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
Macroscopy looks at stool colour and formation, as well as for evidence of mucous or blood which may require further investigation.
Brown is the colour of normal stool. Other colours may indicate abnormal gastrointestinal conditions.
A formed stool is considered normal. Variations to this may indicate abnormal gastrointestinal conditions.
Mucous production may indicate the presence of an infection, inflammation or malignancy.
This test is used to detect bleeding in the digestive tract. This test can detect tiny traces of blood in the stool, and can indicate the presence of disease at a relatively early stage when stools may appear normal.
Gastrointestinal Functional Markers
This protein is released into the stool when the intestinal lining is damaged. It's usually very high in cases of Inflammatory Bowel Disease (such as Crohn's or ulcerative colitis), and low in IBS. Calprotectin is also elevated with gut infections and colon cancers.
Pancreatic Elastase is used to assess pancreatic exocrine function and levels reflect the activity of the pancreatic enzymes trypsin, chymotrypsin, amylase and lipase.
Faecal secretory IgA (sIgA) is secreted by mucosal tissue and represents the first line of defence of the GI mucosa and is central to the normal function of the GI tract as an immune barrier.
Zonulin is a protein that facilitates the opening of tight junctions between cells of the wall of the intestinal lining to allow for passage of nutrients and fluids into the body.
Increased levels of b-Glucuronidase may reverse the effects of Phase II detoxification processes.
The steatocrit is a measure of faecal fat excretion and is associated with pancreatic insufficiency.
The tTg antibodies test is the most sensitive and specific gluten intolerance test for coeliac disease. This tTG test can also be used to help evaluate the effectiveness of treatment as antibody levels should fall when gluten is removed from the diet.
Key Microbiota
The two largest phyla making up the gut microbiome in humans are Firmicutes and Bacteroidetes. The relationship of these two large groups, expressed as the Firmicutes/Bacteroidetes ratio, has been associated with a number of pathological conditions.
Studies have shown that when there is a higher ratio of Firmicutes within the gastrointestinal tract, that there is a link to obesity.
Bacteroidetes are bacteria that ferment polysaccharides and otherwise indigestible carbohydrates and produce short-chain fatty acids (SCFAs) that have many beneficial effects in the gut.
Firmicutes bacteria make up the largest part of the gut microbiome. Due to their negative influence on glucose and fat metabolism, they are commonly referred to as bad gut microbes.
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
In a healthy individual with a balanced gut microbiome, opportunistic bacteria are usually kept in check by the beneficial bacteria that dominate the gut ecosystem. However, when the microbial balance is disrupted or the immune system is weakened, these opportunistic bacteria can multiply and potentially lead to infection or other health 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. a
Methanobacteriaceae are microbes that produce methane. Facilitates carbohydrate fermentation and short-chain fatty acid production by beneficial bacteria.
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 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.
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.
Enterohemorrhagic Escherichia coli is a type of pathogenic E. coli that can cause diarrhea or haemorrhagic colitis.
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.
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
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
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.
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.
Most Escherichia strains are harmless and play an essential role in keeping the digestive system healthy, helping to digest food and producing Vitamin K. However, some E. coli bacteria are pathogenic and can cause disease.
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.
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.
There is some evidence to suggest that this bacterium lowers the risk of developing kidney stones by breaking down oxalate in the gut.
Akkermansia lives in the mucus lining of your gut and uses mucous as its primary energy source. It regulates mucous turnover and promotes healthy intestinal barrier and modulates immune responses.
Short Chain Fatty Acids
SCFAs are molecules produced by bacteria when they ferment dietary components (primarily fibre: non-digestible carbohydrates) inside the colon.
Decreased Butyrate levels may indicate inadequate colonic function.
Decreased Acetate levels may indicate inadequate colonic function.
Decreased Propionate levels may indicate inadequate colonic function.
Valerate is a type of short-chain fatty acid produced by certain gut bacteria through the fermentation of dietary fibres. Valerate plays and important roles in maintaining gut health and overall well-being.
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.
You may also be interested in
SIBO Check
Helicobacter Pylori Check
Microbiome Check
Looking for something specific?
Contact us