Unpacking your Irritable Bowel
IBS affects over 20% of Australians with a long list of all too familiar and awkward symptoms that include abdominal pain, cramping or discomfort, bloating, diarrhoea and/ or constipation, mucus, excess wind, and indigestion. Only recently have we begun to unpack the mysteries of IBS. Whilst we don't yet know exactly what causes it, a number of causal factors have been put forward, which range from genetics, the immune system, the microbiome and infections, to diet, stress and even mental health. Since many gut disorders have similar symptoms to IBS, ruling out a more serious underlying gut disease is an important first step in troubleshooting the irritable bowel.
What we test
Faecal Macroscopy
Macroscopy looks at stool colour and formation, as well as for evidence of mucous or blood which may require further investigation.
Brown is the colour of normal stool. Other colours may indicate abnormal gastrointestinal conditions.
A formed stool is considered normal. Variations to this may indicate abnormal gastrointestinal conditions.
Mucous production may indcate the presence of an infection, inflammation or malignancy.
This test is used to detect bleeding in the digestive tract, and is used in Australia's National Bowel Screening program. This test can detect tiny traces of blood in the stool, and can indicate the presence of disease at a relatively early stage when stools may appear normal.
Digestive & Metabolic Markers
Microscopy is performed for detection of blood cells which may indicate infections or inflammation, as well as markers of maldigestion. The presence of food remnants may indicate poor digestion from too little gastric acid or reduced output from the pancreas.
Imbalances in gut pH influence short chain fatty acid production and their effect.
The presence of red blood cells in the stool may indicate the presence of an infection, inflammation or haemorrhage.
The presence of white blood cells in the stool may indicate the presence of an infection, inflammation or haemorrhage.
The presence of food remnants may indicate maldigestion.
The presence of meat fibres may indicate maldigestion from too little gastric acid or reduced output from the pancreas.
The presence of vegetable fibres may indicate maldigestion from gastric hypoacidity or diminished pancreatic output.
Too much fat in your faeces is called steatorrhoea which can be a sign of malabsorption. This means your body either isn’t absorbing nutrients properly or isn’t making the enzymes or bile needed to digest food effectively.
The presence of starch grains may indicate carbohydrate maldigestion.
PCR Test - Bacteria
Technology for detecting parasites and other pathogens has improved dramatically since 2013. This PCR (polymerase chain reaction) test looks for the genetic fingerprint of a wide range of pathogens. This is a far more sensitive test than the old fashioned technique of looking through a microscope.
Salmonella infection usually results from ingestion of the bacteria from contaminated food, water or hands. Eggs, milk, meat or poultry are particularly high risk foods.
Campylobacter infection (campylobacteriosis) is a bacterial infection which most commonly causes gastroenteritis (also known as 'gastro') but may also cause illness affecting the entire body.
Shigella infection (shigellosis) is a type of gastroenteritis caused by Shigella bacteria. The symptoms of Shigella infection include fever, diarrhoea, (sometimes with blood and mucous), vomiting and stomach cramps.
This infectious bacteria can cause gastroenteritis and symptoms beyond the gut. Symptoms include diarrhoea, nausea, vomiting, fever and abdominal pain. It can mimic appendicitis or Crohn's disease.
Aeromonas are bacteria that can cause an acute diarrhoeal illness that normally clears without treatment. It is a fairly common cause of gastroenteritis, which occurs most often throughout the warm summer months in most countries.
PCR Test - Parasites
Technology for detecting parasites and other pathogens has improved dramatically since 2013. This PCR (polymerase chain reaction) test looks for the genetic fingerprint of a wide range of pathogens. This is a far more sensitive test than the old fashioned technique of looking through a microscope.
Symptoms of Giardia infection can occur with 3 to 25 days and may include diarrhoea, nausea, vomiting, pale greasy foul-smelling stools, stomach cramps, passing excess gas, bloating, weight loss and fatigue.
Cryptosporidium is a microscopic parasite that causes the diarrhoeal disease cryptosporidiosis. Both the parasite and the disease are commonly known as "Crypto."
The bacteria can be present in the gut for months or year and misdiagnosed as IBS. Infection can cause diarrhoea, abdominal pain and cramping, anal itching, nausea, loss of appetite, headache, dizziness, depression, weight loss and fatigue.
Amoebiasis is a parasitic disease (also known as amoebic dysentery) caused by infection with Entamoeba histolytica or another amoeba (for example, E. dispar). The disease may not cause symptoms in most individuals.
Some research suggests that people with IBS may be more likely to have Blastocystis hominis organisms in their stool.
Ova, Cysts and Parasites
This microscopic evaluation is used to look for parasites that have infected the lower digestive tract. The parasites, or their eggs or cysts can be detected under the microscope.
The ova refers to the eggs of the parasite which are visible under a microscope. The majority of people who are infected by gut parasites become infected by drinking water or eating food that has been contaminated with the parasite eggs.
Refers to the cellular form of a parasite that has a thick cell wall which allows for survival of the parasite in the environment and transmission into an uninfected host.
Parasites that have infected the lower digestive tract are shed into the stool.
Beneficial Bacteria
Significant numbers of bacteria are normally present in the healthy gut. Lactobacilli and Bifidobacteria in particular, are essential for gut health because they help to inhibit gut pathogens and carcinogens, control pH, reduce cholesterol and synthesise vitamins.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Bifidobacteria are considered "friendly” bacteria that are found in fermented foods like yogurt and cheese, and are used in probiotics. The gut needs these bacteria to perform several jobs, including breaking down foods, taking in nutrients, and preventing overgrowth of "bad” pathogenic bacteria.
Most E. coli strains are harmless and play an essential role in keeping the digestive system healthy, helping to digest food and producing Vitamin K. However, some E. coli bacteria are pathogenic and can cause disease.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Lactobacilli and Bifidobacteria are essential for gut health because they prevent overgrowth of gut pathogens, and contribute to managing intestinal pH, cholesterol, and synthesis of vitamins and disaccharidase enzymes.
Together with other healthy bacteria and fungi, enterococci work to keep unhealthy (pathogenic) bacteria from flourishing and helps to restore the balance of the microbiome.
Opportunistic Bacteria
Our gut bacteria can be divided into ‘bad’ and ‘good’. The good ones for the most part benefit us, whreas the bad 'pathogenic' ones can cause disease. Pathogens are usually present in small quantities in the microbiome, however in excessive amounts they can have adverse effects on the body. The beneficial bacteria of the microbiome have a protective function against colonisation by pathogenic bacteria.
Pseudomonas is found in water and soil as well as fruits and vegetables, and is considered an opportunistic pathogen.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
Enterococcus species are part of normal flora in the human gut, but can however be implicated in a variety of infections of which urinary tract infections are the most common.
Most E. coli strains are harmless and play an essential role in keeping the digestive system healthy, helping to digest food and producing Vitamin K. However, some E. coli bacteria are pathogenic and can cause disease.
There are 14 species in the genus, although only E. cloacae has been associated with gastrointestinal infection.
There are 14 species in the genus, although only E. cloacae has been associated with gastrointestinal infection.
Yeasts
This test looks for evidence of candida or other yeast overgrowth. Whilst yeasts are a normal inhabitant of the gastrointestinal tract, they may become an opportunistic pathogen after disruption of the mucosal barrier, imbalance of the normal intestinal flora or impaired immunity. This can be caused by things like antibiotics, antacids and stress.
Candida albicans is the main type of yeast which colonises the human body. It normally lives in the gastrointestinal tract and other areas of the body without causing problems, but imbalance in the microbiome can lead to overgrowth.
Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now one of the leading causes of invasive candidal disease.
Candida glabrata is an opportunistic yeast pathogen that has adapted to colonise all segments of the human gastrointestinal tract.
Geotrichum yeasts can be found in soil, dairy products and in human skin and mucosae, and are usually only considered an opportunistic pathogen in immune-compromised hosts. Geotrichum may play a role in IBS.
A common environmental yeast which is not considered pathogenic in nature. These yeasts are ubiquitous in the environment and can be found on fruits, vegetables and other plant materials.
Whilst yeasts are a normal inhabitant of the gut, they may become an opportunistic pathogen after disruption of the mucosal barrier, imbalance of the normal intestinal flora or impaired immunity. This can be caused by things like antibiotics, antacids and stress.
Gut Inflammation
These tests are used to detect inflammation in the body, which may be caused by Inflammatory Bowel Disease (such as Crohn's or ulcerative colitis).
This protein is released into the stool when the intestinal lining is damaged. It's usually very high in cases of Inflammatory Bowel Disease (such as Crohn's or ulcerative colitis), and low in IBS. Calprotectin is also elevated with gut infections and colon cancers.
A high-sensitivity C-reactive protein (hs-CRP) test measures low levels of CRP and may be used to help evaluate an individual for risk of cardiovascular disease
Coeliac Marker (tTGA)
People with coeliac disease who eat gluten have higher than normal levels of tissue transglutaminase antibodies in their blood. These antibodies are produced by the immune system because it views gluten - the proteins found in wheat, rye and barley - as a threat. This gluten intolerance test is positive in about 98% of patients with coeliac disease who are on a gluten-containing diet.
The tTg antibodies test is the most sensitive and specific gluten intolerance test for coeliac disease. This tTG blood test can also be used to help evaluate the effectiveness of treatment as antibody levels should fall when gluten is removed from the diet.
Nutrient Malabsorption
If the intestines can't absorb nutrients then they are eliminated from the body in the stool. This can happen when there's damage to the intestine, as well as the amount of time available where nutrients can be absorbed from food as it passes through the gut.
Ferritin is a marker of iron stores in the body, and is used to assess iron status. Low levels can indicate iron deficiency, which is a common nutritional deficiency that can lead to anaemia, fatigue, and impaired immune function.
A measure of all of the proteins in the plasma portion of your blood. Proteins are important building blocks of all cells and tissues - they are important for body growth and health.
Calcium is important in building strong bones and teeth, but it also plays a key role in other functions including muscle contraction, nerve function, blood clotting, and enzyme function.
Corrected calcium adjusts for changes in serum albumin levels, providing a more accurate measure of the biologically active form of calcium, and is therefore a better reflection of the body's calcium status.
Magnesium and calcium work together closely to maintain strong bones, and magnesium deficiency has been associated with an increased risk of osteoporosis.
Phosphate is a mineral which is essential for the formation of bones and teeth. It is also essential for many other cellular processes including energy metabolism and the formation of DNA and RNA.
Triglycerides are the main storage form of fatty acids in the body and a source of energy. High levels of triglycerides are associated with cardiovascular disease, obesity, type 2 diabetes, and metabolic syndrome.
Pancreatic Function
Proteins, fats, and carbohydrates are broken down by stomach acids, enzymes produced by the pancreas, and bile from the liver. This process also releases micronutrients. This blood test measures the levels of enzymes produced by the pancreas.
An enzyme produced by the pancreas which is released into the digestive tract to help digest fatty foods.
An enzyme made mainly by the pancreas which is released from the pancreas into the digestive tract to help digest starch in our food.
Liver Function (LFTs)
Your liver processes drugs and alcohol, filters toxic chemicals, stores vitamins and minerals, and makes bile, proteins and enzymes. This liver function test examines enzymes and other markers for evidence of damage to your liver cells or a blockage near your liver which can impair its function.
Bilirubin tests are use to screen for or to detect and monitor liver disorders or haemolytic anaemia.
Alkaline phosphatase (ALP) is an enzyme located mainly in the liver and the bones. High levels can indicate liver disease.
Aspartate aminotransferase (AST) is an enzyme created mainly by the liver and the heart. High levels can indicate damage to your liver caused by alcohol, drugs or hepatitis.
Alanine aminotransferase (ALT) is an enzyme mainly produced by the liver. A good indicator of liver damage caused by alcohol, drugs or hepatitis.
Gamma-glutamyl transferase (GGT) is a liver enzyme which can be used to diagnose alcohol abuse as it is typically raised in long term drinkers.
Albumin is a protein which keeps fluid from leaking out of blood vessels, nourishes tissues, and carries hormones, vitamins, drugs, and ions like calcium throughout the body. Low levels can indicate malnutrition or other health problems.
A measure of all of the proteins in the plasma portion of your blood. Proteins are important building blocks of all cells and tissues - they are important for body growth and health.
Any of a group of simple proteins found in the blood.
Kidney Function
This panel of tests is used to detect electrolyte imbalances that could be impacted by malabsorption and diarrhoea.
Sodium is important for maintaining fluid balance in the body and for proper nerve and muscle function.
Potassium is important for nerve and muscle function, including regulating heart rhythm, and is also involved in fluid balance.
Chloride is important for maintaining fluid balance and for the proper functioning of the digestive system.
Higher than normal levels suggests trouble maintaining pH balance either by failing to remove carbon dioxide or because of an electrolyte imbalance. Elevations may be seen with severe vomiting, chronic lung problems and some hormonal disorders. Low levels may be seen with chronic diarrhoea, diabetic ketoacidosis and kidney failure.
A high concentration of this waste product can indicate dehydration or that your kidneys aren’t working properly.
A waste molecule generated from muscle metabolism, and an accurate marker of kidney function.
The estimated glomerular filtration rate (eGFR) measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function.
Test instructions
This test includes both a blood test and stool test. For the blood test, take your form to one of our affiliated collection centres for your blood draw.
Fast from all food and drink (other than water) for at least 8 hours, and no more than 12 hours prior to your test.
Your test kit for your stool sample and all instructions are posted directly to you.
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