The next step - Thorough testing - Request which tests?

[mike987]

I went to a gastroenterologist in the past year. I more of less just gave my symptoms, my suspicions, and gave control to the doctor. He dicked around with helpless IBS meds. After many return visits, they seemed to have given up, so I did too.

There's another gastroenterologist in the area I'm considering going to next.
But this time, rather than saying 'I don't know what's wrong, please help me', I want to come prepared, requesting testing and NOT ask for the doctor to solve any problem.. No more meds.. Just test me for these very specific things!

Now I had taken praziquantel after finally acquiring it from an international drugstore and can't tell if it did anything. My suspicions are that it didn't, as it's been over a week now and all my digestive symptoms still exist. I've had a cold this past week too, so I can't properly gauge my breath.

I want to be prepared for the next step, something I should have done a long time ago.. Specific, and thorough testing!
I was hoping you guys could help me compile a list of things I should test for, and details about the test would be very helpful for me too.


So here's what I have so far..

- Blood test for Hypothyroidism

- Test for fructose intolerance (saw this mentioned around here)

- Thorough tests for a large variety of parasites (this will probably include blood and stool tests, yes?)

- Test for H.pylori (Is this a blood test?)

- Allergies tests for foods such as 'Gluten' (though I've been off that for a while)

I have vague ideas of others, but I would be very grateful if someone with a clearer understanding of these and other tests could give me some input.



Also, drawing blood a single time is probably sufficient to test for as many problems, so the more I can get down on paper before doing a blood test, the better.



Halitosisux is right in that testing should be done.. I'll never know if I have parasites and other problems until tests are completed.

Sheesh.. I really didn't appreciate that doctor just assuming I had IBS and giving me a variety of meds for that same thing for months.

Anyway, please help me compile a good list that could be helpful for myself, and anyone with digestive related BB issues.

[ruthere1]

you're smart to look into getting tests done. i did a pretty recent post about some of the tests you can get that target certain factors like bacterial imbalance, ibs, etc.

[potty_mouth]

Mike,
you're absolutely right to demand whatever tests you want. I did exactly the same. I use my doctor just as a point of referral and prescription. If your doctors are not doing their job then you have to become your own doctor!

I would certainly recommend the gut fermentation profile:
http://www.biolab.co.uk/index.php/cmsid ... on_Profile
I had this done in August and I came up as positive for yeast overgrowth. Do you live in the UK? If not I think they may accept postal samples or there must be someone near you does it. (This is an absolute scientific way to prove to your damn doctor that you have candida!)
If you suspect you have candida, you may also want to check if the extra alcohol in your blood is affecting your vitamin absorption as per this interesting article:
http://www.biolab.co.uk/index.php/cmsid ... rssid__189
I had a "health risk profile" at the same time, which came up with Vitamin E deficiency, low lutein, low omega 3 and 6, and low paraoxonase. (and I have a fairly good diet). Unfortunately that test did not include B vitamins and Zinc so I might test for those soon.
Check out all biolabs test under the heading Gut function and see which may apply (e.g. gut permeability - or "leaky gut" - I was negative for that).
If you can afford it you might want to find somebody who offers the Heidelberg ph test for stomach acidity. (many of us believe that we don't produce enough stomach acid).
Also if you have PND/sinus problems I would recommend getting a referral to an ENT and ask the ENT receptionist if they will take a swab of your sinus on the first appointment. If they say no then go elsewhere. I'm getting mine done next week.

Keep us posted on any results

[compor]

Hello,

I too am being prepared for a doctor's appointment. Hope he won't kick me out when he sees my list of symptoms and tests I wish to take.



SYMPTOMS:
-----------------------------------------------------------
IBS symptoms (you know them)

low B12 levels

some Candida symptoms (many of which can be related to some other condition that I mentioned in parantheses):
abdominal gas and bloating (ibs)
headaches
excessive fatigue (depression)
anxiety (bb?)
inability to think clearly or concentrate (depression)
mood swings (depression)
diarrhea (ibs)
constipation (ibs)
depression (bb)
dizziness (b12 deficiency)
poor memory (b12 deficiency)
low sex drive (depression)
muscle weakness (depression)
learning difficulties (b12 deficiency)
sore throat
indigestion (ibs)
acid reflux

headache and lethargy after meals

vulnerability to cold weather

very weak immune system (I get sick all the time)

uncontrollable bb after consuming alcohol last weekend:
I was alcohol free for about 2 months, was drinking 1.5-2 liters of water every day, was avoiding junk food. I still had bb but it was not horrible, and my mouth felt more fresh. On my personal scale;
1 - mouth is fresh, you can't smell your own bb, you get no reactions (best case scenario)
2- mouth is NOT fresh, you can't smell your own bb, you get mild reactions
(tolerable I guess)
3- mouth is NOT fresh, you CAN smell your own bb, you get BAD reactions
(worst case scenario).
For the last 2 months I was level 2, which made me feel better so I went out with friends. After drinking beer (and later wine), my bb got out of control. No matter what I eat, or which cleaning procedures I apply, it's always level 3 since then. I remember reading alcohol favors candida.

-------------------------------------------------
TESTS:
Diabetes
Lung infection
Kidney disease
Stomach acid test (might be the cause for bad digestion)
Candida immune complexes test
Candida antibodies test
Leaky gut sydrome test
Gut fermentation test
Hypothyroidism test
Helicobacter pylori test (stool, blood and urea breath test)
Liver enzyme tests (low digestive enzymes perhaps?)
Food intolerance tests (milk, gluten, fructose and yeast)

I will describe my situation as openly as I can and will request all these tests. Worst case scenario: doctor will run only 1-2 tests, then I will go see another doctor and ask from him.


Do you have any additions to the list, or anything that I should remove cause it looks stupid?

I'm coming doctor, and I will get some answers!

[mike987]

-------------------------------------------------
TESTS:
Diabetes
Lung infection
Kidney disease
Stomach acid test (might be the cause for bad digestion)
Candida immune complexes test
Candida antibodies test
Leaky gut sydrome test
Gut fermentation test
Hypothyroidism test
Helicobacter pylori test (stool, blood and urea breath test)
Liver enzyme tests (low digestive enzymes perhaps?)
Food intolerance tests (milk, gluten, fructose and yeast)
--------------------------------------------------


Compor, I like your list.

Anyway, I wanted to come here to cross off two tests I had today.

I test in normal levels for Diabetes and Thyroid hormones.
Next week I'm going to request a stool test and see what's going on there.. It should definitely show something even if they can't narrow down the problem.

[compor]

I'm going to see a GI specialist on Wednesday. Hopefully I will have some answers or at least some test results that will lead me somewhere..

[deebo]

i wonder if h-py or candida are found on a full blood exam (FBE) . i would think it would be 1st on ones list . It can find deficiencies like vits and minerals .

[compor]

I just returned from doctor's appointment. Well to be honest, it was a disappointment. I told the GI specialist about my complaints, she wrote them down. When my list of complaints are done I asked her questions about candida, enzymes for digestion, acidity and stuff she kept dodging them with 1-2 word answers. She overruled candida immediately. I asked her if this could be a candida infection, and she responded with a confused look in her face "candida? where?", I said "in my guts?", then she looked at me as if she never heard something like that before.

She ordered a full blood test, that's the only good thing about the appointment. At least I will have more data in my hands to show other doctors. They drew 4 test tubes of blood. And on my way to the lab I saw an informative bulletin board about candida infection on Infectious Diseases Department (or something like that). I will wait for the blood test results then see the doctor again. If she doesn't give me satisfactory answers I will go see a doctor from infectious diseases.

[dick.karma]

i'm making a list myself. good luck to us!

[deebo]

She ordered a full blood test, that's the only good thing about the appointment. At least I will have more data in my hands to show other doctors. They drew 4 test tubes of blood. And on my way to the lab I saw an informative bulletin board about candida infection on Infectious Diseases Department (or something like that). I will wait for the blood test results then see the doctor again. If she doesn't give me satisfactory answers I will go see a doctor from infectious diseases.

compor .., did she smell any BB?

[compor]

Yes deebo, she definitely smelled it.

I got my biochemical and hormonal test results, unfortunately they are all within range.

BIOCHEMISTRY
Blood Sugar 88 ( 70 - 100 ) mg/dl
Total Protein 7.8 ( 6.4 - 8.5 ) g/dL
Albumin 4.8 ( 3.5 - 5 ) g/dL
Total Bilirubin 1.08 ( 0.3 - 1.2 ) mg/dL
D.Bilirubin 0.36 ( 0 - 0.5 ) mg/dL
AST(SGOT) 20 ( 0 - 40 ) U/L
ALT(SGPT) 29 ( 0 - 40 ) U/L
Alkaline Phosphatase 68 ( 42 - 128 ) U/L
GGT 21 ( 0 - 50 ) U/L
LDH 138 ( 125 - 243 ) U/L

HORMONE
FT3 3.56 ( 2.3 - 4.2 ) pg/mL
FT4 1.61 ( 0.76 - 1.89 ) ng/dL
TSH 1.045 ( 0.55 - 4.78 ) uIU/mL


Do you think these results prove that I don't have any problems with digestive enzymes or are there more specific tests?

Still waiting for other test results, then I will go see the doctor again next week. Hopefully I can convince her to order food intolerance tests or something else I can eliminate.

[compor]

I got all my blood test results. They are all within range, unfortunately. A normal person would be happy to know that there was nothing wrong with his tests. But I got devastated. I was hoping for an extremely low or high number to indicate a disease or something... anything... 3 pages of test results and I got nothing.

A friend of mine (who I can talk freely about my bb) asked me about it and I said "I wish I had cancer, at least I would know what's wrong with me". He tried to comfort me of course, "come on it's no big deal, people have much worse problems, it's just bad smell... so what, don't worry about what people think" etc. etc. I know he's trying to help but noone can even begin to understand what kind of a hell we're living in.

I went to the hospital again, luckily there was another doctor, much better that the previous one. He answered all my questions, most of them made sense. He said the first thing we should fix was acid reflux and see if my complaints will become better or worse, prescribed me some drugs for acid reflux. I will see him again next month or so.

[deebo]

I got all my blood test results. They are all within range, unfortunately. A normal person would be happy to know that there was nothing wrong with his tests. But I got devastated. I was hoping for an extremely low or high number to indicate a disease or something... anything... 3 pages of test results and I got nothing.
I went to the hospital again, luckily there was another doctor, much better that the previous one. He answered all my questions, most of them made sense. He said the first thing we should fix was acid reflux and see if my complaints will become better or worse, prescribed me some drugs for acid reflux. I will see him again next month or so.

does he know you have acid reflux ?

[deebo]

heres a list off the net to take to the Doc /research
Common Causes

If previously normal breath turns into halitosis, causes could include:

Abscessed tooth
Alcoholism
Cavities
Dentures
Drugs
Paraldehyde
Triamterene and inhaled anesthetics
Insulin - injection
Food or beverages consumed (such as cabbage, garlic, raw onions, or coffee)
Foreign body in the nose (usually in children)
Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
Gum disease (gingivitis, gingivostomatitis)
Impacted tooth
Lung infection
Poor dental hygiene
Sinusitis
Throat infection
Tobacco smoking
Vitamin supplements (especially in large doses)
Diseases that may be associated with breath odor (not presented in order of likelihood -- some are extremely unlikely):

Acute necrotizing ulcerative gingivitis
Acute necrotizing ulcerative mucositis
Acute renal failure
Bowel obstruction (can cause breath to smell like feces)
Bronchiectasis
Chronic renal failure (can cause breath to smell like ammonia)
Diabetes (fruity or sweet chemical smell with ketoacidosis)
Esophageal cancer
Gastric carcinoma
Gastrojejunocolic fistula (fruity-smelling breath)
Hepatic encephalopathy
Diabetic ketoacidosis
Lung abscess
Ozena, or atrophic rhinitis
Periodontal disease
Pharyngitis
Zenker's diverticulum

Home Care

Use proper dental hygiene (especially flossing), and remember that mouthwashes are not effective in treating the underlying problem.

Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking. Otherwise, follow prescribed therapy to treat the underlying cause.

Call your health care provider if

Breath odor persists and there is not an obvious cause (such as smoking or eating odor-causing foods).
You have breath odor and signs of a respiratory infection, such as fever, cough, or face pain with discharge from the nose
What to expect at your health care provider's office

Your doctor will take a medical history and perform a physical examination.

You may be asked the following medical history questions:

Is there a specific odor?
Is there a fishy smell?
Does the breath smell like ammonia or urine?
Does the breath smell like fruit or is there a sweet-chemical smell?
Does the breath smell like feces?
Does the breath smell like alcohol?
Have you recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
Do you take vitamin supplements?
Do you smoke?
Does good oral hygiene improve the odor?
What home care measures have you tried? How effective are they?
Is there a recent sore throat, sinus infection, tooth abscess, or other illness?
What other symptoms do you have?
The physical examination will include a thorough examination of the mouth and the nose. A throat culture may be taken if you have a sore throat or mouth sores.

In rare cases, diagnostic tests that may be performed include:

Blood tests to screen for diabetes or kidney failure
Endoscopy (EGD)
X-ray of the abdomen
X-ray of the chest
Antibiotics may be prescribed for some conditions. For an object in the nose, the doctor will use an instrument to remove it.