Just take a quick gut check


The stomach sags. Tormented, he looks to the display in a women’s magazine. The attacker – nasty green germ with thread-like tails to put him. About the line: “A pain that tortures Your stomach?”

The advertising promotes a rapid test for the home, the consumer can easily check whether or not you suffer from the stomach germ Helicobacter pylori. And whether this is behind the stomach pain, heartburn and Stress. “Easy”, “fast”, “safe”, the ad promises. Available to the Test via the Website of a well-known drugstore market.

Test is not a substitute for a doctor

Other, similar Tests of the same provider are now on the shelves of drugstores. Thus, for example, a quick test of the “Healthy gut”, a “iron Test” and a Test that is intended to help a “gluten Allergy” to prove. They all cost around ten Euro.

The nano repro AG, a manufacturer of home tests, shall request that the fast tests “for the user to give a first qualitative detection of the” – “discreetly and without a long wait”. They could not, however, replace the more detailed Tests at the doctor. “The test results are not a diagnosis and not a treatment approach, but are only a first indication.” The bowel test was merely a “supportive tool”. A diagnosis should only a doctor.

How useful are the home tests? SPIEGEL ONLINE has tried three, and the professionals asked you to assess.


The “iron Test”: What is it?

On the packaging, a woman yawns. “Tired? Headache? Prone to infections?” next to it. Other typical signs of iron deficiency according to the packet about pallor or strong heart Supplement palpitations. The Test is advertised as an “aid to diagnosis”. It measures the so-called Ferritin, a protein complex in which iron is stored.

How does the Test work?

Anyone who has experimented as a child with the chemistry box, should be happy. Pipette, glass capillary tube and a test cassette stuck in the pack, next to a jar with a sample dilution buffer, an automatic lancing device, alcohol swabs and plasters. This includes a detailed manual with pictures.

First, the cap of the lancing device is rotated. Who is curious and is equal to the shutter button presses, and blew it the first time. The needle shoots up with a loud clack to the front, re-use impossible. Since only helps: needle from the plastic housing, or equal to another Piekshilfe for the tip of your finger disinfect. Glass tube held in a horizontal position to the drop of blood, so that blood is drawn. Completely filled, as intended, is not the tube, however. After the first prick, not exceeding one-tenth is reached. A bit of squeezing and prodding must be, even then it will only three-quarters full.

Then the solution tubes in the test, shaking and three drops of the mixture on the test cassette. After ten minutes, the result can be read on the basis of strokes, similar to a pregnancy test. A residual uncertainty remains: Have I really done everything correctly? Or was it too little blood?

What experts say about the Test?

“Ferritin is a good Marker for the iron budget,” says Thomas Frieling, Director of the Medical clinic II, gastroenterology Department at the Helios Klinikum Krefeld, and is a member of the German society for gastroenterology, digestive and metabolic diseases. The Test itself was fine. But, out of the laboratory, the clinic works together, appear in all Tests, the “handling, for the home, however, relatively complicated and therefore error-prone”.

Frieling is to consider: Why pay for something, what is assumed in the case of a justified suspicion of the health insurance? Yet, when ultimately a doctor to clarify the diagnosis is to be definite must. In practice, the Patient learns the value of the exact Iron.


The “gluten-Allergy-Test”: What is it?

Also this Test is promoted as “an aid in the diagnosis of a gluten intolerance”. In the case of celiac disease, so the technical term, not tolerate the the body, the adhesive protein Gluten, which leads to a chronic inflammatory disease of the small intestine. An Allergy is not, however, even if the immune response of the Affected plays an important role. Gluten is in wheat, spelt, rye, or barley.

The information on the frequency of celiac disease vary, they are between 0.3 and up to one percent of the population. Only 10 to 20 percent of the full picture of the disease, however, writes the German celiac society on your Homepage. 80 to 90 percent have atypical, therefore, or no symptoms and therefore often unaware of the disease.

Food Affected of gluten-containing foods, they often diarrhea, Nausea, or bloating. Also fatigue, lack of drive or a lack of nutrients can be signs. A gluten-determine intolerance, the Test measures specific antibodies in the blood.

How does the Test work?

The Equipment is similar to that of the iron-test, the process is the same.

What experts say about the Test?

Gastroenterologist Frieling is skeptical: even Doctors would make in the case of a suspicion of and often a anti-body test. But: “It is a hint, but not evidence. There are also patients who have a positive result, but no celiac disease.” In the other, the Test is negative, and you respond however, the protein in the Glue.

Sure to find a gluten-can unveträglichkeit only with small-bowel biopsies. This Frieling recommends a reasonable suspicion. Because who is actually ill, you must eat life-long gluten-free, and the limits. In addition, increases in Affected the risk of developing a Tumor in the intestine.

In the guideline, a kind of recommendation, it is advised not to fast tests. The laboratory submitted the findings should not only contain the rating “positive” or “negative”, but also information about the concentration of the antibody, the limit and the test manufacturer. Also, the quality of the Tests is important. “Laboratories must show that they actually measure what they are supposed to measure,” says Frieling. In the case of the quick test, the consumer must trust the information given in this leaflet.

As a public health scientist and Doctor Ingrid Mühlhauser, University of Hamburg, is precisely the point skeptical. Your information is missing, the others find them misleading. Be listed in the package insert the performance data from the test was compared with a reference test. But: “I don’t know, as a consumer, which is the reference test it was and who performed the Tests, Amateurs or professionals.”

Also: In the small study with 80 participants, the Test showed that at 50 a gluten intolerance, once he was in the wrong. “Because celiac disease is much rarer appearance, you have tested the Test to a preloaded group,” says Mühlhauser. In other words: In the investigation, the probability is high that a positive result is in fact a celiac. “As a user, I would like to know, however, how well the Test can predict, that I really have a gluten intolerance. For these Info sources are missing.” I can be me, so after a positive result, make sure I’m affected? “No,” says Mühlhauser.

The German coeliac society considers the epistemological value of such Tests as “extremely low”. Those who start after such a shaky evaluation, to eat gluten-free, also makes it difficult medical diagnosis, as this can distort the result.


The “Healthy gut Test”: what is it?

“Blood in the stool? Through the case? Intestinal cramps? Constipation” is on the packaging. Including: “early detection can protect”. The Test is to demonstrate the hidden, human blood in the stool, a “first signs of diseases such as polyps or colon cancer”.

How does the Test work?

Here, too, there is a tube for the sample. From the chair at various Points to collect samples. This one dissolves in a liquid, and drips some of it on the test kit until dashes appear. The Test, however, is neither nice nor easy: the toilet water, blood in the urine or stomach irritations can distort the result. In the case of a positive result, it is advised to go to the doctor immediately.

What experts say about the Test?

Ingrid Mühlhauser is missing here, too, the sources, in order to check the quality of the Tests. “From studies using similar Tests, we also know that a majority of consumers interpreted the result wrong,” she says. “The Test does not prove to be colon cancer be ruled out. A positive result does not mean that I am ill.”

This is also so in the package insert. But the note is missing, that a bleeding is often harmless causes. Only a small part of those, which Tests for hidden blood have to beat, find the Doctors by further investigations, in fact, a malignant Tumor, writes about the cancer information service. On the other hand, each Tumor or Polyp bleeds. Such Tests are overlooked, therefore, cases of cancer.

Especially the old Tests, the concealed blood evidence in the chair, biochemically, are prone to failure. Since 2017, the Fund will pay for newer, more reliable method, so-called immunological stool tests. You have the blood using antibodies. But they are also error-prone.

The Alternatives

Frieling feared, that provides commercially available Test without the filing of conversation rather uncertainty – and, although the bowel cancer screening uses. From 50 years, every Insured person is entitled to regular examinations for the early detection of colorectal cancer. This includes annual Tests on hidden blood in the stool, and 55 years colonoscopy. If you decide against the Mirror, it can make instead, all of the two years of the Test. The funds to pay for the studies.

The colonoscopy is the most reliable method for early detection, men should be in the future, recommended starting at 50. Who belongs to a risk group because, for example, in the family, colon cancer has occurred, it can take a Pension earlier.

Gastroenterologist Frieling sees the danger that the freely available, is used in commercial rapid-test early and often. “Then, also, false-positive findings occur more frequently,” he says. “As a result, I have to let unnecessary inquiries go through me.” As a striking result has to be investigated with a colonoscopy.


In summary: self-tests for blood in the stool, iron, or Gluten there are freely available in the trade. However, the handling is difficult, the significance of the Tests will be limited and the Interpretation prone to error. The health scientist Ingrid Mühlhauser therefore says: “All that is necessary, I get for free, and more specifically to the family doctor, advice included.” The gastroenterologist Thomas Frieling emphasized: “the danger is that such Tests are to be used uncritically.” And that the consumer is ultimately much smarter – but a few euros poorer.