Last Updated on 5 August 2024 by Brisbane Livewell Clinic
April is IBS Awareness Month, helping to address the ongoing issues that are associated with the syndrome. Last year we looked at some of the treatment challenges and the reasons why women are more likely to experience IBS symptoms. This time around, we’re looking at tailoring solutions with functional stool testing.
Functional stool testing provides IBS Sufferers with acceptable diagnostic accuracy, while also aiding in the exclusion of more serious conditions. (1) Stool testing also gives Naturopaths the ability to screen and rapidly identify specific, treatable diagnoses that can explain the cause of IBS symptoms for IBS Sufferers
With current technologies providing important information about the composition and functionality of the gut microbiome, (2) part one of our two-part blog will focus on functionality via faecal digestive markers. These markers are a helpful adjunctive tool in overall evaluation of IBS Sufferers with nonspecific gut symptoms (3) and can offer many insights into digestive health.
Digestive Markers as Diagnostic Tools
Some common functional markers on a stool test include:
- Calprotectin – a marker of colorectal inflammation, calprotectin is released by leukocytes (a type of white blood cell) in inflammatory conditions. Calprotectin may be a reliable and non-invasive screening tool to identify inflammatory causes of chronic, non-bloody diarrhoea. (4) Faecal calprotectin levels have been demonstrated to effectively differentiate IBS from IBD and is more diagnostically discriminative than routine blood tests. (1)
- Helicobacter pylori (H. pylori) antigen – detection indicates an ongoing infection and the antigen test may be used for making the diagnosis of H. Pylori infection as well as for confirming eradication. (5)
- Short-chain fatty acids (SCFAs) – are produced by fermentation of anaerobic bacteria breaking down carbohydrates. (6) SCFAs lower pH of the colon and defend against colonisation by non-commensal intruders. (7) SCFA production and absorption are closely related to the nourishment of the colonic mucosa (6) and may influence IBS pathophysiology. (8)
- Zonulin – a modulator of tight junctions that controls the selective permeability of the intestine. (9) Zonulin is the only physiological modulator of intercellular tight junctions, that can reversibly regulate the permeability of the intestinal barrier. (10) Studies have shown increased intestinal permeability in irritable bowel syndrome, with zonulin levels correlating with severity of bowel habits in diarrhoea-predominant IBS. (11)
The Benefits of Stool testing for IBS
There are several reasons why stool testing should be considered in the IBS population. Some key factors include:
- An alternative first line test – Compared to colonoscopy, stool testing is a less invasive form of testing, can be performed at a lower cost, is more convenient and in some cases helps to avoid the need for further procedures.
- Accurate and sophisticated information – Compared to conventional stool tests, additional information is provided. While much of the focus is placed on microbiome composition, there are several specific digestive markers which are recognised as diagnostic (both inclusion and exclusion) some of which expands on medical mainstream options.
- Collaborates gut symptoms with diagnostic signs – Stool testing helps to identify or exclude other individual causes of IBS symptoms, such as bile acid malabsorption, pancreatic exocrine insufficiency and coeliac disease. (1)
Your IBS Report Card
Functional digestive markers alone can provide real insight into gut health, with a range of answers being provided that are unique to the individual. For IBS sufferers, gaining clarity can be a game changer when it comes to targeting treatment, refining supplements and creating a baseline with test results in order to monitor changes in symptoms.
In Part 2 next week, we will explore how intestinal dysbiosis can also be readily assessed via test results, with emerging evidence suggesting that there may exist a colonic microbiome pattern unique to IBS patients. (1)
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