Lab -1- Practical Technical Institute-Samawa

Medical Virology and Parasitology Nursing Department

General Stool examination (GSE).

Aim: Examination of stool is very helpful in diagnosis the disease of gastrointestinal
tract (GIT).

Sample collection
A sample is transferred with the sticks to the container. The specimen
should contain at least 5 g of faeces, if present; parts that contain blood
and/or mucus should be selected. The specimen should not be
contaminated with urine. After collection of stool sample submits the following test of GSE
include:

A. PHYSICAL EXAMINATION OF STOOL:

(1) Quantity: the adult person excretions about 150-250 gm. /day of feces.

(2) Consistency and form: Normal stool is soft and well formed.

(3) Colour:

1- Normal colour of stools are light to dark brown due to the Presence of bile Pigments

2- Black or tarry stool: due to bleeding in upper parts of Gastro-intestinal tract (GIT)
such as stomach.

3- Red colour stool: due to bleeding in the lower parts of GIT such as rectum. But in
some cases resulted from eating certain colorful foods such as red beets.

4- Clay colour stool: due to absence of stercobilinogen in biliary tract obstruction.

(4) Odor: The normal fecal odor of stool resulted from Indole and Skatol. Odor of stools
may become offensive in conditions like, Intestinal amoebiasis.

(5) Blood: 1- If the blood is present on the outer surface of the feces, this indicates
either contamination from menstrual cycle blood in women or bleeding hemorrhoids.

2- If Blood noted in stools, indicative of Ulceration or presence of any other pathology

like malignancy.

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Lab -1- Practical Technical Institute-Samawa
Medical Virology and Parasitology Nursing Department

(6) Mucus: Is present in certain conditions like amoebic or bacillary dysentery.

(7) Parasite: Stools may contain adult helminthes. Nematodes like Ascaris are easily
visible by naked eye as their size is large.

B. MICROSCOPIC EXAMINATION OF STOOL:

The laboratory diagnosis of most parasitic infections is by the demonstration of ova,

Trophozoite and cyst of the parasite in the stools of the infected person. The stool can be
examined by the following techniques.

(a)Wet mounts examination.

(b) Iodine examination.

C. CHEMICAL EXAMINATION OF STOOL

(a) pH: The pH of stools is acidic in amoebic dysentery and is alkaline in bacillary
dysentery.

(b) Occult blood: Presence of blood in feces which is not apparent on gross inspection
and which can be detected only by chemical tests is called as occult blood

D. STOOL CULTURE

(1 gram) of stool is transferred to a tube of Selenite broth and a loop is streaked on

Xylose Lysine Deoxycholate (XLD). Incubate at 37 oC. Pick up suspect colonies and
perform biochemical test to check of bacteria.

DYSENTERY

Dysentery is an infection of the intestines causing diarrhea that contains blood or mucus.

There are two main types of dysentery:

* Bacillary dysentery or Shigellosis, caused by the Shigella bacteria. This form of

dysentery is more common in Europe orthe Americas.

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Lab -1- Practical Technical Institute-Samawa
Medical Virology and Parasitology Nursing Department
* Amoebic dysentery or Amoebiasis, caused by a parasite called Entamoeba histolytica.

Transmission of amoebic dysentery:

 Eating or drinking contaminated food that contain infective stage (mature cyst
have 4 nucleus) or trophozoite.
 Direct contact with infected people.

Symptoms of amoebic dysentery

Symptoms can appear as many as 10 days after exposure and infection by the parasite.
Signs of infection include:

* Watery diarrhea with blood or pus in it. * Nausea or vomiting . * Stomach pain

* High temperature * Chills * Bleeding from rectum * Weight loss * Loss of appetite

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Lab -1- Practical Technical Institute-Samawa
Medical Virology and Parasitology Nursing Department

Diagnosis of amoebic dysentery

If the person shows the above symptoms of amoebic dysentery or if has diarrhea with
blood or mucus, medical advice should be sought for the doctor may:

* Arrange an ultrasound if a liver abscess is suspected

* Request a stool sample to identify mature cyst or trophozoite of parasites

Mature Cyst stage of Entamoeba Trophozoite stage of Entamoeba

histolytica: Non-motile, Spherical or histolytica: Motile, Irregular shape,
round or oval shape, Contain (4) number of food vacuoles in the
nucleus (mature cyst). cytoplasm containing (RBC).

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