Fecal feces, like urine, are the final product of human life . They are formed in the colon as a result of a variety of biochemical processes. They include water, undigested food particles, metabolic products, bacteria and more.
Do not underestimate the analysis of feces (otherwise - a coprogram). Sometimes this study allows you to identify a person's diseases of the stomach and intestines, liver pathology, pancreatitis. But in most cases it is carried out not only for the diagnosis of diseases, but also for monitoring treatment.
Let's look at this topic in more detail and define: sterkobilin in feces is positive - what is it?
Basic concepts
A coprogram, or analysis of feces, is one of the most important ways to study the functions of the digestive system with a large set of indicators. It reveals diseases of the stomach, liver, small and large intestine, gall bladder, pancreas, and also allows you to track the development and progression of already obvious diseases.
As a result of the coprogram, you can:
- Examine the physical and chemical properties of feces. This is color, consistency, sterkobilin in feces (you should not be afraid of a positive reaction, because it is normal), etc.
- Perform a microscopy of the material.
- Identify helminth eggs.
- Detect occult fecal blood.
- Make a bacteriological study (detection of pathogenic microorganisms, analysis of feces for stercobilin and intestinal microflora).
Four stages of fecal analysis
The coprogram consists of several stages:
1. The study of the physical properties of feces. During its conduct, the appearance of the stool is determined: color, shape, texture, smell, the presence of pathological microorganisms and impurities, the identification of undigested food particles, parasites.
2. Chemical examination includes the identification of several indicators (blood in the stool (which cannot be detected with the naked eye), bilirubin, stercobilin in feces and other substances).
3. Microscopic examination is used to assess the degree of assimilation of food, the presence of parasites and yeast.
4. Bacteriological analysis, as a rule, is carried out in order to detect dysbiosis, disorders of microflora and pathogenic bacteria.
How to prepare for the delivery of feces for analysis?
To obtain more accurate results 3 days before the study, you must adhere to several rules.
Firstly, it is strictly forbidden to do a cleansing enema. And also do not take medications (laxatives or antidiarrheals) that affect the intestines.
Secondly, suppositories should not be injected into the anus or other similar medications.
Thirdly, do not use drugs that change the color of feces.
And most importantly, doctors recommend that before you do a feces analysis (reaction to sterkobilin), adhere to a certain diet. Two types are suitable for this purpose:
- Pevzner's diet. Its main goal is to maximize the load on the human body. Within one day, you need to eat 400 g of white bread, 250 g of fried meat, 100 g of butter, 40 g of sugar, buckwheat or rice porridge, fried potatoes, lettuce, sauerkraut, compote and apples. Calorie content is quite high - 3250 kcal. If you choose this diet, be sure to consider the state of your digestive system. It will detect even a small degree of digestive upset;
- Schmidt's diet. This daily diet includes 1-1.5 liters of milk, 2-3 boiled eggs, white bread and butter, 125 g minced meat, 200 g mashed potatoes, 40 g boiled oatmeal. The daily calorie content is 2250 kcal. Food should be divided into 5 receptions.
Preparation for stool examination for occult blood
Before examining stool for occult blood, doctors strongly recommend that patients eat foods such as green vegetables (cucumber, cabbage, zucchini, green pepper, broccoli, and others), meat products, fish, eggs.
In addition, you need to refrain from taking medications that contain iron.
In the case when a person urgently needs to make a coprogram and determine what the reaction to stercobilin in feces will be, or the patient cannot adhere to one of the above diets for health reasons, experts recommend not drinking alcohol and coffee the day before the study.
The main rules when collecting a chair
For research, you need to take only morning feces. After stool, the patient collects a small amount of feces with a wooden spoon or spatula and places it in a clean container, then closes it tightly. In order to identify stercobilin in feces, 10-15 g of stool is enough.
There are some recommendations for collecting feces:
1. Rinse the back of the body well before collecting feces.
2. Women should not collect feces during menstruation, because there should be no admixture of menstrual blood in the stool.
3. It is not recommended to collect feces after undergoing x-ray examination of the esophagus with barium.
4. You can not collect feces after the introduction of suppositories and other drugs that affect the color of feces.
5. It is not recommended to collect after an enema and use laxative tablets that affect the digestive system.
After collecting the feces, wash your hands thoroughly with soap and dry them with a clean towel!
Other important recommendations
To detect fecal eggs of helminths, feces should be fresh and stored until delivery to the hospital in a warm place.
For bacteriological examination of feces (especially stercobilin in feces in a child), the patient needs to receive a sterile cotton swab in the laboratory. Only a specialist will enter the tube into the anus.
To detect hidden blood in feces, it is necessary to exclude meat and mushrooms, as well as drugs with iodine, bromine and iron, from the diet for 3 days before analysis. On the fourth day, the patient collects feces and sends to the laboratory.
In severe constipation, a special massage of the colon should be performed. If this does not lead to anything, the doctors give an enema and take only dense stools for examination.
Normal analysis rates. Sterkobilin in feces positive - what is it?
The norm is a dense texture of feces and a cylindrical shape. The color is brown, without pungent and harmful odors. During a visual inspection, food particles and harmful parasites should not be detected.
Microscopic examination of feces should not contain blood cells, muscle fibers of connective tissue, fats, starch, eggs of harmful parasites, yeast and simple organisms (amoeba, giardia).
Samples for occult blood, protein, and bilirubin should usually be negative. If you have a normal analysis of feces, the reaction to sterkobilin is positive, since it is this pigment that gives the feces a brown color.
Abnormal indicators
The main indicators that are uncharacteristic of a normal stool:
1. Shapeless feces.
2. Feces too hard.
3. Pungent smell.
4. The presence of visible or hidden particles of blood.
5. Positive reaction to bilirubin.
6. The presence of muscle fibers.
7. Fat was found in the stool.
8. A change in color (black or the color of white clay), which indicates that stercobilin is absent in feces.
9. The presence of food particles.
10. The presence of white blood cells (white blood cells).
11. Larvae and eggs of dangerous parasites.
12. Giardia and amoeba.
Analysis of the results of a coprogram in a child
Deciphering the analysis of feces of children should be carried out by a pediatrician or pediatric gastroenterologist. In the study, it is important to consider the age of the child and the nature of the food. In children under the age of one year who are not yet eating solid food, a high concentration of undigested muscle fibers and fats in the feces is allowed.
If the baby has a lactase deficiency (an enzyme that breaks down milk sugar - lactose), stool can be found in the feces.
With dysbiosis, stool analysis is an additional research method. The main considered microbiological analysis. However, the coprogram shows stercobilin in the feces, positive in the child or negative, whether the intestines are inflamed (mucus and fecal leukocytes are found in the feces), digestion and absorption of carbohydrates, proteins and fats are disturbed (muscle fibers, fats, starch in the stool are detected). After the analysis, the doctor can conclude that the child has dysbiosis.
If the baby has hepatitis, feces become grayish-white in color and resemble clay. This suggests that sterkobilin is absent in the feces of the baby (which stains the normal stool brown) and the bile ceases to enter the intestines.
If the child has chronic pancreatitis, the frequency of bowel movements per day will be increased, the color of the stool will turn gray. The stool consistency with pancreatitis is pasty, the smell is sour. Muscle fibers, fats, starch and a large number of white blood cells can also be detected - all these are signs of inflammation in the body and that stercobilin is absent in the feces.
Black stool in a child and the presence of latent blood in it is a consequence of the formation of ulcers in the stomach.
Diseases that provoke changes in the composition of feces in adults
For diseases of the digestive system it is very important to monitor the increase in the amount of feces during the day. Usually this is due to pathological processes leading to impaired digestion and absorption of food and water in the intestine. A decrease in the number of stools per day is observed in diseases that are characterized by prolonged constipation, such as peptic ulcer. Let us consider in more detail the main changes in the composition of feces, which indicate the appearance of various diseases:
1. Discoloration of feces is observed, as a rule, with cholestasis. In this case, gallstones are formed, which disrupt the outflow of bile into the intestine. Jaundice develops, the stool loses color, acquiring a white hue. In the case (we are talking about a study when stercobilin is determined in the feces) of a positive reaction, the color of the feces would be brown, and the state of the body would be normal. The appearance of discolored feces with obstructive jaundice is mainly combined with nausea, belching, and an increase in body temperature. If the stool turns black, it means that the patient has a peptic ulcer. This is due to rupture of blood vessels at the bottom of the ulcer. Esophageal varicose veins are common in people with cirrhosis.
2. The appearance of blood particles in the feces. If fresh blood was found during visual examinations, then this indicates the appearance of diseases such as ulcerative colitis, hemorrhoids, anal fissures, dysentery.
3. Change in stool odor. The sharp, sour, unpleasant smell of feces is the result of the appearance of inflammatory processes in the body, a sign of chronic pancreatitis and confirmation that sterkobilin is absent in the feces. This disease is characterized by insufficient production of pancreatic juice, which is involved in the digestion of carbohydrates, proteins and fats in the body. A large amount of undigested food residues leads to an increase in putrefactive bacteria, which causes a sharp smell of feces.
4. The presence of protein in the stool indicates the occurrence of chronic atrophic gastritis, in which gastric juice is not produced in the stomach. With its deficiency, the protein in the small intestine does not break down, but leaves the body with feces. Other symptoms of chronic atrophic gastritis are heaviness in the stomach after eating, belching with a rotten smell. Chronic pancreatitis also leads to the appearance of protein in the stool. Its symptoms are bloating, unpleasant pain in the epigastric region or around the navel, and a low body mass index.
5. Hidden blood in the stool. Blood cannot be seen with the naked eye. These microscopic particles can only be detected by passing a special analysis for occult blood. It occurs with ulcers in the stomach and inflammation of the duodenum. Polyps of the stomach or intestines - a disease that is characterized by proliferation of the mucous membrane, the formation of polyps that cover the walls of the intestine or stomach. Food passing through the digestive tract damages polyps, which leads to the appearance of a small amount of blood that enters the feces. Helminthiasis or the presence of worms in the intestine also causes hidden blood to be detected in the feces, as harmful parasites damage the intestinal wall.
6. Positive reaction to bilirubin. Bilirubin is a bile pigment that, under the action of the microflora of the colon, turns into stercobilin. Acute gastroenteritis and food poisoning lead to an increase in the rate of passage of food through the digestive tract. Bilirubin bile simply does not have enough time to turn into stercobilin in the colon, and then it is simply excreted in feces. A positive reaction to stercobilin in feces (a positive result is the norm) would mean that everything in the body is in order.
7. The presence of mucus in the stool. Mucus is a jelly-like substance that serves to better glide food. It is impossible to detect with the naked eye, because it is evenly mixed with feces. The appearance of mucus in the feces indicates inflammation of the colon, as well as the occurrence of infectious diseases: dysentery and salmonellosis.
8. The appearance of muscle fibers in the stool is a consequence of chronic atrophic gastritis and chronic pancreatitis.
9. The presence of fat in the stool is the result of a violation of the pancreas, which produces a special substance - lipase, which breaks down fat in the intestines.
10. The detection of fecal starch is characteristic of chronic pancreatitis.
11. The presence of white blood cells in the stool. White blood cells, or white blood cells, are designed to fight infections in the body. If they appear in the feces, then this indicates the occurrence of inflammatory processes in the intestine.
12. Fecal parasites. As a rule, in the study of feces, parasites should not be detected. This suggests that eggs, harmful cysts, and helminth larvae are absent. If the result is positive, then some type of helminth was found in the feces.
13. The appearance of giardia in the feces. Giardia is a parasite that lives in the intestines. Accurate diagnosis of giardiasis is additionally carried out using special blood tests. The appearance of giardia in the body is accompanied by severe abdominal pain.
So, now we know that the digestive system can be judged on the basis of an analysis called a coprogram. Doctors strongly recommend conducting it every 6 months in order to track the appearance of possible diseases in the body.