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What is a Stool Routine test?

Stool routine test, also called a faecal test, involves the analysis of a stool (faeces) sample, which provides valuable data about stomach, intestine and other parts of the gastrointestinal system. It helps in identifying the presence or absence of diseases of the digestive tract including bowel cancer; infections due to bacteria, parasites and virus; and malabsorption of nutrients.

Stool samples are tested on the basis of the information required from the test.

  • Faecal occult blood test (FOBT) is done to diagnose the presence of blood in stool sample, which may be an indication of bowel cancer. However, more tests are needed in combination with FOBT to confirm the diagnosis of bowel cancer.
  • Stool culture is performed to identify the presence of unwanted and harmful bacteria in the gastrointestinal tract.
  1. Why is a Stool Routine test performed?
  2. How do you prepare for a Stool Routine test?
  3. How is Stool Routine test performed?
  4. What do Stool Routine test results mean?

A stool routine test may be recommended for various conditions such as:

  • Problems in digestion, e.g., improper absorption of certain nutrients
  • Invasion of the gastrointestinal tract by certain bacteria, parasites or viruses, which have caused an infection
  • Bleeding in the digestive tract
  • Allergy
  • Inflammatory bowel diseases such as Crohn's disease (inflammation of the lining of the digestive tract) and ulcerative colitis (inflammation of the colon and rectum)

A stool test is useful in identifying the presence of harmful microorganisms in the digestive tract that interfere with normal functioning of body. It is also valuable for detecting certain types of gastrointestinal disorders, e.g., in a healthy person, fat is completely absorbed from the intestine and is virtually absent in stools; hence presence of fat in stools indicates digestive disorders.

Many medicines can interfere with test results. The doctor should be informed of the following before a stool test:

  • If you take any non-prescription medications
  • If you take anti-diarrhoeal, laxative, antibiotic, anti-parasitic or non-steroidal anti-inflammatory drugs. These medicines should be stopped at least 1-2 weeks before the test
  • Any recent x-ray test performed employing barium contrast material, as barium can interfere with their results
  • A recent journey, especially an international one; this will help the doctor look for some specific microorganism causing the problem

If stools are being tested for the presence of blood, a  doctor may recommend avoiding certain foods for about 2-3 days before the test. Stool routine test should not be performed during menstruation and in the presence of active bleeding due to piles.

A stool sample is collected in a sterile container, which can be sealed afterwards. Ensure that the stool sample is not contaminated with urine or toilet paper. Store the stool sample in the refrigerator and submit it to the lab for testing as soon as possible.

Contact the physician in case of any delay in submission of the stool sample. Special precautions should be taken while collecting a stool sample for stool culture. The sample should be carefully handled with clean hands to prevent contamination.

Normal results:

Stools of a healthy person are soft and brown with well-formed consistency and an absence of harmful microorganisms, mucous, pus, blood and undigested meat fibre. Also, presence of less than 0.25 g/dL of sugar and 2-7 g fat per 24 hours is considered to be normal.

Abnormal results:

Results of a stool routine test are considered to be abnormal if the stool is black, white, red, yellow or green in colour or of abnormal consistency like liquid or very hard. Presence of blood, mucus, pus, undigested meat fibre and harmful microorganisms or low levels of enzymes (trypsin or elastase) also indicates abnormal results.

Higher than normal sugar or fat content is another indication of an underlying condition.

Results of a stool routine test should be discussed with a physician for a proper diagnosis as the condition may need to be correlated with symptoms. E.g., presence of blood in stools may indicate cancer, but may also be caused by inflammation, polyps and haemorrhoids in the gastrointestinal tract. Hence, a  doctor may recommend other tests like colonoscopy in case of presence of blood in stools.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. This is information purely from the educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. Michigan Medicine: University of Michigan [internet]; Stool Analysis
  2. National Health Call Center Network: Healthdirect Australia [internet]. Council of Australian Governments; Stool tests
  3. National Health Service [internet]. UK; How should I collect and store a stool (faeces) sample?
  4. Michigan Medicine: University of Michigan [internet]; Stool Analysis Results
  5. Michigan Medicine: University of Michigan [internet]; Stool Analysis: How To Prepare
  6. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Tests to Detect Colorectal Cancer and Polyps
  7. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Fecal Occult Blood Test (FOBT)