Many thanks for your question regarding your client with digestive issues. It is not clear whether the stool test included Helicobacter pylori testing – I would recommend ruling this out in view of her heartburn.
You mention her main digestive symptom is bloating. It may be the case that she actually has SIBO (small intestinal bacterial overgrowth) and that a hydrogen breath test may be indicated to check for any imbalances in the small intestine. These are not reflected by a stool test. There are clearly imbalances in her gut flora with low levels of beneficial flora present so this is certainly something to work on, and this is referred to as insufficiency dysbiosis. However, it may be best to start slowly and gradually build up levels as initially the use of probiotics may provoke further bloating as the bacteria establish in the gut.
There also does appear to be some digestive considerations too. The fat stain may indicate that support for the gallbladder and bile flow could be beneficial and / or considering a digestive enzyme in addition, particularly providing lipase.
Heartburn can be due to a number of factors, not just Helicobacter, and I wonder whether her current high stress levels may be indicated here and by including some adrenal support you may be able to help support this. You may also wish to consider use of Epsom salt bathing to calm her in the evening and support magnesium levels and / or castor oil packs as well. Todd has written about their use on the Clinical Education website http://tinyurl.com/z5hwobz.
With high morning cortisol level as well it may be worth looking at whether her evening meals are balanced with sufficient protein to support stable blood sugar overnight.
Other considerations for bloating would be timing of when she eats, mindful eating and not eating too late at night or large portions of food just before going to bed.
Even with heartburn she may benefit from supporting natural digestive secretions with a little lemon juice and water before meals and including some fermented foods if tolerated such as sauerkraut. If, however, there is SIBO present she may find initially that a low FODMAPs approach could help relieve the bloating. This is only a short term dietary approach while you address the underlying gut imbalances.
While I appreciate she has some yeast present this is more likely to be due to the low levels of beneficial flora as yeast is opportunistic so the focus here would be on supporting beneficial flora initially and digestive function.
I also note that Lyzosyme is high – do you suspect a food reaction here? Gluten or other foods could be involved in her symptoms and provoking inflammation and may contribute to the bloating she is experiencing. You may therefore wish to look at the Cyrex testing for food reactions and cross reactive foods. In some people other considerations such as lactose intolerance can contribute to bloating and loose stools.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Stress / resilience support
Zen (ARG) – take 1 midmorning and 1 afternoon (contains L theanine and GABA) – http://tinyurl.com/jotgrow
Stabilium (ARG) – take 4 first thing in the morning for resilience – http://tinyurl.com/hgyms8f
Phos Serine Complex (ARG) – take 1-2 in the evening to help promote sleep – http://tinyurl.com/j86w44z
Bio-6-Plus (Pancreatic Enzymes) (BRC) – take 1-2 with each meal – http://tinyurl.com/zzadu4u
Lactobacillus Plantarum/Rhamnosus/Salivarius (ARG) – take 1 daily – gradually build up to 2 daily http://tinyurl.com/he735rz
Beta-TCP (BRC) – take 1-2 with each meal – http://tinyurl.com/j8yyepn
Sano Gastril lozenges (ARG) – suck 1-2 lozenges shortly after each meal or when experiencing heartburn – http://tinyurl.com/hoeekjv
And / or
HCL Ease (BRC) – take 1-2 shortly before each meal
I hope this helps with your client
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