stool examination

With the bowel movement, all this is excreted from the digestive tract, what the body no longer needs. But feces are more to the doctor than just a waste product. Appearance and smell, texture, quantity and composition can give important clues to diseases.

Chair - a meaningful substance

The chair consists of three quarters of water, besides it contains indigestible food components, mucus and shed cells of the intestinal mucosa and bacteria and their fermentation and decay products. Stool urgency arises as soon as a certain filling state has been reached in the rectum; The defecation can be controlled at will.

The nature of the faeces and the frequency of defecation depend on the diet and are subject to individual fluctuations. An average of 60-250 g of stool are emptied per day; less with fasting, more with fiber-rich food. The normally homogeneous, mushy-solid stool is softened by carbohydrates, a lot of protein makes it harder. Its brown color is obtained by a degradation product of bile pigments.

What is being investigated?

One or more of the factors described above can be altered by pathological processes and thus help with diagnostics. In addition, it is possible to search for blood, pathogens and worm eggs. In certain metabolic and digestive disorders, enzymes, fats and degradation products can be measured.

Chair changes and possible causes

  • Color: Certain foods such as beets or medications such as iron and charcoal tablets cause temporary discoloration. Bowel disease, metabolic disorders and infections can also lead to discoloration. Thus yellow or discolored stool indicates an illness of liver or bile, green-yellowish on an infection, greyish on a fat digestion disturbance eg with illness of the pancreas. In the case of a black stool ("tarry stool") there is an urgent suspicion of haemorrhage in the upper, in the case of a red-brown stool a bleeding in the lower gastrointestinal tract.
  • Quantity and odor: When fat metabolism disorders occur often massive, sharp-smelling "fatty stools", putrefaction processes in the intestine cause a smelly odor.
  • Texture (consistency): Slimy-slimy, frequent draining are typical for diarrhea, thickened faeces or large Stuhlbrocken occur in constipation and intestinal constrictions. If hard and soft stools change, this indicates irritable bowel syndrome, polyps, or a carcinoma. Fettstühle are clay-like and sticky and shine usually ointment-like.
  • Composition: Slime or pus buildup is often a sign of inflammatory bowel disease, undigested food chunks may be the result of intestinal infection. Pale red blood deposits can occur with hemorrhoids or anal fissures, but can also be signs of a colon cancer. With the naked eye, parasites such as maggots or ring worms, their eggs or tapeworm parts can sometimes be seen.

laboratory diagnosis

A further analysis in the laboratory is carried out depending on findings and suspected diagnosis. Usually, other examinations such as blood tests are also performed at the same time.

  • Hidden (= occult) blood: The so-called hemoccult® test can be used to detect blood in the stool that is not visible to the naked eye. Since it is often an early symptom of colorectal cancer, the easy to be performed test is used from the age of 50 as part of the check-up. For this purpose, on three consecutive days, some chair is placed in the test field of the prefabricated Stuhlbriefchens and this closed. If the stool contains blood pigment, the test panel on the back will discolour when dabbed with a specific solution.
  • Stool sample for investigation for pathogens: The stool sample is given immediately in the laboratory for three consecutive days in a special tube. Pathogen detection is carried out under the microscope, in culture or indirectly by detection of bacterial toxins. Sometimes blood has to be taken in parallel and a culture created from it.
  • Determination of stool fat: in case of diarrhea, diseases of the pancreas.
  • Enzyme detection: in diseases of the pancreas.
  • Measurement of nutrient composition: is used in cases of suspected metabolic disease as the cause of failure to thrive.
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