Digestive Health Program

Do you experience:

  • Gas

  • Bloating

  • Heartburn / Reflux

  • Tummy pain

  • Diarrhea

  • Constipation

  • Nausea / Vomiting

  • IBD (Inflammatory Bowel Disease - Crohn’s / Colitis)

  • IBS

Your digestive health is very important because your gut is the gate to the rest of your body. Your digestive tract is considered external to the rest of your body and nutrients must enter the digestive tract first then get absorbed through the intestinal walls to enter the rest of the body so they can be used for metabolic processes and functions. If there is any problem that affects digestion or damage to the intestines, then this will impair nutrient absorption leading to disease and malnutrition throughout the rest of the body. Not absorbing nutrients can contribute to fatigue too!

This is why as part of our intake assessment, you will always be asked about your gut health to see if there could be signs of indigestion or gut inflammation. Gut disturbances and/or inflammation can lead to some of the following:

  • Intestinal hyperpermeability (“leaky gut”)

  • Throw off your hormones

  • Affect neurotransmitters like histamine or serotonin which can affect your mental health

  • Autoimmunity

  • Body aches, joint pain and widespread inflammation

  • Food sensitivities

Feeling like it is time to fix your gut? Maybe you intuitively know something doesn’t feel right in there but your blood tests and ultrasounds have been coming back normal so your medical doctor doesn’t know what else to do and told you that “you have IBS”. Now you are living with a diagnosis of IBS but not knowing what the problem is and feel unwell more often than not. Turns out you are in the right place in your journey to search for other options so keep reading!

What is “IBS” (Irritable Bowel Syndrome)

Fun Fact: Did you know that according to the Canadian Digestive Health Foundation, Canada has the highest prevalence of IBS at 18% vs 11% for the rest of the world (1)?

IBS stands for Irritable Bowel Syndrome.  The CDHF (2021) has defined IBS as “a disorder affecting the intestine. IBS involves problems with motility (movement of digested food through the intestines) and sensitivity (how the brain interprets signals from the intestinal nerves), leading to abdominal pain, changes in bowel patterns and other symptoms.” (2)

IBS is a diagnosis of exclusion which means you often will get the diagnosis if blood tests, stool cultures, and abdominal ultrasounds come back normal so your family doctor cannot identify any other cause or condition that explains the bloating, gas, cramping, mucus in your stools, constipation and/or diarrhea you frequently experience. Some doctors will tell you to eat low FODMAPs and leave you at that. A low FODMAP diet is not the solution and can be unhealthy to follow for an extended period of time because it is a low fibre diet and we need fibre for a healthy colon or that can result in other problems.

Cue naturopathic medicine: Seeing a naturopathic doctor (ND) or functional medical doctor (FMD) can help you unravel the root cause of your “IBS”. A common cause of IBS is SIBO (Small Intestinal Bacterial Overgrowth), particularly if a low FODMAP diet felt better. Under underlying causes of your IBS symptoms could be any form of dysbiosis (mold, candida, parasites, bad bacteria), food sensitivities, insufficient stomach acid leading to a lack of digestion or even something else like a hormone imbalance such as a thyroid disorder or estrogen dominance. These are often functional conditions which is likely why you may not hear about them until you were to see a functional medicine doctor or a naturopathic doctor because they are not taught in conventional medical schools (at least, not yet). Functional testing options can help you and your ND or FMD figure out what is going on. 

How Our Digestive Health Program Works at the Clinic

SET UP AN INITIAL ASSESSMENT WITH OUR NATUROPATHIC DOCTOR

Your digestive health concern (IBS, Crohn’s, Colitis, diarrhea, etc) will be discussed in great detail as well as a head-to-toe review of symptoms will be conducted because the entire body is connected. This helps figure out if there is something else going on or it is simply a digestive problem and helps us to identify the root cause. This is also why the initial assessment can range from 60-90 minutes. Necessary physical exam will be conducted as well like your blood pressure, listening to your tummy, and anything else.

Please bring any test results with you to this appointment if you have them or your ND will have you sign a release form during the appointment and request it from your doctor.

Functional testing can be offered during this appointment if necessary at an additional cost.

Simple treatment recommendations will be provided on this visit.

TREATMENT STRATEGY VISIT

This appointment usually happens 1-2 weeks later or whenever we get the test results and we review the test findings and how you have done with the initial treatment plan. These findings will be used along with the research your ND has done from the initial intake assessment to establish a short- and long-term treatment plan with you. you will receive an overview of the entire treatment plan but you will walk away with the first step in the treatment plan or as much as you can handle without feeling overwhelmed because overwhelm can lead to paralysis.

PROGRESS VISITS

30 to 45-minute Follow-up appointments will be every 3-5 weeks and the duration increases based on symptom improvement.  These are check-ins to see how everything is going, if anything needs to be modified, and if you are ready to move on to the next stage of the treatment plan.

Functional testing can be re-ordered or ordered at any point to verify improvement.

Functional Digestive Testing

(Additional fees for testing are applicable. Testing can be partially covered under your naturopathic benefits as ‘naturopathic diagnostic testing’

FOOD SENSITIVITY TESTING

Food sensitivities and food allergies are immune system-mediated reactions to certain foods.  The most common are dairy, eggs, gluten, soy, and nuts.

A food sensitivity is a delayed-type hypersensitivity reaction involving an immune-mediated IgG response and the IgG last in the body for up to 3 months following exposure to a particular food. These are the reactions that happen when you eat something and feel sick a few days after. There are four types of IgG antibodies and IgG 1-3 are involved in inflammatory reactions in the body where IgG4 is a protective response against any IgE-mediated allergies to keep the inflammation and immune response in check. Food sensitivity tests are looking at IgG antibodies to foods. A person can develop a food sensitivity at any stage of their life due to a variety of different factors.  Usually, a person can develop an immune sensitivity to food if there is an increased intestinal hyperpermeability (“leaky gut”) situation and this can arise from repeated exposure to toxins, antibiotics, or, bacteria or microbes. Symptoms of food sensitivities can range from diarrhea, constipation, gas, bloating, acid reflux, low energy, to joint pain, muscle pain, migraines, and difficulty losing weight. They may also often be implicated in autoimmune conditions like Hashimoto’s and lupus. Food alle

Food allergies are immediate-hypersensitivity reactions involving an IgE response to a food that results in the release of histamine and can present with hives, itchy skin, allergy symptoms, itchy eyes, or anaphylaxis (difficulty breathing, lip swelling, and tongue swelling). These are often tested for by an MD using a “skin scratch test” or a serum IgE test. Since these are immediate, for them to be accurate, the skin scratch test must be done up to 48 hours following the consumption of the tested foods. Serum IgE tests are safer because they may not require the consumption of the food.

The food sensitivity testing we offer is done in-office and involves a finger prick to obtain a small amount of blood for the sample.

  • There are Basic, Enhanced, and Vegetarian panel options.

  • Results take approximately 7-10 business days to receive and then we book a follow-up to establish the treatment plan.

A person can expect to remove reactive foods from their diet from anywhere ranging between 3-6 months or possibly longer based on the situation. While elimination of the foods is occuring, we are concurrently working to heal the gut before food reintroduction.

The cheaper alternative to the IgG food sensitivity testing is the elimination diet.  While cheaper, this does require a good amount of compliance in order to identify any food triggers and can be a lengthy process.  The elimination diet, if done carefully and under the guidance of a naturopathic doctor, can help identify both food sensitivities and intolerances.

COMPREHENSIVE STOOL TESTING

In order to maximize nutrient intake from foods consumed, foods must be digested first in order to be absorbed.  Many factors can contribute to improper digestion and absorption such as low stomach acid, decreased pancreatic enzyme secretion, food sensitivities, inflammation, and microbial infections in the gut.  Some symptoms of improper digestion can be gas and bloating after meals, diarrhea and/or constipation.

The comprehensive stool analysis is a stool test that not only looks at occult blood in the stools but looks at gut dysbiosis – an imbalance in the amount of good commensal bacteria, pathogenic bacteria, yeast and parasites in your intestine.  Stool chemistry markers for digestion and inflammation are assessed as well to see if your symptoms may be attributed to IBD (inflammatory bowel disease), pancreatic insufficiency, and also look at your sIgA level which is the first line of defence in your gut against an infection. Short-chain fatty acids are measured and stools are assessed for blood and mucus.

ORGANIC ACID TESTING

This is a urine test that measures organic acids, which are products of metabolism in the body.  The testing gives you a comprehensive whole-body metabolic profile while testing approximately 70 different markers for:

  • Candida

  • Mold exposure/infection in the body

  • Absence or presence of dysbiosis (imbalance between good and bad bacteria in the gut)

  • Clostridia bacteria (commonly present in behavioural / neurological disorders like Autism Spectrum Disorders and can affect dopamine activity)

  • Mitochondrial function (mitochondrial dysfunction is common in chronic health conditions like chronic fatigue syndrome, fibromyalgia, and autoimmunity)

  • Oxalates which can be elevated when there is joint pain, urinary difficulties, and kidney stones.

  • Neurotransmitter metabolites for dopamine, norepinephrine, and serotonin for mental health conditions

  • B vitamin metabolites

  • Glutathione and methylation status

  • Amino acid metabolites for errors of inborn metabolism

  • Phosphoric acid which helps to determine vitamin D and bone metabolism.

Addressing infections or deficiencies highlighted on the organic acid test has yielded improved gut function, energy levels, improved ADHD and autistic symptoms to name some of the few benefits.

SIBO (SMALL INTESTINAL BACTERIAL OVERGROWTH) TESTING

Small intestinal bacterial overgrowth is a condition that is becoming increasingly common.  Unfortunately, many MDs are unaware of this and may establish a diagnosis of IBS instead. This can often be what is going on if you feel better on a Low FODMAP diet. It is normal to have some good bacteria in our small intestines, but as the condition implies, it is an overgrowth of bacteria in the small intestine.

Excess bacterial accumulation in the small intestine can happen for numerous reasons including decreased gastrointestinal motility.  This can happen from the use of acid-blocking medication, the use of antibiotics, decreased stomach acid, liver/gallbladder disorders, hypothyroidism, high insulin, stress, and other causes. As bacteria accumulate, they ferment sugars and fermentable fibres resulting in excess bloating like maybe that “pregnant feeling”, gas, diarrhea or constipation, acid reflux, heartburn, burping, and, abdominal pain. Fermented foods and probiotic supplements may make you feel worse. There are 3 different types of SIBO based on the dominant gas that is present and testing can help determine this.

The test involves collecting a breath sample at home which measures the concentration of hydrogen and methane in your breath. Results are returned in 7-14 business days and if positive, a SIBO treatment protocol is implemented that includes gut healing.  Some MDs may order a SIBO breath test but often this uses glucose.  Our SIBO breath tests use lactulose which doesn’t get absorbed and therefore can react with bacteria throughout the entire small intestine.

REFERENCES:

  1. Canadian Digestive Health Foundation (2021). “Statistics” in Irritable Bowel Syndrome (IBS). Retrieved on August 25 2021 from https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/statistics/

  2. Canadian Digestive Health Foundation (2021). “What Is Irritable Bowel Syndrome (IBS)?” in Irritable Bowel Syndrome (IBS). Retrieved on August 25 2021 from https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/what-is-irritable-bowel-syndrome-ibs/