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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).
Either the patient or medical professional smears a small fecal sample on to the film. The fecal sample is obtained by catching the stool and transferring a sample with an applicator. Digital rectal examination specimens are also used but this method is discouraged for colorectal cancer screening due to very poor performance characteristics. [10]
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 .
Slide tests are based on orthotolidine (Hematest reagent tablets and Bili-Labstix) or guaiac (Hemoccult and Gastroccult). There is some evidence that orthotolidine-based tests more sensitive than specific, the Hemoccult test's sensitivity reduced by the acidic environment; and the Gastroccult test be the most accurate. [ 11 ]
The American College of Gastroenterology has recommended the abandoning of gFOBT testing as a colorectal cancer screening tool, in favor of the fecal immunochemical test (FIT). [3] The newer and recommended tests look for globin, DNA, or other blood factors including transferrin, while conventional stool guaiac tests look for heme.
Melena is a form of blood in stool which refers to the dark black, tarry feces that are commonly associated with upper gastrointestinal bleeding. [1] The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria.
Many point-of-care test systems are realized as easy-to-use membrane-based test strips, often enclosed by a plastic test cassette. [2] This concept often is realized in test systems for detecting pathogens, the most common being COVID-19 rapid tests. Very recently such test systems for rheumatology diagnostics have been developed, too. [12]
Tumor markers can be molecules that are produced in higher amounts by cancer cells than normal cells, but can also be produced by other cells from a reaction with the cancer. [2] The markers can't be used to give patients a diagnosis but can be compared with the result of other tests like biopsy or imaging. [2]
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