Investigations for Abdominal Pain When I see a client with gut pain and loss of appetite, there are many causes to consider. First off, I want to know where the pain is located. Is it possible to point a finger at it? Is the pain in the lower right quadrant? Is the pain in the lower left quadrant?

I also want to know the characteristics of the pain. Is it sharp? Is it dull and throbbing? How long does the pain last? When does the pain come?

These and other questions are important to start narrowing down the possible causes of abdominal pain.

The most obvious investigation to do is a comprehensive stool analysis (CSA). When I hear the phrase “painful gut,” I think of microorganisms like parasites or bacteria. Candida can also cause abdominal pain, but a dysbiotic load of bacteria or parasites are more common causes. Parasites very commonly cause pain around the umbilicus or around the ileocecal valve region on the right. I’ve seen that presentation many times in the clinic.

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Pain means inflammation. Evidence of inflammation will almost certainly show up on the stool test. It could be elevated IgA that surfaces or high levels of harmful bacteria. Inflammatory markers may be elevated on the CSA.

The timing of the pain in relation to eating can help determine the location of the harmful bacteria. The SIBO (small intestinal bacterial overgrowth) breathe test will spike based on the location of the problematic bacteria in the GI tract. This is particularly true if the SIBO breath test measurements are done at thirty-minute intervals.

Doing a SIBO test and stool test simultaneously gives the practitioner the ability to identify the target species and location. Do those two tests as a starting point when you are trying to figure out the cause of your gut pain.

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