When Your Doctor Says You're Fine, Part 2 - Analyzing Stool Test Results
Stool testing is no fun. No fun at all.
So, if you’re going to subject yourself to that kind of torture, you want to make sure your results are actually going to tell you something meaningful!
And unfortunately, most of the stool tests run by conventional gastroenterologists just aren’t that reliable.
That’s why the second part in my series on digging deeper into your health concerns is all about GI stool testing.
In this four-part series, I’m offering you some guidance for when your conventional doctor tells you all your labs look normal, but you’re still not feeling your best.
Sometimes, seeking out alternative testing or solutions to your medical concerns, even when your doctor says you’re fine, can be all you need in order to get over that last roadblock in your healing journey.
If you missed Part 1 of this series on how to analyze your lab ranges, you can read it here.
Functional Stool Testing
Functional stool testing is often times much more accurate than the stool tests your conventional GI doc will give you - which means you’re more likely to actually detect whatever’s in your gut that’s affecting your health.
And as an added bonus, these functional versions can actually give you a peek into the overall health of your gut, not just figure out what’s making you feel sick.
I’ve done more than my fair share of stool tests, and the only ones that have actually uncovered anything of significance were the ones NOT run by my GI doctor.
This doesn’t mean that I don’t go to my gastroenterologist. Not at all. I rely on her services for things like blood work, prescriptions, and diagnostic testing (like endoscopies, or colonoscopies).
Conventional medicine is great, and I’m very thankful it exists, I just think that its strengths lie in areas other than root cause determination - which is the main reason why I would run a stool test in the first place.
Stool testing gives us a very unique look into what is actually going on in our gastrointestinal tract.
The GI tract, for many reasons, is one of the most complex systems in our body.
Not to mention, we don’t know much about how the function of our actual GI tract is affected by factors like our gut bacteria or stress levels.
Which is why getting an accurate and complete look into our gut is so important, and is a huge reason why I’m a proponent of using functional stool testing over conventional.
And there’s a few reasons why.
Functional Testing Can Detect More Things
Typical conventional medicine stool tests (like the ones you would pick up at your gastroenterologist’s office) are only going to check for disease causing pathogens.
These are things like giardia, salmonella, h pylori, and so on.
And if you’re one of the patients whose health is being affected by one of those typical bad guys, there’s absolutely nothing wrong with that.
But, for many of us (myself included) our conventional stool test results will come back squeaky clean, with no pathogens in sight - even though we’re still experiencing GI distress.
Unfortunately, pathogens aren’t the only things that can cause ill health, but they happen to be the only things that conventional stool tests are going to test you for.
Functional stool tests, on the other hand test and report everything they can detect in your stool sample.
That means you’ll get a big picture of not only anything that might be causing your symptoms, but you’ll also know if you have low levels of beneficial bacteria (which is sometimes just as critical to your health!).
And as far as what could be causing your symptoms, there’s actually a good chance that pathogenic organisms aren’t to blame.
For example, at the beginning of 2018, I had a stool test run through my gastroenterologist.
I was having unexplained symptoms of diarrhea, nausea, and stomach pain that I just couldn’t get to the bottom of. In fact, my symptoms were so bad that I had lost so much weight and was so dehydrated that I found myself in the hospital a few days before Christmas.
I was so hopeful that this stool test from my GI doc would uncover what was wrong with me - I had all the symptoms of an h pylori or c diff infection, and I needed to figure out what was making me so sick.
And of course, the stool test came back negative - there was absolutely nothing wrong with me from a gut pathogen perspective.
But, I didn’t stop my search there. A few weeks later I had a functional stool test done (I used GI MAP by Diagnostic Solutions Laboratory), and I had my answer.
I was negative for all of the pathogens (like the conventional stool analysis had showed), but the functional stool test picked up that I had overgrowths of opportunistic parasites Blastocystis hominis and Endolimax nana.
Two parasites that have been studied to cause the exact symptoms I was experiencing!
Because the functional stool test looks for other organisms in your gut besides the typical pathogens, I was able to determine the root cause of my symptoms and get on a path to start feeling better.
Commensal, or opportunistic, organisms in your gut can range from bacteria, to parasites, to fungi, and at low levels generally cause no symptoms.
But when there are co-infections involved (like in my case), or when the levels of these bugs get to certain levels they can start making you feel not so great.
And if you just use the traditional stool testing done at your doctor’s office, you’ll never even know that these guys were hanging out in your gut, potentially as the cause of your symptoms.
And while there is no perfect stool test, functional testing does a great job at giving you a comprehensive snapshot of what’s in your gut. From the good guys keeping you healthy, to the ones that in large numbers or certain varieties can make you sick, functional stool testing is very likely to be able to detect and report them, if they exist.
Functional Testing Uses More Accurate Methods
Along with checking for a wider range of organisms than conventional stool tests, functional testing also uses more accurate and reliable methods for determining if a certain organisms exists in your gut.
Most conventional stool testing is done using microscopy and culturing in order to determine what is in your stool sample.
There are a few reasons why these methods aren’t the most reliable.
First, in order to culture something, it has to be alive.
Culturing works by allowing organisms, like bacteria, to have a hospitable place to live and reproduce. However, if the bacteria in your stool sample isn’t alive at the time of analysis, nothing will grow in the culture, and you’ll get a false negative result.
Second, in order to culture something, it has to actually be present in the sample.
Stool testing is particularly tricky for this reason. You’re taking such a small sample from just one window in time, and using it to explain what’s in your entire gastrointestinal tract.
If the sample that you collected just happened to not contain the one strain of bacteria or the parasite that is making you sick, it won’t show up in the culture, and you’ll get a false negative result.
For these two reasons, I trust the results of functional stool testing a whole lot more.
Functional stool testing most often looks for the organisms DNA or RNA in order to determine if it’s present in your gut.
This means that the organism doesn’t actually have to be alive, or even present, in the sample you send, but as long as it’s left a piece of its DNA behind, we’ll know its there.
Think of it kind of like a forensics unit searching for evidence at a crime scene. Even though the criminal isn’t there anymore (the bacteria or parasite making you sick), if they can find evidence of him being there, like a fingerprint or blood spot (or in our case, DNA or RNA), we can link him to the crime.
And to be even more thorough, some functional stool tests give you the option to submit samples over multiple days.
This greatly increases your chances of catching something that maybe wouldn’t have shown up in the first day’s sample. (This is especially true for certain types of parasites, which can have a cyclical nature to their lifecycle, and won’t show up in your stool at all times.)
So, when you combine the ability of functional stool tests to view a broader range of gut bugs with their superior technology for determining if the organism is present in your intestines, these tests are by far going to give you a more meaningful peek into what’s actually going on in your gut.
If you’ve recently gotten a stool testing done at your doctor’s office, I would highly recommend taking a second look at the lab that ran the test. Check and see if they have a conventional approach, or take a more functional look into your gut.
Especially if your doctor has told you that everything checks out, and there are no imbalances - it’s always worth a second look.
Using functional stool testing over conventional could be the key to getting you to the root cause of your health issues - it sure was for me!
This is why it’s so important to keep searching for those answers to your health concerns - they’re out there, you just have to know where to look.
The Bottom Line
Stool testing is an important diagnostic tool that can give you a great picture into your gut health.
However, simply relying on conventional stool testing, without doing your own research to determine how the lab is analyzing the sample could leave you with some missing pieces to your gut health puzzle.
I recommend using a functional stool test (like GI MAP or Viome) in order to get you the most complete and accurate read on what’s actually going on inside your gut.
These tests are going to be a little pricier than what you’ll get from your GI doc (and most likely won’t be covered by insurance), but if your finances allow, it’s so totally worth it to have a higher degree of certainty that you aren’t missing anything in your gut that could be contributing to your ill health.