 Fecal Occult Blood Test

 Quantitative Fecal Fat Testing

CHEMICAL TEST FOR

STOOL SPECIMEN
Mary Christelle G. Aquitania
UST Medical Techonology Intern
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
 Fecal Occult Blood Test
Mechanism
 PSUEDOPEROXIDASE ACTIVITY OF

HEMOGLOBIN

Pseudo 0 Oxidized
Hemoglobin H2O2 Guiac Guiac +
H2O
peroxidase
Fecal Occult Blood Test
 AVOID [3 days]
 Red meat
 Horseradish
 Melons
 Raw broccoli
 Cauliflower
 Turnip
Fecal Occult Blood Test
 AVOID [7 days]
 Aspirin
 NSAIDS
 AVOID [3 days]
 Vitamin C
 Iron supplements
Fecal Occult Blood Test
 PROCEDURE - Materials
 Filter Paper
 Reagent A: Guiac
 Reagent B: Hydrogen peroxide
 Applicator stick
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.
Fecal Occult Blood Test
 INTERPRETATION

 POSITIVE: A trace of blue on the stool

 NEGATIVE: No change of color

Fecal Occult Blood Test
 FALSE POSITIVE  FALSE NEGATIVE
 Aspirin & anti-  Vitamin C >
inflammatory medication 250mg/day
 Red meat  Iron supplements
 Horseradish  Containing VIT C
 Raw broccoli,
cauliflower, radish, turnip
 Melon
 Menstrual & hemorrhoid
contamination
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
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.
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.
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:
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