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Smart Pill Test
Hi B. & Daniel,
In October 2021, I underwent a wireless motility capsule test (smart pill test). Please see attached results. It showed I have:
- Low caecal pH and
- Delayed colonic transit.
I was prescribed a medication called “Linaclotide” (active ingredient) or brand name was called “Constella.” It didn’t help.
Please also see two pub med linked to the above findings
I wanted your expertise on whether the above issues are linked to low SCFA. If yes, what could I take to address this?
The PDF file password was entered by the clinic and it’s 160369
Naveed Aslam 4.10.21 Wireless Motility Capsule Test (Smart Pill Test).PDF
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12 Replies
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Hey ,
For some reason, I can’t open the pdf. Perhaps the password you gave isn’t the right one?
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hello.
Please try 16031969
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Hey ,
In this test, they didn’t measure SCFA. What they mentioned in the results they mention that a low caecal pH is suggestive for increased production of SCFA produced by gut bacteria. But they only measured the pH.
The low pH could be indicative of SIBO.
Basically what they say is: it could be you had more bacteria and therefore more SCFA production.
The delayed colonic transit could be caused by other factors as well. If the medication wasn’t working, it would be more likely that other factors might be at play as well. For example, a slow thyroid can also cause a delayed colonic transit time. Linaclotide wouldn’t help with that
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Thank you Daniel. I’m not sure if I have a slow thyroid. In August 2023, I did a GI Effect stool test as it shows different markers to GI map. I am trying to locate the PDF. I’m pretty sure it has SCFA marker. Let me find it and will upload it here.
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I was just making an example, there can be other contributing factors to slow transit time besides SIBO. I just wanted to raise the awareness that the slow transit time could have other root causes.
Direct SCFA markers are more accurate. Especially if they are more recent. I would give more weight to the stool test since SIBO comes in different varieties.
The results of the smart pill are from 2021. I wouldn’t give too much weight to the results of these tests anymore. The microbiome changes with how you eat and you applied quite a few changes in those 2 years I believe.Even if you still have SIBO (read carefully: I’m not saying you have SIBO right now!), the composition of the bacteria could have changed!
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Hi Daniel,
Yes, two years on, with dietary and supplement changes, bacteria composition changes can affect the gut microbiome. Sure, I won’t press too heavily on results from 2 years ago.
Please find attached GI Effect from August. I am quite surprised by these results as I still feel awful, especially my lower gut. The bloating, distension and pain is intolerable.
This PDF mentions SCFA. [Naveed Aslam 9.8.23 GI Effects.pdf]As for SIBO, I don’t have it. Please see attached results from June 2023. Password is 16031969
[Naveed Aslam 14.6.23 Lactulose Hydrogen Methane SIBO Breath Test.PDF][Naveed Aslam 26.06.2023 Lactulose H2S Report.PDF]
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Hey ,
Well, the first step is determining if the pain is really caused by the gut. Unfortunately that’s hard to assess from here. I’m assuming a healthcare professional helped you find out, but if it’s just an assumption, you might want to ask someone first!
Besides the awful pain and the bloated feeling, can you tell me more about what you (don’t) feel?
• Are you gassy?
• How often per day do you poop currently?
• How do you score on the Bristol stool chart? (You’ll find good pictures on google)
• What color is your stool? And is it light or dark?
• Do you also feel pain in the groin? (see pictures attached)[groin.jpg] -
Hi Daniel,
Are you gassy?
Do you mean, whether I pass wind? I don’t I’m afraid and nor am I burping.If I do, it smells extreme foul. Like rotten eggs. Excuse TMI.
How often do I poop?
After 3 to 5 days.Bristol Chart poop is 4. It’s formed and soft, but when I do go it’s painful to defecate.
The stool can be sometimes light or medium brown.
Yes, I do feel pain pre bowel movement and alot more at time post Bowel movement. Yes, definitely picture 3 and can also be across the entire lower abdominal region from left to right. Laying down and heat helps. It’s worse when sitting, sitting and walking.
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Hey ,
With my questions, I am actually trying to find out whether the pain you mean is caused by the intestines or by something around the intestines. However, I realize this is better done by a doctor or other healthcare professional sitting opposite you.
After all this time, taking a fresh look at basic habits is also good!
For example: for a good colon transit time you need sufficient exercise. So if you sit a lot, there is a lot of profit to be made.
If you eat a lot of sugar, this can affect the composition of the bacteria in your intestine.
Do you know how many grams of fibre you eat? A lack of SCFA in the feces may be due to insufficient types of bacteria that produce SCFAs, but the test shows that there are strains present that produce SCFA. The SCFAs may be absorbed by the body due to the long transit time. But it may also be that in the days before the GI Effects test you hadn’t consumed enough fibre.
Being sufficient in magnesium, eating the right types of fats, being sufficiently hydrated and consuming enough food are other basics that influence transit time. Are there things on the list you can feel you can improve on?
Medications (such as antidepressants) can also contribute to constipation. Have any of your doctors looked at all the side effects of your current medications?
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Hi Daniel,
I’m not taking any antidepressants. I take the following medications
1. Femotidine (H2 Blocker)
2. Sucralafate (10ml during the night)
3. Gaviscon (not regularly)
4. Prucalopride (prokinetic)I take one – two capsules of Magnesium of pure encapsulation Magnesium Glycinate daily.
Ony fats I take is 1/2 to 1 table spoon of coconut or Ghee oil in my food whilst cooking.
I certainly am not eating a lot due to the gastroperisis or lower abdominal tightness, bloating or distension.
I don’t know how much fibre I am eating. I will check and will let you know. I don’t think I eat alot due to the gastroperisis as fibre and meat is painful on the stomach.
I don’t sit a lot, but am standing. I find when I sit the pressure from the lower abdomen causes an upward pressure and heartburn especially after eating.
I only eat two meals a day fibre and meat causes problems on the stomach. I’ve tried beets, okra, bitter gourd but don’t agree. Only vegetables which agree are Courgettes (1/2), carrots (1/2) and pak choi (1 bulb), but only with jasmine rice as the rice masks the texture of the vegetables and therefore soothing on the stomach. The same with chicken thigh and it’s meat stock when I have it rice. This is my evening meal.
My breakfast is lunch which is Oatmeal or millet (6 tbsp) in Coconut milk and one booked egg. The oatmeal and or millet once cooked is blended.
Unfortunately, sugar trigger in the evening is a real problem. I know it’s wrong but I am only keeping my weight up this way. Lack of food is the cause or not knowing and sticking with safe food.
I can’t have healthy fats due to high histamine in avocado or salmon.
I’ve tried stopping grains, but having meat or vegetables on their own is painful on the stomach.
I haven’t had sugar for a week, but sugar craving keeps coming back.
I am just going round in circles.
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Not sure why, but the post is one long paragraph. I was typing from my mobile.
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Hey ,
I’m so sorry to hear your struggles. From your reply, I think there are things you can try. Pick things you are comfortable doing. You don’t need to address it all at once.
Lifestyle factors you can explore.
It’s great that you are standing. But with moving your body I mean exactly that. From personal experience leg exercises and movement in the core area are more effective. When you explore this option, don’t immediately go from standing to a full workout, but gradually add movement (or workout intensity) to see how your body reacts.Vegetables contain fibre, but vegetables as the only source of fibre won’t provide you the amount you’ll need daily. Oats are a great source of fibre. If you discover your fibre intake is low, you can play with the amounts of oats.
Your medications & constipation
I can only educate you on the side effects of your medications. Almost all of them, besides Prucalopride, can contribute to constipation through different mechanisms of action.Prucalopride was meant to counter constipation. Does the Prucalopride have an effect? This medication works by activating serotonin receptors in the gut.
H2 blockers, like Famotidine, interfere with digestion. Even if it helps you with the heartburn, it can cause side effects like constipation.
The Sucralafate can have a constipating effect (look here). It is also a source of aluminium. Although it is advertised as safe, I’m not the biggest fan of getting any form of aluminium sources in the body. Aluminium can cause damage to nerves. When taken on a regular base, the accumulative effect of aluminium exposure on long-term health is hard to study. The gut is also, just like the brain, extremely rich in nerves. One of the functions of the gut nerves is to create coordinated muscle contractions to cause a bowel movement.
If you and your doctor decide that this is for now the best strategy for dealing with your heartburn, focus on the lifestyle factors first. If you’re going to try different medications, don’t switch them all at once. You won’t be able to tell which medication has the biggest impact.
I hope you can find some relief with these tips!
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