Stool Tests

Firmicutes/Bacteroidetes Ratio Test Summary

Description/Background Information

A healthy gut microbiota is vital to our wellbeing—it helps to establish and maintain our immune system, fend off opportunistic pathogens, extract nutrients and energy from foods we cannot digest (e.g., dietary fiber), produce vitamins, and stimulate communication between the gut and brain.1-5 The beneficial end-products of fiber fermentation are short-chain fatty acids (SCFAs), which nourish the gut lining and regulate food intake, inflammatory tone, and insulin signaling.1,6 Microbiota diversity is dependent on both diet and colonic transit time, and may confer resilience to stress.2,7 Overall microbial composition affects the structural integrity of the gut lining and, although influenced by our genetic background and maternal flora, also reflects what we eat.5,8

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Short Chain Fatty Acids Test Summary

Description/Background Information

Humans lack the enzymes needed to break down the bulk of dietary fiber and other indigestible complex carbohydrates (e.g., cellulose, resistant starch, and oligosaccharides). Such food components are instead fermented by bacteria in the colon to produce short chain fatty acids (SCFA), primarily n-butyrate, acetate, and propionate. These beneficial SCFA have immunomodulatory and anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis:1-7

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Calprotectin Test Summary

Description/Background Information

Calprotectin is a small calcium- and zinc-binding protein that derives mainly from neutrophils, constituting 60% of the cytosolic protein.1 Active inflammation in the gut that induces neutrophil influx into the mucosa will eventually disrupt the mucosal architecture, allowing neutrophils (with their cytosolic calprotectin) to leak into the intestinal lumen and be excreted with the feces.2 Fecal calprotectin (fCal) has been shown to correlate with the severity of intestinal inflammation, and is a sensitive biomarker of inflammatory bowel disease (IBD).3,4

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Eosinophil-Derived Neurotoxin (EDN)(Eosinophil Protein X; EPX) Test Summary

Description/Background Information

Measurement of eosinophil-derived neurotoxin (EDN; also called eosinophil protein X or EPX) is the preferred method for sensitive, noninvasive assessment of intestinal eosinophilic activity, commonly associated with intestinal parasites and food allergies—both IgE-mediated (e.g., food anaphylaxis or protein-induced enteropathy) and non-IgE dependent (e.g., celiac disease).1

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Secretory IgA Test Summary

Description/Background Information

Secretory IgA (sIgA) is the primary antibody in mucous membranes in humans, which are the entry point for most foreign antigens (e.g., in the nose, lungs, and gut lining). It therefore plays a critical role in mucosal immunity—the protection and homeostatic regulation of mucosal epithelia.1,2  Upon exposure to microbial or other antigens, sIgA is synthesized in B-lymphocyte-derived plasma cells and transported across the mucosa by the polymeric immunoglobulin receptor (pIgR) into external secretions (e.g., tears, saliva, and mucus lining the gut).1-3

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Pancreatic Elastase Test Summary

Description/Background Information

A healthy pancreas is vitally important for digestion of our food and absorption of nutrients. After a meal, hormonal and neural signals stimulate the production of pancreatic secretions, typically 1-2 liters per day, into the duodenum.1

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Zonulin Test Summary

Description/Background Information

Zonulin – the “GateKeeper” of Intestinal Permeability

The intestinal wall—the single-cell-thick layer of epithelial cells lining the inside of the gut—is the largest barrier between the human body and the outside world. Maintaining control of this barrier is crucial for regulation of the immune system and protection against pathogens. There are two routes from gut lumen to the bloodstream—across the enterocyte brush border via transporters (the “transcellular” route, as in absorption of most nutrients), or through gaps between the cells (the “paracellular” route, through which ions, water-soluble molecules, and occasional microbes passively flow). The paracellular route is finely controlled by intricate protein “gates” called tight junctions.1-3 These dynamic structures open and close in tune with dietary state, physical activity, hormonal and neural signals, and inflammatory mediators.4,5

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Immunochemical Fecal Occult Blood Test Summary

Description/Background Information

Fecal occult blood is defined as the blood contained in feces that is hidden or not visibly apparent. It can be a late symptom of inflammatory mucosal damage to the intestine from multiple potential causes, including inflammatory bowel disease (Crohn’s disease or ulcerative colitis), diverticulitis, peptic ulcers, polyps, or colorectal cancer (CRC).1 Inflammatory bowel conditions may lead to CRC if left untreated.

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Gastrointestinal Pathogens Test Summary

Description/Background Information

The Gastrointestinal (GI) Pathogen Test is a new multiplex molecular diagnostic assay to simultaneously detect and identify 22 bacterial, viral, and parasitic pathogens that are responsible for the vast majority of infectious gastroenteritis.1

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H. pylori Test Summary

Description/Background Information

Helicobacter pylori, or H. pylori as it is more commonly known, is a ubiquitous bacterium which is estimated to be present in 40–50% of the world’s population.1Prevalence and incidence of H. pylori infection differs by geography and race. In the United States, H. pylori prevalence is 60% in Hispanics, 54% in African Americans, and 20% in Caucasians.2

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Yeast Culture Test Summary

Description/Background Information

While the human microbiota is made up mostly of bacterial species, everybody carries some fungal species too — a much smaller component of the microbiota, separately referred to as the “mycobiota.”1,2 In healthy individuals, these fungi cause no problem. However, when the gut microbiota is upset by antibiotics, chemotherapy, or immunosuppressive drugs, or the immune system is compromised, certain fungi can become opportunistic and pathogenic.

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