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    Fecal Occult Blood-2020

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    Djdjjd Siisus
    The fecal occult blood test (FOBT) detects hidden blood in stool that is too small to be seen. It can find as little as 10cc of blood, while usually at least 200cc is needed to be visible. A positive FOBT indicates gastrointestinal bleeding that could be from conditions like ulcers, polyps, cancers, or parasites. The chemical test uses aminophenazone reagent to cause a color change in the presence of blood peroxidase. Dietary and medication restrictions are required before the test to avoid false positives or negatives interfering with accurate results.

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    Fecal Occult Blood-2020

    Uploaded by

    Djdjjd Siisus
    43 views3 pages
    The fecal occult blood test (FOBT) detects hidden blood in stool that is too small to be seen. It can find as little as 10cc of blood, while usually at least 200cc is needed to be visible. A positive FOBT indicates gastrointestinal bleeding that could be from conditions like ulcers, polyps, cancers, or parasites. The chemical test uses aminophenazone reagent to cause a color change in the presence of blood peroxidase. Dietary and medication restrictions are required before the test to avoid false positives or negatives interfering with accurate results.

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    The fecal occult blood test (FOBT) detects hidden blood in stool that is too small to be seen. It can find as little as 10cc of blood, while usually at least 200cc is needed to be visible. A positive FOBT indicates gastrointestinal bleeding that could be from conditions like ulcers, polyps, cancers, or parasites. The chemical test uses aminophenazone reagent to cause a color change in the presence of blood peroxidase. Dietary and medication restrictions are required before the test to avoid false positives or negatives interfering with accurate results.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    43 views3 pages

    Fecal Occult Blood-2020

    Uploaded by

    Djdjjd Siisus
    The fecal occult blood test (FOBT) detects hidden blood in stool that is too small to be seen. It can find as little as 10cc of blood, while usually at least 200cc is needed to be visible. A positive FOBT indicates gastrointestinal bleeding that could be from conditions like ulcers, polyps, cancers, or parasites. The chemical test uses aminophenazone reagent to cause a color change in the presence of blood peroxidase. Dietary and medication restrictions are required before the test to avoid false positives or negatives interfering with accurate results.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Clinical Immunol./ Practical/ Fecal Occult Blood Test / GIT Dz/ Prof. Dr.

    Batool Al-Haidary

    Fecal Occult Blood (FOB)


    Bleeding into the gastrointestinal tract may be profuse with the vomiting of blood
    (haematemesis) or the passage of blood through the rectum (melaena). When the
    bleeding is chronic with only small amounts of blood being passed in the faeces, the
    blood (or its breakdown products) is not recognized in the faeces.
    The fecal occult (hidden) blood test (FOBT) is a lab test used to check stool (feces)
    samples for hidden blood or blood products that may arise due to small amount of
    bleeding in the gastrointestinal tract. Fecal occult blood is blood in feces that cannot be
    seen in stool or on toilet paper by yourself. Usually we require approximately 200 cc of
    blood to be able to visually recognize bleeding. Using FOBT we can detect bleeding
    that is as little as 10 cc of blood in the stool.
    Occult blood in the stool indicates gastro intestinal bleeding that may be because of
    helminth infestation (hookworm infection). Other conditions associated with internal
    gastro-intestinal bleeding are;
     Oesophagitis (inflammation of Oesophagus; often associated with Acid reflux)
     Esophageal cancer
     Gastratitis
     Stomach ulcer or cancer
     Arterie venous malformation
     Colon polyp
     Colon cancer
     Diverticulosis
     Ulcerative colitis and
     Hemorrhoid

    Uses of Occult Blood Testing


    Requests for occult blood testing are usually made to investigate the cause of iron
    deficiency anemia, or to assist in the diagnosis of bleeding lesions of the gastrointestinal
    tract, e.g. peptic ulcer, carcinoma, or diverticulosis.

    Test Methods:
    1. Chemically using laboratory reagents: e.g. Aminophenazone Test.
    2. Immunologically using ready-made reagents in kit tests (More expensive and
    usually less stable than aminophenazone test)
    Aminophenazone Test:
    This test detects the presence of hemoglobin in test sample. Hemoglobin and its
    derivatives catalyze the transfer of oxygen from hydrogen peroxide to
    aminophenazone. Oxidation of the aminophenazone produces a blue color (Positive
    Occult Blood Test).

    Principle
    Occult blood consist of phenolphthalein swam by a lzinc, is found of
    oxygen water and peroxidase blood cell. Oxidation of phenolphthalein leads to give red
    to pink color according blood concentration in the stool (Meyer Kastle method).

    1
    Clinical Immunol./ Practical/ Fecal Occult Blood Test / GIT Dz/ Prof. Dr. Batool Al-Haidary

    Reagents required:
     Acetic acid 10% v/v
     Alcohol, 95% v/v
     Hydrogen peroxide 10 vols solution
    Preparation of working Aminophenazone reagent
    The amounts given are sufficient for 1 test with positive and negative controls. Prepare
    fresh as follows:
     Acetic acid 10% v/v: 1 ml
     Alcohol, 95% v/v: 15 ml
     4 Aminophenazone (4-Aminoantipyrine):0.4g
    Dissolve the aminophenazone in the alcohol solution and immediately before use add
    the acetic acid. Mix well.

    Points to remember: Preparing for the test


     Any source of blood will give a positive test. Blood from another source, like
    bleeding hemorrhoids or menstrual period will interfere with the test.
     Do not eat red meat before testing for occult blood test. Red meat in the diet can
    give false positive test result.
     Do not eat Cantaloupe, Fish, Uncooked broccoli, Turnip, Radish,
    Horseradish for 3 days before the test. Patient should eat plenty of vegetables,
    corn, and non-citrus fruits. Any fruit juices containing ascorbic acid, iron, barium
    sulphate, cimetidine also has to be avoided 2/3 days before testing.
     Avoid drugs like Aspirin, Anti-inflammatory drugs, cough medicines for the
    3 days before the test.
     Taking Vitamin C supplements may give false negative results. It is
    recommended not to take Vitamin C supplements for the 3 days before the test.

    Procedure of Occult Blood Test (Chemical Method):


    1. Dispense about 7 ml of distilled water into a wide bore test tube.
    2. Add a sample of faeces about 10-15 mm in diameter (taken from various parts of
    the specimen). Using a glass or plastic rod, emulsify the faeces in the water.
    3. Allow the fecal particle to settle or centrifuge the emulsified specimen.
    4. Take three completely clean tubes and label them as;
    A. T: Patient’s Test
    B. Neg: Negative Control
    C. Pos: Positive Control
    5. Add to each tube as follows:
    A. T: 5ml supernatant fluid from emulsified faeces.
    B. Neg: 5 ml distilled water
    C. Pos: 5 ml distilled water in which about 50 microliter of whole blood
    has been mixed
    6. Layer 5 ml of working aminophenazone reagent on top of the fluid in each tube
    (i.e. pipette down the side of each tube). Do not mix.

    2
    Clinical Immunol./ Practical/ Fecal Occult Blood Test / GIT Dz/ Prof. Dr. Batool Al-Haidary

    7. Add 10 drops of the 10 volumes hydrogen peroxide solution. Do not mix. Allow
    to stand for 1 minute.
    8. Look for the appearance of a blue color where the aminophenazone reagent meets
    the sample or control solutions.

    Report the test results


    1. No color Change: Negative Test
    2. Pale Blue: Positive +
    3. Dark blue: Positive + +
    4. Blue-black: Positive + + +
    Control
     Negative Control: This should show no color change.
     Positive Control: This should show a positive reaction.

    Interpretation of Results and Sources of Errors


    A positive result means that the test has detected blood. This does not mean you have
    tested positive for cancer or any other illness. Its just an indication of internal bleeding
    which will require a formal evaluation of the patient’s gastrointestinal tract. Physician
    may request colonoscopy or endoscopy to examine to examine the entire lining of the
    gastro-intestinal tract. The commonest causes of positive occult blood tests in tropical
    and other developing countries are hookworm infection, peptic ulcer any other causes
    mentioned above.
    False Positive result: A false positive reaction may occur if the faeces contains
    peroxidase-like substances. Such reactions may be avoided by dietary restrictions (read
    above-preparing for the test). Further testing and examinations should be performed by
    the physician to determine the exact cause and source of the occult blood in the stool.
    A false negative reaction may be obtained if the faeces contains a high concentration
    of ascorbic acid.
    Note: If the test is negative but there is high clinical suspicion, two further specimens
    should be tested to detect bleeding which may be intermittent.

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