CDSA from Genova

[Rebecca Carey]

I have attached a GI Effects Stool Profile. We used Genova as their offered a free test and this family has very limited financial resources. This is a young boy with developmental delay who is completely feed via a feeding tube. He has chronic issues diarrhea and poor weight gain. He has gas and bloating and is currently on a protein hydroxylate formula that is corn syrup based with MCT oil. I have treated him from presumed SIBO but he seems to dump huge amounts of diarrhea with even small doses of antibiotics. I wanted to try to go the botanical route thinking it might be milder and he would tolerate better and was hoping to use this test to guide me. But honestly have no idea where to start. Sorry that it is not deindentified…if you reuse please remove name.

[Rebecca Carey]

It won’t let me post as file too large – can I email?

[DrWoeller]

Rebecca,
Go ahead and email to gimasterycourse@gmail.com. Some lab files are too big for uploading. I will look at the lab and get back to you with some input and questions.

Sincerely,
Dr. Woeller

[DrWoeller]

Rebecca,
His Calprotectin is very high. My suspicion is some type of inflammatory bowel disease. Has this boy been scoped?

Also, the low short chain fatty acids, i.e. Butyrate can be linked to poor mucosal barrier function and biodiversity of gut flora. Butyrate enema’s have been used for colitis, and oral Butyrate could be useful too in this case for intestinal health as well.

Are you familiar with Butyrate supplementation?

BTW – I would agree with the botanical route too, but perhaps try the Butyrate first.

Let me know about my questions.
Sincerely,
Dr. Woeller

[Rebecca Carey]

I have used butyrate enemas for diversion colitis before but do not know reliable source to obtain. do you have any recommendations? he has a gastrostomy tube so oral supplementation should not be difficult and probably easier on the family

he is completely formula dependent and does not eat by mouth. do you have any other thoughts to increase microbial diversity other than high dose probiotics?

[DrWoeller]

Rebecca,
Increasing biodiversity would be mostly through probiotics. Cultured vegetables could help, as well as kefir products, i.e. dairy, coconut. Also, fecal microbiota transplant is an option too.

Butyrate – I have used the Body Bio Calcium/Magnesium Butyrate – one capsule twice daily to start – http://www.bodybio.com/storeproduct360.aspx

Butyrate enemas can be done through various compounding pharmacies, i.e. Hopewell, Lee-Silsby, Wellness. Hopewell is in New Jersey, Lee-Silsby is in Ohio, and Wellness is in Alabama.

Sincerely,
Dr.Woeller

[Rebecca Carey]

Thanks for the great info

A lot of families have asked be about FMT for their children with IBD but right now I have not had any insurance pay for it other than for chronic CDiff which I have been doing via colonoscopy. Are you having them do these at home with a home protocol or using a fee for service lab?

Sorry for all the questions…

[DrWoeller]

Rebecca,
No worries on the questions.

I haven’t ventured very far into this area myself because of the uncertainty with it medically-legally. The problem is the pure focus on C. diff, and knowing it could help other conditions, but getting it paid for, etc. is challenging. I know people are opting for home use, and I can provide information resources, but am reluctant to give my stamp of approval to any particular one.

Dr. Woeller

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