Download - CM - Chemical Test for Stool Specimen
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CHEMICAL TEST FOR STOOL SPECIMENMary Christelle G. Aquitania
UST Medical Techonology Intern
Fecal Occult Blood Test Quantitative Fecal Fat Testing
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Fecal Occult Blood Test
Most frequently performed test Positive result suggests
BLEEDING of GI tract UPPER: black, tarry stool LOWER: overly bloody stool
Early detection of colorectal cancer
>2.5ml/150g stool
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Fecal Occult Blood Test
Mechanism PSUEDOPEROXIDASE ACTIVITY OF
HEMOGLOBIN
Hemoglobin H2O2 Guiac
Oxidized Guiac +
H2O
Pseudo 0
peroxidase
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Fecal Occult Blood Test
AVOID [3 days] Red meat Horseradish Melons Raw broccoli Cauliflower Turnip
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Fecal Occult Blood Test
AVOID [7 days] Aspirin NSAIDS
AVOID [3 days] Vitamin C Iron supplements
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Fecal Occult Blood Test
PROCEDURE - Materials Filter Paper Reagent A: Guiac Reagent B: Hydrogen peroxide Applicator stick
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Fecal Occult Blood Test
PROCEDURE Place a smear of stool specimen on the filter
paper in circular form. Add 2 gtts. of Reagent A then Reagent B on
the smear. Read after 1 minute.
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Fecal Occult Blood Test
INTERPRETATION
POSITIVE: A trace of blue on the stool
NEGATIVE: No change of color
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Fecal Occult Blood Test
FALSE POSITIVE Aspirin & anti-
inflammatory medication
Red meat Horseradish Raw broccoli,
cauliflower, radish, turnip
Melon Menstrual &
hemorrhoid contamination
FALSE NEGATIVE Vitamin C >
250mg/day Iron supplements
Containing VIT C
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Developments
Hemoquant Fluorometric test for hemoglobin and
porphyrin Immunochemical FOBT
Specific for globin of human Hb Uses Anti-human hemoglobin antibodies
Hemoccult ICT Uses Anti-human hemoglobin antibodies Early detection of colon cancer OK: patients taking aspirin and other anti-
inflammatory medication Does not detect other source of bleeding
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Quantitative Fecal Fat Testing Confirmatory test for steatorrhea (Gold Std. -
fat) Collection: at least 3-day specimen. Patient: maintain a regulated intake of fat (100
g/day) prior to and during the specimen collection period
Containers: Paints cans Specimen must be homogenized prior to analysis(conventional paint-can shaker)
Refrigeration: prevents bacterial degeneration.
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Quantitative Fecal Fat Testing Routine Method: Van de Kamer titration
Gravimetric methods are also available Fecal lipids are converted to fatty acids and
titrated to a neutral endpoint with sodium hydroxide.
Manner of reporting: gram of fat coefficient of fat retention per 24 hours.
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Quantitative Fecal Fat Testing Routine Method: Van de Kamer titration
Normal values based on a 100 g/day intake are 1 to 6 g/day or a coefficient of fat retention of at least 95%. The coefficient of fat retention is calculated as follows:
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Quantitative Fecal Fat Testing Acid steatocrit
rapid test: estimates the amount of fat excretion
similar to the microhematocrit test more convenient than a 72-hou stool
collection
reliable tool to monitor a patient’s response to therapy and screen for steatorrhea in pediatric population