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In some patients, an increased expression of Toll-like receptor (TLR)-4 which recognizes bacterial LPS, TLR-5 which recognizes bacterial flagellin and increased levels of anti-flagellin antibodies were found in post-infection IBS ( There had been many instances when commensals (normal microbiota) reportedly turned pathogenic such as the case of Enterococcus faecalis which had inadvertently acquired a number of virulence genes that conferred vancomycin resistance (Paulsen et al., 2003)

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It does not include a complete metabolic or optimization panel to establish baseline biomarkers

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