home Cosmetology Coprogram: norms and interpretation of results. What types of stool tests are there, their interpretation and what can be detected Fecal microscopy for protozoa

Coprogram: norms and interpretation of results. What types of stool tests are there, their interpretation and what can be detected Fecal microscopy for protozoa

- this is the result of a diagnostic study, known under several names: scatology, coproscopy, general stool analysis.

When you have a ready-made coprogram in your hands, decoding can cause difficulties, since opposite the indicators in the form there will be letter abbreviations, numbers, or even just pros and cons, but what they mean is not clear. Of course, the doctor will answer your questions, but almost any person is interested in understanding the results of the examination for himself. We will help you with this and tell you in an accessible language about how to correctly take a coprogram, what this diagnostic procedure shows, who needs it, what are the norms for a general stool analysis in children and adults, and what deviations from healthy indicators may indicate. But we would like to emphasize that the information provided does not replace medical advice, especially if there is a serious illness.

As part of a scatological study, the following types of stool properties are assessed step by step:

Chemical - acid-base reaction of feces, the presence of hidden blood, bile pigments and soluble proteins in them;

Microscopic– the presence of detritus, starch, fatty acids, connective tissue, leukocytes, erythrocytes, fungi and other components.

Based on these parameters, the doctor can assess the functional status of the patient’s gastrointestinal tract - how well food is digested, whether it is moving correctly, whether nutrients are absorbed in the required volume. In addition, stool coprogram allows one to suspect an inflammatory or oncological process in the digestive system, disorders of the pancreas, liver, stomach and intestines, the presence of gallstones, diverticula, varicose veins of the esophagus and many other pathologies.

Indications for scatological examination

You should definitely contact your doctor for a stool test if you have any of the following symptoms:

Abdominal pain - girdle pain, in the epigastrium, in the upper or lower abdomen, in the right or left hypochondrium. The nature and cyclicity of the pain do not matter - even mildly expressed discomfort in the liver, stomach, intestines or pancreas should prompt you to be examined, especially if they do not have an obvious cause and often recur;

Strange appearance, smell, color of stool, abnormal volume, presence of suspicious inclusions;

Blood stains, pus, or mucus on underwear adjacent to the anus, as well as tenderness, itching, or a foreign body sensation in the rectum;

The need to monitor the condition of the gastrointestinal tract during treatment, before diagnostic manipulation, surgery or for preventive purposes (preferably annually);

Decoding coprograms in children and adults

Now let's briefly look at each of the indicators in the table and outline the possible reasons for deviations from the norm. But first, let us once again emphasize that this is the task of a qualified doctor, especially considering the fact that the results of a scatological examination alone, without taking into account symptoms, medical history and data from other tests, mean little and cannot serve as the basis for making a final diagnosis.

Daily volume

The daily volume of feces varies depending on the nature of the diet: it increases from the abundance of raw plant foods, and from the predominance of protein products (meat, fish, eggs) it decreases, but in any case, the amount of feces excreted by a person per day should be within the range norms indicated in the table.

Increased amount of feces - reasons:
Decreased amount of feces - reasons:
Consistency

The consistency of feces is influenced primarily by the water content in them. Normally, decoding the coprogram indicates a fully formed, cylindrical stool in children and adults - this happens if the stool is 70-75% liquid. The exception is for infants: if the mother is breastfeeding, the baby’s stool will be mushy, and if the baby is fed artificial milk formula, the stool will take on the appearance of putty, and this is quite normal.

Abnormal consistency of stool - causes:
Undigested food

The feces of a healthy person should normally contain no particles of undigested food. If they are present, especially in large quantities, this is an alarming signal that indicates a serious disruption of the stomach, pancreas or liver.

In infants, a small amount of mucus may be present in the stool, but it should be transparent and barely noticeable. For older children and adults, the presence of mucus in feces is a deviation from the norm and a sign of trouble.

Mucus in stool - causes:
Blood

Neither in adults nor in children, when decoding the coprogram, should blood appear in the stool - this is an extremely undesirable sign, indicating the presence of a serious pathology of the gastrointestinal tract. Depending on what type of blood it is, in what volume and when it is released, you can make assumptions about the causes of the problem.

Blood in stool - causes:
Pus

The presence of purulent inclusions in the feces of infants, older children or adults is a gross deviation from the norms of coprogram and, most often, indicates the presence of an inflammatory process in the gastrointestinal tract. In this case, further examination is necessary, aimed at establishing the cause and exact localization of inflammation, as well as the specific type of pathogen.

Acidity, pH

Infants have a slightly acidic or acidic stool reaction due to the fact that the basis of their diet is mother's milk or artificial milk formula. Older children and adults have a neutral stool reaction. This indicator can be shifted to the acidic side by an excess of carbohydrate foods or poor digestion, and to the alkaline side by protein foods.

Stool acidity disorders - causes:
hidden blood

The fecal occult blood reaction should be negative. If this is not the case, then perhaps the person has erosive gastritis, a stomach ulcer, ulcerative colitis, diverticulosis, hemorrhoids, or even a malignant tumor of the gastrointestinal tract - the list of diagnoses can be very long and varied. Therefore, a positive result when decoding the coprogram becomes the reason for an in-depth examination of the patient.

Normally, intestinal microflora processes the bile pigment bilirubin and converts it into stercobilin. However, in babies under 6 months of age, the body is only colonized by bacteria, and a healthy balance is formed between them. Therefore, the presence of a small amount of bilirubin in the feces of infants is a variant of the norm, while for adults this is already a serious deviation.

Bilirubin in stool – reasons:
Stercobilin

This substance is the result of the processing of bilirubin by intestinal bacteria and causes the characteristic brown color of stool. A person secretes from 75 to 350 mg of stercobilin per day. The infant's coprogram may show lower values. But in an adult, this indicator should be within the established norm.

Stercobilin in feces is increased - reasons:
Stercobilin in feces is reduced - reasons:
- Cholangitis;
  
  Mechanical jaundice.
Soluble protein

When deciphering a coprogram, the indicator of the presence of soluble protein in feces should be negative, both in infants and older children, and in adult patients. If the result is positive, this indicates putrefactive dyspepsia or an inflammatory process in the gastrointestinal tract (gastritis, enterocolitis, pancreatitis).

Detritus

The term “detritus” refers to a collection of tiny particles of digested food, as well as intestinal epithelial cells, bacteria and their metabolic products, salts, toxins and other components that are normally subject to regular evacuation from the body. Doctors consider detritus to be something like a coefficient of digestive efficiency - the more of this substance in the feces, the better.

Ammonia

In healthy infants, deciphering the coprogram shows the absence of ammonia in the feces, and in older children and adults this compound may be present in the feces in a minimal concentration (20-40 mmol/kg), and this is the norm. If there is a lot of ammonia in the feces, this indicates problems with digesting protein foods, the presence of putrefactive dyspepsia or colitis.

Starch

In healthy people, this complex carbohydrate is completely broken down as it moves through the gastrointestinal tract. Therefore, starch in feces should be absent in both children and adults. If the decoding of the coprogram says otherwise, it means that the person has pancreatitis, gastritis with low acidity, or fermentative dyspepsia.

Neutral fats

Triglycerides are an important source of energy, so normally they should be completely processed and absent from feces. It is acceptable for infants to have a small amount of neutral fats in their feces, because the enzyme activity of their gastrointestinal tract has not yet reached the required level, but this is only a matter of time. If triglycerides are found in the coprogram in an adult or a child over 1 year old, this indicates a malfunction of the pancreas, liver, gallbladder or small intestine.

These substances are the result of the processing of neutral fats, but can also be contained directly in food. One way or another, fatty acids are completely processed in the body of a healthy person, which means they should not be present in feces. If there is a significant deviation from the norm, pancreatitis, as well as liver or biliary tract disease, can be suspected. In infants, fatty acids can be detected in small amounts in the feces due to defective enzymatic activity of the pancreas.

Soap

The result of the processing of fats in the gastrointestinal tract are soap compounds, which are present in the feces of people of any age, including infants, and this is the norm of coprogram. If the transcript of the study results indicates the absence of soap in the stool, this indicates problems with the pancreas or liver, or the presence of stones in the gall bladder.

Digestible plant fiber

Plant fibers are divided into two conditional categories: those that a person can digest and those that cannot. These include hard fruit skins, nut husks, and hard plant veins. And all the fiber that the body is able to absorb should be absent from the feces. If it is present there, it means that the gastrointestinal tract cannot cope, or the person consumes too many raw vegetables and fruits.

Muscle and connective tissue fibers

Fragments of muscle fibers and connective tissues are one of the products of processing protein foods - meat, fish, poultry, seafood. According to the standards for deciphering the coprogram, a small number of such inclusions may be found in the feces of children and adults, but the fewer there are, the better, because this indicates the good functioning of the enzymatic digestive organs.

Leukocytes

These are immune cells, the presence of which in feces indicates an inflammatory process in the gastrointestinal tract. However, the presence of single cells in the field of view during a scatological examination is acceptable. An alarming signal is a significant content of leukocytes in the stool. This situation requires further examination.

Yeasts

Microorganisms of this type belong to the opportunistic flora and are normally present in the intestines of healthy people of any age. However, if yeast fungi are found in feces, this means that their colonies have multiplied excessively, and accordingly, the person has dysbiosis. This often happens, for example, after taking antibiotics. Preparations containing live bifidobacteria and lactobacilli will help solve the problem.

Pathogenic flora

This category includes pathogens of dysentery, salmonellosis and other intestinal infections. Of course, normally, deciphering the coprogram confirms the complete absence of these dangerous bacteria in the stool. If they are detected, the patient needs antibacterial therapy, which will be prescribed by the attending physician.

Take care of yourself and be healthy!

Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Feces - is the final product of food digestion and is formed during the passage of food through the entire digestive tract and therefore contains information about the functioning of all digestive organs.

Correct preparation of the patient, correct collection, storage and delivery of research material are very important for the results of the study.

Feces for research are collected after spontaneous defecation in a dry, clean container; it is advisable to use plastic jars with a wide neck. Do not collect feces in containers with a narrow neck, cardboard or matchboxes. It is advisable to conduct the study immediately after defecation, but no later than 8-10 hours. It is not recommended to take the test after taking oil enemas, barium, taking medications that affect intestinal motility, using Vaseline or castor oil, after inserting suppositories into the anus. Also, urine or menstrual blood should not be present in the stool.

To obtain reliable analysis results preliminary preparation is required . To do this, the patient must be on a certain diet for 2-3 days. It is recommended to consume vegetable puree (preferably potato), dairy products, cereals, and a small amount of fruit.

Feces are collected 3-4 days from the start of the diet.

To conduct research on hidden bleeding The patient should exclude meat, fish, all types of green vegetables, as well as tomatoes and eggs for 3-4 days. Since these nutrients can be catalysts in those reactions that are used to detect blood.

Let's consider the indicators of scatological research.

Color. Normally, stool is brown in color.
Depending on the diet, the color may change: a dairy diet gives a lighter color, a meat diet gives a darker color.
The greenish color is given by plant pigments contained in sorrel, spinach, etc. Beets, blueberries, and black currants are colored black or reddish. Some medications taken orally, such as barium, give a light yellow or whitish color, bismuth - black, purgen - reddish.

In pathological processes, stool coloring:
gray or white “clayey” - with obstruction (blockage) of the bile ducts;
bright yellow – for acute enteritis and when taking antibiotics orally;
red color - the presence of unchanged blood occurs with bleeding from the lower intestines (tumor, hemorrhoids, ulcer);
black color “tarry” - bleeding from the stomach or small intestine. In some infectious diseases, for example, in typhoid fever, stool looks like pea soup; in cholera, it looks like rice water.

Consistency. Normally, an adult's stool is quite dense and well-formed.
Pasty stools can be observed when the secretion of the pancreas is impaired and there is a lack of bile flow.
Pasty stools occur when there is a violation of evacuation from the colon, colitis, or fermentative dyspepsia.
“Sheep feces”, small hard lumps, are a sign of colitis with constipation.
Foamy stools are characteristic of intestinal infections and fermentative dyspepsia.
Liquid is observed with insufficient digestion in the intestines and diarrhea.

Smell. Normally, stool does not have a strong, characteristic fecal odor.
A foul odor is possible if there is a violation of the secretion of the pancreas, the flow of bile, or increased secretion of the glands of the large intestine.
A putrid odor characterizes insufficiency of gastric digestion and weak intestinal motility, putrefactive dyspepsia, colitis with constipation. A sour smell appears with fermentative dyspepsia.

Reaction. Normally, stool has a neutral or slightly alkaline reaction.
An acid reaction occurs when bile secretion is impaired and when absorption in the small intestine changes. A sharply acidic reaction is observed with fermentative dyspepsia.
An alkaline reaction is characteristic of indigestion in the stomach, constipation, colitis, and increased secretory function of the colon.
Strongly alkaline – a sign of putrefactive dyspepsia.

Muscle fibers. Normally they are absent or present in small quantities.
An increase in level indicates pancreatic insufficiency, decreased secretory function of the stomach, and accelerated peristalsis.

. Not found normally.
It is detected in cases of accelerated evacuation, diseases of the pancreas, impaired absorption of carbohydrates in the intestine, and increased fermentation processes in the large intestine.

Starch. It shouldn't be normal.
A large amount can occur when consuming a diet rich in carbohydrates, with damage to the pancreas, impaired absorption in the small intestine, or accelerated evacuation of starch through the intestines.

Fat is neutral. It shouldn't be normal.
A large number is noted with damage to the pancreas and with accelerated evacuation of fat through the small intestine.

Fatty acid.Normally they should not be present.
They are detected when absorption processes through the wall of the small intestine are disrupted, in diseases of the biliary system, in the absence or deficiency of bile acids entering the intestinal cavity.

Soap. Normally available in small quantities.
They are found in large quantities during intestinal congestion, malabsorption, and constipation.

Leukocytes. Normally, the presence of single leukocytes is allowed. A number over 10 indicates an inflammatory process in the intestines, such as ulcerative colitis or dysentery.

Red blood cells. It shouldn't be normal.
Their appearance indicates bleeding. They are found in polyps and fissures of the rectum, hemorrhoids and colitis with ulcers.

Iodophilic flora. Not found normally.
Its appearance indicates a violation of the absorption of starch and digestible fiber in the small intestine, the entry of a large amount of plant substances into the large intestine, an increase in fermentation processes in the intestine, and dysbiosis.

Laboratory assistant of the clinical department Bondareva Liana Aleksandrovna

valeo.ua

general description

Feces are formed in the large intestine.
consists of water, remnants of food taken and secretions of the gastrointestinal tract, products of the transformation of bile pigments, bacteria, etc. For the diagnosis of diseases associated with the digestive organs, stool examination in some cases can be crucial. A general stool analysis (coprogram) includes macroscopic, chemical and microscopic examination.

Macroscopic examination

Quantity

In pathology, the amount of feces decreases with prolonged constipation caused by chronic colitis, peptic ulcers and other conditions associated with increased absorption of fluid in the intestine. With inflammatory processes in the intestines, colitis with diarrhea, and accelerated evacuation from the intestines, the amount of feces increases.

Consistency

Thick consistency - with constant constipation due to excessive absorption of water. Liquid or mushy consistency of stool - with increased peristalsis (due to insufficient absorption of water) or with abundant secretion of inflammatory exudate and mucus by the intestinal wall. Ointment-like consistency - in chronic pancreatitis with exocrine insufficiency. Foamy consistency - with enhanced fermentation processes in the large intestine and the formation of a large amount of carbon dioxide.

Form

The form of feces in the form of “large lumps” - when feces remain in the colon for a long time (hypomotor dysfunction of the colon in people with a sedentary lifestyle or who do not eat rough food, as well as in cases of colon cancer, diverticular disease). The form in the form of small lumps - “sheep feces” indicates a spastic state of the intestines, during fasting, stomach and duodenal ulcers, a reflex nature after appendectomy, with hemorrhoids, anal fissure. Ribbon or “pencil” shape - for diseases accompanied by stenosis or severe and prolonged spasm of the rectum, for rectal tumors. Unformed feces are a sign of maldigestion and malabsorption syndrome.

Color

If staining of stool by food or drugs is excluded, then color changes are most likely due to pathological changes. Grayish-white, clayey (acholic feces) occurs with obstruction of the biliary tract (stone, tumor, spasm or stenosis of the sphincter of Oddi) or with liver failure (acute hepatitis, cirrhosis of the liver). Black feces (tarry) - bleeding from the stomach, esophagus and small intestine. Pronounced red color - with bleeding from the distal parts of the colon and rectum (tumor, ulcers, hemorrhoids). Gray inflammatory exudate with fibrin flakes and pieces of the colon mucosa (“rice water”) - with cholera. The jelly-like character is deep pink or red in amoebiasis. In typhoid fever, the stool looks like “pea soup.” With putrefactive processes in the intestines, the feces are dark in color, with fermentative dyspepsia - light yellow.

Slime

When the distal colon (especially the rectum) is affected, the mucus occurs in the form of lumps, strands, ribbons, or a glassy mass. With enteritis, the mucus is soft, viscous, mixing with feces, giving it a jelly-like appearance. Mucus, covering the outside of formed feces in the form of thin lumps, occurs with constipation and inflammation of the large intestine (colitis).

Blood

When bleeding from the distal parts of the colon, the blood is located in the form of streaks, shreds and clots on formed stool. Scarlet blood occurs when bleeding from the lower parts of the sigmoid and rectum (hemorrhoids, fissures, ulcers, tumors). Black feces (melena) occur when there is bleeding from the upper digestive system (esophagus, stomach, duodenum). Blood in the stool can be found in infectious diseases (dysentery), ulcerative colitis, Crohn's disease, disintegrating colon tumors.

Pus

Pus on the surface of the stool occurs with severe inflammation and ulceration of the mucous membrane of the colon (ulcerative colitis, dysentery, disintegration of an intestinal tumor, intestinal tuberculosis), often together with blood and mucus. Large amounts of pus without mucus are observed when opening paraintestinal abscesses.

Leftover undigested food (lientorrhea)

The release of undigested food residues occurs with severe insufficiency of gastric and pancreatic digestion.

Chemical research

Fecal reaction

An acidic reaction (pH 5.0-6.5) is observed when iodophilic flora is activated, producing carbon dioxide and organic acids (fermentative dyspepsia). An alkaline reaction (pH 8.0-10.0) occurs with insufficient digestion of food, with colitis with constipation, sharply alkaline with putrefactive and fermentative dyspepsia.

Reaction to blood (Gregersen reaction)

A positive reaction to blood indicates bleeding in any part of the gastrointestinal tract (bleeding from the gums, rupture of varicose veins of the esophagus, erosive and ulcerative lesions of the gastrointestinal tract, tumors of any part of the gastrointestinal tract in the stage of decay).

Reaction to stercobilin

The absence or sharp decrease in the amount of stercobilin in the feces (the reaction to stercobilin is negative) indicates obstruction of the common bile duct with a stone, compression by a tumor, stricture, stenosis of the common bile duct, or a sharp decrease in liver function (for example, in acute viral hepatitis). An increase in the amount of stercobilin in feces occurs with massive hemolysis of red blood cells (hemolytic jaundice) or increased bile secretion.

Reaction to bilirubin

The detection of unchanged bilirubin in the stool of an adult indicates a disruption in the process of bilirubin recovery in the intestine under the influence of microbial flora. Bilirubin can appear during rapid evacuation of food (sharp increase in intestinal motility), severe dysbiosis (syndrome of bacterial overgrowth in the colon) after taking antibacterial drugs.

Vishnyakov-Triboulet reaction (for soluble protein)

The Vishnyakov-Triboulet reaction is used to identify a hidden inflammatory process. The detection of soluble protein in stool indicates inflammation of the intestinal mucosa (ulcerative colitis, Crohn's disease).

Microscopic examination

Muscle fibers - with striations (unchanged, undigested) and without striations (changed, digested). A large number of changed and unchanged muscle fibers in the feces (creatorrhoea) indicates a violation of proteolysis (protein digestion):

in conditions accompanied by achlorhydria (lack of free HCl in gastric juice) and achylia (complete absence of secretion of HCl, pepsin and other components of gastric juice): atrophic pangastritis, a condition after gastric resection;
with accelerated evacuation of food chyme from the intestines;
in case of violation of the exocrine function of the pancreas;
with putrefactive dyspepsia.

Connective tissue (remnants of undigested vessels, ligaments, fascia, cartilage). The presence of connective tissue in the feces indicates a deficiency of proteolytic enzymes of the stomach and is observed with hypo- and achlorhydria, achylia.

Fat is neutral. Fatty acid. Salts of fatty acids (soaps)

The appearance of large amounts of neutral fat, fatty acids and soaps in the stool is called steatorrhea. This happens:

with exocrine pancreatic insufficiency, a mechanical obstruction to the outflow of pancreatic juice, when steatorrhea is represented by neutral fat;
if the flow of bile into the duodenum is impaired and if the absorption of fatty acids in the small intestine is impaired, fatty acids or salts of fatty acids (soaps) are found in the feces.

Plant fiber

Digestible - found in the pulp of vegetables, fruits, legumes and grains. Indigestible fiber (the skin of fruits and vegetables, plant hairs, the epidermis of cereals) has no diagnostic value, since there are no enzymes in the human digestive system that break it down. It is found in large quantities during rapid evacuation of food from the stomach, achlorhydria, achylia, and the syndrome of bacterial overgrowth in the colon.

Starch

The presence of a large amount of starch in the feces is called amilorrhea and is observed more often with increased intestinal motility, fermentative dyspepsia, and less often with exocrine insufficiency of pancreatic digestion.

Iodophilic microflora (clostridia)

With a large amount of carbohydrates, clostridia multiply intensively. A large number of clostridia is regarded as fermentative dysbiosis.

Epithelium

A large amount of columnar epithelium in the feces is observed in acute and chronic colitis of various etiologies.

Leukocytes

A large number of leukocytes (usually neutrophils) are observed in acute and chronic enteritis and colitis of various etiologies, ulcerative necrotic lesions of the intestinal mucosa, intestinal tuberculosis, and dysentery.

Red blood cells

The appearance of slightly changed red blood cells in the stool indicates the presence of bleeding from the colon, mainly from its distal parts (ulceration of the mucous membrane, disintegrating tumor of the rectum and sigmoid colon, anal fissures, hemorrhoids). A large number of red blood cells in combination with leukocytes and columnar epithelium is characteristic of ulcerative colitis, Crohn's disease with damage to the colon, polyposis and malignant neoplasms of the colon.

Worm eggs

Eggs of roundworms, tapeworms, etc. indicate a corresponding helminthic infestation.

Pathogenic protozoa

Cysts of dysenteric amoeba, Giardia, etc. indicate a corresponding invasion by protozoa.

Yeast cells

Found in feces during treatment with antibiotics and corticosteroids. Identification of the fungus Candida albicans is carried out by culturing on special media (Sabouraud's medium, Microstix Candida) and indicates a fungal infection of the intestine.

Calcium oxalate (oxalic lime crystals)

Detection of crystals is a sign of achlorhydria.

Triple phosphate crystals (ammonium phosphate-magnesia)

Triple phosphate crystals found in feces (pH 8.5-10.0) immediately after defecation indicate increased protein putrefaction in the colon.

Norms

Macroscopic examination

Parameter	Norm
Quantity	A healthy person produces an average of 100-200 g of feces per day. Normally, feces contain about 80% water and 20% dry matter. With a vegetarian diet, the amount of feces can reach 400-500 g per day; when using easily digestible food, the amount of feces decreases.
Consistency	Normally, formed feces have a dense consistency. Pasty feces can occur normally and are caused by the intake of predominantly plant foods.
Form	Normally cylindrical.
Smell	Normally, stool has a mild odor, which is called fecal (ordinary). It may intensify with the predominance of meat products in the diet, with putrefactive dyspepsia and weaken with a dairy-vegetable diet, constipation.
Color	Normally, stool is brown in color. When eating dairy foods, stool turns yellowish-brown, and meat stool turns dark brown. Ingestion of plant foods and some medications can change the color of stool (beets - reddish; blueberries, blackcurrants, blackberries, coffee, cocoa - dark brown; bismuth, iron color stool black).
Slime	Normally absent (or in scanty quantities).
Blood	Normally absent.
Pus	Normally absent.
Leftover undigested food (lientorrhea)	Normally none.

Chemical research

Parameter	Norm
Fecal reaction	Normally neutral, less often slightly alkaline or slightly acidic. Protein nutrition causes a shift in the reaction towards the alkaline side, while carbohydrate nutrition causes the reaction to shift towards the acidic side.
Reaction to blood (Gregersen reaction)	Normally negative
Reaction to stercobilin	Normally positive.
Reaction to bilirubin	Normally negative.
Vishnyakov-Triboulet reaction (for soluble protein)	Normally negative.

online-diagnos.ru

Synonyms Russian

General stool analysis.

English synonyms

Koprogramma, Tool analysis.

Research method

Microscopy.

What biomaterial can be used for research?

How to properly prepare for research?

Avoid taking laxatives, administering rectal suppositories, oils, limit taking medications that affect intestinal motility (belladonna, pilocarpine, etc.) and the color of stool (iron, bismuth, barium sulfate) for 72 hours before donating stool.

General information about the study

A coprogram is a study of feces (feces, excrement, stool), an analysis of its physical and chemical properties, as well as various components and inclusions of various origins. It is part of a diagnostic study of the digestive organs and the function of the gastrointestinal tract.

Feces are the final product of food digestion in the gastrointestinal tract under the influence of digestive enzymes, bile, gastric juice and the activity of intestinal bacteria.

The composition of feces is water, the content of which is normally 70-80%, and a dry residue. In turn, the dry residue consists of 50% living bacteria and 50% from the remains of digested food. Even within normal limits, the composition of stool is largely variable. It largely depends on nutrition and fluid intake. The composition of feces varies even more in various diseases. The amount of certain components in the stool changes with pathology or dysfunction of the digestive organs, although deviations in the functioning of other body systems can also significantly affect the activity of the gastrointestinal tract, and therefore the composition of stool. The nature of changes in various types of diseases is extremely diverse. The following groups of violations of the composition of feces can be distinguished:

change in the amount of components that are normally contained in stool,
undigested and/or undigested food remains,
biological elements and substances secreted from the body into the intestinal lumen,
various substances that are formed in the intestinal lumen from metabolic products, tissues and cells of the body,
microorganisms,
foreign inclusions of biological and other origin.

What is the research used for?

For the diagnosis of various diseases of the gastrointestinal tract: pathologies of the liver, stomach, pancreas, duodenum, small and large intestine, gall bladder and biliary tract.
To evaluate the results of treatment of diseases of the gastrointestinal tract requiring long-term medical supervision.

When is the study scheduled?

For symptoms of any disease of the digestive system: pain in various parts of the abdomen, nausea, vomiting, diarrhea or constipation, changes in the color of feces, blood in stool, loss of appetite, loss of body weight despite satisfactory nutrition, deterioration in the condition of skin, hair and nails, yellowness of the skin and/or whites of the eyes, increased gas formation.
When the nature of the disease requires monitoring the results of its treatment during therapy.

What do the results mean?

Reference values

Index	Reference values
Consistency
	Shaped, cylindrical
	Fecal, sour

	Neutral, weakly acidic


Leftover undigested food	None
Muscle fibers are changed
Muscle fibers unchanged	None

Digestible plant fiber	None, small quantity
Fat neutral	Absent
Fatty acid
	None, small quantity
Intracellular starch	Absent
Extracellular starch	None
Leukocytes	Single in the preparation
Red blood cells
Crystals	No, cholesterol, activated carbon
Iodophilic flora	Absent
Clostridia	None, small quantity
Intestinal epithelial cells
Yeast-like fungi	None

Consistency/shape

Ordinary

Very dark stool

Red color

Black color -

Leftover undigested food

Remains of food in the stool

Muscle fibers are changed

Muscle fibers unchanged

Digestible plant fiber

Fat neutral

Fatty acid

Intracellular starch

Extracellular starch

Leukocytes

Red blood cells

Crystals

Iodophilic flora

Clostridia

Epithelium

Yeast-like fungi

Fecal occult blood test
Analysis for enterobiasis

Who orders the study?

Literature

helix.ru

They represent microscopic crystals

Index

Reference values

Consistency

Dense, shaped, hard, soft

Shaped, cylindrical

Fecal, sour

Light brown, brown, dark brown, yellow, yellow-green, olive

Neutral, weakly acidic

None, small quantity

Leftover undigested food

None

Muscle fibers are changed

Large, moderate, small amount, none

Muscle fibers unchanged

None

Absent, small, moderate, large amount

Digestible plant fiber

None, small quantity

Fat neutral

Absent

Fatty acid

None, small quantity

Intracellular starch

Absent

Extracellular starch

None

Leukocytes

Single in the preparation

Red blood cells

Crystals

No, cholesterol, activated carbon

Iodophilic flora

Absent

Clostridia

None, small quantity

Intestinal epithelial cells

Single in the field of view or absent

Yeast-like fungi

None

Consistency/shape

The consistency of the stool is determined by the percentage of water it contains. The normal water content in feces is 75%. In this case, the stool has a moderately dense consistency and a cylindrical shape, i.e. the feces are formed . Eating an increased amount of plant foods containing a lot of fiber leads to increased intestinal motility, and the feces become mushy. A thinner, watery consistency is associated with an increase in water content to 85% or more.

Liquid, mushy stool is called diarrhea. In many cases, stool liquefaction is accompanied by an increase in the quantity and frequency of bowel movements during the day. According to the mechanism of development, diarrhea is divided into those caused by substances that interfere with the absorption of water from the intestine (osmotic), resulting from increased secretion of fluid from the intestinal wall (secretory), resulting from increased intestinal peristalsis (motor) and mixed.

Osmotic diarrhea often occurs as a result of impaired breakdown and absorption of food elements (fats, proteins, carbohydrates). Occasionally, this can occur when consuming certain indigestible osmotically active substances (magnesium sulfate, salt water). Secretory diarrhea is a sign of inflammation of the intestinal wall of infectious and other origins. Motor diarrhea can be caused by certain medications and dysfunction of the nervous system. Often the development of a particular disease is associated with the involvement of at least two mechanisms of diarrhea; such diarrhea is called mixed.

Hard stool occurs when the movement of stool through the large intestine slows down, which is accompanied by excessive dehydration (water content in stool is less than 50-60%).

The usual mild smell of feces is associated with the formation of volatile substances that are synthesized as a result of bacterial fermentation of protein elements in food (indole, skatole, phenol, cresols, etc.). This odor intensifies with excessive consumption of protein foods or insufficient consumption of plant foods.

The sharp foul odor of feces is due to increased putrefactive processes in the intestines. A sour smell occurs with increased fermentation of food, which may be associated with a deterioration in the enzymatic breakdown of carbohydrates or their absorption, as well as with infectious processes.

The normal color of stool is due to the presence of stercobilin, the end product of bilirubin metabolism, which is released into the intestines with bile. In turn, bilirubin is a breakdown product of hemoglobin, the main functional substance of red blood cells (hemoglobin). Thus, the presence of stercobilin in feces is the result, on the one hand, of the functioning of the liver, and on the other, the constant process of updating the cellular composition of the blood. The color of stool normally varies depending on the composition of the food. Darker stool is associated with the consumption of meat foods, while a dairy-vegetable diet leads to lighter stools.

Discolored feces (acholic) is a sign of the absence of stercobilin in the stool, which can be caused by the fact that bile does not enter the intestines due to blockage of the biliary tract or a sharp violation of the biliary function of the liver.

Very dark calinogda is a sign of increased concentration of stercobilin in the stool. In some cases, this is observed with excessive breakdown of red blood cells, which causes increased excretion of hemoglobin metabolic products.

Red flowers may be caused by bleeding from the lower intestines.

Black color is a sign of bleeding from the upper gastrointestinal tract. In this case, the black color of the stool is a consequence of the oxidation of hemoglobin in the blood by hydrochloric acid of the gastric juice.

The reaction reflects the acid-base properties of the stool. An acidic or alkaline reaction in feces is due to the increased activity of certain types of bacteria, which occurs when food fermentation is disrupted. Normally, the reaction is neutral or slightly alkaline. Alkaline properties increase with the deterioration of enzymatic breakdown of proteins, which accelerates their bacterial decomposition and leads to the formation of ammonia, which has an alkaline reaction.

The acid reaction is caused by the activation of bacterial decomposition of carbohydrates in the intestines (fermentation).

Blood in the stool occurs when there is bleeding in the gastrointestinal tract.

Mucus is a secretion product of cells lining the inner surface of the intestine (intestinal epithelium). The function of mucus is to protect intestinal cells from damage. Normally, there may be some mucus in the stool. During inflammatory processes in the intestines, mucus production increases and, accordingly, its amount in the feces increases.

Detritus is small particles of digested food and destroyed bacterial cells. Bacterial cells can be destroyed by inflammation.

Leftover undigested food

Residues of food in the stool can appear when there is insufficient production of gastric juice and/or digestive enzymes, as well as when intestinal motility accelerates.

Muscle fibers are changed

Changed muscle fibers are a product of digestion of meat foods. An increase in the content of weakly modified muscle fibers in feces occurs when the conditions for protein breakdown worsen. This may be caused by insufficient production of gastric juice and digestive enzymes.

Muscle fibers unchanged

Unchanged muscle fibers are elements of undigested meat food. Their presence in the stool is a sign of impaired protein breakdown (due to impaired secretory function of the stomach, pancreas or intestines) or accelerated movement of food through the gastrointestinal tract.

Digestible plant fiber

Digestible plant fiber is the cells of the pulp of fruits and other plant foods. It appears in feces when digestive conditions are violated: secretory insufficiency of the stomach, increased putrefactive processes in the intestines, insufficient secretion of bile, digestive disorders in the small intestine.

Fat neutral

Neutral fat is the fatty components of food that have not been broken down and absorbed and are therefore excreted from the intestines unchanged. For normal fat breakdown, pancreatic enzymes and a sufficient amount of bile are necessary, the function of which is to separate the fat mass into a fine-droplet solution (emulsion) and repeatedly increase the area of contact of fat particles with molecules of specific enzymes - lipases. Thus, the appearance of neutral fat in the stool is a sign of insufficiency of the pancreas, liver, or a violation of the secretion of bile into the intestinal lumen.

In children, a small amount of fat in the stool may be normal. This is due to the fact that their digestive organs are not yet sufficiently developed and therefore do not always cope with the load of assimilation of adult food.

Fatty acid

Fatty acids are products of the breakdown of fats by digestive enzymes - lipases. The appearance of fatty acids in the stool is a sign of a violation of their absorption in the intestines. This may be caused by a violation of the absorption function of the intestinal wall (as a result of the inflammatory process) and/or increased peristalsis.

Soaps are modified remains of undigested fats. Normally, 90-98% of fats are absorbed during the digestion process; the remainder can bind with calcium and magnesium salts contained in drinking water and form insoluble particles. An increase in the amount of soap in the stool is a sign of impaired fat breakdown as a result of a lack of digestive enzymes and bile.

Intracellular starch

Intracellular starch is starch contained within the membranes of plant cells. It should not be detected in feces, since during normal digestion the thin cell membranes are destroyed by digestive enzymes, after which their contents are broken down and absorbed. The appearance of intracellular starch in feces is a sign of digestive disorders in the stomach as a result of a decrease in the secretion of gastric juice, digestive disorders in the intestines in the event of increased putrefactive or fermentative processes.

Extracellular starch

Extracellular starch is undigested starch grains from destroyed plant cells. Normally, starch is completely broken down by digestive enzymes and absorbed during the passage of food through the gastrointestinal tract, so it is not present in feces. Its appearance in the stool indicates insufficient activity of specific enzymes that are responsible for its breakdown (amylase) or too rapid movement of food through the intestines.

Leukocytes

Leukocytes are blood cells that protect the body from infections. They accumulate in the tissues of the body and its cavities, where the inflammatory process occurs. A large number of leukocytes in the stool indicates inflammation in various parts of the intestine caused by the development of infection or other reasons.

Red blood cells

Erythrocytes are red blood cells. The number of red blood cells in the stool may increase as a result of bleeding from the wall of the colon or rectum.

Crystals

Crystals are formed from various chemicals that appear in feces as a result of digestive disorders or various diseases. These include:

tripelphosphates - are formed in the intestines in a sharply alkaline environment, which may be the result of the activity of putrefactive bacteria,
hematoidin is a product of the transformation of hemoglobin, a sign of blood secretion from the wall of the small intestine,
Charcot-Leiden crystals are a product of crystallization of the protein of eosinophils - blood cells that take an active part in various allergic processes; they are a sign of an allergic process in the intestines, which can be caused by intestinal helminths.

Iodophilic flora

Iodophilic flora is a collection of different types of bacteria that cause fermentation processes in the intestines. During laboratory testing, they can be stained with iodine solution. The appearance of iodophilic flora in the stool is a sign of fermentative dyspepsia.

Clostridia

Clostridia is a type of bacteria that can cause rot in the intestines. An increase in the number of clostridia in the stool indicates increased putrefaction of protein substances in the intestines due to insufficient fermentation of food in the stomach or intestines.

Epithelium

Epithelium is the cells of the inner lining of the intestinal wall. The appearance of a large number of epithelial cells in the stool is a sign of an inflammatory process in the intestinal wall.

Yeast-like fungi

Yeast-like fungi are a type of infection that develops in the intestines when there is insufficient activity of normal intestinal bacteria that prevent its occurrence. Their active reproduction in the intestines may be the result of the death of normal intestinal bacteria due to treatment with antibiotics or certain other drugs. In addition, the appearance of a fungal infection in the intestines is sometimes a sign of a sharp decrease in immunity.

Fecal occult blood test
Fecal analysis for helminth eggs
Stool analysis for protozoan cysts
Analysis for enterobiasis

Who orders the study?

General practitioner, internist, gastroenterologist, surgeon, pediatrician, neonatologist, infectious disease specialist.

Literature

Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th edition. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 5th edition. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th edition. St. Louis: Mosby Elsevier.

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Tripelphosphates in feces - what does this mean?

They represent microscopic crystals, consisting of ammonia phosphate and magnesium. The shape resembles hexagons elongated lengthwise. They can be detected by microscopic examination. Tripelphosphates are formed when the intestines have a sharply alkaline environment (pH 8.5 - 10.0). They should not be present in the stool of a healthy person.

The presence of these crystals indicates that increased protein decay occurs in the large intestine due to the activity of putrefactive bacteria. When the acidity of the stomach is low, its mucous membrane does not produce enough bactericidal mucus, and therefore harmful microorganisms quickly multiply in the intestines.

In addition, tripel phosphates indicate that bilirubin (bile pigment) entering the colon does not have time to turn into stercobilin. This occurs due to impaired motility - intestinal contents are evacuated very quickly. Often the cause is profuse diarrhea.

Why is it dangerous?

The presence of tripelphosphate crystals is a signal of an inflammatory process in the digestive tract, in particular - protein rotting in the colon.

Protein intake from food is vital, as new cells are formed from them. Therefore, you need to include proteins of different origins (plant and animal) in your diet. In order for proteins to perform their role, they must be broken down into amino acids. This process begins in the stomach under the influence of hydrochloric acid, then continues in the duodenum and small intestine. After this, amino acids are absorbed into the blood through the intestinal walls.

But due to disturbances in the gastrointestinal tract, some amino acids enter the large intestine. The microorganisms located there break them down to form toxic substances. Thus, the protein rots. The breakdown products of this process enter the venous bloodstream and then into the liver.

Over time, this gland is unable to neutralize the toxic products of protein decay. Then some of these poisons are carried through the blood throughout the body, causing: nausea, colic, a feeling of heaviness, rumbling in the stomach, bad breath, headache.

When proteins rot, they form ammonia, which is absorbed into the blood. As a result, there is a negative effect on the central nervous system. Oxygen starvation sets in. In this case, weakness, depression, and depression are observed.

The presence of tripelphosphate crystals also indicates increased motility in the intestinal tract.

Normally, part of the bilirubin entering the colon should be converted into stercobilinogen, which should subsequently be oxidized to stercobilin. This is what turns the stool brown. With profuse diarrhea, the movement of intestinal contents accelerates and bilirubin does not have time to be converted into stercobilin. The human body becomes dehydrated and loses many essential microelements.

Diagnostics

A stool examination is carried out - coptogram. It can be used to determine the composition of the intestinal microflora, chemical and physical indicators, microscopic material, the presence of helminths, and blood.

Microscopic examination is necessary to detect tripelphosphates. A chemical analysis will show the presence of bilirubin, stercobilin, blood, as well as the pH reaction.

In order for the analysis result to be as objective as possible, a number of requirements must be met:

A few days before donating stool, do not take any medications. Avoid vegetables and fruits with bright colors (beets, tomatoes, greens), do not drink tea, coffee, or alcohol.
Stick to a gentle diet - porridge, pureed vegetables, dairy products.
Do not use laxatives.
In the morning before bowel movements, it is important to wash yourself thoroughly.
Prepare in advance a dry, clean container with a lid and a spatula, put about 20 grams there. feces

On the same day, the analysis must be submitted to the laboratory, since the next day it is no longer suitable.

What to do and how to treat

First of all it is necessary contact a gastroenterologist. He will prescribe a comprehensive examination to identify the cause of the inflammatory process and its location, as well as concomitant diseases. Having a complete picture of the development of the disease, the doctor will determine which treatment plan will be optimal.

For this purpose use:

Probiotics, which include living microorganisms (lactobacteria, bifidobacteria, etc.). Taking root in the large intestine, they quickly multiply, suppressing the growth of pathogenic bacteria. This group includes drugs: Linex, Bifidumbacterin, Bifiform, etc.
Prebiotics. They contain lactulose, which provides nutrition for beneficial bacteria and activates their growth, helping to normalize intestinal motility. This group includes drugs - Dufalak, Lactusan, Lactofiltrum, etc.

If profuse diarrhea is diagnosed, the main thing is to prevent dehydration. Drink water after every bowel movement. You can replenish the loss of sodium and potassium salts using the drug Regidron.

You need to adjust your diet:

If you have diarrhea, it is better to avoid foods that promote fermentation - sweet pastries, bread, sour fruits and vegetables.
Minimize the intake of spicy and fatty foods, as they inflame the intestinal mucosa and provoke the proliferation of harmful bacteria.
Consume lactic acid products with a short shelf life. They contain live bifidibacteria and lactobacilli (kefir, acidophilus milk, fermented baked milk).
Avoid industrially processed meat products (sausages, sausages, dumplings, etc.), as they intensify putrefactive processes.
Introduce foods with plant fiber and pectin into your diet - bran, carrots, cabbage, beets, pumpkin, apples, grapes.

When trying to keep your digestive tract in working order, you shouldn’t go to extremes when it comes to diet: eating just one type of food. Different products are needed, the main thing is quality. Choose those that do not contain preservatives, nitrates and other chemical additives.

It is important not to overuse antibiotics and hormonal drugs, since they destroy not only harmful, but also beneficial microflora in the intestines. And in all cases, try to avoid stress and emotional overload. try to avoid stress and emotional overload.

Feces should be examined no later than 8-12 hours after defecation. The material is collected in clean, dry containers. If, when collecting material for examining feces for the presence of worm eggs, blood, and stercobilin, it is advisable to use paraffin cups, then to determine the degree of digestion of food, when you need to collect all the feces excreted during defecation, the dishes should be glass and capacious.
To test for the presence of protozoa, feces must be immediately taken to the laboratory.
Before a scatological examination, in some cases it is necessary to resort to appropriate preparation of the patient. If the purpose of the study is to identify hidden blood, then it is necessary to exclude from the diet for 3 days foods that can affect reactions aimed at detecting blood. Such products are meat, fish, all types of green vegetables, tomatoes.

For research to find worm eggs, there is no need for the entire daily amount of feces, but a small portion of 40-50 g, collected in a clean, dry container, is sufficient.
A small piece (the size of a pea) of feces is placed on a glass slide with a previously applied drop of 50% glycerin solution and mixed with a glass rod. Then microscopy under a coverslip with an 8X or sometimes 40X objective. The study of such a native drug is successful when there is a high content of eggs in the feces. When their quantity is small, it is necessary to use concentration methods.
The simplest and most common is the Fulleborn method. A small lump of feces the size of a pea is mixed with 20 times the volume of table salt solution in a thick-walled glass cup. Leave for up to 1"/2 hours. Using a wire loop calcined in the flame of an alcohol lamp, remove the surface film. In this way, several preparations are prepared and examined microscopically. A saturated solution of table salt is used as a reagent. The specific gravity of a saturated solution of table salt is not high enough to contain all the eggs floated, so a number of other solutions with a high specific gravity were proposed. The most successful was the saturated solution of sodium nitrate proposed by E. V. Kalantaryan, in which helminth eggs float for 10 minutes. The prepared native preparations are microscoped, and helminth eggs are differentiated in them according to the following signs.
Roundworms (Ascaris lumbricoides). A characteristic feature of the egg is a lumpy brown protein shell located on top of a smooth inner shell. Sometimes the protein shell is absent and the surface of the egg is smooth.
Pinworm (Enterobius verniicularis). The egg is oval in shape, asymmetrical (one side is flattened), colorless, transparent, the shell is thin, double-circuited.
Whipworm (Trichocephalus trichiurus). The egg has a characteristic barrel shape, thick walls are colored brown, and colorless corks are located at the poles. The contents of the egg are fine-grained.
Hookworm (Ancylostoma duodenale). The eggs are oval-shaped, colorless, surrounded by a thin transparent shell, under which 2-8 crushed balls are visible.
Naked tapeworm (Tachiarynchus saginatus). What is usually found in feces is not eggs, which quickly collapse, but embryos - oncospheres, which have an oval shape and a thick shell with radial striations; inside there is an embryo with 3 pairs of hooks.

Armed tapeworm (Tachia solium). Oncospheres are indistinguishable from oncospheres of unarmed tapeworms, usually round in shape.
Dwarf tapeworm (Humenolepis nana). The egg is round or elliptoid in shape and strongly refracts light. It has two thin shells, of which the inner one covers the oncosphere. There are 6 hooks in the oncosphere.
Broad tapeworm (Diphyllobothrium latum). The eggs are oval-shaped, yellow or brown. On one pole there is an operculum, on the opposite there is a tubercle. The inside of the egg is coarse-grained.
Detection and differentiation of protozoa in feces is one of the most difficult sections of research, which requires a certain amount of experience and thoroughness in work.
Most unicellular organisms are found in feces in 2 forms: vegetative-active, living and in the form of immobile cysts resistant to the external environment.
Vegetative forms can be found mainly in liquid feces; in formalized feces they are found only in the encysted state. Therefore, if the stool is not formalized and a stool analysis is prescribed to identify vegetative forms, then the stool should be immediately delivered to the laboratory and examined, since in cooled stool the protozoa lose their mobility, die and are quickly destroyed by the action of proteolytic enzymes.
A chemical study in a general stool analysis comes down to determining the pH using litmus paper, reactions to detect hidden blood and a test for stercobilin.

Qualitative test for stercobilin

To detect occult blood in the feces, a benzidine test (Gregersen) and a test with guaiac resin (Weber) are used.
The benzidine test is performed on a glass slide. The glass is placed in a Petri dish placed on white filter paper, a little fecal emulsion is applied to the glass and 2 drops of a solution of benzidine in acetic acid and 2 drops of hydrogen peroxide are dripped onto it and the time of appearance of the blue-green color is noted. If the color appears instantly, then the sample is considered sharply positive (+ + +); the appearance of color between the 3rd and 15th s is regarded as a positive test (+ +); if color appears between the 15th and 60th seconds, then the sample is considered weakly positive (+). A faint green color appearing between the 1st and 2nd minutes is regarded as traces. The color that develops after 2 minutes is not taken into account, since blood participates in this reaction as its accelerator (catalyst). If the benzidine test is positive, then you must definitely do the Weber test, which is much less sensitive. If the benzidine test is negative, there is no point in performing the latter, but if it is positive, it makes it more likely to confirm the presence of hidden bleeding.
The Weber test is also performed on a glass slide with a piece of white filter paper. Apply 2 drops of acetic acid, 2 drops of alcohol tincture of guaiac resin and 2 drops of hydrogen peroxide to the fecal emulsion. The appearance of a blue-green color indicates a positive reaction.
Filter paper serves to better detect color changes.

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Odor assessment
The sharp unpleasant odor of feces appears due to the occurrence of pathological reactions of rotting or fermentation in the digestive tract. This is found in chronic pancreatitis and dysbacteriosis.

Examination of feces for occult blood
If it is necessary to conduct a stool test for occult blood, the patient must strictly adhere to a diet with the exception of meat and fish products for 3 days. If blood is present in a significant amount, then its presence is determined even visually. A small amount of blood is determined using a special benzidine test, as well as the pyramidon reaction or Weber reaction. The collection of material for research from the patient is carried out in the same way as for general analysis. Hidden blood is present in the stool in diseases such as peptic ulcer of the stomach or duodenum with slight bleeding, polyposis of the stomach or intestines, neoplasms of any part of the gastrointestinal tract and helminthiases.
The benzidine test for the presence of occult blood in the stool is better known as the Gregersen test. This analysis allows you to detect even a minimal amount of blood in the stool - up to several milliliters.

Examination of stool for enterobiasis
This analysis identifies pinworm eggs. The material for it is often obtained by scraping helminth eggs with a cotton swab soaked in a 50% glycerin solution from the perianal folds.

Stool protozoa testing
Among the protozoa found in stool are dysenteric amoeba and Trichomonas. In preparation for collecting material for research, the patient should refrain from administering medications, especially through enemas. The container for feces should not contain the slightest traces of disinfectants. Material is collected for research from mucous, bloody areas of stool. Their microscopy is carried out immediately within 15-20 minutes.

Examination of stool for Giardia cysts
Giardia cysts have the ability to persist in research material from a patient without changes for a long time. In this regard, it is not necessary to send stool to the laboratory urgently.

Examination of stool for bile pigments
This analysis allows us to determine the quantitative content of stercobilin in feces.
The collection and sending of material for research from the patient is carried out in the same way as for a general stool analysis.

Examination of stool for dysentery, typhoparatyphoid group of microorganisms and coli and pathogenic bacillus
For this analysis, a special case with a preservative is used, into which the material for research is placed. In this case, it is preferable to send mucous and bloody fragments of stool. The study is carried out using the bacteriological method.

Examination of stool for tuberculosis bacilli
To maximize the information content of laboratory test results, mucous and bloody feces are collected in a sterile container.

Examination of stool for dysbacteriosis
A small portion of feces is placed in a regular sterile container without a preservative and urgently sent for laboratory testing.

Stool examination for stercobilin and stercobilinogen
This analysis is carried out for the purpose of diagnosing cholelithiasis and hepatitis, in which the content of pigments in the stool is significantly reduced.

Stool test for bilirubin
In a healthy person, this reaction is negative. The presence of bilirubin in feces is determined in dysbiosis and acute gastroenteritis.

Study of material from a patient for Vibrio cholerae
In this case, the material for bacteriological analysis to detect Vibrio cholerae is not only the patient’s feces, but also his vomit. The container for collecting material must be glass or enameled. The use of tin utensils is excluded in order to avoid oxidation of the test material and distortion of the analysis results. After collecting material for research from the patient, the container must be packed in a special metal container. Due to the special danger of spreading infection, analysis for the detection of Vibrio cholerae is carried out only in special laboratories of sanitary and epidemiological stations.

Feces, like urine, are the end product of human life. It is formed in the large intestine as a result of a number of biochemical processes. Feces include water, undigested food debris, metabolic byproducts, bacteria, and so on.

Do not underestimate stool testing. Sometimes it is this analysis that makes it possible to identify pathologies of the digestive tract, liver disease, and pancreas in adults and children. This examination is prescribed not only for the purpose of diagnosing diseases, but also to monitor the treatment being carried out.

What a coprogram (stool analysis) shows:

study of the physical and chemical properties of feces (color, consistency);
microscopy of material;
bacteriological examination (detection of pathogenic microbes and analysis of intestinal microflora);
detection of helminth eggs;
detection of occult blood in the stool.

How to prepare for a stool test?

Preliminary preparation for submitting the material for children and adults normally lasts 3-4 days. It is aimed at cleansing the intestines and preventing food debris, muscle and plant fibers from entering the feces. With special training, laboratory assistants will be able to detect even a small degree of disruption of the evacuation and digestive functions of the digestive tract.

The essence of preparation is to follow a special diet with a certain content of proteins, fats and carbohydrates. Two types of diets are suitable for this purpose: according to Pevzner and according to Schmidt.

Pevzner's diet

It involves eating black and white bread, meat (boiled or fried), sauerkraut, rice and buckwheat porridge, fresh apples, potatoes (in any form), and butter. The total energy value is about 3000 kcal per day.

Diet according to Schmidt

She is gentle. It is recommended to eat 5 times a day, mainly dairy products (milk, butter), a couple of eggs, meat, potatoes, oatmeal (mucus broth). Daily caloric intake should be limited to 2200-2400 kcal.

Feces for occult blood

Before examining stool for occult bleeding, patients are not recommended to eat foods that may cause a false-positive reaction to blood. These include: all varieties of green vegetables (cucumber, cabbage), fish, meat, eggs, tomatoes.
Patients should also refrain from taking medications containing iron (ferrum-lek, ferrumbo).

If you urgently need to get tested or your health does not allow you to follow a diet, it is recommended not to drink alcoholic beverages, tea, or coffee for at least 24 hours.

It is strictly prohibited before the examination

do a cleansing and siphon enema;
take medications that affect intestinal motility (laxatives or antidiarrheals);
insert suppositories or other forms of medication into the anus;
use medications that change the color of the material (barium sulfate, bismuth preparations).

How to take a coprogram?

The material should be collected in a clean container after spontaneous bowel movement in the morning. 10-15 g of feces is enough for the study. In rare cases, your doctor may order a 24-hour stool test. In this case, the patient must collect stool for 24 hours.

If the patient suffers from prolonged constipation and cannot empty himself, it is recommended to massage the colon. If this procedure does not bring results, the patient should undergo a cleansing enema. In this case, a solid piece of feces is taken from the washing water.

Analysis collection method:

In the morning after sleep, the patient is advised to defecate in a pot or vessel
then, using a special stick or spatula, take a small amount of feces into a clean, dry jar and close the lid tightly.
It is advisable to immediately deliver the analysis to the laboratory. The deadline is 8-10 hours. After this time, the material may deteriorate and become unsuitable for examination.
Stool is stored at a temperature of 3-6 0 C.

When examining for worm eggs the material must be completely fresh, that is, delivered to the laboratory warm.

Stool sampling for bacteriological examination performed with the help of a laboratory assistant. The patient is asked to lie on his right side or lean forward while standing. The laboratory assistant spreads the patient's buttocks and inserts a metal loop with a cotton swab wrapped around it into the anus. The insertion should be carried out with rotational movements, very carefully so as not to damage the mucous membrane of the anus. The loop is also carefully removed and then placed in a sterile tube.

Coprogram analysis

Norm of indicators		Microscopic examination
Consistency	Dense	Muscle fragments with striations	None
Form	Decorated	Muscle fragments without striations	Single
	Brown	Connective tissue	None
Smell	Unsharp, specific feces	Neutral fats
Reaction	From 6.01 to 8.01	Fatty acid
Slime	A small amount of	Fatty acid salts	A small amount of
Blood	None	Digested vegetable fiber	Single fibers
Leftover undigested food	None	Starch intra- and extracellular	Absent
Reaction to stercobilin	Positive	Normal iodophilic intestinal microflora	Small number
Reaction to bilirubin	Negative	Pathological microflora Columnar epithelium Epithelium is flat Leukocytes Red blood cells Protozoa Worm eggs Yeasts	None
Reaction to protein
Reaction to occult blood

Decoding stool analysis in middle-aged and older children and adults

Quantity

Normally, a person excretes 150-200 g of feces per day 1-2 times.
For children, the weight of feces is 80-150 g per day

The volume of bowel movements depends on the amount of food eaten and its quality composition. For example, if a person eats meat or dairy products, the amount of feces decreases. Plant foods, on the contrary, increase its volume. Pathological reasons for changes in the amount of feces in the table:

Consistency and shape

Stool of a dense consistency and shaped (sausage-shaped) is considered normal. Loose, unformed stools are called diarrhea. This condition is usually accompanied by increased bowel movements and polyfecal loss. Diarrhea occurs:

osmotic - occurs due to impaired absorption of osmotically active substances (potassium, sodium) and proteins - pancreatitis, Crohn's disease, sprue, taking magnesium sulfate;
secretory - usually caused by inflammatory processes in the intestines (enteritis, colitis);
motor – occurs with increased peristalsis of the digestive tube (laxatives);
mixed – due to all of the above factors.

The peculiar ribbon-like shape of feces can be caused by spasms in the rectum and sigmoid colon. When the evacuation of food from the intestines is impaired, a person experiences constipation. In this case, feces become hard, dense, similar to sheep balls. Its hardness is due to excessive absorption of water.

Color

Normal stool is brown in color. This is due to the presence of stercobilin in it, a breakdown product of bilirubin, which is released into the intestines with bile. The change in color of the material may be due to various factors:

Stool color	What is the reason
Light yellow	Occurs when consuming large amounts of dairy products.
Bright yellow	The reason is the accelerated evacuation of food from the intestines (diarrhea of infectious and non-infectious origin) or treatment with medications from hay.
Dark brown (pleiochromia)	excessive consumption of meat foods; hemolytic jaundice; resolution of obstructive jaundice (elimination of gallstones, tumor disintegration).
Black (tarry) – melena	eating black currants, blueberries, chokeberries, and cherries; gastrointestinal bleeding (the black color is due to the compound of hemoglobin with hydrochloric acid, which is called hematin) - bleeding stomach or duodenal ulcer, bleeding from dilated veins of the esophagus; treatment with bismuth and iron preparations; thrombophlebitis of the splenic vein.
Greenish	Eating a lot of lettuce, asparagus, celery, sorrel.
In the form of "rice water"	Transparent stool with flakes is observed with cholera.
In the form of "pea soup"	Such material indicates the presence of typhoid fever in the patient.
Red, reddish	Occurs when bleeding from the lower intestines (rectum and colon).
Discolored, clayey (acholic)	Feces lose their color due to the cessation of stercobilin entering the intestines. This happens when: liver cirrhosis; viral hepatitis; cholelithiasis; cancer of the head of the pancreas; cancer of the papilla of the duodenum; adhesions of the common bile duct.
Light	an abundance of undigested fat in the feces - steatorrhea - (due to impaired pancreatic function in pancreatitis, neoplasms); admixture of a large volume of pus and mucus (Crohn's disease, ulcerative colitis); after contrast radiography of the gastrointestinal tract (due to barium sulfate); increased fermentation processes in the intestines.

Smell

Normal stool has a mild, specific odor. This is due to the processes of bacterial fermentation that occur in the intestine. During the breakdown of proteins, indole, skatole, phenol and cresol are formed, and they form the odor of feces.

Reduces odor stool with a plant-based diet and constipation, and increases with a meat diet and diarrhea.

Strong foul odor speaks of putrefactive processes in the intestines. The sour aroma of excrement indicates the presence of an increased amount of fatty acids (propionic, butyric).

Visible impurities

Normally, the stool should not contain blood, mucus, undigested food remains, stones, helminths, and so on. Their presence indicates a pathological process in the gastrointestinal tract.

Impurity	What does it mean
Lumps of undigested food	dysfunction of the pancreas; atrophic gastritis; accelerated intestinal motility (diarrhea). Normally, feces may contain small bones, peels of vegetables and fruits, cartilage, cucumbers, and nuts.
Fat	This may occur due to insufficient pancreatic function. In this case, the feces become shiny, ointment-like, with white lumps.
Slime	Normally, a small amount of mucus is allowed in the stool. Its abundance indicates inflammatory processes in the intestine, both infectious (dysentery, salmonellosis) and non-infectious (ulcerative colitis). Mucus may be mixed with stool or located on its surface.
Blood	The release of small portions of blood is usually invisible to the human eye and can only be detected by microscopic examination. An admixture of scarlet blood indicates bleeding from the lower intestines or from the initial sections, if motility is increased.
Pus	Pus appears in feces during severe inflammatory pathologies (dysentery, intestinal tuberculosis), rupture of an abscess into the intestinal lumen, or suppuration of a tumor.
Worms	Some helminths (whipworms, pinworms, roundworms) can be excreted in the stool entirely or in fragments.
Stones	Coprolites (fecal stones), gallstones, pancreas.

pH

In a healthy person with a normal diet, feces have a neutral or slightly alkaline reaction (pH 6.87-7.64). Change in stool pH:

acidic reaction (pH 5.49-6.79) – occurs when the absorption of fatty acids in the small intestine is impaired;
sharply acidic reaction (pH less than 5.49) - occurs with excessive activity of fermentation microflora or lactose intolerance;
alkaline reaction (pH 7.72-8.53) - occurs when proteins rot (excessive consumption of meat);
sharply alkaline reaction (pH more than 8.55) - indicates.

Reaction to occult blood

Hidden blood is called blood that is not visible to the human eye (macroscopically) and under a microscope. Normally, the reaction can be positive if you eat meat, fish, blood sausage, iron supplements, vigorously brush your teeth, or get menstrual blood into your stool. Pathologies that cause the appearance of blood in feces:

gum disease (gingivitis, periodontal disease);
peptic ulcer of the stomach and duodenum;
ingestion of blood from the upper respiratory tract (nosebleeds);
bleeding tumors;
varicose veins of the esophagus and rectum;
Mallory-Weiss syndrome;
helminthic infestation;
intestinal tuberculosis;
dysentery;
colitis;
Stevens-Jones syndrome;
haemorrhoids;
intestinal polyposis;
typhoid fever.

Reaction to protein

Normally, the reaction to protein is always negative. It can be positive when:

inflammatory diseases of the gastrointestinal tract (gastritis, duodenitis, enteritis);
dysbacteriosis;
celiac disease.

Reaction to stercobilin

Stercobilin is a breakdown product of bilirubin, which gives stool a brown color. It is secreted into the duodenum with bile. Normally, 100 g of feces contains 75-100 mg of stercobilin. Changes in the content of stercobilin in stool can occur in various diseases:

Reaction to bilirubin

Bilirubin can normally be detected in the stool of a breastfed infant. It gives feces a greenish color. In an adult, only bilirubin breakdown products are excreted in feces. Detection of bilirubin in stool occurs when:

diarrhea;
severe dysbacteriosis while taking antibiotics.

Microscopic examination of stool

What is discovered	What pathologies does it indicate?
Muscle fibers with and without striations (creatorhoea)	ahilia; fermentative and putrefactive dyspepsia; diarrhea.
Connective tissue (connective tissue fibers)	It is detected when there is a deficiency of pepsin in gastric juice and diarrhea. The detection of bones and cartilage in the stool is not a pathology.
Plant fiber	ahilia; diarrhea of any nature.
Starch	atrophic gastritis; acute pancreatitis; diarrhea.
Fat and its products (fatty acids, salts of fatty acids)	disruption of the pancreas; insufficient flow of bile into the intestines; diarrhea.
Intestinal epithelium (squamous and columnar)	inflammation of the intestinal mucosa
Leukocytes	Neutrophils: colitis; enteritis; intestinal tuberculosis; nonspecific ulcerative colitis; amoebic dysentery; helminthic infestation.
Red blood cells	Their detection indicates bleeding into the lumen of the digestive tract.
Crystal formations	Human feces may contain: hematoidin crystals (bleeding); tripelphosphates (putrefactive dyspepsia); oxalates (reducing the acidity of gastric juice); Charcot-Leyden crystals (allergies, helminthic infestation); cholesterol crystals.
Protozoa	dysenteric amoeba; Trichomonas; balantidia; Giardia.
Worm eggs	In cases of helminthiasis, whipworm, roundworm, and pinworm eggs are released in feces.
Bacteria and fungi	Bacteria found in feces can be pathological (Escherichia coli, Proteus) or part of the normal microflora (lacto- and bifidobacteria). Among fungi, the detection of Candida mycelium is of diagnostic importance.

Coprogram in a newborn and infant

Features of stool after the birth of a child

In the first couple of days after the baby is born, he produces a special stool called meconium. Meconium is dark green or olive in color and is a thick, homogeneous mass.
After a week, mucus and lumps appear in the baby’s stool, and stools become more frequent and loose. The color of feces also changes: dark green gives way to yellow and yellow-brown.

Analysis of stool in children of such a young age has a number of features. At birth, the baby’s intestines are not yet sufficiently developed and are not adapted to receiving regular adult food. Therefore, proper feeding is a very important factor in the development of a baby.

In the first days of life, the baby receives all the necessary microelements, nutrients and vitamins through mother's milk. Also, during feeding, the baby's intestines are contaminated with lacidobacteria and bifidobacteria, which are necessary for the production of feces.

If a pediatrician orders a baby to undergo a stool test, the mother must follow a certain diet for 2-3 days, since what the mother eats must enter the baby’s body with milk.

Features of mommy's diet (see):

exclude all possible allergens (eggs, citrus fruits, chocolate);
do not drink alcohol, do not smoke;
It is preferable to eat slimy porridges (oatmeal, rice), vegetable soups, steamed cutlets;
do not abuse fatty foods or easily digestible carbohydrates.

However, the mother cannot always provide the baby with enough milk. Recently, infants are starting to be supplemented with formula feeding from the first months or are immediately transferred to artificial feeding.

Main differences

The coprogram for natural and artificial feeding of children may differ. No matter how balanced the formula is, it will never replace breast milk in quality. This is also reflected in the functioning of the baby’s digestive system, the product of which is feces.

Options	When feeding formulas	When feeding with milk
Daily amount	Up to 35-45 grams	The normal amount is considered to be 45-55 grams
Color	Light brown	Yellow with a greenish tint (this color is due to the presence of bilirubin in the stool, which is considered normal)
Smell	More putrid	More sour
pH	Slightly alkaline (7.58-7.74)	Slightly acidic (5.52-5.89)
Fats and fatty acids	Drops of neutral fat	Fatty acids and their salts (provide acidic stool)
Slime	None or small amount
Blood	Absent
Leftover undigested food	Possibly a small amount due to immature intestinal microflora
Reaction to stercobilin	Positive
Reaction to bilirubin	Positive
Reaction to protein	Negative
Reaction to occult blood	Negative
Muscle fibers	Possibly in small quantities
Leukocytes	In small quantities
Intestinal epithelium	In small quantities
Red blood cells	None

Coprogram - what kind of research is this? Indications, material collection technique and interpretation of coprogram results

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

What is a coprogram ( general stool analysis)?

Coprogram is a laboratory test of stool ( stool analysis ), during which their physical, chemical, biological and microscopic characteristics are assessed. A detailed study of the composition and structure of feces allows us to identify some diseases of the gastrointestinal tract, in which a person’s digestion or absorption of nutrients is impaired.

The methodology for studying the functions of internal organs based on the nature of feces is scientifically justified. The fact is that the food a person takes in the process of passing through the gastrointestinal tract is subjected to intensive processing.
It is crushed mechanically, after which it is mixed with saliva, gastric juice and other digestive enzymes produced by the liver and pancreas. All this contributes to the breakdown of foods into simple substances, which are absorbed through the intestinal mucosa into the human body. Unabsorbed food debris, water and microorganisms ( being permanent inhabitants of the large intestine, also taking part in the digestive processes) form feces.

If all organs of the digestive system function normally, the composition and characteristics of feces in people will be approximately the same ( adjusted for the nature of the food that the patient took some time before the analysis). If any organ of the gastrointestinal tract does not work properly, this disrupts the absorption of food products and other important processes in the body, which will affect the composition, consistency and other characteristics of stool.

Indications for coprogram

As mentioned above, analysis of stool characteristics can help in diagnosing diseases of various organs of the digestive system.

The coprogram allows you to diagnose:

stomach diseases;
intestinal diseases;
liver diseases;
pancreatic diseases;
surgical diseases of the gastrointestinal tract;
causeless weight loss and so on.

These pathologies can manifest themselves in a wide variety of signs, and therefore the analysis should only be prescribed by a doctor after a thorough interview and examination of the patient. Also, this study can be prescribed in the treatment of various diseases of the digestive system to evaluate the results of the therapy and monitor its effectiveness.

Coprogram – specialist consultation

How to donate feces for coprogram?

In order for the results of the coprogram to be as accurate and informative as possible, stool sampling for research must be carried out according to certain rules. Strict adherence to these rules will allow us to deliver clean material to the laboratory, not contaminated with foreign substances and bacteria, which will guarantee the quality of the research results. At the same time, this will prevent the spread of infection to foreign objects or people, ensuring their safety.

Is special preparation necessary before collecting stool for analysis?

No special preparation is required before performing a coprogram. At the same time, there are a number of limitations that should be considered before performing this analysis.

Before collecting material for a coprogram, you should:

Avoid any enemas or other bowel lavages. These procedures will distort the results of the study. The collection of material should be carried out no earlier than 24 hours after the last enema.
Exclude rectal ( through the anus) administration of medications. Administration of medications ( including candles) in this way will distort the research results, since it will disrupt the physical state of feces and their chemical composition.
Avoid taking medications that affect digestion. These drugs include activated carbon ( interferes with the absorption of almost all substances in the intestines), enzyme preparations ( may hide diseases of the pancreas or liver), medications that speed up or slow down intestinal motility, and so on ( A more detailed list of medications should be checked with your doctor). The intake of these medications should be limited 2–3 days before the test.

Do I need to follow a diet before undergoing coprogram?

In general, it is not necessary to follow a diet before undergoing coprogram. Before collecting material, only those patients who are expected to have bleeding in the gastrointestinal tract should adhere to a special diet ( that is, during the analysis of stool, the laboratory assistant will look for traces of blood in them). If the patient consumes certain foods before this, this may distort the results of the study.

If you suspect bleeding before coprogram, you should exclude from the diet:

meat products;
fish products;
eggs ( any);
green vegetables and/or fruits;
iron supplements;
magnesium preparations;
bismuth preparations.

Also, the day before taking the material, such patients should not brush their teeth, since traumatizing the gums with a toothbrush can lead to blood entering the gastrointestinal tract and distorting the results of the study.

How to properly collect feces for coprogram?

The material can be collected by the patient himself at home. The material should be collected after spontaneous defecation ( not after an enema). To collect the material, you should purchase it from a pharmacy ( or take it to the laboratory) a special sterile container with a screw cap to which a special spoon is attached ( putty knife). The use of this equipment will prevent contamination of the collected material.

Immediately after defecation, remove the lid from the container and immediately scoop the feces into the container with a spatula ( it should be filled approximately 25 – 30%). It is important to ensure that the collected material does not contain traces of urine, menstrual fluid or water from the toilet, as this can lead to a significant distortion of the research results.

Immediately after collecting stool, close the lid of the container tightly. The resulting material must be delivered to the laboratory as early as possible. If this cannot be done immediately ( for example, the material was collected in the evening when the laboratory was closed), the container can be stored in the refrigerator ( at temperatures from +4 to +8 degrees) for 8 – 12 hours.

When collecting stool for analysis, it is unacceptable:

Use non-sterile glassware. It is forbidden to collect stool in matchboxes or cardboard boxes, as this can change the appearance of the stool, and foreign matter may also get into it. In addition, this method of collecting, storing and transporting feces poses a danger to others ( increased risk of contamination and bacterial infection).
Store feces at temperatures above +8 degrees. High temperature stimulates the growth of bacteria, as well as the processes of rotting and fermentation. If stool is stored at room temperature for at least 2 to 3 hours, this can significantly distort the analysis results.
Store stool for more than 12 hours. During long-term storage of a material, its chemical properties change, the amount and nature of microflora and other indicators change. If the collected material could not be delivered to the laboratory within 12 hours, it should be destroyed. To collect new material, you should take a new one from a pharmacy or laboratory ( sterile) container. Do not rinse the old container and use it to collect a new portion of feces.

How long does it take to make a coprogram?

Analysis results can be obtained approximately 5 - 6 days after the material is submitted to the laboratory. During this time, the laboratory assistant performs a macroscopic and microscopic examination of the stool, identifying the presence of foreign impurities, pathogenic bacteria and other harmful substances in the stool.

What does a coprogram normally show in adults and children?

When assessing the characteristics of feces, the laboratory technician performs a macroscopic examination ( visual) and microscopic examination. Also, if necessary, a number of chemical tests are performed to identify certain abnormalities in the composition of feces.
Macroscopic description of feces ( norm)

Index	Normal for an adult	Normal for infants
*Quantity*	100 – 200 grams per day.	Up to 50 grams per day.
*Form*	Cylindrical ( sausage-shaped).	Pasty stool.
*Consistency*	Soft ( rather dense), thick.	Pasty stool.
*Presence of foreign inclusions*	A small amount of undigested food remains ( predominantly plant-based).	None.
*Color* *(depends on the nature of the food)*	Light brown or yellowish ( dairy diet).
	Dark brown ( meat diet).
	Brown with a greenish tint ( plant based diet).
	Brown-red ( when eating beets, carrots, watermelon and other “red” foods).
*Smell*	Characteristic unpleasant odor of feces.
*Acidity* (pH )	Neutral reaction ( 7,0 – 7,5 ).	Acid reaction ( 5,0 – 6,0 ).
*Slime*	Absent.
*Blood*	Absent.
	None.

Microscopic description of stool ( norm)

Index	Normal for an adult	Normal for infants
*Leftover food*	A small amount of digested muscle fibers.	There are no muscle fibers or other food debris.
*Indigestible fiber* *(rough parts of plants)*	Present unchanged.	May be present if appropriate foods are included in the child's diet.
*Digestible fiber* *(plant food)*	Absent.	Absent.
*Starch*	Absent.	Absent.
*Fats*	Can be detected in small quantities.	Very little or none.
*Soap*
*Fatty acid*
*Leukocytes* *(immune system cells)*	Single leukocytes may be detected.	Single.
*Red blood cells* *(red blood cells)*	None.	None.
*Tumor cells*	None.	None.
*Calcium oxalates*	May occur when eating large amounts of fresh vegetables.	None.
*Cholesterol crystals*	Present ( excreted into the intestines along with bile).	Can be determined.
*Detritus*	The main substance that makes up feces.
*Microorganisms* *(bacteria)*	Normal intestinal microflora makes up about 40% of feces.	Mainly lactic acid bacteria.

Decoding the results of the coprogram ( by quantity, shape, color, smell, acidity, microscopic characteristics)

Changes in the external, macroscopic and microscopic characteristics of feces may indicate the presence of certain diseases of the digestive system, liver, pancreas, and biliary tract. Also, changes in stool may be characteristic of metabolic disorders in the body and other diseases.
A change in the amount of stool may indicate:

malabsorption in the intestines;
enteritis ( inflammatory diseases of the small intestine);
amyloidosis of the small intestine;
colitis ( inflammatory diseases of the large intestine);
eating disorders;
pancreatitis).

A change in the shape of stool may be a sign of:

rectal cancer;
polyp ( benign tumor) rectum;
hemorrhoids;
anal sphincter spasm;
lesions of the large intestine ( colitis).

Changes in the color of stool may indicate:

the nature of the food taken;
taking certain medications;
liver failure;
diseases of the biliary system ( cholangitis, stones in the bile ducts);
pancreatic diseases ( lack of digestive enzymes);
dysbacteriosis ( development of pathogenic bacteria in the intestines);
accelerated intestinal motility;
bleeding in the gastrointestinal tract;
typhoid fever;
cholera

Changes in stool odor may occur with:

excess protein foods;
dysbacteriosis;
tumor disintegration in the intestine;
strengthening the processes of decay and fermentation in the intestines.

Changes in stool acidity may indicate:

excess protein in the diet;
increased decay processes in the intestines;
enteritis ( inflammatory process in the small intestine);
putrefactive colitis ( inflammatory process in the large intestine);
pancreatitis ( pancreatic lesion);
liver damage;
obstructive jaundice ( damage to the biliary tract);
dysbiosis.

The presence of undigested muscle fibers and connective tissue in the stool may be a sign of:

pancreatitis;
pancreatic insufficiency;
insufficient secretion of gastric juice;
increased peristalsis ( motor skills) stomach and/or intestines;
poor chewing of food.

The presence of a large amount of digestible fiber in stool indicates:

on accelerated motility of the gastrointestinal tract;
for anacid gastritis ( inflammatory disease of the stomach, accompanied by a decrease in the production of gastric juice).

The presence of starch in stool may be a sign of:

malabsorption in the small intestine;
enteritis ( inflammation of the small intestine);
increased intestinal motility;
dysfunction of the pancreas.

The appearance of neutral fats, fatty acids and soaps in the feces can be observed when:

diseases of the biliary tract;
liver diseases;
diseases of the pancreas;
accelerated intestinal motility;
enteritis ( inflammation of the small intestine);
thyroid disease ( thyrotoxicosis).

The appearance of a large amount of mucus in the stool indicates:

enteritis ( inflammation of the small intestine);
colitis ( inflammation of the large intestine);
dysentery;
intestinal ulcer.

The appearance of a large amount of columnar epithelium in the stool is a sign of:

enteritis;
colitis;
benign intestinal tumors;
malignant intestinal tumors.

The appearance of leukocytes in the stool indicates:

enteritis;
colitis;
gastritis;
dysentery;
nonspecific ulcerative colitis;
tuberculosis of the intestine;
other infectious diseases of the gastrointestinal tract.

The appearance of traces of blood in the stool may indicate:

bleeding in the gastrointestinal tract;
ulcerative lesions of the intestinal mucosa;
inflammatory lesions of the gastrointestinal tract ( gastritis, enteritis, colitis);
tumor disintegration in the intestine;
anal fissure;
haemorrhoids;
damage to gums when brushing teeth.

Pathogenic microorganisms appear in stool when:

dysbacteriosis;
dysentery;
treatment with antibiotics;
strengthening fermentation processes in the intestines;
fungal infections of the intestines and so on.

Pathological indicators of coprogram

As mentioned earlier, the composition, shape and consistency of feces can change significantly with various diseases of the gastrointestinal tract. If the digestion process does not occur fully, many undigested foods will be excreted in the feces. At the same time, with other diseases, blood impurities, pathogenic bacteria, mucus and other substances that should not normally be there may appear in the stool. The detection of these substances allows one to suspect a particular disease or even make an accurate diagnosis.
Macroscopic description of feces in various diseases

Index	Characteristic	Possible diseases
*Quantity*	*Increased*	Damage to the pancreas ( due to a lack of digestive enzymes, food is not digested and is excreted unchanged).
*Quantity*	*Increased*	Intestinal diseases ( food products are not absorbed through the affected intestinal mucosa and are excreted in feces).
*Form*	*Thread-like* *(thin)*	May indicate the presence of an obstruction in the path of feces ( rectal tumor, hemorrhoidal node).
*Form*	*Unformed* *(liquid, mushy stool)*	It is observed when fluid absorption in the intestine is impaired.
*Color*	*Grayish* *(clayey)*	Diseases of the liver and biliary tract, in which bile stops flowing into the intestines and taking part in the digestion of food. Because of this, stool becomes discolored.
	*Grey*	Damage to the pancreas, in which the secretion of digestive enzymes is disrupted.
	*Yellow*	Accelerated passage of food through the gastrointestinal tract.
		Lack of bile.
		Destruction of intestinal microflora by antibiotics or infection.
	*Black*	Bleeding from the upper gastrointestinal tract ( esophagus, stomach, duodenum). The blood is digested by digestive enzymes, causing it to turn black.
	*Red* *(scarlet)*	Bleeding from the lower gastrointestinal tract ( blood is not digested by digestive enzymes and is excreted pure in feces).
	*Type of "pea soup"*	Typhoid fever.
	*Type of "rice water"*
*Smell*	*Fetid*	Indicates an increase in the processes of decay in the large intestine.
*Smell*	*Sour*	Indicates an increase in fermentation processes in the large intestine.
*Acidity* (pH)	*Alkaline reaction* *(8,0 – 8,5* )**	Increased putrefaction in the intestines.
		The presence of inflammatory disease of the stomach or intestines.


		*The worms themselves or their eggs can be found on the surface of the stool.*

Microscopic analysis of stool for various diseases

Index	Characteristic	Possible diseases
*Undigested muscle fibers*		Pancreatic dysfunction ( the gland does not produce enzymes that are necessary for the digestion of muscle fibers, as a result of which they are excreted unchanged along with feces).
		Lack of gastric juice also disrupts the digestion of muscle fibers.
		Increased intestinal motility promotes food moving too quickly through the gastrointestinal tract, as a result of which muscle fibers do not have time to be digested and absorbed.
*Connective tissue*	*Present*	Lack of gastric juice.
		Pancreatic dysfunction.
		Poor chewing of food.
*Digestible plant fiber*	*Present in large quantities*	Violation of the secretion of gastric juice is accompanied by insufficient loosening of fiber, as a result of which it mixes poorly with digestive enzymes and is excreted unchanged in feces.
*Digestible plant fiber*	*Present in large quantities*	Accelerated motility of the gastrointestinal tract promotes the release of fiber, since it does not have time to be digested.
*Starch*	*Present*	Malabsorption in the small intestine.
		Pancreatic insufficiency.
		Accelerated intestinal motility.
*Neutral fats*	*Present*	Diseases of the pancreas in which the secretion of the enzyme lipase is impaired. Lipase is responsible for the digestion of fats. With its deficiency, fats are not digested.
*Neutral fats*	*Present*	Diseases of the liver and/or biliary tract, in which there is insufficient flow of bile into the intestines. Bile is necessary so that fats can be digested and absorbed in the intestines. Without it, fats will also be excreted in the feces.
*Soap*	*Present*	Liver diseases accompanied by insufficient production or secretion of bile.
*Slime*	*Present in large quantities*	Inflammatory diseases of the small intestine ( enteritis) or large intestine ( colitis).
*Cylindrical cells*	*Present* *(in mucus)*	Inflammatory bowel diseases.
*Cylindrical cells*	*Present* *(in mucus)*	Tumor diseases of the intestine.
*Leukocytes*	*Present in large numbers*	White blood cell count ( immune system cells responsible for fighting infections) in feces increases in inflammatory and infectious diseases of the gastrointestinal tract.
*Unchanged red blood cells* *(red blood cells)*	*Present*	Inflammatory processes in the lower intestines.
		Bleeding from the lower intestine or perianal area ( for hemorrhoids, anal fissure).
		Disintegration of the tumor in the lower intestine.
*Charcot-Leyden crystals*	*Present*	Allergic process in the gastrointestinal tract.
*Charcot-Leyden crystals*	*Present*
*Pathogenic microorganisms*	*Present*	Identification of pathogenic microorganisms ( different from normal intestinal microflora) is carried out using microscopy. If necessary, bacteriological culture is performed, which makes it possible to determine the type of infectious agent and select the most effective antibacterial treatment.
*Iodophilic flora* *(special bacteria that are detected when stool is treated with special solutions)*	*Present*	Strengthening fermentation processes in the intestines.
	*Present*	Acceleration of gastrointestinal motility.
*Yeast cells*	*Present in large numbers*	A large number of yeast cells in stool indicates that the stool has been stored for too long. The reliability of the analysis in this case may be questionable.
*Bilirubin*	*Present*	A component of bile that appears in the stool during severe diarrhea ( diarrhea) .

Fecal occult blood test

This analysis allows you to detect even the smallest traces of blood in the stool. This is necessary in cases where the doctor suspects that the patient has hidden or extremely minor bleeding. In this case, it will be impossible to detect blood in the stool with the naked eye or using microscopy, but special chemical treatment of stool will make it possible to determine its presence.

The essence of the analysis is that feces are treated with a special substance that reacts with hemoglobin ( pigment present in red blood cells). If there is hemoglobin in the stool, after a chemical reaction the stool changes its color. If hemoglobin ( and therefore blood) is not present in feces, there will be no color change. This test is extremely sensitive and can detect even the smallest traces of blood.

Where to make a coprogram?

A coprogram can be done in almost any large hospital, clinic or laboratory in the city. If a doctor has given a referral for testing, it can be performed free of charge ( under compulsory health insurance policy). In other cases, you will have to pay for the analysis ( on average from 60 to 600 rubles, which depends on the city, clinic and laboratory).

In Moscow

Clinic name	Address	Telephone
*Medical Center "Miracle Doctor"*	St. Shkolnaya, house 11.	7 (495 ) 967-19-78
*SM clinic*	St. Klara Zetkin, house 33/28.	7 (499 ) 519-38-82
*Medical Center "On Clinic"*	St. Vorontsovskaya, house 8, building 6.	7 (495 ) 927-02-85
*Treatment and diagnostic center "MedCentreService"*	Vernadsky Avenue, house 37, building 1a.	7 (495 ) 927-03-01
*Scandinavian Health Center*	St. 2 Kabelnaya, building 2, building 25.	7 (495 ) 125-22-36

In St. Petersburg

In Voronezh

Clinic name	Address	Telephone
*City clinic number 7*	St. Writer Marshak, house 1.	7 (473 ) 263-09-60
*Medical Diagnostic Center "Zdorovye"*	Leninsky Prospekt, building 77.	7 (473 ) 248-15-92
*Medical Center "Healthy Family"*	Leninsky Prospekt, building 25/1.	7 (473 ) 261-46-21
*Medical laboratory "Invitro"*	St. Vladimir Nevsky, building 55a.	7 (473 ) 261-99-10
*Voronezh Regional Clinical Consultative and Diagnostic Center*	Lenin Square, building 5a.	7 (473 ) 202-02-05

In Krasnodar

Clinic name	Address	Telephone
*Laboratory "Hemotest"*	Chekistov Avenue, building 12, building 1.	7 (861 ) 265-09-00
*Medical laboratory "Helix"*	St. Korenovskaya, house 21.	7 (861 ) 992-45-17
*Treatment and diagnostic center "Health Corporation"*

Ophthalmology. Urology and nephrology. Medicines. Allergy. Cosmetology. Proctology

Coprogram: norms and interpretation of results. What types of stool tests are there, their interpretation and what can be detected Fecal microscopy for protozoa

Indications for scatological examination

Decoding coprograms in children and adults

Daily volume

Increased amount of feces - reasons:

Decreased amount of feces - reasons:

Consistency

Abnormal consistency of stool - causes:

Undigested food

Mucus in stool - causes:

Blood

Blood in stool - causes:

Pus

Acidity, pH

Stool acidity disorders - causes:

hidden blood

Bilirubin in stool – reasons:

Stercobilin

Stercobilin in feces is increased - reasons:

Stercobilin in feces is reduced - reasons:

Soluble protein

Detritus

Ammonia

Starch

Neutral fats

Soap

Digestible plant fiber

Muscle and connective tissue fibers

Leukocytes

Yeasts

Pathogenic flora

general description

Macroscopic examination

Quantity

Consistency

Form

Color

Slime

Blood

Pus

Leftover undigested food (lientorrhea)

Chemical research

Fecal reaction

Reaction to blood (Gregersen reaction)

Reaction to stercobilin

Reaction to bilirubin

Vishnyakov-Triboulet reaction (for soluble protein)

Microscopic examination

Fat is neutral. Fatty acid. Salts of fatty acids (soaps)

Plant fiber

Starch

Iodophilic microflora (clostridia)

Epithelium

Leukocytes

Red blood cells

Worm eggs

Pathogenic protozoa

Yeast cells

Calcium oxalate (oxalic lime crystals)

Triple phosphate crystals (ammonium phosphate-magnesia)

Norms

Macroscopic examination

Chemical research

Tripelphosphates in feces - what does this mean?

Why is it dangerous?

Diagnostics

What to do and how to treat

Qualitative test for stercobilin

How to prepare for a stool test?

Pevzner's diet

Diet according to Schmidt

Feces for occult blood

It is strictly prohibited before the examination

How to take a coprogram?

Coprogram analysis

Norm of indicators

Microscopic examination

Decoding stool analysis in middle-aged and older children and adults

Quantity