InstalabStoolOMX™
Should you take a StoolOMX™ test?
This test is most useful if any of these apply to you.
46 biomarkers included
- Total Bile AcidsThe sum of all bile acids in stool, showing how much bile is reaching and leaving the colon overall.Unusually high totals can point to bile acid diarrhea; very low totals may reflect reduced bile flow into the gut.
- Secondary Bile AcidsThe microbe-made bile acids. This value captures how much converting work your gut bacteria are actually doing on the bile your liver sends down.Low secondary bile acids suggest your gut bacteria are converting less bile than usual, a sign of an imbalanced gut community.
- Primary Bile AcidsThe liver-made bile acids that reach the colon before microbes reshape them. High amounts hint at weak conversion or fast transit.High primary bile acids in stool can signal weak microbial conversion or transit moving faster than bacteria can process.
- Total Primary Bile AcidsThe combined pool of liver-made bile acids in stool, read against the secondary pool to judge conversion.A high total primary pool relative to secondary forms flags reduced downstream microbial transformation.
- Cholic AcidOne of the two main liver bile acids and the raw material microbes turn into deoxycholic acid.Elevated cholic acid suggests it is escaping conversion into deoxycholic acid by gut bacteria.
- Chenodeoxycholic AcidThe other main liver bile acid, feedstock for lithocholic and ursodeoxycholic acids.High levels indicate limited conversion downstream and, in diarrhea-predominant IBS research, correlated with greater gut sensitivity.
- Taurochenodeoxycholic AcidChenodeoxycholic acid still carrying its taurine tag, another readout of the first processing step.Raised levels point to incomplete removal of the taurine tag, the gateway step of bile processing.
- Taurocholic AcidCholic acid still carrying its taurine tag, showing whether the first bacterial step of bile processing has happened.Elevated levels suggest bacteria are not efficiently unclipping conjugated bile acids.
- Glycochenodeoxycholic AcidChenodeoxycholic acid still carrying its glycine tag.Reflects incomplete tag removal from this liver bile acid by gut microbes.
- Glycocholic AcidCholic acid still carrying its glycine tag before microbes remove it.High levels signal that removing the tag, the gateway step of bile transformation, is lagging.
- Hyocholic AcidA minor bile acid studied for metabolic signaling that adds nuance to the primary bile acid picture.A minor bile acid of research interest in metabolism, adding depth to the primary pool.
- Total Secondary Bile AcidsThe combined pool of all microbe-transformed bile acids, the clearest single readout of your microbiome's conversion capacity.A low secondary total, especially against high primary bile acids, is a core signal of reduced microbial conversion capacity.
- Deoxycholic AcidThe major secondary bile acid made from cholic acid, and a direct marker that the main conversion step is running.Marks active bile conversion; very high levels have been linked in research to colorectal cancer risk.
- Isolithocholic AcidAn iso form of lithocholic acid made when microbes reshape it, part of fine-tuning the bile pool.Reflects microbial reshaping of lithocholic acid, a sign of a varied bile-transforming community.
- Lithocholic AcidThe major secondary bile acid made from chenodeoxycholic acid, another readout of microbial conversion.Marks conversion of chenodeoxycholic acid; it ran lower in stool of people with diarrhea-predominant irritable bowel syndrome (IBS).
- 12-Ketolithocholic AcidAn oxidized bile acid derivative reflecting the oxidation steps microbes run.An oxidized derivative that ran higher in some colorectal cancer research settings.
- 3-oxoDeoxycholic AcidAn oxidized form of deoxycholic acid, marking the oxidation branch of bile processing.Signals that the oxidation route of secondary bile acid handling is active.
- Ursodeoxycholic AcidA gentler secondary bile acid made by a side route of oxidation and reshaping rather than the main conversion path.Reduced in diarrhea-predominant IBS; a milder bile acid made by a bacterial side route rather than the main conversion.
- 7-Ketolithocholic AcidAn intermediate on the path to ursodeoxycholic acid.Shows the oxidation-and-reshaping route toward ursodeoxycholic acid is running.
- 7-Ketodeoxycholic AcidAnother oxidized intermediate that reflects the breadth of your microbes' bile-transforming enzymes.Its presence reflects a wider range of active bile-transforming enzymes.
- Dehydrolithocholic AcidAn oxidized lithocholic acid product that rounds out the map of secondary bile acid routes.Fills in the oxidation side of the secondary bile acid map.
- Hyodeoxycholic AcidA minor secondary bile acid whose presence signals additional microbial modification routes.Points to extra microbial modification routes beyond the main conversion pathway.
- Alloisolithocholic AcidA recently recognized microbial bile acid studied for immune signaling in the gut.One of the panel's frontier markers, tied in research to gut immune signaling.
- 3-Dehydrocholic AcidAn oxidized cholic acid derivative marking early oxidation steps in bile transformation.Marks early oxidation activity as microbes begin reshaping cholic acid.
- Glycolithocholic AcidGlycine-tagged lithocholic acid, one of the tagged secondary forms.Its level reflects re-tagging and handling of this potent secondary bile acid.
- Glycoursodeoxycholic AcidGlycine-tagged ursodeoxycholic acid, adding detail on how the gentler bile acids are tagged.Adds nuance to how your microbiome tags the milder ursodeoxycholic acid.
- Glycodeoxycholic AcidGlycine-tagged deoxycholic acid, showing how secondary bile acids are re-tagged.Contributes to the picture of how your secondary bile acids are tagged and handled.
- Taurolithocholic AcidTaurine-tagged lithocholic acid, a tagged secondary form shifting with diet and bile handling.Tracks how the potent lithocholic acid is tagged as diet and bile flow change.
- Tauroursodeoxycholic AcidTaurine-tagged ursodeoxycholic acid, a tagged form of the gentler bile acid studied for metabolic interest.Follows tagging of the milder ursodeoxycholic acid, a form of research interest in metabolism.
- Taurodeoxycholic AcidTaurine-tagged deoxycholic acid, completing the tagged secondary set the panel measures.Rounds out the tagged secondary bile acid picture alongside the glycine forms.
- Total Short Chain Fatty AcidsThe combined fermentation output, a single number for how actively your microbes ferment fiber.A low total signals reduced fermentation; lower levels track with inflammatory bowel disease and colorectal cancer.
- Total Saccharolytic Straight Chain Fatty AcidsThe sum of the fiber-driven fatty acids, separating carbohydrate fermentation from protein fermentation.Low values suggest your microbes are fermenting less dietary fiber than a balanced gut community would.
- Acetate %The proportion of fermentation output that is acetate, a marker of community balance.Shifts in the acetate share hint at changing microbial communities behind your fermentation.
- Butyrate %The share of total fermentation made up by butyrate, showing how the fermentation mix is balanced.A low butyrate share means proportionally less of the colon lining's preferred fuel is being produced.
- Proprionate %A short-chain fatty acid made by gut bacteria when they ferment fiber, measured as its share of the total short-chain fatty acids in your stool.
- Valerate %A minor straight-chain fermentation acid that sharpens the fermentation profile.Adds resolution to the fermentation picture beyond the three main acids.
- AcetateThe proportion of fermentation output that is acetate, a marker of community balance.Shifts in the acetate share hint at changing microbial communities behind your fermentation.
- ButyrateThe share of total fermentation made up by butyrate, showing how the fermentation mix is balanced.A low butyrate share means proportionally less of the colon lining's preferred fuel is being produced.
- Proprionate
- ValerateA minor straight-chain fermentation acid that sharpens the fermentation profile.Adds resolution to the fermentation picture beyond the three main acids.
- CaproateA six-carbon fatty acid reflecting microbial chain-elongation activity.Reflects chain-elongation, an extra window into how your microbes handle fermentation.
- Total Proteolytic Branched Chain Fatty AcidsThe combined protein-fermentation acids, showing whether microbes are leaning on protein instead of fiber.A high branched-chain total signals more protein fermentation, often alongside lower fiber intake.
- IsobutyrateA branched fatty acid made when microbes ferment the amino acid valine instead of fiber.A protein-fermentation marker; levels rise with aging and lower fiber intake in studies.
- IsovalerateA branched fatty acid from fermentation of the amino acid leucine.Higher isovalerate adds to the picture of a microbiome leaning on protein for fuel.
- 2-MethylbutyrateA branched fatty acid from fermentation of the amino acid isoleucine.Reflects isoleucine fermentation, another sign of protein-based rather than fiber-based fuel use.
- IsocaproateA branched fatty acid from amino acid fermentation, rounding out the protein-fermentation markers.Marks additional amino-acid fermentation, completing the protein-fermentation set.
About StoolOMX™
Your gut is home to trillions of microbes, and what matters most is not only which ones live there but what they actually make. This panel skips the census and reads the output: the bile acids and fatty acids your bacteria produce as they process your food and your own digestive fluids.
That output is a functional snapshot of how your microbial community is working. Standard microbiome tests tell you who is present. This one estimates what they are doing, though the frameworks for interpreting the numbers are still taking shape.
What This Panel Reveals
The panel tells two intertwined stories. The first is about bile acids, the fat-digesting compounds your liver makes and releases into your gut. Bacteria reshape them in a two-step relay: first they snip off a chemical tag (deconjugation), then a smaller group of specialist microbes converts these liver-made "primary" bile acids into "secondary" bile acids like deoxycholic acid and lithocholic acid. In healthy people, secondary forms usually make up most of the stool bile acid pool.
When that conversion falters, the balance tips toward primary bile acids and away from secondary ones. A low secondary-to-primary balance has been reported in conditions from bile acid diarrhea to cirrhosis, where stool showed the lowest secondary bile acids and the highest primary ones. In research on diarrhea-predominant irritable bowel syndrome (a common gut disorder, often shortened to IBS), stool cholic acid and chenodeoxycholic acid ran markedly high while lithocholic acid and ursodeoxycholic acid ran low.
The second story is about fermentation. When your microbes ferment dietary fiber, they release short-chain fatty acids (the fuel-like chemicals that feed your colon lining and calm inflammation, often abbreviated SCFAs). Butyrate is the standout: it is the preferred fuel of the cells lining your colon. Lower stool SCFAs show up repeatedly in inflammatory bowel disease (chronic gut inflammation, abbreviated IBD) and colorectal cancer (abbreviated CRC). One pooled analysis found lower stool butyrate in people with colorectal cancer than in healthy people, and separately, when several short-chain fatty acids were combined, lower overall levels tracked with higher cancer occurrence, with a pooled standardized difference of 0.45 (95% CI 0.19 to 0.72).
A third set of markers reads protein fermentation. When microbes run low on fiber and lean on protein instead, they make branched-chain fatty acids like isobutyrate and isovalerate. Measuring these alongside the fiber-derived acids shows whether your microbiome is tilting toward fiber or toward protein as its main fuel, a distinction neither bile acids nor total fatty acids can reveal alone.
How to Read Your Results Together
The value of this panel is in the combinations. Bile acids read out how your microbes transform your own compounds, while the fatty acids read out how they ferment your diet. Reading both at once shows whether a shift is confined to one pathway or reflects a broader change in the community.
| Pattern | What it may suggest |
|---|---|
| High primary bile acids, low secondary bile acids | Your microbes are converting less bile than usual, seen in bile acid diarrhea and some inflammatory states |
| Low butyrate and other fiber-derived fatty acids | Less fiber fermentation and less fuel reaching the colon lining |
| High branched-chain fatty acids | More protein fermentation, often alongside lower fiber intake |
| Low secondary bile acids plus low butyrate together | A broad move away from a fiber-fed, balanced microbial community |
What to Do with Your Results
This panel is used mainly in research and functional-medicine settings, and standardized clinical cutoffs for it do not yet exist. Treat the results as a starting point for conversation, not a diagnosis. If your primary bile acids run high with watery stools, bile acid diarrhea is worth raising with a clinician. If butyrate and other fiber-derived acids run low, added dietary fiber is the most direct lever, and a repeat test can show whether the change moved the numbers.
Pair the panel with markers that measure different things: a stool inflammation marker such as calprotectin, a digestion marker such as pancreatic elastase, and a stool blood test if colorectal cancer screening is due. Because a single stool sample is a weak proxy for your usual state, serial testing is more informative than a one-off. Retesting a few months after a meaningful diet change, and again to confirm a trend, gives a clearer read than any single result.
When Results Can Be Misleading
Several factors move many of these markers at once. What you ate in the days before collection shifts both fatty acids and some bile acids. How fast stool moves through you changes concentrations independent of what your microbes are producing. Medications, including antibiotics and some diabetes drugs, alter bile acid and microbial activity.
The measurement itself is reliable, but the biology is not steady. Lab reproducibility for these assays is high, yet the same person's values over six months are often quite variable. That is why a lone abnormal value is best read as a prompt to look closer, ideally with a repeat sample, rather than as a fixed fact about your gut.