Should I Get My Gut Tested?

July 17, 2017 3:59 PM

I'd like your thoughts on/experiences with gut microbiome testing. More inside.

I have had trouble with my digestion for nearly 18 years now. I've been to four different doctors, had a barrage of tests, and wound up with an unhelpful diagnosis of IBS. I've done exclusion diets to try to find out what foods trigger me, but so far none have given me any answers. Sometimes my stomach bleeds and I now have frequent bouts of acid reflux in addition to all the other issues. I'm am frustrated with doctors. My husband sent me a link to uBiome Microbiome testing. It sounds like a friggin' miracle to me...

I distrust things that sound too good to be true.

Has anyone done this yet, or know anyone who had this done? Should I trust these people with my genetic information, do you think? I am still researching this, but wondered if anyone else has any thoughts.

posted by WalkerWestridge to Health & Fitness (8 answers total)

This is... not well researched. We're only just starting to understand the micro-biome and this sounds super quacky to me.
My mom has had terrible IBS/diverticulitis and what stopped most (like 90%) of the flare ups was going on the low FOD-MAP diet which is super restrictive, but if you have a fucked up GI tract, pretty effective.
IBS sucks, sorry you're going through this!
posted by Homo neanderthalensis at 5:35 PM on July 17, 2017 [2 favorites]

I think it could be helpful in the context of drastically improving your diet toward enhancing a favorable microbiome profile. This means you will need to get tested twice: now and then several months to year or so after being on a highly restricted diet. There are several books on feeding your microbiome well mainly by eliminating sugar and other simple carbs while increasing resistant starches, like those found in undercooked, cooled potatoes. While the diet described in the book called The Potato Hack isn't necessarily well documented, the author does a good job describing how resistant starches optimally nourish gut bacteria to establish a great source of nutrients for your body. He did the microbiome profile before and after being on the diet and correlated the profile with his Heath. So, I think it could be helpful to see where a good diet leads you wrt you microbiome.
posted by waving at 7:06 PM on July 17, 2017 [2 favorites]

Heath = health
posted by waving at 7:16 PM on July 17, 2017

Australia's national broadcaster, the ABC, did a thing about the importance of gut biomes on its flagship science show Catalyst. There seems to be pretty solid emerging evidence that the biome plays a role in all sorts of things. And they used one of these biome testing outfits to track changes to the host's biome and also a few guinea pigs to see how they responded to dietary changes.

But 'there's good evidence that gut biome is important' isn't the same thing as 'firms that claim to be able to test your gut biome actually do a good job'. Here's an article from 2014 about somebody who sent two apparently identical samples off to two different labs (including uBiome) and got completely opposite results, and the two firms had pretty unconvincing and unhelpful answers about why that might be the case.

Similar things have happened with those DNA ancestry / disease predictor outfits, with blogger sending the same saliva tests to different outfits and getting drastically different results.

So by all means, try to find a reputable, doctor-recommended way of getting your gut biome measured accurately. Just don't assume a $100 test is going to be the way to do that.
posted by obiwanwasabi at 7:44 PM on July 17, 2017 [3 favorites]

Best answer: Hi! I run clinical trials on fecal microbiota transplantation (FMT), and work at an organization that looks at the gut microbiota and FMT in relation to inflammatory bowel disease (as well as a lot of other indications). There is great early evidence that the gut microbiome is related to IBD, and that restoring a healthy microbiome may reduce the symptoms or severity of IBD in some patients. There are NOT any targeted ways of diagnosing diseases like IBD, or treating diseases like IBD, based on a single sample of an individual patient's gut microbiome.

So no, you should not order sequencing from uBiome, unless you're just curious about what bacteria are in your gut. The information you get from uBiome will not be actionable in any way. Your doctor can't diagnose anything from that data. Your doctor can't make any treatment decisions from that data. AT MOST, you and your doctor will go "huh, that's interesting, I have [more/less] of taxa XYZ than their healthy reference samples," but you won't know anything about what that means, or if it's related to your symptoms, or anything at all, really. The field just isn't far enough along yet, not when it comes to IBD.

If you are curious about exploring microbiome-mediated treatment for your IBD, I really urge you to search clinicaltrials.gov for "inflammatory bowel disease" and "fecal microbiota transplantation" and see if there is a clinical trial that you qualify to participate in.
posted by amelioration at 8:06 PM on July 17, 2017 [28 favorites]

Non-Australians might not already be aware that the ABC's

flagship science show Catalyst

was presented for quite some while by a doctor whose woo detector was somewhat below par.
posted by flabdablet at 12:57 AM on July 18, 2017 [2 favorites]

Did you do the exclusion diets since you've had the diagnosis of IBS? You sound very much like me, and I have had some relief from the fodmap diet, although it is very restrictive. Take a look and see if it's something you might be willing to try for a month or so. Something like 70% of IBS sufferers report that this diet gives them relief. The reason why exclusion diets did not work for me originally is that I simply wasn't excluding the right things. I will not say that it has totally removed all of my symptoms, but I am feeling much better these days.
posted by backwards compatible at 7:21 AM on July 18, 2017 [1 favorite]

Catalyst was presented for quite some while by a doctor whose woo detector was somewhat below par

That's absolutely true, and I hate that person with the fire of a thousand suns for what they did, but it wasn't the case for this particular series. All very reasonable talking to actual scientists in actual universities and a liberal sprinkling of 'this is all new and emerging' and do no harm advice like 'eat more fibre'.
posted by obiwanwasabi at 8:48 PM on July 18, 2017 [1 favorite]