Coprogram analysis. Coprogram - General analysis of feces. What abnormalities does fecal analysis reveal?

A coprogram is a comprehensive analysis that allows you to determine the digestive capacity of the digestive tract.

Food gruel (chyme) passes through the entire gastrointestinal tract and is formed in the large intestine into feces. Digestion and absorption of substances occurs in the digestive system. By the composition of the stool, one can judge a violation of digestion in one of the organs. Therefore, scatological examination is prescribed for the diagnosis of many diseases.

After a macroscopic, chemical, microscopic examination, the specialist gives a description of the composition of the feces. The coprogram shows deviations from the norm, typical for a particular disease.

Such a study allows to identify disorders of the secretory function of the stomach, intestines, pancreas; inflammatory process in the digestive tract, violation of the absorption process, dysbacteriosis, colitis of various etiologies.

Indications for the study of feces are:

Fecal analysis for coprology is prescribed for complex preventive examinations.

How to properly collect feces?

In order for the results to be reliable when assembling feces for analysis, several requirements must be met.

A few days before the study, exclude meat and stool-coloring foods (tomatoes, beets, green vegetables), red fish from the diet.

When they can distort the result. You can eat dairy products, eggs, cereals, potatoes.

In some cases, the doctor may prescribe a special diet with the exact amount of proteins, fats and carbohydrates. It creates the maximum load on the digestive tract and helps to identify even minor deviations in the processes of digestion, absorption of food and motility.

It is necessary to stop taking enzymes, drugs that affect peristalsis and contain iron and bismuth, antibiotics, antacids and anti-inflammatory drugs.

You will have to wait a few days with the analysis if an x-ray examination with barium was performed or a colonoscopy for which bowel cleansing was performed using an enema or medications.

Stools obtained by natural defecation are suitable for sampling. It is advisable to donate material taken from the morning portion of feces. The evening sample can be stored in the refrigerator for no more than 10 hours.

Feces must be collected in a sterilized glass jar or a special container.

Enough 15 g of material (approximately a teaspoon).

Stool collection from babies

If the child suffers from constipation, you can massage the tummy or put a gas tube.

Be sure to wash your hands before collecting feces and use clean diapers and oilcloth.

How to collect material for analysis in children?

The child can go to the toilet on a potty previously washed with soap.

Make sure that urine does not get into the feces. Do not use suppositories and laxatives to stimulate defecation. When donating feces for occult blood, the same diet is recommended as for adults. It is necessary to tell the doctor what drugs and vitamins the child is taking. Perhaps some of them will have to be canceled for 2-3 days before passing the analysis.

For example, fatty foods or antibiotics give stools a light color.

How long to wait for results?

The result of the analysis is issued 1-2 days after delivery. The patient receives a form with the data of macroscopic, chemical, microscopic examination of feces. The doctor is engaged in deciphering the coprogram. With its help, he can identify various pathologies. Exceeding the norm of the concentration of various substances indicates the initial or progressive stage of the disease of a particular organ.

What does the analysis show?

By the color of the form, the smell of feces, some diseases can be suspected.

Light stool indicates problems with the liver, bile ducts, pancreas. Black stools are observed with bleeding from the upper gastrointestinal tract, tumors in the stomach, ulcerative colitis, Crohn's disease in the large intestine. A reddish stool indicates a bleeding lesion in the lower intestines. In an adult, brown feces are considered normal.

A macroscopic method in the feces can detect pus, blood, mucus, worms, bile, intestinal, pancreatic stones.

Microscopic examination shows the quality of food digestion.

Chemical analysis is carried out to determine acidity, detect hidden blood, protein, bilirubin, soluble mucus.

Deciphering the coprogram in adults

If the patient is an adult, the results of the coprogram can be deciphered as follows (parameter: norm):

Features of decoding the coprogram in children

Differences with adults in infants (parameter: norm):

• Volume: 40-50 grams.
• Color: golden, greenish or yellowish.
• Smell: slightly sour.
• Leftover food: no.
• Mucus: present, clear.
• Acidity: 5-6.
• Bilirubin: Present in small amounts.
• Ammonia: no.
• Neutral fats: a little.
• Fatty acids: a little.
• Muscles and Comm. fabric: no.

How can analyzes differ in older children:

• Volume. Adequate value: 100-250 grams.
• Acidity. Adequate value: 6.5-7.5.

How to prepare for a stool test

1. Before donating feces for a coprogram, you need to follow a diet.
2. Fecal analysis - a coprogram - must be taken after the abolition of drugs that affect digestion and absorption.
3. Feces for analysis can only be collected in a sterile container. You can buy it in the laboratory where you will take the analysis. The container should be included in the cost of the survey.
4. The maximum duration of biomaterial storage is 12 hours.
5. Biomaterial should be stored in the refrigerator.

Diet before donating feces

Here is a general list of foods that you can eat:

• dairy products (but not fermented milk!);
• cereals;
• mashed potatoes;
• White bread;
• butter;
• scrambled eggs;
• non-sour fruits.

Follow the diet should be 5 days before collecting the material.

In no case should you expand the list with meat products and fish.

What is strictly prohibited before the examination

• drink alcohol;
• put an enema;
• take pills for the intestines.

Soluble protein

The norm is stool without protein. A positive reaction indicates the presence of an inflammatory process in the digestive tract (pancreatitis, enteritis, colitis, gastritis). The protein is detected in ulcers, polyposis, proctitis, cancer.

Note! A single protein cannot be used to make an accurate diagnosis. But its presence in the feces and symptoms such as intense pain in the pit of the stomach or in the hypochondrium, nausea, fetid stools indicate acute pancreatitis.

Blood

Appears with ulcers of the duodenum and stomach, complicated by bleeding. During the passage of food, the mucous membrane affected by tumors is injured and a small amount of blood is released. Helminths can also disrupt the integrity of the intestine. Unaltered red blood cells are found in bleeding from the large intestine. The altered blood enters the feces from the upper gastrointestinal tract.

Note. A fecal occult blood test can detect tumors at an early stage.

Sterkobilin

The pigment gives stools a brown color. The rate of formation of the substance is 75-350 mg per day. With hemolytic anemia, the level of stercobilin increases. The amount of pigment is reduced due to blockage of bile duct stones. To establish an accurate diagnosis, the gallbladder is examined.

Bilirubin

The substance enters the feces as a result of the accelerated passage of food, in which it does not have time to be converted into stercobilin. It can be detected in dysbacteriosis, acute gastroenteritis.

Slime

Produced by cells of the mucous membrane to protect the walls of the intestines and stomach from irritating substances. A large amount of mucus is produced to protect against pathogenic organisms, in case of malabsorption, lactose intolerance. Increased production is observed in colitis, dysentery, salmonellosis.

Iodophilic flora

Indicates a violation of the intestinal microflora. Pathogenic bacteria are found in indigestion.

Detritus

It is particles of destroyed epithelial cells and digested food. A small content of detritus is observed with poor digestion of food.

Neutral fat

Normally, it should be absent. With the normal functioning of the digestive organs, more than 90% of fats are absorbed. An increased content is observed with a lack of bile production and absorption in the intestine. With a decrease in the synthesis of lipase (digestive enzyme), incomplete absorption of fats occurs.

Muscle fibers

Normally, only altered fibers should be present in the feces. In diseases of the pancreas, unchanged fibers are detected. Due to the reduced formation of digestive juice, meat food is poorly digested. Fibers in the stool may indicate pancreatitis.

Starch

The substance must be completely broken down, therefore it is not normally observed. Starch is found in the form of extracellular and intracellular grains during the accelerated movement of food masses. This picture is typical for malabsorption syndrome and chronic pancreatitis.

Soaps

Normally allowed in small quantities. A significant excess is characteristic of insufficiency of digestion in the small intestine and stomach. Meet with pancreatitis, cholelithiasis.

Leukocytes

In a healthy person, cellular elements of blood in the feces are not observed. They are found in diseases of the gastrointestinal tract of an inflammatory nature.

The result of the analysis may be inaccurate if discharge from the vagina or urethra gets into the feces.

Fatty acid

Not present during normal digestion. The reason for the appearance is a decrease in the activity of the digestive enzyme, insufficient intake of bile, accelerated progression of chyme.

vegetable fiber

There are two types of matter. Soluble fibers (pectin, polysaccharides) should not be present in feces. They are observed with insufficient intake of hydrochloric acid.

Insoluble fibers (peel of vegetables and fruits, shell of grains) contribute to the movement of food and the removal of undigested nutrients, cholesterol, and toxins.

Connective tissue fibers

These are the remains of food of animal origin. Connective tissue normally should not be present. Fibers in the feces are observed with low acidity of gastric juice, insufficient secretion of hydrochloric acid, or a lack of enzymes involved in the breakdown of meat food. The reason for the detection of connective tissue may be anacid gastritis, pancreatitis.

Ammonia

Norm - at 20-40 mol / kg. The increased content is a consequence of the intensive process of putrefaction in the intestine, which occurs as a result of an increase in protein production during inflammation of the intestinal walls.

If the diagnosis cannot be established after deciphering the coprogram, further examination is prescribed by more accurate methods.

Pathological indicators of the coprogram

Deviation in the chest

Deviation in a child after a year

Deviation in an adult

Less than 40, more than 50 grams

Less than 100, more than 250 grams

Less than 100, more than 400 grams

Consistency

Loose, tarry, with water, with foam

Loose, slurry, tarry, with water, with foam

Brown, red vein, black, white

Red veined, black, white, greenish, yellow, orange

Strong, rotten

Weak, strong, sour, rotten

undigested food

Anything other than indigestible fiber

Yes, opaque

Present

Present

Present

Present

Present

Present

Acidity

Less than 5, more than 6

Less than 6.5, more than 7.5

Less than 7, more than 7.5

hidden blood

Bilirubin

Yes, in large quantities

Sterkobilin

Missing

Missing

Missing

Soluble proteins

Missing

Missing

Missing

Less than 20, more than 40

Less than 20, more than 40

Neutral Fats

There are many

Fatty acid

There are many

Cellulose

Present

Present

Present

Muscles and Comm. the cloth

Leukocytes

Present

Present

Present

pathogens

What does the extended coprogram include

Extended coproscopy - what is this analysis and how does it differ from a conventional coprogram? The difference is that the extended version gives more information. In addition to the above parameters, advanced coproscopy reveals:

• additional information about proteins in feces;
• the presence of urobilinogen;
• accurate information about all other inclusions;
• chymotrypsin;
• pancreatic enzymes;
• albumen;
• immunoglobulins;
• neurotoxins;
• lysozyme;
• antibodies to Helicobacter pylori;
• meconium.

An extended coprogram shows itself better in terms of diagnostics, because the clinical data from it make it possible to calculate and recognize, if not all, then the vast majority of diseases.

This analysis alone can replace many studies, including colonoscopy. Its only disadvantage is the high price.

Is coprology and coprogram the same thing?

No. Coprology is the science that deals with feces as such. Coprogram is one of the methods of coprology, along with copro-ovocystoscopy and other studies.

Coprogram is often called coprology, but the reason for this is that ignorant people get confused in terminology.

Where to do a fecal analysis for a coprogram

Coproscopy is a common analysis, so it can be done in any laboratory.

What is the price? In Moscow - from 500 rubles, in St. Petersburg - from 250 rubles.

Fecal analysis for coprogram and Gregersen's reaction

Sometimes patients are prescribed not only a study of feces, but also the Gregersen reaction. The Gregersen reaction is a special laboratory method that allows you to detect hidden blood in the stool. In fact, this reaction is carried out even with standard analysis, a separate mention of the reaction simply indicates to laboratory assistants that special attention should be paid to the detection of occult blood.

Coprogram - a study of fecal contents to determine its properties, physical and chemical composition, the presence of pathological inclusions in order to diagnose diseases and monitor the dynamics of the disease, the treatment process.

Fecal masses are formed when a food bolus (chyme) passes through the entire human digestive tract from the oral cavity to the rectum. Therefore, these coprograms are most valuable in the diagnosis of diseases of the gastrointestinal tract.

What does the coprogram show

In the feces, microorganisms of various types and quantities, particles of undigested food, fecal pigments, and epithelium of various parts of the intestine are found.

note: knowing these features, the laboratory assistant can determine the pathological processes in certain parts of the intestine in certain diseases.

The coprogram is indicated for:

Coprological examination allows to identify dysbacteriosis (violation of the ratio of microorganisms and reproduction of pathogenic forms).

The coprogram is rarely used as an isolated study, most often it is an additional, but at the same time informative diagnostic method.

How to take a coprogram

Preparation for passing the analysis is not difficult, but some rules must be strictly observed.

If the patient is taking medications containing iron and bismuth, then they must be canceled. Also, do not take laxatives, rectal suppositories. It is forbidden to wash the intestines with enemas.

If the person under study underwent radiography with a contrast agent (barium), then the coprogram should not be done earlier than 7-10 days after the study. Barium can change the properties of feces.

In the patient's diet during the few days preceding the test, excessive variety, exotic dishes, etc. should be limited.

Preparatory rule for donating feces for a coprogram:

2 days before collecting the material, you should completely abandon tomatoes, tomato juice, pasta, beets and other vegetables and fruits that contain dyes. 3 days before the collection of feces, it is necessary to stop taking antibiotics, drugs that cause a change in the motor function of the intestine, drugs based on enzymes. Nutrition should consist of vegetables, fruits, cereals, dairy products, the amount of food should be within normal limits. You should refrain from fatty foods, smoked meats, spicy and pickled. Women should not be tested during menstruation. Feces must be collected so that urine does not get into it. Evacuation of feces for analysis should occur naturally, without the use of stimulants and enemas.

How to collect feces for coprogram

Important: the collection rules are simple, but they should be followed carefully.

To collect feces, you must:

empty the bladder, conduct a thorough toilet of the genitals and anal area using warm water and neutral soap without aromatic additives. Then rinse the washed areas with warm, boiled water; in pre-prepared clean dishes with a wide neck, using a spatula (which is available in pharmacy containers for collecting feces), collect material from different parts of the resulting feces; after collection, the stool is closed with a lid and signed with the name and surname of the patient, as well as the date of collection.

Wooden boxes, food cans should not be used as dishes for feces. The total amount of material collected should be 15-20 grams (approximate volume of a teaspoon). Try to bring approximately this amount of stool to the laboratory.

Feces should be collected in the morning and delivered to the study as soon as possible.

Note: the faster the material is brought to the laboratory, the more accurate and reliable the results of the coprogram will be.

If necessary, the container with the biomaterial is placed in a refrigerator, where it can be stored for no more than 8 hours, at a temperature of about 5 degrees Celsius.

The results of the coprogram are usually obtained within 2-3 days, sometimes the analysis takes 5-6 days.

Features of the collection of feces in small and infants

If a child goes to the potty on his own, then the same rules apply to him as to adults.

In infants, a diaper or oilcloth is used (if the stool is liquid).

In case of constipation, to stimulate defecation, it is necessary to massage the abdomen, in some cases, you can put a gas outlet tube that stimulates the act of defecation.

All materials must be clean, hands must be washed with soap and water before collection.

Deciphering the coprogram in adults

First, a macroscopic examination of the stool is performed.

In deciphering the coprogram in adults, it is estimated:

the appearance of the stool; density of feces; staining (normal or pathological); the presence of a specific smell; the presence of bloody inclusions, veins, undigested food, purulent discharge, mucous lumps; the presence of mature forms of helminths; possible isolation of gallstones and pancreatic stones.

Microscopic analysis allows you to assess the ability of the gastrointestinal tract to digest food.

Microscopic examination may reveal:

squirrel, which appears during inflammatory processes in the digestive tract system, with ulcerative changes in the mucosa, polyposis formations, oncological diseases. Normally, there is no protein in the feces; blood- appearing with hidden intra-intestinal bleeding, which can cause ulcers, tumors, polyps, helminths. Altered blood indicates processes in the upper intestines, unchanged - in the lower. Occult blood is characteristic of tumors; stercobilin. This is a pigment that is a metabolite of bilirubin, which gives the feces a specific color. About 75-350 mg of this pigment is formed per day. An increase in the rate in deciphering the coprogram in adults is characteristic of hemolytic anemia. A decrease indicates a possible process of obstruction of the bile ducts (stones, tumor); bilirubin. The appearance of this chemical indicates an acceleration of the digestion process, as a result of which bilirubin does not have time to be metabolized into stercobilin. This situation occurs with acute inflammation and with dysbacteriosis; slime. Mucus performs a protective function in the intestines, so its increased formation indicates strong inflammatory changes in the intestines in acute infectious diseases (salmonellosis, dysentery, infectious colitis, etc.); iodophilic flora. The appearance in the decoding of the coprogram in children and adults of pathological bacteria is characteristic of dysbacteriosis; detritus. Cellular destroyed material that emerges from the intestinal epithelium. A decrease in the amount is observed in violation of the digestive process; neutral fats. Excessive content is characteristic of insufficient excretion (bile production), as well as the process of absorption of bile in the intestine; muscle fibers. The appearance of these elements in an unchanged form (normally they change) indicates a disease process in the pancreas, due to violations of the composition of the juice, which is involved in the digestion of meat food; starch. Normally, it undergoes a splitting process, if during the study it is found in the form of grains, then the accelerated passage of the food bolus in malabsorption syndrome should be suspected, and this symptom also appears in chronic pancreatitis; soaps. Soapy substances are normally present in small amounts. The increase can be with digestive insufficiency of the small intestine, stomach and duodenum. These problems occur with inflammation of the pancreas, with gallstones; leukocytes. Not normally defined. Their appearance in the decoding of the coprogram indicates inflammatory diseases of the digestive tract; fatty acids. In the secretions of a healthy intestine are absent. Appear with digestive and enzymatic insufficiency, violations of the outflow of bile, accelerated intestinal activity;
vegetable fiber. If soluble fibers are noted in the decoding of the coprogram in adults, then we can talk about insufficient secretion of hydrochloric acid in the stomach. Normally, soluble plant fibers are absent in feces. Insoluble fibers (peel of fruits and vegetables, outer shell of grains and legumes) are part of the normal contents of the intestine. Insoluble fibers remove indigestible foods, poisons, cholesterol from the intestines. The amount of these elements depends on the qualitative composition of the food; connective tissue fibers. These fibers are formed from the undigested remains of animal food. Normally, they shouldn't be. The appearance of fibers is characteristic of conditions in which the acidity of gastric juice decreases - (antacid gastritis). Also, these elements are noticeable with a decrease in the production of hydrochloric acid in the stomach, enzymatic deficiency that occurs with pancreatitis; ammonia. An increase in the content of this chemical compound is characteristic of processes accompanied by decay in the intestinal lumen. Normally, ammonia in feces contains 20-40 mol / kg. If an increased value of ammonia is indicated in the decoding of the coprogram in adults, then the presence of intestinal inflammation in a person should be suspected; pathological and conditionally pathological microorganisms causing bowel disease, dysbacteriosis.

The reaction of feces (pH) can be different (weakly alkaline, neutral, slightly acidic). This indicator depends on the nature of the diet.

Features of decoding the coprogram in children

The main indicators of the coprogram in children are similar to those in adults. But there are some features.

Most children have a normal coprogram with a neutral or slightly alkaline reaction (in the pH range of 6-7.6.

note: in infants, the reaction is most often sour in nature, as a result of the nutritional habits characteristic of this age category.

Alkaline reaction in children is determined in violation of the absorption process, with increased putrefactive processes in the intestines, prolonged exposure to undigested food in the stomach and intestines.

Until the age of three months, a child with breastfeeding, the presence of bilirubin in the feces is a variant of the norm. After 3 months, in deciphering the coprogram in children, only stercobilin should normally be determined.

Lotin Alexander, medical columnist

A fecal analysis for a coprogram is one of the first studies that a doctor prescribes to a patient with digestive disorders. The appearance, chemical composition and microflora of feces can tell a lot about the state of the gastrointestinal tract.

The content of the large intestine consists not only of liquid and food debris, it includes elements of digestive juices, enzymes, bile, blood, and bacteria.

General analysis of feces (coprogram) is aimed at a comprehensive study of excrement: physical, chemical and microscopic.

Indications

Coprogram analysis is performed for the following diseases:

Haemorrhoids; anal fissures; chronic constipation; stomach ulcer, duodenal ulcer; pancreatitis; Diverticula of the intestine; Crohn's disease; Colitis; Cirrhosis of the liver; colon polyps; irritable bowel syndrome; malignant tumors; Worm infestations; amoebic dysentery; Acute intestinal infections (cholera, salmonellosis, etc.); Anemia and a number of other pathologies.

The reason for coprology are abdominal pain, cramps, bloating, nausea, heartburn, problems with defecation, blood in the stool and other symptoms that indicate disorders in the digestive tract.

A general analysis of feces according to the coprogram is prescribed for suspected poisoning, infection, helminthiasis - it allows you to quickly identify pathogens and make a diagnosis, which is especially important in such urgent cases as acute intoxication, the need to isolate a patient with an infectious disease.

Feces for the coprogram of children are handed over for any digestive problems, allergic reactions, suspicion of worms, with colic.

Coprogram is invaluable in the diagnosis of pathologies of the digestive tract. Those violations that this simple and painless analysis shows require additional examinations.

The study of feces helps the doctor to make a preliminary diagnosis and subsequently refer the patient to the necessary procedures.

What is an analysis?

The technique for performing fecal analysis for a coprogram provides:

Visual study of excrement by qualitative and quantitative parameters and the presence of foreign inclusions. Carrying out chemical tests to determine impurities. Examination of material under a microscope.

Let us consider in more detail what is included in the fecal coprogram:

Normal indicators of the coprogram

Normally, stool is a thick brown mass with a pronounced fecal odor, free of blood, mucus and pus, with a minimum amount of unprocessed food (insoluble fiber is allowed).

The nature of nutrition, the intake of certain medications can significantly affect the physical parameters of feces: change color, texture, smell. Small deviations related to nutritional characteristics are considered acceptable.

The norm of the comp program in adult patients is shown in the table:

The norm in children differs from the indicators in adults due to the characteristics of nutrition. This applies to the amount, consistency and other physical parameters of feces, as well as the level of acidity.

The norms of the coprogram in children under one year old have deviations in chemical composition, which is associated with the immaturity of the digestive tract, postpartum changes in the body of newborns, and mainly the milk diet in infants.

How to decipher the results?

The results of the coprogram should be evaluated by a specialist, taking into account all the conditions: the patient's complaints, the characteristics of his diet, the available history, indicators of other studies.

Consider how to decipher deviations from the norm:

Too little feces happens with constipation, colitis, ulcerative conditions. An increase in stool indicates accelerated evacuation, inflammation in the digestive tract. Very dense feces are formed with excessive absorption of fluid through the intestinal walls, constipation. Liquefied stools give active peristalsis, impurities of inflammatory mucus. Ointment-like consistency is a possible consequence of chronic pancreatitis. Foaminess indicates fermentation in the intestines. A large form of feces indicates a long stay of the contents in the intestine, which may be associated with colon dysfunction due to malnutrition, a sedentary lifestyle, diverticulosis, and tumors. Small lumps (sheep feces) occur with intestinal spasms, hemorrhoids, anal fissures, starvation, peptic ulcers. Excrement in the form of a tape, a thin column indicates stenosis of the rectum, the presence of a neoplasm. Unformed stool is a sign of impaired digestion and absorption of food due to enzymatic deficiency. Color changes not related to food coloring are likely symptoms of disease. Discoloration of feces is caused by liver failure and blockage of the bile ducts. Tar-colored feces - a sign of bleeding of the upper gastrointestinal tract, if it bleeds in the colon and rectum - red feces. Mushy green stools are excreted in typhoid fever. Yellow feces are produced during fermentation in the intestines. The mucus in the coprogram has a different consistency and shade depending on the pathology. Gray inclusions resembling rice water indicate cholera infection. Amoebic dysentery is manifested by a jelly-like mucous mass of pink hues. When the rectum is damaged, mucus impurities are found in the material in whole lumps, ribbons. With colitis and constipation, mucus envelops the formed feces from above, with inflammation of the small intestine, it mixes with food masses and gives them a semi-liquid character. In some cases, blood does not stain the feces, but is excreted along with them in the form of separate clots, veins. We are talking about bleeding in the lower digestive sections, ranging from anal fissures and ending with necrosis of the colon tumor. Hidden blood in the feces is determined by the Gregersen test. Purulent discharge in the stool is a sign of severe inflammation, an ulcer, abscess, tuberculosis, or a decaying tumor. With infectious lesions, suppuration is supplemented by mucus and blood. Pieces of undigested food in the analysis of feces are called tentorrhea. Occurs in violation of the stomach and pancreas. Small elements of digested food mixed with the remains of bacteria and epithelial cells (detritus) are the normal contents of feces. Only a violation of their homogeneity with the isolation of individual particles, for example, an increased content of bacteria during a coprogram, makes it possible to suspect an inflammatory process. Detritus in the coprogram in combination with mucous and bloody impurities is an unequivocal sign of pathology. Detritus in a coprogram in an infant or a child older than a year without associated symptoms is not a cause for concern. The iodophilic flora in the coprogram causes fermentation in the intestines. These bacteria are determined by staining with iodine and the acid reaction of feces (pH 5.0-6.5). Pathological iodophilic flora (clostridia) leads to active fermentative dyspepsia. If yeast fungi are found in the stool, candidiasis caused by antibiotics is possible. Muscle fibers in the coprogram can be detected both in digested and unchanged form, which is not the norm. The presence of muscle tissue in the feces is called creatorrhea and indicates poor digestion of proteins: a violation of the secretion of gastric juice, pancreatic enzyme deficiency. The same applies to the remnants of connective tissue in the stool. Problems with lipid digestion are expressed in steatorrhea. Neutral fat in the coprogram is released with pancreatic dysfunction and blockage of the pancreatic ducts. Disorders in the duodenum lead to poor absorption of fatty acids. Soaps in the coprogram are fatty acid salts in the feces as a result of bile deficiency. Starch in the coprogram (amilorrhea) is a consequence of enzymatic deficiency and too active peristalsis. The release of intracellular carbohydrates indicates that the source of the pathology is the stomach: starch is not absorbed due to the fact that the gastric juice does not process plant cells. Extracellular starch in the coprogram appears due to amylase deficiency. Leukocytes in the coprogram are not normally detected. Their presence indicates an infectious lesion of the intestine, enteritis, colitis, ulcerative lesions. The combination of leukocytes with erythrocytosis, a large amount of squamous and cylindrical epithelium in the feces shows a coprogram in intestinal cancer, polyposis, Crohn's disease. If leukocytes are found in the coprogram in the baby, it is necessary to analyze the results in a complex. In the absence of other alarming symptoms, a positive analysis occurs in healthy children with an improperly organized diet. to content

How to prepare and pass?

Special preparation for the analysis of feces is not required, since the material obtained naturally is taken for the study.

In order not to distort the results of the study, it is necessary to follow simple rules on how to prepare for a coprogram.

A week before the date, refuse:

antibiotics; Iron-containing preparations; Any laxatives; Applications of rectal suppositories; Enema; Procedures through the anus; X-ray with barium.

Preparation for the coprogram includes dietary restrictions 4 to 5 days before stool delivery. The diet before the coprogram consists of the following menu:

Dairy; Mashed potatoes; Lean meat; Kashi; Soft-boiled eggs; Fresh fruits; White bread with butter.

Preparation for the study with suspected occult bleeding requires a complete rejection of meat, green vegetables, tomatoes, most fruits, otherwise the analysis may give a false result.

Preparing the patient directly for the delivery of the material consists in buying a container for analyzes and organizing hygienic conditions for defecation. It is forbidden to collect feces from the toilet - only from a clean surface. You need to take care of the pot or disposable lining in advance.

How to take the test correctly:

Perform a natural bowel movement, avoiding the ingress of urine and discharge from the genitals; With a special spatula, collect the material in an amount as much as you need feces for analysis - about a third of the jar; For the best result of the study, it is advisable to follow the recommendations on how to collect feces for a coprogram - at least from three different stool sites; Screw and sign the container.

How to pass a fecal analysis correctly so that the biomaterial does not deteriorate: take the biomaterial to the laboratory on the same day, no later than 12 hours after defecation. If necessary, place the container on a refrigerator shelf.

The stool coprogram in the baby is collected whenever possible, since it is difficult to control the frequency and time of the child's bowel movements. For analysis, a teaspoon of biomaterial placed in a sterile container is sufficient. If the child does not go to the potty, the problem of how to collect feces from the baby is solved with the help of disposable diapers - feces can be taken from their surface.

Where to take the analysis?

A general analysis of feces in the direction of a doctor is usually taken at a polyclinic. Research is also carried out in many diagnostic centers where you can make a coprogram:

Sinevo, Gemotest, Invitro, Helix and others.

You can contact any laboratory where coprogram and coprology are presented - this is one and the same study.

How much is done and how much the analysis costs depends on the specific honey. center: the maximum period is 6 working days, and the average price is about 500 rubles.

Where to take tests, the patient has the right to choose independently, focusing on the cost, the declared period, how many days the coprogram is done, and the reviews of the laboratory's clients.

Coprogram - a study of fecal contents to determine its properties, physical and chemical composition, the presence of pathological inclusions in order to diagnose diseases and monitor the dynamics of the disease, the treatment process.

Fecal masses are formed when a food bolus (chyme) passes through the entire human digestive tract from the oral cavity to the rectum. Therefore, these coprograms are most valuable in the diagnosis of diseases of the gastrointestinal tract.

What does the coprogram show

In the feces, microorganisms of various types and quantities, particles of undigested food, fecal pigments, and epithelium of various parts of the intestine are found.

note : knowing these features, the laboratory assistant can determine the pathological processes in certain parts of the intestine in certain diseases.

The coprogram is indicated for:

Coprological examination allows to identify (violation of the ratio of microorganisms and reproduction of pathogenic forms).

The coprogram is rarely used as an isolated study, most often it is an additional, but at the same time informative diagnostic method.

Preparation for passing the analysis is not difficult, but some rules must be strictly observed.

If the patient is taking medications containing iron and bismuth, then they must be canceled. Also, do not take laxatives, rectal suppositories. It is forbidden to wash the intestines with enemas.

If the person under study underwent radiography with a contrast agent (barium), then the coprogram should not be done earlier than 7-10 days after the study. Barium can change the properties of feces.

In the patient's diet during the few days preceding the test, excessive variety, exotic dishes, etc. should be limited.

Preparatory rule for donating feces for a coprogram:

How to collect feces for coprogram

Important : the collection rules are simple, but they should be followed carefully.

To collect feces, you must:

• empty the bladder, conduct a thorough toilet of the genitals and anal area using warm water and neutral soap without aromatic additives. Then rinse the washed areas with warm, boiled water;
• in pre-prepared clean dishes with a wide neck, using a spatula (which is available in pharmacy containers for collecting feces), collect material from different parts of the resulting feces;
• after collection, the stool is closed with a lid and signed with the name and surname of the patient, as well as the date of collection.

Wooden boxes, food cans should not be used as dishes for feces. The total amount of material collected should be 15-20 grams (approximate volume of a teaspoon). Try to bring approximately this amount of stool to the laboratory.

Feces should be collected in the morning and delivered to the study as soon as possible.

Note: the faster the material is brought to the laboratory, the more accurate and reliable the results of the coprogram will be.

If necessary, the container with the biomaterial is placed in a refrigerator, where it can be stored for no more than 8 hours, at a temperature of about 5 degrees Celsius.

The results of the coprogram are usually obtained within 2-3 days, sometimes the analysis takes 5-6 days.

If a child goes to the potty on his own, then the same rules apply to him as to adults.

In infants, a diaper or oilcloth is used (if the stool is liquid).

In case of constipation, to stimulate defecation, it is necessary to massage the abdomen, in some cases, you can put a gas outlet tube that stimulates the act of defecation.

All materials must be clean, hands must be washed with soap and water before collection.

Deciphering the coprogram in adults

Initially held macroscopic examination of feces.

In deciphering the coprogram in adults, it is estimated:

• the appearance of the stool;
• density of feces;
• staining (normal or pathological);
• the presence of a specific smell;
• the presence of bloody inclusions, veins, undigested food, purulent discharge, mucous lumps;
• the presence of mature forms of helminths;
• possible isolation of gallstones and pancreatic stones.

Microscopic analysis allows you to assess the ability of the gastrointestinal tract to digest food.

Microscopic examination may reveal:

• squirrel , which appears during inflammatory processes in the digestive tract system, with ulcerative changes in the mucosa, polyposis formations, oncological diseases. Normally, there is no protein in the feces;
• blood - appearing with hidden intra-intestinal bleeding, which can cause ulcers, tumors,. Altered blood indicates processes in the upper intestines, unchanged - in the lower. Occult blood is characteristic of tumors;
• stercobilin . This is a pigment that is a metabolite of bilirubin, which gives the feces a specific color. About 75-350 mg of this pigment is formed per day. An increase in the rate in deciphering the coprogram in adults is characteristic of hemolytic anemia. A decrease indicates a possible process of obstruction of the bile ducts (stones, tumor);
• . The appearance of this chemical indicates an acceleration of the digestion process, as a result of which bilirubin does not have time to be metabolized into stercobilin. This situation occurs with acute inflammation and with dysbacteriosis;
• slime . Mucus performs a protective function in the intestines, so its increased formation indicates strong inflammatory changes in the intestines in acute infectious diseases (salmonellosis, dysentery, infectious colitis, etc.);
• iodophilic flora . The appearance in the decoding of the coprogram in children and adults of pathological bacteria is characteristic of dysbacteriosis;
• detritus . Cellular destroyed material that emerges from the intestinal epithelium. A decrease in the amount is observed in violation of the digestive process;
• neutral fats . Excessive content is characteristic of insufficient excretion (bile production), as well as the process of absorption of bile in the intestine;
• muscle fibers . The appearance of these elements in an unchanged form (normally they change) indicates a disease process in the pancreas, due to violations of the composition of the juice, which is involved in the digestion of meat food;
• starch . Normally, it undergoes a splitting process, if during the study it is found in the form of grains, then the accelerated passage of the food bolus in the syndrome should be suspected, this symptom also appears in chronic;
• soaps . Soapy substances are normally present in small amounts. The increase can be with digestive insufficiency of the small intestine, stomach and duodenum. These problems occur with inflammation of the pancreas, with gallstones;
• leukocytes . Not normally defined. Their appearance in the decoding of the coprogram indicates inflammatory diseases of the digestive tract;
• fatty acids . In the secretions of a healthy intestine are absent. Appear with digestive and enzymatic insufficiency, violations of the outflow of bile, accelerated intestinal activity;
• 
  vegetable fiber . If soluble fibers are noted in the decoding of the coprogram in adults, then we can talk about insufficient secretion of hydrochloric acid in the stomach. Normally, soluble plant fibers are absent in feces. Insoluble fibers (peel of fruits and vegetables, outer shell of grains and legumes) are part of the normal contents of the intestine. Insoluble fibers remove indigestible foods, poisons, cholesterol from the intestines. The amount of these elements depends on the qualitative composition of the food;
• connective tissue fibers . These fibers are formed from the undigested remains of animal food. Normally, they shouldn't be. The appearance of fibers is characteristic of conditions in which the acidity of gastric juice decreases - (antacid gastritis). Also, these elements are noticeable with a decrease in the production of hydrochloric acid in the stomach, enzymatic deficiency that occurs with pancreatitis;
• ammonia . An increase in the content of this chemical compound is characteristic of processes accompanied by decay in the intestinal lumen. Normally, ammonia in feces contains 20-40 mol / kg. If an increased value of ammonia is indicated in the decoding of the coprogram in adults, then the presence of intestinal inflammation in a person should be suspected;
• pathological and conditionally pathological microorganisms that cause bowel disease.

The reaction of feces (pH) can be different (weakly alkaline, neutral, slightly acidic). This indicator depends on the nature of the diet.

Features of decoding the coprogram in children

The main indicators of the coprogram in children are similar to those in adults. But there are some features.

Most children have a normal coprogram with a neutral or slightly alkaline reaction (in the pH range of 6-7.6.

note : in infants, the reaction is most often sour in nature, as a result of the nutritional habits characteristic of this age category.

Alkaline reaction in children is determined in violation of the absorption process, with increased putrefactive processes in the intestines, prolonged exposure to undigested food in the stomach and intestines.

Until the age of three months, a child with breastfeeding, the presence of bilirubin in the feces is a variant of the norm. After 3 months, in deciphering the coprogram in children, only stercobilin should normally be determined.

Lotin Alexander, medical columnist

Many patients ask about what a coprogram is, how to take this analysis correctly. Before the study, you need to learn how to collect feces correctly so as not to get distorted results. This will lead to the fact that the doctor will make an incorrect diagnosis, and then prescribe an ineffective therapy that will not lead to a positive result.

1 The essence of the study

An analysis of the coprogram is necessary in order to detect diseases or pathologies in the following organs and systems of the human body:

1. Stomach.
2. Intestines.
3. Pancreas.
4. Liver.
5. Duodenum.
6. Gastrointestinal tract.

The collected stool for analysis allows you to find out how the digestive organs work, to suggest or diagnose a particular disease, to control the development of the disease and its treatment.

The coprogram allows diagnosing the following pathologies:

1. Congenital disorders of the functions of the digestive system.
2. Hereditary disorders in the structure of organs.
3. Dysfunction of the stomach and intestines, which often manifests itself in accelerated absorption of food.
4. The presence of spastic, allergic and ulcerative colitis.

The study is conducted both for adults and children, which is convenient when other diagnostic methods cannot be used for certain reasons.

It is necessary to collect material for a coprogram if it becomes necessary to diagnose diseases or evaluate the results of treatment, its effect on other organs.

2 Preparatory stage

How to take the analysis? The condition of the feces depends on many factors, in particular:

• nutrition;
• the use of drugs;
• lifestyle, etc.

Therefore, in order to obtain truthful results, it is necessary to prepare carefully and correctly collect feces for the test. The training scheme will be based on dietary nutrition. To do this, you need to remove proteins, fats and carbohydrates from the diet a few days before the diagnosis, as a result of which you can get correct analyzes of various pathologies.

Usually, the doctor prescribes one of two diets, Schmidt or Pevsner, before taking the test. They are a short-term and effective tool to properly prepare for the delivery of the coprogram.

The Pevzner diet is a conventional mixed diet, which should maximally load the digestive organs. To follow a diet, you need to eat the following foods every day (the daily calorie load will be 3,250 kcal):

1. White and black bread: 400 g each.
2. Fried meat: 250 g, only a piece.
3. Butter - 100 g.
4. About 40 g of sugar.
5. Kashi: buckwheat and rice.
6. Fried potatoes.
7. Sauerkraut.
8. Cucumber salad.
9. Dried fruits compote.
10. Fresh apples.

Diet allows you to detect pathologies and dysfunctions in other digestive organs.

The Schmidt diet is more sparing and low in calories, which is about 2200 kcal per day. The daily diet includes foods such as:

1. Milk (0.5 l).
2. Soft-boiled eggs.
3. 125 g lightly fried minced meat.
4. Mashed potatoes: about 200-250 g.
5. Viscous decoction of oatmeal.
6. White bread or crackers: 100 g.
7. Oil.

The Schmidt diet promotes good digestion of food, and undigested food residues are not found in the feces.

From the diet, the doctor may exclude foods that contain iron, which is done if internal bleeding is suspected in the organs of the digestive system. Usually, meat, fish, green vegetables, tomatoes, green onions and bell peppers are excluded from the diet.

If this is not done, then these products will give a false positive reaction to occult bleeding. But the diet will not become poorer from this, you can eat cereals cooked in milk, bread, dairy products. Excluded for a while and drugs, which include iron or other drugs that can stain the feces. Usually it is bismuth, barium preparations.

3 Delivery of material and results

Before the procedure, the doctor should explain to the patient that feces should be collected only after a natural bowel movement has occurred. Not suitable for analysis is material that was obtained after an enema, taking laxatives, administering rectal suppositories, drugs that affect intestinal motility.

In the stool, which is collected for analysis, foreign substances should not be present:

• urine;
• menstrual blood;
• discharge from the urinary tract.

Therefore, stool sampling at home is done only after taking a shower. It is necessary to collect feces in a clean and always dry dish using a spatula.

Pharmacies sell special plastic containers that are sterile. Its material for examination is filled by one third and immediately taken to a hospital or laboratory. The material should get there no later than 8-12 hours after collection.

If this cannot be done, then the feces in a closed container should be placed in a refrigerator or other cool place.

The analysis cannot be taken if women have menstrual flow, or a diagnostic examination of the intestine has been completed. Most often, this is an x-ray or colonoscopy, in which special contrast agents are used that can color the feces.

Also, the sampling of material for a coprogram is not done after an enema. You need to wait 2-3 days to collect the stool and take it to the laboratory.

Feces are studied by several methods, which makes it possible to obtain reliable results on the state of the organs of the digestive system and tract, to detect hidden pathologies. Therefore, in the form based on the results of the analysis, several indicators corresponding to microscopic, biochemical and physical (macroscopic) studies will be noted.

In particular, the consistency of feces, its shape, color, smell, acidity, the presence of mucus, blood, undigested food residues, the reaction to protein, bilirubin, occult blood, stercobilin, etc. are studied.

Among the main results of the analysis, the following should be noted. If the feces are colorless, then the patient is diagnosed with gallstone disease. A positive test for occult blood can detect stomach ulcers, cirrhosis of the liver, hemorrhoids, ulcerative colitis, dysentery.

A change in smell indicates the presence of chronic pancreatitis. An analysis of carbohydrates in babies allows you to detect. Mucus indicates that dysbacteriosis and salmonellosis are developing.

A stool coprogram is a mandatory examination, which is recommended not only for children, but also for adults. It allows you to establish the presence of human diseases associated with the digestive system. In order to find out what a fecal coprogram is, it is necessary to understand the features of its implementation and preparation for it. In addition, the patient needs to be able to independently decipher the data of this analysis.

Fecal coprogram is a laboratory method for studying fecal masses. As already noted, such a diagnosis makes it possible to identify certain deviations in the work of the gastrointestinal tract. A similar diagnosis is shown in acute and chronic forms of gastric pathology, deviations in the work of the duodenum 12. In addition, the examination is able to identify certain diseases of the small and large intestines, which also applies to the sigmoid and rectum.

Coprological analysis shows whether a person has problems associated with the functioning of the liver, gallbladder and bile ducts. In addition, diagnostics show:

Laboratory diagnostics is also carried out in order to assess the degree of effectiveness of treatment, to identify how effective corrective measures were after the main therapy. The coprogram (general analysis of feces) is indispensable in the process of diagnosing dysbacteriosis, which is a violation of the number of microorganisms and the subsequent reproduction of pathogenic components.

It is also important to understand that examination is rarely used as an isolated diagnosis. Most often, diagnostics is an additional, but the most informative diagnostic method.

The features of the preparation will be discussed later in this article.

How to take and properly prepare for the analysis?

In order for the decoding of the coprogram in adults to be correct, it is necessary to pass this analysis correctly, not to mention compliance with all the rules of preparation. Experts pay attention to the fact that:

1. You will need to pre-purchase a sterile container with a screw cap and a spoon.
2. Feces are collected in a ratio of not more than 30% of the total volume of the container. Exceeding this amount is fraught with the fact that leukocytes in the coprogram will be identified incorrectly.
3. The container indicates the patient's last name, his initials, as well as birth. The necessary additional data should be considered the date and time of collection of feces. It is very important that the entries are made in the most legible handwriting.
4. The material must be delivered to the laboratory only on the day of its collection. During the collection of faeces, it is strongly recommended to completely eliminate any impurities of urine, as well as secretions from the genitals.
5. Feces must be stored in a refrigerator until dispatch. In this case, the temperature indicators should be from four to eight degrees of heat.

In some cases, a second fecal coproscopy (this is a synonym for a coprogram) may be required to identify other previously unnoticed problems.

It will be necessary to exclude the use of drugs, namely laxatives, iron and bismuth preparations, enzymes and all other items that in one way or another affect the process of digestion and absorption of food. It is unacceptable to carry out scatological examinations after setting an enema, because bilirubin in the feces may be incorrectly identified.

When conducting a survey for the presence of occult blood, meat and fish are excluded from the diet. The restriction applies to fresh and pickled tomatoes, all kinds of green vegetables, as well as iron preparations. After an X-ray examination of the stomach and intestines, a coprogram is done two days later. An earlier study may also skew the results.

It is advisable to introduce a certain diet, in which only milk is consumed, as well as some dairy products. It is permissible to introduce various cereals, mashed potatoes, as well as white bread with butter into the diet. Useful before the coprogram and hemotest will be one or two soft-boiled eggs, as well as a small amount of fresh fruit.

Such food is recommended to be consumed for at least four to five days, while feces are examined on the third to fifth day. In this case, independent emptying of the intestine should be considered a prerequisite, without which the diagnosis cannot be carried out.

Deciphering the scatological examination of feces - the norm in adults

Deciphering the coprogram, norms in adults are always presented in the form of a table. I would like to draw attention to the fact that according to the results of the examination, the appearance of feces is evaluated, as well as the degree of their density and other physical parameters. The following is being studied:

The analysis also shows the probable allocation of calculi, namely biliary and pancreatic. The final table looks like this:

Briefly about microscopic analysis

Microscopic examination deserves special attention in terms of diagnosis. It allows you to determine the presence or absence of neutral fats or fatty acids, leukocytes and erythrocytes. Based on the data of the microscopic part of the coprogram, a specialist determines acute and inflammatory diseases, obstruction of the bile ducts, polyps and other pathological conditions.

Pay attention to the fact that the coprogram costs about 500-600 rubles, which is more than affordable and allows you to reliably verify the current state of the digestive system.