Can Stool Testing Help Chronic Digestive Issues? You bet it can! Diseases of the human digestive system are a painful reality to many people every day. Over 50 million people currently suffer from debilitating digestive system diseases such as Irritable Bowel Syndrome, Crohn’s Disease and Colitis. Other people with various digestive symptoms such as hemorrhoids, acid reflux, gerd, diarrhea, constipation, heartburn, painful bowel movements, indigestion, blood or mucous in the stool, irregular stools, gas and bloating know that they greatly diminish their quality of life. Most people have seen at least their regular doctor and one or two G.I. specialists before seeking out help from a Nutritionist to see if nutritional therapy may help.
In Clinical Nutrition, the focus is on a few main areas when dealing with chronic digestive symptoms. Usually, food sensitivities are considered first, using either an elimination diet or Food Antibody Testing. We look at what foods the person is eating regularly and which ones they may be sensitive or reacting to. A food sensitivity is different from an actual food allergy. After identification of food reactions, all offending foods (any foods that cause an immune system reaction), must be removed from the diet in order for healing to begin. The amount of time these foods must be avoided depends on many factors. Read my article on Food Allergies and Sensitivities for more on this important subject.
The other important area to focus on, and the one that pertains more to this article is assessing the biochemical status of the digestive system. Digestive stool testing can help to figure out what is going on biochemically in the gut. It also helps the health practitioner to determine how to get the gut back into balance. Digestive Stool testing is a valuable tool to assess digestive health issues in people with chronic or acute digestive system problems. Using a high quality specialty lab and an experienced health practitioner, this testing can oftentimes steer you toward the solution by giving you a picture of what is going on the gut. Stool testing can help to evaluate digestion and absorption, it can give you clues as to what foods and nutrients you are digesting and absorbing well, and what you need assistance with, such as proteins, carbohydrates, vitamins, minerals or fats. It can also show you the bacterial balance in the gut as well as gut metabolism, yeast (including Candida), parasites and immune status. Certain stool tests are helpful for differential diagnosis between IBD (Inflammatory Bowel Disease) and IBS (Irritable Bowel Syndrome) as they calculate inflammatory markers found in the stool. The Genova Diagnostics CDSA 2.0 analyzes
Anyone having chronic or acute digestive issues including indigestion, malabsorption, undigested food in the stool, nutrient deficiencies despite a healthy diet, diarrhea, constipation, hemorrhoids, fissures, ulcers, reflux, gas, bloating after or between meals and most other GI-related problems should consider finding an experienced health care practitioner and taking a stool test. There are quite a few labs now that specialize in stool testing and many different stool tests from which to choose. Your Doctor or Nutritionist should be able to help you choose the correct test based on your symptoms. It is very important that you choose your lab carefully, especially if you are trying to do this without hiring a well informed Doctor or Nutritionist. If you really want answers, make sure to use a lab that specializes in stool, nutritional, and metabolic testing. Many people have routine stool testing done when they go to the emergency room with acute diarrhea or when they first see their GI Doctor for any of the chronic or acute GI symptoms. These test often times show nothing detected. Yet the person still has all the symptoms. I usually recommend that they test again, using a specialty lab.
Jacob Teitelbaum, a world renown Internist and specialist in Chronic Fatigue Syndrome and Fibromyalgia, and Author of the book “From Fatigued to Fantastic – The complete guide to overcoming chronic exhaustion, achiness, brain fog, poor sleep, decreased sex drive and recurrent infections",[i] says in his book that “most lab technicians have less than one hour of training in looking for parasites …..(he goes on to say)…in fact a gastroenterologist friend once noted that during a bowel exam he noted a large number of parasites swimming in the patient’s bowel, yet when he sent a sample for confirmation and identification, it came back negative." I have also seen many of my clients who walk in with stool tests done by a regular lab showing no pathogens. When we retest using a specialty lab, the results oftentimes show bacterial imbalance, yeast, microbes and low levels of beneficial bacteria like acidophilus and bifidus. Doing the correct stool testing can take a lot of time and requires well trained lab staff and cutting edge techniques. It is usually pretty expensive, but it’s worth it if it means an answer to an unresolved, chronic GI problem that is greatly diminishing a person’s quality of life.
Dr. Teitlebaum says in his book, that he mails samples to Genova Diagnostic Labs and the Parasitology Center. I have used Genova Diagnostics Labs digestive stool tests for over 15 years in my practice and I have consistently received answers to my client’s health issues, along with a medical or nutritional solution for them. In doing research for this article, and in working with the Autistic and ADD/ADHD pediatric clients, as well as adults with chronic digestive issues, Chronic Fatigue and Fibromyalgia, I recently contacted Metametrix Labs to open an account. They have taken stool testing even further by using DNA methods to detect pathogens in the stool. They also do an organic acid profile which certain other labs also provide, that tests for the presence of chemical markers in the urine that would indicate certain pathogens in the digestive system. For example, yeast, parasites and bacteria each create different chemical byproducts in the urine. This lab looks promising from what I have read and seen from clients coming in to work on diet issues, with this test already done by their biomedical or DAN! (Defeat Autism Now!) Doctors. Working with a practitioner experienced in nutritional testing will help you to decide which lab and test to use.
What I see most often in test results from clients with chronic G.I. symptoms, is a clinical picture caused by past overuse of antibiotics along with a poor diet of refined foods, sugars and low nutrient levels, and antacid use, which can leave the digestive system lacking the beneficial bacteria it needs to protect itself. Overuse of antacids can cause the gut to be too alkaline which stops the pain from indigestion and reflux in the short run but causes more problems in the end. This perfect storm of actions allows unhealthy or possibly pathogenic (disease causing) bacteria to increase and take over. Once this happens the mucosal lining of the gut can become inflamed, damaged and even “leaky". Leaky Gut Syndrome or Intestinal Permeability means the gut lining has become so run down and ripped up by pathogenic yeast like Candida and bacteria or occasionally parasites that molecules of partially digested foods are able to pass into the blood stream and the immune system becomes active as it sees these food molecules as unwanted invaders. The immune system then begins to see the foods eaten regularly (usually favorite foods) as a threat to the body and builds up antibodies to the food molecules getting into the blood stream. This immune response can cause symptoms commonly seen with food sensitivitiesand most of the digestive issues mentioned above. Once in awhile we see a bad case of bacterial infection or parasites like Blastocystis Hominis, Cryptosporidium or a Proteus species, gram- negative bacteria, but most of the time it is this cycle of low healthy bacteria, overuse of antibiotics, antacids and an unhealthy gut mucosal lining that causes most of the chronic problems. Most people take these tests envisioning a giant worm from articles they read or stories they hear. This is usually not the case.
A good quality stool test will test for sensitivities (called MIC’s) to any pathogen it finds. A small amount of any pathogen found in the stool is tested against each of many prescription medications and natural agents like Oregano Oil, Caprylic Acid and Berberine to see which one is most effective in killing the pathogen.
It usually takes diet therapy and repair of the gut mucosal lining and bacterial balance in order to resolve most chronic gut imbalances. Many times medications like anti-fungal agents are used. This something your nutrition savvy Doctor can decide. Your gut is like a garden. It must be kept clean of pests, planted with healthy flora, given nutrients and kept in the proper PH. The first step toward healing is an accurate picture of what is going on.
After selection and completion of the right test, and identification of the digestive imbalances, a protocol is implemented to bring the system back into balance. Usually this involves the correct probiotics (healthy bacteria), digestive enzymes, prescription medicine or herbal anti-viral, anti-bacterial or anti-fungal and other vitamins, amino acids and nutrients to support the healthy balance of the digestive system.
Buyer Beware: Oftentimes people suffering from digestive issues, find an internet survey or answer a few questions, and buy a product for Candida, parasites, a huge worm, or the alleged 20 pounds of fecal material that is supposedly “trapped” in their intestines causing all of their digestive distress. Be wary of what you read on the internet, including this and most other articles. Look for citations and the background on the person writing it. Make sure they are not a supplement manufacturer or self- proclaimed expert with no education trying to sell you a product (like a colon cleanse). Chances are this will make you feel even worse. Not everyone has Candida or parasites and it is doubtful anyone with these chronic digestive issues has a giant worm or 20 pounds of fecal material in their colon curable with a week of fasting and a bottle of herbs. Also with many of these digestive symptoms, adding a bulky fiber and herbs with laxative properties will usually make you feel worse if your gut lining is already irritated. While the internet is an amazing source of information, remember to get more than one opinion. Look for well-balanced, credible websites and blogs and listen to experts and not salespeople. When in doubt, consult with an expert and do the testing you need.
Juli Keene, B.S.c, CN
www.JuliKeene.com (Official Website)
[i]J.E. Teitelbaum From Fatigued to Fantastic – The complete guide to overcoming chronic exhaustion, achiness, brain fog, poor sleep, decreased sex drive and recurrent infections (New York, NY: Penguin Group Publishing 2007 3rd revision.)