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Comprehensive Digestive Stool Test – GI Effects

Comprehensive Digestive Stool Test – GI Effects


This new and exciting health test offers the best of all the other stool tests put together along with combining new technology for checking levels of 24 different types of bacteria. The is done via a new process called PCR. This works by checking the DNA of the bacteria and is fast becoming the world leader in ways to test for bacteria.

Gastrointestinal (GI) function is important for general health. This includes balancing beneficial microbial flora in the gut to enhance health benefits. GI health is key in digestion, nutrient usage, and ridding the body of waste and pathogens. Poor digestion and malabsorption can lead to immune dysfunction, nutritional insufficiencies, and various disease states. Poor GI function can also lead to food allergies and other toxicities.

What is being measured

Digestion/Absorption Markers

This part of the test looks at how well you are breaking down and absorbing protein, fats and carbohydrates.

  • Pancreatic Elastase 1 – Pancreatic Elastase is secreted by the pancreas, with a direct correlation to pancreatic function and a strong correlation with the gold-standard test for pancreatic insufficiency (secretin-pancreozymin test). PE1 is a stable marker; it is not degraded during intestinal transit, is not greatly affected by changes in intestinal transit time, and is not affected by pancreatic enzyme-replacement therapy
  • Products of Protein breakdown (Valerate, Isobutyrate and Isovalerate) – also known as Putrefactive short chain fatty acids -Intestinal proteins (from food, albumin, blood, muscle, intestinal secretions and exudate) are metabolized by gut bacteria. High levels can be associated with insufficient stomach acid or pancreatic function that is affecting the digestion of protein.
  • Fecal Fat; Total fecal fat, Long chain fatty acids, Cholesterol and Phospholipids – Dietary fats are digested by pancreatic enzymes in the small intestine. Increased fecal fat has been correlated with fat malabsorption. Fat malabsorption can be associated with: diarrhea, intestinal dysbiosis, parasites, IBS, IBD, gluten intolerance, food intolerances, celiac disease, hypochlorhydria, gastric by-pass, pancreatic or bile salt insufficiency, excess alcohol intake, ileal resection, and/or chronic non-steroidal anti-inflammatory drug (NSAID) usag

Gut Inflammation and Immunology Markers

This part of the test is looking for inflammation in the gut.

  • Calprotectin – Calprotectin is a sensitive, stable marker that is unaffected by medications, dietary supplements or digestive enzymes.  Calprotectin is the noninvasive “test of choice” for differentiating Irritable Bowel Syndrome (IBS) from Inflammatory Bowel Disease (IBD).
  • Eosinophil Protein X (EPX) – As a non-invasive marker, EPX offers increased sensitivity for evaluating inflammatory disease activity and for predicting relapses in patients with Inflammatory Bowel Disease. EPX can also be raised when food allergy is a problem, or  other GI disturbances.
  • Fecal sIgA – Fecal SIgA is the chief antibody in the membranes of the gastrointestinal and respiratory tracts. It is the most abundant antibody produced in the intestine. Secretory IgA is resistant to degradation in the harsh environment of the gastrointestinal tract and regulates the balance of commensal bacteria in the gut, preventing colonization of pathogens and regulating epithelial barrier function (associated with Leaky gut / intestinal permeability). Levels of SIgA that are abnormally elevated or depressed can signal alterations in gastrointestinal immunity. Low or absent SIgA may increase susceptibility to pathogens and also produce a leaky gut barrier, contributing to increased risk of food allergy.

Metabolic Markers

This part of the test is looking to see how well you are able to provide fuel to the cells of the gut and also how good the gut is at removing toxins.

Short Chain Fatty Acids (SCFA’s)
Total – Acetate, n’Butyrate & propinate
n-Butyrate Concentration
n-Butyrate %
Acetate %
Propinate %

SCFA’s – including acetate, propionate, and butyrate are produced by gut bacteria fermenting  dietary carbohydrates, specifically resistant starch and fiber (prebiotics). SCFA contribute to normal bowel functions (such as maintenance of the intestinal barrier) and prevent pathology. SCFA, and specifically n-butyrate, serve as fuel for the colonocytes.

Beta Glucoronidase – Raised levels can be associated with an increased risk of colon cancer.

Microbiology Markers – Microbiome

This part of the test is looking at levels of good and bad bacteria, yeasts and parasites.

PCR technology is used to test for the presence of the DNA of bacteria –  the new and more comprehensive way that levels of  different bacteria are checked. The different types of bacteria checked are;

Bacteriodes Phylum
Bacteriodes- Prevotella group
          Bacteriodes vulgatus
Barnesiells spp.
Odoribacter spp.
Prevotella spp.

Firmicutes Phylum
Anaerotruncus colihominis
Butyrivibrio crossotus
Coprococcus eutactus
Faecalibacterium prausnitzil
Lactobacillus spp.
Pseudoflavonfractor spp.
Roseburia spp.
Ruminococcus spp.

Bifidobacterium spp.
Bifidobacterium longum
Ccollinsella aerofaciens

Preoeobacteria Phylum
Desulfovibrio piger
Escherichia coli
oxalobacter formigenes

Euryarchaeota Phylum
methanobrevibacter smithii

Fusobacteria Phylum
Fusobacterium spp.

Furmicutes/Bacteriodes Ratio
Firmicutes/Bacteriodes (F/B Ratio)

Bacteriology – Cultured

Lactobacillus spp.
Escherichia coli
Bifidobacterium spp.

Additional Bacteria – Cultured
A board range are tested for and can include;
Alphahaemolytic streptococcus
Citrobacter frendii (and other strains of citrobacter)
Klebsiella (many strains)

The presence of some bacteria may be clinically relevant in those with bacterial gastroenteritis, including: traveler’s diarrhoea, food poisoning, IBD and/or IBS.

Mycology – Cultured
Candia albicans
Candida dubliniensis and other species of candida are checked for.
Yeast that are not related to candida.

Opportunistic fungi are associated with gastrointestinal symptoms and may be considered pathogenic, especially in immune-compromised individual

Bacterial Sensitivity
A Sensitivity panels is provided against any of the additional bacteria or yeasts that may be pathogenic (problem causing) which will show which pharmaceutical medicines and plant based supplements will be effective and which they are resistant to and would there for  would be ineffective.

The GI Effects profile utilizes the accepted gold standard for parasite detection, the microscopic Ova & Parasites (O & P) exam. O & P approaches have the highest proven diagnostic and clinical utility for parasite detection. While governing bodies, such as the Centers for Disease Control, recommend a minimum of three samples on at least three separate days for the highest parasite detection, literature suggests that > 90% of enteric parasitic infections are detected in a single stool sample using O & P collection. In addition, Cryptosporidium, Giardia lamblia, and Entamoeba histolytica/dispar are assessed by EIA Enzyme immunoassay.

Fecal Occult Blood ( Hidden blood) – This can reflect bleeding higher up in the GI tract.

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

Additional Markers – The following markers below can be added on for an additional fee. Please add these at check out should you like to include them in your test.

Stool Zonulin Family Peptide – Research by Fassano concluded that zonulin acted like a shoe lace to pull the cells of the intestines together. If it was found outside of the reference range it was concluded that it was associated with a leaky gut or intestinal permeability. A recent research paper published in Frontiers in Endocrinology suggested that the zonulin kits from Immundiagnostik (IDK) ( who supply All the labs that we know that run zonulin) did not detect zonulin (a precursor of Haptoglobin 2). This issue was further confirmed by the kit manufacturer, Immundiagnostik. Because some researchers are conducting studies and have received data from the current zonulin kits, Genova are still offering zonulin but have renamed it Zonulin family peptide.

The Scheffler paper suggests that the kits may detect properdin, a protein involved in the alternative complement pathway and inflammation. Preliminary study results from an external investigator suggest that properdin may be structurally and functionally similar to zonulin. When analysing data Genova found a high correlation with raised zonulin and other markers associated with gut mucosal health.

Helicobacter PyloriEIA. Recent studies have shown that up to 45 – 50% of the world’s population may harbor H. pylori. Many carriers are asymptomatic, but H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer. Direct stool testing of the antigen (HpSA) is highly accurate and is appropriate for diagnosis and follow-up of infection.

Campylobacter spp – EIA. Campylobacter jejuni is the most frequent cause of bacterial-induced diarrhea. While transmission can occur via the fecal-oral route, infection is primarily associated with the ingestion of contaminated and poorly cooked foods of animal origin, notably, red meat and milk. Symptoms range from mild to severe abdominal pain, diarrhea, fever, malaise; lasting several days to several weeks.

Clostridium difficile  EIA. Clostridium  Difficile also known as C.Diff  is an anaerobic, spore-forming gram-positive bacterium. Changes in gut flora, usually caused by antibiotics can lead to colonization with Clostridium difficile. Symptoms include inflammation, abdominal pain, cramping, fever, and diarrhea. Symptoms often present during antibiotic use and often subside once antibiotics are discontinued.

E. coli EIA is a group of bacterial strains that have been identified as worldwide causes of serious human gastrointestinal disease. Enterohemorrhagic E. coli includes over 100 different serotypes; 0157:H7 is the most significant, occurring in over 80% of all cases. Contaminated food continues to be the principal vehicle for transmission; foods associated with outbreaks include alfalfa sprouts, fresh produce, beef, and unpasteurized juices. The symptoms may include severe abdominal cramps and diarrhea and bloody diarrhea.

KOH Prep. A KOH prep is a further way to test for yeast

Fecal Lactoferrin –In the gastrointestinal tract, lactoferrin serves as a non-specific marker of inflammation

Microscopic exam for worms. Examination for adult cestodes, nematodes and trematodes or macroscopic worms or pieces of worms that may be shed in the stool


General Information

The GI effects stool test also comes with an insightful interpretation at a glance front page which informs you or your status for infection, inflammation, Insufficiency and imbalance as well as giving you a measure or your own bacterial diversity and abundance in relation to the general health population.

Age range this test is suitable for

Adults and children 2 years and above. The child needs to be potty trained and out of nappies. The sample must not be contaminated with urine or fibres from nappies. Please note the reference ranges for digestive and inflammatory markers are for adults.

Specimen Requirement

3 stool samples. Sample 1 & 2 can be taken up to a month before posting if stored correctly ( as per instructions sent with the kit.) The third sample has to reach the lab the next day by guaranteed delivery.

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.

Before Taking this Test

Refrain from taking digestive enzymes, antacids, and aspirin for two days prior to specimen collection, unless otherwise instructed by your healthcare provider

If taking antibiotics, antiparasitics, antifungals, probiotic supplements (acidophilus, etc.), or consuming food products containing beneficial flora (e.g. Activia®), it is recommended that you wait a minimum of 14 days after your last dose before beginning the test; 28 days may be preferred after antibiotics have been utilized (unless instructed otherwise by your physician). There may be times when your healthcare provider prefers that you stay on one of these agents (e.g. acidophilus) during testing in order to evaluate its effectiveness. Follow your healthcare provider’s recommendation.

Never discontinue prescription medications without consulting your healthcare provider first.

The test kit will come with full instructions.

Turn-Around Time

21 Days

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. 

Smart Nutrition Comprehensive Stool Test – GI Effects Sample Report – Updated January 2018