Case Study: IBS-M with Parasitic Infection and Dysbiosis

Patient Profile

• Age/Sex: 28-year-old female
• Primary Concerns:
  • Irritable Bowel Syndrome, mixed type (IBS-M) – alternating constipation and diarrhea, more prone to constipation
  • Bloating and fatigue
  • Autoimmune thyroiditis
  • Eczema since age 4
  • Hair thinning/loss
  • Weight gain
  • Hormonal concerns, including periods of amenorrhea
    

Symptoms and History

The patient has a long history of eczema and gut-related symptoms. She has PCOS and a history of menstrual irregularities. Despite dietary interventions, she continues to experience persistent bloating, fatigue, and skin flare-ups. Constipation is more common than diarrhea, though both are present. This can be a common scenario we see with patients who have tried a variety of dietary changes and lifestyle adjustments but they just haven’t seen their symptoms improve or they feel like they have hit a “wall” and are no longer getting symptom improvement from their interventions. 

Key Laboratory Findings

GI Effects™ Stool Test

1. Digestion & Absorption

• Pancreatic Elastase 1: 342 mcg/g (within normal range but on the low side of optimal)
• Protein Breakdown Products: Low (0.7, below reference range) → suggests suboptimal protein digestion
• Fats & Lipids: Normal ranges

2. Inflammation & Immunology

• Fecal Secretory IgA: Very high at 4,152 mcg/mL (normal < 2,040) → Indicates an activated gut immune response
  
• Calprotectin: Normal (<16 mcg/g)
• Eosinophil Protein X (EPX): Not detected

3. Gut Microbiome Metabolites

• Short Chain Fatty Acids (SCFAs): Total 34.9 (low side of optimal)
• n-Butyrate Concentration: 6.8 (good but low side of optimal)
• Beta-glucuronidase: 726 (normal range)
• Overall Interpretation: Ok SCFA production, but low beneficial bacteria abundance (likely due to imbalance from parasite or dysbiosis) that should be targeted to help build the ecosystem
  

PCR Parasitology

• Blastocystis spp.: Detected, specifically Subtype 3

Highest priority areas:

1. Gut immune response high 
2. Dysbiosis
3. Parasitic infection
   

Interpretation

• The patient’s symptoms and stool findings point to gut immune activation driven by insufficiency dysbiotis and suspect Blastocystis subtype 3.
• Although not every individual with Blastocystis is symptomatic, the elevated fecal secretory IgA and clinical picture strongly suggest this parasite is contributing to her symptoms.
• Low protein breakdown products suggest that digestive support could be beneficial, even though pancreatic elastase is close to optimal.
• Presence of moderate dysbiosis indicates a need to rebuild the gut microbiome following antimicrobial treatment.

Treatment Plan

Stage 1: Address Infection & Reduce Inflammation (60-90 days)

• Goal: Eradicate Blastocystis and decrease gut immune response
• Treatment protocol: Using a combination of herbal antimicrobial treatments (GI Synergy, Biocidin, etc), biofilms disruptors and the option for medication use if needed. 

Stage 2: Rebuild and Restore Microbiome (following treatment or layered into treatment)

• Start or continue a targeted probiotic to address the specific strains of deficiency 
• Add fermented foods and prebiotic-rich dietary fibers to support butyrate production. 
• Focus on anti-inflammatory foods and Omega-3 supplementation.
• Support overall gut immune function and barrier integrity.

Summary

This case demonstrates a classic presentation of IBS-M with gut dysbiosis and parasitic infection. The patient has a long-standing history of autoimmune and hormonal challenges, likely influenced by gut immune dysregulation.

Testing Outcomes:

• Identified Blastocystis subtype 3 as a likely contributor to symptoms.
• Found significantly elevated secretory IgA, indicating gut immune system overactivation.
• Revealed low protein digestion markers, suggesting potential benefit from digestive support.
• Opportunity to support the beneficial microbe ecosystem and their metabolic byproducts (SCFA)
  

Treatment Strategy:

• Begin with targeted antimicrobial botanicals to address parasites and potential pathogens
• Support the gut immune system and support gut lining
  
• Transition to a rebuilding phase with probiotics and dietary interventions to restore gut balance.
  

Expected Results:

• Reduction in bloating and IBS symptoms.
• Improved skin (eczema) and energy levels.
• Better menstrual regulation and hormonal balance over time.
• Restoration of a healthy gut microbiome to prevent recurrence.
• Move to next phase of evaluation once we assess the impact of balancing the gut microbiome and restoring gut health. 

Actual Results:

• After approximately 4.5 months of treatment that included antimicrobial  treatments and restoring the gut microbiome, this patient experienced 80% improvement in gut symptoms. Her eczema improved by 50% as well.
• Most notable, she felt increased resilience around food tolerances with less sensitivities and being able to expand her diet. 
• Follow up testing showed Blastocystis infection resolved, SCFA (butyrate specifically) had improved, elastase levels increased to > 500, markers of digestion improved and beneficial bacteria levels improved. 
• She continued to have irregular menstrual cycles but did note less pre-menstrual symptoms leading up to the cycle start date.