Fecal Analysis

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created 2 years ago by Pmborton
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updated 6 months ago by Pmborton
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1

100-200 g

amount of feces normally passed each day

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small instestine

digests and absorbs foodstuffs

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large intestine

absorbs water, sodium and chloride

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diarrhea

an increase in volume, liquidity, and frequency of bowel movements compared with individual's normal pattern

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secretory

increased solute secretions by intestine draws water and electrolytes into intestine

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osmotic

increased osmotically active solutes draw water and electrolytes into intestine

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intestinal hypermotility

decreases time available for absorption; can occur alone or with secretory or osmotic

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enterotoxin-producing organisms and damage to mucosa due to drugs or disease

secretory causes

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maldigestion or malabsorption

osmotic causes

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maldigestion

inability to convert foodstuffs into readily abailable absorbable substances

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malabsorption

normal digestive ability, but inadequate intestinal absorption of already processed foodstuffs

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abdominal distention stimulates motility; laxatives, stress, drugs or other diarrheas

intestinal hypermotility causes

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steatorrhea

fecal fat excretion greater than 7g/day

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malabsorption syndrome features

feces are pale, greasy, spongy, or pasty and very foul smelling

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contamination

should be avoided in specimen collection

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bile pigments (urobilins)

cause normal brown color of stool

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formed cylindrical masses

normal consistency and form

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mucus

not normally present in feces; associated with many conditions

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metabolic by-products of intestinal flora bacteria

causes normal odor

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white blood cells

not normally present; smallest amount indicates invasive or inflammatory condition of intestinal wall

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lactoferrin

protein present in activated neutrophils; detected through immuno-based tests

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fecal fat

qualitative orange-red staining of neutral fats with Sudan 3 or 4 or oil red O; detects total fats

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meat fibers

can be seen on fecal fat slides; increase is abnormal

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occult blood

small amount in feces and is not visualy apparent; any increase is always significant

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osmotic

increased active solutes draw water and electrolytes into intestine

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bright red stools

can indicate bleeding in the lower GI tract

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dark or mahogany or black stools (melena)

can indicate bleeding in upper GI tract

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Guaiac-based occult blood testing

based on pseudoperoxidase activity of hemoglobin resulting in color change

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immunochemical occult blood testing

based on reaction of polyclonal antihuman antibodies to globin portion of undegraded hemoglobin

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porphyrin-based occult blood testing

based on chemical conversion of heme to fluorescent porphyrins

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Apt test for fetal hemoglobin

used to differentiate between fetal and maternal blood in newborn's stool; qualitative based on alkaline resistance of fetal hemoglobin

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quantitative fecal fat

definitive test for steatorrhea