Why Invest in a Stool Analysis?
Symptoms like constipation, diarrhea, abdominal discomfort and bloating are often placed under the umbrella term of irritable bowel syndrome (IBS). It is a diagnosis often given after other pathologies have been ruled out. However, there are underlying causes of IBS that can go undetected in traditional testing such as food sensitivities, dysbiosis, and low-grade inflammation.
Comprehensive stool analyses utilize biomarkers that provide insight into digestive function, intestinal inflammation, the microbiome (commensal bacteria that reside in the GI tract), and the metabolome (how the commensal bacteria are interacting with the host). Here are some examples of the markers used in a stool analysis to assess these different areas of GI function:
- Pancreatic elastase – how well the pancreas is secreting digestive enzymes
- Fecal fat – how well fat is being digested/absorbed
- Products of protein breakdown – how well protein is being digested/absorbed
- Calprotectin – very high levels can be an indication of IBD or gluten sensitivity
- Secretory IgA – increased with infections and food sensitivities
- Eosinophil Protein X – increased with allergies and parasites
- Short chain fatty acids – these are produced by bacteria & have profound influence on epithelial cell health in the gut as well as metabolism
Summary Page from Genova’s GI Effects stool analysis – scores broken down into categories: maldigestion, inflammation, dysbiosis, metabolic imbalance, infection.
Let’s use an example to demonstrate how this test could be useful! If someone was experiencing diarrhea, there are a variety of reasons this could be occurring – an infection, food allergies or sensitivities, pancreatic insufficiency, or fat malabsorption. Instead of creating a hypothesis and treating empirically (which could lead to ineffective treatment plans), we can use this test to rule in or out multiple causes all at once. It also allows us to retest at the end of a protocol to ensure our treatment plan has been effective. If, for example, we identified a pathogenic organism that was the cause of the diarrhea, we could choose an anti-microbial agent based on the culture and sensitivity results on the stool analysis. When the lab identifies a pathogenic or potentially pathogenic organism in the stool sample, they will run a culture and sensitivity test to see which antimicrobial agents are likely to be effective against that particular organism. This helps to take a lot of the guess work out of treatment plans. We are then able, at the end of the treatment protocol, to use the same test to confirm that the pathogenic organism has been eradicated. Let’s use a second example! Let’s say someone is experiencing some gas and loose stool due to issues with digestive enzymes. The digestive markers on the analysis (products of protein breakdown and fecal fat) can help us to determine which type of enzyme might be more beneficial. If products of protein breakdown are high, the patient could most likely benefit from an enzyme with HCl. If fecal fat is high, the patient could most likely benefit from some gallbladder support or an enzyme with lipase.
While these types of tests are an investment, they are a valuable one. They allow us to create personalized and effective treatment plans for our patients. Furthermore, they allow us to ensure treatment plans have been followed through to completion or modify our plans as needed.
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