Digestive Stool Test 2 Comprehensive GI-MAP + Zonulin

Digestive Stool Test 2 Comprehensive GI-MAP + Zonulin


Gastrointestinal function is critical for good health. In addition to performing digestive functions, the intestinal tract contains significant amounts of organisms. Imbalances in this internal ecosystem and the overall GI function is associated with a wide variety of common illnesses including, but not limited to:

  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease (IBD)
  • Diabetes
  • Obesity
  • Cardiovascular disease
  • Coeliac and other malabsorption disorders
  • Mood disorders
  • Autoimmune conditions
  • Autism

There are several reasons why our gut health can be compromised including pathogens, parasites, low digestive secretions, infection, inflammation and compromised beneficial gut bacteria. All of these are measured in the GI-MAP Stool Profile.

The GI-MAP + Zonulin is designed to assess a patient’s microbiome with particular attention to microbes that cause disease or that disrupt normal microbial balance and contribute to perturbations in the GI flora and contribute to illness. With full PCR quantification, we can now see the level of infection thus, providing accurate, actionable clinical information. The results gleaned from this digestive profile help the clinician to provide personalised, targeted protocols to address gut dysfunction.

Additionally, the quantification of the levels of identified bacteria offers a useful ability to see how treatments are working because a retest can show whether a parasite has resolved, dysbiosis has improved and more.

Zonulin, a marker for leaky gut (intestinal permeability), is now included with the test.

Below you will find an explanation as to the importance of all the parts of the GI MAP test. A concise list of the analytes can be found in the ‘what is being measured’ section.


The GI-MAP includes pathogens (bacterial, parasitic, and viral) commonly known to cause gastrointestinal infections. However the presence of a pathogen may not necessarily result in the presence of symptoms. Many factors, including the health of the individual, the transient nature of some pathogens, and the severity of the presence and expression of the pathogen can all influence whether symptoms will express and persist.

Bacterial Pathogens

  • C-Difficile Toxin A
  • C-Difficile Toxin B
  • Campylobacter
  • Enterohemorrhagic coli
  • Coli O157
  • Enteroinvasive coli/Shigella
  • Enterotoxigenic coli LT/ST
  • Shiga-like Toxin coli stx1
  • Shiga-like Toxin coli stx2
  • Salmonella
  • Vibro cholerae
  • Yersinia enterocolitica

Parasitic Pathogens

  • Cryptosporidium
  • Entamoeba histolytica
  • Giardia

Viral Pathogens

  • Adenovirus 40/41
  • Norovirus GI
  • Norovirus GII

Helicobacter Pylori and Virulence Factor

  • Helicobacter Pylori
  • Virulence Factor, baba
  • Virulence Factor, cagA
  • Virulence Factor, dupA
  • Virulence Factor, iceA
  • Virulence Factor, oipA
  • Virulence Factor, vacA
  • Virulence Factor, virB
  • Virulence Factor, virD

Studies show that nearly 50% of the world’s population may carry H. pylori. Many carriers show no symptoms at all, however, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer. Additionally, in early phases of colonisation, patients may experience low stomach acid or hypochlorhydria.

Over time, additional H. pylori strains may colonise, including those with Virulence Factors making the bacteria more harmful and with increased disease potential.

Normal / Commensal and beneficial bacteria

Trillions of microorganisms inhabit the human intestine to make up a complex ecosystem that 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.

The individual species in these gut communities were long considered commensal organisms, meaning they were neither pathogenic nor particularly harmful when in their natural site and in a proper amount – in balance.

The predominant classes or families of bacteria in the gut are Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria.

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
  • Modulating oxidative responses
  • Producing vitamins (e.g. biotin, vitamin K)
  • Metabolising xenobiotics and phytochemicals – removing toxins
  • Preventing colonisation by potential pathogens

Optimal healthy gut microbiota/bacterial balance and composition is different for everyone. The composition of each person’s microbiome is highly variable and can change according to age, ethnicity, location, diet, lifestyle, medications and environmental factors.  Rather than concentrating on any one commensal bacteria, understanding overall patterns is essential when assessing the impact of individual results.

Commensal Bacteria

  • Akkermansia mucinophilia
  • Bacteroides fragilis spp.
  • Bifidobacterium spp.
  • Enterobacter spp.
  • Enterococcus spp
  • Escherichia spp.
  • Faecalbacterium prausnitzii
  • Lactobacillus spp
  • NEW – Roseburia spp.

Bacterial Phyla

  • Bacteroidetes
  • Firmicutes
  • Firmicutes/Bacteroidetes ratio

Opportunistic Bacteria / Overgrowth of Microbes

Many bacteria measured on the GI-MAP are considered opportunistic pathogens since they may only cause symptoms in some individuals, particularly those with compromised immune systems. Many people come into contact with these opportunistic bacteria species  and experience no symptoms at all. They can be considered to be a normal part of our microbiome, however, for vulnerable patients they can cause inflammation and ill health. Symptoms may include diarrhoea, loose stools, abdominal pain and constipation.

Overgrowth and excessive colonisation by opportunistic bacteria may occur when the commensal (friendly or beneficial) bacteria are impaired by poor diet, antibiotic use, parasitic infection or a weakened immune system. When intestinal permeability (or leaky gut) is present, these microbes can cause further damage.

Dysbiotic / Imbalanced or Overgrowth of Bacteria

  • Enterococcus faecalis
  • Enterococcus faecium
  • Morganella spp.
  • Pseudomonas spp.
  • Pseudomonas aeruginosa
  • Staphylococcus spp.
  • Staphylococcus aureus
  • Streptococcus spp.
  • Methanobacteriaceae (family)
  • NEW – Bacillus spp
  • NEW Desulfovibrio spp.

Inflammatory Bacteria or Bacteria associated with autoimmune diseases

  • Citrobacter
  • Citrobacter freundii
  • Klebsiella
  • Klebsiella pneumoniae
  • avium subsp. Paratuberculosis
  • Proteus
  • Proteus mirabilia
  • Prevotella spp
  • NEW Enterobacter
  • NEW Escherichia
  • NEW Fusobacterium

Funghi / Yeast

Fungal organisms are commonly found in the human digestive tract, but fungal overgrowth may only cause symptoms in those who are susceptible or immune-compromised. Fungal growth is localised in the body and can be found the large intestine,  small intestine or elsewhere in the body including the mouth, vagina, nails etc. Stool profiles provide information only about the presence of fungi in the large intestine, and additional tests may be necessary to understand the complete picture of fungal overgrowth. Organic acid profiles (add link) can also provide useful information about the presence of yeast in the body.

  • Candida spp.
  • Candida albicans
  • Geotrichum spp.
  • Microsporidium spp.
  • Rhodotorula spp.


  • Cytomegalovirus
  • EBV- Epstein Barr virus


A parasite is an organism that lives and feeds on a host organism at the expense of the host. The GI-MAP tests for pathogenic parasites and protozoa most commonly occurring in the GI tract. Sources of exposure should be identified and eliminated to prevent reinfection.


  • Blastocystis hominis
  • Chilomastix mesnili
  • Cyclospora spp.
  • Dientamoeba fragilis
  • Endolimax nana
  • Entamoeba coli
  • Pentatrichomonas hominis


  • Ancyclostoma duodenale
  • Ascaris lumbricoides
  • Necator americanus
  • Trichuris trichiura
  • Taenia spp.

Intestinal Health Markers


This part of the test gives information about how well you are digesting and absorbing your food. It therefore indicates how well your GI tract is performing its basic digestive functions.

It includes the following markers:


A check to see how well the pancreas is playing its part in the digestion of protein, fat and carbohydrate. Pancreatic elastase is secreted exclusively by the pancreas and provides insight into the production of the digestive enzymes amylase, lipase and trypsin.


Faecal fats are normally broken down by bile salts and absorbed in the small intestines. High levels of fat in the stool may be an indication of maldigestion or malabsorption of dietary fats.

GI Markers

One of the ways that toxins are removed from the body is via the stool – the toxins are bound to a molecule that allows them to be removed. Beta-glucuronidase can uncouple these toxins resulting in them being recirculated. Beta-glucuronidase can also break down carbohydrates and help the absorption of some plant polyphenols and nutrients.

Occult Blood
The term ‘occult blood’ simply means blood that is not evident to the naked eye and 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. Follow-up testing is recommended.

Immune Response

Secretory IgA
SIgA is secreted by the mucosal tissue of the gastrointestinal tract. Mucosal tissue is strategically located in areas where external pathogens enter the body and it helps to form the protective lining or barrier of the digestive tract to protect us against pathogens and bad bugs and toxins.

Anti-gliadin IgA
Gliadin is a component of gluten, the protein found in wheat and other field grass grains such as barley, malt and rye. The presence of faecal anti- gliadin antibodies can indicate an immune response (in the gut) to gluten in the diet. Faecal anti-gliadin antibodies do not necessarily correlate with blood levels.

NEW Eosinophil Activation Protein
Eosinophil Activation protein is a protein released by activated eosinophils which has strong cytotoxic characteristics. The protein plays a significant role in a variety of inflammatory and mast-cell mediated pathologies in addition to fighting pathogens, particularly viral infections.


Calprotectin is a simple measure that checks for inflammation in the gut. Calprotectin can be useful for distinguishing between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).  Levels can vary with age and children under 10 have higher levels.

Antibiotic Resistance Genes, Genotypes

Helicobacter pylori  Antibiotic Resistance Genes.

The GI-Map test checks for antibiotic resistance genes to H.pylori. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol.

**The sensitivity panel for the complete microbiome is no longer available on this test – however the sensitivity panel for the H.pyloris is still available**





The recently updated and improved GI-MAP now measures the following;


  • Campylobacter
  • C. difficile Toxin A
  • C. difficile Toxin B
  • Enterohemorrhagic E. coli
  • E. coli O157
  • Enteroinvasive E. coli/Shigella
  • Enterotoxigenic E. coli LT/ST
  • Shiga-like Toxin E. coli stx1
  • Shiga-like Toxin E. coli stx2
  • Salmonella
  • Vibro cholerae
  • Yersinia enterocolitica
  • H. pylori
    • Virulence Factor, babA

    • Virulence Factor, cagA
    • Virulence Factor, dupA
    • Virulence Factor, iceA
    • Virulence Factor, oipA

    • Virulence Factor, vacA

    • Virulence Factor, virB

    • Virulence Factor, virD


  • Cryptosporidium
  • Entamoeba histolytica
  • Giardia


  • Adrenovirus 40/41
  • Norovirus GI
  • Norovirus GII


  • Akkermansia Mucinophilia
  • Bacteroides fragilis
  • Bifidobacterium spp.
  • Clostridia (class)
  • Enterobacter spp.
  • Enterococcus spp.
  • Escherichia spp.
  • Faecalbacterium prausnitzii
  • Lactobacillus spp.


  • Bacteroidetes
  • Firmicutes
  • Firmicutes/Bacteroidetes Ratio


  • Bacillus spp.
  • Enterococcus faecalis
  • Enterococus faecium
  • Morganella spp.
  • Pseudomonas spp.
  • Pseudomonas aeruginosa
  • Staphylococcus spp.
  • Staphylococcus aeureus
  • Streptococcus spp.
  • Methanobacteriaceae (family)


  • Citrobacter spp.
  • Citrobacter freundii
  • Fusobacterium spp.
  • Klebsiella spp.
  • Klebsiella pneumoniae
  • Mycobacterium avium subsp. paratuberculosis
  • Prevotella spp
  • Proteus spp.
  • Proteus mirabilis


  • Candida albicans
  • Candida spp.
  • Geotricum spp.
  • Microsporidia spp.
  • Rhodoturula spp.


  • CMV- Cytomegalovirus
  • EBV- Epstein Bar Virus



  • Blastocystis hominis
  • Chilomastix mesnelli
  • Cyclospora spp.
  • Dientamoeba fragilis
  • Endolimax nana
  • Entamoeba coli
  • Pentatrichomonas hominis


  • Ancyclostroma duodenale
  • Ascaris lumbricoides
  • Necator americanis
  • Trichuris trichiura
  • Taenia spp



  • Elastase-1
  • Steatocrit


  • SIgA
  • Anti-gliadin SIgA


  • Calprotectin


  • ß-Glucuronidase
  • Occult Blood – FIT



  • Amoxicillen
  • Clarithromycin
  • Fluroquinolines
  • Tetracycline



A marker for leaky gut (intestinal permeability), is now included.

Add-on option: Zonulin used to be available as an add-on for this test at a cost of around £70 is now included in your test for no extra cost.


The GI MAP stool test requires 1 single stool sample.

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.

Lactoferrin supplements. Whilst lactoferrin supplements will not have a direct impact on the test results they can have an indirect influence owing to the support it provides to the gut wall. Lactoferrin is good for permeability and the overall health of the gut wall. You may like to consider waiting for 72 hours after taking lactoferrin supplements before completing your test samples.

Never discontinue prescription medications without consulting your healthcare provider first.

The GI MAP Digestive Stool test kit will come with full instructions.

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 given digestive and inflammatory markers are for adults.

This test is to be taken over one day and it must be shipped back within 24 hours. The GI MAP stool test has a short stability time.

To ensure that your sample reaches the laboratory in time, you must collect your sample on a Sunday or Monday. (If you collect on a Sunday, you must ship on Monday.

You may collect your sample any time during your collection day.

If you are returning samples from outside of the UK you will need to arrange your own courier return to the UK. We recommend using DHL.

You will receive the address to return the samples to and a customs letter to assist you.

It will take 21 -28 days to get the results for your GI MAP stool test.



Your GI MAP stool test results will be emailed to you.

Digestive Stool Test 2 Comprehensive GI-MAP + Zonulin


Please do not return samples to the laboratories that may arrive after Wednesday 27th March and up to and including Monday 2nd April.

The laboratories are closed from the 28th March – 2nd April for the Easter Holiday.