A coprogram is a study of feces to determine their properties, chemical and physical composition, the presence of abnormal inclusions to confirm the diagnosis of a disease, as well as to monitor the dynamics of diseases and the effectiveness of therapy.
Fecal contents are formed as the chyme (lump of food) advances through the digestive tract from entering the oral cavity to the anal canal. Therefore, the results of the coprogram are a valuable diagnostic criterion for determining gastrointestinal diseases.
When a coprogram is assigned
In feces, you can find microorganisms of various numbers and types, fecal pigments, undigested food particles, epithelial cells from various areas of the intestine.
In accordance with the peculiarities of fecal contents, an experienced laboratory assistant will easily identify pathological processes that are localized in a particular section of the intestine.
A coprogram is assigned when:
- Helminthic infestation.
- Acute, chronic diseases of the stomach.
- Neoplasms.
- Diseases of the duodenum.
- Various infections.
- Pathologies of the pancreas, liver, gall bladder and ducts.
- Pathological processes in the small intestine.
- To assess the effectiveness of the therapy and the need for treatment correction.
With the help of a coprological analysis, dysbiosis can be detected (a condition when the ratio of normal and pathogenic microorganisms is violated and the latter multiply intensified).
A coprogram is rarely used as an isolated diagnostic method, more often its purpose is combined with other studies. However, despite this, the diagnostic value of coprological analysis is very high.
Rules for Submission of Analysis
There are several simple rules that you must consider when submitting material for this analysis:
- If the patient takes iron preparations or drugs containing bismuth, they will have to be stopped. In addition, do not use laxatives and rectal suppositories. Do not wash the intestines with an enema.
- If the patient underwent contrast radiography, then the analysis of feces can be carried out no earlier than seven to ten days after this, since barium is able to change the properties of feces.
- For several days, before the analysis, exotic dishes should be excluded.
- Forty-eight hours before the delivery of the material, it will be necessary to exclude beets, tomatoes, tomato paste and juice, as well as other products with coloring substances.
- For seventy-two hours, you should stop taking antibiotics and enzymes.
- The diet should include cereal cereals, fruits, dairy products, vegetables. Overeating is not worth it.
- It is necessary to limit spicy, smoked, pickled, fatty foods.
- During menstruation, the coprogram does not give up.
- Collection of feces should be organized so that urine does not enter the material.
- The evacuation of feces for collection should be natural, without the use of enemas and stimulants.
Fecal collection for research
- Before collecting the material, you need to empty the bladder, thoroughly wash the anal area and genitals with warm water and a neutral soap without flavorings. After that, wash the above areas again with boiled water.
- In a clean container with a wide neck with a spatula (included in the set of containers for feces) you will need to collect pieces of feces.
- After collecting the material, the container is tightly closed and signed, indicating the name of the patient and the date of collection.
The use of food cans and wooden boxes as containers is not recommended. The approximate amount of collected feces should be equal to fifteen to twenty grams.
It is necessary to collect the material in the morning and deliver it to the laboratory as quickly as possible (the accuracy of the data obtained depends on this).
If necessary, the filled container can be stored in the refrigerator for no more than eight hours (temperature not higher than five degrees).
The study of feces is carried out for two to three days, sometimes a little more time is required for an answer (five to six days).
Feeding Material in Infants
In infants, feces are collected using oilcloth or diapers (in the case of loose stools).
In the presence of constipation, the stimulation of defecation is carried out using a massage of the abdomen, sometimes a gas tube is placed.
Hands must be washed before collecting material.
Collecting material from diapers is undesirable.
The stool coprogram: decoding in older children and adults (research order)
First, a macroscopy of feces is performed, while assessing:
- The appearance of feces.
- Its density.
- Hue (normal or pathological).
- Smell.
- The presence of blood, undigested food, mucus, pus.
- The presence of helminths.
- The presence of pancreatic or gallstones.
Then, stool microscopy is performed to evaluate the function of digesting food.
Copy of the feces (transcript in children): table
| Physical parameter | Norm |
| Color | All shades of brown. In children up to a year - yellow, greenish |
| Smell | Specific. In children under the age of sour. |
| Consistency | Soft. In children up to a year it may be liquid. |
| The form | Decorated. In children, up to six months can be unformed. |
| Impurities | Are absent. Children under one year old may have mucus. |
| pH | slightly acidic, slightly alkaline, neutral, for children under the age of 6.7-7 |
| Hidden blood, fresh blood | is absent |
| Bilirubin | absent, for children up to six months normal may be present |
| Sterkobilin | + |
| Microscopy | Result |
| Red blood cells | are absent |
| White blood cells | absent, in children up to a year their presence is a normal option |
| Epithelium | unit |
| Muscle fibers unchanged | are absent |
| Detritus | + |
| Soaps | are absent |
| Iodophilic flora | - |
| Starch grains | are absent |
| Fatty acid | are absent |
| Indigestible fiber | + |
| Digestible fiber | Is absent |
| Slime | None, in children under one year of age, its presence is a normal variant |
| Neutral fat | small amount |
Color
The color of feces is normally brown (various shades) due to the presence of stercobilin in it. Shades of feces depend on the diet and medications taken. So, a vegetable diet can give the feces a greenish tint, coffee and blueberries - black, dairy products - light yellow, beets - red, and antibiotics - golden.
With some pathologies, the color of feces also changes:
- Red-brown feces - bleeding from the lower intestines.
- Black - bleeding with ulcers of the duodenum or stomach.
- Green - the presence of enteritis, dysbiosis.
- White-gray feces - diseases of the biliary tract, liver.
When decoding the coprogram of feces in children (see photo below) that are on breast (natural) feeding, yellow, green-yellow, golden-yellow color of feces is determined. Artificial feces are light brown or pale yellow.
In children, up to six months with feces, bilirubin can be released, which gives the feces a greenish color. That is, if, except for green stool, there are no other symptoms, then this condition does not require treatment.
Microscopy
The presence of protein indicates inflammation in the digestive tract, polyps, ulcers and neoplasms. There is no protein in a normal coprogram.
Blood appears in the stool due to bleeding, which can be caused by helminths, tumors, ulcers, polyps. Altered blood indicates bleeding in the upper gastrointestinal tract, and unchanged blood from the lower.
An increase in stercobilin appears in feces with hemolytic anemia. A decrease in this indicator is a sign of blockage of the bile ducts.
The appearance of bilirubin indicates dysbiosis and acute inflammatory processes.
The presence of mucus is a sign of intestinal infections (dysentery, salmonellosis, colitis). However, it is worth considering the age of the child, since with the stool coprogram (decoding in children), mucus may be a variant of the norm (children under one year old).
The presence of pathological flora is a sign of dysbiosis.
In the stool coprogram (when decoding in children), detritus, if its amount is below the age-appropriate norm, can indicate violations in the digestive process.
The presence of a large number of neutral fats is a violation of the secretion or absorption of bile.
Unchanged muscle fibers - pathology of the pancreas.
The presence of starch grains - malabsorption syndrome, chronic pancreatitis.
Soaps (which should normally be small) - problems of the duodenum, pancreatitis, gallstones.
In the stool coprogram (transcript in children), white blood cells in large numbers indicate the presence of inflammatory processes of the gastrointestinal tract.
Fatty acid. Normally not determined. If they are present in the feces, it is worth suspecting the lack of enzymes, the acceleration of intestinal activity and the violation of the outflow of bile.
Plant fiber. If the fibers are insoluble (for example, the peel of vegetables and so on) - this is a variant of the norm, but if soluble fibers are present in the feces - this indicates a lack of hydrochloric acid in the stomach.
Connective tissue fibers are normally absent. Their appearance is a sign of anacid gastritis, pancreatitis.
Elevated ammonia in feces is a sign of intestinal inflammation.
The presence of pathogenic bacteria - bowel disease and dysbiosis.
pH of feces can be different (slightly acidic, slightly alkaline, neutral). This indicator depends on human nutrition.
Features of the results
With the stool coprogram (decoding in children under 1 year of age and infants), the main data of the coprological study are similar to the data of an adult, but there are some features in the children's coprogram.
In children up to a year, the presence of leukocytes in the feces can be observed even in absolutely healthy babies. If the child is gaining weight normally, the parents do not complain, then the presence of white blood cells (as well as mucus) is one of the normal options.
In the majority of children, feces have a neutral or slightly alkaline reaction (pH from 6 to 7.6). However, it is worth remembering that the feces of infants are often acidic, which depends on the nature of the diet.
If, when decoding the stool coprogram in children, feces have an alkaline reaction, in this case it is worth suspecting imperfect absorption or the development of putrefactive processes in the intestine.
For children under three months of age who are breast-fed, bilirubin present in feces is a normal option. When decoding the stool coprogram in older children, only stercobilin should normally be present.