As an IBS & Gut Health Nutritionist, two of the most common symptoms that I see in my virtual practice are bloating and constipation.

These digestive symptoms are frustrating, uncomfortable, often painful, embarrassing… and just not nice to live with.

If you experience bloating and constipation, you’ll know exactly what I’m talking about 🥲

If you’ve had these symptoms for at least six months, it’s likely you’ve already started to investigate WHY you’re dealing with them:

maybe you’ve booked doctors appointments with your PCP and/or a gastroenterologist
you’ve likely had bloodwork done (maybe your standard blood panels, maybe even things like testing for H.Pylori or Celiac)
perhaps you’ve been sent for x-rays, ultrasounds and scopes
and you’ve likely tried all the elimination diets, IgG sensitivity testing, probiotics, enzymes, colonics

If you’ve tried all these things, and still aren’t finding solutions to your constipation and bloating … it may be time to dig deeper via strategic functional lab testing 🫶

These are the three labs I would consider running, if you want to investigate the root cause of why your symptoms are occuring, so you can fix them at the source.

📊 Test 1: Comprehensive Thyroid Panel (looked at through a functional lens):

Our thyroid plays a significant role in our digestion.

The thyroid is one of the main players in our overall metabolism, but as it relates to our digestive system specifically, our thyroid impacts our motility (how things move through our digestive system).

If your thyroid isn’t functioning optimally — if you have hypothyroidism or Hashimoto’s — your digestion could be experiencing the impacts of that. Slow motility due to poor thyroid function can lead to symptoms like constipation, bloating, gas, and distention.

Slowed gastric emptying time can also be the result of poor thyroid function, which can contribute to symptoms like reflux, feeling really full after eating, nausea, abdominal upset, and more.

Hypothyroidism can also leave us more susceptible to developing things like SIBO (small intestine bacterial overgrowth), which is a bacterial overgrowth in the small intestine, that can cause digestive symptoms, impact nutrient absorption, and more. SIBO testing is one of these three labs, so I’ll talk about it more below!

All that to say… testing our thyroid is mega important if we’re struggling with bloating and constipation, and really, any other digestive concern.

You can test your thyroid hormones, and antibodies through a simple blood panel that can be requisitioned by your PCP. It’s important to inquire about a comprehensive thyroid panel that looks at ALL thyroid markers, as this will provide the most comprehensive look at what the thyroid, the status of hormones available, and the conversation between the brain-thyroid looks like.

Too often, we’re only being tested for TSH (thyroid stimulating hormone), and maybe T4 and T3 (which are our inactive and active thyroid hormones, thyroxine, and triiodothyronine respectively).

We need a full scope panel, to get a full scope picture as to what’s going on.

🧪 Ideally, this is the comprehensive thyroid panel I’d recommend you have tested: TSH, tT4, fT4, tT3, fT3, rT3, TPO, TgAB

*Sample report of a comprehensive thyroid panel*

📊 Test 2: Comprehensive Stool Testing

This is one of my favourite labs to run (specifically the GI MAP stool test, at least at the time of writing this article).

A comprehensive stool test can provide an excellent look into various aspects of digestion and gut health:

It will test for microbes like H. Pylori, pathogens (bacterial, parasitic, viral), parasites, yeast overgrowth, and imbalances in the 'good' and 'bad' bacteria in the gut (all of which can impact how we feel and potentially contribute to digestive issues).

They’ll also look at various intestinal health markers that can give us information on digestive function (how well your digestion is actually working to break down food), detoxification, inflammation in the gut, immune function stemming from the gut, and gluten sensitivity.

For most of my 1:1 clients, comprehensive stool testing tends to be the most bang for your buck as far as gaining insights into their IBS & digestive symptoms.

Some of the common patterns and results that I see in my IBS/gut health clients are:

Depleted beneficial (commensal) bacteria leading to digestive symptoms and food sensitivities
Overgrowth of methane producing microbes contributing to constipation, bloating, gas, and distention
H.Pylori, Candida and poor digestive function leading to reflux, heartburn, bloating, food sensitivities, nutrient deficiencies, and irregular bowel movements
Bacterial overgrowth (dysbiosis) contributing to excess histamine production (which can cause diarrhea, reflux, flushing, sleep issues, crappy periods, headaches, skin issues), irregular bowels (diarrhea, constipation, a mixture of both), bloating, food sensitivities, skin issues

(If you want to grab a GI MAP Stool test, I have a couple of options available to access it here)

Here are some panels pulled from the GI MAP:

📊 Test 3: SIBO (Small Intestine Bacterial Overgrowth):

SIBO (AKA Small Intestine Bacterial Overgrowth), is a common dysbiosis pattern that causes folks a lot of gut grief.

The small intestine is where the majority of our digestion and nutrient absorption occurs. While there are some populations of bacteria present in the small intestine, the large intestine is where the majority of the gut microbiome lives. We shouldn’t have tons of bacteria present in the small intestine.

What happens when there is overgrowth of bacteria in the small intestine, is that all of the foods (specifically fibers, saccharides, etc) we’re consuming are fermented.

Excess fermentation in the small intestine can contribute to an influx of symptoms like: bloating, gas, altered bowel movements (depending on the type of SIBO, people may experience constipation, diarrhea, or a combination of both), food sensitivities, acid reflux, skin concerns, and more.

SIBO is not a root cause itself — there is always something that’s making the environment in the small intestine friendly for overgrowth… but it can lead to a lot of digestive concerns!

In addition to testing for & addressing SIBO, it’ll be important to also investigate the potential root causes of it.

Which can be things like:

poor thyroid function/hypothyroidism (that dang thyroid again!)
chronic stress
diabetes
post-infectious IBS (after getting food poisoning/gastroenteritis)
various gut infections
mold
ileocecal-valve dysfunction
poor bile flow/gallbladder removal
motility issues

… and more

The gold-star standard for testing for small intestine bacterial overgrowth, SIBO testing is a breath test that you can complete from home or at your physicians/GI’s office.

There are a few different types of SIBO tests available: 2- and 3-hour glucose and lactulose tests, and the Trio-SMART (which tests for all three types of SIBO and must be ordered via a physician).

SIBO testing can help us identify if SIBO is present, and which of the 3 types (hydrogen, methane, hydrogen sulfide) we’re dealing with, so a targeted plan to address it may be developed.

*(partial sample report of a lactulose breath test from Genova Diagnostics)*

Honourable Mentions: Additional Labs to Consider to Investigate your Bloating, Constipation, and Other Digestive Concerns

📊 MICRONUTRIENT TESTING:

Comprehensive micronutrient (via blood) looks at vitamins, minerals and electrolytes, amino acids, antioxidants, fatty acids and metabolic markers (which are foundational for everything, including digestion and gut health!)

📊 HTMA:

This is a hair tissue mineral analysis that takes a small sample of hair (as the name suggests), and measures for mineral status & heavy metals! It’s a great lab for telling us how your body is handling stress, and providing information across hormones, blood sugar, energy production, digestion pathways, and more (it’s also very reasonably priced compared to other functional labs!)

📊 OAT:

An organic acids test provides us with information microbial populations, fungal and potential mold presence, detoxification, metabolism, and the status of various nutrients. For gastrointestinal symptoms, energy issues, skin concerns, histamine issues and more, an OAT test can be really insightful.

Interested in running some labs?

Functional labs like these have helped my clients completely transform their lives — even after countless attempts at trying to fix their gut issues, and “normal” after “normal” lab result.

These labs allows us to gather data, and further customize your healing plan to reverse your symptoms. They take a lot of the guesswork out of the process. They allow us to get even more targeted and strategic, so you can see results, faster.

If you’re interested in running labs like these for yourself, to help you get to the bottom of your bloating, constipation, and GI issues, you can: