GI-MAP Interpretive Guide by Diagnostic Solutions
StoolPerformed by: Diagnostic Solutions Laboratory
GI-MAP Result Interpretation - How To Interpret The GI MAP Stool Test
Overwhelmingly, research indicates that gut health impacts overall health. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic and neuroendocrine functions. Assessing GI health with the proper tools can help practitioners get to the root cause of chronic illness.
The GI-MAP is unique in the field of comprehensive stool testing. It relies exclusively on quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria and fungi by targeting the specific DNA of the organisms tested.
Who Should Have the GI-MAP Comprehensive Stool Analysis Done?
Almost every patient can benefit from a GI-MAP gut health assessment. Some patients are looking to achieve optimal health, while other patients have been chronically ill and frustrated without a diagnosis for years.
Some conditions that warrant testing are:
- Autoimmune diseases
- IBS/IBD
- Digestive complaints, diarrhea or constipation
- Brain fog
- Skin problems, like acne and psoriasis
- Mood disorders, depression, and anxiety
- Diabetes and weight loss issues
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 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.
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Biomarkers included in this panel:
Genes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with tetracycline resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic re
Learn moreAdenovirus serotypes 40 and 41 cause acute gastroenteritis (inflammation of the stomach and intestines) primarily in children.
Learn moreGenes associated with tetracycline resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic re
Learn moreAkkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Learn moreThe GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re
Learn moreThe distribution of hookworm (Necator americanus and Ancylostoma duodenale) is worldwide, with particular prevalence in rural areas of the moist tropics where there is inadequate sanitation and people walk barefoot. The two species produce indis
Learn moreAntigliadin antibodies (AGAs) are antibodies of the IgA and IgG classes found in the serum of celiac disease patients. These antibodies mainly target gliadin-derived peptides, which are the main proteins of gluten. AGAs are not specific for celiac di
Learn moreAscaris lumbricoides, an intestinal roundworm, is one of the most common helminthic human infections worldwide. Ascaris lumbricoides is the largest intestinal nematode of man. The female worms are larger than the males and can measure 40 cm in len
Learn moreBeta-glucuronidase is an enzyme that breaks the tight bond between glucuronic acid and toxins in the intestines. The liver and intestine bind toxins, steroid hormones and some dietary components to glucuronic acid. That is a protective process that l
Learn moreBacillus spp. are spore forming bacteria, ubiquitous in the environment. B. cereus in particular is a frequently recognized cause of toxin-induced acute gastroenteritis. Other infections caused by this genus include: - sepsis
Learn moreGram-negative species of the Bacteroidetes phylum. Immune-modulating normal gut species. Believed to be involved in microbial balance, barrier integrity, and neuroimmune health (Hsiao 2013). High levels may result from reduced digestive capacity or c
Learn moreBacteroidetes are the most prominent gut microbes in much of the world. They are thought to help protect against obesity because they do not digest fat well.
Learn moreGram-positive genus in the Actinobacteria phylum. Present in breast milk. Colonizes the human GI tract at birth. Common in probiotics. Thrives on a wide variety of prebiotic fibers.
Learn moreBlastocystis hominis is found throughout the world in both people with and without symptoms. It is a non-pathogenic parasite. Non-pathogenic parasites are present in the gastrointestinal tract and generally are self-limiting and do not cause illness.
Learn moreC. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use). C. difficile produces two toxins: - Toxin A is a ti
Learn moreC. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use). C. difficile produces two toxins: - Toxin A is a ti
Learn moreCalprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool
Learn moreWhen people worry about eating undercooked chicken, they usually focus on getting sick from salmonella bacteria. But another common type of bacteria called campylobacter can also make you ill if you eat poultry that isn’t fully c
Learn moreCommensal 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
Learn moreCommensal 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
Learn moreChilomastix mesnili is a nonpathogenic flagellate that is often described as a commensal organism in the human gastrointestinal tract.
Learn moreGram-negative bacteria in the Proteobacteria phylum.
Learn moreGram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity. Autoimmune Association: Rheumatoid arthritis
Learn moreThe GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re
Learn moreMarkers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.
Learn moreCryptosporidium is notorious for being spread by swimming pools. A number of Cryptosporidium outbreaks have occurred after contamination of public swimming facilities. Cryptosporidium can cause gas, bloating, diarrhea, and abdominal pain. In a health
Learn moreThis parasite causes an intestinal infection called cyclosporiasis.
Learn moreEpidemiology: - Herpes virus that has infected 60% of the US population - One in three children have contracted CMV by five years old - Passed around in child daycare centers
Learn moreDesulfovibrio is a genus of gram-negative sulphate-reducing bacteria. This genus has been positively correlated to IBD, colorectal cancer (in animal model), ulcerative colitis, liver disease and autism. Desulfovibrio spp. is predominant member of
Learn moreDientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.
Learn morePancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Learn moreEpidemiology: - Fecal contamination of food or water Clinical Implications: - Considered non-pathogenic; individuals may be asymptomatic - May be indicative of dysbiosis, conservative treatment may be indicated if clinical presentat
Learn moreEntamoeba coli are intestinal amebae that are found in the large intestine. They generally are not considered pathogenic. However, when these amebae are found in stool samples it can indicate the presence of other potentially pathogenic organisms.
Learn moreEntamoeba histolytica is a disease-causing parasite that can affect anyone, although it is more common in those who lived or travelled in tropical areas with poor sanitary conditions. Diagnosis can be difficult since, under a microscope, it look
Learn moreGram-negative genus in the Proteobacteria phylum. Closely related to E. coli (in the same taxonomic family). High levels may indicate increased intestinal inflammatory activity. Low levels may indicate reduced mucosal health.
Learn moreGram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.
Learn moreGram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.
Learn moreGram-positive genus of lactate-producing bacteria in the Firmicutes phylum. High levels may be due to reduced digestive capacity, constipation or small intestinal bacterial overgrowth. Low levels may indicate insufficiency of beneficial bacteria.
Learn moreWhat is enterohemorrhagic E. coli? Escherichia coli (or simply E. coli) is one of the many groups of bacteria that normally live in the intestines of healthy humans and most warm-blooded animals. E. coli bacteria help maintain the balance of norma
Learn moreEosinophil Activation Protein (EDN/EPX) is a protein released by activated eosinophils which has strong cytotoxic characteristics. Cytotoxic means that a substance or process can damage cells or cause them to die. "Cyto"
Learn more- One of the most common viruses worldwide; infects 90–95% of the population - Commonly contracted in childhood and causes mild symptoms
Learn more- Gram-negative genus in the Proteobacteria phylum. - Normal gut flora. - Escherichia coli (E. coli) is the primary species in this genus. - Most E. coli are nonpathogenic (pathogenic E. coli strains are measured separately).
Learn moreFaecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintain
Learn moreGram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.2 An abnormal result in one or both of these phylum suggest imbalanced normal mic
Learn moreAn abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract. Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth,
Learn moreThe GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re
Learn moreAutoimmune Association: Systemic sclerosis or inflammatory bowel disease.
Learn moreMay cause disease in immunosuppressed patients. Low levels may be a dietary artefact; certain strains are used to make soft cheeses.
Learn moreGiardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States.
Learn moreGluten Peptide
Fecal gluten monitoring is an important tool to: - Quantitively evaluate amount of gluten peptide in stool for accurate assessment of potential exposure - Monitor adherence to gluten-free diet for anyone aiming to follow a GF lifestyle - Mon
Learn moreGenes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreGenes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic
Learn moreHelicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect your stomach. Helicobacter pylori has been evolving with human beings for well over 50,000 years, since they migrated out of Africa. H. pylori colonization
Learn moreGram-negative bacteria in the Proteobacteria phylum. Common residents of the oral cavity and respiratory tract. May cause diarrhea, gas, abdominal pain, and bloating; Common after long-term antibiotic use; May release histamine in the gut; High level
Learn moreKlebsiella species are gram-negative bacteria normally found in the intestinal tract that are associated with a wide range of small intestinal disorders including: - alterations of motility, - diarrhea, - gas, - abdominal pain, - and b
Learn moreGram-positive genus of lactate-producing bacteria in the Firmicutes phylum. Many strains used as probiotics.
Learn moreBacterial species in the Actinobacteria phylum. Higher levels have been associated with Crohn’s disease and rheumatoid arthritis.
Learn moreFamily of bacteria-like microbes that produce methane. Facilitates carbohydrate fermentation and short-chain fatty acid production by beneficial bacteria. High levels linked to chronic constipation, as well as some types of SIBO and IBS. Low levels m
Learn moreGram-negative group in the Proteobacteria phylum. May produce histamine. High levels may indicate increased intestinal inflammatory activity. High levels may cause diarrhea, and may also be associated with SIBO.
Learn moreHookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species.
Learn moreNorovirus GI & GII, or Norwalk virus, is the most common cause of non-bacterial gastroenteritis in the world. It is widely known for causing the stomach flu on cruise ships. Three genotypes of this diverse virus, GI, GII, and GIV, can infect
Learn moreThe fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visi
Learn moreGenes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res
Learn moreGenes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res
Learn moreGenes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res
Learn moreEpidemiology: Fecal contamination of food or water Clinical Implications: - Considered harmless, a non-pathogen - Infected individuals are usually asymptomatic - May contribute to dysbiosis - Also colonizes dogs, cats, and other ani
Learn morePrevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.
Learn moreOpportunistic Bacteria associated with Autoimmunity. Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals c
Learn moreGram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source.
Learn more- Gram-negative bacteria in the Proteobacteria phylum. - Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.
Learn moreGram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity and may cause abdominal cramping and loose stools. Some strains of P. aeroginosa may produce toxins that can damage cells.
Learn more- Common in soil, plants, bathrooms, and in beverages like milk, juice, and water. - May be a commensal (=living in a relationship in which one organism derives food or other benefits from another organism without hurting or helping it).
Learn moreA genus of Gram-positive anaerobic bacteria in the Clostridia class that inhabit the human colon. The Roseburia genus has five well-characterized species, all of which produce short-chain fatty acids (SCFAs), such as acetate, propionate, and butyrate
Learn moreEpidemiology - Fecal contamination of ingested foods (eggs, poultry, meat, unpasteurized milk, raw fruits, and vegetables) - Exposure to pets (reptiles, amphibians, baby chicks) Clinical Implications - May be asymptomatic - Symptoms in
Learn moreAs the most abundant class of antibody found in the human intestinal lumen, secretory IgA (sIgA) is recognized as a first line of defense in protecting the intestinal epithelium from enteric pathogens and toxins. It is used to assess gastrointestinal
Learn moreEpidemiology - Fecal contamination of ingested foods (undercooked meat, unpasteurized milk, juice, and water) Clinical Implications - Symptoms may include severe abdominal cramps and diarrhea - Toxins may elicit strong inflammatory respon
Learn moreGram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.
Learn moreGram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.
Learn moreThe steatocrit is a measure of the amount of fat in stool.
Learn moreStreptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, n
Learn moreTaeniasis in humans is a parasitic infection caused by the tapeworm species Taenia saginata (beef tapeworm), Taenia solium (pork tapeworm), and Taenia asiatica (Asian tapeworm). Humans can become infected with these tapeworms by eating raw or unde
Learn moreThe GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re
Learn moreEpidemiology: - Fecal contamination of produce or person-to-person contact - Prevalent in Asia, Africa, South America, and rural southeastern United States
Learn moreDuodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer.
Learn moreThe iceA gene is recognized as a significant virulence factor in the genome of Helicobacter pylori, a Gram-negative, spiral-shaped bacterium implicated in the pathogenesis of various gastrointestinal diseases, including gastritis, peptic ulcers, and
Learn moreH. pylori virulence factor OipA (Outer Inflammatory Protein A) - associated with gastric cancer and peptic ulcer.
Learn moreThe virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections. Helicobacter pylori (H. pylori): Recent studies have sh
Learn moreThe virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections. Recent studies have shown that nearly 50% of the world’s
Learn moreZonulin is a protein that opens intercellular tight junctions in the gut lining (the connections between epithelial cells that make up the gastrointestinal lining). Zonulin increases intestinal permeability in the jejunum and ileum and is considered
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