IBS Resolve IBS Therapy with Nicola Warran in Bromley

Prices

*** PLEASE NOTE: I receive between 10-15 emails a day asking for help. I do not have time to reply to all of these so please do not take offence if I do not reply. Each email takes time and I do not have this time. Many are already with another practitioner but are emailing me for advice. If you are with a Practitioner please email your OWN practitioner for advice. If you wish to book an appointment where I will go through your case in detail and spend time looking at it then please contact me to book. Thank you. ***

*** PLEASE ALSO NOTE - I prefer not to work with Healthpath Tests - I use the GI EcologiX Comprehensive Microbiome Test or I will work with the GI Effects Comprehensive Stool Test. ***

Working Hours

My Working Hours are Monday to Friday 9-5.

I do not check my emails, nor take work related calls in the evenings or over the weekend because this is my family time.

If you need an evening appointment then I can occassionally arrange this so please advise me when you email.

Charges, TERMS & CONDITIONS & Current Laboratory Test Fees

My Charges and Booking Conditions

Initial Appointment 1 Hour £120
In Person or by Skype/Phone

This charge includes an hour in depth case history consultation and personalised typed consultation report detailing what we have discussed, any tests decided upon and how we have agreed to proceed.


Follow up Appointment Charge £95
In Person or by Skype/Phone

Please Note the Following: This follow up charge includes a 30 minute consultation to run through your test results but also includes my time in analysing your test results, researching your particular case, providing updated consultation report (which can usually take me at least 4 hours to do due to the devising of a suitable treatment plan), checking any interactions with your prescription medicine and natural supplements, discussions with lab technicians if necessary in both the UK and US, suitable individualised product recommendations if i feel this is necessary and any necessary GP letters written.

Some more indepth cases will require more than one follow up. If it is a basic SIBO test result for example then this will likely require just one follow up. However, if working with both the GI EcologiX and a SIBO test, please be prepared that this may take more than one follow up appointment as we work through a protocol. A second appointment will generally be 4-6 weeks after treatment plan has started.

I am happy to answer the odd email when I have time but for longer questions or a series of questions please book in a 20-30 minute follow up call (see below).

20-30 minute mid-treatment follow up call £65

We will discuss current symptoms, treatment progression, alternate treatment options etc.
I will also provide an updated consultation report to confirm discussions and what we have agreed on as the next step.


10-15 minute catch up call with notes £45

Sometimes there will be too many questions to answer on an email chain and I don't have time for this, so its best to book in a quick 10-15 minute catch up phone call or zoom call. I will provide quick notes in the form of an email back to you for this.

Discovery Call - 15 Minutes - £25

If you wish to discuss your case but are not sure whether or not to proceed I am happy to discuss this with you in advance. This is to be paid in advance by paypal on nicola.warran@outlook.com (please use friends and family method only) and then contact me to book a slot for this.


Please Note: ALTERNATIVE OPTION

If you don't want to book an initial consultation but want me to run the SIBO test and the GI EcologiX then I am happy to do this. If you then wish me to analyse the tests and come up with a treatment plan then I will still need to accept you as a client and you will need to complete a Consultation Form and we will need to have a full consultation where I can get your full case history. I cannot devise a treatment plan without knowing your history because I will look at test results in correlation with this history. Once your case history has been discussed then I will explain the results of the test to you, we will discuss these and I will formulate a treatment plan.

This also applies if you have had tests done elsewhere but without interpretation and want me to interpret these and devise a treatment plan. The cost of this will be £195 which will include initial consultation plus test analysis, consultation notes and treatment plan.

(This is amalgamating two appointments into one session but which still takes me the time of two consultations)


Payment to be made by Cash (in person only) or Bank Transfer - An invoice will be sent following your appointment with payment details. Invoices to be paid in full within 7 days.

If you are booking in with previous test results please email these to me but please also post these to me before our appointment. I do not have printer capacity to print off previous test results taken elsewhere. I will provide the address to post these to before our appointment. Thank you.

If you are unable to keep your appointment for any reason please advise me asap and we can reschedule this. If you wish to cancel the appointment please provide me with 48 hours notice.

Please do not book an appointment with me if you have not read the above Terms and Conditions. By booking an appointment with me I am expecting that you will have read and are in agreement with the above booking conditions. Thank you !

Digestive System Laboratory Testing

This page details the tests that I use on a regular basis. If there is another test you have seen with one of the labs that you are interested in please contact me and we can arrange this.

I work mainly with three tests which I will detail below with a brief summary of each. However, I am mindful that budgets are tight with many people so the Organic Acid test is not an essential requirement, but a useful test nonetheless.

The GI EcologiX™ comprehensive GI health and microbiome profile and the Aerodiagnostics SIBO Breath Test are the two tests I regularly use which I feel will give you the best results in looking at your digestive issues. If budget allows, the Organic Acid can also be useful in looking at nutritional status particularly.

SIBO test: A breath test which gives me an indicator of overproduction of hydrogen and/or methane (and possible indicator of hydrogen sulphide depending on test presentation - needs confirming by stool test).

GI EcologiX Microbiome Stool Test - this one tells me pretty much everything else (except SIBO!). In this I am looking for levels of dysbiosis, parasites, bacterial pathogens, mucosal integrity (health of the mucosal barrier and leaky gut), GI immunity, inflammatory markers, bile acids, markers of digestion, plus also what the levels of commensal (good) bacteria are. Without this test and this information, a SIBO test alone is pretty pointless.

OAT: Organic acid urine test - this tells me two things. Firstly what is overgrowing (whether this clostridia, bacterial or yeast/fungus) and secondly, what nutritional deficiencies may be likely (particularly useful in looking at B12 status). This test is more sensitive at picking up yeasts than a stool test generally.

For Current Lab Test Prices please see below. Please note the labs do increase their prices from time to time so these prices are subject to change (hopefully not by much and I try to keep up to date with these changes!)

For details how to order please contact me and I will send you details.

1) GI EcologiX Stool Test

GI EcologiX is a comprehensive gastrointestinal health and microbiome profile by Phylo Bioscience, a CQC laboratory in Bristol.

This test replaces the GI-MAP which I haven't used for several years.

GI EcologiX™ uses quantitative real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) to provide an accurate, reliable and quantifiable measurement of microbiota abundance and host inflammatory markers.

The profile detects:

Healthy gastrointestinal microbiome (homeostasis of host and microbiome)
Gastrointestinal dysbiosis detected (imbalance of the GI microbiota and/or host immune response)
Gastrointestinal pathogens detected (bacteria and amoebae)

This test will look for the following information in your stool sample:

• Bacterial Pathogens
• Commensal bacteria
• Sulphur and Methane producing bacteria
• Dysbiotic bacteria
• Opportunistic parasites
• Yeast, fungi and moulds
• Secretory IgA (sIgA)
• Pancreatic elastase 1
• Faecal Occult blood
• Zonulin

Parasites such as Dientamoeba Fragilis, Blastocystis Hominis, cause IBS symptoms but are not looked for by an NHS stool test.

Pathogenic Bacteria such as Klebsiella, Citrobacter freundii or Pseudomonas Aeruginosa can be a hidden cause of IBS which is why testing can be an invaluable tool.

Candida Albicans or other species of yeast such as Geotrichum can be a contributory cause of IBS and the stool test can identify the presence of these yeasts.

Click here to view more details - you will also be able to view a sample test from this page

My Charges, Laboratory Testing & Prices. breathtest

2) SIBO Lactulose Breath Test

The Lactulose breath test involves following a very strict 24 hour prep diet and then a 12 hour fast. The diet will ensure there are no fermentable fibres in your system that could mess up the results. You have to follow it strictly or the results may not be valid.

You then breathe into a tube to get your base line reading, drink a solution of lactulose and then take further readings for 3 hours. No test is 100% accurate.

Please be aware that some people (about 5%) are hydrogen sulphide producers which this test does not look for. There is still currently no effective home based breath test for hydrogen sulphide (the TRIO test in the USA has not been found particularly effective and a huge quantity of breath is needed making a home test not a practical option). However, there is a distinctive pattern on the breath test that may indicate this bacteria is present and I can check this against the stool test.

Please click here to read further information from Aerodiagnostics about the breath test.

3) Organic Acid Comprehensive Test (OAT) – Urine Test

The Organic Acid Test (OAT) looks for metabolites in the urine that signal a block or metabolic inhibition. These metabolites can indicate nutritional deficiencies, enzyme deficiencies, toxicity etc and some are indicative of intestinal bacterial or yeast overgrowth.

The Organic Acid test basically gives me two pieces of information.

Firstly, what is overgrowing in terms of Clostridia markers, Fungal/mold markers or Bacterial markers. I can then use a stool test to look at these in more detail. The OAT is also generally more sensitive at picking up fungal issues than a stool test.

Secondly, it provides me information on nutritional status - I am looking at what is being blocked in terms of nutrients in relation to energy production, detoxification, B vitamin status (particularly important looking at B12), neurotransmitter breakdown.

Abnormally high levels of these micro-organisms can cause or worsen behaviour disorders, hyperactivity, movement disorders, fatigue and immune function. The cause of these high levels may include: oral antibiotic use, high sugar diets, immune deficiencies, and genetic factors. If abnormalities are detected using the OAT, treatments can include supplements, such as vitamins and antioxidants, or dietary modification.

My preferred lab for the OAT is Mosaic Diagnostics (formerly Great Plains Laboratory). This is £250.

Genova also do an OAT panel which is also £279 and also have a new Metabolomix test which includes new markers such as oxalates and optional add-ons such as genetics, fatty acids and heavy metals. This test is £335.

Invivo do a reduced panel at £245 but this has far less metabolites so I don't generally use this one.

If you would like to see details of each test please look at the links below.

The Mosaic Diagnostics (formerly Great Plains) test details can be found here
The Genova OAT details can be found here
Further details of the Invivo test can be found here.

I charge £65 for interpretation of this test (this includes discussion with the Lab and written notes)

4) GI EcologiX - GI Microbiome Only

A useful follow up tool for the GI EcologiX that just assesses the key microbial markers related to chronic health conditions such as IBS/IBD, SIBO, Neurodegeneration, Autoimmunity, and other chronic inflammatory conditions. Please click here for info on the GI EcologiX - Microbiome Only and see a sample report for a full break down of the microbes measured.

This microbiome profile is also part of the comprehensive GI EcologiX gastrointestinal health and microbiome profile (as above), which also assesses gut and digestive health markers.

I sometimes use this as a follow up when the first page of the GI EcologiX (health markers section) is fine to save the client money when we want to do a follow up.

5) Candida - Stool or Urine Test

Candida is a very clever organism and can switch from a yeast to a fungus in a bid to survive and secretes toxic chemicals to protect itself. Candida has the ability to damage brain structure/function, decrease anti-inflammatory capabilities, damage red blood cells and create vitamin B5, B6 and Niacin deficiencies. Most people have some Candida in the gut which is kept under control with normal flora. However, it is very opportunistic and things like antibiotics, birth control, steroids, stress can all help Candida proliferate. It can live anywhere where there is a mucosal lining, such as the mouth, sinuses, gut, vagina, genitals and the anus.

Candida symptoms include Impaired memory, brain fog, lethargy, apathy, depression, irritability, anxiety attacks, cravings for alcohol and sugar, headache, migraine, PMS, itchy skin, Constipation or Diarrhoea, Vaginosis, thrush, athletes foot, oral thrush (white tongue)

Like many parasites, SIBO and pathogenic bacteria, Candida can cause intestinal permeability of the mucosal gut barrier leading to food sensitivities and potential auto immune issues.

If you present with any of the above symptoms, it may be worth getting tested for Candida. However, many people who believe they have Candida often have a gut infection or parasite instead and find the Candida diet does not help them. Without the testing they will not know.

There are two ways of testing for Candida, either using the GI-EcologiX stool test or Organic acid urine testing.

Click here to view more details and see a sample stool test:-

Click here for more details of the urine Organix dysbiosis profile

There is also a reduced version of the OAT which is the MOAT (microbial organic acid test). This looks at just yeast and fungal, bacterial and Clostridia species. Is suitable for age 2 above. Children must be potty trained as the sample must not have any trace of nappy fibres or stools.

6) Microbial OAT Test

Reduced version of the Organic Acid Profile
This test looks at yeast and fungal markers, Bacterial markers and Clostridia markers
A great test for somone particularly focused on the above, without having to run the full OAT panel.

Click here for a sample report

Other Useful Tests 

7) Adrenal Stress Profile

Adrenal Fatigue is a much overlooked condition in the UK. This is a 4 x saliva test that can detect imbalances in the daily circadian rhythm of the stress hormones, Cortisol and DHEA.

This saliva test can detect imbalances in the daily circadian secretions of the stress hormones cortisol and DHEA. Imbalances in these hormones can indicate an inappropriate response that can negatively impact energy levels, emotions, and many other health complaints. These include anxiety, chronic inflammatory conditions, allergies, chronic fatigue syndrome, insomnia, depression, migraines, headaches, recurrent infections, menstrual difficulties and infertility. If your adrenals are fatigued it makes life much harder, and also harder to heal from gut conditions.

For further information click here

8) IGG Profile - Food Sensitivity Test

This test can be done at home. It is a blood draw which is a finger prick test. You will need to prick your own finger and draw blood and fill 3 circles on a test kit with blood so you must be happy to do this (its easy I’ve done it!)

For a sample report please click here

My Charges, Laboratory Testing & Prices. labtesting

9) GI-MAP (Microbial Assay Plus) – Stool Test

(Please note I do not use this test anymore but is available if a Client really wants to do this). This test is very outdated now.
It is still available to me through Nordic Labs if this is the test you wish to take. This can be useful in very acute symptomatic cases.

The GI Microbial Assay Plus (GI-MAP) was designed to assess a patient’s microbiome from a single stool sample, with particular attention to microbes that cause disease or that disrupt normal microbial balance in the GI flora and contribute to illness.

Click here to view more details.

10) Oral EcologiX Profile

A ground-breaking clinical tool to assess the oral microbiome – a key ecosystem in the gut-brain connection, and for cardiovascular and female reproductive health.

The microbiota of the oral cavity exists as a complex biofilm that remains stable, despite environmental changes. However, dysbiosis, in form of infection, injury, dietary changes and risk-associated factors (e.g. smoking) may disrupt the biofilm community, favouring colonisation and invasion of pathogens. Disruption of the biofilm community to a pathogenic profile, induces host immune responses, chronic inflammation and ultimately, the development of local and systemic disease, such as gingivitis, periodontitis, oral cancer, cardiovascular disease and neurodegeneration. However, much of this damage is reversible if pathogenic communities are reduced, and homeostasis is restored. Click here for more info on the Oral EcologiX and to view a sample report.

11) Female/Vaginal EcologiX Profile

This ground-breaking clinical tool assesses the vaginal microbiome (bacteria and yeast) – a key ecosystem for female health and reproductive optimisation. Dysbiosis of the vaginal microbiota has been linked to a multitude of disorders including BV, Thrush, Intersticial Cystitis, Fertility Issues, premtature delivery in pregnant women, miscarriages and increased risk of STI's.

This is the most technologically advanced vaginal microbiome profile to provide accurate analysis of the microbiota abundance, host inflammatory markers and pH. A vaginal swab test. Click here for more info on the Vaginal EcologiX and to see a sample report.

Vaginal EcologiX Test Analysis and suggested treatment plan               £75

 

12) Great Plains Urinary Mycotoxins Profile

Mycotoxins are some of the most prevalent toxins in the environment, produced by fungi like mould, which can infest buildings, vehicles and foodstuffs. A majority of mycotoxin exposures are through food ingestion or airborne exposure.

Fungi are able to grow on almost any surface, especially if the environment is warm and wet. Inner wall materials of buildings, wallpaper, fibreglass insulation, ceiling tiles and gypsum are all good surfaces for fungi to colonize. These fungi then release mycotoxins into the environment causing symptoms of many different chronic diseases. This profile identifies mycotoxin exposures and provides recommendations for detoxification treatments that have been shown to be effective. Mid stream urine sample.

Click here for more info on the Urinary Mycotoxins Profile and to see a sample report.

Current Lab Test Prices (2024 Prices)

1) GI EcologiX - Comprehensive GI Health and Microbiome Profile (Stool Test) - £379

2) Aerodiagnostics Lactulose Breath Test for SIBO - £165

3) Organic Acid - Organix Comprehensive Profiles
Mosaic Diagnostics (formerly Great Plains) Organic Acid Test - 76 markers - £250
This is my OAT profile of choice.

Genova Metabolomix Organic Acids -
(the previous Genova Comprehensive OAT test plus new markers such as oxalates and a more detailed breakdown - £335
(the previous Genova OAT is still available at £279)

Invivo Organic Acids & Environmental Pollutants - £245 (I don't use this generally as not enough metabolites)

I charge £60 for interpretation of the OAT test (includes my time for lab discussion and notes)

4) GI EcologiX - Microbiome Only - £189

5) The Organic Acids Test (OAT) (Urine Test) - Mosaic Diagnostics OAT £250

6) Microbial Organic Acid Profile - Mosaic Diagnostics (formerly Great Plains) - £234
(bacterial/fungal/yeast/clostridia species only - no nutrient status)

7) Adrenal Stress Profile - 4 X SALIVA SAMPLES –
Genova END01 - ask for price

8) IGG Profile – Food Sensitivity Test - £244

9) GI-MAP (Microbial Assay Plus) – Stool Test - £335 (I only use this now in acute cases as the EcologiX is my preferred test)

10) Oral EcologiX - £149

11) Vaginal EcologiX - £199

12) Urinary Mycotoxins Profile - £331

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