A New Test - The CDSA - For IBS Sufferers - Michael Franklin

Michael Franklin is a nutritionist who has specialised in food intolerance and IBS. He is very excited about a new test which allows the practitioner to examine no less than 25 areas of intestinal ecology.

There is a new test available which is proving to be of enormous benefit to IBS sufferers. Called the CDSA test, it stands for Comprehensive Digestive Stool Analysis, and comprehensive is exactly what it is. Patients send in stool samples and they are examined under an extremely powerful microscope to discover if they contain various substances which might be causing IBS type symptoms or digestive problems.

Almost always in my experience with patients who have taken the test, it reveals at least one or two things which NHS tests such as the endoscopy or sigmoidoscopy or even the comprehensive colonoscopy have not revealed. Not surprising perhaps, when you think about it, because it examines stool samples, which the other tests don’t, and it takes great care to get them in the right form, unlike any other stool sample test. (Careful instructions are provided with the test kit sent to patients and samples can be taken at home - which saves time and a trip to the hospital.)

What is remarkable about the CDSA?

The fact that it examines no less than 25 different areas of digestion and intestinal ecology. All are helpful, as getting one’s intestinal ecology right is an important step for everyone. For IBS sufferers the major areas are as follows:


These are a cause of IBS symptoms in, I would say, at least 15% of long-term sufferers. They are especially likely to be a cause where diarrhoea or endless loose bowel movements are the major symptom and they are particularly likely to be present if the patient’s symptoms can be traced back to a stomach bug experienced on foreign travel. Even if this stomach bug was treated with antibiotics at the time it seems that the parasite will often not have been completely eradicated and could still be causing symptoms several years later. This is particularly true if the patient was ill on a trip to India or similar exotic location. Even if the patient has been tested for parasites on the NHS it is very possible the CDSA, because of its more sophisticated techniques, will find something the previous test did not. Giardia, Dientamoeba fragilis and Blastocystis hominis are all examples of hard-to-detect parasites that cause IBS.


Just as is the case with parasites, bacteria such as Campylobacter or Enterobacter can be the hidden cause of IBS. It is almost impossible to tell from clinical symptoms if they are a cause so here the CDSA is invaluable. And just as in the case of parasites, not only does the test reveal which bacteria are the problem, it provides a list of which drugs and/or natural remedies have been found to be the most effective.

Candida Albicans & Yeast Infection

Infections such as Geotrichum can be a definite contributory cause of IBS and the test identifies the presence of any of these yeasts, all of which can contribute to gut fermentation.

Friendly Gut Flora

Friendly gut flora or probiotics, are very important to a healthy gut. The test measures on a scale of one to four the presence or absence of lactobacillus acidophilus and bifido bacteria, two of the friendly bacteria which are found in natural, organic yoghurt. These are very beneficial to intestinal health and are why, just in the last few years, commercial yoghurt makers such as Yakult and Benecol have entered the market to try and persuade us all to eat yoghurt with these friendly bacteria added.

The CDSA also tests for occult blood in the stool, which can be due to haemorrhoids or an anal fissure, but which can also indicate the possibility of more serious pathology, such as cancer. It measures the presence of meat and vegetable fibres in the stool which are an indicator of the efficiency of protein and carbohydrate digestion, and it also measures beta-glucuronidase which can be an indicator of a potential risk of colon cancer.

My background is that of a nutritionist who specialises in food intolerances, which is why I also have a practice called the Oxford Nutrition and Allergy Centre. I used to look at IBS mostly in terms of food intolerances and, believe me, they are often a cause of IBS symptoms. But when the CDSA test became available to a small number of private nutritionists (different from dieticians, who work in hospitals), and some private doctors, I was intrigued. Since then I have used it with every IBS patient (and those with Ulcerative Colitis and Crohn’s) who does not respond to the food intolerance approach, or who wants to take the test immediately. In the case of those with a history of one or more stomach upsets in the course of foreign travel I recommend it at once.

To be honest, I recommend it for everyone with IBS because, even if their symptoms have improved considerably via the food intolerance approach, it shows if something is still basically wrong. We should all have one or two perfectly formed bowel movements every day. You can bet your life that everyone with really good health does. It seems to me that anyone who differs from that norm can improve their health considerably with the aid of this test.

The IBS and Gut Disorder Centre has branches in Oxford (01865 459553) and London (0845 4560944) and is open Monday - Saturday, 9.30am-1pm.

CASE HISTORY : John Taylor

John Taylor was a dynamic executive in his late forties who had got everything in his life very much under control. In fact his life was pretty perfect in every respect, bar one. He had had very distressing IBS symptoms for at least ten years.

John came to the IBS and Gut Disorder Centre, a branch we have established especially for people with IBS, because he’d taken a food intolerance test and he wanted my help with formulating a diet for him which avoided milk and oats, the two foods his particular test had shown him to be intolerant of.

(N.B. This does not apply to all IBS sufferers; it simply applied to John Taylor.)

In many cases very accurate identification of one’s food intolerances will relieve symptoms of IBS considerably but, as I have stated in the accompanying article, there are some people who just do not respond to elimination of allergenic foods. John Taylor was one of them. So I suggested he do the CDSA test and its revelations were startling. He had parasites, unusual bacteria and a very high degree of Candida albicans. So he had not just one cause of his IBS but three major ones, and in addition, a finding of a complete absence of the friendly bacteria, lactobacillus acidophilus. After appropriate treatment he has improved considerably.

The above article originally appeared in Gut Reaction, the journal of the IBS Network in April 2002.


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First Published in 2002

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