The Digestive System / The Comprehensive Digestive Stool Analysis

Mycology

The CDSA includes a mycology culture that identifies and quantitates fecal yeast. Some of the more commonly identified species are C. albicans, C. tropicalis, Rhodotorula and Geotrichum. Broth dilution sensitivity analyses are performed on all yeast cultures of 2+ or greater utilizing both pharmaceutical and natural substances. Quantitative MIC analysis determines the relative potency of differing antimycotic agents. This provides more information on the effective agents and dosages for each yeast. MIC analysis is available by request for yeasts reporting below 2+.

Metabolic Marker

n-Butyrate: Butyric acid is a key SCFA because it is the main energy source for colonic epithelial cells. Adequate amounts are necessary for healthy metabolism of the colonic mucosa. A possible mechanism for the anticancer action of dietary fiber is the increased fermentation of fiber to butyrate. It has been suggested that failure to use butyric acid by colonic mucosal cells or inadequate amounts available in the colon could be a primary factor in the etiology ofulcerative colitis, inflammatory bowel disease and colon cancer.^66,70,71

Beta-glucuronidase: Beta-glucuronidase is a bacterial enzyme elaborated by several microorganisms, including E. coli, Bacteroides and Clostridium. Via the uncoupling of glucuronides (compounds detoxified through the hepatic glucuronidation pathway), this enzyme catalyzes reactions which may result in the formation of carcinogens in the bowel as well as the persistence of certain hormones and drugs in the body. Thus, excess betaglucuronidase activity may possibly contribute to the pathogenesis of colon cancer, as well as estrogen-related cancers via enhanced enterohepatic recirculation of estrogen in the body. The activity of this enzyme is strongly influenced by diet, levels of Lactobacilli and Bifidobacteria, intestinal pH and nutrients such as calcium glucarate.^72-75

pH: Fecal pH appears to be an indicator of the health or status of colonic digestive processes. Abnormally acidic or alkaline pH usually reflects an abnormality in either acid production or its absorption. Increasing evidence supports fecal pH as a useful biomarker linked to the development of colon cancer.^76-78 We have observed a correlation between alkaline pH and decreased short chain fatty acids (particularly butyrate).⁷⁹ Elevated fecal pH and diminished SCFAs suggest inadequate digestion of fiber and/or inadequate intake of dietary fiber.

Short Chain Fatty Acid Distribution: Adequate amount and proportions of the different SCFAs reflect the basic status of intestinal metabolism. The ratios of the individual SCFAs remains relatively constant in healthy colons but becomes imbalanced in various disease states. Imbalanced ratios of the SCFAs reflect imbalanced metabolic processes due to disordered bowel flora—a state called “dysbiosis”. Researchers are beginning to identify unique SCFA “fingerprints” with specific bacterial infections.⁷⁰ Hoverstad proposed that the ratio among SCFAs has diagnostic value for intestinal infections.⁷¹ A significantly higher ratio of acetate/total SCFAs and lower ratio of butyrate/total SCFAs has been found in the feces of patients with large bowel adenomas and cancer compared to control groups.⁷⁰

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