GI Map Panel Explained
The functional medicine model of care offers a patient-centered approach to finding out the root cause of illness.
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What is a GI MAP test?
The GI map (Gastrointestinal Microbial Assay Plus) is an innovative functional medicine stool test that was created to get a deeper understanding of how the GI system is functioning. It measures gastrointestinal bacteria 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 created to detect bacteria 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, or “bugs”, commonly known to cause intestinal gastroenteritis. There are many factors, including the health of the individual, the short-term effects of some pathogens, and the factors that contribute to severity of the illness, that impact an individual’s symptoms. The GI map is DNA based, so it doesn’t necessarily consider the toxins being produced.
The following pathogens are tested in the GI map:
- Campylobacter
- Clostridium difficil, toxin A and B
- E coli 0157
- Enteroinvasive E. coli (EIEC)/ Shigella
- Enteropathic E coli (EPEC)
- Enterotoxigenic E. coli
- Shiga-like Toxin E. coli (STEC)
- Salmonella
- Vibrio cholerae
- Yersinia enterocolitica
- Cryptosporidium
- Entamoeba histolytica
- Giardia
- Adenovirus 40/41
- Norovirus GI/ GII
The GI map also tests for another bacteria called Helicobacter pylori (H. pylori). Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. Many carriers are asymptomatic, but it can be a causative role in stomach ulcers, chronic gastritis, and stomach cancer. A typical lab test checks for the presence of the bug, but GI map checks for the bug. It also checks for virulence factors, which check for genetic potential for H. pylori strain to cause cancer. Only 2% of those infected with H. pylori develop gastric cancer.
The body’s “commensal bacteria” are what we think of as the microbiome. There are trillions of microorganisms that inhabit the human intestine to make up a complex ecosystem that plays an important role in human health. These bacteria take nutrients and energy from our diet, maintain gut barrier function, produce vitamins, and protect against pathogens taking over.
The GI map checks for the following “normal” bacteria:
- Akkermansia municiphila
- Bacteroides fragilis
- Bifidobacterium spp.
- Clostridia (class)
- Bifidobacterium spp.
- Clostridia (class)
- Enterococcus spp.
- Escheria spp.
- Faecalibacterium prausnitzii
- Lactobacillis spp.
- Enterobacter spp.
Opportunistic bacteria are those that only cause disease and illness in some individuals, particularly the immune compromised. Many of these bacteria can be “normal” in the stool and most individuals encounter them and experience no symptoms. They can cause gastroenteritis and inflammation at high levels in sensitive patients. Overgrowth of these bacteria can occur when the normal bacteria are impaired by poor diet, antibiotic use, parasitic infection, or a weakened immune system. When the gut lining is not ideal, these bacteria can escape and infect other parts of the body.
The following opportunistic bacteria are tested on the GI map:
- Bacillis spp.
- Enterococcus faecalis/enterococcus faecium
- Methanobacteriaceae (family)
- Morganella spp.
- Pseudomonas spp./ Pseudomonas aeruginosa
- Staphylococcus spp./Staphylococcus aureus
- Streptococcus spp.
- Citrobacter spp./Citrobacter freundii
- Fusobacterium spp.
- Klebsiella spp./Klebsiella pneumoniae
- Mycobacterium avium subsp. Paratuberculosis
- Prevotella copri
- Proteus spp./Proteus mirabilis
Fungi/yeast is something else that GI Map can test for. Fungal organisms are commonly found in the human digestive tract, but fungal overgrowth can cause illness in susceptible individuals.
The following organisms are tested for on the GI map:
- Candida albicans and Candida spp.
- Geotrichum spp.
- Microsporidia spp.
- Rhodotorula spp.
Viruses are a very common infection that we as humans experience throughout our whole life. The GI map looks for viruses in the stool. The test checks for Epstein Barr Virus and Cytomegalovirus.
Parasites are organisms that live and feed on a host organism at the expense of the host. The most common parasites and protozoa that occur in the GI tract are tested for on the GI map test.
The following parasites and protozoa are tested for:
- Blastocystis hominis
- Chilomastix mesnili
- Cyclospora spp.
- Dientamoeba fragilis
- Endolimax nana
- Entamoeba coli
- Pentatrichomonas hominis
- Hookworms
- Roundworms
- Whipworm
- Tapeworm
The GI map goes further than just telling us the bacterial balance and if there are any abnormal bacteria or organisms. It tests for certain health markers to aid in understanding how the gut is working.
The following markers are checked in the GI Map.
Digestion
- Pancreatic elastase 1- gives us indication of pancreatic function
- Steatocrit- how much fat is in the stool and is it being digested and absorbed?
Additional GI markers
- Beta-glucuronidase- high levels can indicate unfavorable metabolic changes in the colon
- Occult blood fecal immunochemical testing (FIT)- measures concentration of hemoglobin present in stool, rather than just how much hemoglobin (blood).
- Immune response- SIgA- the gut’s “first line defense” in response to pathogens and antigens in GI and respiratory tracts.
- Anti-gliadin SIgA- gliadin is a component of gluten and the presence of this can indicate an immune response (in the gut) to gluten in the diet
Inflammation
- Calprotectin- fecal calprotectin is the most studied marker or gastrointestinal inflammation. It is the gold standard marker for the diagnosis and monitoring of inflammatory bowel disease.
- Zonulin- protein that opens intercellular tight junctions in the gut lining. It increases intestinal permeability and is considered a marker of barrier permeability (are tiny particles leaking through the gut lining).
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Written by Virginia Conner, PA-C