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Doctor's Data

Comprehensive Stool Analysis (CSA)

Doctor's Data

Sample type: Stool

Requires fasting: No

At home test


Details

Gastrointestinal complaints are among the most common in medical care. The CSA profile helps pinpoint the causes of gastrointestinal symptoms and chronic systemic conditions, and measures key markers of digestion, absorption and inflammation. It contains comprehensive bacteriology and yeast cultures to identify the presence of beneficial flora, imbalanced flora including Clostridium species, and dysbiotic flora, as well as the detection of infectious pathogens by PCR and other gold standard methods. Antimicrobial susceptibility testing to prescriptive and natural agents is also performed for appropriate cultured bacterial and fungal species at no additional charge.


  • Yeast Culture
  • Butyrate
  • Pancreatic Elastase 1
  • Enterotoxigenic E. coli
  • Campylobacter spp.
  • Clostridium difficile toxin a
  • Clostridium difficile toxin b
  • Salmonella spp.
  • Shiga-like toxin E. coli stx1
  • Shiga-like toxin E. coli stx2
  • E. coli o157
  • Vibrio cholerae
  • Secretory IgA
  • Norovirus GI/GII
  • Adenovirus 40/41
  • Lactoferrin, Stool [Mass/Volume]
  • Lysozyme
  • Acetate
  • Carbohydrates
  • Propionate
  • Valerate
  • Rotavirus A
  • Shigella spp.
  • Total Short-Chain Fatty Acids
  • Calprotectin, Stool
  • Occult Blood, Stool

Estimated days for results: Results should arrive 6 to 8 days after the lab receives samples.

The Comprehensive Stool Analysis (CSA) is an invaluable non-invasive diagnostic assessment that permits practitioners to objectively evaluate the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast/fungus by culture, PCR, and other gold standard methods. Precise identification of pathogenic species and susceptibility testing greatly facilitates selection of the most appropriate pharmaceutical or natural treatment agents. 

Important information regarding the efficiency of digestion and absorption can be gleaned from the measurement of the fecal levels of elastase (pancreatic exocrine sufficiency), fat, muscle and vegetable fibers, and carbohydrates. 

Inflammation can significantly increase intestinal permeability and compromise assimilation of nutrients. The extent of inflammation, whether caused by pathogens or inflammatory bowel disease (IBD), can be assessed and monitored by examination of the levels of biomarkers such as calprotectin, lactoferrin, and lysozyme via this stool test. These markers can be used to differentiate between inflammation associated with potentially life-threatening inflammatory bowel disease (IBD), which requires lifelong treatment, and less severe inflammation that can be associated with irritable bowel syndrome (IBS) which is frequently due to the presence of enteroinvasive pathogens. Calprotectin and lactoferrin are only markedly elevated prior to and during the active phases of IBD, but not with IBS. Monitoring these levels in patients with IBD can therefore facilitate timely treatment of IBD, and can be ordered separately. Since the vast majority of secretory IgA (sIgA) is normally present in the GI tract, where it prevents binding of pathogens and antigens to the mucosal membrane, it is essential to know the status of sIgA in the gut. sIgA is the only bona fide marker of humoral immune status in the GI tract. 

Cornerstones of good health include proper digestion of food, assimilation of nutrients, exclusion of pathogens and timely elimination of waste. To obtain benefits from food that is consumed, nutrients must be appropriately digested and then efficiently absorbed into portal circulation. Microbes, larger-sized particles of fiber, and undigested foodstuffs should remain within the intestinal lumen. Poor digestion and malabsorption of vital nutrients can contribute to degenerative diseases, compromised immune status and nutritional deficiencies. Impairment of the highly specific nutrient uptake processes, or compromised GI barrier function, as in "leaky gut syndrome," can result from a number of causes including: 
  • Low gastric acid production
  • Chronic maldigestion
  • Food allergen impact on bowel absorptive surfaces
  • Bacterial overgrowth or imbalances (dysbiosis)
  • Pathogenic bacteria, yeast or parasites and related toxic irritants
  • The use of NSAIDs and antibiotics 

Impairment of intestinal functions can contribute to the development of food allergies, systemic illnesses, autoimmune disease, and toxic overload from substances that are usually kept in the confines of the bowel for elimination. After performing a stool test, efficient remediation of GI dysfunctions incorporates a comprehensive guided approach that should include consideration of elimination of pathogens and exposure to irritants, supplementation of hydrochloric acid, pancreatic enzymes and pre- and probiotics, and repair of the mucosal barrier.

The Comprehensive Stool Analysis does not include analysis for parasites. For a stool test that includes assessment of the presence for parasites, consider the Comprehensive Stool Analysis + Parasitology.

Useful for: 
  • Gastrointestinal Symptoms 
  • Autoimmune Disease 
  • Joint Pain 
  • IBD/IBS 
  • Inflammation 
  • Food Sensitivities 
  • Nutritional Deficiencies 
  • Skin Conditions (Atopic Dermatitis)

6–8 business days


View here

  • Add-on: Beta-glucuronidase
  • Add-on: Comprehensive Clostridium Culture
  • Add-on: H. Pylori Antigen
  • Add-on: Zonulin Family Protein

Before You Start 
  • Please read the test collection instructions carefully.
  • DO NOT collect samples if you are actively bleeding from hemorrhoids or menstruation.
  • Wait at least 4 weeks after a colonoscopy or barium enema before collecting your sample.
  • DO NOT contaminate the stool with urine or water.

2 Weeks Before Collection
  • Discontinue the following unless otherwise directed by your healthcare provider:
    • Antibiotics
    • Antiparasitics
    • Antifungals
    • Probiotic supplements
    • Proton pump inhibitors (PPIs)
    • Bismuth

2 Days Before Collection
  • Discontinue the following unless otherwise directed by your healthcare provider:
    • Aspirin and other NSAIDs
    • Digestive enzymes
    • Laxatives (especially mineral oil, castor oil, and glycerin-based enemas/suppositories)
    • Activated charcoal
    • Betaine HCl
    • Antacids
    • Bentonite clay

State restrictions:

Patient can't order this test if they are located in Hawaii, Puerto Rico, New Jersey, New York, or Rhode Island

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