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Recommendation needed
Hi @Bernadette Abraham and community,
could anyone suggest a reliable gastroenterologist in Dubai who would help with investigations with a functional medicine approach.
thank you
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12 Replies
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Hi @Szilvia Bartalos – unfortunately I do not know of any. If you need access to any functional tests however, we can help with that along with the interpretation.
Please let us know.
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Thank you @Bernadette Abraham, what kids of functional tests could I run for the following? It is still an ongoing issue not new. I used to panic about it I think I better manage it now but still I want to know how I could improve or get rid of it.
Occasional chest pain on left hand side (behind left breast close to middle). It gets worst before and first days of period. Evenings, sometimes in bed and gets better when I elevate myself. I assume this is acidity related issue.. I did a colonoscopy and endoscopy last year and that had no findings (thankfully) but maybe I should repeat a colonoscopy. I went to a cardiologist and is super unlikely it is anything to do with heart.
I just did my annual health check and everything looked ok, except I’m taking iron and vit D and my WBC was a little low so I’ll go for a check again in a few months to compare.
Thank you
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Unfortunately I sometimes have bad breath also and tried all sorts of things but I assume that also could be gastro related.
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@Szilvia Bartalos I think your gut instinct may be correct in that it’s gut/acidity related. This was my initial thought as well since the pain goes away when you elevate yourself which can point to the possibility of silent reflux.
And bad breath is also very often related to low stomach acid or an abnormal gut microbiome. Do you have an idea of what your breath smells like? This could give us a clue. I explain the different smells and common risk factors for bad breath in the Symptom Dictionary handout HERE.
As a next step if you’re looking to do functional testing, a comprehensive stool test like the GI Map for example could provide insights into microbiome balance, any overgrowths, possible parasites, digestive markers, inflammatory markers, and zonulin which is associated with “leaky gut”. If budget is a concern, you can get an H Pylori only stool test, as that’s very often related to bad breath and low stomach acid.
You can find more information about the GI map HERE and another comprehensive functional stool test HERE from the Gut Health Masterclass course.
This test is not something a gastroenterologist will order or know how to interpret unless they have additional functional medicine training, so if you’d like to pursue this test, please send an email to support@bbettermembership.com and they can give you access to it directly with the lab for ordering.
If you’ve already been to the gastro and done scoping but they are unable to help you, I would suggest going the FM route now to look at microbiome/digestive health.
But first, please read through the Symptom Dictionary handout and let us know about the smell and whether or not any of those non-gut related risk factors may be at play in your case. Those would require different testing.
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Hi @Bernadette Abraham
Thank you so much, this is very informative.
Regards to the smell, my husband says is metallic acidic smell. Last time it actually got better after having a meal and drinking apparently. He says I had it even when he met me but is worst and more common. These days. 🙁 I have even got rid of some wisdom teeth recently as they grew sideways and thought they might have caused this. But it seems no.I think I would be interested in a GI map testing. I’ll email regards to this. Maybe I could check with my insurance if they could cover it.
I have Gilbert syndrome so my bilirubin is always above the normal mark but apparently there is little I could do about it. However, after my parasite cleaning and liver support supplementation (together) last year the levels improved. Although I’m not sure whether that could just be coincidence or could have slightly different figures depending on the time of the day or month I do the test.
Thank you.
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@Szilvia Bartalos most insurances don’t cover these tests, but it really depends on the insurer and your policy. Clients of mine with BUPA or Cigna International seem to be able to claim everything and anything.
So an acidic/metallic smelling breath could be diet related as well. Do you restrict carbs and get into ketosis a lot (when the body breaks down fat for energy instead of carbs)? That can give off an acetone-like breath which could be perceived as metallic smelling.
Do you consume a lot of foods high in sulfur compounds, such as garlic and onions? That can also contribute to acidic breath odor in some people.
Iron supplementation or copper intake can also lead to acidic type of breath.
But if it’s been longstanding however, I would still point the finger at the gut and really want to know what’s at play there. A comprehensive stool test can hopefully shed more insight – especially with quantifying H Pylori and microbiome balance.
And Gilbert syndrome won’t have an effect on the stool test – so no worries there.
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Thank you @Bernadette Abraham.
I’m almost always on iron supplements.. unfortunately and I do like spring onion (that I often incorporated into breakfast) which I recently started reducing.
I’m curious now to try and see if the test could help shed light to anything else so will look into it. I have Bupa so let’s see. Hopefully I’ll manage to claim it somehow.
Thank you
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@Szilvia Bartalos ok, so having to be on iron supplements is a symptom unless you follow a vegan diet?
If not, please watch THIS VIDEO in our Mineral Balance course discussing the risk factors for low iron, and let’s start helping you rule out why that might be!
Connecting your symptoms of bad breath and possible silent reflux, low stomach acid can also lead to malabsorption of iron (and other minerals/vitamin B12) so I’m really suspecting this to be at play. Have you ever tried the at-home baking soda challenge? You can find it HERE from the Gut Health Masterclass course at the 3-minute mark.
But there are many other possible causes for low iron. Have you ever tested zinc and copper levels? RBC B12? Do you have heavy periods?
From your point of view after watching the video on the different causes, what do you suspect might be a probable culprit?
And if you try the baking soda test, please report back and let us know the results.
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Hi @Bernadette Abraham ,
I did the baking soda test and no burps whatsoever. I also just tried around 11 am (had early breakfast but now totally empty stomach and hungry – and I was warned of the bad breath). No burps. Could it be that because I’m having low stomach acid? But how would the smell come up, could it be something wrong with the esophagus or LES? My husband has actually GERD and he rarely has bad breath.
Regards to iron, I think is because of the copper coil I have. I couldn’t find any better option so far for birth control so I’m unfortunately paying this price for having heavy periods and needing to supplement with iron. I’m just not very comfortable with hormonal contraceptives. Perhaps it is accompanied by poor absorption. That I’m not sure about but my levels adjust after 3-6 months of supplements. But then again would go down.
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@Szilvia Bartalos while the baking soda challenge is not diagnostic, it does give a pretty good indication of stomach acid status. No burping would indicate the possibility of hypochlorhydria (low stomach acid), which is what I’ve been suspecting.
Now the question is why. I discuss common reasons for low stomach acid in this video HERE. H. Pylori overgrowth is a common reason, which can also cause bad breath so I’m suspicious. A comprehensive stool test can help rule that out and if there is an overgrowth, close partners should treat it at the same time since it’s very contagious. We have protocols that can help.
Regarding contraception, have you considered or tried the combination of condoms during the fertile window along with fertility tracking? It seems like it could be a good option since it’s non-invasive and doesn’t have any negative health impacts. Let me know if you’d like some suggestions about fertility tracking devices.
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Hi @Bernadette Abraham
I’m afraid I didn’t have a lot of luck with the gastroenterologist regards to trying to ask for referral for GI map. (Is actually a new doc because my old one moved back to Germany) However I was told that I was tested for H Pylori a few times negative including when I had my colonoscopy and endoscopy in late 2022. I’m doin better, I’m told – by eliminating spring onion and increasing water and small meals. However, the occasional and still unexplained right side discomfort is still occurring.
Regards to contraception, I have not tried yet. I’m a bit worried how reliable that would be, but maybe I’m wrong. If you could please give some suggestions about fertility devices that would be great. I’m actually using an app Clue but the free version just to track my period. Is it something like that you are referring to?
Thank you
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@Szilvia Bartalos unless the gastro is trained in functional medicine, it’s rare to get a referral for this functional stool test. By the way, it doesn’t only test for H Pylori, and in my experience, I’ve seen a lot of false negatives. What I like most about the GI Map is the quantitative nature of it. It doesn’t just tell you positive or negative, but also the actual value which is helpful for tracking progress.
Glad the breath issue seems to be resolving with those small dietary changes. The right side pain however could be pointing to liver/gallbladder issues possibly. If I recall correctly, I believe you’ve already uploaded a liver panel for us to look at right? More specifically these markers: ALT, AST, GGT, Alk Phos, Bilirubin, and especially Direct bilirubin.
As for fertility tracking devices, take a look at Daisy and Lady-Comp. Both of these track your body’s basal temperature and synch with a tracking app. They have very high accuracy rates. Here’s Daisy’s “how it works” video to explain it better. Using the combination of condoms and fertility tracking is not for everyone, but definitely is empowering to know your body’s rhythms and have better control.
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