Comprehensive Stool Analysis - Doctor's Data

1 LAB #: F000000-0000-0 PATIENT: Sample PatientID: P0000000000 SEX: FemaleDOB: AGE: 30 CLIENT #: 12345 DOCTOR: Doctor's Data, Illinois Charles, IL 60174 !!!! Comprehensive Stool AnalysisBACTERIOLOGY CULTUREE xpected/Beneficial floraCommensal (Imbalanced) floraDysbiotic flora 4+ Bacteroides fragilis group1+ Alpha hemolytic strep 4+ Bifidobacterium + Gamma hemolytic strep 4+ Escherichia coli1+ Klebsiella oxytoca 2+ Lactobacillus + Pseudomonas putida group 2+ Enterococcus spp. 2+ Clostridium = No GrowthBACTERIA INFORMATIONYEAST CULTUREN ormal floraDysbiotic flora 1+ Candida parapsilosis2+ Rhodotorula mucilaginosa 1+ Saccharomyces cerevisiae/boulardiiMICROSCOPIC YEASTYEAST INFORMATIONR esult:Expected:FewNone - RareComments: Date Collected: 01/17/2020 Date Received: 01/20/2020 Date Reported: 01/28/2020 DOCTOR S DATA, INC. ! ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 ! MED DIR: Erlo Roth, MD ! CLIA ID NO: 14D06464700001793 Expected /Beneficial bacteria make up a significant portion of the total microflora in a healthy & balanced GI tract.

2 These beneficial bacteria have manyhealth-protecting effects in the GI tract including manufacturing vitamins, fermenting fibers, digesting proteins and carbohydrates, and propagating anti-tumor and anti- inflammatory are prevalent flora in a healthy intestine. Clostridium spp. should be considered in the context of balance with other expected/beneficial of clostridia or over abundance relative to other expected/beneficial flora indicates bacterial imbalance. If C. difficile associated disease issuspected, a Comprehensive Clostridium culture or toxigenic C. difficile DNA test is (Imbalanced) bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficientlevels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher bacteria consist of known pathogenic bacteria and those that have the potential to cause disease in the GI tract.

3 They can be present due to anumber of factors including: consumption of contaminated water or food, exposure to chemicals that are toxic to beneficial bacteria; the use of antibiotics,oral contraceptives or other medications; poor fiber intake and high stress may normally be present in small quantities in the skin, mouth, and intestine. Wheninvestigating the presence of yeast, disparity may exist between culturing and microscopicexamination. Yeast are not uniformly dispersed throughout the Stool and this may lead toundetectable or low levels of yeast identified by microscopy, despite culture and identified yeastspecies. Conversely, microscopic examination may reveal a significant amount of yeast present butno viable yeast cultured. Yeast may not always survive transit through the intestines. Nonviable diet-derived yeast may also be detected microscopically. Consideration of clinical intervention for yeastdetected microscopically should be made in the context of other findings and presentation in Stool is expected at a level of none-rare.

4 A microscopic finding of yeast in Stool offew, moderate, or many may be helpful inidentifying potential yeast overgrowth, or non-viable or dietary yeast.*Aeromonas, Campylobacter, Plesiomonas, Salmonella,Shigella, Vibrio, Yersinia, & Edwardsiella tarda havebeen specifically tested for and found absent #: F000000-0000-0 PATIENT: Sample Patient ID: P0000000000 SEX: FemaleDOB: AGE: 30 CLIENT #: 12345 DOCTOR: Doctor's Data, Illinois Charles, IL 60174 ! Comprehensive Stool AnalysisDIGESTION /ABSORPTIONW ithinOutside Reference RangeElastase362> 200 g/mLFat StainNoneNone - ModMuscle fibersNoneNone - RareVegetable fibersRareNone - FewCarbohydratesNegNegINFLAMMATIONW ithinOutside Reference RangeLactoferrin< < g/mLCalprotectin< 10<= 50 g/gLysozyme*267<= 600 ng/mLWhite Blood CellsNoneNone - RareMucusNegNegIMMUNOLOGYW ithinOutside Reference RangeSecretory IgA* - 204 mg/dL*For Research Use Only. Not for use in diagnostic : Elisa, Microscopy, Colormetric,Gas Chromotography, ph Electrode DOCTOR S DATA, INC.

5 !!!! ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 !!!! CLIA ID NO: 14D0646470 !!!! LAB DIR: Erlo Roth, MD0001953 Elastase findings can be used for the diagnosisor the exclusion of exocrine pancreaticinsufficiency. Correlations between low levelsand chronic pancreatitis and cancer have beenreported. Fat Stain: Microscopic determinationof fecal fat using Sudan IV staining is aqualitative procedure utilized to assess fatabsorption and to detect steatorrhea. Musclefibers in the Stool are an indicator of incompletedigestion. Bloating, flatulence, feelings of fullness may be associated with increase inmuscle fibers. Vegetable fibers in the Stool maybe indicative of inadequate chewing, or eating on the run . Carbohydrates: The presence ofreducing substances in Stool specimens canindicate carbohydrate and Calprotectin are reliablemarkers for differentiating organic inflammation(IBD) from function symptoms (IBS) and formanagement of IBD.

6 Monitoring levels of fecallactoferrin and calprotectin can play an essentialrole in determining the effectiveness of therapy,are good predictors of IBD remission, and canindicate a low risk of relapse. Lysozyme* is anenzyme secreted at the site of inflammation inthe GI tract and elevated levels have beenidentified in IBD patients. White Blood Cells(WBC) and Mucus in the Stool can occur withbacterial and parasitic infections, with mucosalirritation, and inflammatory bowel diseases suchas Crohn s disease or ulcerative IgA* (sIgA) is secreted by mucosaltissue and represents the first line of defense ofthe GI mucosa and is central to the normalfunction of the GI tract as an immune levels of sIgA have been associatedwith an upregulated immune : Date Collected: 01/17/2020 Date Received: 01/20/2020 Date Reported: 01/28/2020 LAB #: F000000-0000-0 PATIENT: Sample Patient ID: P0000000000 SEX: FemaleDOB: AGE: 30 CLIENT #: 12345 DOCTOR.

7 Doctor's Data, Illinois Charles, IL 60174 Stool AnalysisSHORT CHAIN FATTY ACIDSW ithinOutside Reference Range% Acetate5640 - 75 %% Propionate279 - 29 %% Butyrate149 - 37 %% - 7 % - mg/mLTotal SCFA s124 - 18 mg/mLINTESTINAL HEALTH MARKERSW ithinOutside Reference RangeRed Blood CellsNoneNone - - Occult BloodNegNegMACROSCOPIC APPEARANCEA ppearanceExpectedColorBrownBrownConsiste ncySoftFormed/Soft DOCTOR S DATA, INC. !!!! ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 !!!! CLIA ID NO: 14D0646470 !!!! LAB DIR: Erlo Roth, MD0001953 Short chain fatty acids (SCFAs): SCFAs arethe end product of the bacterial fermentationprocess of dietary fiber by beneficial flora in thegut and play an important role in the health of theGI as well as protecting against intestinaldysbiosis. Lactobacilli and bifidobacteria producelarge amounts of short chain fatty acids, whichdecrease the pH of the intestines and thereforemake the environment unsuitable for pathogens,including bacteria and yeast.

8 Studies have shownthat SCFAs have numerous implications inmaintaining gut physiology. SCFAs decreaseinflammation, stimulate healing, and contribute tonormal cell metabolism and differentiation. Levelsof Butyrate and Total SCFA in mg/mL areimportant for assessing overall SCFA production,and are reflective of beneficial flora levels and/oradequate fiber Blood Cells (RBC) in the Stool may beassociated with a parasitic or bacterial infection,or an inflammatory bowel condition such asulcerative colitis. Colorectal cancer, anal fistulas,and hemorrhoids should also be ruled : Fecal pH is largely dependent on thefermentation of fiber by the beneficial flora of blood: A positive occult blood indicatesthe presence of free hemoglobin found in thestool, which is released when red blood cells : Stool is normally brown because ofpigments formed by bacteria acting on bileintroduced into the digestive system from theliver.

9 While certain conditions can causechanges in Stool color, many changes areharmless and are caused by pigments in foodsor dietary supplements. Consistency: Stoolnormally contains about 75% water and ideallyshould be formed and soft. Stool consistencycan vary based upon transit time and #: F000000-0000-0 PATIENT: Sample Patient ID: P0000000000 SEX: FemaleAGE: 30 CLIENT #: 12345 DOCTOR: Doctor's Data, Illinois Charles, IL 60174 !"#$%&!'(%)#*&+,+-+&+#%. Saccharomyces cerevisiae/boulardiiNATURAL ANTIFUNGALSLowHighSensitivitySensitivity BerberineCaprylic AcidUva UrsiPlant TanninsOreganoUndecylenic AcidGrapefruit Seed ExtractNON-ABSORBED ANTIFUNGALSLowHighSensitivitySensitivity NystatinYeast antifungal susceptibility testing is intended for research use for use in diagnostic DOCTOR S DATA, INC. !!!! ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 !!!! CLIA ID NO: 14D0646470 !!!! LAB DIR: Erlo Roth, MD0001717 Natural antifungal agents may be usefulfor treatment of patients when organismsdisplay in-vitro sensitivity to these test is performed by using standardizedtechniques and filter paper disksimpregnated with the listed agent.

10 Relativesensitivity is reported for each natural agentbased upon the diameter of the zone ofinhibition surrounding the disk. Data basedon over 5000 individual observations wereused to relate the zone size to the activitylevel of the agent. A scale of relativesensitivity is defined for the natural antifungals may be usefulfor treatment of patients when organismsdisplay in-vitro sensitivity to these test is performed using standardizedcommercially prepared disks impregnatedwith Nystatin. Relative sensitivity is reportedbased upon the diameter of the zone ofinhibition surrounding the : Date Collected: 01/17/2020 Date Received: 01/20/2020 Date Reported: 01/28/2020 LAB #: F000000-0000-0 PATIENT: Sample Patient ID: P0000000000 SEX: FemaleAGE: 30 CLIENT #: 12345 DOCTOR: Doctor's Data, Illinois Charles, IL 60174 !"#$%&!'(%)#*&+,+-+&+#%. Candida parapsilosisNATURAL ANTIFUNGALSLowHighSensitivitySensitivity BerberineCaprylic AcidUva UrsiPlant TanninsOreganoUndecylenic AcidGrapefruit Seed ExtractNON-ABSORBED ANTIFUNGALSLowHighSensitivitySensitivity NystatinAZOLE ANTIFUNGALSR esistantS-DDSusceptibleFluconazoleSItrac onazoleSKetoconazoleSStandardized test interpretive categories established for Candida spp.