Have you ever thought about what your stool can tell you about your health? While it may not be a topic that comes up often in everyday conversation, your stool can actually provide valuable insights into the state of your digestive system and overall health.
In fact, a comprehensive stool test can be one of the most powerful tests you can do, even if you’re not experiencing any digestive issues. From skin issues to migraines and immune system problems, your stool can provide important clues about what’s happening inside your body.
This blog post will explore how a stool test works and what it can reveal about your health. So, let’s dive in!
Rather watch or listen?
Why You Should Consider Getting a Stool Test
Perhaps you have been experiencing health issues for quite some time, and you have even visited a GI doctor who has even recommended a basic stool test, or you have received lab values, yet everything appears normal. Is that why you feel like crap, you may be asking?
If we consider the power of the microbiome, this test can provide us with valuable insights into our bacteria, parasites, intestinal health, possible infections, and so much more.
The stool test, most importantly, must be used to support your overall healing plan, so it should be correlated it with your clinical symptoms.
When you take any tests, whether it’s a lab test, stool test, or micronutrient panel, it must be paired with your clinical presentation. Just like an MRI of your low back, which might show that you have a hernia, disc degeneration does not necessarily mean that you have low back pain. The same goes for this test. We want to ensure that we consider all of the information and make it suitable for you so that it can guide your health decisions.
When looking at a comprehensive stool test, there are a few things to keep in mind. First and foremost, we are looking for pathogenic bacteria such as C. diff, E. coli, and Salmonella. These bacteria can cause various digestive symptoms. It is, therefore, crucial to understand if they are present and at what levels.
“Detectable limit” or DL tells us the amount of pathogens present per gram of stool. For example, if C. diff shows up on this panel, it does not necessarily mean that we are experiencing an acute C. diff infection. Instead, we may have chronic colonization of C. diff, which could make us more susceptible to infection.
When it comes to parasites, the test results can be a bit more complicated. For instance, Giardia, a parasite, may be detected, but it is not necessarily flagged as high. However, treating it, particularly if it is related to symptoms, is still essential.
Digestive symptoms are a bit complicated because many symptoms overlap, whether we have H. pylori, maldigestion, or parasites. They all can cause bloating, fullness, constipation, or diarrhea. Therefore, it is necessary to examine all symptoms and understand which things that pop up on this stool exam are relevant to this person.
For example, H. pylori is a bacterial infection in the stomach. If this is elevated, it is imperative to test and will often be towards the top of the hierarchy of treating. It is easily transmittable, particularly among family members. It is also likely to occur when someone has low stomach acid.
Therefore, we may see a parasite, as well as H. pylori, if there is poor digestion or low stomach acid, which can cause a sense of fullness, nausea, and burping.
Once again, this is high on our priority list.
The next part pertains to commensal bacteria, which are essentially our beneficial bacteria. Commensal bacteria extract nutrients and energy from our food, maintain gut barrier function, produce vitamins, and protect against pathogens. Although we aim for all values to fall within a healthy range and maintain a normal balance, having too much of a good thing can be harmful.
For instance, we do not want any values to be elevated. We also do not want them to be too low. Various bacteria can contribute to different presentations. For example, low level of Akkermansia municphila is associated with obesity. On the other hand, metabolic function and high levels can be associated with Multiple Sclerosis. Thus, we can see how bacteria and bacterial colonization can affect a person’s overall health.
We can also encounter opportunistic or overgrowth microbes, otherwise known as ‘potentially bad bacteria,’ which are not as beneficial to our health. Many individuals will come into contact and experience no issues and can be normal in the stool. However, they can cause disease, especially in the immune-compromised. We don’t want to see elevated numbers for these microbes.
Examples of these microbes include staphylococcus and streptococcus, which can trigger Mast Cell Activation and histamine responses in some individuals.
Methanobacteriacea, for example, is a methane-producing bacteria that is strongly associated with constipation and bloating.
These opportunistic microbes are linked to systemic inflammation and certain autoimmune conditions, like rheumatoid arthritis and autoimmune thyroiditis. Therefore, if someone is experiencing autoimmune symptoms, we can gain more insight by assessing stool.
Candida can also be detected on the stool test. However, we need to look at other tests, such as an organic acid test, to gain more insight into it. Fungal overgrowth can be elevated in the large intestine but not in the small intestine.
Moving on to viruses, the stool test is not the best way to test for them. We would need a blood test to test for viruses such as Epstein-Barr.
A stool test can also detect parasites, which are given high priority because they can be harmful to our health.
When we look at intestinal health markers, we get a better idea of how well our body absorbs nutrients. For example, we can look at steatocrit to evaluate a person’s ability to absorb fats. If steatocrit is elevated, it means there is a higher amount of fats in the stool. This also means that the person may not be absorbing fat-soluble vitamins properly.
We also look at pancreatic elastase, which tells us about our digestive function. Elastase 1 is a digestive enzyme secreted exclusively by the pancreas, giving a direct indication of pancreatic function.
β-glucuronidase is another marker that helps us evaluate our detoxification and hormonal activity. High levels can indicate unfavorable metabolic changes in the colon. It can also be associated with dysbiosis and interference with phase II detoxification.
Occult blood measures the concentration of hemoglobin present in the stool rather than just the qualitative presence of hemoglobin. This may indicate something as simple as hemorrhoids or warrant a referral for a colonoscopy.
The secretory IgA (Immunoglobulin A) is the primary immunoglobulin in the intestinal mucosa and is an important marker for assessing the gut’s immune system. If it is low or elevated, we need to address it. We can also determine if there is an elevated response to gliadin (gluten) in the lumen of the gut.
We should also look at the Eosinophil activation protein, and if it is elevated, further investigation may be necessary. Fecal Calprotectin is one of the most common inflammatory markers of the gut, and if it’s high, we need to investigate further. It is used to differentiate IBD (inflammatory bowel disease from IBS). Zonulin, a protein that opens intercellular tight junctions in the gut lining, increases intestinal permeability and is a biomarker for leaky gut.
The Bottom Line
The stool test provides valuable insights into our microbiome, and it is one of the most important tests I perform for my patients. I highly recommend it to anyone who hasn’t had it done yet.
Please leave a comment if you’ve already had a stool test and let me know what information you received and how you applied it. If you found this helpful, please like, share, and subscribe to our YouTube channel, The Movement Paradigm, for weekly tips on mindset, nutrition, and movement. If you’d like to schedule an appointment or evaluation, I would be happy to help you get started on your healing journey. Thank you.
Other things that might interest you: