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Comprehensive Digestive Stool Test – GI 360

Comprehensive Digestive Stool Test – GI 360

About this test

Recently added to the Smart Nutrition range of stool tests the GI-360 is an innovative, comprehensive and clinically-applicable stool profile.

In addition to the traditional laboratory culture methodology, it also includes DNA PCR technology to detect pathogenic bacteria, viruses and parasites and microscopy provides an additional assessment of parasites. The results include an analysis of the abundance and diversity of key bacteria. And a sensitivity panel is also provided showing which natural and pharmaceutical agents would work to eradicate any bad guys that are found with the test.  Digestion and absorption are also checked as is intestinal health – markers related to the health of the gut wall.

This stool test is at the forefront of stool testing and is one of the top 3 stool tests we now offer. We have struggled to find a front runner as all three comprehensive stool tests we now offer cover a broad range of test markers and all use the most up to date testing technology available.

The difference in stool testing quality used to be vast but now, when using reputable labs as we always do the difference is much smaller.  As technology has improved so has access to great stool tests and we are proud to offer a range of what we see as the top available tests done by accredited labs. So how do you decide which one to do? There is still a difference in reporting style and there is still a difference on what exactly is included  – so if you are looking for a specific ‘marker’ as we call them in the trade then that may lead your decision.

Some comprehensive stool tests focus more on digestion, some on parasite and some the microbiome (bacteria and microorganisms in the gut) If you are struggling to know which is the right one for you then please do get in touch as we are happy to help.

What is being measured?

The GI-360 stool profile assesses 3 major areas of gut health:

  1. Digestive function. Namely your ability to digest protein, fats and carbohydrates.
  2. Gut inflammation; Markers on this test assess inflammation in the gut and can be used to help differentiate between IBD; Inflammatory bowel disease and IBS Irritable bowel syndrome.
  3. The Gut microbiome (organisms within the gut). Recent research has highlighted the important
    role gut bacteria and its balance play in not only digestive health but an array of different health concerns such as metabolic syndrome, inflammatory and autoimmune disorders and metabolic health and general wellness.

Your Gastrointestinal Microbiome – Good and bad bacteria, yeasts and parasites.

Microbiome Abundance and Diversity Summary

bacterial abundance (quantity present) as well as diversity (range of species present) are both indicators of gastrointestinal health. Using the DNA PCR technology, the GI-360 Profile uses 45 targeted bacterial analytes across 6 phyla (bacterial families) and compares results to a healthy reference population. Results are shown in a web chart, where the white shaded area represents your results compared to the healthy population. The centre of the web represents lower abundance while the outer edges represent levels higher than was seen in the healthy cohort.

Dysbiosis Index

The Dysbiosis Index (DI) is a calculation with scores from 1 to 5 based on the overall bacterial abundance and profile within your sample as compared to the reference population. Values above 2 indicate a microbiota profile that differs from the defined healthy reference population (i.e. dysbiosis). The higher the DI above 2, the more the sample is considered to deviate from what is considered healthy.

Key Findings

Found on page 1 of the report you will find a summary of all the key finding from your report.

 

Commensal Bacteria

Commensal bacteria discussed above form a part of what makes up your microbiome. It is made up of trillions of microorganisms; commensal, good, bad and imbalanced bacteria, yeasts and for some parasites as well. Surprisingly parasites and imbalances are much more common than people expect.

Your microbiome plays an important role in human health. The gut microbiota is diverse, varies among individuals, and can change over time, especially during developmental and life stages and with disease. The microbiome is viewed as an integral part of the body. Research has demonstrated the bacteria in the gut interact with the immune system and play an important part in immunity.

Some of the jobs gut bacteria do are;

  • Producing short-chain fatty acids (SCFAs)
  • Helping digestion
  • influencing the immune system
  • Modulating GI hormone production
  • Maintaining gut barrier function and motility – associated with leaky gut.
  • Modulating oxidative responses
  • Producing vitamins (e.g. biotin, vitamin K)
  • Metabolising xenobiotics and phytochemicals – removing toxins
  • Preventing colonisation by potential pathogens

The GI 360 tests your microbiome – good and bad bacteria, yeasts and parasites  via

  1. PCR Testing
    More than 95% of commensal gut organisms are anaerobic (don’t survive in oxygen) and are therefore difficult to recover by traditional (aerobic) culture techniques (growing in a petri dish). The new DNA techniques are now considered the standard for assessing these types of bacteria with a process called Polymerase Chain Reaction (PCR) methodology. This test checks 45 clinically relevant bacteria and 6 major phyla (groups of bacteria) with the new DNA PCR technology. It is also used to assess viruses, pathogenic bacteria and parasites.
  2.  Culture
    The process of culturing means that the lab checks for the presence of good, bad and imbalanced bacteria and yeasts by trying to grow them in a petri dish. If they manage to grow any bacteria or yeasts such as candida, they then treat them with pharmaceutical and natural antimicrobial agents to see which are sensitive – meaning which are reduced or killed off by the agent. In the ever expanding world of microbial resistance, the sensitivity panel is a valuable tool to help inform which antimicrobial drugs or plant based antimicrobials may be most effective in addressing any imbalances and /or pathogens.
    Pathogenic bacteria consist of known pathogenic bacteria that can cause disease in the GI tract. They are present due to the consumption of contaminated food or water, exposure to animals, fish, or amphibians known to harbor the organism. These organisms can be detected by either Multiplex PCR or microbiology culture.Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels. Dysbiotic bacteria consist of those bacteria that have the potential to cause disease in the GI tract. They can be present due to a number of factors including: exposure to chemicals that are toxic to beneficial bacteria; the use of antibiotics, oral contraceptives or other medications; poor fiber intake and high stress levels. Yeast may normally be present in small quantities on the skin, in the mouth and intestine. While small quantities of yeast may be normal, yeast observed in higher quantities is considered abnormal.Bacteria and Mycology Sensitivity. In the ever expanding world of microbial resistance, the sensitivity panel is a valuable tool to help inform which antimicrobial drugs or plant based antimicrobials may be most effective in addressing any imbalances and /or pathogens.
  3. Microscopy
    Highly skilled lab technicians check for eggs, parasites, worms and yeasts with a microscope.

Please see the comparison table here (coming any day now) to see exactly which bacteria, yeasts and parasites are checked for on the GI effects.  Or check out the sample report at the bottom of the page.

Digestion and Absorption markers

Elastase is a digestive enzyme secreted exclusively by the pancreas and provides a good reflection of the pancreatic output of the other digestive enzymes amylase, lipase and trypsin.  These markers give insight into our digestive capacity.
Pancreatic exocrine insufficiency can result in maldigestion and malabsorption, leading to abdominal pain, steatorrhea, malnutrition, nutrient deficiencies, and weight loss.

Fat Stain
Fecal fat is utilised to assess fat maldigestion, fat malabsorption and to detect steatorrhea. Ideally, fat should be absorbed, and not be excreted at elevated levels in the stool. Indigestion after eating fatty meals and pale, floating stools can be signs of sub-optimal fat digestion or absorption.

Carbohydrates
This can provide information about carbohydrate malabsorption.

Inflammation

Lactoferrin
Lactoferrin is used to detect inflammation in the intestines. Intestinal inflammation is associated with some bacterial infections, and with inflammatory bowel disease (IBD), it is associated with disease activity and severity. This marker can help to distinguish between IBD and non-inflammatory disorders and to monitor IBD disease activity.

Lysozyme
This is an enzyme secreted at the site of inflammation in the gastrointestinal tract and elevated levels have been identified in IBD patients.

Calprotectin
Calprotectin is released from the intestinal mucosa into the stool in intestinal inflammation. Levels of Calprotectin can be useful for differentiating Irritable Bowel Syndrome (IBS) from Inflammatory Bowel Disease (IBD). Levels can vary with age, with children under 10 having higher levels.

Immunology

Secretory IgA
Fecal secretory IgA, or sIgA, is a class of antibodies produced and secreted by mucosal tissue and represents the first line of defence of the gastrointestinal mucosa and is central to the normal function of the digestive tract as an immune barrier. It is a marker of gut immunity and important for general immune tolerance to both foods and gut organisms. It helps to protect the intestinal epithelium from pathogens and toxins. Elevated levels of sIgA have been associated with an upregulated immune response.

Short Chain Fatty Acids

% Acetate
% Propionate
% Butyrate
% Valerate
Butyrate
Total SCFA’s

These are produced by the fermentation of dietary fibre and resistant starch by the gut bacteria, and play an important role in the health of the gastrointestinal tract as well as protecting against intestinal dysbiosis.

Studies have shown that SCFAs have numerous implications in maintaining gut physiology. They maintain intestinal barrier function, provide fuel for the colon cells (colonocytes), regulate colonic absorption of water and electrolytes, salvage unabsorbed carbohydrates, support beneficial bacteria and modulate anti-inflammatory and anti-microbial activity. They also play a role in decreasing inflammation, stimulate healing, and contribute to normal cell metabolism and differentiation.

Research has identified that SCFA levels can be affected bya variety of factors, including: diet, faecal ammonia, obesity, inflammation, environment, and gender. Low SCFA may indicate inadequate fibre intake, an unbalanced commensal bacterial population, or impaired bowel health.

Levels of Butyrate and Total SCFA in mg/mL are important for assessing overall SCFA production, and are reflective of beneficial flora levels and/or adequate fibre intake.

Intestinal Health Markers

pH
Fecal pH is largely dependent on the fermentation of fiber by the beneficial flora of the gut.

Beta-glucuronidase
This is an enzyme that breaks down complex carbohydrates helping absorption of some plant polyphenols or nutrients.
It can also break the tight bond between glucuronic acid and toxins in the intestines. The binding of toxins in the gut is protective by way of blocking their absorption and facilitating excretion. This enzyme can act to uncouple these bound toxins resulting in the recirculation of these toxins.

Occult Blood
The term “occult” in this context simply means blood not evident to the naked eye, that is, blood present in microscopic quantities only. Normally, stools should be entirely free of blood. A positive occult blood indicates the presence of free haemoglobin found in the stool, which is released when red blood cells are broken down.

Additional Results also on the GI 360

RBC
Red Blood Cells (RBC) indicate blood in the stool and may be associated with a parasitic or bacterial infection. They can also be seen with bleeding haemorrhoids or menstrual blood, as well as serious conditions such as malignancy or IBD such as ulcerative colitis. Colorectal cancer, anal fistulas, and haemorrhoids should also be ruled out. If a serious condition is suspected, a follow-up faecal occult blood test or colonoscopy is recommended.

WBC
White Blood Cells (WBC) indicate an immune response that can be seen in infectious conditions or in inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis. WBCs can also occur with bacterial and parasitic infections and mucosal irritation.

Muscle fibres
These are an indicator of incomplete digestion. Bloating, flatulence, feelings of “fullness” may be associated with increase in muscle fibre.

Vegetable fibres
These may be indicative of inadequate chewing, or eating “on the run”.

Charcot-Leyden Crystals
This is a breakdown product of white blood cells (eosinophils) and is present in patients with tissue-invading parasites and allergic conditions.

Pollen
High levels of pollen in the stool may be associated with a gut-specific sensitivity or allergic response.  In these cases, it is recommended to consider levels of lysozyme, sIgA, intestinal permeability, and presenting symptoms.

Colour and consistency
Stool colour is generally related to diet or medications, though it can also be an indication of health condition. Patients self-report consistency with ranges from diarrhoea to hard/constipated.

Mucus
Mucus in the stool can occur with bacterial and parasitic infections, with mucosal irritation, and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.

Type of specimen required for the test

5 stool samples;

1 stool sample on collection day 1
1 stool sample on collection day 2
3 stool samples on collection day 3.

The lab recommends samples are collected on 3 consecutive days but if this is not possible they should be collected over a week. If this is not possible please do get in touch to discuss this.

Important information

This test is suitable for age 2 years and over.

If you are taking antibiotics, antifungals, anti-parasitic, probiotic supplements, or foods containing beneficial bacteria, botanicals or herbs please wait at least 14 days after your last dose before beginning the test.

Refrain from taking digestive enzymes, antacids, and aspirin for two days prior to collecting your samples.

Please consult your GP prior to stopping any medication.

Returning your sample

You will need to send your sample back to the lab via a next day postal service. If you are in the UK, Royal Mail offer a suitable next day service. If you are outside of the UK then please check with your postal service for options. The cost of the test does not cover the return postage.

Please note that samples should only be posted on Monday – Thursday so that they do not arrive over the weekend when the lab is closed.

A courier returns option is offered by the lab and details will be included in with your test kit. This is an optional service and the cost is not included in with the test fee. Details about payment, should you wish to take up this offer, are included with the courier details.

How long does it take to get my results

10 working days

How will I receive my results?

Results will be emailed to the address you use when ordering unless requested differently.

All sample reports are for representational and educational purposes only. Biomarkers, references ranges, results, and all other data may differ from actual reports. All data included in no way represents an actual patient. Any comparisons of results to actual patients is completely incidental. 

Please find a sample report here; Smart Nutriton GI 360 Sample report 1 –

Updated April 2020