Fecalysis

• What are the main components found in urine and body fluids?

  Bacteria, cellulose, undigested foodstuff, gastrointestinal secretions, bile pigments, cells from intestinal walls, electrolytes, and water
• What is the major normal flora found in the intestine?

  Escherichia coli
• What is the major anaerobic bacteria present in the gastrointestinal tract?

  Bacteroides fragilis
• What role does Bacteroides fragilis play in the gastrointestinal tract?

  It helps in the metabolism of certain substances
• How much stool is typically passed per day?

  Around 100-200 g
• What does more than 200 g of stool per day indicate?

  It indicates diarrhea
• How much fecal matter reaches the large intestine under normal conditions?

  500-1500 mL
• What is the normal frequency of defecation?

  Below 3 times a day
• What is the composition of feces?

  • ¾ water
  • ¼ solid
  • 30% bacteria (mostly non-pathogenic)
  • 50-60% intestinal secretions (food residues)
  • 10-20% fat droplets and other soluble substances
• What causes the foul to offensive odor of feces?

  Skatole, indole, and butyric acid
• What is the normal pH range of feces?

  1. 0 to 8.0
• What does acidic feces indicate?

  Carbohydrate fermentation
• What does alkaline feces indicate?

  Protein fermentation
• Where does protein fermentation occur in the gastrointestinal tract?

  In the distal colon
• What potentially toxic products can be produced during protein fermentation?

  Ammonia, amines, phenols, or sulfides
• What is the normal consistency of feces?

  Soft to well-formed
• What does a large amount of mucus in feces indicate?

  It indicates irritable bowel disease
• What is the purpose of mucus in the large intestine?

  To absorb more water
• What is the purpose of mucus in the small intestine?

  To prevent infiltration of microorganisms
• What are the reasons for conducting fecalysis?

  • Early detection of GI bleeding (colorectal cancer)
  • Liver and biliary duct disorders
  • Maldigestion and malabsorption
  • Inflammation
  • Diarrhea
  • Steatorrhea
  • Detection of pathogenic bacteria and parasites
• What type of container is required for fecal specimen collection?

  Clean, dry, non-breakable, leakproof, and screw-capped
• What is the minimum amount of stool required for FOBT, WBCs, and qualitative fecal fat tests?

  At least 3 grams
• What is the purpose of a 2- to 3-day fecal collection?

  To conduct quantitative tests for fat in the stool
• What are the methods for specimen preservation?

  • Refrigeration
  • Freezing in dry ice
  • 10% Formalin (2% and 5% can also be used)
  • Alcohol
  • 20% glycerin in saline (Cumming Method)
  • Methiolate-Iodine Formaldehyde (MIF) Solution (not for trophozoites)
  • Polyvinyl alcohol (PVA) Fixative
• What is the normal daily fat excretion in stool for a fatty diet?

  5 grams/day
• What is the normal daily fat excretion in stool for a free fat diet?

  1. 4 grams/day
• What does steatorrhea indicate?

  Increased fats in the stool
• What can cause steatorrhea?

  Deficiency in lipase, bile salts, or lymphatic obstruction
• What is the screening test for fecal fat determination?

  Microscopic examination of free fat globules
• What is the gold standard for fecal fat determination?

  Van de Kamer Titration
• What is the normal value for fecal fat excretion per day?

  1. 6 g fats/day
• What is creatorrhea?

  Abnormal excretion of undigested muscle fibers in the feces
• How is creatorrhea determined?

  The patient should include meat in the diet for at least 3 days
• What indicates abnormal creatorrhea?

  More than 10 undigested muscle fibers per HPF
• What are the causes of creatorrhea?

  Biliary obstruction, gastrocolic fistulas, pancreatic insufficiency
• What indicates an invasive condition in fecal leukocytes?

  More than 3 neutrophils per HPF
• What does an increased daily stool rate indicate?

  Frequent defecation
• What is the lactoferrin latex agglutination test used for?

  To detect invasive bacterial pathogens
• What is the stool weight indicating diarrhea?

  More than 200 g/day with increased liquidity
• What is the duration of acute illness in stool analysis?

  Less than 4 weeks