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Functional Medicine University > Stool Analysis and Interpretation > Flashcards

Stool Analysis and Interpretation Flashcards

1
Q

what can cause leaky gut

A

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

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2
Q

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

A

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

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3
Q

inflammation biomarkers measured on GI panel

A

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

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4
Q

only biomarker of humoral immune status in the GI tract

A

SIgA

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5
Q

functions of bacteria in GI tract

A

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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6
Q

obligate anaerobes (define)

A

bacteria that cannot survive in the presence of oxygen

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7
Q

bacteria that cannot survive in the presence of oxygen

A

obligate anaerobes

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8
Q

what are the obligate anaerobes (3)

A

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

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9
Q

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

A

bacteroides sp.

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10
Q

what are the obligate anerobes (3)

A

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

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11
Q

what is a facultative anaerobes

A

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

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12
Q

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

A

faculatative anaerobes

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13
Q

what are the facultative anaerobes

A

lactobacillus and bifidobacter

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14
Q

lactobacillus and bifidobacter are what type of bacteria

A

facultative

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15
Q

two most common GI tract infections

A

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

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16
Q

4 common bacterial pathogens tested

A

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

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17
Q

H. pylori s/s

A

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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18
Q

cryptosporidium parvum s/s and what it does

A

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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19
Q

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

A

oral cavity and prostate gland

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20
Q

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

A

lungs and conjunctiva of the eyes

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21
Q

where does SCFA come from

A

-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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22
Q

3 main beneficial SCFA (names)

A

acetate
propionate
butyrate

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23
Q

benefits of SCFA

A

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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24
Q

what is the preferred substrate for colonocytes

A

butyrate

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25
Q

benefits of butyrate

A

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

26
Q

how to increase butyrate

A

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

27
Q

what are the 6 gut inflammation markers

A

lactoferrin
WBCs
Mucus
lysozyme
Eosinophil Protein X (EPX)
Calprotectin

28
Q

lactoferrin
WBCs
Mucus
lysozyme
Esinophil protein X (EPX)
Calprotectin

A

6 markers of gut inflammation

29
Q

what does lysozyme do

A

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)

30
Q

what secretes lysozyme

A

granulocytes

31
Q

what do granulocytes secrete and the function

A

lysozyme
anti-bacterial defense of the GI

32
Q

moderate elevations in lysozyme

A

significant overgrowth of pathogens

33
Q

very high levels of lysozyme

A

IBD, Crohns, UC

34
Q

what is lactoferrin and what does it do

A

marker of gut inflammation
iron-binding protein released by neutrophils as antimicrobial mechanism.

released in inflammatory states such as Crohns, IBD, US

35
Q

is lactoferrin increased with IBD

A

yes. but not IBS.

36
Q

is lactoferrin increased with IBS

A

no. but with IBD yes.

37
Q

remedies for noninfectious inflammation

A

tumeric
ginger
fish oils
quercitin
eliminate food sensitivities

38
Q

where do eosinophils reside in a healthy individual? unhealthy?

A

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

39
Q

what inflammatory marker is the test of choice for IBD

A

calprotectin

40
Q

elevated calprotectin levels (50-100mg)

A

inflammation of the GI fract
IBD
infection
polyps
neoplasia
NSAIDs

41
Q

calprotectin >250; above 500?

A

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

42
Q

decreased SIgA lecels associated with

A

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

43
Q

what suppresses SIgA

A

stress
alcohol
anxiety

44
Q

what are things that can normalize depressed SIgA

A

sacchromyces boulardii
L-glutamine

45
Q

use for Anti-gliadin SIgA

A

assessing adherence to diet
strengthening a diagnosis of celiac disease

may also be positive in Crohns, IBS, food sensitivities.

46
Q

high fecal pH risk factor for

A

colorectal CA

47
Q

what to do for low fecal pH (too acidic)

A

address cause of diarrheal syndromes
viral infection
malsabsoprtion
bacterial toxins

48
Q

what to do for high fecal pH (too basic)

A

correct constipation

too much dietary protein
improve transit time
increase fiber

49
Q

increased pH (too alkaline) causes what in the stool

A

constipation

50
Q

decreased pH (too acidic) causes what in the stool

A

diarrhea

51
Q

Testing recommendations for occult blood

A

every other year after yr 50

52
Q

reasons for blood in stool

A

early sign of digestive conditions

polyps
CA
peptic ulcer
IBD
diverticulosis
pancreatitis

53
Q

clay white or tan color stool indications

A

absence of bile (biliary obstruction) or pancreatic insufficiency

54
Q

lack tarry stool indications

A

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

55
Q

red stool indications

A

lower GI bleed or beet ingestion

56
Q

elastase 1

A

pancreatic enzyme
use to test for pancreatic insufficiency

57
Q

what does elastase 1 do

A

breaks down dietary protein into absorbable amino acids

58
Q

elastase 1 decreased in what conditions

A

diabetes
gallstones/post cholecystectomy
osteoporosis
cystic fibrosis

59
Q

what are the two pancreatic markers

A

elastase 1
chymotrypsin

60
Q

abnormally high amounts of putrefactive SCFAs suggest what

A

protein malabsorption

61
Q

how to treat high putrefactive SCAFs

A

pancreatic enzynes
irradicate H pylori

Functional Medicine University (2 decks)

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