FECALYSIS

What is Fecalysis?
Routine fecal examination includes macroscopic, microscopic, and chemical analyses for the detection of gastrointestinal bleeding, liver and biliary duct disorders, malabsorption syndromes, and the detection and identification of pathogenic bacteria and parasites.

Specimen Collection
Adult
Passed out in a well rinsed bed pan Get a pea size stool from the middle part Place in a transport vial Avoid mixing the specimen with urine or water from the toilet
URINE has harmful effect to protozoans; alter the pH, ammonia, and chloride content WATER FROM TOILET may contain chemical disinfectants

Preservation of Stool Specimen

PHYSICAL
Freezing Refrigeration

CHEMICAL
1 part stool: 3 parts preservative
Formalin 40% Ethanol 20% glycerin in NSS Merthiolate Iodine Formaldehyde Polyvinyl Alcohol

Physical Examination
Appearance Soft to Well Formed Small, hard, dark ball Voluminous, odorous, floating Loose with mucus Loose with blood and mucus Sticky, black, tarry Cause Normal Constipation Malabsorption of fats or proteins Villous adenoma Inflammatory bowel syndrome Upper GIT hemorrhage

Physical Examination
Color normally light brown to dark brown
Substance responsible for the color of the stool
Stercobilin Urobilin Hydrobilin

Physical Examination
pH/Reaction
Normal neutral

Mucus
Transluscent gelatinous mucus clinging to the surface of formed stool

Blood
Indicates bleeding HEMOFECIA presence of blood in stool

Chemical Examination
Occult Blood hidden blood
Screening test for carcinoma Patient will undergo 3-4 days fish and meat free diet GUIAC TEST routine test Pseudoperoxidase activity of hemoglobin liberates oxygen from hydrogen peroxide to oxidize guiac reagent

Guiac test
Blue color indicates gastrointestinal bleeding
NEGATIVE POSITIVE

Apt test
Test to differentiate between fetal or maternal blood Addition of NaOH to hemoglobincontaining emulsion determines presence of maternal or fetal blood Pink color indicates presence of fetal blood

Chemical Examination
Bilirubin Gmelins concentrated HNO3
POSITIVE: GREEN

Urobilinogen Ehrlichs reagent

POSITIVE: CHERRY RED

Urobilin Schlesingers test

POSITIVE: GREENISH FLUORESCENCE

Microscopic Examination
Cells
Epithelial cells Pus cells RBC Macrophage

Crystals
Calcium oxalate Triple phosphate Charcot-leyden

Food Remnants
Bacteria Mucus threads

Microscopic Examination
White blood cells
Neutrophils are seen in the feces in conditions that affect the intestinal wall, such as ulcerative colitis and infection with invasive bacterial pathogens

Parasites
Presence of a parasite or worm-like infection of the intestine, or ova.

THE END