Can gynecological malignancy or other pathology cause abnormal stool sample results with elevated inflammatory markers, low sIgA, and intestinal yeast?

Gynecological Malignancy Cannot Directly Cause These Stool Findings

These stool findings—elevated MMP-9, beta defensin 2, lactoferrin, eosinophil protein X, low sIgA, and intestinal yeast—indicate active intestinal inflammation and dysbiosis, not gynecological pathology. While gynecological cancers can alter the gut microbiome, they do not directly cause the specific pattern of elevated fecal inflammatory markers you describe 1.

Why These Markers Indicate Intestinal Disease

The combination of elevated lactoferrin, eosinophil protein X, and low sIgA specifically reflects intestinal mucosal inflammation and immune dysfunction, not pelvic pathology:

• Fecal lactoferrin is elevated in intestinal inflammation from inflammatory bowel disease (IBD), infections, or NSAID-induced enteropathy, with the AGA recognizing it as a validated biomarker for ruling in active intestinal inflammation 1
• These inflammatory markers (lactoferrin, calprotectin) may be elevated from nonintestinal sources of infection or inflammation, but gynecological malignancies are not recognized as such sources in gastroenterology guidelines 1
• Low secretory IgA indicates intestinal immune dysfunction and is associated with intestinal dysbiosis and inflammatory conditions, not pelvic tumors 2
• The presence of multiple intestinal yeast species reflects gut dysbiosis that correlates with intestinal inflammation markers, not gynecological disease 2

What Actually Causes This Pattern

This specific constellation of findings indicates primary intestinal pathology requiring gastroenterological evaluation:

• Inflammatory bowel disease (Crohn's disease or ulcerative colitis) is the most likely diagnosis given the elevated inflammatory markers and dysbiosis pattern 1, 3
• NSAID use within the past 6 weeks can cause all these findings through direct mucosal injury and should be specifically excluded 4
• Celiac disease causes intestinal inflammation with elevated calprotectin and dysbiosis, and tissue transglutaminase antibodies should be checked 4
• Intestinal infections including Clostridioides difficile and other enteric pathogens must be ruled out before attributing findings to chronic inflammatory conditions 1
• Microscopic colitis can present with these inflammatory markers despite normal-appearing mucosa on colonoscopy 4

The Gynecological Cancer-Microbiome Connection Is Indirect

While gynecological cancers can alter the gut microbiome, this does not translate into the specific inflammatory marker elevations you describe:

• Gynecological cancers may be associated with changes in gut and vaginal microbiomes, but these are compositional changes in bacterial species, not elevations in fecal inflammatory proteins 5, 6
• The microbiome changes in gynecological cancers involve shifts in bacterial populations (dysbiosis), not the acute inflammatory response indicated by elevated lactoferrin, eosinophil protein X, and defensins 5, 6
• Endometriosis causes systemic inflammatory marker elevations (IL-6, hs-CRP, CA-125 in serum), but does not cause the specific fecal inflammatory marker pattern you describe 7

Required Next Steps

Proceed with colonoscopy and upper endoscopy with biopsies to evaluate for IBD, microscopic colitis, and colorectal neoplasia:

• Endoscopic evaluation with biopsies is essential when fecal inflammatory markers are elevated, as biomarkers have no role in dysplasia detection and cannot distinguish between different causes of intestinal inflammation 1
• Test for Clostridioides difficile and other enteric pathogens before initiating any immunosuppressive therapy 1
• Check celiac serology (tissue transglutaminase antibodies) as untreated celiac disease causes intestinal inflammation with elevated calprotectin 4
• Review all medications taken in the past 6 weeks, particularly NSAIDs (including over-the-counter ibuprofen, naproxen, aspirin), as these significantly elevate fecal inflammatory markers through direct mucosal injury 4

Critical Pitfall to Avoid

Do not attribute intestinal inflammatory markers to gynecological pathology and delay appropriate gastroenterological evaluation. The pattern you describe requires colonoscopy with biopsies to rule out IBD, colorectal neoplasia, and microscopic colitis 1, 4. Fecal inflammatory markers are specific for intestinal mucosal inflammation, not pelvic disease 1.