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The test was developed by Leonard Apt (1922–2013), [3] an American pediatric ophthalmologist. The test was originally used to identify the source of bloody stools in newborn infants. It has been modified to distinguish fetal from maternal hemoglobin in blood samples from any source. [4]
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]
The presence of bright red blood in stool, known as hematochezia, typically indicates lower gastrointestinal bleeding. Digested blood from the upper gastrointestinal tract may appear black rather than red, resulting in "coffee ground" vomit or melena. [2] Other signs and symptoms include feeling tired, dizziness, and pale skin color. [18]
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Eating beetroot can cause harmless red-colored feces because of insufficient metabolism of a red pigment, and is a differential sign that may be mistaken as hematochezia. Consumption of dragon fruit or blackberries may also cause red or black discoloration of the stool and sometimes the urine (pseudohematuria). This too, is a differential sign ...
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.
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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).