By Diana Arundell – University Qualified Naturopath
We don’t know what we don’t know about the human body however as time progresses, modern science leads to discoveries and tools which provide valuable confirmation when diagnosing health conditions.
Orthodox medicine is brilliant at identifying and treating acute illness and naturopathic medicine is of particular benefit in the treatment of chronic health issues. Naturopaths have been banging on about the importance of the gut and digestive health for many decades and if tv commercials are anything to go by, it appears now everyone is more interested in gut health.
Digestive disturbance can present in many ways: excessive burping/flatulence, too loose/hard stools, bloating, pain/cramping, blood/mucous present in stools, urgency, frequency or lack of regular bowel motions, reflux/heartburn, nutrient deficiencies etc and it’s not always easy to identify specific causes. Excellent case history taking, examination and pathology testing are essential and used to be all that could be relied upon for accurate diagnosis and treatment of gastrointestinal issues. More recently, other functional investigations such as digestive stool analysis has become available and can provide very specific information about what is going on inside the digestive tract and may lead to otherwise difficult to determine causes of some of the above presentations.
Comprehensive digestive stool analysis also known as gastrointestinal (GI) mapping uses a stool sample to measure the health of the gut microbiome and other indicators of digestion, absorption, infection and inflammation. Specific treatment plans may be more confidently prescribed based on actual results of what is going on for that individual. More modern stool analysis uses technology that gives quantifiable amounts of bacteria, viruses, fungal or parasitic load which is also important as this can indicate directly what may be contributing to otherwise difficult to determine causes of digestive upset. It’s especially useful as many bacteria are beneficial and essential to good gut health in certain numbers, however can be problematic if out of balance so a simple positive or negative test may not be overly useful.
In the past, a basic stool sample was used to establish the presence of pathogenic microbes but functional stool analysis not only detects the presence of unfavourable pathogenic organisms, it also can measure the presence of the desirable commensal bacteria in the gut. These beneficial bacteria are part of a complex ecosystem inside our gastrointestinal tract which helps produce vitamins from our ingested nutrients, protect our gut wall barrier, contribute to our immune function and protect against over colonisation from the pathogenic strains.
Testing for quantity presence of normal commensal bacteria in the gut can help identify which strains of probiotics (if any) are going to have the best impact on optimising digestive function. For example the firmicutes and bacteroidetes phyla are the most dominant phyla in the human digestive tract running from the nose/mouth through to the intestines. If these come back out of range, it’s indicative of an imbalance in favourable bacteria in the digestive tract. Further more specific imbalances of normal commensal bacteria as well as pathogenic bacteria may help identify the presence of other underlying diseases or an associated increased risk of developing certain diseases. For example certain bacteria in the gut are associated with an increased risk of developing auto immune related illnesses.
Opportunistic bacteria are referred to as such because when they are out of balance, they only cause symptoms in some, not all individuals. Overgrowth by opportunistic bacteria is more likely in individuals with history of antibiotic use, a weakened immune system, unhealthy dietary/lifestyle choices or may result from other intestinal infection. Similarly fungal organisms may be happily existing in the gastrointestinal tract not causing any issues until overgrowth occurs and treatment is required.
Other than isolating amounts of favourable and unfavourable microbes in the gut, functional stool analysis can provide specific information about digestion function. Intestinal markers such as pancreatic elastase, beta–glucuronidase, secretory IgA and zonulin amongst others can add valuable information to a digestive health picture. Pancreatic enzymes are crucial for upper digestive processes, elevated beta–glucuronidase may be associate with unfavourable balance of bacteria in the gut and issues with optimal liver detoxification. Secretory IgA is one of the most important players in our gut and is vital for good immune function and protecting the gut against pathogens. High levels of zonulin is considered a sign that intestinal permeability may be an issue as it’s a protein that can open up the important tight junctions in the gut wall. A strong, healthy gut lining barrier is essential to reduce contaminants including larger food particles and microbes entering into the blood.
Comprehensive digestive stool analysis will also analyse the amount of undigested food particles in the stool to help create a comprehensive upper digestive picture by way of digestive enzyme and hydrochloric acid function. Stool samples can also be tested for antibiotic resistant genes which is useful in establishing the best treatment protocol.
Functional digestive stool analysis is non invasive so a relatively easy test to do for both adults and children who have unexplained digestive disturbance. The test itself is not cheap and will usually cost around $300–$500 depending on how many markers are tested so it’s best kept for those tricky digestive issues that have escaped an easy diagnosis.
For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.
Diana Arundell is a university–qualified naturopath and consults from her Avoca Naturopath clinic. She has a special interest in fertility and pregnancy health, digestive health, immune function and family wellness programs. She was a nutrition lecturer at Macquarie University for 10 years, and is an accredited Journey Practitioner. For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.