Unpacking your Irritable Bowel
IBS affects over 20% of Australians with a long list of all too familiar and awkward symptoms that include abdominal pain, cramping or discomfort, bloating, diarrhoea and/ or constipation, mucus, excess wind, and indigestion. Only recently have we begun to unpack the mysteries of IBS. Whilst we don't yet know exactly what causes it, a number of causal factors have been put forward, which range from genetics, the immune system, the microbiome and infections, to diet, stress and even mental health. Since many gut disorders have similar symptoms to IBS, ruling out a more serious underlying gut disease is an important first step in troubleshooting the irritable bowel.
What we test
Faecal Macroscopy
Faecal macroscopy examines the physical appearance of the stool, including colour, form, mucus content, and hidden (occult) blood. These visible features offer valuable insights into digestion, gut lining integrity, and the presence of irritation or inflammation. Changes in stool appearance can often be early signs of underlying digestive issues.
Stool colour can provide important clues about digestion, gut health, and how well the body is absorbing nutrients. Changes in colour may signal issues like bile flow problems, infections, or imbalances in the gut microbiome.
Stool form is an important indicator of digestive health and how efficiently the body is processing food and waste. Abnormal stool shapes can signal issues like dehydration, gut inflammation, slow or fast transit time, or imbalances in the microbiome.
The presence of mucus in stool can be a sign of irritation or inflammation in the gut lining. While small amounts can be normal, larger or frequent amounts may indicate conditions like infections, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD).
Occult blood refers to hidden blood in the stool that isn’t visible to the eye but can signal bleeding somewhere in the digestive tract. Its presence may indicate conditions like polyps, inflammatory bowel disease, ulcers, or early signs of colorectal cancer, making it an important marker for further investigation.
Gut Functional Markers
Gut functional markers assess how well the gut is performing its key roles in digestion, absorption, and immune defence. They measure important indicators such as enzyme activity, inflammation levels, gut barrier function, and detoxification capacity. Together, these markers provide a clearer picture of overall digestive system health.
Faecal calprotectin is a marker of gut inflammation, helping to differentiate between inflammatory conditions like Crohn’s disease and non-inflammatory issues like IBS. Elevated levels suggest active inflammation and may warrant further investigation.
Pancreatic elastase tells us how well your pancreas is producing digestive enzymes. Low levels mean you might not be digesting food properly, leading to gut symptoms and nutrient problems.
Faecal Secretory IgA measures how strong your gut’s immune defense is — acting like a “security system” for your digestive tract. Too low or too high can signal imbalance or stress in the gut.
Zonulin controls how tightly your gut cells are sealed. Elevated levels suggest your gut lining is "leaky," letting unwanted substances into the body, which can drive inflammation and immune problems.
β-Glucuronidase is a gut enzyme that can cause toxins and hormones to be recycled instead of eliminated. High levels suggest a need to support detoxification and balance gut bacteria.
Steatocrit measures how much fat is in your stool. High levels suggest your body isn't digesting or absorbing fats properly, which could affect energy levels, nutrient status, and gut health.
α-Transglutaminase IgA helps detect if your gut immune system is reacting to gluten. High levels suggest gluten sensitivity or possible coeliac-related gut damage, even if blood tests are normal.
Imbalances in gut pH influence short chain fatty acid production and their effect.
Short Chain Fatty Acids
Short chain fatty acids (SCFAs) are important compounds produced by gut bacteria when they ferment fibre, helping to nourish the gut lining, regulate inflammation, and support immune function. Healthy SCFA levels are linked to better digestion, stronger gut barrier integrity, and reduced risk of chronic diseases like diabetes, obesity, and colorectal cancer.
Short chain fatty acids (SCFAs) are produced by gut bacteria when they ferment fiber, helping to nourish the gut lining, control inflammation, and support immune health. Healthy SCFA levels are linked to better digestion, stronger gut barriers, and lower risk of chronic diseases.
Butyrate is a short-chain fatty acid produced by gut bacteria when they break down dietary fiber. It plays a crucial role in nourishing colon cells, reducing inflammation, strengthening the gut barrier, and supporting overall digestive and immune health.
Acetate is the most abundant short-chain fatty acid produced by gut bacteria during the fermentation of fiber. It supports gut health, helps regulate appetite and metabolism, and acts as a building block for other beneficial compounds in the body.
Propionate is a short-chain fatty acid produced by gut bacteria during the fermentation of dietary fiber. It helps regulate blood sugar levels, supports metabolism, and has anti-inflammatory effects that benefit both gut and overall health.
Valerate is a lesser-known short-chain fatty acid produced in small amounts by gut bacteria during the fermentation of fiber and protein. It plays a minor role in supporting gut health and may help maintain a balanced microbial environment.
Microbial Diversity
Microbial diversity reflects the variety and richness of different bacterial species living in the gut. A diverse microbiome is associated with stronger immunity, better digestion, reduced inflammation, and improved resilience against disease. Supporting a wide range of beneficial microbes is key to long-term gut health.
The Firmicutes:Bacteroidetes ratio is a key indicator of how well your gut is supporting digestion, metabolism, and overall health. A balanced ratio helps maintain a healthy weight, strong immunity, and a resilient gut environment.
Bacteroidetes are a major group of gut bacteria that help break down complex carbohydrates and support digestion. A healthy level of Bacteroidetes is linked to better gut health and metabolism.
Firmicutes are a major group of gut bacteria involved in breaking down dietary fats and supporting energy absorption. Their balance with other bacteria, like Bacteroidetes, plays an important role in digestion, metabolism, and overall gut health.
Actinobacteria are a group of beneficial gut bacteria that help break down complex plant fibers and support gut and immune health. They include important species like Bifidobacteria, which play a key role in maintaining a balanced microbiome.
Proteobacteria are a group of gut bacteria that include both normal residents and potential pathogens. Elevated levels are often linked to gut imbalance, inflammation, and digestive issues.
Verrucomicrobia are a smaller group of gut bacteria, best known for including Akkermansia muciniphila, a species linked to gut lining health and reduced inflammation. Healthy levels of Verrucomicrobia are associated with better metabolism, immune balance, and gut barrier function.
Euryarchaeota are a group of microorganisms called archaea, naturally found in the human gut, that help break down food and produce gases like methane. While some are normal, an overgrowth can contribute to symptoms like bloating, constipation, or SIBO.
Parasites
Some gut problems can be a consequence of an undetected gut infection. A significant number of IBS (irritable bowel syndrome) cases could actually be due to undiagnosed gut parasites such as Blastocystis hominis and Dientamoeba fragilis.
Cryptosporidium is a microscopic parasite that causes the diarrhoeal disease cryptosporidiosis. Both the parasite and the disease are commonly known as "Crypto."
Amoebiasis is a parasitic disease (also known as amoebic dysentery) caused by infection with Entamoeba histolytica or another amoeba (for example, E. dispar). The disease may not cause symptoms in most individuals.
Symptoms of Giardia infection can occur with 3 to 25 days and may include diarrhoea, nausea, vomiting, pale greasy foul-smelling stools, stomach cramps, passing excess gas, bloating, weight loss and fatigue.
Some research suggests that people with IBS may be more likely to have Blastocystis hominis organisms in their stool.
The bacteria can be present in the gut for months or year and misdiagnosed as IBS. Infection can cause diarrhoea, abdominal pain and cramping, anal itching, nausea, loss of appetite, headache, dizziness, depression, weight loss and fatigue.
Endolimax nana transmission occurs by ingesting contaminated food or water. Infections may be no symptoms or present with diarrhoea.
Worms
PCR-based stool worm tests are particularly useful when other diagnostic methods, such as microscopic examination of stool samples, do not yield definitive results. They can provide a more precise identification of the specific worm species present, aiding in targeted treatment and management of the infection.
Opportunistic Bacteria
Opportunistic bacteria are strains that are normally harmless in small amounts but can cause problems if they overgrow. Elevated levels may contribute to digestive symptoms, inflammation, or disruptions in the gut microbiome balance. Monitoring these bacteria helps protect gut health and prevent chronic issues.
B. licheniformis and B. subtilis are associated with food-borne diarrhoeal illness and meat dishes are a common source of infection.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
M. morganii originates from the gill and skin of fish. It is possible that it may cross-contaminate during handling of fish in processing plants and restaurants. Diarrhoea has been associated with infection of this organism
Pseudomonas is found in water and soil as well as fruits and vegetables, and is considered an opportunistic pathogen.
Pseudomonas is found in water and soil as well as fruits and vegetables, and is considered an opportunistic pathogen.
Food poisoning is often attributed to staphylococcus. Symptoms of staphylococcal food poisoning usually appear within 1 to 6 hours after ingestion but depends upon the amount of contaminated food eaten. Nausea, vomiting, abdominal cramping, and diarrhoea are the most common symptoms. Recovery generally takes two day, but can sometimes take longer.
Food poisoning is often attributed to staphylococcus. Symptoms of staphylococcal food poisoning usually appear within 1 to 6 hours after ingestion but depends upon the amount of contaminated food eaten. Nausea, vomiting, abdominal cramping, and diarrhoea are the most common symptoms. Recovery generally takes two day, but can sometimes take longer.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Methanobacteriaceae are microbes that produce methane. Facilitates carbohydrate fermentation and short-chain fatty acid production by beneficial bacteria.
Desulfovibrio piger is a sulfate-reducing bacterium found in the gut microbiome. While it is a normal part of the gut ecosystem, excessive levels have been linked to increased hydrogen sulfide production, which may contribute to gut inflammation and conditions such as IBS, IBD, and SIBO.
Enterobacter cloacae complex is a group of opportunistic bacteria found in the gut microbiome, typically present in low levels as part of the normal flora. However, an overgrowth may indicate dysbiosis and has been associated with inflammation, gastrointestinal discomfort, and increased risk of infection, particularly in immunocompromised individuals.
Potential Autoimmune Triggers
An imbalance in the gut microbiome (called ‘dysbiosis’) has been associated with autoimmune diseases, particularly, rheumatoid arthritis, type 1 diabetes, multiple sclerosis and autoimmune liver disease.
Citrobacter is considered an opportunistic pathogen and therefore can be found in the gut as normal flora. It is occasionally implicated in diarrhoeal disease, particularly C. freundii, C. diversus and C. koseri.
Citrobacter is considered an opportunistic pathogen and therefore can be found in the gut as normal flora. It is occasionally implicated in diarrhoeal disease, particularly C. freundii, C. diversus and C. koseri.
Klebsiella forms part of the normal gut flora in small numbers, but can be an opportunistic pathogen
Klebsiella forms part of the normal gut flora in small numbers, but can be an opportunistic pathogen
Part of the normal flora of the gastrointestinal tract, though has been shown to be an independent causative agent of intestinal disorders. May also play a role as an opportunistic organism in enteric infection due to other pathogens. Food has been implicated as a vehicle of infection.
Part of the normal flora of the gastrointestinal tract, though has been shown to be an independent causative agent of intestinal disorders. May also play a role as an opportunistic organism in enteric infection due to other pathogens. Food has been implicated as a vehicle of infection.
Fusobacterium bacteria is commonly found in the mouth and the gut. In the mouth, high levels are strongly linked to oral hygiene. In the gut, high levels have been observed in individuals with colon cancer and appendicitis.
Fungi & Yeast
This test looks for evidence of candida or other yeast overgrowth. Whilst yeasts are a normal inhabitant of the gastrointestinal tract, they may become an opportunistic pathogen after disruption of the mucosal barrier, imbalance of the normal intestinal flora or impaired immunity. This can be caused by things like antibiotics, antacids and stress.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida albicans is the main type of yeast which colonises the human body. It normally lives in the gastrointestinal tract and other areas of the body without causing problems, but imbalance in the microbiome can lead to overgrowth.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Candida is a type of yeast that grows in the body in areas such as the mouth, gut, and vagina. At normal levels, it does not cause any problems, but when a person has an overgrowth of Candida in the gut, it can appear in stools.
Geotrichum yeasts can be found in soil, dairy products and in human skin and mucosae, and are usually only considered an opportunistic pathogen in immune-compromised hosts. Geotrichum may play a role in IBS.
S. cerevisiae is commonly known as Bakers or Brewers yeast. It commonly colonises mucosal surfaces but isn't considered an opportunistic pathogen. Overgrowth may be associated with dietary ingestion of as part of a "health food" regimen.
A common environmental yeast which is not considered pathogenic in nature. These yeasts are ubiquitous in the environment and can be found on fruits, vegetables and other plant materials.
Bacterial Pathogens
This panel also looks for evidence of other bacteria which may be pathogenic in nature, such as C.Diff, Citrobacter and Klebsiella.
Aeromonas are bacteria that can cause an acute diarrhoeal illness that normally clears without treatment. It is a fairly common cause of gastroenteritis, which occurs most often throughout the warm summer months in most countries.
Campylobacter infection (campylobacteriosis) is a bacterial infection which most commonly causes gastroenteritis (also known as 'gastro') but may also cause illness affecting the entire body.
Clostridium difficile, also known as C. difficile or C. diff, is bacteria that can infect the bowel and cause diarrhoea. The infection most commonly affects people who have recently been treated with antibiotics. It can spread easily to others.
Clostridium difficile, also known as C. difficile or C. diff, is bacteria that can infect the bowel and cause diarrhoea. The infection most commonly affects people who have recently been treated with antibiotics. It can spread easily to others.
Enteroaggregative E. coli is a pathogenic strain of Escherichia coli associated with persistent diarrhoea and gut inflammation, characterised by its ability to form biofilms and produce toxins that disrupt intestinal function.
Enteropathogenic E. coli is a diarrheagenic strain of Escherichia coli that disrupts the intestinal lining, leading to persistent diarrhoea, gut inflammation, and nutrient malabsorption, particularly in young children.
E. coli O157 is a highly virulent strain of Escherichia coli that produces Shiga toxin, causing severe foodborne illness with symptoms like bloody diarrhoea and abdominal cramps.
Hypervirulent Clostridium difficile is a highly aggressive strain of C. difficile that produces excessive toxins, leading to severe diarrhoea, colitis, and an increased risk of complications such as toxic megacolon and recurrent infections.
Shigella infection (shigellosis) is a type of gastroenteritis caused by Shigella bacteria. The symptoms of Shigella infection include fever, diarrhoea, (sometimes with blood and mucous), vomiting and stomach cramps.
Enterotoxigenic Escherichia coli (ETEC) is a type of Escherichia coli and one of the leading bacterial causes of diarrhoea in the developing world.
Shiga toxin-producing Escherichia coli (STEC) strains are human pathogens linked to haemorrhagic colitis and haemolytic uremic syndrome.
Shiga toxin-producing Escherichia coli (STEC) strains are human pathogens linked to haemorrhagic colitis and haemolytic uremic syndrome.
Salmonella infection usually results from ingestion of the bacteria from contaminated food, water or hands. Eggs, milk, meat or poultry are particularly high risk foods.
Shiga toxigenic Escherichia coli (STEC) is a pathogenic strain of E. coli that produces Shiga toxin, which can cause severe gastrointestinal illness, including bloody diarrhea and abdominal pain.
Cholera is a well-known disease caused by intestinal infection with the toxin-producing bacteria. This potentially fatal diarrhoeal disease results in large volumes of watery stool, causing rapid dehydration.
Yersinia infection (yersiniosis) is a bacterial infection of the bowel (intestine). It occurs worldwide, but is fairly uncommon. Many domesticated and wild animals carry Yersinia in their intestines, and spread to people occurs by eating food or water contaminated by infected faeces.
Helicobacter pylori (H. pylori) is a bacteria that infects the stomach lining, often causing inflammation (gastritis) and peptic ulcers. It can lead to symptoms like stomach pain, bloating, and nausea, and may increase the risk of stomach cancer. The bacteria spread through contaminated food, water, or close contact with an infected person.
Helicobacter Pylori
Helicobacter pylori A2142C is a genetic variant of H. pylori associated with increased resistance to clarithromycin, which can reduce treatment effectiveness and contribute to persistent infections linked to gastritis, ulcers, and an increased risk of gastric cancer.
Helicobacter pylori A2142G is a genetic variant of H. pylori associated with increased resistance to clarithromycin, which can reduce treatment effectiveness and contribute to persistent infections linked to gastritis, ulcers, and an increased risk of gastric cancer.
Helicobacter pylori A2143G is a genetic variant of H. pylori associated with increased resistance to clarithromycin, which can reduce treatment effectiveness and contribute to persistent infections linked to gastritis, ulcers, and an increased risk of gastric cancer.
Viral Pathogens
Adenovirus serotypes 40 and 41 cause acute gastroenteritis primarily in children. Symptoms may include fever, diarrhoea, vomiting, and abdominal pain, and last for approximately 10 days.
Norovirus infection can cause the sudden onset of severe vomiting and diarrhoea. The virus is highly contagious and commonly spread through food or water that is contaminated during preparation or through contaminated surfaces.
Norovirus infection can cause the sudden onset of severe vomiting and diarrhoea. The virus is highly contagious and commonly spread through food or water that is contaminated during preparation or through contaminated surfaces.
Norovirus infection can cause the sudden onset of severe vomiting and diarrhoea. The virus is highly contagious and commonly spread through food or water that is contaminated during preparation or through contaminated surfaces.
Norovirus infection can cause the sudden onset of severe vomiting and diarrhoea. The virus is highly contagious and commonly spread through food or water that is contaminated during preparation or through contaminated surfaces.
Normal Bacterial Gut Flora
A healthy gut microbiome is rich in beneficial bacteria that aid digestion, produce important nutrients, and support immune function. Measuring the levels and balance of these bacteria helps assess the resilience and health of the gut ecosystem. Strong levels of beneficial flora are linked to better digestion, mood balance, and disease prevention.
Bacteroides fragilis is a common gut bacterium that plays an important role in breaking down complex molecules and supporting immune system development. In healthy amounts, it helps maintain gut balance, but overgrowth can sometimes contribute to inflammation or infection.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Bifidobacterium adolescentis is a beneficial gut bacterium that helps break down complex carbohydrates and produce important short-chain fatty acids. It supports digestive health, immune balance, and may help reduce inflammation in the gut.
Bifidobacterium bifidum is a beneficial gut bacterium that supports digestion, strengthens the gut barrier, and helps regulate the immune system. It is one of the first bacteria to colonise the gut after birth and plays a key role in maintaining overall gut and immune health throughout life.
Bifidobacterium breve is a beneficial gut bacterium known for helping digest complex carbohydrates and producing nutrients like short-chain fatty acids. It supports a healthy gut environment, boosts immune function, and may help protect against harmful bacteria and inflammation.
Bifidobacterium longum is a beneficial gut bacterium that helps break down dietary fiber, produce important nutrients, and support immune health. It also plays a role in reducing inflammation and protecting the gut lining, contributing to overall digestive wellbeing.
Enterococcus species are a group of bacteria that naturally live in the gut and help with digestion and maintaining a balanced microbiome. However, if they overgrow or move outside the gut, they can sometimes cause infections or contribute to gut imbalance.
Escherichia species, including Escherichia coli, are common gut bacteria that play a role in nutrient absorption and maintaining a healthy gut environment. While most strains are harmless and even beneficial, some can cause infections or digestive symptoms if they become imbalanced.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Lactobacillus acidophilus is a beneficial probiotic bacterium that helps maintain a healthy balance of gut bacteria, supports digestion, and boosts immune function. It also produces lactic acid, which helps protect the gut from harmful microbes and promotes overall digestive health.
Lactobacillus casei is a beneficial probiotic bacterium that supports healthy digestion, helps break down lactose, and strengthens the gut's natural defenses. It also contributes to maintaining a balanced gut environment and promoting immune health.
Lactobacillus delbrueckii is a beneficial bacterium commonly found in fermented foods and the gut, where it helps support digestion and maintain a healthy balance of gut bacteria. It produces lactic acid, which protects the gut environment and promotes overall digestive health.
Lactobacillus plantarum is a beneficial probiotic bacterium that supports digestion, strengthens the gut barrier, and helps reduce inflammation. It also plays a role in protecting the gut against harmful microbes and promoting overall gut and immune health.
Lactobacillus rhamnosus is a well-studied probiotic bacterium known for supporting digestive health, boosting immune function, and helping protect against harmful bacteria. It is also commonly used to help manage symptoms like diarrhea, gut inflammation, and food sensitivities.
Lactobacillus salivarius is a beneficial probiotic bacterium that helps maintain a healthy balance of gut and oral microbiota. It supports digestion, strengthens the immune system, and produces compounds that help protect against harmful bacteria.
Clostridium species are a diverse group of bacteria naturally found in the gut, with some strains playing important roles in fiber breakdown and short-chain fatty acid production. However, certain Clostridium strains can become harmful if they overgrow, potentially leading to inflammation or digestive disturbances.
Oxalobacter formigenes is a beneficial gut bacterium that helps break down oxalates, compounds found in many plant foods. By reducing oxalate levels, it may help lower the risk of kidney stone formation and support overall urinary and gut health.
Akkermansia muciniphila is a beneficial gut bacterium that plays a key role in maintaining the gut lining and supporting a healthy immune response. Higher levels of Akkermansia are associated with better metabolism, reduced inflammation, and improved gut barrier function.
Faecalibacterium prausnitzii is one of the most important beneficial bacteria in the gut, known for producing butyrate, a short-chain fatty acid that nourishes the gut lining and reduces inflammation. High levels of this bacterium are associated with better gut health, stronger immunity, and protection against chronic diseases.
Test instructions
Your test kit and all instructions are posted directly to you, and there is no need to visit a collection centre.
Mail your sample back to the lab according to the instructions provided with your kit
Results for this test available in 2-4 weeks depending on region and will be published in your online dashboard.
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