Fecal Examination

• What does routine stool examination consist of?

  1. Gross examination

  2. Microscopic examination

  3. Chemical examination
• Gross examination consists of?

  1. Consistency

  2. Color

  3. Quantity

  4. Odor

  5. Mucus and Blood
• Types of consistency

  1. loosely formed

  2. watery

  3. Dry/hard

  4. pasty

  5. ribbon like
• Cause of watery stool

  diarrhea
• Cause of pasty stool

  1. high fat content

  2. bile duct obstruction

  3. celiac
• Cause of dry/hard stool

  constipation
• Types of stool colors

  1. brown

  2. yellow

  3. black tarry

  4. reddish

  5. clay

  6. pale and greasy
• cause of brown stool

  stercobilinogen
• cause of yellow stool

  diahrrhea
• cause of black tarry stool

  bleed from upper GI tract
• cause of reddish stool

  1. lower GI bleed

  2. hemorrhoids

  3. fissure

  4. inflammation process
• cause of clay color stool

  billary obstruction
• cause of pale and greasy stool

  pancreatic deficiency leading to malabsorption
• Normal quantity of stool

  100 - 200 G/day
• cause of decreased stool quantity

  constapation
• cause of increased stool quantity

  1. poor food breakdown

  1. poor absorption

  3. steatorrhea
• What does steatorrhea lead to?

  large, bulky, frothy, and foul smelling stool
• Types of stool odors

  1. stool odor

  2. foul

  3. sickly
• cause of stool odor

  1. Indole and skatole

  2. formed by bacterial fermentation and putrefaction
• cause of foul odor

  1. undigested protein

  2. excessive carbohydrates
• cause of sickly odor

  1. undigested lactose and fatty acids
• What can macroscopically be seen in stool

  blood and mucus
• cause of mucus in stool

  1. severe constipation

  2. mucous colitis
• How is mucus formed in the stool

  1. produced by mucosa of colon

  2. response to parasympathetic stimulation
• cause of mucus and blood in stool

  1. dysentery

  2. colitis

  3. tuberculosis

  4. malignancies

  5. inflammation lesion
• Seen in microscopic examination

  1. leukocytes

  2. RBCs

  3. Epithelial cells

  4. macrophages

  5. fat

  6. meat and muscle fibers

  7. ova and parasites
• where are leukocytes found in stool

  mucus
• Normal amount of leukocytes

  occasional (0-1)
• Clinical significance of leukocytes in stool

  1. dysentery

  2. colitis

  3. shingles

  4. salmonella

  5. E. coli

  6. fistula

  7. abscess

  8. amoebiasis and typhoid
• cause of leucocytes

  not caused by viral or parasitic infection
• Cause of RBCs

  1. hemorrhoids

  2. GI bleed

  3. dysentery
• Cause of epithelial cells

  inflammation of bowels
• cause of macrophages

  1. dysentery

  2. colitis
• cause of fat

  1. malabsorption

  2. bile deficiency

  3. digestive enzyme deficiency
• cause of meat and muscle fibers

  digestive defect
• What causes an increase of meat fibers`

  1. malabsorption

  2. pancreatic defect (i.e. cystic fibrosis)
• Collection of Ova and Parasites

  1. multiple stool samples collected to rule out parasitic infection

  2. taken over the course of three consecutive days
• Entamoeba Histolytica (trophozoite)

  1. protozoa

  2. motile

  3. central nucleus and karyosome

  
• Entamoeba histolytica cyst

  1. 4 nuclei

  2. 1 karyosome

  3. chromatid bars

  4. protozoa

  
• Giardia lamblia trophozoite

  1. pear shape

  2. motile

  3. 2 nuclei

  4. granular cytoplasm

  5. protozoa