GI Map: Testing for Digestive Health

Health starts in the gut.  In addition to processing food, the intestine is particularly important to proper immune system function.  The bacteria in the gut plays a vital role. Billions of bacteria reside in the gut and microbiota or gut flora, which protect the intestine from the growth of fungus and disease-causing germs.  Also, they are essential for the production of vitamins, providing nutrients to the intestinal mucosa, supporting intestinal blood circulation and many other functions.  

Balance of the gut flora is altered due to daily things like an unhealthy diet, stress, overuse of antibiotics, environmental toxins, and other medications.  This leads to multiple symptoms ranging from a feeling of fullness, bloating, constipation, diarrhea, fungal infection, and fatigue. Imbalanced gut flora can also affect weight loss and mood.  

How an Imbalance Gut Affects Health

Dysbiosis is a state of imbalance of the microorganisms on or within the body. Dysbiosis can be triggered by a leaky gut.  While naturally there is some level of permeability in the intestinal membrane to allow for electrolyte flow, water and nutrients into the bloodstream, larger spaces between these junctions allow partially digested foods and toxins to pass. Increased intestinal permeability lets toxins called lipopolysaccharides (LPS) into the blood and triggers systemic inflammation.  Inflammation is one of the most important factors contributing to the state of health and onset and progression of nearly every disease. 

Digestion

Gut microbes help with digestion of much of the food ingested.  They turn food into nutrients, neurotransmitters, vitamins, and hormones.  Through these metabolites, the composition of the gut microbiome influences nearly all metabolic activity.  The gut microbiome act as an organ that is part of the immune system and regulates energy. When imbalanced, certain bacteria work to protect themselves from harsh environments and are less likely to do the job it is supposed to do.  

Nutrient Absorption

Several micronutrient deficiencies are associated with gut barrier function, specifically vitamin A, magnesium, zinc, vitamin D, and calcium.  Vitamin A, zinc, and magnesium all help to maintain the tight junctions, while vitamin D stimulates the intestinal lining to renew and resist damage through modulation of the immune system.  Vitamin D and calcium assist in maintaining the intestinal barrier. Malabsorption caused by dysbiosis or low intake of these protective nutrients can exacerbate leaky gut conditions.  

Weight and Mood 

The gut microbiota talks to the brain through the vagus nerve and influence how often and how much the body feels like eating. The vagus nerve is the direct line of communication between the brain and the gut.   Neurotransmitters that carry these signals are created in the gut and influence ghrelin, leptin and other peptides involved in food intake and energy expenditure. Low microbiome diversity is associated with obesity and metabolic syndrome.   Also, other neurotransmitters like serotonin are affected by gut dysbiosis. Serotonin is the feel-good hormone and acts as both hormone and neurotransmitter. Low moods, depression, and anxiety are associated with altered serotonin levels.  

How can I find out if my gut is causing my symptoms?

If you are experiencing consistent symptoms like bloating, diarrhea, constipation, brain fog, concentration issues, depression, anxiety or weight loss issues, checking the gut is the best way to identify the specific issues causing these symptoms.  Stool testing using the GI-MAP (Gastrointestinal Microbial Assay Plus) test from Diagnostic Solutions provides a comprehensive assessment of GI health. GI-MAP testing uses a single stool sample to identify microbes that may be disturbing normal microbial balance and contributing to illness, digestion and absorption issues, inflammation, and immune function.  The test uses cutting-edge DNA technology to assess bacteria, fungus, viruses, and parasites, which may be affecting normal gut function. It takes the guesswork out of identifying issues, allowing for a comprehensive, personalized treatment plan. 

What does the GI-MAP test assess?

The GI-MAP assesses several biomarkers which contribute to gut dysbioses, like pathogens, bacteria, yeast, and parasites. 

Pathogens

Pathogens are bacteria, parasites, and viruses which commonly cause irritation and inflammation.  Often pathogens exacerbate digestive problems through disruption of the gut microbiota. Some of the pathogens assessed with the GI-MAP are campylobacter, clostridium difficle (c.diff), e.coli, cryptosporidium, and h.pylori.  Campylobacter is a common foodborne illness in the US, contracted through contaminated water or poultry.  Clostridium difficle or c.diff as it is more commonly referred to is a common pathogen caused by the prolonged use of antibiotics.  E. coli comes from fecal contamination of food like undercooked beef, raw milk, and unpasteurized juice and water.  Cryptosporidium is derived from the fecal contamination of ingested foods, and liquids like water and contaminated swimming pools, undercooked meats and are often the cause of traveler’s diarrhea.  Helicobacter pylori (h. pylori) is common throughout the globe, and many carriers have no symptoms.  H.pylori is known to have a role in causing ulcers, gastritis, and even stomach cancer.  Another issue caused by h. Pylori is hypochlorhydria or low stomach acid.  Low stomach acid has a profound effect on the body’s ability to properly ingest and absorb nutrients leading to several chronic health issues.  The GI-MAP test will detect these and many other pathogens indicating levels found showing low, moderate, or high indicators.  

Normal or Commensal Bacteria

Trillions of microorganisms reside in the human intestines making up a complex ecosystem which is important to human health.  Commensal or “normal” bacteria absorb nutrients and energy from the food we eat, help to maintain gut barrier function and produces vitamins like biotin and vitamin K as well as protect against the pathogenic bacteria we encounter.  GI-MAP reports Bacteroides fragilis, Bifidobacterium spp., Enterococcus spp., Escherichia spp., Lactobacillus spp., Clostridium spp. and Enterobacter spp., some names you may recognize from your probiotic’s labels.  Appropriate levels of these bacteria keep the gut healthy. Bacteroidetes and Firmicutes are bacteria that dominate the GI tract.  High levels of Firmicutes and low levels of Bacteroidetes, resulting in a high F/B ratio, have been related to causes of obesity.  

Opportunistic Bacteria 

Opportunistic bacteria refers to those that cause illness and disease in individuals who have a weakened immune system.  Overgrowth and excessive amounts of these bacteria occur when the normal bacteria have become impaired by poor diet, a parasitic infection, or a weakened immune system.  These bacteria escape the gut, wreaking havoc, with intestinal permeability or leaky gut. Some of the oppturnitistic bacteria examined in this test are Bacillus spp., Morganella spp., Staphylococcus spp., and Citrobacter spp.  These bacteria have been cited as triggering autoimmune disorders like thyroiditis and arthritis.  

Fungi/Yeast

While there is a normal level of fungi/yeast present in the body, an overgrowth can cause illness.  Candida albicans, Candida spp., Geotrichum spp. and Microsporidia spp. and more are fungi/yeast examined in the GI-MAP.  Overgrowth in various parts of the GI tract can cause various symptoms like diarrhea, gas, bloating, nausea, as well as other symptoms like eczema, athlete’s foot, thrush, and yeast infections.  

Parasites

Parasites are organisms that feed on a host at the expense of the host. Worms or protozoa can cause imbalance by taking advantage of dysbiosis within the gut.  

Intestinal Health Markers

The GI-MAP identifies four areas within the intestinal health category: digestion, immune response, inflammation, and other GI markers.  Two enzymes, pancreatic elastase, and steatocrit, are assessed in the digestion area. Pancreatic elastase is an essential enzyme for protein digestion and an overall marker for digestive health.  High levels of steatocrit indicate that there is evidence of fat malabsorption and maldigestion. An immune response is evaluated through secretory IgA, a primary immunoglobin in the intestinal mucosa.  This immunoglobin represents a “first line of defense” in response to foreign invaders in the GI and respiratory tract. Besides being a protector, it helps to maintain balance in the microbiome. Another marker for an immune response is anti-gliadin IgA which identifies antibodies to gliadin, a component of gluten.  Elevated anti-gliadin IgA indicate a sensitivity to gluten. Two indicators for inflammation are calprotectin and zonulin. Calprotectin is the gold standard for diagnosis and monitoring of inflammatory bowel disease, is used to distinguish between irritable bowel syndrome and inflammatory bowel disease. Zonulin is a protein that opens the spaces called tight junctions in the gut lining.  This biomarker is used for determining the barrier permeability of the gut. The last biomarkers are used to measure other GI health indicators. Beta-glucuronidase indicates dysbiosis and is produced when toxins are omitted by various bacteria and in those with small intestinal bacterial overgrowth (SIBO). Occult blood fecal immunochemical testing (FIT) directly measures the concentration of hemoglobin in the stool.  Using the antibodies, this method detects lower levels of hemoglobin, eliminating false negatives. Many issues can cause blood in the stool such as hemorrhoids, anal fissures, pathogenic infections like giardia, liver disease, and upper GI infections.  

Why GI-MAP testing is the best option

Testing is necessary to identify dysfunction in the GI tract and to get to the root cause of possible digestion problems and other chronic health conditions.  The GI-MAP test uses one sample, providing an assessment on a wide variety of pathogens and other digestive health markers to help explain the complex issues occurring in the gut.  GI-MAP is an FDA approved test, providing evidence-based results to aid your healthcare provider to build a proper treatment approach to optimal health.  

References

Diagnostic Solutions Laboratory. (n.d.) Interpretive guide – GI-MAP-Unparalleled DNA based stool testing. [PDF].  Retrieved from https://www.diagnosticsolutionslab.com/.  

Evrensel, A., & Ceylan, M. E. (2015). The Gut-Brain Axis: The Missing Link in Depression. Clinical Psychopharmacology and Neuroscience, 13(3), 239–244. doi:10.9758/cpn.2015.13.3.239