The GI MAP was designed to assess the microbiome from a single stool sample, with particular attention to microbes that may be disturbing normal microbial balance and may contribute to perturbations of the gut flora or illness. The panel is a comprehensive collection of microbial targets as well as immune and digestive markers. It screens for pathogenic bacteria, commensal or beneficial bacteria, opportunistic pathogens, fungi, viruses, parasites and certain bacteria linked to specific autoimmune conditions.
Using the latest in DNA technology, the Gastrointestinal Microbial Assay Plus (GI-MAP) provides the most comprehensive window into gastrointestinal health to date. Previous tests have relied on cultures to determine the presence of certain bacteria in the stool. However, a large number of microbial species can’t survive in the presence of excess oxygen, leading to minimal growth on the culture plates. This would lead to skewed representations of the make up of the microbiome. Instead, GI MAP strips down the sample to the genetic level, isolating microbe-specific genes to identify the types and concentrations of a host of organisms.
Not only will it tell us if there are potentially problematic microbes, but is goes so far as to measure the toxins they produce. For example, we all have some degree of H. pylori in our gut. This is normal. It becomes a problem when it is allowed to flourish and begins producing Virulence Factors. GI MAP can determine how much H. pylori is in the gut, as well as measure the presence of cagA and vacA, the virulence factors it may produce. This gives us a clear idea of what intervention is best suited. No other comprehensive stool test I know of includes these markers.
What is also great about this test is it gives a detailed composition of the many beneficial microbes, not just the problematic ones. Because our bacteria are responsible for so many important functions, from vitamin and enzyme production to defense, immunity and metabolism, maintaining adequate populations of the wide range of beneficial species is important. One example of this is the ratio between Bacteroidetes and Firmicutes, two commensal bacteria. It has been found that when the ratio is tipped to heavily favor Firmicutes, a fat-storing state is triggered, leading to obesity. On the other hand, a high Bacteroidetes to Firmicutes ratio promotes a healthy body composition.
In addition to microbes, the GI MAP measures markers for digestion, immune function, inflammation, gliadin sensitivity
Steatocrit and pancreatic elastase are markers to assess digestive capacity. Steatocrit has been used widely since 1981 to detect steatorrhea, or increased fats in the stool, indicating pancreatic insufficiency and small intestinal malabsorption of fats and fat-soluble vitamins A, D, E and K. Pancreatic elastase is an excellent marker of pancreatic enzyme function and can be an indicator of poor digestive capacity or pancreatitis when extremely low.
To screen for Immune Health, the GI MAP measures Secretory Iga, an antibody protein secreted into the gastrointestinal tract as a first line of immune defense against pathogens. This immunoglobulin influences the gut microbiome and helps to maintain barrier function by forming complexes with gut pathogens and allergens. Impairment of secretory IgA may increase the risk of infectious, allergic, and inflammatory diseases of the intestine. Chronic stress may also disrupt levels of sIgA. Elevated levels of sIgA may indicate an activated immune response to chronic infections or inflammatory reactions.
A portion of this immunoglobulin might be directed toward gliadin, the common protein in wheat and other field grass grains. Because gliadin can stimulate intestinal immunity and increase levels of fecal anti-gliadin antibody even when serum concentrations are undetectable, it is often used as marker for non-celiac gluten sensitivity.
Fecal Calprotectin is the most studied marker of gastrointestinal inflammation and the gold standard marker for the diagnosis and monitoring of inflammatory bowel disease (IBD). It is used to discriminate IBD from irritable bowel syndrome (IBS).
Zonulin is a protein released in the gut that regulates the small spaces between cells that make up the lining of the intestines. This intestinal barrier is a critical interface between the lumen of the gut and the rest of the body. Dysfunction of this barrier is believed to initiate immune dysfunction because it allows large, often undigested molecules, toxins and bacteria from the gut to pass into the bloodstream. Intestinal permeability, also known as “leaky gut,” has been associated with inflammatory bowel disease, celiac disease, food allergy, irritable bowel syndrome, critical illness, autoimmune diseases, and obesity and metabolic disease. In many cases, permeability precedes disease.
There is a wealth of knowledge that can be gained by analyzing the contents of our GI tract. While the microbiome is sensitive to external influences and may fluctuate regularly, the brief window provided with the GI MAP provides an accurate representation of our internal composition. Of course, patient history and symptoms must be taken into consideration with this and any other lab work. If you are interested in ordering this test, or know someone with chronic health challenges that may be related to poor gut health, please send me an email.
Please give the office a call if you are interested in ordering the GI MAP.