Friday, April 9, 2010

Journey Down the Stomach Continues

diagram of a human digestive systemImage via Wikipedia
Saw a holistic doctor and then my GI doctor.  Both are pretty stumped.  As far as the holistic doctor is concerned, I have a very healthy GI system.   He had run some tests looking for a plethora of critters that can run around in your tummy  and he found bupkis.  

No IgG (immunoglobulin G) food sensitivities to dairy, fruits, vegetables, nuts, seafood, etc.  IgG is an indication of a breakdown in mucosal immunity and compromised intestinal barrier. IgG also has a neuro-endocrine connection.   Looking at IgG is important for me in that it can play a role in ataxia, problems with muscle coordination, especially in vision.  Compromised IgG can also lead to compromised blood brain barrier (separation of circulating blood and cerebrospinal fluid maintained by the choroid plexus in the central nervous system ), HPA axis dysfunction (hypothalamic, pituitary, adrenal (HPA) axis one of the body's major control systems, serves to maintain body homeostasis with hormone feedback regulatory loops. In other words, the regulator of the body's fight or flight system. ) and end-organ autoimmune functions.

The only thing that is a bit out of whack is that I have a moderate Aspergillus Niger IgG.  Aspergillus Niger is a form of mildew present nearly everywhere that generally contaminates dry food, dried fruits, nuts, fermented teas and herbal teas, when they are exposed to humidity during storage.  Also, Aspergillus Niger or its extracts may be used in the food industry as a non-declared additive. The principal products affected are: bread, beer, cheese, chocolate, fruit juices, and especially precooked meals.   This means avoiding mass-produced foods... but intuitively, I sort of know this so I avoid a lot of processed foods by following the simple maxim:  "Avoid what's made in a plant, Eat what comes from a plant"... And, since I do eat meat, Eat Fresh Meat whenever possible.

Parasitology test also didn't show anything.  I have normal flora (bacterial tummy flowers!).  No yeast, giardia or cryptosporidium(water borne parasites).

As far as the digestive tract is conerned, nada.  All in the normal range: elastase (measure of pancreatic insufficiency), fat stain(measure of fat absorption), muscle fibers, and carbohydrates.  Except for vegetable fibers.  I do eat a lot of vegetables and fruits in the stomach. The presence of vegetable fibers also can come from a tendency to "eat on the run" and not chew your food properly which I suppose I do.

Test for any inflamation are also normal: lysozyme, lactoferrin, White Blood Cell Count, and Mucus are all  normal.  Ditto on Inflamation and Secretory IgA (Immunoglobulin A deficiencies are common in Autism).

The only other indicator outside the norm is the fecal split fat which measured high.  Fecal Neutral Fat measured normal which means the pancreas is OK and the split fat measures absorption of nutrients. It is important to me as it may point towards a cause of a B12 deficiency.

No evidence of Leaky Gut.

As far as these tests show, the holistic doctor said that I am in the top 1% of his patients in terms of intestinal health!  So as far as he is concerned, take some probiotics (PB8 and VSL3) to increase stomach bacteria and I should be fine. He will run one more blood panel to look for some vitamin and mineral deficiencies and then that's the end of that

The next day, I saw the gastroenterology doctor and he said that the capsule endoscopy is normal and that he is running out of tests.  Everything looks OK.  The only thing left to check is a hydrogen breath test to measure the amount of hydrogen in the breath to diagnose several conditions that cause gastrointestinal symptoms.  Apparently, large amounts of hydrogen also may be produced when the colon bacteria move back into the small intestine, a condition called bacterial overgrowth of the small bowel.  I am willing to do anything that will help him out but both of us are unsure that this test will really find anything.  Unfortunately, their machine that does this test is out getting serviced so I will have to call in 2 weeks to make the appointment.  It involves more fasting... Oh well, hopefully, this will help me lose some weight.  I fast for 12 hours and then and then blow into a balloon.  Then I will eat some test sugar and then blow another into another balloon.

He continues to hem and haw about the Schilling test to measure B12 deficiency but that is quite some test.  It is outdated and not many places do it.  The Schilling test is a four part test involving swallowing radioactive B12: oral vitamin B12 plus intramuscular vitamin B12, vitamin B12 and intrinsic factor, vitamin B12 and antibiotics, and vitamin B12 and pancreatic enzymes.   We will wait on this to see the results of the latest blood test from the holistic doctor which will include measuring B12. I have seen some doctors on the web not bother with the Schilling test and just give the patient B12 injections and wait a few few months to see if that fixes the problem.  So maybe, I'll see what he thinks about that.   I am very keen on resolving any issues with B12 as B12 deficiency directly impacts myelin (the sheaths around the neurons in the brain) formation and can be a factor in my neurological problems with my eyes, hearing, motor skills and balance

I think I am close to closing this chapter in the book about the tummy after the hydrogen breath test.  I will take my all these test results to another GI Specialist for a second opinion to see if we've missed anything (I doubt it) and then just watch my diet and eat my probiotics.  

I have tended to get pickier about where I source my food.  I noted that there seem to be more recalls, a lot more Chinese food is getting in the system, and a lot more warnings about chain restaurant foods  particularly with imported chicken parts, hamburgers, lettuce and scallions.  So I have joined a CSA(community supported agriculture. To find one in your area, go here.)  to get my vegetables and fruits.  I don't eat in chain  restaurants and have limited eating in other restaurants (between my husband's and my diets, there aren't too many restaurants we can eat in together), and go to farms and delis to get my meat as locally sourced as possible.   That seems to help.  I have lost 15 pounds by going gluten free so that's a good thing as well.
So, what's the upshot of all of this commotion about the motion in the tummy?   Well, after taking some probiotics and VSL3, my derriere is a lot more lady like and not trumpeting forth as much as it used to (it was really getting out of control.  Making rude noises in public can be funny in a frat boy kind of way for guys; but, for girls, it is mortification.  Fortunately, my husband doesn't get upset about it when it happens at home.).  My tummy is not quite as irritated if I stay away from wheat, dairy, fat, and alcohol (even one drink makes it uncomfortable).   I feel a lot more calmer and in control of myself.    

It would have been nice to find some biological precursor to my neurological problems that I could treat with a pill or two.  There's a lot of research being done in terms of the stomach and neurology.  Gershon talks about the interesting interconnection between serotonin levels in the stomach and the brain especially in regard to Irritable Bowel Syndrome. (Did you know that the stomach actually secretes the most serotonin?).  And, there is a lot in the alternative medicine community and the DAN doctors (Defeat Autism Now) about diet, the GI system and the brain.  However, many mainstream scientist won't make definitive statements on the relationship between the stomach and autism beyond a vague hemming and hawing about gee, there's possibly a connection out there.  So, you really are left with looking for medical logic in the alternative medicine or the research communities.   And, that can be a tough one for a lay person to decipher.  We really don't have the medical or scientific background to weigh in on the medical validity of procedures.  All we can go on is interviewing practitioners to find the best folks out there, networking with fellow patients in physical or occupational therapy, cruising the web, seeing mainstream medical practitioners to cover known theories,  and trying to make some sense out of controversial claims.  Finally, there is plain flat out listening to your body to see what makes it feel better and looking at test results to see if any of this really improved your results.  Listening to your body does have its pitfalls as there is always the placebo effect.  On the one hand, no one likes wasting their time on the useless.  But, if it's harmless and it makes you happy, why not?   On the other hand, there is something to this mind-body connection when your body is happily humming along, your mind will be happier too.

Maybe I'll revisit the subject in 10 years with someone new as science always changes and neurogastroenterology is a relatively new field.  But I do think I am coming to the end of the end.

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