Stool Analysis
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Stool Analysis
Background: Female originally diagnosed with Crohn's in 1990 . Treated with Sulfasalazine, then Asacol, then Lialda. Symptoms continued. In 2010 Diagnosis changed to Lymphocytic Colitis and treatment changed to Budesonide for about 2 years with some reduction in diarrhea but a borderline osteopenia test and other issues made me want to stop Budesonide via taper. Then Welchol, now no meds, trying to address through diet. Diarrhea is biggest issue anywhere from 7 to 17 times daily. Tried the SCD and Low Fodmap without much luck. Now working with a nutritionist/functional medicine practitioner who doesn't have much experience with Lymphocytic Colitis but lots with food sensitivity. She has me halting gluten, dairy, corn, soy, etc. adding probiotic, and She wants me to get a Comprehensive Digestive Stool Analysis test through Genova Diagnostics. After reading "Microscopic Colitis", I am wondering about which lab to use. (I was also diagnosed with Hashimoto's Thyroiditis in 1985). Does anyone have experience with Genova Diagnostics. Can I get the same information as would be provided from EnteroLab?
I've had the Genova CDSA done twice, first 2 years ago, then last month. I'm still waiting for the second result (this time we are primarily checking to see if I caught my daughter's amoeba). I think it's an excellent way to look at the diversity of your gut flora and rule out any pathogens. It may also tell you if you have yeast overgrowth. It will not shed light on food intolerances the way Enterolab does, but it's a good test. I also had a Great Plains Lab Organic Acids urine test that was very eye-opening too regarding yeast, bacteria and neurotransmitters. But Enterolab is best for food intolerances. MRT may be helpful for short-term food reactions. .
1987 Mononucleosis (EBV)
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
2014 Low Dose Naltrexone
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
2014 Low Dose Naltrexone
Hi,
Welcome to our Internet family. You've been dealing with this for a long time, so I certainly hope that you can find what you need here to get your symptoms under control, and get your life back.
The problem with the SCD of course, is the dairy products. Most of us who have LC react to dairy products. And the problem with many functional medicine practitioners is that they believe that probiotics are helpful for someone who has LC. That idea is valid in theory, but in the real world it almost never works. The vast majority of us are not helped by probiotics (at least not until after we have been in remission for a while), and for many of us, probiotics trigger an adverse reaction. So they are typically not helpful during the recovery stages, and therefore they are best avoided (at least early on during recovery). With this disease, less is better. We have found that the key to remission is to eliminate all foods that cause us to react (rather than to add probiotics or other foods that are promoted as "healthy".
Totally avoiding the foods that you listed are definitely a step in the right direction, though. It's critical when doing an elimination diet to make sure that the few foods we are eating, do not cause us to react. Please be aware that the safest meats, for example (based on member success here) are turkey and lamb. Surprisingly, many of us are sensitive to chicken, beef, and certain fish, for example.
By contrast, if you look at the results of one of our polls (a link is below), you will see that EnteroLab testing is typically very helpful for most of us, because it pinpoints the foods that we must avoid in order to prevent autoimmune reactions. Genova Diagnostics results don't provide that information. Personally, I have never ordered any tests from Genova Diagnostics, but I have used EnteroLab test results with excellent success on a couple of occasions in the past.
EnteroLab Testing
The bottom line is, if you have a bacterial infection (or yeast overgrowth) that is causing your symptoms, the Genova Diagnostics tests might be helpful, but their tests that show digestive efficiency, and related issues are worthless, IMO, because we already know that we have a digestive problem. It seems that many of us suspect bacterial overgrowth, but resolving that issue never resolves our microscopic colitis symptoms. If you want to pinpoint the foods currently in your diet that are causing the production of antibodies, then EnteroLab offers the only tests that we have found to be useful for that purpose. If money is not an object, I would consider adding Geneva Diagnostic testing, but on the average, we definitely get more bang for our buck with EnteroLab testing.
Incidentally, another of our polls shows that we are approximately 7 times as likely as someone in the general population to have a thyroid problem.
Poll About Thyroid Issues
Again, welcome aboard, and please feel free to ask anything.
Tex
Welcome to our Internet family. You've been dealing with this for a long time, so I certainly hope that you can find what you need here to get your symptoms under control, and get your life back.
The problem with the SCD of course, is the dairy products. Most of us who have LC react to dairy products. And the problem with many functional medicine practitioners is that they believe that probiotics are helpful for someone who has LC. That idea is valid in theory, but in the real world it almost never works. The vast majority of us are not helped by probiotics (at least not until after we have been in remission for a while), and for many of us, probiotics trigger an adverse reaction. So they are typically not helpful during the recovery stages, and therefore they are best avoided (at least early on during recovery). With this disease, less is better. We have found that the key to remission is to eliminate all foods that cause us to react (rather than to add probiotics or other foods that are promoted as "healthy".
Totally avoiding the foods that you listed are definitely a step in the right direction, though. It's critical when doing an elimination diet to make sure that the few foods we are eating, do not cause us to react. Please be aware that the safest meats, for example (based on member success here) are turkey and lamb. Surprisingly, many of us are sensitive to chicken, beef, and certain fish, for example.
A few members here have used Genova Diagnostics testing, and as Zizzle noted, those tests are sometimes useful for detecting uncommon issues such as bacterial infections and yeast overgrowth, but I'm not aware a single member here who has been able to resolve their MC symptoms by utilizing the test results from Genova Diagnostics.mbozard wrote:Can I get the same information as would be provided from EnteroLab?
By contrast, if you look at the results of one of our polls (a link is below), you will see that EnteroLab testing is typically very helpful for most of us, because it pinpoints the foods that we must avoid in order to prevent autoimmune reactions. Genova Diagnostics results don't provide that information. Personally, I have never ordered any tests from Genova Diagnostics, but I have used EnteroLab test results with excellent success on a couple of occasions in the past.
EnteroLab Testing
The bottom line is, if you have a bacterial infection (or yeast overgrowth) that is causing your symptoms, the Genova Diagnostics tests might be helpful, but their tests that show digestive efficiency, and related issues are worthless, IMO, because we already know that we have a digestive problem. It seems that many of us suspect bacterial overgrowth, but resolving that issue never resolves our microscopic colitis symptoms. If you want to pinpoint the foods currently in your diet that are causing the production of antibodies, then EnteroLab offers the only tests that we have found to be useful for that purpose. If money is not an object, I would consider adding Geneva Diagnostic testing, but on the average, we definitely get more bang for our buck with EnteroLab testing.
Incidentally, another of our polls shows that we are approximately 7 times as likely as someone in the general population to have a thyroid problem.
Poll About Thyroid Issues
Again, welcome aboard, and please feel free to ask anything.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I appreciate your help so much. Your book has been a great comfort to me. Of course, my gastroenterologist says food changes won't do anything and wants me back on Entocort. I'm resisting that until I really work on the food side. I have gotten so much different advise about foods that it is making me a bit crazy. However, I am definitely leaning towards the EnteroLab testing and a consult with Dr. Fine. One thing that bothered me was that Dr. Fine's website doesn't specifically mention Lymphocytic, Collagenous, or Microscopic Colitis. Is that a problem? Your book says he's an expert right? Also, do you think that if I follow the Modified Elimination Diet on Dr. Fine's website that I might get some relief from current distress? Hate that it says no citrus, strawberries, coffee, alcoholic beverages, honey...Do you think this is applicable to people with LC? Also, what's the best way to determine which test(s) I should order from EnteroLab?
Hi,
Welcome!
I had the Genova Diagnostic test done, only because of insurance coverage, the test is $1000-2000. What I found was, pancreatic Elastase was very low and that I could benefit from digestive enzymes. Also, my stool cholesterol was high meaning I have poor absorption, which I already knew. My Bifid bacteria was low and I could benefit from a probiotic. Probiotics can be hard to tolerate with MC, I tried several and did not tolerate them well . I have tried digestive enzymes, they appear to help digest the food but do not eliminate MC symptoms. I did not have any yeast or parasite issues.
The test that helped me the most was Enterolab A1 & C1 panel. When I did the Enterolab test, I found that I needed to be off Entocort several months to get accurate results.
Welcome!
I had the Genova Diagnostic test done, only because of insurance coverage, the test is $1000-2000. What I found was, pancreatic Elastase was very low and that I could benefit from digestive enzymes. Also, my stool cholesterol was high meaning I have poor absorption, which I already knew. My Bifid bacteria was low and I could benefit from a probiotic. Probiotics can be hard to tolerate with MC, I tried several and did not tolerate them well . I have tried digestive enzymes, they appear to help digest the food but do not eliminate MC symptoms. I did not have any yeast or parasite issues.
The test that helped me the most was Enterolab A1 & C1 panel. When I did the Enterolab test, I found that I needed to be off Entocort several months to get accurate results.
Donna
Diagnosed with CC August 2011
Diagnosed with CC August 2011
Thank you for the kind words. You know, I really don't understand why GI docs make such a stupid assumption, because there is absolutely no published medical research that proves that diet has nothing to do with MC. They just assumed that, years ago, and they seem to be stuck on it. In fact (as mentioned in the book), there is a significant amount of research that shows that diet changes can indeed be used to treat IBDs (even though virtually no GI doc seems to be aware of it). Instead, they prefer to write prescriptions for drugs with side effects that range from moderate to Draconian. 
You probably overlooked the information on MC at the EnteroLab site. Here's a link to some info:
Frequently Asked Questions about Microscopic Colitis.
I can assure you that Dr. Fine is quite familiar with the disease, as he has MC himself, and he controls the disease by diet only. His own diagnosis is the reason why he began to do research on the disease almost 2 decades ago, and that research led to his creation of the lab tests. To be honest, I wasn't aware that he has a modified elimination diet listed on his site.
For an elimination diet, most members here select a meat or 2 (turkey and lamb are examples of meats that the fewest members react to), and a few peeled, over-cooked, easy to digest vegetables (such as squash, carrots, cauliflower, green beans, etc.). Most of us can tolerate bananas, and that is basically the only raw fruit or vegetable that most of us seem to be able to tolerate while we are recovering. After we are in remission, and we have healed for a while, we can usually add many fruits and vegetables back into our diet (slowly at first), and we are eventually even able to eat raw fruits and veggies.
Also, I wasn't aware that he offers a consulting service now. No member here has ever posted about using it (to the best of my memory), so I'm pretty sure that no one here has ever tried it. Most members just order the tests, because that provides the information needed to get their health back on track. He has recently redone his website and added a lot of stuff that appears to cater to those who are interested in the current popularity of health advisers on the Internet. Personally, the only part of his website that appeals to me is the food sensitivity tests offered by EnteroLab.
As Donna mentioned, most members seem to prefer the A1+C1 test panels, because this combination offers a maximum amount of useful information at a discounted price.
https://www.enterolab.com/StaticPages/T ... #PanelA1C1
And also, as Donna mentioned, if you plan to order the tests, you would be better off doing that as soon as possible, because if you decide to begin using Entocort, after a few months of use, your immune response will begin to be suppressed, and the antibody levels in your stool sample will be suppressed. That creates the possibility of false negative results on any IgA-based stool tests for food sensitivities.
I hope you don't mind, but I made an avatar from your photo and uploaded it into your profile, so that you won't need to add it to your posts in the future. If you don't like that change, please let me know, and I will remove it.
You probably overlooked the information on MC at the EnteroLab site. Here's a link to some info:
Frequently Asked Questions about Microscopic Colitis.
I can assure you that Dr. Fine is quite familiar with the disease, as he has MC himself, and he controls the disease by diet only. His own diagnosis is the reason why he began to do research on the disease almost 2 decades ago, and that research led to his creation of the lab tests. To be honest, I wasn't aware that he has a modified elimination diet listed on his site.
For an elimination diet, most members here select a meat or 2 (turkey and lamb are examples of meats that the fewest members react to), and a few peeled, over-cooked, easy to digest vegetables (such as squash, carrots, cauliflower, green beans, etc.). Most of us can tolerate bananas, and that is basically the only raw fruit or vegetable that most of us seem to be able to tolerate while we are recovering. After we are in remission, and we have healed for a while, we can usually add many fruits and vegetables back into our diet (slowly at first), and we are eventually even able to eat raw fruits and veggies.
Also, I wasn't aware that he offers a consulting service now. No member here has ever posted about using it (to the best of my memory), so I'm pretty sure that no one here has ever tried it. Most members just order the tests, because that provides the information needed to get their health back on track. He has recently redone his website and added a lot of stuff that appears to cater to those who are interested in the current popularity of health advisers on the Internet. Personally, the only part of his website that appeals to me is the food sensitivity tests offered by EnteroLab.
As Donna mentioned, most members seem to prefer the A1+C1 test panels, because this combination offers a maximum amount of useful information at a discounted price.
https://www.enterolab.com/StaticPages/T ... #PanelA1C1
And also, as Donna mentioned, if you plan to order the tests, you would be better off doing that as soon as possible, because if you decide to begin using Entocort, after a few months of use, your immune response will begin to be suppressed, and the antibody levels in your stool sample will be suppressed. That creates the possibility of false negative results on any IgA-based stool tests for food sensitivities.
I hope you don't mind, but I made an avatar from your photo and uploaded it into your profile, so that you won't need to add it to your posts in the future. If you don't like that change, please let me know, and I will remove it.
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex! I was on a completely different Dr. Fine website http://www.drfoodsensitivity.com/food-s ... llness.htm . Thanks for the link with all the MC info. The EnteroLab testimonials are where I first learned about Dr. Fine's Consultations. I felt like I might need it in order to interpret the results and come up with the appropriate eating plan but it sounds like that shouldn't be an issue.
I will go ahead with the testing.
Thanks for giving me the avatar. I appreciate you doing this for me!
I will go ahead with the testing.
Thanks for giving me the avatar. I appreciate you doing this for me!
Thanks for clarifying the website mixup. I think the other Dr. Fine may be Kenneth Fine's brother, but I'm not certain. Maybe someone else here knows for sure. I do know that Kenneth has a brother who is also a gastroenterologist, and as I recall, he also has a practice in the Dallas, TX area (Irving is just northwest of Dallas). I suspect there's some sibling rivalry going on there. 
The test results from EnteroLab come with interpretations that specifically apply to those particular results, and they do a pretty good job of explaining the details so that most of us can understand them. If you need any additional explanations, just post your questions, and I'm sure someone here will be able to help. Or, you can always call the lab. Someone is always available there to provide expert answers to any questions that you might have about your results.
If you want to compare with other members' results, or get an idea of how our results turned out, you can see examples here and here.
Note that the C1 Panel results are not posted for many members (including me) because that test panel only became available in the last couple of years. And of course not everyone orders the same tests, for various reasons.
You're very welcome,
Tex
The test results from EnteroLab come with interpretations that specifically apply to those particular results, and they do a pretty good job of explaining the details so that most of us can understand them. If you need any additional explanations, just post your questions, and I'm sure someone here will be able to help. Or, you can always call the lab. Someone is always available there to provide expert answers to any questions that you might have about your results.
If you want to compare with other members' results, or get an idea of how our results turned out, you can see examples here and here.
Note that the C1 Panel results are not posted for many members (including me) because that test panel only became available in the last couple of years. And of course not everyone orders the same tests, for various reasons.
You're very welcome,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex,
Thanks again. I did receive a response from Phyllis Zermeno at EnteroLab and they seem very helpful. Took a look at those posted results and it does appear to clearly point to what you can and cannot eat. That's great. It's comforting to know there are people here that I can discuss this with. I don't want to be sappy, but until I read your book, I have felt very alone with my LC problems. When I had the original mid-diagnosis of Crohn's that I lived with and was treated for incorrectly for 20 years and then got the LC diagnosis, people would look at me like I had two heads. So, what a comfort this forum is. I appreciate it so much.
Thanks again. I did receive a response from Phyllis Zermeno at EnteroLab and they seem very helpful. Took a look at those posted results and it does appear to clearly point to what you can and cannot eat. That's great. It's comforting to know there are people here that I can discuss this with. I don't want to be sappy, but until I read your book, I have felt very alone with my LC problems. When I had the original mid-diagnosis of Crohn's that I lived with and was treated for incorrectly for 20 years and then got the LC diagnosis, people would look at me like I had two heads. So, what a comfort this forum is. I appreciate it so much.
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Sheila
- Rockhopper Penguin
- Posts: 1150
- Joined: Wed May 18, 2011 5:10 am
- Location: Palm Beach Gardens, Fl
This website has been a lifesaver for many of us. Tex's book should be required reading for GI docs who haven't got a clue about treating MC. Without Tex, Polly and the information and support found here, I'm sure I would be a sick, undiagnosed celiac with chronic diarrhea, just like my mother.
You are not alone in feeling intense gratitude to Tex, Polly and the members of the Board who offer support and advice. Enterolab testing is, in my opinion, necessary and should be undertaken as soon as possible.
Sheila W
You are not alone in feeling intense gratitude to Tex, Polly and the members of the Board who offer support and advice. Enterolab testing is, in my opinion, necessary and should be undertaken as soon as possible.
Sheila W
To get something you never had, you have to do something you never did.
A person who never made a mistake never tried something new. Einstein
A person who never made a mistake never tried something new. Einstein
Here's what Phyllis from EnteroLab said about the testing and consultation, "I think the Genova testing is going to be much more comprehensive as a digestive/intestinal health profile than what we could provide in that respect. However, for the issue of IgA food sensitivities, our Panel A1+C1 might be very helpful for you to learn if certain foods might be contributing to your health issues. I have attached a sample report of that panel for you here. I hope you will find it helpful.
Once you have your results back from EnteroLab, if you would like to schedule an consultation it would be with me. Dr. Fine is no longer providing consultations due to his lecture/travel schedule. We can do a 45 minute phone consultation for $99, and if you provide me with labs from other places in advance, we can look at everything together to see what dietary and/or other options might help with your situation."
So, I think I will proceed with both tests just to address everything at once and get a comprehensive plan underway.
Once you have your results back from EnteroLab, if you would like to schedule an consultation it would be with me. Dr. Fine is no longer providing consultations due to his lecture/travel schedule. We can do a 45 minute phone consultation for $99, and if you provide me with labs from other places in advance, we can look at everything together to see what dietary and/or other options might help with your situation."
So, I think I will proceed with both tests just to address everything at once and get a comprehensive plan underway.
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I'm with Jean. The BEST thing I've ever done was joining this board and secondly the Enterolab testing.
We all welcome you here. This board has saved my life, I too felt so lonely not really knowing where to turn and not seeing anyone else with the problem I was having.
I believe you would say I'm in remission. My life turned around immediately right after taking gluten and dairy out of my diet. I did lose about 15# in that time but hey that's a bonus, I'm now 120# and that is wonderful for me.
Please feel free to ask anything. I can answer some things but there's a WHOLE family here that would love to help you and see you get your life back.
Love,
Connie
We all welcome you here. This board has saved my life, I too felt so lonely not really knowing where to turn and not seeing anyone else with the problem I was having.
I believe you would say I'm in remission. My life turned around immediately right after taking gluten and dairy out of my diet. I did lose about 15# in that time but hey that's a bonus, I'm now 120# and that is wonderful for me.
Please feel free to ask anything. I can answer some things but there's a WHOLE family here that would love to help you and see you get your life back.
Love,
Connie
Live, Laugh & Love Much