Comprehensive Digestive Stool Testing

The CDSA Test x 3 (Comprehensive Digestive Stool Analysis)

The identification of abnormal levels of yeast species, bacteria and parasites in the stool is an important diagnostic step in therapeutic planning for patients in my clinic with chronic gastrointestinal and other symptoms that may be linked with conditions like IBS or IBD, chronic food allergies, suspected parasite or bacterial infections like SIBO and especially if I suspect an ongoing candida yeast infection. The CDSA test provides me the clinician with a wide array of the most useful clinical information to help me plan my most appropriate treatment protocol that is quite specific to the individual patient.

The Comprehensive Stool Test is The Best Test

This is the # 1 test to do if you have tried everything and still can’t find out why you are feeling so bad. It has helped to solve many of the most difficult cases by providing me with all the answers I am looking for. The CDSA x 3 with parasitology is the most comprehensive and commonly ordered functional stool test in my clinic, assessing the widest range of intestinal conditions. This test will provide information on your ability to digest, metabolize, and absorb nutrients, as well as report all bacterial flora (beneficial, imbalanced and disease causing, all yeasts, and all intestinal parasites (worms, eggs, larva, and protozoa).

It is important to analyse both the intestinal digestion/absorption functions as well as the levels of yeast, bacteria, and parasites because symptoms of mal-digestion or mal-absorption often mimic those of chronic bacterial, yeast, or parasitic infections. Additionally, chronic bacterial, yeast, or parasitic infections may have adverse effects on the body’s metabolic and absorptive processes, which can all be assessed using this most comprehensive test.

As you probably aware by now, an overgrowth of yeast can infect virtually every organ system, leading to an extensive array of clinical manifestations. Most patients I have seen over the years that have had a bad bacteria, parasite or candida yeast infection present with some kind of digestive symptom which often includes varying degrees or different kinds of abdominal pain, cramping, bloating, gas, diarrhea or constipation and/or various forms of digestive irritations.

Stool Culture To Determine Candida Is Best

When investigating the presence of yeast in a stool sample, disparity may exist for example between the culturing of yeast and any actual microscopic examination. Yeasts are not uniformly dispersed throughout the stool, which is a good reason why you should insist on three stool samples, and by only having one sample performed it may lead to undetectable or low levels of yeast identified by microscopy, despite a cultured amount of yeast. Conversely, microscopic examination may reveal a significant amount of yeast present, but no yeast cultured. Having three stool samples assayed, and not all mixed together and assayed as one sample, something many labs do, you are increasing your chances of yeast detection. While candida does not always survive transit through the digestive tract rendering it unviable, the microscopic finding of yeast in the stool is helpful in identifying whether there is proliferation of yeast or not. Although some yeast may be normal; yeast observed in higher amounts is considered abnormal.

My Personal Choice Of Testing For Digestive Problems Is Functional Stool Testing

Personally I like the CDSA test the best out of all the functional tests because it goes right to the heart of the problem, the digestive system. The CDSA give me the most useful information of all the tests, and here are the main points this test reveals:

  • Bacteriology culture
  • Yeast culture
  • Parasitology microscopy
  • Giardia and cryptosporidium assay
  • Digestion & absorption markers (elastase, fat stain, muscle & vegetable fibers, carbs)
  • Inflammatory markers (lysozyme, lactoferrin, white blood cells, mucus)
  • Immunology (secretory IgA – sIgA)
  • Short chain fatty acids (the end product of bacterial fermentation of beneficial bacteria in the bowel)
  • Intestinal health markers (red blood cells, pH, occult blood)
  • Macroscopic (visual) appearance

The CDSA test in my opinion is the Rolls Royce of candida tests, and if you can afford the rather hefty price tag then you should definitely do this test, no question about it. I have solved an amazing amount of difficult right through to “impossible” cases with this test, when all else failed the patient.


Comprehensive Stool Testing Is Now Available

direct labs 1Click here right now to access the Direct Labs page, all you need to do is register with them and then you can order this test. I can interpret the test results (if you wish) for a follow-up consultation fee. You can read more about booking consultation with me on that page.

There is no need to suffer for several years before you can expect optimal health, you just need the right information and the right protocol. Is your optimal health worth this kind of money?


With The CDSA – Should I Do 1, 2 Or 3 Stool Samples?                                                                  

I recommend that you always consider the x 3, especially if you are chronically unwell. The 3 day collection period is considered the gold standard by most gastroenterologists, and the scientific literature suggests that three-day collections give maximum sensitivity and specificity for parasite and candida yeast detection because many parasites do not shed from the host at even intervals, and yeasts have varying growth cycles as well. One day’s sample may produce negative results, while the following day’s sample may be positive, and the day after that the stool may be absolutely loaded with bugs. As I’ve mentioned previously, the effects of this optimal collection are diminished by the unscrupulous practice of some laboratories which unfortunately blend the three samples into one and perform only one analysis.

There are only a handful of labs that do not pool samples and perform separate analyses on each sample submitted for testing. You can also just do a parasitology test and even a stand-alone candida test through the same company, and if your results have come back positive with the CDSA x 3, you may just want to repeat the candida test as a follow- up to save on costs.

Because candida albicans is present in the gastrointestinal tract, it is possible to culture (grow it) from a stool sample. Using a special culture medium and the right anaerobic conditions (reduced oxygen), candida albicans can be grown and identified this way. David Quig Ph.D, technical manager from Doctors Data Labs (Chicago, USA) said to me that if you can culture candida albicans from a stool sample, then you have a pretty bad case of a yeast infection. Other say that this is fine, just look at the numbers, and if all three samples come back as positive (especially 3+ count like Jean, the case study I just outlined to you) then you have a real problem on your hands. You should not be able to culture a significant viable yeast population from a motion you have passed, if you can, it means you have a significant candida overgrowth in your large bowel.

Some specialist laboratories are even able to identify the different species of candida present, and such a result could be quite significant, as some strains have a tendency to be harder to eradicate (such as candida tropicalis) than candida albicans.

 What About Your Level Of Beneficial Bacteria?

The other thing I look for in a CDSA test apart from the actual level of bad bacteria, parasites and candida (or different yeast species) in the sample is the level of beneficial bacteria. Is there a 1, 2 or a 3+ of good and/or bad bacteria? You may be concerned for example if you have a positive result with candida after a stool analysis, but have failed to look at the amount of beneficial bacteria, only to discover that you have a 3+ Lactobacillus acidophilus level. You should be concerned if there is NG (no growth) in terms of Lactobacillus acidophilus, and some of the chronic cases this is exactly what I have found, yeast in all three stool samples and NG in terms of the lactobacillus species.

I want you to remember that it is not always about killing candida; it is about restoring digestive harmony, and by assessing your level of the good and bad bacteria as well as yeast you will be in a powerful position to restore this harmony. No other pathological or functional test can give you this incredible level of information, now you can see why I believe this to be the best test you can do if you are serious about getting rid of your yeast infection permanently.

Microscopic Yeast In Stool Samples

A CDSA will reveal whether yeast will be in the stool sample or not, and microscopy will be most helpful in finding if fungi like candida are present. Yeast is commonly found in very tiny amounts in a healthy intestinal tract, and while small quantities which are reported as “none or rare” may be normal, any yeast observed in higher amounts, “few, moderate, or many” is considered abnormal. In a healthy individual, any candida overgrowth will be prohibited by beneficial flora, the intestinal immune defence (secretory IgA) as well as intestinal pH.

Acids like lactic acid are produced by lactobacillus species which lower the pH and thereby create an environment which is unsuitable for yeast to thrive in, a good reason to have a 2 or a 3+ of beneficial lactobacillus in your stool counts. It is most beneficial to have excellent numbers of lactobacillus, because they also produce natural antibiotics themselves like hydrogen peroxide, acidolin and lactobacillin.

A significant and much over looked problem with culturing yeast from a stool sample is that they are colony forming agents and are therefore not evenly dispersed throughout the stool sample, so even though yeast may well be found microscopically, it may not necessarily be cultured successfully even when collected from the patient’s same bowel motion.

CDSA Inflammatory Markers

Inflammation in the digestive system can significantly increase your chances of intestinal permeability, indicating an underlying leaky gut and compromising your ability to absorb nutrients. The extent of this inflammation, whether caused by bad bacteria or candida or inflammatory bowel disease (IBD), can be assessed and monitored by examination of the levels of biomarkers such as lysozyme, lactoferrin, white blood cells and mucus.

These markers can be used to differentiate between inflammation associated with Crohn’s disease or ulcerative colitis (IBD – inflammatory bowel disease), and less severe inflammation (IBS – irritable bowel syndrome) that can be associated with the presence of bacteria or yeast overgrowth.


In the CDSA stool test, you will find that a marker called lactoferrin is only markedly elevated prior to and during the active phases of IBD, but not with IBS. Therefore, monitoring stool levels of lactoferrin in patients with IBD can therefore facilitate timely treatment of IBD.


Lysozyme is another stool marker some labs perform; it can be detected particularly during an acute attack of Crohn‘s disease. It is one of the best inflammatory markers to detect this kind of IBD.


Calprotectin is a protein found in white blood cells called neutrophils that make up three-quarters of your white blood cell counts. Some stool testing labs use calprotectin as their inflammatory marker, and some experts consider calprotectin to be the gold standard measurement of intestinal inflammation. The main diseases that cause an increased excretion of fecal calprotectin are Crohn’s disease, ulcerative colitis and neoplasms such as bowel cancer. Levels of fecal calprotectin and lysozyme will be found to be normal in patients with irritable bowel syndrome (IBS). Although a relatively new stool test, fecal calprotectin is regularly used as indicator for inflammatory bowel disease IBD during treatment and as diagnostic marker.

The SIgA Marker: Candida, Infection, Allergies And Leaky Gut

Since the vast majority of the antibodies called IgA (sIgA, or secretory IgA) normally resides in your digestive system where it prevents binding of bad bacteria and yeasts to the mucosal membrane, it is essential to know the status of sIgA in the digestive system. I have discovered that SIgA is quite possibly the only bona fide marker of immune status in your digestive system.

There are several different immunoglobulins in the various tissues of your body, but secretory IgA is the main one found in mucous secretions. In my practice, I have found that a person’s SIgA levels is one of the first factors I look at when it comes to the stool test, it allows me to see how strong that person’s gut immune health connection is, and in particular, how capable their immune system is in fighting any intestinal infection.

IgA is produced in your blood and transported across the mucosal layer in addition to your intestinal cells, which produce an incredible two to three grams of this antibody everyday. SIgA production appears to peak in childhood, declining after about sixty years of age. When it comes to mucous, people are all too aware of this about their nose or throat, but in fact the whole digestive system is coated in the stuff.

A healthy layer of mucous is the gut’s first line of defense against pathogens like ingested viruses, parasites, bacteria, yeast in addition to any foreign food proteins and toxins.

It is important to know that your mucosal barrier doesn’t only consist of the lining of your entire digestive system, it also makes up the lining of your mouth, eyes, nasal cavity, sinuses, upper part of your lungs, the urethra of men and women and the vagina in women. Everywhere there is a mucosal system you will find that it is covered in a fine layer of mucous, and in this mucous you will find secretory IgA.

You may have you noticed, these are also key areas where you will find a yeast infection and therefore it is important for your body to maximize this antibody’s production and heighten its activity if you are you are to win the fight and crush your yeast infection, or any infection for that matter.

The main role of SIgA is to defend the surfaces of the digestive system and other systems coated in mucous and to prevent these potential toxic substances from biding to cell surfaces, becoming absorbed by cells lining the mouth, throat, lungs, urethra, vagina and intestines, and ultimately invading the body. SIgA has the ability to cling or adhere to these foreign substances and neutralize them along with their toxins which may be released, and help to remove these foreigners by ensuring they get excreted out of the body in the feces.

Low sIgA Levels

Low SIgA levels can signify that there is a progressive or underlying developing food allergy occurring, and if levels remain too low or are borderline, you will find that it can take considerably longer for the body to heal and repair any leaky gut.

When a patient has a consistently low SigA level in her stool or saliva, it tells me why she can’t seem to get on top of her chronic yeast infection or food allergy. But it also reveals that her immune system generally is having a hard time coping, and can reflect in a poor recovery from psoriasis, rheumatoid arthritis or any other auto-immune condition.

It’s more important and intelligent to fix the gut when it comes to the immune system than to worry about rubbing coal tar on a person with psoriasis or treating a patient with rheumatoid arthritis with steroids to reduce their inflammation.
SIgA levels which persistently remain low for years can eventually result in some of the most severe cases of systemic candidiasis I have ever seen, because the mucosal barriers are no longer effective in protecting the body against yeast and its metabolites. If you take the IgA soldiers away from their mucosal borders, what is ultimately protecting your body from being over run by free loading bacteria and yeasts?  A person with chronic candidasis will need to get their sIgA levels UP, and this is often the key when it comes to healing that leaky gut quickly and permanently.

A sustained higher sIgA level will mean more immune fighting power internally. Research has revealed that children with autistic tendencies and celiacs have low sIgA levels and SIBO (small intestine bacterial overgrowth), and so do people with irritable bowel syndrome and inflammatory bowel syndrome (ulcerative colitis and Crohn’s disease).

I always try to establish why a person’s sIgA levels are low and remain low, and it could be as simple as one food the person is routinely eating which is challenging the body. What are their levels of beneficial bacteria? It is surprising how many stool tests I have seem that “NG” (no growth) when it comes to lactobacillus acidophilus, and sometimes a probiotic can make all the difference for this reason. Do they have a significant parasite or bacterial overgrowth that could be reduced through diet and supplementation?

If your sIgA levels don’t seem to come up to speed in spite of your very best and sustained efforts, consider looking at any obstacles to cure. You may have a diseased tooth or a low-grade inflammation elsewhere in the body, and there is a specific panel of blood tests that can be done to establish this inflammatory response. A bit of investigation can go a very long way towards resolving the low sIgA, and ultimately your digestive (and general health) problems once and for all.

Perhaps you may have an established yet undiagnosed auto-immune disease? I’ve seen this occur on numerous occasions. Any chronic low-grade inflammation will be an immune-drain and will need to be addressed before you can expect a healthy rise in sIgA levels, and then watch what happens to the unresolved yeast infection. The longer and more severe and compromised the sIgA levels remain low in your digestive system, the more drain on the adrenal gland function that occurs, and you may slowly slide into adrenal fatigue. For this reason, I like a patient to complete the adrenal fatigue questionnaire if they have had their yeast infection for some time, and most will have some degree of adrenal fatigue as a consequence of an ongoing leaky gut and low sIgA levels. It is very important for you to understand the relationship between your immunity and adrenal fatigue, and for this reason I have written plenty on this topic. You will find more information on adrenal fatigue and immunity in chapter 7, section 2 – Understanding Immunity, Metabolites And Stress.

Key Causes Of Low sIgA

  • High Antigenic Load. A high load of circulating antibodies from food allergies can significantly depress sIgA levels, even in people who don’t really have many overt symptoms. Check carefully for leaky gut syndrome, and be sure to follow the Low-Al
  • Certain Pharmaceutical Drugs. A little known fact is that certain drugs can induce a temporary IgA deficiency which will generally resolve after the drug is removed. These include anti-inflammatories both steroidal and non-steroidal, sulfasalazine, hydantoin, cyclosporine, gold, fenclofenac, sodium valproate, and captopril.
  • lergy Diet as outlined in the Candida Crusher Diet in the first section of chapter 7.
  • Certain Viral Infections. Viral infections such as congenital rubella infection, Epstein-Barr virus (EBV) or Coxsackie virus infection, may result in persistent IgA deficiency. I am always on the lookout to see if the person had these infections in the past, as they can be a cause of continual low-grade SIgA levels for many years. Treat the adrenals and see what happens, get that cortisol UP.
  • Poor Nutrition A person with nutritional deficiencies may have difficulty mounting an appropriate SIgA immune response, deficiencies like zinc, vitamin C, iron, folate and various other deficiencies can hinder the production of SIgA. This is just one of the reasons to take a top quality multi like the Candida Crusher Multi.
  • Inflammatory Bowel Disease. Lower sIgA levels are frequently found in those with ulcerative colitis or in those whose first degree relatives have the disease. A diagnosis must be made, has the person had a colonoscopy and appropriate blood testing?
  • Stress. Lower levels of SigA are frequently found in those with excessive cortisol production, so decreasing stress may lead to higher sIgA levels. These are the people more prone to developing adrenal fatigue, and I recommend most with a yeast infection of long duration do the adrenal fatigue test and get treatment when appropriate.
  • Chronic Low-Grade Infections. Lower SIgA levels may also be found in those with chronic infections which may last for many years and remain undetected. They may have undetected bacteria or parasites because their mucosal defence mechanism may be weak or very poor. The allergic response may be increased as well, and they may have a potential tendency towards multiple food allergies. This is why I am careful in questioning patients about any hidden focal infections, and you can read a lot more about this in section 5 of chapter 7.

High sIgA Levels

I more often will find a lower level of sIgA when it comes to stool testing, but occasionally discover an elevated IgA in a stool test. An increase in SIgA will generally mean a heightened immune respone which usually signifies inflammation. It will generally be an acute immune response, ongoing infection or significant food allergy.

An elevated SIgA along with an elevated lysozyme, calprotectin or lactoferrin level will tell you that there is inflammatory bowel disease (Crohn’s disease or ulcerative colitis), an elevated SIgA with low or normal lysozyme, calprotectin or lactoferrin levels will tell you that there is either IBS (irritable bowel syndrome) or a significant food allergy or infection.

I have noticed that patients with markedly elevated SigA levels often feel quite ill, and some can feel really sick. An upregulated immune respone can create many different clinical scenarios and can affect many different systems of the body. Microbial and mircoscopic studies of the stool are useful in identifying if bacteria, candida or parasites are present, and as you can now begin to see, this information can significantly aid in formulating a plan of successful yeatst infection treatment. It is important to remember however that elevated SigA levels have been found in the absence of bacteria, candida and parasites in people with atopic conditions like food allergies, urticaria and dermatitis. Again, testing will reveal what is really going on inside the gut, and will take all that guesswork out of the equation.

Best Nutritional Way To Increase sIgA – The 4-R Method

There are different things you can do to elevate SIgA, but one of the best ways is to use the right kind of diet and take the dietary supplements specifically formulated to enhance your program.

Here is my 4-R method of nutritional supplementation, an excellent method to significantly enhance your SigA levels:

  1. Remove offending foods, crush candida and correct nutritional deficiencies: Follow the 3-Stage Candida Crusher Diet as outlined in section 1 of chapter 7. Consider antimicrobial, antifungal, and antiparasitic treatment in the case of opportunistic/ pathogenic bacterial, yeast, and/or parasite overgrowth (the Candida Crusher Formula). Take the Candida Crusher Multi to correct any underlying nutritional deficiencies.
  2. Replace what is needed for normal digestion and absorption: Take the Candida Crusher Digestive Enzyme to significantly improve digestion and absorption.
  3. Reinoculate with favorable microbes: Take the Candida Crusher Probiotic to enhance the growth of the favorable bacteria, supplement with prebiotics such as the correct fibers in your diet.
  4. Repair digestive system cells: Repair the leaky gut and the immune system. Reduce the inflammatory response by taking the Candida Crusher Omega 3 and the Candida Crusher Probiotic.

More Ways To Increase SIgA Levels

  • Colostrum has also been shown to increase SIgA levels. Colostrum is the first milk that contains a significant amount of immunoglobulins (antibodies) which helps confer additional immunity to an infant cow or human straight after birth. Colostrum has been shown to stimulate the production of SIgA and is certainly a good supplement to try.
  • Prebiotics Make sure you eat plenty of healthy dietary fiber, you can read a lot more about fiber in section 1 of chapter 7. This is an overlooked area, because most people are too busy taking probiotics to worry about eating healthy prebiotic foods which feed the probiotics in their digestive system!
  • Cayenne pepper has the ability to stimulate B-lymphocytes into manufacturing more SIgA. By taking 2 cayenne pepper capsules a day you will be increasing your levels.
  • Saccharomyces boulardii is a beneficial yeast and one of the few probiotics which not only helps to fight a yeast infection, it can assist in boosting SIgA levels.
  • Lowering stress levels has been shown to increase SIgA levels by lowering the stress hormone cortisol. Elevated cortisol levels have been proven to suppress the production of SIgA. Be sure to study section 5 of chapter 7 to more fully understand why rest and relaxation is one of the best kept secrets when it comes to crushing your candida for good.
  • Folowing the Candida Crusher Diet principles By following my dietary recommendations you will be ensuring your that you are doing everthing right diet-wise to repair the leaky gut and elevate lowered levels of SIgA.
  • Take the Candida Crusher Supplements Be sure to follow the 4-R dietary supplement program, it will ensure that you will increase your SIgA levels in the shortest possible time. It could mean the difference between inhibiting yeast and reducing the severity of your symptoms to permanently eliminating your yeast infection in the shortest possible time.

Whenever I get test results back, I immediately wonder what the immune panel of this patient’s CDSA test looks like; are there high levels of sIgA in the test results, indicative of a lot of antibody production in the digestive system? If there is a high level, then I know that I have to work quite hard on the Hypo Allergenic Diet up front with this patient, because the higher the level of sIgA, the stronger the immune response will be towards allergenic foods that person is consuming right now. The Hypoallergenic Diet by the way is the second stage of the Candida Crusher Diet, you can read about it in section 1 of chapter 7.

Positive Test Results: 38yr Old Male With Major Yeast Problem

Here you can see a colorful section of a CDSA test result, showing the yeast panel. If yeast is positive then a yeast susceptibilities panel will be shown on your CDSA test results. The following panel is the test results from a 38yr old male who had been experiencing major digestive issues for several years, including a bad case of diarrhoea. He was diagnosed as having “irritable bowel syndrome” and placed on several drugs, including a pharmaceutical drug commonly prescribed for diarrhoea an anti-anxiety drug as well as an anti-depressant for the past few years due to his increasing despondency.

He used to work for a major telecommunications company, but had to stop work and eventually go on a sickness benefit due to his poor bowel function. The result of his CDSA was strongly positive (3+ on all 3 stool samples) for candida albicans, and here below are the results of the sensitivity panel included with this test. We treated Paul (not his real name) for over 3 months before we started to notice significant results, but it took almost 6 months before we started to see a 90%+ improvement in his condition. It has been now 2 years ago, and Paul is now back at work and most grateful for the help he has received. And his bowel function? We are pleased to say that Paul is back to one or two motions daily, instead of up to ten bowel motions daily.

CDSA Test Collection Requirements

  • Eat the foods as you normally would. Just like the food allergy tests, I would prefer that you eat what you WANT to eat, follow your desires as the test results will then be a more true reflection of not only what is going on in your gut, but what digestive issues got you to this point where you now seek treatment. What is the point of testing the stool of a person who a month ago went onto a super strict healthy dietary approach for example, after they spent years drinking alcohol a few times a week, eating fries and following a processed and refined supermarket diet in general. I want the patient’s stool test results based on the diet which they followed before they decided to clean up their act. This is the best way to ascertain what is really going on. You go back onto your healthy diet as soon as you have performed the stool test, but for the week leading up to the stool test you eat whet you like and want to eat.
  • Avoid probiotics and preferably ALL dietary supplements for up to three days (but preferably an entire week) prior to the test. You may otherwise get a false negative result, especially with candida, bacteria and parasites.

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  • Hi I’m trying hard to figure out my test results I just recieved,
    I had citrobacterfreuni complex and klebsiella pneumoniae found in my gut along with alpha hemolytic strep and gamma hemolytic strep. I’ve been suffering from lots of burning pain in my stomach and lower bowel area. I can only eat one fruit and one vegetable without pain and severe bloat. I also have VERY high lysozyme (2320ng/ml) but normal IGA (130mg/dl).. I’m being put on an antibiotic as my ND said the herbal stuff apparently won’t work. Do you have any ideas as to what the high lysozyme with normal IGA means. I would really appreciate it!!!