Para

• Anemia


  Blood loss from bleeding ulcer
• Polyp


  Abnormal growth of tissue projecting from a mucous membrane

  
• Colitis


  Inflammation of the colon
• Diverticulitis


  Common digestive disease which involves the formation of pouches (diverticula) within the bowel wall

  
• Do not show any visible symptoms, only presence of blood
• Anal fissure


  Small tear in the thin, moist tissue (mucosa) that lines the anus
• An anal fissure may occur when

  You pass hard or large stools during a bowel movement
• Anal fissures


  • Typically cause pain and bleeding with bowel movements
• Crohn's disease and ulcerative colitis are both forms of inflammatory bowel disease
• Crohn's disease


  Most commonly affects the colon and the last part of the small intestine (ileum)

  
• Ulcerative colitis


  Affects only the colon
• Anal fissure


  Painful linear tear or crack in the distal anal canal
• Guaiac-based Occult Blood Test


  Use a special guaiac impregnated paper upon which a stool sample is smeared, then add a few drops of a special developer and observe for the development of a blue color
• Any blue color is a positive test
• Guaiac-based Occult Blood Test


  • Lacks sensitivity and specificity and has diet-restrictions prior to testing
• Principle of Guaiac-based Test


  1. Smear stool sample on guaiac paper

  2. Turn paper over and add developer

  3. Hemoglobin catalyzes oxidation of guaiac to form blue color

  4. Appearance of any blue color indicates presence of occult blood
• Patients experiencing hemorrhoidal bleeding, having a menstrual period, or bleeding from the nose, gums, etc. should delay testing for at least 48 hours from the time that all such bleeding has stopped
• Specimen Collection and Testing


  1. Collect stool samples from 3 different bowel movements

  2. Make 2 smears from different areas of each sample, especially from darkened or discolored areas
• False positive substances


  • Red meat
  • Aspirin and other NSAIDs (ibuprofen, indolemethacin, neproxen)
  • Corticosteroids, phenylbutazone, reserpine, anticoagulants, antimetabolites, and cancer chemotherapeutic drugs
  • Alcohol in excess
  • Antiseptic preparations containing iodine
• False negative substances


  • Ascorbic acid (vitamin C) in excess of 250 mg per day
  • Excessive amounts of vitamin C enriched foods
  • Iron supplements which contain quantities of vitamin C in excess of 250 mg per day
• Fecal Immunochemical Test (FIT)


  Qualitative, sandwich dye conjugate immunoassay to selectively identify the globulin component of human hemoglobin in fecal specimens
• Fecal Immunochemical Test (FIT)


  • Tests for hidden blood in the stool
  • Only detects human blood from lower intestines
  • Does not require a restricted diet
  • Uses antibodies to detect blood in the stool
• Monoclonal antibody


  Antibody made by cloning a unique white blood cell, having monovalent affinity binding only to the same epitope
• Polyclonal antibody


  Antibodies created from different plasma cell lines, having different affinities
• Enterobius vermicularis


  • Tiny, thread-like and whitish worm
  • Adult females measure 9–12 mm and have a pointed tail, whereas males are 2–5 mm in length
  • Gravid adult females migrate to the anal area mostly during the night and deposit thousands of eggs on perianal area
• This parasite may not be recovered in stools because they rarely oviposit the bowel
• Cellulose Tape Technique


  1. Apply a strip of transparent scotch tape to a glass slide

  2. Fold a small portion of the end to provide a non-sticky surface for handling

  3. Pull the folded tab to free the sticky side of the tape

  4. Carry the freed tape over the end of a tongue depressor so the sticky side is out

  5. Press the tape against the right and left perianal fold but do not insert the depressor in the rectum

  6. Replace the tape onto the slide and examine for eggs and female adults under low power
• Eggs


  Diagnostic stage, thin-shelled and D-shaped
• Females die after laying eggs, which can be retrieved using the tape technique
• 5 Consecutive daily collection is recommended before reporting a negative result
• A single positive result automatically warrants a + report
• Collection should be done at night (late at night) or early morning before taking a bath