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Developing Effective Clinical Protocols Based on the GI-Map Test

an introduction to omx metabolomics testing

What makes the GI-Map Test unique?

The uniqueness of the GI-MAP is that it is the only quantitative PCR (Polymerase Chain Reaction), or real-time PCR molecular test that is available in the integrative and functional medicine market.

Anaerobes vs. Aerobes

What has been available until now, are older technologies and older microbial culture-based tests, which inherently have many significant limitations. The vast majority of the GI microbiota are strict anaerobes, and the only thing that you can assess with culture technologies is aerobes and facultative organisms, a tiny percentage, somewhere around five per cent of the total microbiota.

The benefits of Molecular Methods

Using molecular methods greatly expands the view. There are other molecular methods available, including direct-to-consumer types of stool tests. These have microbiome panels that are using next-gen sequencing or shotgun sequencing technology.

What’s the Difference between Direct-to-Consumer Tests and the GI-Map Test?

Dr Brady: “Direct-to-consumer tests were never meant or intended for clinicians to order for a specific patient and to then make clinical decisions and interventional decisions. They’re really not diagnostic tests. They don’t test pathogens, because they’re direct-to-consumer. They have a hard time getting down beyond the genus sense of species, and then they certainly don’t get into some of the genetic characteristics of organisms that provide their virulence or their ability to produce pathology, as a quantitative test (such as GI-Map) does’.

“On the direct-to-consumer tests, not only are you not getting pathogens, but you’re essentially getting reported information, in just the percentage of the total recovered DNA that a certain genus or, in some cases, genus and species, make up in the sample. You’re getting a relative comparison of the different DNA’s of different organisms across a very, very wide swath of organisms. For most of these, we don’t know what the clinical significance is if any.”

The Advantages of the GI-Map Test

The GI-Map Test looks at a narrow band of specific organisms of various types, such as:

  • Pathogens
  • Commensals and Opportunists
  • Bacterial, Fungal and Viral organisms
  • Protozoal and Helmet organisms

In addition, there is a quantitative amount of relevant DNA to know whether there’s a need for treatment.

Another advantage of the GI-Map Test over a next-generation sequencing test is how the stool chemistries can reveal important and relevant diagnostic data:

  • Is the patient digesting?
  • Is the patient absorbing?
  • Is there inflammation along the gut lining?
  • Is there a leaky gut?
  • Is there blood in the stool?
  • Are they making deconjugating enzymes, like beta-glucuronidase?
  • Is their immunoglobulin production secretory IgA production adequate or less than optimal?
  • Are they producing IgA against gluten and gliadin?

How does the GI-Map Test provide Benefits for Patients?

From a clinical intervention perspective, you can use the information from the GI-Map Test in a very personalised way. Precise diagnosis can guide a practitioner how to try to lower what Dr Brady refers to as, ‘the oxygen feeding the fire’ of someone’s chronic inflammatory disorder, or their chronic autoimmune disorder.

Dr Brady feels that the GI-Map provides a very significant difference in his practice. He sees constant benefits for his patients by using the GI-MAP and states “it really fits with the functional medicine paradigm, where we really think that gut health is of prime concern to the overall health of the individual.”

When is a GI-Map Test relevant for a Patient?

The GI-MAP is one of the most common tests that Dr Brady orders for his patients. As Dr Brady is a Functional Medicine Doctor, many of his patients, consult him with chronic inflammatory conditions, chronic pain conditions, and often chronic autoimmune disorders. Sometimes these are already diagnosed and the patient or referring practitioner are looking for other types of approaches, or, they’re not yet diagnosed.

When the patient comes to him, he conducts a thorough, detailed history, and an examination. Then if they seem to have a chronic inflammatory disorder or an autoimmune disorder, even if they only have a family history of this type of illness but no symptoms yet, he will often want to assess the status of their gastrointestinal health and environment, and for that, he does a GI-Map Test.

How does the GI-Map Test work with Patients?

The patient is told why the test is of benefit as a diagnostic tool and that the process is straightforward.

There’s a kit with simple instructions on how to collect the sample. Because the GI-Map Test is a new molecular test, only one stool sample is needed. Whereas three samples over three days are common in some other older tests.

The sample is sent to the lab and once the results come back, they are reviewed before the patient is seen again. When the patient makes a return visit, the results are evaluated and discussed with them, and treatment recommendations are made based on the findings.

The findings may show an overt pathogenic infection that needs to be dealt with, preferably with natural therapeutics, such as standardised botanicals and volatile oils, followed up with probiotic and prebiotic therapy. Dysbiosis patterns with imbalances of commensal and opportunistic organisms are considered. Sometimes, Dr Brady finds organisms that he knows trigger specific autoimmune disorders. Here again, natural therapeutics can be prescribed.

More on the GI-Map Test

Dr Brady says: The GI-Map Test is very specific on which organism’s DNA may be collected at a higher level than normal and is based on the virulence of that organism, the type of organism, and whether or not it’s an overt pathogen…

  • Is it an opportunistic organism?
  • Is it bacterial?
  • Is it protozoal?
  • Is it fungal?

The answers to these questions may inform the selection of:

  • The type of intervention to use – treatment protocols
  • How strong an intervention is appropriate?
  • How broad spectrum an intervention to use?
  • Duration of treatment

The GI-Map Test – an important resource for clinical protocols

The GI-Map Test provides a practitioner with powerful insights and guidance into clinical protocols for optimising someone’s GI health and their overall health.

Reference: Interview with Dr David Brady, Chief Medical Officer of Designs for Health and Diagnostic Solutions Lab, and the Director of the Human Nutrition Institute at the University of Bridgeport, Connecticut in the United States developed the GI-Map Test to bring a sophisticated diagnostic tool to the market.

Source: Interview with Dr David Brady, November 2018 

Designs for Health Australia proudly presented
The
Gl-Map Seminar

Learn about the clinical applications and the research behind this new DNA/PCR stool test.

Presented by Dr David Brady, Chief Medical Officer for Diagnostic Solutions Laboratories and Dr Oscar Coetzee, Doctor of Clinical Nutrition and Associate Professor.

SEMINAR RECORDING:

•  This in-depth live seminar is available to DFH Registered Practitioners…
You can view the recording here…

GI-Map Event Recordings