Characteristics associated with comprehensive stool analysis findings in adult integrative medicine patients

Abstract

This pilot study explores relationships between clinical and socio-demographic characteristics and abnormal comprehensive stool analysis (CSA) results of patients at the Integrative Medicine Clinic at the University of Kansas Medical Center, to evaluate comprehensive stool analysis as a potential tool to stratify patients by risk of developing gastrointestinal disease as a first step to defining personalized risk reduction strategies. The primary hypothesis was that Integrative Medicine Clinic patients with lower socioeconomic status, chronic disease, poor nutritional status, and/or general health risks would be more likely than other patients to have abnormal bacterial counts and abnormally low levels of short-chain fatty acids. Data were abstracted from paper charts in the Integrative Medicine Clinic, representing current adult patients in the clinic with comprehensive stool analysis reports in their files (N=295). Analysis of the available data revealed that not all relevant data (race/ethnicity, occupation, household income) were recorded for all patients, making correlations between the outcomes of interest and certain socio-demographic variables impossible. However, multivariable relative risk regression revealed that stomach pain, fecal pH, and methylation insufficiency were significant predictors of abnormally low levels of total short chain fatty acids, while abnormal lactoferrin levels, and detoxification genome markers NAT2*K268R and NAT2*I114T were significant predictors of abnormally low levels of the beneficial Bifidobacter bacterial species. Future work should establish CSA baseline results in a larger, more generalizable population and follow a cohort prospectively to establish the relationship between abnormal CSA and disease risk.