I think that many of us go through life trying not to think about poop. We're blissfully unaware of how important poop is in our lives, as well as what affect various parts of our lives have on our bowl habits. Before my schooling I remember being vaguely aware of the fact that poop was just the aftermath of whatever I had previously eaten, but I never really stopped to comprehend what that meant. In the same way that most of us process other vague health-related statements ("you should eat a healthy, balanced diet", "exercise is important"), I brushed off the thought that my food eventually turned into poop. It's like garbage. Why would we care about garbage? Because poop is more than just garbage, and it can tell us a lot about how our body is functioning. For that matter, the process by which your body makes poop is tremendously complex and a lot of things can interfere and cause gastric distress.
This is a brief breakdown of how I get to the root cause of what's causing digestive distress.
1. Basic blood work can help me glean a lot of information and assess many systems of the body at once. Thyroid hormone problems, anemia, detoxification (liver) problems, diabetes and blood sugar problems, infection, magnesium and vitamin D are just a few of the things I screen for in most patients- all of which can cause gastric distress. For about $140 for this type of panel, this is an incredibly effective way to start my investigation.
2. Food sensitivity testing my be run, depending on the patient's history. I find that gluten, dairy (casein), soy, corn and eggs are very common culprits that cause gastrointestinal and systemic (whole-body) distress. I generally run panels through Cyrex Labs, although I do have the ability to run other labs if the need arises. Even if you've been "tested for gluten" before, the testing was most likely sub-par and will need to be re-run. Most "gluten" panels only assess for full-blown Celiac disease and miss the vast majority of people who are sensitive to gluten. Leaky gut syndrome is something that often goes hand-in-hand with food sensitivities and should be ruled out and treated, too.
3. Stool testing (yes, you have to poop in a cup) may be necessary in cases in which I suspect a potential infection. These come in three basic varieties: bacterial, yeast, and parasitic. In my experience, chronic bacterial and yeast infections are fairly responsive to herbal treatments, however some parasitic infections may be more stubborn and require prescription medications. Either way, the first step in treatment is proper diagnosis. Stool testing also allows us to see how much good bacteria (probiotics) and enzymes you have in your system, and may guide us in finding the right supplement.
4. Antibodies causing an autoimmune reaction are often the culprit behind chronic gastrointestinal problems. Diseases that have a known autoimmune component include Celiac Disease, Crohn's Disease, Ulcerative Colitis, and Pernicious Anemia. In the event that an autoimmune disease is diagnosed, I would work-up and treat accordingly.
5. Other hormones such as estrogen and progesterone can play a role in gastrointestinal distress. In some cases salivary (spit) hormone testing needs be conducted in order to further assess those pathways. Often times, male and female hormone problems are very responsive to diet and lifestyle changes.
6. Stress can have a profound impact on our digestive systems. I personally became aware of this in graduate school when my crazy roommate stopped talking to me for a month. Not only was I subjected to her freezing cold shoulder, but the stomping around the apartment and slamming doors and cupboards made me a nervous wreck. During that month I noticed a dramatic increase in bloating, food sensitivities, and gastric distress which resolved after my other roommate and I moved and got away from our stressor. In cases like this, it's obviously best to get away from the cause of the stress. However, if escape isn't an option things like meditation and yoga can help.
As you can tell, there is a lot of things that can contribute to digestive problems- and none of them involve a Pepto bismol deficiency! The gut is an incredibly complex beast, and it is best to get a proper work-up and exam by a functional medicine doctor. There is no such thing as a "normal" amount of constipation, diarrhea, blood in the stools, stomach discomfort, bloating, indigestion, or pain.
If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.