So, good news, you just had your colonoscopy and everything came back fine. Wonderful! That's what I love to hear; however, your colonoscopy isn’t perfect. What did they miss? They do miss a few things. I always encourage patients when they get the good news of having a clean colonoscopy (no polyps, no other lesions): what's the next step?
Stool Testing as a Valuable Resource
This is where we often use stool testing. Stool testing can give us some other markers that a colonoscopy can't tell us. It can look at inflammation at levels more microscopic than a colonoscopy can find. Remember, a colonoscopy is a camera. It's actually looking for tissue changes, polyps, and other lesions. Stool testing can actually find inflammation at a microscopic level and it can tell us that there's something going on. It can find that there is something present when maybe there have been no changes than the actual tissue. It can tell us about markers of leaky gut, AKA: increased intestinal permeability. This is a term that is becoming more and more popular and it speaks to the health and the integrity of the GI lining. There are markers in our stool proteins, that we can measure, that tell us how permeable our GI tract may be. That's important because that can actually lead to inflammatory processes as well as overactivity of our immune system.
Infections
It can look at infections. These can come in the form of bacterial infections, viral, parasitic, etc… Stool testing can look at DNA markers of all these different microbes, and it is very sensitive for finding out if there's some infection present, whether at an acute level, or potentially even a sub acute level. We call this dysbiosis or dysfunction in the microbiome. The balance between the good bugs and, maybe, not so good bugs is off, and that's another value that stool panels are very helpful for.
Ecosystems Inside the Colon
Last, but certainly not least, the other part that colonoscopies miss is telling us about the ecosystem inside the colon. What I mean by that is: are the bugs living in our gut making the byproducts we want them to make? Remember, we live in harmony with all the bacteria that live in our gut, and there are millions and billions of them. They make products for us. It's a symbiotic relationship: we help them, they help us. You can actually measure that they are making some of these beneficial nutrients that we use.
Why Short Chain Fatty Acids as Beneficial Nutrients
Common ones are called short chain fatty acids, and these are byproducts of what's called: microbial fermentation. When we eat fiber, the microbes in our gut ferments it, and they produce short chain fatty acids. These short chain fatty acids help our intestines repair. They can help blood sugar regulation, they can help our metabolism, and they can even keep our colon clear of polyps and colon cancer.
Some really valuable research on short chain fatty acids and colon cancer so those are some of the things that colonoscopies can miss. This is why I love to follow the negative colonoscopies up with stool testing.