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Diagnonistic Test

Fecal Occult Blood Test

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Alternative Names: Guaiac smear test; Fecal occult blood test – guaiac smear; Stool occult blood test – guaiac smear

Definition
The stool guaiac test finds hidden (occult) blood in the stool (bowel movement). It is the most common form of fecal occult blood test (FOBT) in use today.…..click & see

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This test detects blood in your stool, which can be a sign of bleeding anywhere from your nose and mouth to your rectum, such as from an ulcer, a polyp, or cancer. If you’re over 50, you should have this test annually during the years when you don’t have either a colonoscopy or sigmoidoscopy to screen for colon cancer. Keep in mind, however, that both colonoscopy and sigmoidoscopy are better at detecting cancer than a fecal occult blood test.

How the Test is Performed
If the test is performed in an office or hospital, stool may be collected by a doctor during an examination.
If the test is performed at home, a stool sample from three consecutive bowel movements is collected, smeared on a card, and mailed to a laboratory for processing. In order to ensure the accuracy of the guaiac test, follow the manufacturer’s instructions on how to collect the stool.

There are many ways to collect the samples. You can catch the stool on plastic wrap that is loosely placed over the toilet bowl and held in place by the toilet seat. Then put the sample in a clean container. One test kit supplies a special toilet tissue that you use to collect the sample, then put the sample in a clean container. Do not take stool samples from the toilet bowl water, because this can cause errors.

For infants and young children wearing diapers, you can line the diaper with plastic wrap. The plastic wrap is positioned so that it keeps the stool away from any urine. Mixing of urine and stool can spoil the sample.

Laboratory procedures may vary. In one type of test, a small sample of stool is placed on a paper card and a drop or two of testing solution is added. A color change indicates the presence of blood in the stool.
How do you prepare for the test?
Do not eat red meat, any blood-containing food, cantaloupe, uncooked broccoli, turnip, radish, or horseradish for 3 days prior to the test.

You may need to stop taking medicines that can interfere with the test. These include vitamin C and aspirin. Check with your health care provider regarding medication changes that may be necessary. Never stop or decrease any medication without consulting your health care provider.

For several days before taking the samples, you must avoid medicines that can interfere with the results. These include NSAIDs and blood thinners  which can cause minor stomach bleeding, thereby giving an abnormal test result. If you have hemorrhoids, wait until they stop bleeding before doing the test. Women shouldn’t collect stool samples near the time of menstruation. Finally, avoid using toilet bowl cleaners for several days before the test, because these chemicals can affect the results if they come in contact with your stool sample.

For several days before the test, you also need to avoid foods and vitamins that can affect the test result. Foods to avoid include red meat (the blood it contains can turn your test positive), radishes, turnips, cabbage, cauliflower, horseradish, uncooked broccoli, and cantaloupe (all of which contain a chemical that can turn the test positive), and citrus fruits and vitamin C supplements (which can turn the test falsely negative).
What happens when the test is performed?
If one of the traditional tests is used, you collect three stool samples, ideally on three different days. Some kits include tissue paper that you can lay on the surface of the toilet bowl water to help keep the stool sample from sinking. As an alternative, you can pass your bowel movement into a disposable container. Once you’ve had a bowel movement, obtain a very small sample of the stool using the thin wooden sticks in your kit and smear it on a card from your kit. Then fold over the card to protect your sample.When you have all three samples, mail the cards to the clinic or lab in the plastic-lined envelope given to you.Make sure that your name is written on each card.

In the lab, the cards are treated with a chemical that produces a blue color when blood is present in the sample. This test works fine no matter how long it took your samples to reach the lab.

If you have the flush pad test, you drop the pad into the toilet bowl after you’ve had a bowel movement, for three consecutive days. The pads change color when blood is present in the toilet bowl. You can flush the toilet to dispose of the pads, but-if blood is detected-should contact your doctor.

How the Test Will Feel
There is no discomfort when the test is done at home, because this test only involves normal bowel functions. If stool is collected during an exam, there may be some discomfort in the anal canal and rectum.

Why the Test is Performed: This test is a screening test to detect blood in the digestive tract.

Risk Factors: No risk. But there can be false-positive and false-negative results. Using the right collection technique, avoiding certain drugs, and observing food restrictions can reduce errors.

RESULTS:
Normal Results : –
A negative test result means that there is NO blood in the stool.

What Abnormal Results Mean:-
Abnormal results may indicate:

*Angiodysplasia of the GI tract
*Colon cancer or other gastrointestinal (GI) tumors
*Colon polyps
*Esophageal varices and portal hypertensive gastropathy
*Esophagitis
*Gastritis
*GI infections
*GI trauma or bleeding from recent GI surgery
*Hemorrhoids
*Inflammatory bowel disease
*Peptic ulcer

Stool guaiac testing is sometimes used to screen for colon cancer, but it is not a reliable test for this purpose, and other screening methods should be used.

Additional non-GI related causes of positive guaiac test may include:

*Nose bleed
*Coughing up blood
Abnormal tests require follow-up with your doctor.
How long is it before the result of the test is known?
With the flush pad method, results are available immediately.With the more traditional methods, testing is performed in only a few minutes once the lab receives your sample. Some clinics or labs do this testing in batches and wait to process the test until samples have been received from several people. You should hear from your doctor’s office within a week after the lab has received your specimen. If your test is positive, it means you have blood in your stool, and your doctor will recommend some additional testing to find out the cause.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/fecal-occult-blood-test.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003393.htm

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Diagnonistic Test

Lower GI Series

Endoscopic image of colon cancer identified in...
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A lower gastrointestinal (GI) series uses x rays to diagnose problems in the large intestine, which includes the colon and rectum. The lower GI series may show problems like abnormal growths, ulcers, polyps, diverticuli, and colon cancer.

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Before taking x rays of your colon and rectum, the radiologist will put a thick liquid called barium into your colon. This is why a lower GI series is sometimes called a barium enema. The barium coats the lining of the colon and rectum and makes these organs, and any signs of disease in them, show up more clearly on x rays. It also helps the radiologist see the size and shape of the colon and rectum.

You may be uncomfortable during the lower GI series. The barium will cause fullness and pressure in your abdomen and will make you feel the urge to have a bowel movement. However, that rarely happens because the tube used to inject the barium has a balloon on the end of it that prevents the liquid from coming back out.

You may be asked to change positions while x rays are taken. Different positions give different views of the colon. After the radiologist is finished taking x rays, you will be able to go to the bathroom. The radiologist may also take an x ray of the empty colon afterwards.

A lower GI series takes about 1 to 2 hours. The barium may cause constipation and make your stool turn gray or white for a few days after the procedure.

Preparation
Your colon must be empty for the procedure to be accurate. To prepare for the procedure you will have to restrict your diet for a few days beforehand. For example, you might be able to drink only liquids and eat only nonsugar, nondairy foods for 2 days before the procedure; only clear liquids the day before; and nothing after midnight the night before. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soda. To make sure your colon is empty, you will be given a laxative or an enema before the procedure. Your physician may give you other special instructions.

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov

The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. The NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

Sources: http://digestive.niddk.nih.gov/ddiseases/pubs/lowergi/index.htm

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Featured Healthy Tips

New Solution for Colon Cancer

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Vitamin D can affect a colon cancer cell by adjusting everything from its gene expression to its cytoskeleton. Recent research shows that one pathway governs the vitamin’s diverse effects, a result which helps to clarify the actions of a molecule that is undergoing clinical trials as a cancer therapy.

Vitamin D stymies colon cancer cells in two ways — it switches on certain genes, and it induces effects on the cytoskeleton. The net result is to curb cell division and cause colon cancer cells to differentiate into epithelial cells that settle down instead of spreading.

The recent study is the first to show that vitamin D’s genomic and nongenomic effects use one simultaneous pathway and integrate to regulate cell physiology.

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Diagnonistic Test

Flexible Sigmoidoscopy

Flexible sigmoidoscopy (SIG-moy-DAH-skuh-pee) enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).

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For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a sigmoidoscope (sig-MOY-duh-skope). The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.

Bleeding and puncture of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.

Flexible sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterward when the air leaves your colon.

Preparation
The colon and rectum must be completely empty for flexible sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions.

Sources:http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm

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Diagnonistic Test

Colonoscopy

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Definition:
A colonoscopy (koh-luh-NAH-skuh-pee) allows a doctor to look inside the entire large intestine. The procedure enables the physician to see things such as inflamed tissue, abnormal growths, and ulcers. It is most often used to look for early signs of cancer in the colon and rectum. It is also used to look for causes of unexplained changes in bowel habits and to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss.

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What is the colon?
The colon, or large bowel, is the last portion of your digestive tract, or gastrointestinal tract. The colon is a hollow tube that starts at the end of the small intestine and ends at the rectum and anus. The colon is about 5 feet long, and its main function is to store unabsorbed food waste and absorb water and other body fluids before the waste is eliminated as stool.

Preparation for Colonscopy test
You will be given instructions in advance that will explain what you need to do to prepare for your colonoscopy. Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure you will have to follow a liquid diet for 1 to 3 days beforehand. The liquid diet should be clear and not contain food colorings, and may include

*fat-free bouillon or broth
*strained fruit juice
*water
*plain coffee
*plain tea
*diet soda
*gelatin
Thorough cleansing of the bowel is necessary before a colonoscopy. You will likely be asked to take a laxative the night before the procedure. In some cases you may be asked to give yourself an enema. An enema is performed by inserting a bottle with water and sometimes a mild soap in your anus to clean out the bowels. Be sure to inform your doctor of any medical conditions you have or medications you take on a regular basis such as

*aspirin
*arthritis medications
*blood thinners
*diabetes medication
*vitamins that contain iron

The medical staff will also want to know if you have heart disease, lung disease, or any medical condition that may need special attention. You must also arrange for someone to take you home afterward, because you will not be allowed to drive after being sedated.

Procedure
For the colonoscopy, you will lie on your left side on the examining table. You will be given pain medication and a moderate sedative to keep you comfortable and help you relax during the exam. The doctor and a nurse will monitor your vital signs, look for any signs of discomfort, and make adjustments as needed.

The doctor will then insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope (koh-LON-oh-skope). The scope transmits an image of the inside of the colon onto a video screen so the doctor can carefully examine the lining of the colon. The scope bends so the doctor can move it around the curves of your colon.

You may be asked to change positions at times so the doctor can more easily move the scope to better see the different parts of your colon. The scope blows air into your colon and inflates it, which helps give the doctor a better view. Most patients do not remember the procedure afterwards.

The doctor can remove most abnormal growths in your colon, like a polyp, which is a growth in the lining of the bowel. Polyps are removed using tiny tools passed through the scope. Most polyps are not cancerous, but they could turn into cancer. Just looking at a polyp is not enough to tell if it is cancerous. The polyps are sent to a lab for testing. By identifying and removing polyps, a colonoscopy likely prevents most cancers from forming.

The doctor can also remove tissue samples to test in the lab for diseases of the colon (biopsy). In addition, if any bleeding occurs in the colon, the doctor can pass a laser, heater probe, electrical probe, or special medicines through the scope to stop the bleeding. The tissue removal and treatments to stop bleeding usually do not cause pain. In many cases, a colonoscopy allows for accurate diagnosis and treatment of colon abnormalities without the need for a major operation.

During the procedure you may feel mild cramping. You can reduce the cramping by taking several slow, deep breaths. When the doctor has finished, the colonoscope is slowly withdrawn while the lining of your bowel is carefully examined. Bleeding and puncture of the colon are possible but uncommon complications of a colonoscopy.

A colonoscopy usually takes 30 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You may feel some cramping or the sensation of having gas after the procedure is completed, but it usually stops within an hour. You will need to remain at the colonoscopy facility for 1 to 2 hours so the sedative can wear off.

Rarely, some people experience severe abdominal pain, fever, bloody bowel movements, dizziness, or weakness afterward. If you have any of these side effects, contact your physician immediately. Read your discharge instructions carefully. Medications such as blood-thinners may need to be stopped for a short time after having your colonoscopy, especially if a biopsy was performed or polyps were removed. Full recovery by the next day is normal and expected and you may return to your regular activities.

For More Information
American College of Gastroenterology
P.O. Box 342260
Bethesda, MD 20827–2260
Phone: 301–263–9000
Fax: 301–263–9025
Email: info@acg.gi.org
Internet: www.acg.gi.org

International Foundation for Functional Gastrointestinal Disorders
P.O. Box 170864
Milwaukee, WI 53217–8076
Phone: 1–888–964–2001 or 414–964–1799
Fax: 414–964–7176
Email: iffgd@iffgd.org
Internet: www.iffgd.org

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov

Sources: http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/index.htm,  http://healthtopics.hcf.com.au/Colonoscopy.aspx

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