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Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).
The stool guaiac test involves fasting from iron supplements, red meat (the blood it contains can turn the test positive), certain vegetables (which contain a chemical with peroxidase properties that can turn the test positive), and vitamin C and citrus fruits (which can turn the test falsely negative) for a period of time before the test.
A multi-target stool DNA test was approved in August 2014 by the FDA as a screening test for non-symptomatic, average-risk adults 50 years or older. [8] A 2017 study found this testing to be less cost effective compared to colonoscopy or fecal occult blood testing. [9]
The fecal immunochemical test (FIT) is a diagnostic technique that examines stool samples for traces of non-visible blood, which could potentially indicate conditions including bowel cancer. [1] Symptoms which could be caused by bowel cancer and suggest a FIT include a change in bowel habit, anaemia, unexplained weight loss, and abdominal pain.
Although the digital rectal exam (DRE) is commonly used as a way to obtain a stool sample for a FOBT (fecal occult blood test) in an office based setting, this is an insufficient way of screening for colorectal cancer and is not recommended.
Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. [6]
A stool culture—the controlled growth of microbial organisms in culture media under laboratory conditions—sometimes is performed to identify specific pathogens in stool. The stool guaiac test (or guaiac fecal occult blood test) is conducted to detect the presence of blood in stool that is not apparent to the unaided eye.
A complete blood count as well as an hemoglobin test should be performed when a patient presents symptoms of hematochezia. A colonoscopy may be necessary if there is suspicion of bleed from colon particularly in the elderly to look for the site and many causes of bleed like carcinoma, ulcerative colitis, rectal varices or other lesions and in certain instances upper gastrointestinal endoscopy ...
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