Products of Protein Breakdown, which includes isovalerate, valerate and isobutyrate are produced by bacterial fermentation of proteinaceous material (polypeptides and amino acids) in the distal colon.
Products of Protein Breakdown (Total) is a set of markers of undigested protein reaching the colon [L]:
- Isovalerate
- Valerate
- Isobutyrate
It is derived from bacterial fermentation of protein in the distal colon.
Normal protein digestion and absorption is relatively complete in the stomach and small intestine.
References:
- Protein origin of the volatile fatty acids isobutyrate and isovalerate in human stool. [L]
A decreased value of Products of Protein Breakdown (Total) indicate:
- decreased protein intake
- imbalanced bacterial levels,
- or intestinal inflammation.
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Increased fecal Products of Protein Breakdown may be due to:
- Underlying gastrointestinal conditions such as exocrine pancreatic insufficiency (maldigestion)
- Bacterial overgrowth of the small intestine
- Excessive delivery of protein to the colon, (ex: hypochlorhydria)
- Insufficient pancreatic proteases
- Excessive protein intake
- Increased colonic protein due to a GI bleed, excess mucus, bacterial overgrowth
May indicate protein maldigestion and malabsorption resulting in colonic protein fermentation, and/or excessive delivery of protein to the colon.
Assess for and treat root causes of insufficient protein digestion:
- Hypochlorhydria: Assess for/reduce use of acid-blocking medications (as clinically indicated). Consider addition of betaine HCl (=stomach acid hydrochloric acid). Please discuss with your doctor.
- Pancreatic exocrine insufficiency: Evaluate fecal PE1 and support with PERT (=Pancreatic enzyme replacement therapy). Please discuss with your doctor.
Assess for excessive delivery of protein to the colon:
- High-protein diet?
- Bacterial overgrowth?
- GI irritation/inflammation, bleeding?
Review, evaluate, and treat any abnormal inflammatory biomarkers and/or infection.
If the below biomarkers are also elevated, it is suggested to perform a SIBO breath test:
- SCFA
- n-butyrate
- Fecal fat (total)
- Methanobrevibacter smithii
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Acetate, Akkermansia muciniphila, Anaerotruncus colihominis, Anaerotruncus colihominis/massiliensis, Ancylostoma/Necator (Hookworm), Ascaris lumbricoides, Bacteroides uniformis, Bacteroides vulgatus, Bacteroides-Prevotella group, Barnesiella spp., Beta-glucuronidase, Bifidobacterium longum, Bifidobacterium longum subsp. longum, Bifidobacterium spp., Blastocystis spp., Butyrivibrio crossotus, Calprotectin, Candida albicans/dubliniensis, Capillaria philippinensis, Cholesterol, Citrobacter species, Clostridium spp., Collinsella aerofaciens, Coprococcus eutactus, Cryptosporidium parvum/hominis, Cyclospora cayetanensis, Desulfovibrio piger, Dientamoeba fragilis, Entamoeba histolytica, Enterobacter cloacae, Enterobius vermicularis, Enterococcus faecalis, Eosinophil Protein X, Escherichia coli, Faecalibacterium prausnitzii, Fecal Color, Fecal Consistency, Fecal Fat, Total, Fecal Occult Blood, Fecal secretory IgA, Firmicutes/Bacteroidetes (F/B Ratio), Fusobacterium spp., Giardia, Klebsiella oxytoca, Klebsiella species, Lactobacillus spp., Long-Chain Fatty Acids, Methanobrevibacter smithii, n-Butyrate %, n-Butyrate Concentration, Odoribacter spp., Oxalobacter formigenes, Pancreatic Elastase 1, Phocaeicola vulgatus, Phospholipids, Prevotella spp., Products of Protein Breakdown (Total), Propionate, Proteus mirabilis, Pseudoflavonifractor spp., Roseburia spp., Ruminococcus bromii, Ruminococcus spp., Short-Chain Fatty Acids (SCFA), Total, Triglycerides, Veillonella spp., Zonulin Family Peptide
