laboratorio Microbiología
laboratorio Microbiología

Faecal study

estudio de heces

Faecal analysis is a basic test that provides information relating to a person’s health and which does not usually require any preparation, it poses no risk to the patient.

 

Its analysis can be used to diagnose infectious diseases of the digestive tract (gastroenteritis or infectious colitis), digestive abnormalities (malabsorption of nutrients), peptic ulcer disease (Helicobacter pylori), carcinogenic processes (colon cancer) or inflammatory processes (ulcerative colitis or Crohn’s disease).

 
 

 
 

análisis molecular de heces
This is the most frequently requested test, performed on samples of diarrhoea for the diagnosis of enteropathogenic bacteria, viruses and parasites.
In our laboratory, a diagnosis of gastroenteritis can be reached by conventional or molecular faecal analysis.

 

Conventional Microbiological Analysis:

 

  • Stool culture: Culture of enteropathogenic bacteria with testing of antibiotic sensitivities. The results are usually returned within 3-4 days, due to the characteristics of the technique it is less effective than the molecular technique.
  • Observation of eggs and parasites: Direct microscopic examination technique, following concentration of the specimen. This has the disadvantage of being less sensitive than the molecular technique for protozoa detection.
  • Performance of special techniques: Strongyloides stercoraliso culture, Kato-Katz technique, etc.
  • Detection of Helicobacter pylori antigens

 

Molecular Faecal Analysis:

 

  • Molecular stool culture:This test detects enteropathogenic bacteria more effectively than conventional stool culture. It allows the detection of bacteria that would otherwise remain undetected, such as Shiga toxin-producing bacteria which can produce very serious conditions such as Haemolytic Uraemic Syndrome in children and adults. It also improves detection of bacteria such as Campylobacter, Salmonella, Yersinia and Shigella.
    The molecular technique can also detect the presence of toxigenic Clostridioides difficile, in cases where symptoms are compatible with pseudomembranous colitis.
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  • Molecular detection of viruses: It is highly sensitive in the detection of outbreak-related viruses such as Norovirus. Furthermore, it allows the detection of other viruses such as the Sapoviruses, Adenovirus, Rotavirus, Astrovirus which are rarely found using other techniques.
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  • Molecular detection of parasites Protozoa: It improves detection of these parasites in comparison to conventional microscopic techniques. It allows the detection of Entamoeba (which can produce very serious invasive symptoms if not treated), Giardia lamblia, Blastocystis hominis, Dientamoeba fragilis, Cyclospora cayetanensis and Cryptosporidium.

 

Serological tests (Strongyloides, Entamoeba, Schistosoma, etc.) can be performed as complementary techniques under the guidance of a Clinical Microbiology Specialist.

 

The molecular technique improves on the diagnostic performance of conventional techniques, detecting mixed infections, and shortening response time. The advice of a Microbiology Specialist is essential to determine the impact and relevance of the mentioned pathogens when detected, both by conventional analysis and through molecular techniques. Interpretation is essential to discern between colonisers and potential pathogens.

Digestive stool analysis can be used to investigate chronic problems. Investigation of digestive disorders can be supplemented by breath tests for lactose or fructose intolerance, or bacterial overgrowth.

sangre oculta en heces
Faecal occult blood tests are used for colon cancer screening prior to gastrointestinal investigations (colonoscopy).

 

Faecal occult blood (FOB):

  • Allows detection of hidden blood, not visible to the naked eye.
  • Is a screening test for the early detection of colorectal cancer.
  • It is recommended yearly from the age of 50 in patients who are symptom free and have no relevant digestive history.
  • Although it can also be performed by the Guaiac test, the test of choice is the immunochemical test , which is more specific and does not need any preparation by the patient.
    The immunoassay detects haemoglobin, a molecule inside red blood cells. Haemoglobin has a component called haem (which contains iron) and a protein called globin that the immunochemical method detects .
    The immunochemical test only detects human globins, so there is no interference from animal globins in the diet,  a special diet is therefore not required. Globins from bleeding from the stomach or small intestine degrade before reaching the colon and are not detected by the immunochemical test, so the purpose of this test is the early diagnosis of colon cancer.

Its main advantages are the following:

  • This is a non-invasive test with a sensitivity for colorectal cancer detection of 74%, requiring subsequent confirmation by colonoscopy.
  • It does not require special preparation, diet, or discontinuation of usual medication.

 

Obtaining the specimen:

  • A stool sample is collected at home in a wide mouth container.
  • It can also be collected more conveniently by using a kit which we are able to provide for you at our centre for you to deliver for analysis at a later date.
    Although it could be done with a single sample, 3 samples are recommended to increase sensitivity or detection.

 

Results:

  • A negative test result indicates that no blood has been detected in the sample.
  • A positive result indicates the presence of human blood.
    Although there are many causes for blood in the stool, one of the most important is the presence polyps or cancer of the digestive system. The presence of human blood may be secondary to a tumour, haemorrhoids, colonic polyps, inflammatory bowel disease, etc. It is therefore necessary to perform a colonoscopy (gold standard method) to confirm the source of bleeding.
    It should be noted that it is possible to obtain a false negative if the polyps have not bled at the time of sample collection, hence the importance of analysing several samples.

 

The detection and quantification of calprotectin may be indicative of an inflammatory bowel process (Crohn’s disease and ulcerative colitis). It is used primarily to diagnose inflammatory bowel disease by detecting the presence of inflammatory bowel activity, to monitor response to treatment and to identify mucosal healing, predicting clinical recurrence or even postsurgical recurrence.

 

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