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Testing for Irritable Bowel Syndrome

Published date: October 23, 2012 | Modified date:
by Dr Stephen Wangen

If you suffer from Irritable Bowel Syndrome (IBS) and other digestive problems, then it’s very possible that you have a microbial imbalance in your digestive tract.

We (at the IBS Treatment Center) are proud to be one of the few clinics in the country where you can now get DNA testing to measure the presence of the bacteria, yeast and parasites in your digestive tract, which we covered yesterday. Today we’re going to review the GI Function Panel.

The Comprehensive GI (gastrointestinal) Function Panel includes everything in the DNA Microbial Profile as well as several other tests that evaluate the overall function of the digestive tract. These tests include inflammatory markers, digestive markers, measurement of absorption, pH, occult blood, and several other tests. Each is described below.

Inflammatory Markers

Beneficial Short Chain Fatty Acids (SCFA)

Beneficial SCFA come from dietary carbohydrates that have escaped digestion or absorption in the small intestine. They are also produced by bacteria in the large intestine via the fermentation of fiber. The production of SCFA in the intestine plays an important role in maintaining the intestinal lining. Beneficial SCFA include acetate, propionate, and butyrate. They affect the bacteria of the colon as well as the health of the colon and the entire body.

Lactoferrin
Lactoferrin is released in inflammatory condition such as Crohn’s disease and ulcerative colitis. It can help to differentiate between IBS and these conditions, and to monitor improvement in inflammatory bowel diseases.

WBC (White Blood Cells)

White blood cells indicate inflammation in the digestive tract.

Mucus
Excess mucus indicates infection, inflammation, or injury of the lining of the digestive tract.

Digestive Markers

Elastase 1

Elastase 1 is a pancreatic enzyme that survives passage through the digestive tract. It is used to measure pancreatic insufficiency.

Triglycerides

Small amounts of triglycerides, are normal. Higher levels indicate incomplete fat digestion and possible insufficient pancreatic enzymes, insufficient bile, or hypochlorhydria.

Putrefactive Short Chain Fatty Acids (SCFA)

These SCFA result from the bacterial fermentation of inadequately digested branch chain amino acids. High amounts of these SCFA (which are valerate, isovalerate, and isobutyrate) suggest the maldigestion of protein.

Vegetable Fibers
Fibrous residue of undigested vegetable matter suggests possible maldigestion.

Immune Markers

Fecal sIgA
Secretory IgA (sIgA) reflects the activity of the immune system in the digestive tract.

Anti-gliadin sIgA
Gliadin is a protein found in wheat and related grains. An immune reaction to gliadin may indicate a gluten intolerance.

Miscellaneous Markers

pH
pH is the acidity of stool environment. An abnormal pH my indicate fat malabsorption or an enzyme deficiency. A stool pH of less than 6 may indicate a carbohydrate malabsorption.

Occult blood
The presence of occult blood in the stool can be a sign of many different conditions, including polyps, cancer, peptic ulcer, inflammatory bowel disease, diverticulosis, and pancreatitis.

RBC (Red Blood Cells)
The presence of red blood cells may be due to diverticulitis, fissures, hemorrhoids, injury or even severe constipation.

Color
The normal stool color is light brown to brown. Clay, white or tan colored stool can indicate the absence of bile or a pancreatic insufficiency.

Absorption

Long Chain Fatty Acids (LCFA)
These fatty acids are usually absorbed by a healthy digestive tract. If malabsorption is present, they are elevated in the stool.

Total Fat
Total fecal fats include triglycerides, cholesterol, and long chain fatty acids. Poor digestion and absorption of fats leads to increased fat in the stool.

Cholesterol
Fecal cholesterol come from dietary sources and bile. Fecal cholesterol levels remain relatively constant regardless of diet. An elevated level may indicate malabsorption.