Enterolab tests
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Enterolab tests
I am considering undergoing testing through Enterolabs and wondering which panel of tests I should start with. I have been gluten free for around a month to 6 weeks and have some okay days but still many not so okay days. Waking up in the middle of the night to go every now and again so I feel that there must be other foods that I'm eating that are doing me in. Just gets so discouraging. Rather than try to figure it out myself I thought this may be the way to go.
Hi Mitzi,
If you can afford the tests, they can certainly save a lot of time and unnecessary suffering. Most insurance companies will not pay for stool tests, (since they are relatively new technology), but that is slowly changing. Some insurance companies will pay for them if a doctor orders them. Most of us have to pay for them out of our own pockets, though. Thinking back, I don't remember ever seeing anyone say that they regretted having the tests done. It's always very "empowering" to see the results, because then we know what we have to do, and we also know which foods we don't have to be concerned about.
For example, I tested negative to soy, eggs, and yeast, but I still consider that to be money well spent, because I was reacting for so long, that I really couldn't be sure if I was intolerant to them or not, so I was happy that the test results told me that I didn't have to worry about those foods.
Unless you are already sure that you're gluten sensitive, it's always reassuring to confirm it with a test result, but virtually all of us test positive to gluten sensivity, so if you want to save some money, you could probably do without that test. Unless you are already sure that you're having problems with dairy products, the casein test, (for cows' milk), is probably a good idea, because most of us seem to be casein intolerant. About half of us are soy intolerant, so that's one test that I would definitely recommend.
Only a few of us seem to be intolerant to eggs, so you will need to decide whether or not you think that test is worth spending the money on. As best I can determine, we only test intolerant to yeast, if we have a yeast overgrowth problem when the test sample is taken, so only a few people test positive to yeast intolerance. Again, you will need to decide if that test is worth it to you. The fecal fat test will tell you if you are having a malabsorption problem, and roughly how much intestinal damage you have accrued, but it's not an essential test, unless you are curious about how long it may take for your gut to heal, and whether or not you need to be taking vitamins while you are healing. This test probably also provides some information on whether or not you might be in the early stages of celiac disease, since fecal fat scores should be higher for celiacs than for non-celiacs. Of course, the gene test also provides some information on that, since it is almost impossible to develop celiac disease, if you do not have a celiac gene. Many of us order the gene test, mostly to try to learn why we have this disease in the first place, but again, it's not an essential test, if you don't have the money to spare, and/or your insurance company will not pay for it. Of course, buying "panels" will allow you to get some tests for free, so you have to look at them and think about which way you can get the tests that you think you need, for the least amount of money.
The lab keeps your sample for about a year, so if you should decide to order additional tests at a later date, you can do so, without having to submit another sample within that time period.
Tex
If you can afford the tests, they can certainly save a lot of time and unnecessary suffering. Most insurance companies will not pay for stool tests, (since they are relatively new technology), but that is slowly changing. Some insurance companies will pay for them if a doctor orders them. Most of us have to pay for them out of our own pockets, though. Thinking back, I don't remember ever seeing anyone say that they regretted having the tests done. It's always very "empowering" to see the results, because then we know what we have to do, and we also know which foods we don't have to be concerned about.
For example, I tested negative to soy, eggs, and yeast, but I still consider that to be money well spent, because I was reacting for so long, that I really couldn't be sure if I was intolerant to them or not, so I was happy that the test results told me that I didn't have to worry about those foods.
Unless you are already sure that you're gluten sensitive, it's always reassuring to confirm it with a test result, but virtually all of us test positive to gluten sensivity, so if you want to save some money, you could probably do without that test. Unless you are already sure that you're having problems with dairy products, the casein test, (for cows' milk), is probably a good idea, because most of us seem to be casein intolerant. About half of us are soy intolerant, so that's one test that I would definitely recommend.
Only a few of us seem to be intolerant to eggs, so you will need to decide whether or not you think that test is worth spending the money on. As best I can determine, we only test intolerant to yeast, if we have a yeast overgrowth problem when the test sample is taken, so only a few people test positive to yeast intolerance. Again, you will need to decide if that test is worth it to you. The fecal fat test will tell you if you are having a malabsorption problem, and roughly how much intestinal damage you have accrued, but it's not an essential test, unless you are curious about how long it may take for your gut to heal, and whether or not you need to be taking vitamins while you are healing. This test probably also provides some information on whether or not you might be in the early stages of celiac disease, since fecal fat scores should be higher for celiacs than for non-celiacs. Of course, the gene test also provides some information on that, since it is almost impossible to develop celiac disease, if you do not have a celiac gene. Many of us order the gene test, mostly to try to learn why we have this disease in the first place, but again, it's not an essential test, if you don't have the money to spare, and/or your insurance company will not pay for it. Of course, buying "panels" will allow you to get some tests for free, so you have to look at them and think about which way you can get the tests that you think you need, for the least amount of money.
The lab keeps your sample for about a year, so if you should decide to order additional tests at a later date, you can do so, without having to submit another sample within that time period.
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.
Mitzi;
Just some info from another perspective.
I have never had testing done by EnterLabs. I chose to go GF, and was encouraged by those on this site to give it plenty of time. It took me 3 months to see any releif at all, and 6 months to consider myself symptom free.
I recognize that I am one of the lucky ones who has mostly remained symptom free with only the GF diet. That does not happen for everyone. However, I'd like to encourage you that 6 weeks of the GF diet is not always enough to see relief.
If you choose that you can afford the tests, that definitely will help you in finding what you need to avoid without all the trial and error.
I do want to encourage you with your diet - keep up the good work!
G'ma Mary
Just some info from another perspective.
I have never had testing done by EnterLabs. I chose to go GF, and was encouraged by those on this site to give it plenty of time. It took me 3 months to see any releif at all, and 6 months to consider myself symptom free.
I recognize that I am one of the lucky ones who has mostly remained symptom free with only the GF diet. That does not happen for everyone. However, I'd like to encourage you that 6 weeks of the GF diet is not always enough to see relief.
If you choose that you can afford the tests, that definitely will help you in finding what you need to avoid without all the trial and error.
I do want to encourage you with your diet - keep up the good work!
G'ma Mary
Those who are not part of the solution, are part of the problem.
G'ma Mary is correct, of course - most people do not achieve remission in only six weeks, (though a few of the lucky ones do). Of course, the test results remove all doubt, but it's possible that you may just need a little more time on the diet. It's a tough call.
Tex
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.
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One again, thank you for the wonderful answer! I know this is redundant, but seriously!!! I appreciate the logic of your answer about Dr Fines tests.
I'm trying to decide if there is a good reason to have testing done. I know I can keep myself symptom free by doing low carb, non-dairy, low sulfite, & grain-free (including rice/millet, etc - ALL grains). I know my blood tests and biopsies are negative for celiac disease, (although I was gluten free at the time). Can you think of any benefit from any of Dr. Fine's tests?
Tex, you asked how I had been doing . . really good unless I decide to tempt fate and eat bad things. I've had some pretty prolonged periods of normalcy, and that almost makes it easier to forget how I feel when sick: and inevitably I get sucked into eating things like sprouted wheat bread. I've even done well with that until I begin eating it 3-4 times a day, and gradually I have looser stools, then D, then all of a sudden I've irritate my GI system so much that I have a hard time getting things under control - right now I've had an upset stomach for about a month because of going off the diet: once it starts, it's hard to get UN-irritated. Its almost as though I've burned the lining of my intestines and they can't heal while food is always in contact, even if it's good food.
But isn't that good news? I finally have eliminated enough irritants to get to a point where I am a good weight, no bloating, gas, D. The problems are: eating at restaurants, & the monotony of a limited diet.
I've been reading your blogs, but how about you? Karen seems to be doing well. How about Matthew, and Polly? I know Polly had problems with her sinuses. My stomach is always worse when my sinuses are bad - the two are connected somehow.
Talk to you soon - kind of late, so I should keep this relatively short . . .
I'm trying to decide if there is a good reason to have testing done. I know I can keep myself symptom free by doing low carb, non-dairy, low sulfite, & grain-free (including rice/millet, etc - ALL grains). I know my blood tests and biopsies are negative for celiac disease, (although I was gluten free at the time). Can you think of any benefit from any of Dr. Fine's tests?
Tex, you asked how I had been doing . . really good unless I decide to tempt fate and eat bad things. I've had some pretty prolonged periods of normalcy, and that almost makes it easier to forget how I feel when sick: and inevitably I get sucked into eating things like sprouted wheat bread. I've even done well with that until I begin eating it 3-4 times a day, and gradually I have looser stools, then D, then all of a sudden I've irritate my GI system so much that I have a hard time getting things under control - right now I've had an upset stomach for about a month because of going off the diet: once it starts, it's hard to get UN-irritated. Its almost as though I've burned the lining of my intestines and they can't heal while food is always in contact, even if it's good food.
But isn't that good news? I finally have eliminated enough irritants to get to a point where I am a good weight, no bloating, gas, D. The problems are: eating at restaurants, & the monotony of a limited diet.
I've been reading your blogs, but how about you? Karen seems to be doing well. How about Matthew, and Polly? I know Polly had problems with her sinuses. My stomach is always worse when my sinuses are bad - the two are connected somehow.
Talk to you soon - kind of late, so I should keep this relatively short . . .
Thank You all for the response regarding the testing. I will give the diet some more time and meanwhile try to cut out other possible irritants. I feel like I am obsessed with my bowels. Everytime I run to the bathroom I'm hoping for something along the lines of normal whatever that may be!! I'm just so greatful to have found this sight and for your help.
Mitzi,
Trust me, all of us are obsessed with our bowels, when we're reacting, and it doesn't take us long to become dedicated "toilet watchers". We're very glad that you found us, too, and we hope that you start seeing some significant improvement, very soon.
You're most welcome,
Tex
Trust me, all of us are obsessed with our bowels, when we're reacting, and it doesn't take us long to become dedicated "toilet watchers". We're very glad that you found us, too, and we hope that you start seeing some significant improvement, very soon.
You're most 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.
Marsha,
Thank you for the kind words, and I appreciate the update. You know, we learn a lot, every time someone who has been on the diet for a while, updates us on their situation. That's especially true for someone who has a lot of intolerances, such as you. That feedback is probably a lot more valuable than most people realize, because it's information that you usually can't get out of the literature on the net, (or any other way, for that matter). Most doctors, for example, send their patients home with a prescription, and if they don't hear back from the patient, they assume that the prescription did the trick, and the patient is fine, so they chalk it up as another case resolved. But is that really true? Or did the patient just get frustrated and go elsewhere, or give up? Without feedback, that doctor will draw the wrong conclusions every time. Sooooooo, many thanks for the feedback.
So, I guess what I'm trying to say, is that unless you are curious about soy, or eggs, (or yeast), or you suspect that you are accidentally getting traces of gluten in your diet, I don't see much point in spending any money on antibody tests. The fecal fat test is a possibility, since it will tell you, in general, how well your diet has been treating your intestines, so it might provide you with some idea of how much damage your gut is dealing with during the current "upset".
The gene testing has always fascinated me, since I believe that it holds a key to the code that determines exactly what our intolerances might be, and I'm hoping that someday, someone will be able to figure out how that code works. Because of all your intolerances, I've always wondered if you might be another member of the Double DQ1 Club. Still, the results of that test probably wouldn't actually affect your treatment decisions, so from that viewpoint, the test is mostly of academic interest.
Avenin, (the prolamin in oats that is the equivalent to the gluten in wheat), is only present in oats in relatively small amounts, (compared with the gluten content of wheat), and avenin is a weaker "irritant", so it really shouldn't be any surprise that it takes longer to initiate a reaction episode. Sprouted wheat is the same way, in that enzymes created during the germination process sort of "digest" the wheat seed, and create significant chemical changes, that theoretically, at least, should de-activate the gliadins contained in the gluten in the wheat kernels. I suspect the problem with sprouted wheat comes from the fact that we live in an imperfect world, and not all kernels properly germinate, (in fact germination rates for wheat seed typically run in the 85 to 95% range, but excursions outside that range are not rare). What that implies is that sprouted wheat could contain roughly 5 to 15% damaged kernels that still contain some viable gluten, (and therefore gliadins). The amount would be unpredictable, since even if the kernels rot, rather than sprouting, some chemical changes take place, which would tend to diminish the gluten content. Anyway, the point is that, (in the real world), sprouted wheat almost certainly has to contain some small amount of gluten, and unless an individual can tolerate that amount, eventually a reaction will be triggered, after a certain damage threshold is exceeded. At least that's the way I see it.
It's great to see that in general, you've got your diet fine-tuned to the point that you know where your limits are, so you only have problems when you "experiment". I suspect that we all do some experimenting, now and then, so don't feel like the Lone Ranger. Experimenting has been my biggest threat to remission ever since my symptoms began. LOL. I never experiment with wheat gluten, though. Anything else is fair game.
Other than occasional "experiments", I have to say that I'm doing pretty doggone good, so I can't complain. You know, now that you mention sinus problems causing digestive system issues, I notice that I usually get minor D when I have hay fever, or a cold, and right now, I'm just getting over a cold, and we're just coming out of the hay fever season down here. So, while this is nothing like an MC reaction, still, it will be good to see that minor irritation disappear. I think that I mentioned in another post somewhere, not too long ago, that I have a hunch that the histamine reaction connected with hay fever and similar allergies, (true allergies), also seem to have an effect on the gut, for those of us with MC. Since I don't see anything in the literature about this connection, I have to assume that it does not apply to the general population, only to MCers. Thanks for asking, by the way.
As far as I know, Matthew and Polly are doing fine, and they mostly stay busy as beavers. Polly finally licked her sinus problem late last year, I believe, but she's taken up more environmental/political causes this year, so she has been posting rather infrequently, lately.
Tex
Thank you for the kind words, and I appreciate the update. You know, we learn a lot, every time someone who has been on the diet for a while, updates us on their situation. That's especially true for someone who has a lot of intolerances, such as you. That feedback is probably a lot more valuable than most people realize, because it's information that you usually can't get out of the literature on the net, (or any other way, for that matter). Most doctors, for example, send their patients home with a prescription, and if they don't hear back from the patient, they assume that the prescription did the trick, and the patient is fine, so they chalk it up as another case resolved. But is that really true? Or did the patient just get frustrated and go elsewhere, or give up? Without feedback, that doctor will draw the wrong conclusions every time. Sooooooo, many thanks for the feedback.
That's a very good question. You know, I did pretty much exactly what you're contemplating. I ordered the tests mentioned above, over three years after I had been on the diet, and when I got the results back, I didn't change my diet much, but I did stop worrying about small amounts of soy and yeast, and I stopped wondering about eggs, (I had been eating eggs somewhat regularly, but was occasionally suspicious of them, because they seemed to bother me if ate them every day). I didn't see any point in ordering any gluten antibody test, but I did order the fecal fat test, and was surprised to find that I still had some residual intestinal damage, even though I had been on the diet for over three years. I also ordered the gene test, and since I found that I have a celiac gene, that added some support to my suspicions that I may be a celiac, or I may have been headed in that direction, before I adopted the diet.Marsha wrote:Can you think of any benefit from any of Dr. Fine's tests?
So, I guess what I'm trying to say, is that unless you are curious about soy, or eggs, (or yeast), or you suspect that you are accidentally getting traces of gluten in your diet, I don't see much point in spending any money on antibody tests. The fecal fat test is a possibility, since it will tell you, in general, how well your diet has been treating your intestines, so it might provide you with some idea of how much damage your gut is dealing with during the current "upset".
The gene testing has always fascinated me, since I believe that it holds a key to the code that determines exactly what our intolerances might be, and I'm hoping that someday, someone will be able to figure out how that code works. Because of all your intolerances, I've always wondered if you might be another member of the Double DQ1 Club. Still, the results of that test probably wouldn't actually affect your treatment decisions, so from that viewpoint, the test is mostly of academic interest.
That's some very interesting information. It reminds me a lot of my "oat challenge", because that is exactly what happened to me. It took me about six weeks to get sick, but once the D set in, it took another six weeks to get completely rid of it, so there was definitely a significant amount of damage. Apparently, once we exceed a certain threshold, (IOW accrue a certain minimum amount of damage), the D becomes chronic, until enough damaged tissue can heal, for the gut to begin to function normally, again.Marsha wrote:and inevitably I get sucked into eating things like sprouted wheat bread. I've even done well with that until I begin eating it 3-4 times a day, and gradually I have looser stools, then D, then all of a sudden I've irritate my GI system so much that I have a hard time getting things under control - right now I've had an upset stomach for about a month because of going off the diet: once it starts, it's hard to get UN-irritated. Its almost as though I've burned the lining of my intestines and they can't heal while food is always in contact, even if it's good food.
Avenin, (the prolamin in oats that is the equivalent to the gluten in wheat), is only present in oats in relatively small amounts, (compared with the gluten content of wheat), and avenin is a weaker "irritant", so it really shouldn't be any surprise that it takes longer to initiate a reaction episode. Sprouted wheat is the same way, in that enzymes created during the germination process sort of "digest" the wheat seed, and create significant chemical changes, that theoretically, at least, should de-activate the gliadins contained in the gluten in the wheat kernels. I suspect the problem with sprouted wheat comes from the fact that we live in an imperfect world, and not all kernels properly germinate, (in fact germination rates for wheat seed typically run in the 85 to 95% range, but excursions outside that range are not rare). What that implies is that sprouted wheat could contain roughly 5 to 15% damaged kernels that still contain some viable gluten, (and therefore gliadins). The amount would be unpredictable, since even if the kernels rot, rather than sprouting, some chemical changes take place, which would tend to diminish the gluten content. Anyway, the point is that, (in the real world), sprouted wheat almost certainly has to contain some small amount of gluten, and unless an individual can tolerate that amount, eventually a reaction will be triggered, after a certain damage threshold is exceeded. At least that's the way I see it.
It's great to see that in general, you've got your diet fine-tuned to the point that you know where your limits are, so you only have problems when you "experiment". I suspect that we all do some experimenting, now and then, so don't feel like the Lone Ranger. Experimenting has been my biggest threat to remission ever since my symptoms began. LOL. I never experiment with wheat gluten, though. Anything else is fair game.
Other than occasional "experiments", I have to say that I'm doing pretty doggone good, so I can't complain. You know, now that you mention sinus problems causing digestive system issues, I notice that I usually get minor D when I have hay fever, or a cold, and right now, I'm just getting over a cold, and we're just coming out of the hay fever season down here. So, while this is nothing like an MC reaction, still, it will be good to see that minor irritation disappear. I think that I mentioned in another post somewhere, not too long ago, that I have a hunch that the histamine reaction connected with hay fever and similar allergies, (true allergies), also seem to have an effect on the gut, for those of us with MC. Since I don't see anything in the literature about this connection, I have to assume that it does not apply to the general population, only to MCers. Thanks for asking, by the way.
As far as I know, Matthew and Polly are doing fine, and they mostly stay busy as beavers. Polly finally licked her sinus problem late last year, I believe, but she's taken up more environmental/political causes this year, so she has been posting rather infrequently, lately.
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.