Fecalysis

A fecalysis is a series of tests done on a stool sample to help MACROSCOPIC

diagnose certain conditions affecting the digestive tract, which NormalValuesorResults
can include infections (such as from parasites, viruses, or amount:100200g/24h(100200g/d)
bacteria),poornutrientabsorption,orcancer. color:Brown(stercobilin)
SPECIMENCOLLECTION consistency: formed; normal to see fiber, vegetable skins, and
SPECIMEN:freshstool seeds
VOLUMEOFSPECIMEN:thumb/peanutsize(3-5grams) sizeandshape:tubular/cylindrical
CONTAINER: clean/sterile, dry, non breakable, sealable, and leak grossblood,mucus,pus,parasites:None
proofwidemouthscrewcapcontainer OtherResults
SPECIMENCOLLECTIONANDTRANSPORT:
Characteristic Result Indication
1. Collectfresh,diarrhealstoolandplaceitinthecontainer.
- The patient shouldunderstandthatthespecimenshould yellow,yellow severediarrhea
notbecontaminatedwith: green,orgreen
urine-affectsdetectionofprotozoa black bleedingintheupperGIT
tissuepaper maroon,red,or bleedingofthelowerGITfromtumors,
toilet water - contains chemicals or cleaning pink hemorrhoids,fissures,oran
agents Color inflammatoryprocess
2. Label the specimen with patients full name, date, andtime
clay biliaryobstruction
ofcollection. (tan-gray-white)
3. Observemacroscopically. pale(greasy) pancreaticdeficiencycausing
4. Observemicroscopically(directlightmicroscopy). malabsorptionoffat
- Place 1 drop of normal saline solution into the slides,
hard constipation(scybala);high-meatdiet
using the applicator stick to spread the sample in the
Consistency soft increasedfecalcontent;high-vegetable
slideandmix.
diet
RESULTS watery diarrhea,steatorrhea
MICROSCOPIC present strainingduringbowelmovements,
NormalResults Presenceof otherGITdiseases(e.g.Crohnsdisease)
WBC&RBC:none Mucus
fat:colorless,neutralfat(18%)andfattyacidcrystals&soaps
undigestedfood,meat,starch,trypsin:nonetosmallamount
eggsandsegmentsofparasites:none
bacteriaandviruses:none
yeasts:none

PHAR112LAB-PH5 KATEA.PILAPIL
 FECALOCCULTBLOODTEST(ChemicalTest)

Occult blood refers to blood that is hidden and undetectable by

the human eye. The main diagnostic value of occultbloodtesting ClinicalImplications
istoscreenforcolorectalcancer. 1. dark red to tarry black stool - indicates a loss of 50.0 to
75.0mLofbloodfromtheupperGIT
Procedure 2. A stool sample should be considered grossly bloody only
1. Obtain a random stool specimen. Tests for detecting fecal afterachemicaltestingforpresenceofblood.
blood use the pseudoperoxidase activity of hemoglobin 3. Positive testing for occult blood may be caused by the
reacting with hydrogen peroxide to oxidize a colorless followingconditions:
compoundtoacoloredone(usuallyblue). a. Carcinomaofcolon
2. Apply a thin smear of stool using a wood applicator stick b. Ulcerativecolitisandotherinflammatorylesions
and allow it to dry. If stool is bloody, the collectormaybe c. Adenoma
atriskforhepatitisB,hepatitisC,orHIVinfection. d. Diaphragmatichernia
3. Protect the slide from light, heat, and humidity. Do not e. GastricorRectalcarcinoma
refrigerate. f. Pepticulcer
4. Do not allow the delay between smearing the stool and g. Gastritis
testing to exceed 14 days. Do not refrigerate sample before h. Vasculitis
testing. i. Amyloidosis
j. Kaposissarcoma
Indicators:
Benzidine - most sensitive but carcinogenic so no longer
used References:
Orthotolidine-2ndinsensitivity
Guaiac - least sensitive, INDICATOR OF CHOICE, eliminates Fischbach, F. & Dunning, M. (2009). A Manual of Laboratory and
falsepositivecausedbydietaryfactors Diagnostic Tests (8th Ed.). Philadelphia: Lippincott
Williams&Wilkins,286-309
False(+)-salicylatesandironsupplements
False(-)-antacidsandascorbicacid

Factorsaffectingtesting
impropercollection
contamination(menstrualorhemorrhoidalblood)
Defectiveguaiacorperoxidedeveloper
Storageoffecalspecimenorslidesbeyond6days

PHAR112LAB-PH5 KATEA.PILAPIL