10 FUNCTIONAL TESTS OFFERED BY DR. FISEL

Are you experiencing health symptoms that have left you feeling less than stellar?

You have tried everything you can think of to address your symptoms:

  • Practiced an over-the-counter medication or supplement regimen
  • Consulted with and obtained an allopathic doctor’s perspective
  • Made lifestyle adjustments related to nutrition, movement, sleep and stress management habits

After all of this, are you still struggling with your symptoms despite the fact that your tests have come back “normal”?

One important aspect of naturopathic medicine is the principle of “doctor as educator.” It is the cornerstone of naturopathic care. Naturopathic physicians teach their patients how to make conscious lifestyle choices, giving them the confidence they need to reach and maintain an optimal state of health.

As such, I want to help you get to the root of your symptoms. Following are ten additional lab tests – you might not have known about or considered – that we often utilize at our office. These tests can help you get a more complete picture of your health and also help you discern how your habits and symptoms are contributing to your overall wellness.

10 FUNCTIONAL TESTS OFFERED BY DR. MATTHEW FISEL ND:

  1. Cardiovascular – Testing done to screen for independent cardiovascular risk factors, such as hs-CRP, fibrinogen, and Lipoprotein(a). This test can give you a much more detailed assessment of your heart disease risk than just measuring cholesterol levels.
  2. Hormone – Detailed female hormone testing, including the DUTCH test, for women who are struggling with hormonal issues, and want more options than just a prescription for oral contraceptives.
  3. Glandular – Comprehensive adrenal and thyroid hormone testing, especially helpful for when you’re taking prescription thyroid medication, but still feel symptomatic.
  4. Environmental Toxicity – Heavy Metal testing, which can help to detect lead, mercury, arsenic, cadmium, and other metals that have been linked to various neurological and autoimmune diseases.
  5. Environmental Allergens – Mycotoxin testing, to identify mold toxicity that doesn’t otherwise show up with typical allergy testing.
  6. Gut Microbiome – Comprehensive stool testing, like the GI Map or GI Effects Profile, which look at a number of factors that can have a negative impact on your digestive health, including parasites, bacterial infections, candida, and inflammatory markers, as well as looking at your healthy microbiome.
  7. Digestion – SIBO breath testing, particularly helpful for patients who have been diagnosed with IBS, or are experiencing persistent bloating that doesn’t seem to resolve with any treatments.
  8. Nutrition – Food sensitivity testing, which can help to identify foods that may be contributing to both digestive and system wide symptoms. 
  9. Metabolic – Genetic SNPs, such as MTHFR and COMT, which can identify predispositions to metabolic problems that may make you more prone to depression, anxiety, fatigue, and a number of other symptoms.
  10. Comprehensive Nutritional Testing – helps to help identify optimal levels of vitamins, minerals, essential fatty acids, and amino acids. Most conventional testing is only looking to identify blatant deficiencies, but doesn’t take optimal ranges into account. 

Navigating the information available to you in terms of your health and wellness can be a daunting task. I work to support your wellness by utilizing all perspectives. If after exploring your health options, you are left with the feeling – THERE MUST BE SOMETHING MORE I CAN DO –let’s talk about the different tests I offer in my office and determine a course of action you might not have already considered.

If you live in the Guilford/ Branford/ New Haven/ Madison/ Clinton area and would like to learn more about integrative solutions for your health care needs, I can help you get to the root of your symptoms by promoting health and healing on all levels – physically, emotionally and spiritually.

Call (203) 453-0122 or CLICK HERE to schedule a consultation.

Could it be SIBO?

Could my symptoms be caused by small intestinal bacterial overgrowth (SIBO)?

It’s normal to grow bacteria in your large intestine, in fact it’s healthy to grow bacteria in your large intestine.

But what about when that good bacteria moves along into the small intestine and starts to grow?

The results are less than optimal and often uncomfortable.

When this happens, when bacteria from the large intestine moves into and grows in the small intestine, SIBO can create the following symptoms (Madormo):

  • Bloating
  • Flatulence
  • Diarrhea
  • Constipation

Frustratingly, these same symptoms might also indicative of other bowel disorders like, Irritable Bowel Syndrome (IBS), for instance. In fact, research shows that SIBO could be an underlying cause of IBS – and often times goes undiagnosed because of the similarities. (Ghoshal).

With persistent IBS, it might be time to take a look at the root cause – SIBO should be considered.

“SIBO sufferers are usually divided into one of three different categories: diarrhoea-dominant (D), constipation-dominant (C) or alternating variations of both.” (Lindemann)

Although there are several ways to determine if SIBO is at work in your gut, breath tests are the main form of diagnosis. Kits can be ordered through our office to measure hydrogen, methane, and hydrogen-sulfide gases – the gases produced in the small intestine that cause such discomfort.

If SIBO is present, treatment options are available. A general naturopathic approach might include the following:

  1. Anti-Microbial Combinations – including some form of: “Candibactin AR” and Candibactin BR” from Metagenics; Neem; “Biocidin and FC Cidal” from Biotics Research; and “Allimax Pro” by Allimax.  (Please consult your naturopathic or medical physician before starting an anti-microbial regimen).
  2. Dietary Changes – Limiting foods that promote fermentation in the lower gut is advisable. Generally, a low FODMAP diet, monitored by a physician, is recommended.
  3. Intestinal Repair – Once symptoms improve, repairing the intestines so that motility normalizes, hopefully decreases the likelihood of recurrence in the future.  

SIBO has a 40% chance of recurrence (Grace) complicated by fungal growth. Therefore, broad spectrum anti-microbial botanicals could provide benefits antibiotics do not. For this reason it always helpful to look at your symptoms from a whole health perspective.

Worried about whether or not you will ever feel relief from your intestinal discomfort? I would be happy to help you determine what underlying factors may be contributing to your symptoms.

If you live in the Guilford/ Branford/ New Haven/ Madison/ Clinton area and would like to learn more about SIBO and whether or not it’s affecting your overall health, Dr. Fisel is here to help. Call (203) 453-0122 or CLICK HERE to schedule a consultation.

REFERENCES

Bella Lindemann. “SIBO Series Part 1: Is Sibo the Hidden Cause of Your Ibs?” Bella Lindemann, Bella Lindemann, 30 Mar. 2021, https://bellalindemann.com/blog/sibo-series-part-1-hidden-cause-ibs.

Ghoshal, Uday C et al. “Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy.” Gut and liver vol. 11,2 (2017): 196-208. doi:10.5009/gnl16126

Grace E, Shaw C, Whelan K, Andreyev H. Review article: small intestinal bacterial overgrowth – prevalence, clinical features, current and developing diagnostic tests, and treatment. Alimentary Pharmacology & Therapeutics. 2013;38(7):674-688. doi:10.1111/apt.12456.

Madormo, Carrie. “SIBO: Symptoms, Treatment, Diet, and More.” Healthline, Healthline Media, 14 Sept. 2021, https://www.healthline.com/health/sibo.

Veloso, Hazel Galon. “FODMAP Diet: What You Need to Know.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know.

Sometimes I Hate My Guts: Alleviating IBS Symptoms

IBS, Irritable Bowel Syndrome, stomach pain, gut health, Dr. Matt Fisel

We had plans to go on a long hike.

I chose my breakfast carefully. I didn’t want to rock the boat with any foods that might upset my stomach. I thought I had covered all of the bases, but a mile in I noticed the usual symptoms:

bloating, gassiness, and then…

my bowels started to activate.

I knew from experience this was not going to go well.

Maybe you’ve had your own bout, in public or private, with cramping, constipation or a sudden onset of diarrhea.

And…your doctor just could not tell you WHY.

Patients who have been categorized with Irritable Bowel Syndrome (IBS) say,

“Dr. Fisel…I was diagnosed with IBS months ago, and was prescribed medication that doesn’t seem to be working. Are there natural ways to find relief from my IBS?”

Unfortunately, IBS tends to be a catchall for those unexplainable symptoms in the intestines, appearing “normal” when tested. Your doctor may have ruled out cancer, colitis, etc., but wasn’t able to specifically answer the question:

WHY ARE MY GUTS HOLDING ME HOSTAGE?

We help patients find answers using an integrative approach that assesses their diagnosis and also gets to the root cause(s) of their underlying symptoms.

HERE’S THREE THINGS WE LOOK AT, from a naturopathic perspective, to understand more about your personal condition and why your symptoms might be persistent:

GUT SYSTEM HEALTH: We can do additional stool, breath, and/or blood testing to identify more definitive causes of IBS (small intestine bacterial overgrowth – SIBO, microbial overgrowths, enzyme deficiencies, food sensitivities, functional bowel problems, leaky gut syndrome).

Also, a number of treatments we can incorporate to improve the FUNCTION of the gut, along with promoting intestinal repair (probiotics, digestive enzymes, intestinal healing herbs and nutrients).

FOOD SENSITIVITIES: We will sometimes do elimination diets or cleansing protocols that often help people identify food triggers within their diets.

Cutting back on FODMAP foods, or following the Specific Carbohydrate Diet, can often help to give the intestines a rest allowing the intestinal tract to repair.

STRESS MANAGEMENT: Stress relief is key. At the very basic level we want to assess your day-to-day life and look at your habits.

You could start monitoring yourself by journaling about the foods you eat, how much sleep you’re getting, how you are moving your body – and of course how it makes you feel. Notice the trends.

Naturopathic medicine is an integrative approach to health care. Where western medicine leaves off, a Naturopathic Doctor helps patients get to the root of uncomfortable symptoms.

Dr. Fisel is here to help you get your life back after an IBS diagnosis and to help you feel relief from your symptoms. Please call (203) 453-0122 or CLICK HERE to schedule an appointment, today.

NEW PATIENT FREE 15 MINUTE CONSULATION: Dr. Fisel promotes health and healing on all levels, physically, emotionally and spiritually. If you live in the Guilford/ Branford/ New Haven/ Madison/ Clinton area and would like to learn more about the innovative programs Dr. Fisel has to offer, call (203) 453-0122 or CLICK HERE to schedule your free 15 minute consultation.

IBS? It May Be Something Else . . .

SIBOPeople often come to my office saying they’ve been diagnosed with IBS. They may complain of intestinal pain, constipation, diarrhea, or all of the above, yet all of their test results come back “normal”, so they are prescribed anti-spasmodic medications to manage their symptoms, and sent on their way. In my experience, IBS is merely a symptom of other underlying causes, rather than  a definitive diagnosis. Whether it’s food intolerances, poor eating habits, or restoring optimal production of stomach acid and digestive enzymes, naturopathic medicine has a lot to offer when it comes to identifying and treating the underlying cause of IBS. [Read more…]

Digestive Health In Early Life Linked To Allergies

dandelionAs a naturopathic physician, I’m always paying close attention to the connection between intestinal health and systemic complaints. Allergies in particular are something that our profession has recognized as having strong ties to the digestive tract. When people present to my office complaining of allergies, one of the first things I ask about is whether or not they’re having any digestive symptoms. I also want to know about their history of antibiotic use, their diet, if they were breastfed as an infant, and whether or not they were born via Caesarean section. So, what do these birth-related issues have to do with someone’s current allergy symptoms? Well, we know that allergies are symptoms that result from antibody responses to antigens (dust mites, pollens, mold, etc.) that our body recognizes as foreign. But what your doctors don’t often discuss is why this occurs in the first place. [Read more…]

What Can I Do About C. diff?

A patient came to me recently after finishing her 2nd course of antibiotic treatment for Clostridium difficile (C. diff) infection. Despite some temporary relief during while taking the medication, her symptoms were beginning to return to the same level of intensity that she was experiencing before the treatment. The patient’s gastric distress was so severe that she barely had the ability to function at work, having to take both prescription and OTC pain relievers just to get through the day. She was reluctant to go through another round of antibiotics, since they weren’t giving her any relief, and were causing other side-effects as well. [Read more…]

Is It Really IBS?

Irritable bowel syndrome (IBS) affects one in five adult Americans, and is responsible for up to 40% of referrals to gastroenterologists. While there are legitimate criteria used to diagnose IBS (alternating constipation and diarrhea, bloating, abdominal pain), the term is generally used to label patients who don’t have Crohn’s disease, ulcerative colitis, or other underlying “organic” diseases. Once patients have been labeled with having IBS, they are often given one or more medications to treat the symptoms, usually with little to no relief.

Fortunately for IBS sufferers, a multitude of underlying factors may be the real cause of digestive symptoms, making the likelihood of recovery much more promising. One condition in particular that’s often overlooked is small intestinal bacterial overgrowth (SIBO). This is an abnormal colonization of bacteria within the small intestine by bacteria that are normally found in the colon, mouth, or pharynx. When left untreated, SIBO is not only mistaken with IBS, but has been linked to fibromyalgia and chronic fatigue syndrome as well. The cause of SIBO isn’t always clear, but patients who are at higher risk include those with chronic constipation, achlorhydria, diabetes, scleroderma, diverticulosis, and adhesions from prior surgeries.

Up to 78% of patients who are diagnosed with IBS may in fact be experiencing SIBO. Testing for this condition is performed by blowing into a tube that measures gases given off by the excessive amount of bacteria that are present in the small intestine. While these tests are typically offered by gastroenterologists, there are several commercial laboratories that offer test kits for home use, which are then mailed back to the laboratory for analysis. If diagnosed, SIBO can be treated initially with specialized antibiotics. Once the offending bacteria are successfully eradicated, measures should then be taken to improve the intestinal environment (probiotics, digestive enzymes, etc.), which should help to prevent recurrence.

A diagnosis of IBS does not mean all hope is lost. Explore the possibility of SIBO, and seek out a naturopath or other alternative practitioner who can focus on how the digestive tract functions, rather than just looking for a disease.

Celiac Disease or Gluten Intolerance?

When people are experiencing nutritional deficiencies, anemia, weight changes, and/or other symptoms that seem to be of an unknown origin, it’s fairly common practice for doctors to rule out the presence of celiac disease with a small intestinal biopsy. While this is certainly considered the “gold standard” for identifying the pathological changes associated with celiac disease, many experienced physicians are finding that patients can still have a sensitivity to gluten containing grains, making celiac disease and gluten intolerance separate entities altogether.  This led experts at the recent International Celiac Disease Symposium to define the term gluten insensitivity for patients who don’t meet the criteria for celiac disease or wheat allergy, yet improve dramatically when following a gluten-free diet.

The incidence of Celiac disease has doubled since 1974, and gluten sensitivity alone is estimated to be 6 times the prevalence of celiac disease. Fortunately, for patients and doctors who have recognized this phenomenon for quite some time, there is finally a more established definition of gluten sensitivity. Some of the criteria being used to separate gluten sensitivity from wheat allergy and celiac disease include: Negative testing for the presence of IgE antibodies to wheat; Negative endomysial and ttg antibodies (typically present with celiac disease); Negative small intestinal biopsy; Resolution of symptoms following as gluten-free diet. Researchers have concluded that the genetic makeup and immune response of gluten sensitivity patients is unique, and may be more enzyme mediated (like lactose intolerance), rather than immune based.

Since objective testing is still lacking, people who are symptomatic should consider implementing a gluten-free diet. Some of the most common symptoms associated with gluten sensitivity include abdominal pain, rashes, headaches, “brain fog”, fatigue, depression, anemia, and joint pain. If your doctor tells you that celiac testing is negative, don’t give up hope!

 

Small Intestinal Bowel Overgrowth and IBS

I’m posting a link here that explains in detail the symptoms of Small Intestinal Bowel Overgrowth (SIBO), and how it is often an underlying cause of IBS. In my clinic, I’ve diagnosed this several times, even after people have already consulted with their gastroenterologist, which indicates that SIBO is not “mainstream” enough for most doctors to pursue the appropriate testing. All that is required is a simple breath test-Once diagnosed, this condition is easily treatable, so talk to your doctor about performing the test if you’re experiencing recurring digestive symptoms, or have been diagnosed with IBS. 

http://www.medicinenet.com/small_intestinal_bacterial_overgrowth/article.htm

IBS and “Mindfulness”

A therapy that combines mindfulness meditation and gentle yoga may help soothe symptoms of irritable bowel syndrome, a small clinical trial suggests.

In a study of 75 women with the digestive disorder, researchers found that those assigned to “mindfulness training” saw a bigger improvement in their symptoms over three months than women who were assigned to a support group.

The findings, they say, suggest that the mindfulness technique should be an option for treating irritable bowel syndrome (IBS).

A doctor not involved in the study agreed.

“I think people with IBS should learn mindfulness skills,” said Dr. Delia Chiaramonte, director of education for the University of Maryland’s Center for Integrative Medicine in Baltimore.

Learning such skills, she said in an interview, is “100 percent safe,” and it could offer people a way to help manage IBS symptoms on their own, long term.

People with IBS have repeated bouts of abdominal cramps, bloating, constipation and diarrhea. The typical treatment includes diet changes, as well as anti-diarrhea medication and, for constipation, laxatives or fiber supplements. There’s also some evidence that regular, moderate exercise helps.

The exact cause of IBS is unknown, but anxiety and less-than-ideal coping strategies — like avoiding going out because of your symptoms — are thought to make IBS worse for many people.

Because of that, psychological counseling is sometimes used. The best-studied form is cognitive behavioral therapy, which tries to change the unhealthy thinking patterns and behaviors that contribute to people’s health problems.

For the new study, Susan A. Gaylord and colleagues at the University of North Carolina, Chapel Hill, looked at a different approach to managing the “brain-gut” connection — known as mindfulness-based stress reduction.

The researchers randomly assigned 75 women with IBS to either undergo the mindfulness training or attend an IBS support group once a week for eight weeks.

The training included lessons on meditation, gentle yoga postures and “body scanning,” in which people focus their attention on one body area at a time to detect muscle tension and other sensations.

Gaylord’s team found that three months after the therapy ended, women who’d undergone mindfulness training were faring better than the support group.

On average, their scores on a standard 500-point IBS symptom questionnaire fell by more than 100 points, with a 50-point drop considered a “clinically significant” improvement.

In contrast, women in the support group averaged a 30-point decline, according to results in the American Journal of Gastroenterology.

Chiaramonte said the trial was “tremendously well-designed,” and set up to address the common criticisms of studies of mind-body therapies. Testing mindfulness training against a support group, for example, helps control for the fact that people involved in any form of therapy may simply expect to get better — and, therefore, do.

In surveys, the researchers found that women in the support group were as likely to expect benefits as those in the mindfulness group.

“And still, the mindfulness group did better,” Chiaramonte said. “So it’s not just the contact with another human being, or not just that they expected to get better.”

It also makes sense that mindfulness training would help people with IBS, according to Chiaramonte. “Part of the problem in IBS,” she explained, “is the attention people give to the physical discomfort, and what the mind then does with that.”

With mindfulness training, the goal is to help people become aware of what they are feeling, but then “let it go” instead of ruminating, and potentially making the physical symptoms worse.

Of course, naturopathic medicine automatically takes “mindfulness” into account, so this is nothing new from my perspective. By always assessing people’s mental/emotional state, along with implementing diet and lifestyle changes, it’s not uncommon for me to see people’s IBS symptoms improve dramatically. It’s unfortunate to see so many patients who come to me after undergoing multiple symptomatic treatments (steroids, anti-spasmodics, etc.), only left to be feeling worse. 

Once again, this study demonstrates what naturopathic med
icine already practices-The impact of the mind on physical health cannot be avoided!

SOURCE: http://bit.ly/lfYimf American Journal of Gastroenterology, online June 21, 2011.