Nicolette: 0:01

Welcome to the Health Pulse, your go-to source for quick, actionable insights on health, wellness and diagnostics. Whether you're looking to optimize your well-being or stay informed about the latest in medical testing, we've got you covered. Join us as we break down key health topics in just minutes. Let's dive in.

Rachel: 0:24

So that gnawing feeling right in your gut, the bloating that just pops up, cramps, those you know, endless bathroom issues. Or maybe it's the opposite, just feeling stuck.

Mark: 0:37

It's such a common story.

Rachel: 0:38

It really is and for so many people, it ends up with this label IBS irritable bowel syndrome. Yeah, ends up with this label IBS irritable bowel syndrome.

Mark: 0:44

Yeah, and while getting any kind of label can feel like a relief at first the IBS one it often brings more frustration than clarity, doesn't it?

Rachel: 0:53

Totally, because it doesn't really tell you why.

Mark: 0:55

Exactly. Ibs is huge, affects maybe 10, 15% of adults across the world. But and this is key, it's not technically a disease. Well, it's a collection of symptoms.

Rachel: 1:05

So your gut feels awful, totally valid. But the diagnosis itself isn't the root cause.

Mark: 1:10

Precisely. It's like your phone battery keeps dying fast. The diagnosis is phone not holding charge. Okay, great, but why isn't it holding the charge? Is it the battery, the software, something else?

Rachel: 1:20

Right and with IBS and standard medical practice, they do rule out the really serious stuff, which is crucial, absolutely essential first step, but then you're often left just managing, trying to cope with the symptoms without knowing what's actually driving them and that's the real kicker.

Mark: 1:34

You might have had scopes, blood tests and they say structurally everything looks fine.

Rachel: 1:40

Your gut looks healthy.

Mark: 1:42

But your experience, it's anything but Bloating. Pain, urgency, that gap between how it looks and how it feels, that's classic IDS territory.

Rachel: 1:52

And because it's symptom-based, the advice can feel well pretty generic sometimes yeah.

Mark: 1:58

Try more fiber, avoid trigger foods. Maybe some medication for diarrhea or constipation.

Rachel: 2:03

Which can help sometimes.

Mark: 2:05

Sure, symptom relief is important. But if you don't know why, some medication for diarrhea or constipation which can help sometimes. Sure, symptom relief is important, but if you don't know why you have the diarrhea or why you're bloated, it feels like you're just putting out small fires instead of finding the source.

Rachel: 2:14

Exactly Just treating the branches, not the root.

Mark: 2:16

So the big question we're kind of digging into today is what if we could go deeper? What if there are ways to uncover the reasons your gut is out of whack beyond that initial IBS workup?

Rachel: 2:26

Okay, I'm intrigued because that sounds like moving from guessing to actually knowing.

Mark: 2:31

That's the goal. We're going to explore some of these modern gut testing options, tools that can potentially shine a light on what's really happening in there.

Rachel: 2:38

All right, let's do it. Where do we start?

Mark: 2:40

A really valuable starting point is comprehensive stool analysis. Now most people might have had a very basic stool test, looking for one specific bug, maybe Right, like for C, diff or something after antibiotics. Exactly. But these functional stool panels, you might hear names like GI map or GI effects. They go way, way beyond that. They give you a much richer picture of the entire gut environment.

Rachel: 3:03

OK, so richer how? What are these tests actually looking for, that the standard ones miss?

Mark: 3:08

Well, think of it like mapping the ecosystem. They look at the balance of your gut bacteria. Are the beneficial microbes thriving or are opportunistic ones starting to take over that imbalance? That's dysbiosis.

Rachel: 3:20

OK, so the overall bacterial community.

Mark: 3:22

Yeah, and, crucially, they also screen for specific unwanted guests, things like parasites that might be hiding out or used overgrowth candida is a common one even viruses or specific bacterial toxins.

Rachel: 3:35

Wow, okay, so not just is there an infection, but a detailed roll call of who's living in there and if they're playing nice.

Mark: 3:43

You got it, and it doesn't stop with the microbes. These panels also give us clues about how well your digestion is actually working.

Rachel: 3:49

Like what.

Mark: 3:50

Like they measure elastase. That tells us about your pancreatic enzyme output. Are you making enough enzymes to break down food properly?

Rachel: 3:59

Ah, okay, if not, that could definitely cause issues.

Mark: 4:02

For sure. They also often measure fat in the stool, which can show if you're having trouble digesting and absorbing fats.

Rachel: 4:08

Makes sense. Undigested food equals trouble down the line. What else?

Mark: 4:12

Inflammation markers, but specifically gut inflammation, things like calprotectin or secretory IgA. These show if there's irritation or immune activation happening right there in the intestinal lining.

Rachel: 4:23

So not just general body inflammation, but gut-specific.

Mark: 4:26

Correct, and some panels even look at something called beta-glucuronidase. High levels might suggest issues with detoxification pathways even how your body handles hormones like estrogen.

Rachel: 4:36

That is A lot of information from one sample, so bring it back to the person with IBS. How does knowing all this actually help?

Mark: 4:46

It helps because it allows for targeted action Instead of just saying eat better. If we see, say, a parasite, we can target that parasite.

Rachel: 4:54

Okay.

Mark: 4:54

If there's clear dysbiosis, specific probiotics or prebiotics might be recommended. If enzyme levels are low, you might need digestive enzyme support. If fat digestion is off, maybe supporting bile flow is key.

Rachel: 5:09

So it moves from guesswork to a much more strategic plan based on what the test actually shows is going on.

Mark: 5:15

Exactly. It's about personalized insights leading to personalized interventions.

Rachel: 5:19

All right, that sounds incredibly useful. Now, another term that pops up constantly with IBS is SIBO.

Mark: 5:24

Ah yes, sibo, Small intestinal bacterial overgrowth.

Rachel: 5:27

What exactly is that and how does it fit into the IBS picture?

Mark: 5:30

Okay, so SIBO is basically bacteria in the wrong neighborhood. Your large intestine is meant to have tons of bacteria. They do important jobs like fermenting fiber.

Rachel: 5:38

Right, that's normal.

Mark: 5:39

But the small intestine that's primarily for digesting and absorbing nutrients. It's not supposed to be teeming with bacteria. Incebo bacteria that should be in the large intestine have migrated up into the small intestine.

Rachel: 5:52

Okay, so they've moved upstream to where they shouldn't be in large numbers.

Mark: 5:56

Precisely. And when those bacteria encounter carbohydrates you've eaten sugars, starches in the small intestine they do what bacteria do.

Rachel: 6:03

They ferment them.

Mark: 6:04

But too early and in the wrong place.

Rachel: 6:06

Exactly this premature fermentation produces gas, hydrogen methane, sometimes hydrogen sulfide, right there in your small intestine.

Mark: 6:14

And that causes the symptoms.

Rachel: 6:16

That can absolutely cause many classic IBS symptoms, especially that rapid onset bloating after eating, maybe within 60 to 90 minutes. Also excessive gas, abdominal discomfort and it can swing bowel habits either towards diarrhea or constipation.

Mark: 6:31

Okay, the timing thing is interesting feeling bad relatively quickly after a meal. So how do you figure out if SIBO is the culprit?

Rachel: 6:38

The main tool is a breath test. It's non-invasive. You drink a specific sugar solution, usually lactulose or glucose.

Mark: 6:45

Then, over the next two to three hours, you breathe into a series of collection tubes at set intervals.

Rachel: 6:50

And they measure the gases in your breath. How does that work?

Mark: 6:53

Yeah, they measure the levels of those gases produced by the bacteria. Hydrogen and methane are the standard ones. If those gases rise significantly within the first 90, 120 minutes, it suggests fermentation is happening too high up in the small intestine.

Rachel: 7:07

Indicating SIBO.

Mark: 7:09

Correct. High hydrogen is often linked more with diarrhea or mixed symptoms. High methane that's frequently associated with constipation, because methane can actually slow down gut motility.

Rachel: 7:19

And you mentioned hydrogen sulfide.

Mark: 7:21

Yes, newer testing can also measure hydrogen sulfide. High levels might be linked to diarrhea. Urgency foul-smelling gas, maybe even things like body aches. It adds another layer to the picture.

Rachel: 7:32

It's pretty amazing. You can detect that just from breath. And you said SIBO is pretty common in IBS.

Mark: 7:36

It's thought to be a major driver. Some studies suggest SIBO might be underlying maybe 50 or even 70 percent of IBS cases, particularly IBSD, the diarrhea type, and IBSM, the mixed type.

Rachel: 7:48

Wow. So identifying and actually treating the SIBO could potentially resolve IBS for a large chunk of people.

Mark: 7:55

It can make a massive difference for many. Yes, instead of just managing the downstream symptoms, you're addressing an upstream cause bacteria fermenting where they shouldn't be.

Rachel: 8:05

OK, another really important potential avenue. Let's shift gears a bit to food. Everyone with gut issues knows food plays a role, but it gets confusing when standard allergy tests are negative.

Mark: 8:16

That's a really common scenario and it's where we get into the territory of food sensitivities, which are different from allergies or intolerances.

Rachel: 8:24

Can you break that down? Allergy, intolerance, sensitivity, what's the difference?

Mark: 8:29

Sure. A classic food allergy involves an IgE immune response, usually rapid and potentially severe think hives, swelling, anaphylaxis.

Rachel: 8:37

The immediate, obvious ones.

Mark: 8:39

Right. A food intolerance typically doesn't involve the immune system directly. It's often about lacking an enzyme like lactase. A food intolerance typically doesn't involve the immune system directly. It's often about lacking an enzyme like lactase. For lactose intolerance Symptoms are digestive but not immune mediated.

Rachel: 8:50

Got it Like lactose intolerance, causing gas and diarrhea.

Mark: 8:54

Exactly. Food sensitivity, however, is thought to involve other parts of the immune system, maybe IgG or IgA antibodies or other cellular reactions, and, crucially, the reactions are often delayed.

Rachel: 9:05

Delayed, how delayed.

Mark: 9:07

They can occur anywhere from a few hours up to maybe 48, even 72 hours after eating the food.

Rachel: 9:16

Ah, okay, that makes it so much harder to connect the dots between eating something and feeling lousy later?

Mark: 9:18

Absolutely. You eat something on Monday and the headache, brain fog, bloating or even joint pain doesn't hit until Tuesday or Wednesday. It's really tricky to pinpoint without some help.

Rachel: 9:29

So this is where food sensitivity testing might come in, when standard allergy tests are clear, but you still suspect food triggers.

Mark: 9:35

Exactly, especially if you've already tried removing the big common culprits like gluten, dairy, and you're still reacting, or if you have those delayed symptoms or systemic symptoms beyond the gut, like fatigue, skin issues, mood changes.

Rachel: 9:47

What kind of tests are we talking about here? I hear about IgG tests a lot.

Mark: 9:51

IgG antibody panels are one type. They measure IgG antibody levels to a wide range of foods. There are also IgA panels, sometimes combined with IgG. Another approach is mediator release testing, or MRT, which looks at how immune cells react to food extracts.

Rachel: 10:08

Okay, and how helpful are these tests really? I know there's some controversy around them.

Mark: 10:12

That's a really important point. These tests aren't perfect and there is debate about their clinical utility. A positive IgG result doesn't automatically mean you'll react badly to that food if you eat it. Immune reactivity doesn't always equal clinical intolerance.

Rachel: 10:26

So it's not a simple test says avoid this, eat that situation.

Mark: 10:30

Not necessarily on its own. However, they can be a useful tool, especially when interpreted in context. If someone has known gut issues like dysbiosis or particularly leaky gut- Leaky gut.

Rachel: 10:41

OK, we need to talk about that.

Mark: 10:43

Right. In that context, elevated antibodies might indicate foods that are currently challenging the immune system or crossing a compromised gut barrier. They can help guide a targeted elimination diet.

Rachel: 10:53

So use the test results as clues to design a more focused elimination and reintroduction plan, ideally with professional guidance.

Mark: 11:01

Exactly. It's not usually the final answer, but it can help narrow down the suspect significantly rather than just guessing or trying to eliminate huge food groups indefinitely.

Rachel: 11:11

OK, that makes sense. A tool in the toolbox Use thoughtfully. Now you mentioned leaky gut. Let's dive into that. What exactly is leaky gut?

Mark: 11:20

So leaky gut is the more common term for what's scientifically known as increased intestinal permeability. It means the lining of your small intestine, which is supposed to be a really selective barrier.

Rachel: 11:30

Like a tight security checkpoint.

Mark: 11:32

Perfect analogy. It should let nutrients through into your bloodstream, but keep out things that don't belong, like undigested food, particles, toxins, microbes In leaky gut. The gatekeepers, these tight junctions between the intestinal cells, become looser, more permeable.

Rachel: 11:47

So the barrier gets leaky, allowing stuff to slip through.

Mark: 11:51

Precisely Partially digested food, bacterial fragments like LPS toxins that can pass through this compromised barrier and enter the bloodstream where they shouldn't be.

Rachel: 12:00

And I'm guessing the body doesn't like that.

Mark: 12:02

Not at all. Your immune system sees these things as foreign invaders and mounts a response. This can trigger inflammation not just locally in the gut, but potentially systemically throughout the body. This can trigger inflammation not just locally in the gut, but potentially systemically throughout the body.

Rachel: 12:13

Ah okay, so leaky gut isn't just a gut problem. It could drive other issues.

Mark: 12:18

Yes, it's increasingly recognized as a potential root cause or contributing factor in IBS itself, certainly in food sensitivities, but also potentially linked to autoimmune conditions, skin problems, fatigue, mood disorders. The list is growing.

Rachel: 12:34

Wow, okay. So how do we know if this barrier is compromised? Are there tests for leaky gut?

Mark: 12:39

Yes, functional medicine labs offer tests to assess gut barrier integrity. One common marker is zonulin.

Rachel: 12:45

Zonulin.

Mark: 12:46

Yeah, zonulin is a protein that actually regulates those tight junctions. High levels of zonulin in the blood or stool can suggest the junctions are more open, indicating increased permeability.

Rachel: 12:55

Okay, so high zonulin equals potentially leaky gut.

Mark: 12:58

What else? Another key marker is LPS lipopolysaccharide. That's part of the outer membrane of certain bacteria. Finding significant levels of LPS antibodies in the blood suggests that bacterial components are crossing the gut barrier and triggering an immune response systemically.

Rachel: 13:15

Because normally LPS should stay inside the gut.

Mark: 13:18

Exactly. Its presence in the bloodstream is a sign the barrier is breached.

Rachel: 13:23

Are there other markers they look for?

Mark: 13:24

Sometimes tests will also look for antibodies against these structural proteins of the tight junctions themselves, like occludin and clodin. If your body is making antibodies against these proteins, it suggests there's damage to the gut lining structure.

Rachel: 13:38

Okay, actual structural damage markers.

Mark: 13:41

And secretory IgA, which we mentioned with stool tests, can also be relevant here. It's the gut's first line of immune defense. Very low levels might indicate a weakened defense, while very high levels could signal ongoing immune activation and stress in the gut. Both can be linked to permeability issues.

Rachel: 13:57

So if that barrier breaks down, it makes sense why someone might suddenly react to foods they used to tolerate fine or develop these wider symptoms like fatigue or joint pain alongside their IBS.

Mark: 14:08

Absolutely. It creates a situation of heightened immune reactivity and potential systemic inflammation, often fueled by things crossing that leaky barrier. Assessing and addressing gut permeability can be a crucial piece of the puzzle for many people with chronic digestive and systemic symptoms.

Rachel: 14:26

It really feels like we're getting layers deeper than just irritable bowels. Okay, so we've covered stool tests, sibo, breath tests, food sensitivity panels, leaky gut markers. What if someone's explored these, or their practitioner has, and they're still struggling? Are there other stones to turn over?

Mark: 14:43

Yes, definitely For complex or persistent cases or when other symptoms are prominent, there are further investigations that can be really valuable.

Rachel: 14:50

Like what.

Mark: 14:51

Well, we touched on pancreatic elastase in stool tests. If that's consistently low, it points towards exocrine pancreatic insufficiency, or EPI. Basically, the pancreas isn't making enough digestive enzymes. That needs specific support and can definitely mimic IBS.

Rachel: 15:06

Okay, so ruling out EPI is important. What else?

Mark: 15:09

Liver and bile function, especially if symptoms like bloating or fatty stools seem worse after fatty meals. Standard liver enzymes ALT, ast, ggt can give clues and sometimes specific tests for bile acids are used. Poor bile flow really hampers fat digestion.

Rachel: 15:27

Right and poor fat digestion can cause a lot of gut upset.

Mark: 15:30

Absolutely. Then there's the organic acids test, the OAT.

Rachel: 15:34

You mentioned that briefly. What does it show again?

Mark: 15:35

It's a urine test that gives a really broad snapshot of your metabolism. You can indicate potential yeast or fungal overgrowth markers that might not show clearly on stool tests. It also looks at markers for nutrient absorption, mitochondrial function, how your cells make energy, b vitamin status, even neurotransmitter byproducts.

Rachel: 15:52

Wow, so that casts a really wide net. When might that be useful?

Mark: 15:55

It can be helpful when symptoms are complex, maybe involve fatigue, brain fog, mood issues alongside the gut stuff, or if there's suspicion of candida overgrowth or issues with energy production contributing to the overall picture.

Rachel: 16:09

OK, and lastly, what about just standard blood markers for inflammation, like CRP or ESR? Do they play a role in figuring out IBS?

Mark: 16:18

Well, ibs itself isn't defined as an inflammatory bowel disease like Crohn's or colitis. So typically major inflammatory markers like CRP and ESR might be normal in straightforward IBS.

Rachel: 16:30

But they're still worth checking.

Mark: 16:31

Yes, because they help confirm that it is more likely functional IBS rather than underlying IBD, which requires very different management. Also, sometimes you might see mildly elevated markers or high ferritin, which isn't just iron storage but also an acute phase reactant.

Rachel: 16:46

Meaning it can go up with inflammation.

Mark: 16:48

Exactly Seeing. Those might hint at low-grade systemic inflammation or oxidative stress that could be playing a role, even if it's not full-blown IBD. It adds context, especially if other tests haven't pinpointed a single cause or if there are lots of extraintestinal symptoms.

Rachel: 17:02

It really underscores that IBS isn't just one thing, and figuring it out sometimes requires looking beyond the gut itself.

Mark: 17:09

It really does. The body is interconnected and gut health impacts and is impacted by so many other systems.

Rachel: 17:16

So, wrapping this all up, if you're listening and you've been handed that IBS diagnosis, maybe felt dismissed or like it's just something you have to live with.

Mark: 17:24

Yeah, if it feels more like a label than an actual explanation, please know you are definitely not alone in feeling that way. It can often feel like a catch all when initial tests don't show something obvious.

Rachel: 17:36

But and this is the hopeful part we've explored today just because those standard tests look normal doesn't mean nothing's wrong.

Mark: 17:43

Absolutely not. It might just mean the investigation hasn't gone deep enough, hasn't looked at the functional aspects, the microbiome balance, the digestive processes, the barrier integrity, potential overgrowth like SIBO.

Rachel: 17:55

And these modern functional tests the stool analyses, breath tests, sensitivity panels, permeability markers they offer the potential to move beyond that frustrating guesswork.

Mark: 18:06

Exactly. They provide data, real, objective information that can help uncover why your gut is struggling. Is it dysbiosis? Is it SIBO? Is it leaky gut Allowing food reactions? Is it poor enzyme function?

Rachel: 18:17

Finding those potential root causes then allows for much more targeted, effective strategies.

Mark: 18:22

That's the goal. Your symptoms are real, they are valid and the data from this kind of deeper testing matters. It can empower you and your practitioner to create a plan and a genuine healing and understanding, not just symptom chasing.

Rachel: 18:35

Moving from just seeking relief to actually building resilience and health with confidence.

Mark: 18:41

Beautifully put. It's about getting answers and taking informed action. So we have a final thought for you, the listener, to ponder, Reflecting on everything we've discussed today. The microbiome mapping, SIBO, food reactions, leaky gut does one of those areas particularly resonate with your own IBS journey? Is there a piece of this puzzle that feels like it might hold a key clue for you, Something worth exploring further?

Nicolette: 19:08

Thanks for tuning into the Health Pulse. If you found this episode helpful, don't forget to subscribe and share it with someone who might benefit. For more health insights and diagnostics, visit us online at wwwquicklabmobilecom. Stay informed, stay healthy and we'll catch you in the next episode.