2200 GI Effects Comprehensive Profile - Stool

Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces.

may represent 3–5% of the microbial composition in the healthy human intestinal tract

A group within the Streptococcus genus

Anaerotruncus colihomonis is a newly described bacterial genus and species isolated from the stool specimens of children. Its clinical significance, however, is unknown.

both ferment amino acids and carbohydrates and are mucin degraders

a fiber-degrading bacteria

Bacteroides vulgatus is among the most commonly isolated microbes

The predominant genera in the human colonic microbiota are Bacteroides and Prevotella, which belong to the major phyla Bacteroidetes.

Barnesiella ssp. is a small group of two species of bacteria that are usually only found at reasonably low levels in the gut.

Beta-glucuronidase is an enzyme produced by certain unfriendly gut bacteria.

Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals. It is added to a variety of foods or dietary supplements as a probiotic due to its many health benefits. It is a gram-positive, branched rod-shaped bacterium that produces lactic acid from the fermentation of sugar in the gastrointestinal tract.

Utilizes diet-derived carbohydrates

Amongst the first bacterial colonizers of the intestine.

a common microscopic organism that inhabits the intestine

Blastocystis spp. (Protozoa) Biomarker in GI Effects Panel: Microscopic O&P vs. PCR Parasitology Microscopic O&P (Ova & Parasites) The GI Effects panel employs microscopic fecal specimen examination for ova and parasites (O&P), considered the gold standard for diagnosing many parasitic infections. In this methodology, Blastocystis spp. is identified based on its physical presence in the stool sample, often indicating an active or substantial colonization. Blastocystis resides primarily in the ileum and cecum, where it adheres to the outer mucus layer and thrives in an anaerobic environment, feeding on bacteria. Its presence has been linked to: - Increased microbial diversity and richness, potentially functioning as a commensal organism. - Indicators of dysbiosis in certain cases, where it may signify gut imbalance. PCR Parasitology - Protozoa The PCR methodology detects Blastocystis spp. through its genetic material, offering high sensitivity even at low levels of colonization. Unlike microscopic examination, PCR may identify subclinical or non-pathogenic strains, which might not correlate with significant microbial imbalance or symptoms. When only one method (PCR or O&P) detects Blastocystis, the clinical relevance is often weaker, as the level of colonization appears to influence its associations with symptoms or microbiota. Unique Insights from O&P vs. PCR The microscopic O&P method reflects direct observation, indicating higher colonization or active parasitism, whereas PCR may detect Blastocystis at subclinical levels. These differences highlight the importance of integrating both results for comprehensive interpretation. Blastocystis spp. Clinical Implications Associated Symptoms and Conditions: - Gastrointestinal: Nausea, loss of appetite, abdominal pain, diarrhea (acute/chronic), constipation, flatulence, anal itching. - Systemic: Fatigue, joint pain, urticaria (hives), and potential links to Irritable Bowel Syndrome (IBS). - Asymptomatic in many cases. Importance of Subtyping Blastocystis spp.: Subtypes are thought to influence symptoms and treatment response, though more research is needed to confirm their clinical significance. Understanding subtype variability may enhance personalized treatment strategies. Treatment Options Conventional Treatments: - Asymptomatic cases: No treatment is typically recommended. - Symptomatic cases: Options include metronidazole, TMP/SMX, iodoquinol, nitazoxanide, or emerging triple-antibiotic therapies. Natural Approaches: - Probiotics: Saccharomyces boulardii has shown favorable outcomes, especially in children. - Dietary Modifications: High-fiber, lactose-free diets may reduce symptoms. - Botanicals: Brucea javanica, Coptis chinensis, garlic (especially for subtype 1), and oregano oil demonstrate some efficacy in research studies. Challenges in Eradication: Blastocystis spp. can be difficult to eliminate entirely, particularly due to resistance in certain subtypes. Combining treatments and addressing gut health holistically may improve outcomes. Key Considerations - Epidemiology: Blastocystis is globally prevalent, often associated with fecal contamination of food or water. - Clinical Significance: Not all cases of Blastocystis colonization lead to symptoms, necessitating careful interpretation of test results in the clinical context. - Therapeutic Options: Integration of conventional and natural approaches, including antiparasitic therapies and probiotics, can be effective. Understanding the context in which Blastocystis is identified—whether through microscopic O&P or PCR—provides deeper insights into its role in gut health and potential symptoms.

Related to obesity

Calprotectin is a protein that binds to both calcium and zinc.

a foodborne pathoge

commonly been identified as part of the healthy human mycobiome

Elevated levels of Cholesterol in the stool may indicate inadequate absorption.

Gram-negative, nonspore-forming, facultatively anerobic bacilli.

Clostridium difficile is an anaerobic, spore-forming gram-positive bacterium that can normally reside in the intestinal flora. However, following a disturbance of the gut flora, often due to antibiotic use, colonization with toxin-producing Clostridium difficile can occur. While not all colonized individuals develop symptoms, those who do may experience a range of symptoms including bloody and non-bloody diarrhea, fever, abdominal pain, and vomiting. Treatment options for Clostridium difficile infection (CDI) typically start with discontinuing the antibiotic that caused the disruption of the gut flora. First-line treatments include specific antibiotics such as vancomycin or fidaxomicin, which target C. difficile. In severe cases, hospitalization may be required to manage dehydration and provide supportive care. For recurrent infections, fecal microbiota transplantation (FMT) has shown promise in restoring healthy gut flora. Additionally, maintaining good hand hygiene and infection control practices are crucial to preventing the spread of C. difficile.

Can produce several endogenous infections.

Collinsella aerofaciens is a group of bacteria found in the gut and also on the surface of the tongue.

Associated with greater bacterial gene richness in the gut

Cryptosporidium parvum/hominis is a group of protozoan parasites belonging to the genus Cryptosporidium, which can cause gastrointestinal disease in humans and a wide range of animals. There are multiple species of Cryptosporidium that can infect humans, but the most prevalent ones associated with human disease are Cryptosporidium parvum and Cryptosporidium hominis (formerly known as C. parvum anthroponotic genotype or genotype 1) [1]. Other zoonotic species that can also infect humans include Cryptosporidium meleagridis, Cryptosporidium cuniculus, Cryptosporidium ubiquitum, Cryptosporidium canis, Cryptosporidium felis, Cryptosporidium viatorum, and Cryptosporidium sp. chipmunk genotype I [2]. In healthy individuals, infection may be asymptomatic or cause mild self-limiting diarrhea that resolves over a few weeks. However, immunocompromised individuals, such as those with impaired immune systems, may develop severe and life-threatening watery diarrhea that is difficult to treat with currently available drugs [2]. Cryptosporidiosis outbreaks have been reported in various settings, including waterparks, community swimming pools, day care centers, hospitals, households, and municipalities with contaminated public water supplies [1][2]. The parasite's ability to survive disinfection procedures, such as chlorination, makes water distribution systems particularly vulnerable to contamination with Cryptosporidium [2]. It is essential to ensure proper water and food safety measures to prevent the transmission of Cryptosporidium and reduce the risk of outbreaks. For patients with compromised immune systems or severe symptoms, medical attention and appropriate treatment are necessary to manage the infection effectively [2].

Cyclospora cayetanensis is a coccidian (= intestinal) parasite that causes a diarrheal disease known as cyclosporiasis in humans and possibly in other primates. It belongs to the phylum Apicomplexa and the genus Cyclospora. The species name, "cayetanensis," refers to the Cayetano Heredia University in Lima, Peru, where early epidemiological and taxonomic work on this parasite was conducted. Symptoms of cyclosporiasis include watery diarrhea, loss of appetite, weight loss, abdominal cramps, nausea, and sometimes low-grade fever. The severity of the illness can vary based on factors such as age, the condition of the host, and the size of the infectious dose. Infection with Cyclospora cayetanensis occurs when individuals consume food or water contaminated with the parasite. People living or traveling in countries where cyclosporiasis is endemic may be at an increased risk of infection. The oocysts are shed in the stool of infected individuals and need favorable laboratory conditions to sporulate and become infective. Cyclosporiasis can also be acquired from contaminated produce, leading to outbreaks in developed countries. How is Cyclospora infection treated? The recommended treatment is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should also rest and drink plenty of fluids.

A sulfate-reducing bacteria

a parasite that lives in the large intestine of people

Need for Microbiome Support

Genova’s data analysis has led to the development of unique dysbiosis patterns, related to key physiologic disruptions, such as immunosuppression and inflammation. These patterns may represent dysbiotic changes that could pose clinical significance.

Epidemiology: → Fecal contamination of ingested foods or water → Pets may be a source of exposure → Sexual contact may be a source of exposure Clinical Implications: → Symptoms include diarrhea, fulminating colitis (resembling ulcerative colitis), and dysentery → Extreme cases may invade liver and lung tissues

a Gram-negative, nonspore-forming, enteric bacilli

Inflammation Marker

a type of bacteria that normally live in the intestines of people and animals.

Anti-inflammatory effect (potentially useful in Crohn disease relief)

a significant component in the evaluation of gastrointestinal health

appearance and texture of stool

When you eat fat, a small amount of the fat passes out the body through the colon.

to assess inflammation in the gastrointestinal tract

Identifies microscopic amounts of blood in the stool

hidden blood in the stool which can indicate gastrointestinal issues like ulcers or cancer.

Mucosal immune antibody measuring gut barrier defence in stool.

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: - Obesity has been specifically associated with a greater abundance of Firmicutes and/or a drop in Bacteroidetes (i.e., an increase in the ratio); some research, however, has shown no change or even an increase in Bacteroidetes in obesity - Disruptions of metabolic homeostasis, e.g., type 2 diabetes and non-alcoholic fatty liver disease - Elevated markers of inflammation such as IL-6 The Firmicutes/Bacteroidetes Ratio captures the following members of each class: Total Firmicutes: - Anaerotruncus colihominis - Butyrivibrio crossotus - Clostridium spp. - Coprococcus eutactus - Faecalibacterium prausnitzii - Lactobacillus spp. - Pseudoflavonifractor spp. - Roseburia spp. - Ruminococcus spp. - Veillonella spp. Total Bacteroidetes: - Bacteroides-Prevotella Group (B. vulgatus & Prevotella spp.) - Barnesiella spp. - Odoribacter spp. Outcomes and General Therapeutic Considerations: Although no specific therapeutic interventions are yet known for a markedly elevated or depressed Firmicutes/Bacteroidetes Ratio, general intervention strategies directed against some of the commensals may impact this ratio and ultimately gut health. For imbalances in the F/B Ratio it is best to start by correlating with microbial diversity and abundance, and base treatments on the analytes that are out-of-range. Age dependent levels: The Firmicutes/Bacteroidetes ratio undergoes an increase from birth to adulthood and is further altered with advanced age. This ratio appears applicable in highlighting variations between infants, adults and the elderly. It can be linked to overall changes in bacterial profiles at different stages of life. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702274/] References: - Association between body mass index and Firmicutes/Bacteroidetes ratio in an adult Ukrainian population [L] - The Firmicutes/Bacteroidetes ratio of the human microbiota changes with age [L]

Flourishes in colon cancer cells

Parasitic Pathogens

Helicobacter pylori stool antigen

Need for Antimicrobial Support

Need for Inflammation Modulation

a metric for evaluating the interplay between gut inflammation and microbiota composition

non-motile, Gramnegative rods that belong to the Enterobacteriaceae family

non-motile, Gramnegative rods that belong to the Enterobacteriaceae family

Microscopic stool test detecting yeast organisms in the GI tract.

A type of bacteria.

A fecal fat

Need for Digestive Support

Need for Prebiotic Support

The Methane Dysbiosis Score on a GI Effects panel is an assessment of the likelihood of methane-dominant dysbiosis in the gastrointestinal tract. Methane production in the gut is primarily attributed to methanogenic archaea, particularly Methanobrevibacter smithii. These organisms thrive in an anaerobic environment and use hydrogen, a byproduct of bacterial fermentation, to produce methane. Elevated methane levels are often associated with a slower transit time in the intestines, contributing to symptoms such as constipation and bloating, as well as potential disruptions in gut motility. The score is calculated based on the abundance of methanogenic organisms in the stool sample and serves as a marker of microbial imbalance rather than a direct diagnostic tool for a specific condition. A high Methane Dysbiosis Score may indicate an overgrowth of methanogens, which could be contributing to symptoms of small intestinal bacterial overgrowth (SIBO), methane-dominant SIBO, or other forms of dysbiosis. Conversely, a low score suggests a minimal contribution of methane-producing organisms to gut health. Addressing a high Methane Dysbiosis Score often involves strategies aimed at restoring microbial balance. These may include dietary modifications (such as reducing fermentable carbohydrates that fuel hydrogen production), antimicrobial therapies targeting methanogens, and the use of prokinetics to improve gut motility. Understanding the Methane Dysbiosis Score in conjunction with other biomarkers on the GI Effects panel helps clinicians develop a more tailored approach to managing symptoms and optimizing gut health.

Methanobrevibacter smithii is highly prevalent in the human gut. Lower counts have been associated with obesity while higher amounts have been associated with anorexia. References: Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii. [L]

Short-chain fatty acid

produced as a result of the fermentation of dietary fiber.

Possibly related to Crohn’s if low

Can reduce the incidence of kidney stones.

Pancreatic insufficiency test

Generally considered a beneficial gut commensal

Lecithin cholesterol acyltransferase deficiency

Prevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.

A set of markers of undigested protein reaching the colon

short-chain fatty acid

Gram-negative bacteria belonging to the Enterobacteriaceae family

Firmicutes phylum

Butyrate-producing gut bacteria

playing a large role in the digestion of resistant starches

Helps to digest resistant starches

Shiga toxin-producing Escherichia coli (STEC) is a significant pathogen detected in GI tests that can cause severe gastrointestinal illness. STEC infection often occurs through the consumption of contaminated food or water, particularly undercooked beef, raw milk, and fresh produce. Patients infected with STEC may experience symptoms such as severe abdominal cramps, diarrhea (often bloody), vomiting, and occasionally fever. The presence of Shiga toxin in E. coli is particularly concerning because it can lead to serious complications like hemolytic uremic syndrome (HUS), a condition that can cause kidney failure, especially in young children and the elderly. Treatment typically focuses on supportive care, as antibiotics are generally not recommended and may increase the risk of complications. Maintaining hydration is crucial, and in severe cases, hospitalization may be required for intensive management and monitoring. Preventive measures, including proper food handling, thorough cooking of meat, and practicing good hygiene, are essential to reduce the risk of STEC infection. If a GI test confirms the presence of STEC, prompt medical attention and appropriate management are vital to mitigate the risk of severe outcomes.

Acetate, n-Butyrate, Propionate

The total commensal abundance is a sum-total of the reported commensal bacteria compared to a healthy cohort. Low levels of commensal bacteria are often observed after antimicrobial therapy, or in diets lacking fiber and/or prebiotic-rich foods and may indicate the need for microbiome support. Conversely, higher total commensal abundance may indicate potential bacteria overgrowth or probiotic supplementation.

a fecal fat

Commonly found in gut, mouth and vaginal tract

Increased risk of gastrointestinal disorders, eye inflammation, thyroid autoimmunity, reactive arthritis.

Assessing impaired gut barrier function