Episode 365: What an Endoscopy and Gallbladder Scan DIDN’T Show: Uncovering Stomach Pain, Bloating, & Rosacea
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Are you navigating mysterious gut issues, only to be told everything looks “normal”? Erin walks us through a real client case that sheds light on what standard GI testing often misses. After 20 years of stomach pain, bloating, rosacea, and food reactions, a functional stool analysis finally gave this woman answers.
Erin breaks down the six major findings from the client’s GI Map stool test, including H. pylori, low commensal bacteria, opportunistic overgrowths, low digestive enzymes, sky-high immune markers, and gluten reactivity. You’ll hear how each result connects to her symptoms and how traditional medicine overlooked all of it.
Erin also speaks candidly about why physical healing must be addressed alongside emotional and energetic work and what realistic healing timelines really look like when you're working with a functional provider.
In this episode:
The GI test that uncovered H. Pylori, low beneficial bacteria, and inflammation, even after years of “normal” endoscopies
Why symptoms like rosacea, joint pain, and food reactions may be rooted in gut dysfunction (and what to do about it)
Opportunistic bacteria like Pseudomonas and Staph aureus can drive food sensitivities, especially to gluten
What elevated secretory IgA and anti-gliadin IgA REALLY say about your gut’s immune response
Erin’s take on realistic healing timelines and why your gut protocol might need constant evolution to truly work
Resources mentioned:
Episode 304: H. Pylori - What You Need to Know
Episode 333: Functional Stool Testing: What It Is & How To Know If You Need It
Order Your Gut Panel
1:1 Functional C.A.R.E with Erin & her team
Organifi supplement powder (save 20% on your order with code FUNK)
LMNT Electrolyte Replenishing powder (Use code FUNK and get a free sample pack with any purchase!)
Qualia Senolytic (get up to 50% off and an extra 15% off your first purchase with link + code FUNKS)
Bon Charge (Use code FUNK to save 15%)
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So let's talk about the things that we caught on this stool test that her other GI tests did not. We need a backstory. We need to know what she's experiencing, what she's eating, what she's tried in the past, so that when I'm looking at the data, I can use it to explain what she's experiencing or use it to say, hey, we might not have enough data with this one lab and we might need to do more digging. When we don't have answers or explanations for why you feel the way you do, we don't just stop. It's not just like a shrug emoji, like, oh, weird. We keep digging. We keep going. We don't stop until we figure it out.
I'm Erin Holt and this is the Functional Nutrition Podcast where we lean into intuitive functional medicine. We look at how diet, our environment, our emotions, and our beliefs all affect our physical health. I've got over a decade of clinical experience, and because of that, I've got a major bone to pick with diet, culture, and the conventional health care model. This show is for you if you're looking for new ways of thinking about your health and you're ready to be an active participant in your own healing, I would love for you to follow the show, rate, review and share. Because you never know whose life you might change.
Hello, podcast buddies. We're back with another episode. My voice is still a little sketch because of this cold that won't quit. Flooby. Eye infection, ear infection, all the things, all the tings. But I finally don't sound like Patty and Selma Bouvier anymore so I feel like it's a pretty solid improvement.
So today I'm getting into a client case. This is a woman who has been dealing with digestive issues and stomach pain on and off for 20 years, which is a long ass time. And she had been to different doctors and specialists and really didn't have a lot of answers, solutions, or clarity, which is obviously very frustrating. And it's why she came to us.
This one really struck an emotional chord with me because when she saw some of what we found, she said that she teared up thinking, maybe it's not in my head and this is really where my heart starts to hurt. For so many people who are really doing their due diligence with their health, these are not people turning a blind eye to what's going on in their body. They are focused on their health.
They're making the appointments, they're seeing the doctors, they're seeing the specialists, they're changing their diet. They're doing everything that they know how to do and they're still not seeing improvement or really getting any answers. And they start to feel like, I guess this is just how it's supposed to be. This is just my norm. It's normal for me to have ongoing stomach pain or digestive issues or to feel stressed out about my gut. And that isn't true. And there are more solutions available to you.
So today we're going to talk about the things that we caught for her that her gastroenterologist testing did not and what we plan to do about it. We're going to talk about why it's important to when we're doing any type of emotional healing, which obviously I'm a huge mega fan of but we don't want to bypass the physical body when we are exploring other healing modalities, mental, emotional and energetic. And then we're also going to talk about reasonable and realistic expectations for a healing timeline because this is something that I have seen a lot of confusion around. So that is the name of the game for today's show.
Okay, so now back to this client. She came to us, like I said, stomach pain on and off for 20 years. Bloating and heartburn, joint pain and inflammation, rosacea. She also had constipation and diarrhea which were more recent, but she had been experiencing them for over a year. So the stomach pain, the bloating, the heartburn had been going on for a long time. The constipation and the diarrhea was a newer thing, but she had still been struggling with it for a year. She was also reacting to a lot of foods. She thought it was primarily fried food and high fat dairy and really thought that she was struggling with fat in particular. So what she had tried on her own because by the time somebody comes to us, they've already done some things, right, they're not starting from scratch here.
She had already gone to GI doctors and they suspected that there was some gallbladder things going on but after several test scans there was no gallbladder disease from found, no gallbladder issues found. She also had an endoscopy run. Nothing was found there. She was prescribed omenprazole and she says that the doctors found nothing and reached the point of if there is no pain, you're okay. So she noticed that if she tweaked her diet slightly, she could reduce those pain flare ups and they were like, yep, that's just kind of how it's going to be. And you guys know by now how I feel about this.
There is a huge difference between okay and thriving.
There's a difference between okay and living my best life.
So the absence of acute stomach pain isn't okay. If this person is still dealing with bloating, joint pain, rosacea, constipation, diarrhea. Right. There's something going on. So she did a gut panel with us, which was the exact right move on her part. I'm like, ten points to you. This was the move. Great job.
Now, in episode 333, I talk more about the gut panel. The episode is titled Functional Stool Testing, what it is and how to know if you need it. So it's a very informative episode. But in that show, I also talked about the difference between this type of stool testing and the test that your gastroenterologist might run. Anything from an endoscopy to a colonoscopy. Now, these labs and these tests are obviously very useful and very important. So we want to have access to these labs but if we're doing those tests and everything is coming back normal, peachy-keen, jelly bean, then we also want to have other resources available to us, and that's where a comprehensive stool analysis comes into play.
So this is the functional stool testing that we run. And it's very different than other labs that you would get. And to be very clear, both have utility. Both are important. We're just looking for different things. One is not better or worse. You can just consider them different tools for different jobs. And if you feel like you have no answers, no clear solutions, no clarity or even no hope, that's where we can really leverage functional lab testing and where it makes sense to work with a functional practitioner.
So let's talk about the things that we caught on this stool test that her other GI tests did not. And again, this is all information from our gut panel, which is a GI map stool test. Now, keep in mind when looking at the results, I'm not just interpreting a lab here. I'm looking at the lab in order to understand: does this data that I'm seeing explain the symptoms that this person is experiencing?
That's what I mean when I say I'm looking at the human being behind the lab. We need a backstory. We need to know what she's experiencing, what she's eating, what she's tried in the past, so that when I'm looking at the data, I can use it to explain what she's experiencing or use it to say, hey, we might not have enough data with this one lab, and we might need to do more digging. And just to be fully transparent here, I love a stool test, but it is one test. We are looking at one part of your body. We can get a lot of really solid data, which is why we run it on like 99% of our clients. But we might need other data to really see the full picture of you, to tell the full story of you and what your body is trying to communicate to us. When we don't have answers or explanations for why you feel the way you do, we don't just stop. It's not just like a shrug emoji, like, oh, weird. We keep digging. We keep going. We don't stop until we figure it out.
So if you've ever wondered what it's like to work with my team here at tfn, that's what it's like. We keep going until we figure it out. We got you.
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Okay, so what did we find?
First things first. We found H. Pylori. Now there is a conventional test for H. Pylori that your GI doc can run. It just wasn't done for this person. H. Pylori is a bacteria that lives in the stomach and it can cause problems for a lot of people. I did a whole episode on it if you want to learn more. Episode 304 H. Pylori what you need to know if you are experiencing heartburn or any type of upper GI pain to the point where you need omeprazole or your GI doc thinks you need an endoscopy in H. Pylori test is a really reasonable idea. Just a pro tip. So I wasn't surprised to see this present on the stool test given the upper GI symptoms in pain she had been experiencing. Also with the rosacea we can see a link between H. Pylori and rosacea. So that's just another little bit of a clue. Other things things can contribute to rosacea. It's not always an H. Pylori game, but when I see that with rosacea there can for sure be a link.
So the H. Pylori is something that we would 100% want to address. In this case, conventional treatment for H. Pylori is triple antibiotic therapy. So it's exactly what it sounds like. It's three different antibiotics which can be as aggressive as it sounds and can have a lot of other side effects just like any type of antibiotic. So we like to use specific antimicrobials that are clinically just as effective but not as harsh or severe or won't have the side effects that triple antibiotic would for H. Pylori.
Number two. Second thing that we found were some low commensals. Commensals or keystone bacteria are the good guys. These are our beneficial bacteria. When we're talking about the microbiome, this is really what we're talking about. So the GI map looks at individual bacteria, but it also also looks at the phyla level, which is more of a big picture view of what's going on with your good bacteria.
Specifically we're looking at Bacteroides and Firmicutes so if one of these groups is low or if they're both low, that can be a pretty big deal for someone because that's basically a whole group of good bacteria that are low or deficient. So we did see one of these as low for her. These beneficial bacteria are considered beneficial because they produce beneficial products, things like anti inflammatory short chain fatty acids, things that are important for maintaining a healthy intestinal lining. So we're preventing leaky gut with these beneficial bacteria. It maintains proper immune balance, so it really runs the whole immune system show. It keeps inflammation at bay. So again, when a big group or a big category of beneficial bacteria is low, that can cause a lot of problems and definitely cause a lot of symptoms. So that was another thing that she wasn't aware of, something that we would want to address.
When I'm thinking about the microbiome, I think about it like a parking lot. So travel back to the 90s with me for a hot second. Indulge me in this. Pop your favorite Cranberries album into the cassette player in your car and let's go to the mall. So think about the mall. Black Friday, Macy's parking lot, totally packed, packed to the gills. That's your microbiome. But it should be filled. All those spaces should be filled with beneficial bacteria, with the good, good bacteria. Now, when these guys are low, what happens is that parking spaces open up. And when parking spaces open up, that creates an opportunity for the opportunists to come on in. And that's exactly what we found with this client. She had significant overgrowths of opportunists. So these bacteria are not the overt pathogens like Salmonella or C. Diff, but they are opportunists in every sense in the word. And if they get the opportunity to overgrow, they will take it and they will run with it and that can oftentimes cause a lot of problems, a lot of symptoms.
So some of the ones that we saw overgrown and elevated for this client are some of the ones that can overgrow in the small intestine. Now, when we're looking at a stool test, we're looking at what's going on in the large intestine, but it can give us some clues as to what's happening in the small intestine. A stool test. I am such a stickler about this, and I say this all the time, but it's important to note that a stool test is not diagnostic for sibo, small intestinal bacterial overgrowth, because the official way to diagnose Sibo is through breath testing ensure. There can be some problems with breath testing, but in my practice, we're not telling somebody that they have SIBO unless we see a positive breath test in Sibo. For sure, without question, could be contributing to a lot of the symptoms that this client is experiencing. So I really suspect Sibo not just from the symptoms, but also from some of the clues that we're seeing on her stool test.
So a reasonable next step would be to talk about potentially testing for sibo, the other opportunists that were overgrown or pseudomonas. Both of her pseudomonas were highly elevated. And why this is so noteworthy to me is because when this bacteria overgrows, it's linked to the increasing risk of food reactions. And same is true for Staph aureus. So Staphylococcus aureus, which was also present. Both of these are linked to food allergies and even ibs. Pseudomonas is especially linked to gluten reactivity. So stay tuned, because that's going to be relevant in just a few short minutes.
So if she's saying, hey, I'm reacting to a lot of these foods, we're saying, like, okay, we're starting to piece together why that might be the case. And some of it might be microbial in nature, bacteria in nature. So that was the third thing that we found. Fourth thing was is her digestive markers. So, interestingly, steatocrit was fine. Steatocrine is measuring fat in the stool. So if she's saying, hey, I don't do well with fat, I think fat is bothering me. I would expect to see steatocrit elevated.
Now, we do know that she's avoiding a lot of fatty foods, so that could be part of the reason why we're not seeing the steatocrit elevated. But what we did see was elastase being low. Elastase is a digestive enzyme that helps the body break down food. And when this is low, we can see a lot of food reactions. We can see a lot of discomfort in response to eating. The body, when this is low, can also struggle to digest fat, so it can lead to symptoms like diarrhea, like abdominal pain, some of the things that she is experiencing. So this tells us that we do, in fact, need to support digestion. We also want to swim upstream and figure out why is elastase low in the first place.
Oftentimes, with H. Pylori, if left untreated, it can begin to suppress stomach acid, hydrochloric acid. And when stom acid is low. We can also see low elastase as a downstream side effect. So that's something that we are taking into account as we go in to support her overall digestion. Now, number five is a big one. She had very, very, very high secretory iga. You guys have heard me talk about secretory IGA before.
I love it. I love it, I love it, I love it. Secretory IGA is the primary immunoglobulin in the intestinal mucosa. So it's a big part of the gut immune system. Hers was screaming high, like, rip roaring high. So this tells me that she's having an elevated immune response to some type of antigen in the GI tract, something that's coming in contact with her GI tract. That her body is like, oh, no. Hell no Get it Get out. So this could be dysbiosis. This could be overgrowths or acute infections. It can also be food reactions and food sensitivity. So her immune system could be reacting to the food antigens that she's consuming. In her case, based on the rest of the test, it was probably all of the above. So we need to support the immune system for sure.
But most importantly, we need to remove the triggers to allow the immune response to be able to calm down. That's a really important thing that we have to do for her. And then number six is a very high anti glidin IgA. So these two things combined. High secretory IgA, high anti glidin IgA, both of these being this high together tells me that her immune system is not happy. Glidin is a component of gluten, a protein found in wheat. So this tells us that she's having an immune response in the gut to gluten. Now, what I will say about the anti glidin marker on the GI map, it's not my favorite marker.
And that's because fecal anti glidin antibodies don't necessarily correlate with blood levels. So if we suspect gluten sensitivity in somebody, we are testing through blood. What I will share with you is that we can see normal levels of anti glidin IGA on a stool test, even when somebody is gluten reactive. So I don't like to use this marker as a diagnostic tool for gluten sensitivity. Just a pro tip, if you've ever done a GI map or you're a practitioner working with other clients running your own GI map, not a huge fan of that one. As a standalone marker, however, when it's high, it tells us that we do need to pay attention to this. So I would recommend following up with a blood test for gluten sensitivity. The one that we really like to use is Wheat Zoomer.
So I think that that would be a really reason next step in this situation. If she didn't want to invest in the lab, then trialing a gluten free diet could be another potential way to go about this. This marker can also be elevated with cross reactive foods, dairy, corn, oats, millet, rice and yeast. And so we actually see that pretty commonly. So we're working with our clients to suss out dietary strategies to help them feel better and again figure out what those trigger foods are so we can remove them to keep the immune system from scream at her. And then the last thing that we found was elevated calprotectin which is a marker of inflammation. Probably not super surprising to hear that given everything else she's got going on. So rather than throw a bunch of anti inflammatories at her to bring down the inflammation, we really want to work on the root drivers of the inflammation.
What is trip wiring that inflammation in the colon? Now here's the great news news about all of this. Everything we found is something we can actually resolve. So after 20 years of on and off suffering, she finally has some real answers and solutions that are not a band aid approach. And I share this with you. I share this whole episode in fact, because I want you to know what is possible with the right kind of testing, the right kind of support and the right kind of care. Especially if you just feel like you're spinning your wheels and you feel like your case is hopeless, you just might need a different approach.
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What is interesting to note here, this is really interesting and fascinating to me and I went back and forth on whether I should share this, but I thought you guys would find this interesting too. This client had done Manifest your Health with me in the past. So Manifest your Health is a program to address the emotional, mental and energetic side of healing. And it's a hugely transformational process. The resources in the practice that I teach in Manifest your Health help me put autoimmunity in remission and they've helped so many other women. But one thing I really emphasize in that program is that we cannot bypass the physical body. Even when we're addressing the three other levels of healing. Emotional, mental, energetic, It's still crucial to give the physical body the appropriate inputs and support. And this case is just such a great example of that. Because no amount of self hypnosis or guided meditations is going to clear these significant overgrowths in these immune triggers without also coming in With a protocol from the physical body side of things. And I think that that's where my approach is really unique and different. It's why I call it intuitive functional medicine. Because it's functional medicine that works on all four levels of healing. We get to support all four bodies of health. We're hitting things from multiple angles.
So let me give you an example this for myself right now in real time. So I've got this ear infection and it's been a whole journey, you guys. It's been a whole journey the past couple of weeks. But I got a cold that was so bad it was actually the flu and it blocked up my ear and I got an ear infection. Blah, blah, blah, blah, blah. So one thing that I know about ears in general, because I'm always thinking about the energetic metaphysical side of what our body represents. I believe that our body speaks to us in metaphors. And so the ears are obviously what we're taking in, what we're hearing, what messages we're being surrounded by the left ear in particular is our receiving side. And so with a blocked left ear, I really have to look at what are the messages that I am being surrounded with and how much of them are self limiting, are potentially kind of critical, judgmental even stuff that I'm telling myself about myself. And so that is really the deeper work that I'm currently doing. And man, does that feel so true. I am not surprised that this happened with my left ear, given all of that, but. And also I'm on antibiotics because I've got this like gnarly infection. It was super painful. It wasn't clearing on its own.
I did all of the, the self massage and the warm compresses and the garlic oil in my ear, like the whole nine yards, and still it wasn't clearing. So I'm on antibiotics to address the physical body. So I'm doing both. I believe that the body knows how to heal itself and sometimes it needs an assist. And part of my job for myself, but then also working with people is to help people clear blocks to healing on all four levels. Because magic happens when we bring them all online together. And by the way, if this kind of thing excites you, then get ready for fall. Because man, do we have something exciting coming your way.
All right, so the last thing that I want to tuck into today, given all that is going on, how long will this take to resolve? Which is a very reasonable question. And I'd love to take a minute to speak into healing timelines, because I think we've become so accustomed to three month programs or six week protocols that we can expect healing to be tied up in this nice neat little package just like that. So I really like to manage expectations and be really transparent about what this process will look like. When you work with us, there is no long term commitment because we work with a lot of people who've been let down by other providers. So I never want anyone to feel trapped with us. But with that said, the majority of our clients that work with us are with us for about six months to see full symptom resolution. Sometimes that's a little bit more and sometimes a little less.
And this can depend on a lot of different factors, one of which is how long you've been suffering with your symptoms. If it's been going on for years, it might not be resolved in six weeks. We're not the team that's just going to put you on a quick protocol and let you go DIY it sometimes, I'll be honest, sometimes you can get some quick wins with that. But then the symptoms more often than not come rip roaring back. And honestly, over 50% of our clients have already done something like that. So we're not gonna take that same approach because it's gonna get you the same result. When you work with our team, our goal is to get you feeling better long term. We're not just looking for symptom resolution, but true health resolution.
And sometimes that can take a little bit of trial and error. Sometimes we put you on a protocol and then that protocol needs to change or evolve or you with one thing and your body doesn't react well so we have to switch it or we start you on one thing and your body reacts really well and then it stops reacting really well, so we have to switch it. So we are really, really, really involved in your case and in your protocol and getting you better. So if that is something that you are looking for, you can apply to work with our team. And if you're not 100% sure if you want to dive in just yet all the way, we do have the gut panel as an option for you. If some of what I talked about today sounds familiar to you, if you're like, gosh, this, this is something that I could probably use or I would really like to see this data for myself, you can absolutely head to the link in our show notes and grab yourself a gut panel. I hope that this episode was helpful. Send it to a friend who you think it might help and I will see you next week.
Thanks for joining me for this episode of the Functional Nutrition Podcast. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. If you got something from today's show don'T forget, subscribe, leave a review, share with a friend, and keep coming back for more. Take care of you.