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Fecal Chemical
Tests
Testing For
Fecal Occult
Blood
Pseudo-peroxidase
O2
Procedures
1.
2.
Continue
6.
Result
No color change
Negative
Pale blue
Positive +
Dark blue
Positive + +
Blue black
Positive + + +
False Reactions
False positive: 1
1. Aspirin and anti-inflammatory medications.
2. Red meat (contain Myoglobin)and fish.
3. Green vegetables (Melons), and Horseradish.
4. Menstrual and hemorrhoid contamination.
5. Some intestinal bacteria that produce peroxidase enzymes.
.False negative: 2
1. Vitamin C greater than 250 mg/dl
2. Iron supplements containing vitamin C
Interpretation
The commonest cause of positive occult blood tests in
tropical and other developing countries are Hookworm
infections, peptic ulcer, and bleeding from esophagus or
liver cirrhosis.
Other causes include carcinoma in gastrointestinal tract,
erosive gastritis duo to alcohol or drugs, or swallowed
blood from nosebleeds.
If the test is negative but there is high clinical suspicion,
a further two specimen should be tested to detect
bleeding which be intermittent.
Commercial Methods
Therefore, to prevent false-positive reactions, the sensitivity
of the test must be increased.
Many commercial testing kits are available for occult blood
testing with guaiac reagent.
The kits contain guaiac impregnated filter paper, to which the
fecal specimen and hydrogen peroxide are added.
Two or three filter paper areas are provided for application of
material taken from different areas of the stool, and positive
and negative controls are also included.
Continue ...
Additional, more sensitive and specific methods, for the
detection of occult blood have been developed.
Hemoquant, provides a fluorometric test for hemoglobin
and porphyrin.
As hemoglobin progresses through the intestinal tract,
bacterial actions degrade it to porphyrin that the guaiac test
cannot detect, this can result in some false-negative results
from upper gastrointestinal bleeding when using the guaiac
test.
Continue ...
iFOBT: The immunochemical fecal occult blood test,
Hemoccult ICT, is specific for the globin portion of human
hemoglobin and uses anti-human hemoglobin antibodies.
Because Hemoccult ICT is specific for human blood in
feces, it does not require dietary or drug restrictions.
It is more sensitive to lower GI bleeding that could be an
indicator of colon cancer or other gastrointestinal disease.
Can be used for patients who are taking aspirin and other
anti-inflammatory medications.