Case Study - Chronic Digestive Problems
Hi everyone,
Dr. Dan Kalish here with our Kalish Research April 2010 Functional Medicine Case Study.
Recently I was speaking with a certified provider who trained with my first Kalish Method 6-Month Training Program. I asked him if we could collaborate on a case study, and he agreed. I hope you enjoy it. We've changed the patient's name but the clinical details are the same. The provider is Glenn Hyman, a chiropractor in Denver, CO.
Dr. Kalish: Thanks for doing this, Glenn. Why don't you give us some background on the case?
Glenn Hyman: Sure. Mike had been a patient of mine for several years before I started the Kalish Method Training Program. He was an active guy, early 30's, who would present with various sports injuries. I'd treat him for specific problems like gluteal pain with Active Release Technique and rehab. He got great results.
I enrolled in Dr. Kalish's training program after we met at a Chek Institute seminar. He was teaching a 3-day course on holistic lifestyle counseling. I was very impressed with how much he knew about lab testing and helping patients with problems that I had never before worked with - like fatigue, digestive problems, depression and weight gain (to name a few).
I let my patients know that I was learning about Functional Medicine, and let them know that I could help them with chronic health problems like the ones listed above. Mike was one of the first patients to come forward and ask for help.
He told me that he'd been "feeling like hell" for a couple of years. Chronic and varied digestive problems had plagued him, and he went through bouts of fatigue or depression. He was frustrated because whenever he ate, he'd have bowel gas. He was dating someone new, and the problem was embarrassing for him. He'd also have bouts of diarrhea that would last for several days at a time.
He'd been evaluated by his primary care doc, had a GI panel run (which found nothing), and was on an SSRI for the bouts of fatigue / depression. He's also had a colonoscopy which was normal. He wanted to know if anything I was learning in the Kalish Program might help. Dr. Kalish: Let me stop you for a second. You said you'd known this patient for a few years prior to his coming to you with these symptoms. And you said that he'd had this problem for 2 years. Did he ever mention any of this to you before?
Glenn: No, he hadn't. And as soon as I found out that all of this had been going on, I felt badly that I didn't know. A great guy had been suffering from these symptoms for a long time and he never told me any of it. It made me wonder how many more of my patients were needlessly suffering with chronic symptoms.
At the same time, I was glad that I had made the decision to move beyond a soft-tissue based practice and start helping my patients with more profound problems. Don't get me wrong, helping an athlete with knee pain is rewarding. Helping someone with rotator cuff problems is great, too. But expanding my skills so I could help patients with chronic, life-ruining symptoms opened up a whole world that had been closed to me before.
Dr. Kalish: So how did you proceed with this patient?
Glenn: I followed what I learned in the training program. I took a detailed history, and asked Mike to think back to when all of this started. At first he said, "I'm not too sure."
So I asked, "Were there any big stresses? Did you do any international travel?"
That's when the light bulb went off. "Yes, I went to China and got very sick about two years ago. I guess I have never felt 100% since then."
I told him he had probably picked up a digestive pathogen in China. Mike replied. "But my doctor already looked for that and didn't find anything."
Earlier in my career, I may have taken that at face value, but in the training program we learned that some labs are better than others, and some of the major labs...
Dr. Kalish: Let's not name any lab names here.
Glenn: Ok. Well, we learned that some labs are better than others, and the ones that we work with in the program are some of the most accurate. Based on his history and symptoms, I was pretty confident that the lab that Mike's primary care doc used missed something. So I suggested that we run an Adrenal Stress Profile and a Digestive Pathogen screen. Mike agreed.
Here's a portion of his Adrenal Stress profile showing high cortisol levels in the morning. We learned in the training program how high morning cortisol readings often correlate with infections.
And here's the relevant part of his Stool test. He had an Entamoeba Histolytica infection in his GI tract.
Dr. Kalish: I remember this case from class. E. Histo is a tough bug that can cause major damage to a digestive system. Finding this and correcting it for a patient can be life-changing.
Glenn: I referred him to an MD that I have a good relationship with, and she prescribed antibiotics. We followed up with a digestive support program to repopulate his gut flora. We also put him on an adrenal program. I had him stay off of gluten and dairy (he was already avoiding soy) during his treatment. After 6 months he felt great. It was really amazing. We retested him and things looked pretty good so we took him off of his adrenal program when he finished the products.
Dr. Kalish: This is pretty typical for traditional chiropractors, trainers and other physically oriented practitioners who start using Functional Medicine in their practices. The docs see that the patients they've known for years have other problems that they need help with.
Glenn: Yes, for me, this case really opened my eyes to how much more I could be doing to help my patients. And incidentally, this is one of literally dozens of cases I could have pulled out for this case study. I like this one because it was the first amoeba that I found. It was great because I worked through the treatment protocols just like you taught us. The structure and progression that I learned helped me discover the facts that I needed to help this patient in an organized way.
Dr. Kalish: That's a great case. Good job.
Hope you enjoyed this months case study.
Best,
Dr. Dan Kalish
