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.

This macroscopy test measures

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.

This microscopy test measures

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.

Digestive and Absorption Markers
This blood test measures:

Chymotrypsin is a pancreatic enzyme involved in protein digestion. Low levels of chymotrypsin may indicate protein maldigestion due to pancreatic insufficiency.

Putrefactive SCFAs are produced when anaerobic bacteria ferment undigested protein, indicating protein maldigestion.

Pancreatic Elastase is used to assess pancreatic exocrine function and levels reflect the activity of the pancreatic enzymes trypsin, chymotrypsin, amylase and lipase.

Elevated levels of LCFAs in the stool may indicate inadequate lipid absorption.

Metabolic Markers
This blood test measures:

Increased levels of b-Glucuronidase may reverse the effects of Phase II detoxification processes.

SCFAs are molecules produced by bacteria when they ferment dietary components (primarily fibre: non-digestible carbohydrates) inside the colon.

Decreased Butyrate levels may indicate inadequate colonic function.

Decreased Acetate levels may indicate inadequate colonic function.

Decreased Propionate levels may indicate inadequate colonic function.

Valerate is a poorly studied metabolite, but it has been shown to inhibit growth of cancerous cells and to prevent vegetative growth of Clostridioides difficile.

Inflammation Markers
This blood test measures:

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.

There is increasing evidence that eosinophils are functionally involved in the pathophysiology of various inflammatory disorders of the gut.

Faecal secretory IgA (sIgA) is secreted by mucosal tissue and represents the first line of defence of the GI mucosa and is central to the normal function of the GI tract as an immune barrier.

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.

Tumour/ Ulcer Markers
This blood test measures:

M2-PK is the key regulator of tumour metabolism and its measurement in faeces identifies gastrointestinal tumours, even in the absence of gastrointestinal bleeding.

A positive test result indicates the presence of a current infection and is not affected by the presence of other organisms, antacids, barium sulphate, blood or fat.

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.

This stool test measures

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.

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.

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.

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.

Potentially Pathogenic Bacteria

This panel also looks for evidence of other bacteria which may be pathogenic in nature, such as Citrobacter and Klebsiella.

This stool test measures

Klebsiella forms part of the normal gut flora in small numbers, but can be an opportunistic pathogen

Citrobacter is considered an opportunistic pathogen and therefore can be found in the gut as normal flora. It is occasionally implicated in diarrhoeal disease, particularly C. freundii, C. diversus and C. koseri.

Pseudomonas is found in water and soil as well as fruits and vegetables, and is considered an opportunistic pathogen.

Part of the normal flora of the gastrointestinal tract, though has been shown to be an independent causative agent of intestinal disorders. May also play a role as an opportunistic organism in enteric infection due to other pathogens. Food has been implicated as a vehicle of infection.

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.

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.

Streptococcus is common in the gut flora. With the exception of very rare cases, streptococcus species are not implicated in gastric disease.

Yersinia infection (yersiniosis) is a bacterial infection of the bowel (intestine). It occurs worldwide, but is fairly uncommon. Many domesticated and wild animals carry Yersinia in their intestines, and spread to people occurs by eating food or water contaminated by infected faeces.

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.

Other bacteria tested for include alpha-haemolytic Streptococcus, gamma-haemolytic Streptococcus, Pseudomonas species, Pseudomonas stutzeri, Bacillus species, Citrobacter amalonaticus, and Klebsiella pneumoniae

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.

This stool test measures

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.

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.

Parasites

Some gut problems can be a consequence of an undetected gut infection. A significant number of IBS (irritable bowel syndrome) cases could actually be due to undiagnosed gut parasites such as Blastocystis hominis and Dientamoeba fragilis.

This stool test measures

Cryptosporidium is a microscopic parasite that causes the diarrhoeal disease cryptosporidiosis. Both the parasite and the disease are commonly known as "Crypto."

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.

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.

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.

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