Everything You Ever Wanted to Know about Stool Testing
Anyone who’s been reading here or following me on social media for any length of time knows I mention stool testing as a useful resource in assessing the root cause(s) of IBS or miscellaneous digestive symptoms. I’m a fan because stool testing takes away some of the guesswork in deciphering WHY a certain symptom is occurring, and so can be a major timesaver in terms of identifying and addressing symptoms. However, I know some of you have questions about the process, so here’s a list of FAQ’s that will hopefully bring clarity to all the questions you’ve wanted to ask:
Why can’t we just treat the symptoms using supplements and diet?
Symptoms are a sign of imbalance, but we don’t always know what specific imbalance.
For example, constipation could be a result of poor fat digestion, infection, sluggish liver, low prebiotic/probiotic status, or any combination of these. And so to make the process more efficient and avoid having to take more supplements than is necessary, it makes sense to test and know what we’re dealing with vs guessing.
Why doesn’t my traditional primary or GI doctor offer this test?
The short answer is: I don’t know. The long-ish answer which is mostly a best guess is that because most traditional practices are built on an insurance model, any resources that aren’t a typical insurance-approved intervention (usually after 30+ years of clinical trials costing thousands or millions of dollars) are not offered. Also, most traditional clinical programs do not train clinicians how to use or read stool tests. I know this is a very frustrating reality, but the good news is that there are a growing number of us who understand its value, and availability of testing is growing.
I’ve already done a stool test through my doctor’s office. How is this different?
GI doctors do sometimes suggest a stool test, such as in the case of diarrhea, vomiting, or severe abdominal pain. However, in my experience, these tests are very simplistic compared to the options offered by functional laboratories. They may measure a few types of bacteria and parasites, perhaps lactoferrin or fecal occult blood. These can be very informative markers, but I find many prospective clients are dealing with a “sub-clinical” issue which is not necessarily as obvious as on a traditional stool test. For example, inflammation and poor digestion could be driving IBS symptoms, and yet a basic GI analysis may come back “unremarkable” or clear.
But my colonoscopy was clear!
Similar to my comparison to a basic stool test, a colonoscopy shows an obvious visual change in the colon, but does not offer a specific evaluation or measure of inflammation. In fact, I’ve worked with several clients whose symptoms worsened before coming to see me, because a colonoscopy 5 years prior was said to be “clear.” Meanwhile, this client had severe digestive symptoms which were never addressed because there was no data to go on since the colonoscopy was clear. Essentially the inflammation was low-grade enough that a colonscopy didn’t pick up on it, but it was still there and just got worse because no one knew how to address it.
Will my insurance cover the cost of a stool test?
Short answer: probably not. Longer answer: it depends on a lot of factors, especially your individual plan. Because it is so time-consuming and costly for labs to bill insurance for you, many opt not to at all, while other will for a fee. Most of my clients find it easiest to use HSA funds to pay for functional labs such as stool testing. I am also seeing a growing number of clients subscribe to a healthshare service (vs traditional insurance) which will sometimes reimburse some testing fees.