This is a very non-invasive test that is shipped directly to you and collected in the comfort of your own home. It is then shipped back to the lab for analysis.
The Gastrointestinal Microbial Assay Plus (GI-MAP™) is an innovative clinical tool that measures gastrointestinal microbiota DNA from a single stool sample with state of the art, quantitative polymerase chain reaction (qPCR or real-time PCR) technology. The GI-MAP was designed to detect microbes that may be disturbing normal microbial balance or contributing to illness as well as indicators of digestion, absorption, inflammation, and immune function.
The GI-MAP quantitatively assesses a patients microbiome with attention to bacterial, parasitic, and viral pathogens that can cause disease, disrupt the normal microbial balance, and contribute to chronic GI illness. Diagnostic Solutions Laboratory utilizes proven qPCR technology with high sensitivity and specificity to provide quantitative, accurate, and reliable results.
For Individuals With Symptoms Of:
• Chronic and Acute Gastroenteritis
• IBD-Inflammatory Bowel Disease
• IBS-Irritable Bowel Syndrome
• Autoimmune Disease
• Suspected H. pylori Infection
• Fungal or Yeast Infections
• Bacterial & Parasitic Infections
• Intestinal Permeability
• Viral Pathogens
THE GI-MAP™ INCLUDES THESE ANALYTES:
• Bacterial Pathogens
• Viral Pathogens
• Parasitic Pathogens
• Parasitic Protozoa
• Parasitic Worms
• Normal Bacterial Flora
• Opportunistic Bacteria
• H. pylori with Virulence Factors
• Immune Response
• Antibiotic Resistance Genes
• Add-on option: Zonulin (Leaky Gut marker)
The GI-MAP includes pathogens (bacterial, parasitic, and viral) commonly known to cause intestinal gastroenteritis. It’s important to note that not all individuals with positive findings for pathogens will present with symptoms. Many factors, including the health of the individual, the transient nature of some pathogens, and the presence and expression of virulence factors all contribute to an individual’s symptoms. Toxins are a type of virulence factor produced by certain pathogens. Since GI-MAP is a DNA-based test, results reflect the levels of pathogenic strains carrying the toxin genes, not the levels of any toxins that may be produced.
Sources of Exposure
To effectively treat infections and prevent reinfection, exposure should be identified and eliminated. Most exposure to pathogens occurs via fecaloral transmission, most often due to use of contaminated water sources or improper hand hygiene. This may include drinking contaminated water, eating raw foods washed in contaminated water or harvested (e.g. shellfish) in contaminated water, or improper handwashing. To remove microorganisms from food, the FDA recommends first washing your hands, running cool water over fruits and vegetables, while rubbing or scrubbing, and then letting them dry out before eating. During treatment, consider all possible sources of fecal transmission: romantic partners, children (especially if in diapers or not toilet-trained), sheets, towels, water source to the home, etc…
Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer. Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.
Many bacteria measured on the GI-MAP are considered opportunistic pathogens, as they only cause disease and illness in some individuals, particularly the immune-compromised. Many individuals come into contact with opportunistic bacteria and experience no symptoms. Most sources consider these microbes to be normal in the stool. However, they can cause gastroenteritis and inflammation at high levels in vulnerable patients. Symptoms may include diarrhea, loose stools, abdominal pain, or even constipation. Overgrowth and excessive colonization by opportunistic bacteria may occur when the commensal bacteria are impaired by poor diet, antibiotic use, parasitic infection, or a weakened immune system. When intestinal permeability is present (see zonulin), these microbes could escape the lumen of the gut and infect extraintestinal sites.
Fungal organisms are commonly found in the human digestive tract, but fungal overgrowth can cause illness in susceptible individuals. Fungal growth may be localized in the body. For instance, Candida spp. may be high in the large intestine but normal in the small intestine, and vice versa. In a patient with suspected fungal overgrowth, additional tests may be necessary to understand the complete picture of fungal overgrowth. Urinary D-arabinitol or antibodies to Candida are sometimes used.
• Common Causes of Yeast Overgrowth Include:
» Antibiotic use
» High intake of sugar, starches, and dietary fungi (beer, bread, nuts, cheese, corn)
»Impaired immune function
• Fungi/Yeast Targeted on the GI-MAP
» Candida albicans and Candida spp. – Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue, and muscle or joint pain but evidence is weak.
» Geotrichum spp. – May cause disease in immunosuppressed patients. Low levels may be a dietary artefact; certain strains are used to make soft cheeses.
» Microsporidia spp. – The GI-MAP specifically detects Encephalitozoon intestinalis, which affects the GI. May cause diarrhea and wasting. Can disseminate
Intestinal Health Markers
Pancreatic Elastase 1
Elastase 1 is a digestive enzyme secreted exclusively by the pancreas, giving a direct indication of pancreatic function. Elastase 1 is unaffected by pancreatic enzyme replacement therapy.
• Causes of Low Elastase 1:
» Suppressed pancreatic function
» Hypochlorhydria, especially if H. pylori present
» Cystic fibrosis
» Low levels may be found in vegetarians/vegans
Fecal fats are normally emulsified by bile salts and absorbed in the small intestines. High levels of fat in the stool may be an indication of maldigestion, malabsorption, or steatorrhea.
Causes of Elevated Steatocrit:
» Pancreatic insufficiency (see elastase-1)
» Bile salt insufficiency
» Improper mastication
» Celiac disease