Tag Archives: short chain fatty acid stool tests

Gastroenterologists’ Stance on Alternative Testing (IgG Food Antigens, Salivary IgA, Intestinal Permeability, etc.)

The duck-rabbit, made famous by Wittgenstein

Quack? (Photo credit: Wikipedia)

Do you have irritable bowel syndrome or some other GI related issues?  Have you had some alternative tests ordered?  Maybe you’re considering alternative tests?  Have you ever wondered if they are legitimate tests?  As I’m reviewing my short chain fatty acid results and the research about short chain fatty acids, I came across this fairly recent article and statement from some doctors submitting to The Journal of Gastroenterology and Hepatology.  They looked at the analytical and clinical validity, clinical utility and ethical implications for some alternative tests, specifically:

  • Serum immunoglobulin G (IgG) to food antigens,
  • Salivary IgA,
  • Intestinal permeability,
  • Fecal short-chain fatty acids, and
  • Fecal microbial analysis.

Their conclusion on the ethics of these tests:

“It is the opinion of the authors that for a test to be viewed as ethically sound it must confer benefit and not do harm to the patient. As the rationale, validity and reliability of all of the investigations are questionable, the benefit to the patient is hence not readily apparent. Moreover as the investigations cost the patient money, the potential to do harm (in a fiscal sense) is apparent.”

Their conclusion overall regarding these tests:

“…None of the investigations examined by the authors can be recommended for routine clinical practice. Not only are the scientific underpinnings for the individual investigations questionable (the validity and rationale for testing), but the reliability of the individual assays are poor. Clinical decisions made on the basis of the test results are not evidence-based. Alternative investigations for IBS should for now be limited to the research laboratory.”

My take:  The more I know, the less I understand. (What?  Seriously?  You wanted me to come over to the “Dark Side” that easily?  I’ll bet you wanted a ranting and a raving. “Those doctors are wrong and arrogant.”  At least a strong opinion either way.  “These lab tests are a waste of time, money–and they manipulate naïve, desperate patients.”  Sorry.  Life doesn’t and ought not work that way.  Most of the time.  I’ll keep to my middle-ground today, with a caution to proceed carefully, not spend more than you have, and not to expect too much.  I’ve taken the microbial test and short chain fatty acid test.  They didn’t rock my world or fix my problem.  As clues, they may prove helpful eventually.  But by then, I and other medical doctors could just call it a chance improvement.)

Closing and Important Disclaimer:

Don’t neglect your health.  Make sure you’ve been evaluated by a doctor for your health concerns.  This blog is not intended for self-treatment or self-diagnosis.  It is intended to share the story of a mainstream medical doctor coming to terms with nutrition and alternative health, now that she has time to research some of it.

Hamish Philpott, Sanjay Nandurkar, John Lubel, and Peter R Gibson.  Alternative Investigations for irritable bowel syndrome.  Journal of Gastroenterology and Hepatology.  2013.  Jan; 28(1): 73-77.