The Questions This Doctor Always Asks Her Patients About Their Poop
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The Questions This Doctor Always Asks Her Patients About Their Poop

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

It’s amazing how uncomfortable many people get around poop. I know someone who will only do it in complete solitude, and I don’t mean with the door closed—I mean alone in a building! In contrast, I’m “into” poop because it’s such a critical component of health. It can tell you a lot about the balance of bacteria in your gut, how well you’re absorbing nutrients, and whether your body is detoxifying toxins properly. As a result, it’s always a big part of my standard work-up and evaluation in my functional medicine practice.

The questions I always ask my patients about their bowel movements.

So let’s dive in; it’s time to get personal! Here are three questions I always ask my patients about their bowel movements:

1. How often do you poop?

It always blows my mind when I ask my patient how often he or she is pooping and I hear “once a week” or “once every two weeks.” I immediately know that this is someone with a challenged gut and a lot of work to do on their health. Unless you’re fasting you’re taking in food every day. Once you’ve gotten what you need from that food, you need some way to get rid of the waste. and you do this by having daily bowel movements! I remember laughing hysterically in medical school when I learned about the “oro-anal” response, which means that when you eat, it causes you to poop. When the gut is functioning normally, you should expect to have a bowel movement at least once a day, and up to four times in a day can be normal depending on its size and shape.

2. What does it look like?

Size matters, people! What I’ll call “bunny poops” (those hard little pellets) are not normal! Nor is diarrhea, watery stool, food particles, or pencil-thickness poops. The ideal poop looks like a pipe, and the thickness will vary based on your colon.

3. Does it require a lot of effort?

Many people don’t know this, but it’s not normal to have to strain. Pooping actually occurs when you relax; you need to relax the muscles to allow the stool to pass. Straining, pushing, or splinting aren’t normal and can be addressed, depending on the underlying cause.

Here’s why this is all so important—especially for women.

For women in particular, a dysfunctional gut can have terrible consequences for our hormones, mood, and skin, not to mention the risk of cancer. You see, in addition to food waste, our gut excretes the hormones that the liver has bound to and deactivated. What does this mean, exactly? Well, your body produces hormones, and the liver is responsible for processing and inactivating them. This happens in two phases: Phase I, which actually converts the hormone into a more toxic form, and Phase II, during which those toxic hormones are bound and deactivated so they can be moved out of the body. For most women, Phase I is a pretty quick process, and Phase II is typically slower. A problem occurs when Phase I is too quick. In this case the system is overloaded, and the body will store the toxic hormones in the fat cells, which can lead to a host of problems.

Once a hormone completes Phase II binding, it’s put into the gut for excretion. And this is where you need to pay attention: If you are not having regular, normal bowel movements, the hormone just sits in the gut. When this happens an enzyme in the gut called “beta-glucuronidase” separates the hormone from its binder, and once the hormone has been cleaved from its binder, your body recycles the toxic hormone. For women, this is particularly worrisome and can lead to dysfunctions like menstrual irregularities, acne, mood disorders, and, most importantly, an increased risk of hormonally derived cancers like breast, uterine, ovarian cancers. This is why it’s particularly critical for women to have effective gut function.

Ready to heal your gut? Here are the top doctor-recommended foods for better gut health.

Originally published by mindbodygreen.com.

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The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test looks for the inappropriate presence of bacteria in the small intestine known as Small Intestinal Bacterial Overgrowth or “SIBO”.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Breath

COLLECTION INSTRUCTIONS

COST

$85-$225 depending on insurance coverage. 

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the presence of harmful mycotoxins (toxins produced by molds).

LOCATION PERFORMED

At Home

SPECIMEN TYPE

Urine

COLLECTION INSTRUCTIONS

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$699

INSURANCE

Fully covered by Medicare. Repeat test prices $249

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the genetic profile for multiple health indicators. Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Blood Spot

COST

$319

INSURANCE

No insurance accepted

COLLECTION INSTRUCTIONS

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This company can test for lyme, babesia, bartonella and additional tick-borne illnesses. Click here for more information.

LOCATION PERFORMED

In office

SPECIMEN TYPE

Blood

COST

around $1600 (depends on panel selected)

INSURANCE

Fully covered by Medicare. May be reimbursed with PPO plans.
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the presence of harmful mycotoxins (toxins produced by molds).

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$299

INSURANCE

No insurance accepted
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates a wide range of environmental toxins that may be leading to harmful health effects.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$199

INSURANCE

No insurance accepted $30 discount given if done with mycotoxins.
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

Blood work for blood count, urinalysis and vitamin levels.

LOCATION PERFORMED

BLOOD FLUID

Blood

NOTES

You often have to fast for these tests-please check your providers notes.

COST

Depending on the test, deductible or copay may apply.

INSURANCE

Depends on insurance coverage, deductible or copay may apply.
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

Glyphosate (“Round Up”) is a pesticide that is widely used and this test indicates the body’s levels.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$99 ($69 if performed with mycotoxins or environmental toxins).

INSURANCE

No insurance accepted $30 discount given if done with mycotoxins or GPL Tox.
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates many measures including micronutrients, antioxidants, minerals, detox, overview of gut function, omegas and toxic exposure. Click here for more information.

LOCATION PERFORMED

At home.

SPECIMEN TYPE

Urine

COST

$179 – $400

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

INSTRUCTIONS

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the gut function and indicates microbiome balance, overgrowth, infection, inflammation, parasites and digestive efficacy. Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Stool

COST

$179-$425 depending on insurance coverage.

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

SPECIAL INSTRUCTIONS

No probiotics for one week.

VIDEO INSTRUCTIONS

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the full menstrual cycle, female hormones, and adrenal profile.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

COST

$160-$329

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

NOTES

Must be off hormones in order to do the testing.
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test is specifically for a tick-borne illness called “Bartonella”.

LOCATION PERFORMED

In office

BLOOD FLUID

Blood

COST

$260

INSURANCE

No insurance accepted
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test evaluates the presence of potentially harmful heavy metals stored in the body.  Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Urine

COST

Testing: $79 x2 paid to Doctor’s Data
DMSA: $38 paid to Johnson’s Compounding Pharmacy

INSURANCE

Not covered by Insurance
The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test measures saliva cortisol testing throughout the course of one day and informs us where there might be an adrenal imbalance.

LOCATION PERFORMED

At home

BLOOD FLUID

Saliva

COST

$80

INSURANCE

No insurance coverage

The Questions This Doctor Always Asks Her Patients About Their Poop
The Questions This Doctor Always Asks Her Patients About Their Poop

WHY DO WE DO THIS TEST?

This test is designed to look at food sensitivities (IgG immune responses). It is available in both a 99 or 184 panel. Click here for more information.

LOCATION PERFORMED

In office

SPECIMEN TYPE

Blood

COST

$129-238

INSURANCE

No insurance accepted