This month I thought I’d talk to you about one of the types of functional medicine testing that I do – GI map. This is also referred to as a Comprehensive Digestive Stool Analysis (CDSA). This is a test that quantifies bacteria, fungi, viruses, and parasites using qPCR. It also gives information about:
- Specific digestive markers – pancreatic elastase, steatocrit, anti gliadin IgA (gluten sensitivity marker), Beta glucuronidase (high levels may indicate unfavourable changes metabolic changes in the colon), occult blood, SIgA (immune response), calprotectin (inflammation), Zonulin (leaky gut marker).
- Opportunistic bacteria overgrowth (bacteria that can be problematic if overgrown).
- Normal commensal bacteria (what good bacteria you have or is missing).
- Pathogens – bacterial, parasitic, viral, worms.
The reason that you might want to have this test done, is when you are presenting with digestive issues that do not respond to ‘normal’ treatment. Or, when looking at your history during a consultation, there does not seem to be any specific underlying cause; especially if you have already been to see your local GP or gastroenterologist, and they haven’t found anything wrong or you’ve been diagnosed with IBS. A diagnosis of IBS doesn’t tell you what is making your bowel irritable so you may wish to go this next step.
GI-Map – Functional Testing
The GI-Map test provides you with a more detailed profile of what is happening within your digestive system such as:
- Microbiome imbalance
- Possible inflammatory bowel disease
- Parasites or infections
- Leaky gut
It requires you to provide a stool sample, while you have maintained your usual diet. Your test will take about 2 weeks for analysis, and once done a full report will come through.
Any imbalances in your digestive system can contribute to issues such as:
- Food intolerances
- Leaky gut
- Poor nutrient absorption
- Other health issues – eczema, psoriasis, mood issues
Important digestive markers
There are several important markers that I look for when you have done a CDSA –
Calprotectin – You produce this marker when there is inflammation. This can be due to food allergies/intolerances, inflammatory bowel disease, bacterial infection or even certain medications.
Secretory IgA – This is the primary immunoglobulin in the intestinal mucosa. It represents a “first line of defense” in response to antigens and pathogens in the GI and respiratory tracts. In addition to protecting against pathogens, SIgA plays a major role in helping to maintain balance in the microbiome and protecting against exposure to food-derived antigens.
Zonulin – This is a protein that opens intercellular tight junctions in the gut lining (the connections between epithelial cells that make up the gastrointestinal lining). Zonulin increases intestinal permeability in the jejunum and ileum and is considered a biomarker for barrier permeability.
Beta glucuronidase – High levels of faecal beta-glucuronidase can indicate unfavourable metabolic changes in the colon. Beta-glucuronidase may indicate dysbiosis and interference with Phase II detoxification involving glucuronidation.
Pancreatic elastase 1– Elastase 1 is a digestive enzyme secreted exclusively by the pancreas, giving a direct indication of pancreatic function.
Steatocrit – Faecal fats are normally emulsified by bile salts and absorbed in the small intestines. High levels of fat in the stool may be an indication of maldigestion, malabsorption, or steatorrhea.
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 fecal anti- gliadin antibodies can indicate an immune response (in the gut) to gluten in the diet.
Bacteria – you have a naturally occurring ecosystem of bacteria, that when kept in balance, works well. You absorb the nutrients that you need and eliminate that which you do not need. This balance can easily be upset, when your diet is inadequate, have been exposed to chemicals, eaten bad food (not cooked or washed properly or, been overseas. This imbalance disturbs the ‘status quo’, disrupting your normal intestinal function.
Worms – you can get worms from eating raw meat or, meat that has not been cooked properly, drinking contaminated water, walking barefoot on contaminated soil, poor hygiene, etc. You may have symptoms such as loss of appetite, bloating, nausea, abdominal pain.
Yeast – if you have a yeast imbalance within your digestive system, this can cause all sorts of issues such as poor nutrient absorption.
Parasites – you may have acquired these by drinking contaminated water, food grown in contaminated soil, poor hygiene. Blastocystis, dientamoeba and giardia are the most prevalent parasites I see come up. Symptoms experienced can be diarrhoea, constipation, hives, itching, fatigue, etc.
Normal gut bacteria – lactobacillus spp., bifidobacterium spp, clostridium spp, esherichia spp., Bacteroides fragilis, Enterococcus spp. These are the bacteria normally found in your intestines, all living in perfect harmony. It is when this balance is disrupted, that you begin to experience issues with your digestion and general health.
If you’ve been suffering digestive symptoms and haven’t got to the bottom of why then this test will likely give you some answers. We can then come up with a plan to rebalance your microbiome and get on top of your symptoms.