Stool Analysis and Interpretation Flashcards by Maddy Meyer

what can cause leaky gut

-low gastric acid
-chronic maldigestion
-food allergies
-SIBO/bacterial overgrowth
-pathogenic bacteria
-yeast
-parasites
-toxic irritant
-NSAIDS
-antibiotics

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information regarding the efficiency of digestion and absorption can be gleaned from measurement of these fecal levels

-elastase (pancreatic exocrine sufficiency)
-muscle and vegetable fibers
-carbohydrates
-steatocrit (% total fat)

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inflammation biomarkers measured on GI panel

lysozyme
lactoferrin
eosinophil protein X (EPX)
white blood cells
mucus

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only biomarker of humoral immune status in the GI tract

SIgA

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functions of bacteria in GI tract

ferment unused energy
communicate with immune system
prevent growth of harmful substances
regulate gut development
produce vitamins (biotin and K)
produce hormones to store fat

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obligate anaerobes (define)

bacteria that cannot survive in the presence of oxygen

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bacteria that cannot survive in the presence of oxygen

obligate anaerobes

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what are the obligate anaerobes (3)

(cannot survive in oxygen)
-bacteroides
-fusobacteria
-clostridia
(prevotella, streomyces, mycoplasma alt.)

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what is the most abundant anaerobe known for ability to metabolize polysaccharies into SCFA–the main colonic fuel source?

bacteroides sp.

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what are the obligate anerobes (3)

(cannot survive in oxygen)
-Bacteroides
-fusobacteria
-clostridia
(prevotella, streomyces, mycoplasma alt.)

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what is a facultative anaerobes

makes ATP by aerobic respiration if oxygen is present but can swtich to fermentation in the absence of oxygen

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name of category that makes ATP by aerobic respiration if oxygen present but can switch to fermentation in the absence

faculatative anaerobes

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what are the facultative anaerobes

lactobacillus and bifidobacter

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lactobacillus and bifidobacter are what type of bacteria

facultative

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two most common GI tract infections

Helicobacter pylori (stomach, esophagus and upper duodenum), and cryptosporidium parvum (parasite in SI)

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4 common bacterial pathogens tested

H. pylori
C. difficile
Campylobacter
E.H.E Coli

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H. pylori s/s

stomach ulcers
acid reflux
burping/belching
upper GI distress
stomach CA

can be hard to irradicate and can produce a toxin that disables the body’s immune rnx against it!

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cryptosporidium parvum s/s and what it does

high fever, severe diarrhea, death or none at all
damages the microvilli of the SI and inhibits absorption of nutrients and compromises the mucosal barrier defenses weaking body against other infectious agents.

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where else can H pylori be found other than GI (hence important to use microbiology and immunological assays)

oral cavity and prostate gland

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where else can cryptosporidium parvum be found other than GI (hence important to use microbiology and immunological assays)

lungs and conjunctiva of the eyes

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where does SCFA come from

-dietary carbs that escaped digestion/absorption in the small bowel
-prebiotics that underwent fermentation in the colon
-fermentation of fiber by anaerobic bacteria in the large bowel

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3 main beneficial SCFA (names)

acetate
propionate
butyrate

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benefits of SCFA

energy for colonocytes/nutrition for intestinal lining
remove sodium and water from colon (anti-diarrheal)
enhance growth of lacto. and bifido.
improve GI barrier
lower ammonia uptake from intestine
stabilize blood sugar
suppress cholesterol synthesis
lower colonic pH (protects lining)
stimulate production of cytokines
enhance apoptosis of tumor cells

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what is the preferred substrate for colonocytes

butyrate

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benefits of butyrate

prevent colon CA (by stimulating healthy cellular growth and reducing DNA damage)

how to increase butyrate

increase fiber intake larch arabinogalactans normalize pH normalize transit time pre and probiotics (fructooligosaccharides) Butyric acid (oral or rectal)

what are the 6 gut inflammation markers

lactoferrin WBCs Mucus lysozyme Eosinophil Protein X (EPX) Calprotectin

lactoferrin WBCs Mucus lysozyme Esinophil protein X (EPX) Calprotectin

6 markers of gut inflammation

what does lysozyme do

enzyme that catalyzes hydrolysis of specific glycosidic bonds in mucopolysaccharides that make up the cell wall of gram-positive bacteria (aka anti-bacterial defense of the GI)

what secretes lysozyme

granulocytes

what do granulocytes secrete and the function

lysozyme anti-bacterial defense of the GI

moderate elevations in lysozyme

significant overgrowth of pathogens

very high levels of lysozyme

IBD, Crohns, UC

what is lactoferrin and what does it do

marker of gut inflammation iron-binding protein released by neutrophils as antimicrobial mechanism. released in inflammatory states such as Crohns, IBD, US

is lactoferrin increased with IBD

yes. but not IBS.

is lactoferrin increased with IBS

no. but with IBD yes.

remedies for noninfectious inflammation

tumeric ginger fish oils quercitin eliminate food sensitivities

where do eosinophils reside in a healthy individual? unhealthy?

connective tissue layer of the gut (lamina propria) move to gut lumen (when damage to lamina propria)

what inflammatory marker is the test of choice for IBD

calprotectin

elevated calprotectin levels (50-100mg)

inflammation of the GI fract IBD infection polyps neoplasia NSAIDs

calprotectin >250; above 500?

250: for patients with IBD suggests low to moderate disease activity 500+: for IBD suggests high disease activity. for those with IBD in remission, above 250 has high risk for relapse within the year

decreased SIgA lecels associated with

increased absorption of fod protein antigens lowered resistance to intestinal infection ( ie yest) increased risk for adhesion and proliferation of pathogens atopic dermatitis dysbiosis

what suppresses SIgA

stress alcohol anxiety

what are things that can normalize depressed SIgA

sacchromyces boulardii L-glutamine

use for Anti-gliadin SIgA

assessing adherence to diet strengthening a diagnosis of celiac disease may also be positive in Crohns, IBS, food sensitivities.

high fecal pH risk factor for

colorectal CA

what to do for low fecal pH (too acidic)

address cause of diarrheal syndromes viral infection malsabsoprtion bacterial toxins

what to do for high fecal pH (too basic)

correct constipation too much dietary protein improve transit time increase fiber

increased pH (too alkaline) causes what in the stool

constipation

decreased pH (too acidic) causes what in the stool

diarrhea

Testing recommendations for occult blood

every other year after yr 50

reasons for blood in stool

early sign of digestive conditions polyps CA peptic ulcer IBD diverticulosis pancreatitis

clay white or tan color stool indications

absence of bile (biliary obstruction) or pancreatic insufficiency

lack tarry stool indications

upper GI bleeding high intake of dark green veggies, red meat or iron

red stool indications

lower GI bleed or beet ingestion

elastase 1

pancreatic enzyme use to test for pancreatic insufficiency

what does elastase 1 do

breaks down dietary protein into absorbable amino acids

elastase 1 decreased in what conditions

diabetes gallstones/post cholecystectomy osteoporosis cystic fibrosis

what are the two pancreatic markers

elastase 1 chymotrypsin

abnormally high amounts of putrefactive SCFAs suggest what

protein malabsorption

how to treat high putrefactive SCAFs

pancreatic enzynes irradicate H pylori