Gut Problems — A Plea for Deep Diagnosis


by Connie Hernandez, ND

“Happy gut, happy life!”

You may have heard this old folk saying. In fact, one of the most common complaints our patients come to us for help with is digestive issues.

With advances in research, the names of these ailments have changed over time, even though the symptoms, of course, remain the same.

Dr. Connie Hernandez, ND
Dr. Connie Hernandez, ND

There’s a clear danger that in our enthusiasm for new diagnostic tools, we may overlook the need to consider some very common secondary causes of gut problems, at the physical, emotional, mental, and even spiritual level.

Whereas, in the past, parasitic and bacterial infections were the most common labels for digestive complaints, nowadays autoimmune and inflammatory conditions are the prevailing diagnosis. Same symptoms – same pain – different names.

  • Remember “Irritable Bowel Syndrome (IBS)”? Today, Small Intestinal Bacterial Overgrowth (SIBO) is the common diagnosis. (Earlier, IBS was simply a new name for alternating constipation and diarrhea.)
  • Digestive problems that respond to supplemental enzymes are now called Pancreatic Exocrine Insufficiency.
    You might have seen advertisements that asked, “Do you have gas and bloating? You may have PEI. Check with your doctor now for a prescription!”
  • What was once simply called “heartburn” became Gastro Esophageal Reflux Disease (GERD).

tummyFortunately, despite the habit of giving ailments fancy new names as our understanding of their causes improves, we’ve actually gained a more accurate picture of the connection between gut health and autoimmunity, gut health and obesity, and gut health and mental health.

For example:

  • Leaky gut” – gut permeability caused by infectious disease, antibiotics, hormonal changes, and/or stress – allows large molecules to pass through the gut wall, evoking an immune response that may evolve into a full-blown autoimmune disorder – for example, gluten sensitivity, or Hashimoto’s Disease (autoimmune thyroiditis).
  • Weight gain and obesity can sometimes be traced to the absence of specific probiotic bacteria in the gut microbiome.

As researchers uncover new causes of gut ailments, we will need to develop new diagnostic techniques.

In naturopathy, we’ve long relied for diagnosis on the Comprehensive Stool Analysis Profile (CSAP).

This panel of tests allows us to distinguish between issues with the gut’s microbiome, pancreatic enzymes, immune response, and inflammatory issues.

The CSAP helps us answer the following questions, among many:

  • Are there parasites present in the sample?
  • Are the parasites associated with the patient’s digestive complaint?
  • Is there a lack of beneficial bacteria in the gut?
  • If the issue is microbial, which remedies will positively affect the overgrowth of yeast or bacteria?
  • Is the gut wall responding appropriately to antigens?

We’re heartened by the progress in developing new diagnostic tools. Here are some examples:

  • Hydrogen and methane breath tests, long the standard for SIBO testing, have been called into question, as newer blood tests have emerged. For example, the Anti-Vinculin and anti-CdtB blood tests can now evaluate the role of earlier food poisoning in both SIBO and IBS.
  • Elastase tests (available on the CSAP) evaluate pancreatic function.
  • Labs such as Cyrexcan evaluate some 20 variables of gluten sensitivity. The labs also offer an intestinal antigenic permeability screen that details how the body’s autoimmune system is reacting in synchrony with gut function.

Researchers have also evolved new treatments in response to the new diagnoses. Yet, with all the progress, it’s well to take a step back and remember that gut issues, on a subtle level, are in the energetic domain of the third chakra, and thus may be sending us messages about the far-flung effects of problems at other levels, including the mental, emotional, and spiritual.

For example, negative thought patterns, dysfunctional behaviors, dietary issues, and inappropriate supplementation or medication are all known to be sources of gut problems.

The link between our gut and emotions is much stronger than previously suspected – did you know that there are more receptor sites in the gut for the calming neurotransmitter serotonin than there are in the brain?

We must not dismiss these very real secondary causes, in our rush to embrace the new diagnostic technologies, which may tempt us to treat symptoms, instead of identifying and addressing the deeper causes.

It’s not at all unusual for gut problems to be amenable to effective treatment with dietary and lifestyle changes, and with energy medicines, mudras, mantras, and specific yoga asanas, all of which are known to have powerful restorative and balancing effects on the body’s hormonal and other systems.

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