Gastrointestinal complaints are among the most common reasons that patients seek medical care. Symptoms associated with GI disorders include persistent diarrhea, constipation, bloating, indigestion, irritable bowel syndrome and malabsorption. The Comprehensive Stool Analysis is a simple stool test that can help assess digestive and absorptive functions, the presence of opportunistic pathogens and to monitor the efficacy of therapeutic remediation of GI disorders.
This test is useful for:
- Gastrointestinal Symptoms
- Autoimmune Disease
- Joint Pain
- Food Sensitivities
- Nutritional Deficiencies
- Skin Conditions (Atopic Dermatitis)
The Comprehensive Stool Analysis is an invaluable non-invasive diagnostic assessment that permits practitioners to objectively evaluate the status of beneficial and imbalanced commensal bacteria including Clostridium species, pathogenic bacteria and yeast/fungus. Precise identification of pathogenic species and susceptibility testing greatly facilitates selection of the most appropriate pharmaceutical or natural treatment agents.
Important information regarding the efficiency of digestion and absorption can be gleaned from the measurement of the fecal levels of elastase (pancreatic exocrine sufficiency), fat, muscle and vegetable fibers, and carbohydrates.
Inflammation can significantly increase intestinal permeability and compromise assimilation of nutrients. The extent of inflammation, whether caused by pathogens or inflammatory bowel disease (IBD), can be assessed and monitored by examination of the levels of biomarkers such as lysozyme, lactoferrin, white blood cells and mucus via this stool test. These markers can be used to differentiate between inflammation associated with potentially life-threatening inflammatory bowel disease (IBD), which requires lifelong treatment, and less severe inflammation that can be associated with irritable bowel syndrome (IBS) which is frequently due to the presence of enteroinvasive pathogens. Lactoferrin is only markedly elevated prior to and during the active phases of IBD, but not with IBS. Monitoring fecal lactoferrin levels in patients with IBD can therefore facilitate timely treatment of IBD, and the test can be ordered separately. Since the vast majority of secretory IgA (sIgA) is normally present in the GI tract, where it prevents binding of pathogens and antigens to the mucosal membrane, it is essential to know the status of sIgA in the gut. sIgA is the only bona fide marker of humoral immune status in the GI tract.
Cornerstones of good health include proper digestion of food, assimilation of nutrients, exclusion of pathogens and timely elimination of waste. To obtain benefits from food that is consumed, nutrients must be appropriately digested and then efficiently absorbed into portal circulation. Microbes, larger-sized particles of fiber, and undigested foodstuffs should remain within the intestinal lumen. Poor digestion and malabsorption of vital nutrients can contribute to degenerative diseases, compromised immune status and nutritional deficiencies. Impairment of the highly specific nutrient uptake processes, or compromised GI barrier function, as in “leaky gut syndrome,” can result from a number of causes including:
- Low gastric acid production
- Chronic maldigestion
- Food allergen impact on bowel absorptive surfaces
- Bacterial overgrowth or imbalances (dysbiosis)
- Pathogenic bacteria, yeast or parasites and relate dtoxic irritants
- The use of NSAIDs and antibiotics
Impairment of intestinal functions can contribute to the development of food allergies, systemic illnesses, autoimmune disease, and toxic overload from substances that are usually kept in the confines of the bowel for elimination. After performing a stool test, efficient remediation of GI dysfunctions incorporates a comprehensive guided approach that should include consideration of elimination of pathogens and exposure to irritants, supplementation of hydrochloric acid, pancreatic enzymes and pre- and probiotics, and repair of the mucosal barrier.
A good balance of beneficial microflora has been known to be associated with health benefits since the turn of the century. At that time Metchnikoff drew attention to the adverse effects of dysbiotic gut microflora on the host and suggested that ingestion of fermented milks ameliorated what he called “autointoxication.” He proposed that the consumption of large quantities of Lactobacillus species would reduce the number of toxin-producing bacteria and result in better health and increased lifespan.
Over the past 90-plus years there has been extensive scientific research demonstrating that a good balance of Lactobacilli, Bifidobacteria and beneficial E. coli bacteria are important to the functional health of the gut, and as a consequence, to the whole organism. The benefits identified include inhibition of microbial pathogens, prevention and treatment of antibiotic-associated diarrhea, prevention of travelers’ diarrhea, reduction of lactose intolerance symptoms, reduction in serum cholesterol levels, enhancement of the immune system, and inhibition of the proliferation of Candida albicans.
Research has shown that improved biological value of food can be achieved through the activity of Lactobacilli and Bifidobacteria which have been reported to produce folic acid, niacin, thiamin, riboflavin, pyridoxine, biotin and vitamin K. The mechanisms by which these benefits are derived are not yet fully understood. However, research suggests that some of the beneficial effects may be due to the following activities of beneficial bacteria:
- Release of substances antagonistic to enteropathogenic microorganisms such as:
- lactobicillin and
- Competition with pathogens for adhesion receptors
- Production of lactase
- Production of short chain fatty acids (SCFAs) such as butyrate, propionate and acetate
In a healthy balanced state of intestinal flora, the beneficial bacteria make up a significant proportion of the total microflora. However, in many individuals we see an imbalance of beneficial bacteria and an overgrowth of non-beneficial or even pathogenic microorganisms—dysbiosis. This can be due to a variety of factors including:
- Daily exposure to chemicals in our drinking water that are toxic to friendly bacteria
- The use of antibiotics
- Chronic consumption of highly processed foods (low in fiber, high in sugar)
- High stress levels
Patients may present with chronic symptoms such as irritable bowel syndrome, autoimmune diseases such as rheumatoid arthritis, fatigue, chronic headaches and allergies to a variety of foods.
Infection with yeast species can cause a variety of symptoms, both intra- and extra-gastrointestinal, and in many cases, may escape suspicion as a pathogenic agent. Controversy remains as to the relationship between Candida infection and episodes of recurrent diarrhea. However, episodes of yeast infection after short-term and long-term antibiotic use have been identified in patients with both gastrointestinal and vaginal symptoms.
There is some evidence linking yeast infections with more chronic extra-gastrointestinal conditions. Studies suggest that the production of antibodies against Candida albicans may contribute to atopic dermatitis in young adults. Other studies have identified the potential role of candidiasis in chronic fatigue syndrome.
According to Dr. Hermann R. Bueno of the Royal Society of Tropical Medicine and Hygiene in London, “parasites are the missing diagnosis in the genesis of many chronic health problems, including diseases of the gastrointestinal tract and endocrine system.”
While parasitic infection may be an underlying etiological factor in several chronic disease processes, doctors often do not consider the potential for parasitic involvement because signs and symptoms of parasitic infection often resemble those of other diseases. However, it has been shown that parasite testing is a reasonable approach to the detection of causative agents for chronic gastrointestinal disorders.
Most Americans are inclined to believe that parasitic infection is a rare and exotic occurrence, limited to those who have traveled to distant, tropical lands. However, for a number of reasons, there has been an increase in the incidence of parasitic infection in this country. These may include:
- Contamination of the water supply
- Increased use of daycare centers
- Increased travel to, and visits from, countries where parasitic infection is endemic
- Household pets
- Consumption of exotic and uncooked foods
- Antibiotic use
- Changing sexual mores
Signs and symptoms of parasitic infection vary from one individual to another. The more common are constipation, diarrhea, bloating, gas, symptoms of irritable bowel syndrome, arthralgias, myalgias, anemia, increased allergic reactions, skin lesions, agitation and anxiety, difficulty with sleep, decreased energy, malnutrition and decreased immune function. Infection can occur by four different pathways. These routes include:
- Contaminated food or water
- Insect vectors
- Sexual contact
- Passage through the skin and nose
**Description courtesy of Doctor’s Data Inc