Functional Diagnosis Gastrointestinal System The Application of FDM Testing Identifying and Assessing for Dysfunctions in the GI NAQ - Upper Digestion 51. Belching or gas within 1 hr. of a meal 60. Do you feel like skipping breakfast? 52. Heartburn or acid reflux 61. Do you feel better if you don t eat? 53. Bloating shortly after eating 62. Sleepy after meals 54. Are you a vegan (no dairy, meat, fish or 63. Fingernails chip, peel or break easily eggs) 64. Anemia unresponsive to iron 55. Bad breath (halitosis) 65. Stomach pains or cramps 56. Section Loss 1 of Upper taste Gastrointestinal for meat System 66. Diarrhea, chronic 57. Sweat has a strong odor 67. Diarrhea shortly after meals 58. Stomach upset by taking vitamins 68. Black or tarry stools 59. Sense of excess fullness after meals 69. Undigested food in stool http://www.fmtrainingcenter.com 1
NAQ Liver and Gallbladder Questions 70 81 are associated with hepato-biliary system Questions 82 97 are associated with liver toxicity 70. Pain between shoulder blades 71. Stomach upset by greasy foods 72. Nausea 73. Greasy or shiny stools 74. Sea, car or airplane sickness, motion sickness 75. History of morning sickness (1 = yes, 0 = no) 76. Light or clay colored stools 77. Dry skin, itchy feet and/or skin peels on feet 78. Headache over the eye 79. Gallbladder attacks (past or present) 80. Gallbladder removed (1 = yes, 0 = no) 81. Bitter taste in mouth, especially after meals 82. Become sick if drinking wine 83. If drinking alcohol, easily intoxicated 84. Alcoholic beverages per week 85. Recovering alcoholic (1 = yes, 0 = no) 86. Hangovers after drinking alcohol 87. History of drug or alcohol abuse (1 = yes, 0 = no) 88. History of hepatitis (1 = yes, 0 = no) 89. Long term use of prescription medications (1 = yes, 0 =no) 90. Sensitive to chemicals (perfume, cleaning solvents, insecticides, exhaust, etc.) 91. Sensitive to tobacco smoke 92. Exposure to diesel fumes 93. Pain under right side of rib cage 94. Hemorrhoids or varicose veins 95. NutraSweet (aspartame) consumption 96. Bothered by aspartame (NutraSweet) 97. Chronic fatigue or Fibromyalgia NAQ Small Intestine 98. Food allergies 107. Crohn's disease (1 = yes, 0 = no) 99. Abdominal bloating 1 to 2 hours after eating 108. Wheat or grain sensitivity 100. Specific foods make you tired or bloated (1= yes, 109. Dairy sensitivity 0= no) 110. Are there foods you could not give up (1 = yes, 0 101. Pulse speeds after eating = no) 102. Airborne allergies 111. Asthma, sinus infections, stuffy nose 103. Experience hives 112. Bizarre vivid or nightmarish dreams 104. Sinus congestion, "stuffy head" 113. Use over-the-counter pain medications 105. Crave bread or noodles 114. Feel spacey or unreal 106. Alternating constipation and diarrhea NAQ Large Intestine 115. Anus itches 124. Less than one bowel movement per day 116. Coated tongue 125. Stools have corners or edges are flat or ribbon 117. Feel worse in moldy or musty place shaped 118. Taken any antibiotic for a combined time 126. Stools are not well formed (loose) 119. Fungus or yeast infections 127. Irritable bowel or mucus colitis 120. Ring worm, "jock itch", "athletes foot", 128. Blood in stool nail fungus 129. Mucus in stool 121. Eating sugar, starch or drinking alcohol l 130. Excessive foul smelling lower bowel gas increases yeast symptoms 131. Bad breath or strong body odors 122. Stools hard or difficult to pass 132. Painful to press along outer sides of thighs 123. History of parasites (1 = yes, 0 = no) (Iliotibial Band) 133. Cramping in lower abdominal region 134. Dark circles under eyes http://www.fmtrainingcenter.com 2
Low Gastric Acid/Pepsin Output (Hypochlorhydria) Signs and Symptoms Belching or gas within one hour after eating Bloating within one hour after eating Bad breath (halitosis) Stomach upset by taking vitamins Fingernails chip, peel or break easily Anemia unresponsive to iron Sense of fullness after meal Physical Exam Findings Nutritional Physical Findings Adult acne Dilated capillaries on nose and face Dandruff Soft, poor growth of fingernails Brittle and splitting nails Functional Physical Exam Findings HCL Point Chapman s Reflex In-Office Tests Zinc Taste test Gastrotest In-Office Testing In-Office Lab Testing Check urine indican levels Check urine sediment levels http://www.fmtrainingcenter.com 3
Gastro-Test Gastro-Test Directions Blood Test Findings Suspect a hypochlorhydria when globulins start to climb above 2.8 or 28 g/l May also see a decreased total protein <6.9 or 69 g/l and/or a decreased albumin <4 or 40 g/l Likelihood increases with these findings: Likelihood increases with these findings: Increased BUN (>16 or 5.71 mmol/l) Decreased serum phosphorous (<3.0 or <0.97 mmol/l) Decreased serum calcium (<9.2 or 2.3 mmol/l) Increased MCV >90 http://www.fmtrainingcenter.com 4
Helicobacter pylori H. Pylori - Symptoms The symptoms of an H. pylori infection include: Discomfort in the upper GI especially upper left quadrant discomfort Bloating Nausea Maybe even vomiting. H. Pylori - Advanced FDM Testing Blood test to measure H. pylori antibodies Breath test The H. pylori stool antigen test CDSA Allopathic Testing Endoscopy with tissue biopsy http://www.fmtrainingcenter.com 5
Gastric Inflammation Gastritis S/Sxs (Very) frequent stools or normal stool frequency Weak appetite Epigastric pain Unexplained nausea Unexplained vomiting Fever: High/moderate/or slight Blood in the stool (end stage) Vomiting blood (end stage) Functional PE Findings Gastritis Blood Testing Pattern: Decreased total globulin (<2.4 or 24 g/l) Decreased serum phosphorous (<3.0 or <0.97 mmol/l) I d BUN (>16 5 71 l/l) Increased BUN (>16 or 5.71 mmol/l) Increased basophils (> 1) Increased ESR http://www.fmtrainingcenter.com 6
Pancreatic Insufficiency Signs and Symptoms Physical Exam Findings In-Office Lab Testing Dysbiosis Dysbiosis/Bacterial Overgrowth Signs and Symptoms Unexplained abdominal symptoms Frequent stools Intolerance to sugar, starchy foods, fiber, or fi friendly flora supplements. General flatulence (usually odiferous) Bloating associated with eating Constant fatigue http://www.fmtrainingcenter.com 7
PE Findings Primary FDM Testing In-Office Testing Advanced Testing Malabsorption & Intestinal Hyperpermeability Signs and Symptoms Functional PE In-Office Testing Blood testing Decreased BUN Iron Deficiency anemia B12/folate deficient anemia Hepato-Biliary Dysfunction Biliary Insufficiency and Stasis http://www.fmtrainingcenter.com 8
Biliary Dysfunction: S/Sxs Pain between shoulder blades Stomach upset by greasy foods Loose, bulky and offensive stools Greasy or shiny stools Nausea Sea, car, airplane or motion sickness History of morning sickness (0 = no, 1 = yes) Light or clay colored stools Dry skin, itchy feet or skin peels on feet Headache over eyes History of gallbladder attacks Bitter taste in mouth, especially after meals Dark orange urine Biliary Dysfunction: PE Nutritional Physical Exam Findings Functional Physical Exam Findings Check for a positive Murphy s sign Check chronic gallbladder sign Check for tenderness in the Chapman reflex for the liver-gallbladder Functional Urinalysis Increased urinary sediment levels Biliary Dysfunction: Blood Test Biliary stasis GGTP levels will frequently be increased (>30) but not necessarily. Bilirubin levels will also be elevated (>1.2 or 20.5 mol/dl) Increased alkaline phosphatase (>100) Increased total cholesterol (>220 or 5.69 mmol/l). SGOT/AST and SGPT/ALT may be normal or increased (>30). Biliary insufficiency Elevated total bilirubin (>1.2) Increased GGTP (>30), Increased SGPT/ALT (>30), Increased alkaline phosphatase (>100) Increased LDH (>200). http://www.fmtrainingcenter.com 9
Specific GI Conditions IBS GERD Crohn s Dz Diverticulitis/Diverticulosis Constipation/Diarrhea Ulcerative Colitis Inflammatory Bowel Disease http://www.fmtrainingcenter.com 10