DÄ internationalArchive3/2010Bacteriological Stool Examinations
LNSLNS I was surprised to see that this article makes almost no mention of the IgG4 mediated food intolerances. These are extremely common and easily treated by abstinence. Further, quantitative bacteriological stool testing is not mentioned. This is a cost effective and non-invasive way to gather comprehensive information on intestinal flora, digestive breakdown products (fats and sugars), and inflammatory markers (fecal calprotectin/alpha-1 antitrypsin). This examination is easily performed even in children. Measuring bacterial activity in breaking down fructose and sorbitol in feces does not provide any information about sugar intolerances. -Especially in children, it is just as easy to undertake a mild provocation test with apple juice or milk, given on an empty stomach. Stools could also be examined for Helicobacter. This avoids a breath test (which takes 3 hours and necessitates abstinence) and gastroscopy.

Extended stool tests such as the ratio of bacteroides to firmicutes provide concrete indications of different idiosyncrasies in the digestive process and energy metabolism.
DOI: 10.3238/arztebl.2010.0040a

Dr. med. Bettina Mrowietz-Ruckstuhl
Fliederweg 26
38226 Salzgitter, Germany
praxis@ruckstuhl.de

Conflict of interest statement
The author has received honoraria for speaking from Takeda and Pfizer. The author has conducted observational studies on behalf of Alcon, Pfizer, and Novartis
1.
Zopf Y, Baenkler HW, Silbermann A, Hahn EG, Raithel M: The differential diagnosis of food intolerance [Differenzialdiagnose von Nahrungsmittelunverträglichkeiten]. Dtsch Arztebl Int 2009; 106(21): 359–69.
1. Zopf Y, Baenkler HW, Silbermann A, Hahn EG, Raithel M: The differential diagnosis of food intolerance [Differenzialdiagnose von Nahrungsmittelunverträglichkeiten]. Dtsch Arztebl Int 2009; 106(21): 359–69.