, know what specific tests to ask for, and start to get answers to what may be going wrong.

Communicating With Your Doctor

• Bring in a written list of your symptoms.
  It also never hurts to bring someone with you to your appointment. Sometimes it can be difficult to remember everything on the spot.
  

• Bring a written listen of questions.
  It can be difficult to ask all the questions you wanted to ask, think of new follow up questions, and then also remember what the doctor said after you have left (especially if they're talking fast and looking at their computer screen 98% of the time, which is usually the case these days).
  

• Don't be afraid to speak medical terms you can't pronounce or never used before! Mumble and muck them up all you want, the most important thing is to ask the questions!
  

• Do your own research.
  Don't expect your doctor to have all the answers. From your doctor's perspective, you're a 15 minute pop quiz amidst two dozen other pop quizzes she already has that day... and everyday. Even when your problems are truly a complex midterm exam, unfortunately there's not enough time in the system to be treated like one. Everyone who tries to take a complicated midterm exam in 15 minutes will fail miserably. It's a tough set-up even for good doctors. Most doctors approach their pop quizzes by cutting through to the basic symptoms. A patient says, "I have X, Y, and Z wrong with me." The doctor says, "We treat X, Y, Z, with A, B, C. Here's A, if it doesn't work, we'll try B." It can be depressing feeling like you are being treated like one of a thousand broken toys on a conveyer belt at Santa's repair-shop the day before Christmas, especially when you know some of your problems are invisible.
  

• It's OKAY to use Google!
  A lot of doctors make fun of patients using the internet to diagnose their problems, but even doctors use Google. At my last appointment my doctor couldn't diagnose a rash I had and was Googling photos... the same thing I did at home. The internet carries up to date information and medical studies your doctor might not always be aware of. Also, when tests come back negative but symptoms persist, finding people who've had similar experiences can be a diagnostic tool.
  
  

• Ask about specific conditions you've researched and how to rule them out.
  One way to filter through this process is to research your symptoms beforehand, be bold and even guess what you may have, ask your doctor's opinion on it, and ask for the right tests. This will give you a broader understanding of your health. Also, don't treat every doctor's opinion as gold, especially if you have a different feeling about their conclusion. I have a long list of prescriptions I have never filled and ended up no worse for it.

• You are your own best advocate.
  Sometimes doctors can dismiss or downplay your symptoms. You know your body best. Be persistent and insistent. Never be afraid to be pushy or involved in your own health.

Getting Tested

Blood Tests

1. Check Vitamin Levels

   • Low vitamin levels can help indicate what is not being absorbed in your digestive tract. Despite low levels of iron and Vitamin D being common these also can be signs of Celiac Disease.

     • Test: Vitamin D, Iron, Vitamin B12, Vitamin A, Vitamin B6, Vitamin B9, Magnesium, Vitamin K2, Electrolytes, Protein, Zinc, Copper, Calcium

     • Also, if your doctor provides Micronutrient panels ask to check your Amino Acids

2. Liver Function Panel

   • If your liver function panel is elevated it can indicate Celiac Disease. It can also determine if any disease is causing damage to your liver.

     • Test: ALT, AST, ALKALINE PHOSPHATE and GGT

3. Celiac Disease Test

   • tTg-IGA

   • Endomysium AB, Serum

   • Endomysial IGA, TITER SERUM

4. Inflammation Markers

   • Erythrocyte Sedimentation Rate (ESR)

   • C-Reactive Protein (CRP)

5. Autoimmune Panel

   • ANA, HLA-B27, Thyroid Stimulating Hormone, Rheumatoid Factor Serum, Lyme

It is extremely important to go in and ask questions about specific testing. Doctor's may overlook symptoms or it may simply be out of the norm for them to do such tests on the average patient.

Doodie Tests

Horrifying, just horrifying, but similarly to how there is only way for Jurassic Park's Laura Dern to make sure the triceratops with symptoms of imbalance, disorientation, and labored breathing was not being exposed to poisonous West Indian Lilac berries was by reaching her hand in into a pile of dino droppings taller than Jeff Goldblum's head, that is also only way you can be sure you too are not being secretly poisoned by West Indian Lilac berries, or something like that.

Calprotectin and Lactoferrin: This can help determine if there is inflammation in your digestive tract.

Giardia, Cryptoporrium+E, Histolytica Antigen Screen: This rules out these infections.

H. Pylori. This can rule out a bacterial infection of H. Pylori.

Less common in traditional medicine, but more in functional medicine is full stool parasitology analysis with a bacterial and yeast culture to look for numerous types of dysbiotic flora.

Breath Tests

SIBO, also known as Small Intestinal Bacterial Overgrowth, can be a common culprit that is less understood, widely experienced, and uncommonly diagnosed. If you are experiencing gas, bloat, and stomach pain, be sure to do a breath test and go through an antibiotic or well-studied herbal treatment for SIBO. It will not go away on its own and can not be helped by diet. There is debate over the indicators of SIBO, how to test for it, and how to treat it. Traditional doctors did not acknowledge SIBO as a source of my stomach pain because they were looking for low Vitamin B12 and other markers I did not have. After taking a test from a fundamental doctor a finding methane dominant SIBO, the course of treatment had a drastic effect on relieving many of my symptoms.

Diagnostic Procedures

Colonoscopy & Endoscopy
Think you're too cool/young/special to need a colonoscopy? Think again! The best way to uncover what is going on inside your body is to actually look inside. Most of us would like to ignore the fact that the bodies we inhabit are essentially one huge ooey gooey tube from intake to output, but the truth of the matter is... we are! If your doctor recommends it, get a colonoscopy and endoscopy to check for inflammation, ulceration, polyps, or indicators of chronic illness to rule out Ulcerative Colitis, Crohn's Disease, and Celiac Disease. Endoscopies are required to confirm blood tests showing Celiac Disease.

MRE
An MRE in this case is not a meal ready to eat, but basically an MRI, but if your upper abdomen. You have to not eat for a bit and then drink some sugary liquid and get your small intestine scanned. In my case this was checking for Crohn's disease in the small intestine.

Capsule Endoscopy
In this procedure you swallow a pill camera to get a closer look of your digestive tract.

Abdominal CT SCAN

For suspected diverticulitis/diverticulosis a CT scan of the lower GI tract can be done to determine the location and size of an infected pocket of intestine to guide proper treatment.

Never Give Up

If you still don't have answers do not be ashamed to constantly switch doctors until you find a good one. When dealing with digestive issues, it can also be worth it to look into seeing a Functional Gastroenterologist. My path towards healing included many doctors, some traditional and a fundamental that really changed my understanding of what it takes to create a healthy environment for all the critters living in my oeey gooey tubes. Functional doctors are often not covered by insurance, but the positives are they usually are very thorough and will spend nearly a half hour just going over your history. They can prescribe blood tests for environmental toxins, especially mold which plays a role in some digestive diseases, gut permeability and food intolerances, as well as genetic testing.

Also *disclaimer* do not fully trust information on personal blogs about gastrointestinal diseases that also contain Jurassic Park references.