GI-MAP by Diagnostic Solutions

Overwhelmingly, research indicates that gut health impacts overall health. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic and neuroendocrine functions. Assessing GI health with the proper tools can help practitioners get to the root cause of chronic illness.

The GI-MAP is unique in the field of comprehensive stool testing. It relies exclusively on quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria and fungi by targeting the specific DNA of the organisms tested.

Who Should Have the GI-MAP Comprehensive Stool Analysis Done?

Almost every patient can benefit from a GI-MAP gut health assessment. Some patients are looking to achieve optimal health, while other patients have been chronically ill and frustrated without a diagnosis for years.

Some conditions that warrant testing are:

- Autoimmune diseases

- IBS/IBD

- Digestive complaints, diarrhea or constipation

- Brain fog

- Skin problems, like acne and psoriasis

- Mood disorders, depression, and anxiety

- Diabetes and weight loss issues

Adenovirus 40/41

Optimal range: 0 - 9000000000 Units

Adenovirus serotypes 40 and 41 cause acute gastroenteritis (inflammation of the stomach and intestines) primarily in children.

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Akkermansia muciniphila

Optimal range: 10 - 50000 Units

Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.

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Ancylostoma duodenale

Optimal range: 0 - 0.00001 Units

The distribution of hookworm (Necator americanus and Ancylostoma duodenale) is worldwide, with particular prevalence in rural areas of the moist tropics where there is inadequate sanitation and people walk barefoot. The two species produce indistinguishable thin-walled eggs that hatch in soil. Infection is usually acquired by walking barefoot in soil contaminated with human faeces. The larvae undergo several moults before infective larvae are produced.

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Anti-gliadin IgA

Optimal range: 0 - 157 U/L

Antigliadin antibodies (AGAs) are antibodies of the IgA and IgG classes found in the serum of celiac disease patients. These antibodies mainly target gliadin-derived peptides, which are the main proteins of gluten. AGAs are not specific for celiac disease as they are also found in patients with other gastrointestinal diseases such as gastritis, gastroenteritis, and IBD.

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Ascaris lumbricoides

Optimal range: 0 - 0.00001 Units

Ascaris lumbricoides, an intestinal roundworm, is one of the most common helminthic human infections worldwide.

Ascaris lumbricoides is the largest intestinal nematode of man. The female worms are larger than the males and can measure 40 cm in length and 6 mm in diameter. They are white or pink and are tapered at both ends. 

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b-Glucuronidase

Optimal range: 0 - 2486 U/mL

Beta-glucuronidase is an enzyme that breaks the tight bond between glucuronic acid and toxins in the intestines. The liver and intestine bind toxins, steroid hormones and some dietary components to glucuronic acid. That is a protective process that limits absorption and enterohepatic reabsorption of toxins, and enhances excretion. A high level of activity of Beta-glucuronidase in the gut is not desirable. A low level of Beta-glucuronidase activity is not known to be of any direct clinical consequence.

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Bacillus spp.

Optimal range: 0 - 149999 Units

Bacillus spp. are spore forming bacteria, ubiquitous in the environment. B. cereus in particular is a frequently recognized cause of toxin-induced acute gastroenteritis.

Other infections caused by this genus include:

- sepsis

- pneumonia

- endocarditis

- central nervous system (CNS) and ocular infections

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Bacteroides fragilis

Optimal range: 1600000000 - 250000000000 Units

Gram-negative species of the Bacteroidetes phylum. Immune-modulating normal gut species. Believed to be involved in microbial balance, barrier integrity, and neuroimmune health (Hsiao 2013). High levels may result from reduced digestive capacity or constipation. Low levels may contribute to reduced anti-inflammatory activity in the intestine.

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Bacteroidetes

Optimal range: 861000000000 - 3310000000000 Units

Bacteroidetes are the most prominent gut microbes in much of the world. They are thought to help protect against obesity because they do not digest fat well.

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Bifidobacterium spp.

Optimal range: 67000000 - 100000000000 Units

Gram-positive genus in the Actinobacteria phylum. Present in breast milk. Colonizes the human GI tract at birth. Common in probiotics. Thrives on a wide variety of prebiotic fibers.

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Blastocystis hominis

Optimal range: 0 - 1999 Units

Blastocystis hominis is found throughout the world in both people with and without symptoms. It is a non-pathogenic parasite. Non-pathogenic parasites are present in the gastrointestinal tract and generally are self-limiting and do not cause illness. However, some research shows an association between non-pathogenic parasites and gastrointestinal symptoms.

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C. difficile, Toxin A

Optimal range: 0 - 999 Units

C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use).

C. difficile produces two toxins:

- Toxin A is a tissuedamaging enterotoxin,

- while toxin B is referred to as a cytotoxin.

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C. difficile, Toxin B

Optimal range: 0 - 999 Units

Calprotectin

Optimal range: 0 - 173 ug/g

Calprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool in intestinal inflammation. 

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Campylobacter

Optimal range: 0 - 999 Units

When people worry about eating undercooked chicken, they usually focus on getting sick from salmonella bacteria. But another common type of bacteria called campylobacter can also make you ill if you eat poultry that isn’t fully cooked.

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Candida albicans

Optimal range: 0 - 499 Units

Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue, and muscle or joint pain but evidence is weak.

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Candida spp.

Optimal range: 0 - 4999 Units

Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue, and muscle or joint pain but evidence is weak.

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Chilomastix mesnili

Optimal range: 0 - 99999 Units

Chilomastix mesnili is a nonpathogenic flagellate that is often described as a commensal organism in the human gastrointestinal tract.

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Citrobacter freundii

Optimal range: 0 - 499999 Units

Gram-negative bacteria in the Proteobacteria phylum.

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Citrobacter spp.

Optimal range: 0 - 4999999 Units

Gram-negative bacteria in the Proteobacteria phylum.

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Clostridia (class)

Optimal range: 5000000 - 50000000 Units

Markers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.

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Cryptosporidium

Optimal range: 0 - 999999 Units

Cryptosporidium is notorious for being spread by swimming pools. A number of Cryptosporidium outbreaks have occurred after contamination of public swimming facilities. Cryptosporidium can cause gas, bloating, diarrhea, and abdominal pain. In a healthy, immune-competent person, this is a selflimiting infection and can be cleared within 2-3 weeks.

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Cyclospora spp.

Optimal range: 0 - 49999 Units

This parasite causes an intestinal infection called cyclosporiasis.

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Cytomegalovirus

Optimal range: 0 - 99999 Units

Epidemiology:

- Herpes virus that has infected 60% of the US population

- One in three children have contracted CMV by five years old

- Passed around in child daycare centers

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Dientamoeba fragilis

Optimal range: 0 - 99999 Units

Dientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.

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E. coli O157

Optimal range: 0 - 999 Units

Elastase-1

Optimal range: 201 - 2000 ug/g

Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.

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Endolimax nana

Optimal range: 0 - 9999 Units

Entamoeba coli

Optimal range: 0 - 4999999 Units

Entamoeba coli are intestinal amebae that are found in the large intestine. They generally are not considered pathogenic. However, when these amebae are found in stool samples it can indicate the presence of other potentially pathogenic organisms.

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Entamoeba histolytica

Optimal range: 0 - 9999 Units

Entamoeba histolytica is a disease-causing parasite that can affect anyone, although it is more common in those who lived or travelled in tropical areas with poor sanitary conditions. Diagnosis can be difficult since, under a microscope, it looks similar to other parasites such as Entamoeba dispar and Entamoeba hartmanii. The latter two parasites generally do not cause illness.

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Enterobacter spp.

Optimal range: 1000000 - 50000000 Units

Enterococcus faecalis

Optimal range: 0 - 9999 Units

Enterococcus faecium

Optimal range: 0 - 9999 Units

Enterococcus spp.

Optimal range: 190000 - 200000000 Units

Gram-positive genus of lactate-producing bacteria in the Firmicutes phylum. High levels may be due to reduced digestive capacity, constipation or small intestinal bacterial overgrowth. Low levels may indicate insufficiency of beneficial bacteria.

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Enterohemorrhagic E. coli

Optimal range: 0 - 999 Units

Enterotoxigenic E. coli LT/ST

Optimal range: 0 - 999 Units

Epstein Barr Virus

Optimal range: 0 - 999999 Units

Escherichia spp.

Optimal range: 3700000 - 3800000000 Units

Faecalibacterium prausnitzii

Optimal range: 1000 - 500000000 Units

Firmicutes

Optimal range: 57000000000 - 304000000000 Units

Firmicutes:Bacteroidetes Ratio

Optimal range: 0 - 0.99 Ratio

Fusobacterium spp.

Optimal range: 0 - 100000000 Units

Geotrichum spp.

Optimal range: 0 - 299 Units

Giardia

Optimal range: 0 - 4999 Units

Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States.

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Helicobacter pylori

Optimal range: 0 - 999 Units

Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect your stomach. Helicobacter pylori has been evolving with human beings for well over 50,000 years, since they migrated out of Africa. H. pylori colonization has been implicated in a variety of gastroduodenal diseases.

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Klebsiella pneumoniae

Optimal range: 0 - 49999 Units

Klebsiella spp.

Optimal range: 0 - 4999 Units

Klebsiella species are gram-negative bacteria normally found in the intestinal tract that are associated with a wide range of small intestinal disorders including:

- alterations of motility,

- diarrhea,

- gas,

- abdominal pain,

- and bloating.

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Methanobacteriaceae (family)

Optimal range: 0 - 5000000000 Units

Microsporidium spp.

Optimal range: 0 - 4999 Units

Morganella spp.

Optimal range: 0 - 999 Units

Necator americanus

Optimal range: 0 - 0.0001 Units

Norovirus GI/II

Optimal range: 0 - 9000000 Units

Norovirus GI & GII, or Norwalk virus, is the most common cause of non-bacterial gastroenteritis in the world. It is widely known for causing the stomach flu on cruise ships. Three genotypes of this diverse virus, GI, GII, and GIV, can infect humans.

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Occult Blood - FIT

Optimal range: 0 - 10 ug/g

The fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visible bright red blood. Therefore, the blood is found only by testing the stool for blood in the laboratory.

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Pentatrichomonas hominis

Optimal range: 0 - 99 Units

Proteus mirabilis

Optimal range: 0 - 999 Units

Proteus spp.

Optimal range: 0 - 49999 Units

Pseudomonas aeruginosa

Optimal range: 0 - 499 Units

- Gram-negative bacteria in the Proteobacteria phylum.

- Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.

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Pseudomonas spp.

Optimal range: 0 - 9999 Units

Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity and may cause abdominal cramping and loose stools. Some strains of P. aeroginosa may produce toxins that can damage cells.

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Rodotorula spp.

Optimal range: 0 - 999 Units

Salmonella

Optimal range: 0 - 9999 Units

Secretory IgA

Optimal range: 510 - 2010 ug/g

As the most abundant class of antibody found in the human intestinal lumen, secretory IgA (sIgA) is recognized as a first line of defense in protecting the intestinal epithelium from enteric pathogens and toxins. It is used to assess gastrointestinal barrier function.

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Shiga-like Toxin E. coli stx1

Optimal range: 0 - 999 Units

Shiga-like Toxin E. coli stx2

Optimal range: 0 - 999 Units

Staphylococcus aureus

Optimal range: 0 - 499 Units

Staphylococcus spp.

Optimal range: 0 - 9999 Units

Steatocrit

Optimal range: 0 - 14.9 %

The steatocrit is a measure of the amount of fat in stool.

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Streptococcus spp.

Optimal range: 0 - 999 Units

Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.

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Taenia spp.

Optimal range: 0 - 0.0001 Units

Trichuris trichiura

Optimal range: 0 - 0.0001 Units

Vibrio cholerae

Optimal range: 0 - 99999 Units

Virulence Factor, babA

Optimal range: 0 - 0.0001 Units

Virulence Factor, cagA

Optimal range: 0 - 0.0001 Units

Virulence Factor, dupA

Optimal range: 0 - 0.0001 Units

Virulence Factor, iceA

Optimal range: 0 - 0.0001 Units

Virulence Factor, oipA

Optimal range: 0 - 0.0001 Units

Virulence Factor, vacA

Optimal range: 0 - 0.0001 Units

Virulence Factor, virB

Optimal range: 0 - 0.0001 Units

Virulence Factor, virD

Optimal range: 0 - 0.0001 Units

Yersinia enterocolitica

Optimal range: 0 - 99999 Units