Coprological examination of stool preparation. How to donate feces for a coprogram: preparation and collection of material. How to collect feces for coprogram

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.

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:

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.

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 stool. 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 a coprogram in an infant, 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 in case of 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.

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 the 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 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 intestine, so its increased formation indicates strong inflammatory changes in the intestine in acute infectious pathology (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.

The alkaline reaction in children is determined by a violation of the absorption process, with increased putrefactive processes in the intestines, a long stay in the stomach and intestines of undigested food.

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 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 appointment

Indications for the study of feces are:

Fecal analysis for coprology is prescribed for complex preventive examinations.

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 examining feces for occult blood, 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.

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.

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, bloating 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. The content of insoluble fiber depends on the nature of the diet.

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.

Note!

The presence of symptoms such as:

bad breath stomach pain heartburn diarrhea constipation nausea, vomiting belching increased flatulence (flatulence)

If you have at least 2 of these symptoms, then this indicates a developing

gastritis or stomach ulcer.

These diseases are dangerous for the development of serious complications (penetration, gastric bleeding, etc.), many of which can lead to

LETHAL

exodus. Treatment needs to start now.

Read an article about how a woman got rid of these symptoms by defeating their root cause. Read the material ...

Fecal analysis is an important tool in the study of diseases and the functioning of the digestive system. In particular, the study of feces allows you to determine the condition of such organs as: the liver, stomach, pancreas, and the small and large intestines themselves. And although this study is not as common as a blood or urine test, the results obtained during its conduct allow your doctor to get a fairly detailed picture of your state of health, the causes of any diseases of the digestive system and, consequently, the appointment of the most appropriate treatment for you.

Norms of general analysis of feces

Amount of feces

The norm of the amount of feces

Causes of an increase in the amount of feces

• Violation of bile secretion (cholelithiasis, cholecystitis)
• Intestinal malabsorption (enteritis)
• Violation of digestion in the small intestine (fermentative and putrefactive dyspepsia)
• Increased intestinal motility (diarrhea)
• Decreased function of the pancreas (pancreatitis)

Causes of a decrease in the amount of feces

• The most common cause is constipation.

Consistency of feces

The norm of the consistency of feces

There are a number of cases when feces can be different from the formed consistency:

Causes of changes in the consistency of feces

• Very dense stool(also called sheep) - (for constipation, stenosis of the colon, spasm of the colon)
• mushy stool(increased intestinal motility, increased intestinal secretion, colitis with diarrhea, fermentative dyspepsia)
• ointment(impaired secretion of the pancreas (chronic pancreatitis), lack of bile flow (cholelithiasis, cholecystitis)
• Liquid(impaired digestion in the small intestine (dyspepsia), malabsorption or excessive secretion of fluid in the large intestine)
• Foamy(may be with fermentative dyspepsia)

stool color

Stool color norm

Causes of discoloration of feces

• Tar-like or black(eating currants, blueberries, bismuth preparations (Vikalin, Vikair, Bisal), may also appear with bleeding from the upper gastrointestinal tract)
• Dark brown(eating a large amount of protein food, indigestion in the stomach, colitis, constipation, putrefactive dyspepsia)
• Light brown(when eating a large amount of plant foods, increased intestinal motility)
• Reddish(may occur in ulcerative colitis)
• Green (increased content of bilirubin, biliverdin, with increased intestinal motility)
• Greenish black(when taking iron supplements)
• Light yellow(pancreatic dysfunction (pancreatitis), dyspepsia)
• grayish white(mechanical blockage of the bile duct (choledocholithiasis), acute pancreatitis, hepatitis)

Smell of feces

The norm of the smell of feces

Causes of odor change

• Fetid(hypersecretion of the large intestine, dysfunction of the pancreas (pancreatitis), violation of the flow of bile (cholecystitis with choledocholithiasis))
• Putrefactive(putrefactive dyspepsia, indigestion, colitis, intestinal motor disorders)
• Sour(fermentative dyspepsia)
• Smell of butyric acid(accelerated evacuation from the large intestine)

acidity of feces(pH)

The rate of acidity of feces

Fluctuations in the acid-base state of the intestine and feces, in turn, are affected by the state of the bacterial flora of the intestine. With an excess of bacteria, the pH can shift to the acid side to pH-6.8. Also, with a large intake of carbohydrates, the pH can shift to the acid side due to the possible start of fermentation. With excessive consumption of proteins, or with diseases affecting the digestion of proteins, putrefactive processes can occur in the intestines, which can shift the pH to the alkaline side.

Causes of changes in the pH of feces

• Slightly alkaline pH 7.8-8.0 (with insufficient digestion in the small intestine)
• Alkaline - pH 8.0-8.5 (impaired pancreatic secretion, hypersecretion in the large intestine, colitis, constipation)
• Sharply alkaline - pH> 8.5 (putrefactive dyspepsia)
• Acid - pH< 5,5 (бродильная диспепсия)

Mucus in stool

The norm of mucus in the feces

To study the composition of feces, to determine its chemical and biological properties, a coprogram is prescribed. This is an informative comprehensive analysis that allows you to identify some diseases of the gastrointestinal tract and track their dynamics. In order for the analysis to be reliable, when passing it, it is necessary to observe the conditions of preparation and correctly collect the biomaterial.

What is a stool coprogram

Feces for a coprogram are given to identify pathological conditions of the organs of the gastrointestinal tract (GIT). Under laboratory conditions, a complete physical and chemical study is carried out, as well as testing for microbiological composition. The result of the analysis will show not only the presence of diseases, but also their localization. That is, the answer to the question, what is a fecal coprogram, is a general analysis of this biomaterial.

In order for the analysis for the coprogram to be informative and without distortion, it is necessary to clarify with the doctor before taking it how to collect feces. It is important that the defecation process occurs naturally. You can not use laxatives, empty the intestines with an enema, etc. It is permissible to eat or drink a product that has a natural laxative effect the day before.

The material for the study should not contain foreign inclusions, urine. Women during menstruation should not be tested to avoid the ingress of foreign substances.

If the patient has prolonged constipation and does not know how to collect feces for analysis, then a colon massage is possible. In exceptional cases, it is allowed to use an enema. For analysis, a fragment of the dense part of the feces is taken.

Before collecting the analysis, you need to empty the bladder, and then carry out hygiene procedures in the anal area. Feces are collected with a sterile spatula in a sterile wide dish. The material needs no more than 1 scoop, but it must be taken from different sectors of the feces. The container with the material is tightly closed with a lid. In infants, feces should be collected not from a diaper, but from a sterile diaper.

It is necessary to collect the analysis in the morning and immediately give it to the laboratory. If this is not possible, then it must be put in a cold place, the air temperature in which does not exceed + 5 ° C, but not longer than 8 hours. If the analysis is given in order to detect protozoa or worm eggs in it, then storage in a cold place is unacceptable, the analysis must be fresh.

The container is taken pharmacy, sterile. It is impossible to take an analysis in non-special dishes, because the test results in this case are distorted. Before delivery, the patient should be prepared for a coprogram.

Coprogram - how to pass

What is a coprogram, how to properly submit material for analysis and how to prepare for it, will be consulted by the doctor directing for analysis. There are several rules that must be observed before passing the analysis:

1. A few days before the test, you need to stop eating meat dishes, green vegetables, beets, fresh tomatoes, and red fish, because if the analysis is performed to detect blood hidden in the feces, the result may be false positive due to the use of these products .
2. Mashed potatoes, dairy products, cereals, lean meat dishes, etc. should be consumed.
3. If the patient used antimicrobials, sorbents, anti-inflammatory drugs, drugs for anemia, then they must be abandoned a week before the coprogram, because these drugs change the color of the feces. Laxatives, rectal suppositories should be abolished.
4. In some cases, a special diet is prescribed, which makes it possible to identify even small deviations in the functioning of the digestive organs. The doctor prescribes the content of carbohydrates, proteins and lipids in the diet.
5. If the patient had an x-ray with barium, colonoscopy and cleansing procedures, then the feces for analysis are submitted no earlier than a week after the procedures.
6. A temporary contraindication is bleeding hemorrhoids.

What does the fecal coprogram show

To understand what the stool coprogram shows, you need to know the designations of the elements. Microscopic examination in the laboratory evaluates the appearance and consistency of feces. The presence or absence of a specific odor, foreign matter in the form of undigested food, mucus, blood or pus is determined, and whether the staining is normal. At this stage, the presence or absence of mature helminths is determined. During microscopic examination, it is determined how fully the digestion process occurs.

There are elements in the feces that indicate the presence or absence of specific diseases. The laboratory assistant determines their number and compares with the norm indicators:

1. If an inflammatory process is present in the gastrointestinal tract, then a protein is found in the feces. Its presence may indicate a disturbed mucosa, the presence of tumors and polyps.
2. If no mistakes were made during the collection of biomaterial, and blood was detected during the analysis, then this may indicate in favor of the presence of helminthic invasions, hidden bleeding, ulcers, polyps and tumors. The blood particles may or may not be shaped. In the first case, this means that the pathology has formed in the upper intestines. If the particles are not changed, then in the lower ones.
3. The color of feces depends on the amount of stercobilin. Normally, its level is in the range of 75-350 mg. If the indicator is below normal, then this may mean obstruction of the bile ducts due to stones or tumors. With elevated rates, the risk of hemolytic anemia is high.
4. The presence of bilirubin in the material testifies in favor of dysbacteriosis, since normally it is completely metabolized into stercobilin.
5. A small amount of mucus may be present in the stool. If the indicator is high, then this indicates an acute infectious process.

In addition to these indicators, the amount of muscle fibers, starch, soaps, acids, leukocytes and erythrocytes, neutral fats and fungi present in the feces is determined. Some of these elements should be completely absent (for example, yeasts and fatty acids), while for others there are quantitative norms. Deviations from these norms indicate the presence of inflammatory processes and chronic diseases in the digestive organs. In case of a large deviation from the norm, the doctor may prescribe an additional examination.

The coprogram is an analysis of the chemical, physical and microscopic characteristics of feces.

Feces are the end product of food digestion. Therefore, it contains complete information about the state of the digestive system.

The composition of feces includes the following components:

• bacteria that occupy up to 75% of feces;
• slime;
• undigested food residues;
• pigments that give color to feces;
• intestinal cells.

Deviations of certain components from the norm may indicate a certain disease of the digestive system. And it is by these indicators that you can determine the location of the problem.

Features of the preparation and delivery of the analysis

In order for the results of the analysis to be correct and informative, the patient must follow the rules for preparing and passing the analysis of feces for a coprogram.

A few days before the test, the following foods should be excluded from the diet:

• green vegetables;
• beets;
• tomatoes;
• meat products;
• oily fish.

Before passing the analysis, the diet should consist of dairy products, cereals, fruits and vegetable puree. Immediately before collecting the material, the anus and genitals should be washed. Women are not recommended to donate feces during menstruation. It is forbidden to analyze feces for two days after examining the digestive system with barium or after an enema.

In order for the coprogram to show correct results, it is necessary to adhere to the rules for collecting material for analysis:

• Defecation should not be forced. For analysis, only feces are used, which are obtained during spontaneous bowel movements. Enemas and laxatives can affect the quality of the material for research.

• Collect feces in such a way that urine or menstrual blood does not get into it.
• To submit the analysis to the laboratory, use a special sterile container that can be purchased at a pharmacy. Only a teaspoon of material is sufficient for analysis, so the container should not be completely filled.
• Fecal analysis does not have to be taken on an empty stomach. Feces can be collected during the day. The analysis should be delivered to the laboratory within 10-12 hours after collection. At the same time, it must be stored at a temperature not exceeding 8 degrees.

Analysis sampling in children

If the child is older, then the analysis should be taken from a clean pot. It is important that other body fluids do not get into the feces. To stimulate bowel movements, you can not use special drugs. It is recommended to include fatty or coloring foods in the child's diet. This can affect not only the color and consistency, but also the chemical composition of the stool. You should also tell the doctor what drugs the child is taking in order to exclude those that can affect the biochemical parameters of feces before taking the test.

Deciphering the analysis in adults

Deciphering the analysis of feces allows you to determine the presence of diseases and malfunctions of organs and systems. You can even suspect the presence of diseases by the smell, shape and color of feces. For example, too light feces may indicate diseases of the liver, pancreas and gallbladder. Black stools occur when there is bleeding in the gastrointestinal tract. It can be caused by an ulcer, Crohn's disease, or a tumor in the stomach. With a reddish tint, there is a suspicion of bleeding in the lower intestine. Brown stools are considered normal.

With a more thorough analysis, blood, mucus, pus, stones and worms can be found in the feces. The analysis allows you to determine the quality of work of all organs of the gastrointestinal tract. And chemical analysis allows you to determine the acidity, soluble mucus, protein and other indicators.

Soluble protein

The presence of protein in the stool is already a deviation from the norm. The cause may be the inflammatory process of the digestive tract. Occurs with pancreatitis, colitis, gastritis, enteritis, ulcers, proctitis and even cancer. Determining the presence of protein in the feces does not make it possible to accurately diagnose, however, it is a serious reason for the appointment of additional studies. If, upon detection of soluble protein in the feces, the patient complains of bloating and nausea, acute pancreatitis may be the cause.

Blood

Blood in the stool occurs with a stomach or duodenal ulcer. Worms can also damage mucous membranes. With unchanged blood cells, we can talk about bleeding from the large intestine. If the blood is altered, then the problem has arisen in the upper shades of the gastrointestinal tract. The presence of blood in the analysis of feces allows you to identify the appearance of neoplasms in the digestive organs in the early stages.

Slime

Mucus is produced by the mucous membrane to protect the organs. However, if mucus is present in a significant amount, the cause may be lactose intolerance, malabsorption, or the presence of pathogens. Also, an excessive amount of mucus in the stool may indicate diseases such as colitis or dysentery.

Bilirubin

This substance occurs in the feces if the passage of food is accelerated. In this case, bilirubin does not have time to convert to stercobilin. It can be detected with dysbacteriosis or acute gastroenteritis.

Sterkobilin

The pigment that gives stool its brown color. An increase in the rate of this substance occurs with hemolytic anemia. A decrease in its level may indicate a blockage of the bile ducts.

Iodophilic flora

The presence of iodophilic flora in the results of the analysis indicates a violation of the intestinal microflora. Most often, pathogenic microorganisms are found with insufficient digestion of food.

Detritus

The presence of this substance indicates poor-quality digestion of food. Detritus is particles of digested food and damaged epithelial cells.

Starch

Starch should not be present in feces. It must be completely broken down during the digestion of food. If it is detected, then the accelerated advancement of food masses may be the cause. The cause may be chronic pancreatin or malabsorption syndrome.

Muscle fibers

In the feces, only altered fibers are normally present. If the fibers are found unchanged, the cause may be a problem with the pancreas. With a decrease in the production of digestive juice, protein foods of animal origin are poorly digested, so their detection indicates the development of pancreatitis.

Neutral fat

Normally, this indicator should be absent. If the digestive system works smoothly, then the body assimilates more than 90% of the fats consumed. The presence of neutral fats in the feces indicates insufficient bile production. It is also observed with a reduced level of the digestive enzyme lipase. In this case, fats are not completely absorbed.

Leukocytes

Normally, this indicator should be absent. Occurs in inflammatory diseases of the gastrointestinal tract.

Soaps

A small amount is allowed. With an increase in permissible norms, we can talk about the shortcomings of the digestion of food in the stomach and intestines. Occurs when there is a malfunction of the gallbladder and pancreas.

Fatty acid

If the digestive system works without failures, this indicator is absent in the analysis results. The presence of fatty acids in the feces indicates a decrease in digestive enzymes, an accelerated promotion of chyme, as well as deficiencies in bile.

Ammonia

The norm of ammonia in feces is from 20 to 40 mol / kg. If the indicator is higher than normal, then the reason is the presence of the process of decay in the intestines. This process occurs when excessive protein production occurs during inflammation of the intestinal walls. It is impossible to establish the exact cause of this phenomenon without further examination. A coprogram with an increased ammonia value can only be the reason for the appointment of an additional examination.

vegetable fiber

Soluble and insoluble fiber fibers can be found in the feces. The presence of soluble fibers is not the norm. It is observed with a lack of intake of hydrochloric acid. The presence of insoluble fiber fibers is the norm and depends on the nature of the diet.

Connective tissue fibers

They are the remains of food of animal origin. Normally, this component should not be present in the feces. Connective fibers may be present in low stomach acid, digestive enzyme deficiencies, and hydrochloric acid deficiency. The reason may be gastritis or pancreatitis.

Deciphering the analysis in children and infants

A deviation from the norm of one or another indicator in the analysis of feces may indicate the presence of various diseases. Therefore, you need to know the decoding of the coprogram in children, the indicators of which differ from the adult.

For example, an important indicator is the amount of feces. A decreased or increased indicator may indicate deficiencies in the production of bile, a violation of the pancreas and other organs of the digestive system.

Consistency is also important. With liquid masses, one can judge about excessive secretion, with mushy - about colitis, with foamy feces - about fermentative dyspepsia, and high density can cause spasms and constipation.

The coprogram also includes the determination of the color of feces. It may vary depending on the diet. But in some cases, the color indicates possible problems with the gastrointestinal tract. For example, green or beige color indicates excessive intestinal motility. A red tint indicates a stomach ulcer, a black one can cause bleeding of the upper gastrointestinal tract.

An important indicator is the acidity of feces. A low indicator indicates putrefactive processes in the gastrointestinal tract, and a high indicator indicates diarrhea and fermentation processes.

A healthy child should not have blood in the feces. If it is present, watering or internal bleeding in the large intestine may be the cause. The presence of protein in the stool indicates an inflammatory bowel disease or insufficient digestion of food.

Mucus is normal only in infants. In babies, undigested fat from mother's milk comes out in the form of mucus. Older children should not have mucus in the stool.

The presence of neutral fat in the feces of a child of any age indicates a violation of the pancreas and gallbladder. And the presence of fatty acids is a clear sign of putrefactive dyspepsia. The presence of leukocytes or erythrocytes indicates diseases such as colitis, hemorrhoids or dysentery.

Bilirubin in children in the feces should be absent. Its presence warns of high intestinal peristalsis. As a rule, this indicator is present in the feces of children after taking a course of antibiotics. A low stercobilin indicates hepatitis or cholongitis, and a high may be an indicator of anemia.

Conclusion

The results of an adult or child stool test may allow the doctor to suspect a number of gastrointestinal diseases and other disorders. However, an accurate diagnosis can only be made after an additional examination. Therefore, one should not independently interpret the results of the coprogram, and even more so, start self-treatment based on them.