IBS, New Blood Test! » BIOME ONBOARD AWARENESS: THE SCIENCE BEHIND FOOD, OUR MICROBIOME, AND DISEASE

Last Updated on January 18, 2019 by Patricia Carter

SUMMARY: There is a SIMPLE IBS new blood test in town that can diagnose the IBS sub-type that is due to a previous food-borne illness with 95% certainty, in 5 to 10 business days after blood draw. It is for those with IBS-D (diarrhea predominant) OR IBS-M (mixed type: diarrhea and constipation) symptoms. The test is called Ibs-smart ™ (from Gemelli Biotech) and it costs $220 (insurance may cover it in part). IBS is an umbrella term, and up until now, diagnosis was by method of exclusion, when all other $$$$ and mostly very uncomfortable tests (like colonoscopy, upper endoscopy, CAT scan, and MRI) have ruled out other potential causes for symptoms. 15% of the population contracts food borne illnesses each year putting many at risk for developing this IBS sub-type! Further, this IBS sub-type is being considered to be AUTOIMMUNE so it is important to get it into remission. Otherwise, you open up Pandora’s box to developing other disease(s) and of undergoing inappropriate surgeries. Ibs-smart™ is B-I-G news for IBS because IBS affects 10 to 15% of the population (according to credible reporting agencies). Not surprising, those stats are LOW for many reasons (mostly people suffer in silence and doctors don’t correctly diagnosis IBS). [Canavan et al 2014]. Heck, only about 50% of patients with IBS are provided with a definitive diagnosis after seeing a physician. [Halpert 2018]. The beauty of Ibs-smart™ is that if it is positive, you know you have IBS, that it is from a previous food poisoning, and you should think about this condition as autoimmune so get it into remission! Further, you know that IF you get food poisoning AGAIN, you are more susceptible to increasing those antibodies and making your IBS symptoms worse! Learn more about all of this below!

For background: WHY do you want to know if you have IBS? There’s health implications!

For everything you need to know about IBS and its implications for your health, read the post, IBS, Microbiome, FODMAPs, Probiotics. For starters: Learn that IBS can alter the brain size and function in the emotion and sensory processing areas when having it a long time along with early life stressors [Labus et al., 2017], that IBS is associated with A LOT of diseases, and there are A LOT of surgeries performed inappropriately because of misdiagnosis or poor manangement of IBS! DISEASES that are associated with IBS — the listing is NOT comprehensive — includes: Type 2 Diabetes, metabolic syndrome, fibromyalgia, chronic fatigue syndrome, IBD, CFS/ME, autism, anxiety, depression, MS, and Parkinson’s. Inappropriate SURGERIES occurring due to IBS misdiagnosis includes — appendectomy, cholecystectomy, ovarian, and hysterectomy. This post also discusses what a normal BM is and future clinical therapeutics for IBS which includes probiotics, the low FODMAP diet (helps about seventy-six percent of IBS patients [Magge et al.,2012][Bohn et al., 2015] [Staudacher et al., 2011]), and mindfulness.

How does ibs-smart™️ work?

One in nine people that experience FOOD POISONING go on to develop IBS (that’s about 11% of that patient population, and most go on to develop IBS-D). This happens because FOOD POISONING leads to infection in the GI tract. This infection can occur MANY years AFTER the original food poisoning event. Food-borne illness affects 15% of the US population each year. That puts MANY at risk for this sub-type of IBS. Source: [Ibssmart.com, Food Poisoning Causes IBS].

It is important to note that there are OTHER factors that can affect the development of IBS such as genetics, diet, the environment like stress (physiological or psychological), family history, gender (women are at greater risk than men), hormones (symptoms can worsen around the time of menstruation), age (diagnosis usually occurs under age 45, often between years 20 to 30), a malfunction of the muscles used to move food through the body, inability of the central nervous system to control the digestive system properly, and infections like gastroenteritis. [Nordqvist, 2017. Medical News Today].

Managing the subtype of IBS that is due to food-borne illness is especially important because it is being considered an autoimmune condition. That means first, knowing that you have it (do the Ibs-smart™ test), and then get it into remission to reduce the risk of developing other disease(s) and of undergoing inappropriate surgeries.

From [Ibssmart.com, Food Poisoning Causes IBS]:

In patients with IBS-D or IBS-M that is due to previous food-borne illness, TWO antibodies that are specific biomarkers of IBS (anti-CdtB and anti-vinculin) are elevated.

Ibs-smart™️ looks at your blood levels for those TWO antibodies –>

Each of the most common bacteria that cause food poisoning (Campylobacter, Salmonella, E.coli, Shigella, and C.difficile) releases a toxin called CdtB.
Our immune system fights CdtB with an antibody called anti-CdtB.
Anti-CdtB can confuse our body into developing another antibody called anti-vinculin.
This harms a naturally occurring protein in our body called vinculin that helps cells migrate and connect to each other.
***This is an AUTOIMMUNE response and leads to gut nerve damage and improper functioning of the Interstitial Cells of Cajal (ICC) and Migrating Motor Complexes (MMC) which regulate the contractions of our gut.
This can ultimately result in IBS-D and IBS-M, sometimes many years after the initial infection.

A positive ibs-smart™️ for BOTH these antibodies results in the diagnosis that this person has greater than 95% certainty of having IBS (and not IBD or celiac which shares common symptoms with IBS provided the patient does not have other complicating symptoms such as weight loss or blood in stool).

What about inconclusive test results? Ibs-smart™️ has a fairly low detection rate (sensitivity). No worries though because that only means that an inconclusive result may occur despite IBS actually being present due to too low of levels for TWO antibodies present in the blood sample (anti-Cdt8 or anti-vinculin). These antibodies are present with IBS that results from previous food poisoning, and this test can tell you IF you have this subtype of IBS. An inconclusive finding means that the patient could have IBS from an event other than previous food poisoning. You and your doctor should look for other causes for IBS (some are listed above).

The IBS –> SIBO connection:

In the IBS-D population, a positive ibs-smart™️ test means that MOST of these patients may actually have a condition called SIBO (small intestinal bacterial overgrowth). Ibs-smart™️ looks at antibodies to an endogenous protein in the gut (vinculin) and anti-CdtB which are biomarkers for IBS. IBS may be associated with SIBO:

From a systematic and meta-analysis review (55 studies): “More than one-third of IBS patients tested positive for SIBO, and the odds of SIBO in IBS were increased by nearly fivefold. [Chen et al 2018]
“IBS-D, marked bloating and flatulence, older age, symptom development while on PPI therapy have been shown to be associated with SIBO among patients with IBS¹⁴³; unless better noninvasive methods for diagnosis of SIBO become available, patients with these clinical predictors may be treated for possible SIBO. Currently, rifaximin is the best treatment for SIBO among patients with IBS. ” [Ghoshal et al 2017].

Should those with IBD (or other conditions that have IBS-D or IBS-M type symptoms) take the ibs-smart test™️?

Those with IBD should take this test because they may have IBS in addition to Crohn’s or Colitis. IBS-type symptoms affect as many as 1 in 5 patients with IBD (that is 20% of this population). [Gracie et al 2017]. Ibs-smart™️ can help determine whether you have IBS-D or IBS-M in addition to IBD. Ibs-smart™️ is usually negative in patients with Crohn’s disease or ulcerative colitis. Source: https://www.ibssmart.com/faq.

Regarding other conditions that have IBS-D or IBS-M type symptoms (autoimmune disorders, autism, food intolerances, celiac disease, and others), ibs-smart™️ is a single diagnostic indicator for IBS only, and does NOT diagnose other conditions. So if a patient presents with a myriad of symptoms and complications (like weight loss, blood in stool…) in addition to the suspicion for IBS, further evaluation should be considered for the presence of other disease(s).

In patients having IBS-D and IBS-M symptoms without other more complicating symptoms, Ibs-smart™️ circumvents the HUGE $$$$ and patient discomfort of additional invasive tests like colonscopy, upper endoscopy, CAT scans, and MRI!

Other important information:

To find doctors offering ibs-smart™️ , and to see a representative sample result of the test, and other test specifics, go to the page: Irritable bowel syndrome (IBS) can be caused by food poisoning.
A patient discussion guide for talking about ibs-smart™️ with your doctor is here: https://docs.wixstatic.com/ugd/6d042b_9c7a1a5b52a34c4098275b5ae39b9936.pdf

Much of this work is from Pimentel Laboratory, Dr. Pimentel’s group (executive director of the Medically Associated Science and Technology Program at Cedars-Sinai Hospital, LA. For background, read:

[Pimentel et al 2015] Development and Validation of a Biomarker for Diarrhea-Predominant Irritable Bowel Syndrome in Human Subjects, (PLoS One 2015;13;e0126438).
Antibodies to both vinculin and CdtB cross-react, and when both are positive, the positive predictive value for autoimmune IBS-D is 96%. The antibody to vinculin appears to produce the autoimmune neuropathy that underlies IBS-D.
[Rezaie et al 2017] Assessment of Anti-vinculin and Anti-cytolethal Distending Toxin B Antibodies in Subtypes of Irritable Bowel Syndrome, https://link.springer.com/article/10.1007%2Fs10620-017-4585-z
[Klem et al 2016] Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis, https://www.gastrojournal.org/article/S0016-5085(17)30008-2/fulltext

In conclusion, there is a new test in town for those with IBS symptoms, called Ibs-smart ™. This test can diagnosis the IBS sub-type that is due to a previous food poisoning event for those having IBS-D or IBS-M with 95% certainty. This IBS sub-type is being considered to be autoimmune so it is important to get it into remission. Otherwise, you open up Pandora’s box to developing further disease(s) and of undergoing inappropriate surgeries.

Best in health through awareness. References are below my signature!