I think we can all unanimously agree that, while doctors are totally necessary, doctors’ appointments can seriously be a PIA.
Let’s take my own health, for example: I’ve been having some—er, plumbing—issues for a while now (okay, fine, I’ve had ’em forever). To put it bluntly: I poop a lot (three to four times a day) and it’s very soft—sometimes even liquid. (In retrospect, I should have seen a doctor way before this point. Hindsight is 20/20.)
So, when I heard about SmartGut, an at-home test by a company called uBiome that promises to test your microbiome (a.k.a., that colony of microbes living inside your gut right now) through a stool sample, I decided to try it.
Full disclosure: I previously tried out uBiome’s SmartJane, an at-home STI-testing kit, and was pleased with the results, so I hoped that I could get some (quick, non-invasive) answers about what was going on with my stomach, too.
Good news: I didn’t have to poop in a cup. Bad news: It was still messy.
When the test came, I immediately registered my kit online (as you’re instructed to do) and then read the directions on the box so I’d know how to set up my own personal poop-testing lab.
The kit included two sample tubes with a stabilizing fluid (you know, to preserve the poop sample), two sterile swabs, and materials to send the sample back. Sounds easy enough, right?
Well, for anyone else it would’ve been—but that wasn’t how things played out for me.
SmartGut instructs you to do your business into the toilet bowl, as usual, then gather the “data” from the toilet paper, post-wipe. But, for me, my samples were never thick enough to actually count as data—meaning they weren’t leaving any residue on the TP.
Finally, when I had a stool that left enough of a smear on the toilet paper to transfer to the Q-tip, I rubbed the tip through the poo until the entire swab was covered. Then, I swirled and swished the Q-tips around in one of the mini jars for a minute, closed the lid, and shook it up. After double-checking that it was closed tight, I put it in the return envelope and mailed it out.
About six weeks later, I got an email that told me my poop results were in.
The message led me to a patient portal where I logged in to view a chart with the verdict (the suspense, right??).
Eventually, that led to a 10-page report about my microbe levels (via a color-coded high-low-normal chart), what they meant, and which health conditions I might be more prone to, based on those levels. I was also given links to published research on the microbiome, in case I wanted to know more.
Unfortunately, my results were…anticlimactic, to say the least: The test confirmed that I have high levels of the bacteria associated with a lot of diarrhea and low levels of bacteria associated with obesity. Given that diarrhea (or close to it) is my M.O. and I’ve always had a tough time gaining weight, I wasn’t particularly shocked.
Still, the test wasn’t wrong—so I wondered, how legitimate are these kits, anyway?
Basically, it’s still unclear how much sending your poop to a lab via snail mail can tell you about your health.
When you send in your poop sample for a microbiome test, it’s analyzed using a RNA ribosomal sequencing method, explains Jessica Richman Ph.D., co-founder and CEO of uBiome. (FYI: RNA is also known as ribonucleic acid—something in all cells.)
Basically, scientists isolate the RNA in a poop sample and look only at the part that comes from bacteria, which can show you which species of bacteria are present in your microbiome and how diverse yours is compared to others (hence the high-low-normal scale).
But according to experts, those results don’t mean a whole lot—at least not yet.
“These commercial tests are coming out, and patients are bringing up these at-home tests at their appointments, but the truth is we don’t know what do with those results,” says Emanuelle Bellaguarda, M.D., a gastroenterologist at Northwestern Memorial Hospital’s Digestive Health Center.
My test, for example, showed I had low levels of four bacteria that were inversely associated with ulcerative colitis, but when I asked Bellaguarda what I could do with that info, her answer was “not much.”
Leo Treyzon, M.D., a gastroenterologist at Cedars-Sinai Medical Center agrees that, while SmartGut, and other at-home microbiome-testing kits can help people begin to take their health into their own hands, the data they provide isn’t terribly insightful yet. “In 2018 we can look at your gut, and give you data on it, but the research on what you can actually do with those results isn’t actually there,” he explains.
Still, some doctors may be able to look at your results and prescribe a diet or lifestyle change that may help, says Teyzon—but those recommendations are going to be based on the doctor’s observations, not necessarily from strong research.
So, while these at-home tests can tell you what’s going on in your gut, they can’t necessarily tell you how to fix whatever’s bugging you, says Teyzon.
So, SmartGut didn’t tell me why I poop so much—or how to fix it.
It did, however, make me feel pretty damn empowered for taking my health into my own hands. The whole at-home testing experience was, dare I say, fun.
That said, there are absolutely benefits to seeing your doctor instead of defaulting to an at-home test, especially if you’re having any gastrointestinal issues, says Stephen B. Hanauer M.D., medical director of the Northwestern Medicine Digestive Health Center.
If someone has chronic G.I. issues like blood in their stool or severe abdominal pain, for example, choosing an at-home test instead of a face-to-face appoint with a doc could potentially be very dangerous for that patient, says Hanauer, as they may have a condition that needs even more intense testing, like a colonoscopy.
There are emotional benefits to seeing a doc in person, too, he says. If you’re anxious about what’s causing your G.I. issues, for example, talking with a professional in person can help soothe your nerves.
The bottom line: Taking the test was fun because it made me feel like I was the boss of my own health—but it didn’t really give me any actionable advice (or tell me anything I didn’t already know).
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