Suggestions on best tests for checking gut health

I live in the UK and I would like to get some tests of my gut health. I'm assuming I would have to supply a sample of faeces and send it through the post - I can't think of any other way I could test without involving the medical profession (which isn't an option).

The kind of thing I think I want to know is...

1) Do I have any parasites.

2) Do I have any bad bacteria, viruses, yeasts, fungi, moulds, or anything else that might live in the recesses of my insides that can be tested this way.

3) Do I have any blood showing up.

4) If I have any bad bacteria that would be best gotten rid of I would like to know what antibiotics they would be sensitive to.

5) Any other questions I ought to find out the answers to that I haven't thought of?

I know of the following companies that do some kinds of gut testing, but whether they do any tests worth the money, I don't know. I don't have a clue how to choose a good test.

Genova Diagnostics UK

Regenerus Labs

Medichecks

If anyone knows of any other company that is UK based who also do gut testing, I'd love to hear about them. I did look at Blue Horizon Medicals but their website has nothing on it just now, which is weird. It used to do loads of tests.

 

Hi @Arnie Pye,

GI health is an incredibly complicated thing to try and understand yourself - I know you say you don't want to involve the medical profession but does this extend to a nutritionist or functional medicine practitioner? These guys generally have a more open mind and would be better placed to assist you.

If you do go it alone one test of value is a hydrogen/methane breath test to diagnose SIBO (Small Intestinal Bacterial Overgrowth). It can be arranged by post and performed at home. Its quite simple to do, you exhale into a small bag and then capture the breath into small vacuum tubes - you do this at intervals for approx 3hrs after drinking a lactulose or glucose solution to see how your gut responds. The worst part of it is the very restrictive diet for 24hrs prior and the morning fast during, but otherwise it is easy and painless.

I have done several through BioLab and the cost is about £130, though I believe BioLab insist on it being ordered & interpreted by a professional (nutritionist or doctor). You may be able to order direct from another test provider.

SIBO symptoms are quite non-specific, but testing is generally indicated if you get a lot of bloating, flatulence, burping, stomach pain etc. after eating, especially if the meal is high in FODMAPs (fermentable carbohydrates). Its a common co-morbidity with POTS, hypermobility syndromes and other conditions that impact gut motility.

Ryan

 

Money is the issue - I don't have very much.

If I go to my own GP, as far as she is concerned she has arranged all the testing I required (ultrasound scan and MRI scans) and it all came back negative. I've even had a couple of colonoscopies, although they weren't directly given for this pain. The only thing that has ever helped with my gut pain is taking erythromycin, which was given to me for a different issue (infected mouth ulcers). It was amazing and totally unexpected - I've suffered this pain for 15 years now - it started after surgery I had done in 2003 (intermittently to begin with but has been continuous now for a very long time). Brain fog disappeared, I had energy, pain disappeared, and I felt the best I had in years. But as soon as I run out of the erythromycin the pain always comes back within a few days or a week or two. I've been on a course of them about three or four times now.

I think I might have a soft tissue infection outside the colon. I also wonder about severe leaky gut or diverticulitis.

I've done a SIBO test (Edit : and it came back negative) - but I can't remember whether it was a hydrogen breath test or a methane breath test. I'm pretty sure it wasn't both. I may be able to find out by looking at old letters from the hospital. It might be worth doing it again and making sure I do both tests.

 

As @Ryan31337 suggested Biolab, I thought I'd throw in my 2 cents worth.

I had professional help with digestive problems and they used Biolab. I had to pay, of course. They seemed fine.

When it comes to lab testing it is very easy to spend money on the wrong test, or to have the test done and then discover that the doc you go to has doubts about the accuracy of the test, how it was carried out, how old the sample was and how it was stored, which lab was used.

For example, the person I consulted used to occasionally check the labs they used by sending two identical samples, but using false details for one so they could check for consistency, or sending in a known negative or known positive sample to see if the lab picked it up.

The timing of tests might also be important, so you might want to test some things at the same time and read the results together. Other things you might want tested weeks, or months, apart.

It's a minefield.

 

The reaction to antibiotic chimes with our experience.
My daughter tested positive for H Pylori ( gp idea re fatigue as no overt symptoms other than burping).
Antibiotic made her feel much better . There was a thread that suggested this response could be due to D Lactate Acidosis ( but gp not so convinced)
Can' t remember if thread was here or on PR, but if you have gut issues it may be worth pursuing that theory .

 

Thanks for thereplies, @Ryan31337 and @Invisible Woman .

Even if I really pushed the boat out and paid for someone to help me privately, I still wouldn't have a clue how to find someone reputable. I am worried that I might end up with someone who just wants to milk me of money I don't have, and/or who doesn't know what they are talking about. I have an entire lifetime of experience of rubbing up the medical profession in the wrong way, and they always think I'm attention-seeking, a hypochondriac, and a waste of space, so I also want someone who would take me seriously and would have the grace and the good manners not to be horrible even though they didn't like me.

I've previously paid for the services of a gastroenterologist who worked in both the private sector and in the NHS, who got glowing reviews online. Well, he was awful. I completely wasted about £260 seeing him. He wrote to my GP after the consultation I had with him, he never wrote to me, and he made derogatory remarks about me in his letter. (My GP gave me a copy.) All I'd done was suggest one particular test I thought might be helpful, and this seemed to have gone down like a lead balloon.

I do have some minor things showing up in private blood tests that might indicate a chronic infection, but I haven't shown them to my GP because they simply aren't bad enough to be taken seriously by a doctor.

My lymphocyte count is over the reference range, but not dramatically so, and has been several times since Jan 2016.
My white blood cell count is in range, but is high in range.
My platelet count is in range, but is high in range.
My basophil count matches the top of the range.

Any results that might be suggestive of a problem are always so damned wishy-washy, and no doctor would ever take them seriously, so I don't waste my time showing them to a GP.

Another issue is that I have to surrender my driving license now, because of a medical problem unrelated to my gut. So I'm feeling trapped. Anyone I want to see will almost certainly cost lots of money just in travelling costs, never mind anything else.

Sorry, I sound whingy.

 

Thanks for that info, @Amw66 . I've heard of this condition but don't know anything about it, so I'll do some research. And I'll look for that thread too.

 

I can't travel, Arnie, and my experience is that a lot of private practitioners are willing to deal with patients entirely by phone. It's worth checking.

 

Thanks, @Sasha , that never occurred to me.

 

One thing I forgot to mention...

Whenever I take certain supplements I get a massive increase in pain. The ones that do this are all acidic. Two of the worst are Vitamin C and caprylic acid. I've tried taking vitamin C in different forms, such as ascorbic acid, Ester C, and magnesium ascorbate. The effect is the same whichever one I take. The caprylic acid was an experiment to see if it would help a suspected, but not proven, candida infection.

 

My honest feeling, and I hope you don't take it the wrong way, is that you'd be wasting money on investigations without having professional guidance alongside. There are so many tests to choose from and so many nuances in interpretation that it would be like finding a needle in a haystack. And that's before you even think about treatment hurdles.

I do understand what you mean about conventional medicine and the bedside manner of many doctors though. I have found nutritionists and functional medicine practitioners to be entirely different. Perhaps worth saving that little bit longer and seeing one, they're not as expensive as consultants.

With regards to the improvement on antibiotics, that could well suggest SIBO too. Its a very difficult problem to overcome and usually requires significant dietary change and multiple courses of antibiotics (rifaximin is a good choice as it only effects the gut) and herbals.

 

It is important to test both as different bacteria produce different gases.

Whether the substrate is glucose or lactulose can be important too, it appears glucose will only detect proximal overgrowth - your gut will absorb glucose so if the bacteria is at the end of the small intestine it won't be detected, unlike with lactulose.

That's the theory anyway, as with all things it's a bit contentious and different docs will do different things. I think most NHS testing is only glucose.

 

Thanks, @Ryan31337. I can't remember if the test I did involved glucose. But because I'm sure I didn't swallow any lactulose, by a process of elimination it must have been glucose!

 

@Arnie Pye have you been given a gastroscopy? Might be more relevant to your issues than endoscopy and could probably be arranged by your GP (if you can get there?)

The pain from acidic supplements reminds me of when I had an inflamed esophagus. Anything that affected my stomach acid levels would give me horrible stomach pain. This, and some beginning ulcers, was easily detectable by gastroscopy. They can also look for general inflammation or other issues with the upper GI tract.

Other than that I have nothing to add, I don’t know the UK system very well.

 

As far as I know, most GP's won't do a gastroscopy themselves. They'll refer you to a gastroenterologist at a hospital.

 

I'm going to throw this out there, please do feel free to disagree as it's a service I've never used.

Have you had a look at the Optimum Health Clinic? Not for all the CFS mumbo jumbo, but they do have people who deal with nutrition and I have heard that side isn't bad and they've helped people get to the bottom of issues where the NHS has failed.

I have a feeling the initial consult may be free and can be by phone.

Having said that I've never used there services personally, but the free consultation might provide pointers to start you off.

 

I meant they will probably refer you without much fuss. Sorry if I was unclear

 

Sorry @andypants, it's probably me misreading - an especially bad night's sleep.

 

I was given an endoscopy/gastroscopy about 8 years ago, but it didn't find anything helpful to my current situation (mild gastritis was the only thing discovered - but they didn't see anything beyond the duodenum).

The pain I want help with is much further down the gut than the esophagus. I should have mentioned this earlier, sorry. I've marked a picture with the spot where most of the pain is :



It's where my colon reaches its highest point on the left hand side before it drops down into the descending colon. The pain has spread over time and extends almost from my left shoulder down to my left hip and has spread almost to my spine. But the centre and the source of it all is where I've marked.

Kidney function tests show completely healthy results, by the way, so I don't think my left kidney is the source of the pain.

If my pain is not caused by an infection then the other most likely alternative (in my opinion) is that I have adhesions reducing the blood flow to my colon and the muscles in that area. I know from past experience that adhesions don't show up on scans unless they are practically rock hard. I also know that doctors often don't believe they are serious. They also often think there is nothing that can be done because operating will just create more adhesions. But I've had successful adhesion surgery in other areas. I just need a doctor who'll agree that I can get the proper help from someone who knows what they are doing. It's like asking for the moon though. *Sigh*