The Comprehensive Stool Analysis + Parasitology (CSAP) profile helps pinpoint the causes of gastrointestinal symptoms and chronic systemic conditions, and measures key markers of digestion, absorption and inflammation. It contains comprehensive bacteriology and yeast cultures to identify the presence of beneficial flora, imbalanced flora including Clostridium species, and dysbiotic flora, as well as the detection of infectious pathogens and parasites by PCR and other gold standard methods. Antimicrobial susceptibility testing to prescriptive and natural agents is also performed for appropriate cultured bacterial and fungal species at no additional charge. Parasitology testing can include one-, two- or three-day collection, based on practitioner preference.

NOTE: Please ensure that a correct amount of stool sample is provided in EACH vial. If this cannot be the case, please click on the <Practical> tab for further information.

Indications

• Autoimmune Disease

• Food Allergies/Sensitivities

• Gastrointestinal Symptoms

• IBD/IBS

• Inflammation

• Joint Pain

• Nutritional Deficiencies

• Systemic illnesses

• Toxic overload

Contributing/causal factors

• Bacterial overgrowth or imbalances (dysbiosis)

• Chronic maldigestion

• Food allergen impact on bowel absorptive surfaces

• Low gastric acid production

• Pathogenic bacteria, yeast or parasites and related toxic irritants

• The use of NSAIDs and antibiotic

Overview

The Comprehensive Stool Analysis + Parasitology (CSAP) is an invaluable non-invasive diagnostic assessment that permits practitioners to objectively evaluate the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast/fungus and parasites by culture, PCR, and other gold standard methods.. Precise identification of pathogenic species and susceptibility testing greatly facilitates selection of the most appropriate pharmaceutical or natural treatment agents.

Inflammation can significantly increase intestinal permeability and compromise assimilation of nutrients. The extent of inflammation, whether caused by pathogens or inflammatory bowel disease (IBD), can be assessed and monitored by examination of the levels of biomarkers such as calprotectin, lactoferrin, and lysozyme via this stool test. These markers can be used to differentiate between inflammation associated with potentially life-threatening inflammatory bowel disease (IBD), which requires lifelong treatment, and less severe inflammation that can be associated with irritable bowel syndrome (IBS) which is frequently due to the presence of enteroinvasive pathogens. Calprotectin and lactoferrin are only markedly elevated prior to and during the active phases of IBD, but not with IBS. Monitoring these levels in patients with IBD can therefore facilitate timely treatment of IBD, and can be ordered separately. Since the vast majority of secretory IgA (sIgA) is normally present in the GI tract, where it prevents binding of pathogens and antigens to the mucosal membrane, it is essential to know the status of sIgA in the gut. sIgA is the only bona fide marker of humoral immune status in the GI tract.

Cornerstones of good health include proper digestion of food, assimilation of nutrients, exclusion of pathogens and timely elimination of waste. To obtain benefits from food that is consumed, nutrients must be appropriately digested and then efficiently absorbed into portal circulation. Microbes, larger-sized particles of fiber, and undigested foodstuffs should remain within the intestinal lumen. Poor digestion and malabsorption of vital nutrients can contribute to degenerative diseases, compromised immune status and nutritional deficiencies. Impairment of the highly specific nutrient uptake processes, or compromised GI barrier function, as in "leaky gut syndrome," can result from a number of causes including:

• Low gastric acid production
• Chronic Maldigestion
• Food allergen impact on bowel absorptive surfaces
• Bacterial overgrowth or imbalances (dysbiosis)
• Pathogenic bacteria, yeast or parasites and related toxic irritants
• The use of NSAIDs and antibiotics

Impairment of intestinal functions can contribute to the development of food allergies, systemic illnesses, autoimmune disease, and toxic overload from substances that are usually kept in the confines of the bowel for elimination. After performing a stool test, efficient remediation of GI dysfunctions incorporates a comprehensive guided approach that should include consideration of elimination of pathogens and exposure to irritants, supplementation of hydrochloric acid, pancreatic enzymes and pre- and probiotics, and repair of the mucosal barrier.

Practical

Practical (add-ons available)

Specimen requirements: STOOL

QUANTITY: Each vial must be filled until the indicated fill line, and must not be filled to the top.

STORAGE: 

Black & Orange capped vials: REFRIGERATE (DO NOT freeze)

White capped vial: FREEZE for at least 6 hours

PLEASE NOTE:

If there are any missing or improperly produced samples, the following options are available:

1. SEND A NEW (COMPLETE) SAMPLE, where the patient/practitioner will be liable for the added shipment costs.

2. REQUEST a downgraded version of the test. The downgraded report will only contain the analytes measured from each vile:

   - BLACK capped vial: parasitology

   - YELLOW/ORANGE capped vial: Bacteria/Yeast Culture & PCR

   - WHITE capped vial: all stool chemistries (acetate, butyrate, calprotectin, elastase, fat stain, lactoferrin, lysozyme, mucus, muscle fibres, occult blood, pH, propionate, RBC, SIgA, valerate, vegetable fibres and WBC.

Once the downgraded version of the test has been requested based on the delivered vials, the invoice price will be adjusted to accommodate the new report. A new order will have to be submitted to receive a full report, as results cannot be transferred between past orders.

The x2 indicates two day collection.

When doing the stool test, you have seven (7) days to collect all the vials from the date you start collecting the first vial.

Taking enzymes will affect the results. We recommend to stop taking digestive enzymes 2 days before starting the test and during the test.

We do allow for patients to take magnesium citrate, Psyllium grain, or prune juice.

Age requirements:

Applicable to all ages. For infants and new-borns, collect from the middle of the stool, not touching the diaper as this will contaminate the sample. The stool needs to be free of urine.

Available add-ons:

• H. Pylori

• Zonulin

• Beta-glucuronidase

Research

Research

Imbalanced flora

Mackowiak PA. The normal microbial flora. N Engl J Med. 1982;307(2):83-93.

Dysbiotic Flora

• Lispki E. Digestive Wellness. New Canaan,CT: Keats Publishing;1996.

• Mitsuoka T. Intestinal Flora and Aging. Nutr Rev 1992;50(12):438-446.

• Murray MT. Stomach Ailments and Digestive Disturbances. Rocklin, CA: Prima Publishing; 1997.

• Pereira SP, Gainsborough N, Dowling RH. Drug-induced Hypochlorhydria Causes High Duodenal Bacterial Counts in the Elderly. Ailment Pharmacol Ther 1998;12(1)99-104.

• Weisburger JH. Tea and Health: The Underlying Mechanisms. Proc Soc Exp Biol Med 1999;220(4):271-275.4.

Beneficial Flora

• Elmer G, Surawicz C, and McFarland L. Biotherapeutic agents - a Neglected Modality for the Treatment and Prevention of Intestinal and Vaginal Infections. JAMA. 1996; 275(11):870-876.

• Fitzsimmons N and Berry D. Inhibition of Candida albicans by Lactobacillus acidophilus: Evidence for Involvement of a Peroxidase System. Microbio. 1994; 80:125-133

• Fuller R. Probiotics in Human Medicine. Gut. 1991;32: 439-442.

• Oksanen P, Salminen S, Saxelin M, et al. Prevention of Travelers’ Diarrhea by Lactobacillus GG. Ann Med. 1990; 22:53-56.

• Percival M. Intestinal Health. Clin Nutr In. 1997;5(5):1-6.

• Perdigon G, Alvarez M, et al. The Oral Administration of Lactic Acid Bacteria Increases the Mucosal Intestinal Immunity in Response to Enteropathogens. J Food Prot. 1990;53:404-410.

• Siitonen S, Vapaatalo H, Salminen S, et al. Effect of Lactobacilli GG Yoghurt in Prevention of Antibiotic Associated Diarrhea. Ann Med. 1990; 22:57-59.

• Valeur, N, et al. Colonization and Immunomodulation by Lactobacillus reuteri ATCC 55730 in the Human Gastrointestinal Tract. Appl Environ. Microbiol. 2004 Feb; 70(2):1176-81.

• Weisburger JH. Proc Soc Exp Biol Med 1999;220(4):271-5.