PREANALYTIC

1. FAECES COLLECTION :
A. COLLECT FAECES IN A DISPOSIBLE CONTAINER
B. DO NOT MIX WITH URINE
C. EXAMINE A FAECES WITHIN 30 - 40
IF NOT, PLACE IT IN REFRIGATOR
D. PATIENT RECOMENDED NOT TO EAT SUBSTANCE
BARIUM, BISMUTH IN 5 DAYS
E. WHEN THERE IS OBSTIPATION
CATHARTIC NaCl/Na 2SO4
NOTES :
USE FAECES RANDOM, RARELY 24 HOURS
IMPORTANT EXAMINATION OF FAECES :
- EGGS OF WORM
- PARASITES
- OCCULT BLOOD
SELECT THE PORTION OF FAECES WHICH GIVE LARGE
POSSIBILITY TO FIND ABNORMALITIES

MACROSCOPIC

EXAMINATION
OF FAECES

MICROSCOPIC

CHEMIST

1. FORM
2. COLOUR
3. SMELL
4. CONSISTENCY
5. MUCUS
6. BLOOD
7. PUS
8. REST. OF FOOD
9. PARASITE
1. REST OF FOOD
2. ERITHROCYTE/
LEUKOCYTE
3. AMOEBAE
4. THE EGGS OF WORMS

1. BLOOD
2. STERCOBILIN

- CARBOHYDRATE
- PROTEIN
- FAT
- VEGETABLES

ANALYTIC AND POSTANALYTIC

EXAMINATION OF FAECES
A. MACROSCOPIC EXAMINATION OF THE FAECES
(FRESH FAECES)
1. FORM : A NARROW / RIBBON LIKE FAECES
2. THE COLOUR OF FAECES :
A. NORMAL : BROWNISH / PALE BROWN
B. ABNORMAL :
1) BLACK : MELAENA = BLEEDING FROM THE UPPER GUT
2) CLAY COLOUR : ACHOLIS = DIMINUTION / ABSCENT
OF STERCOBILIN
3) RED = BLOOD, ORIGINATING FROM THE LOWER GUT
= FOOD / BEETS
4) THE OTHER : VEGETABLES DIET
- GREEN
- YELLOW
3. SMELL OF FAECES :
- NORMAL : SMELL WITH INDOL,SKATOL, BUTIRIC ACID
- PUTRESCENT : PUTREFACTION OF PROTEIN BY BACTERIA
- ACID : CARBOHYDRATE FERMENTATION = DIARE
- ROTTEN : FAT
FATTY ACID
- RANCID : BACILLARY DYSENTRI

4. CONSISTENCY OF FAECES :
A. NORMAL : SOFT
B. ABNORMAL :
- HARD : CONSTIPATION
- LIQUID : PAPPY FORM (DIARRHE)
WATERY (CHOLERA)
- + (CO2) : FERMENTATION OF CARBOHYDRATE

5. MUCUS
INFLAMMATION / STIMULATION ON INTESTINE WALLS

TRANSLUCENT GELATINOUS MUCUS :

- SPASTIC CONSTIPATION
- MUCOUS COLITIS
BLOODY MUCUS : INFLAMMATION
MUCUS + BLOOD + PUS : ULCERATIVE COLITIS, BACILLIARY,
DYSENTRY
OUT OF THE FAECES : FROM LARGE INTESTINE
MIX MUCUS : FROM SMALL INTESTINE

6. BLOOD :

- FRESH BLOOD, FAECES LIQUID

FRESH BLOOD, FAECES NORMAL

- BLACK

: MELAENA

7. PUS :

- LOCALIZED ABSCESSES

DYSENTERIAE
ANAL FISSURES
HAEMORRHOID

BROKEN

PUS IN FAECES

8. REST OF FOOD :
- VEGETABLES
- GRAINS

9. PARASITE :

LEGUMINOCEAE, ETC.

- ASCARIS LUMBRICOIDES (ROUND WORM)

- ENTEROBIUS VERMICULARIS

B. MICROSCOPIC EXAMINATION OF THE FAECES

1. REST OF FOOD :
A. CARBOHYDRATE
B. PROTEIN
C. FAT
D. VEGETABLES
2. AMOEBA / OTHER PROTOZOA
3. ERYTHROCYTE / LEUKOCYTE
4. THE EGGS OF WORM
PREPARATION FOR THE TEST
MAKE :

: LUGOL SIDE
: ACETIC ACID SLIDE
: SUDAN III SLIDE
: ACETIC ACID SLIDE
: EOSIN SLIDE
: EOSIN SLIDE
: - DRY SLIDE METHOD
- CONCENTRATION TEST

1. SUSPENSION
OF FAECES
2. REAGENT FOR TEST
(EOSIN, ETC)

PUT THE COVER GLASS ON IT

MIX

EXAMINE BY MICROSCOPE

MICROSCOPIC EXAMINATION OF FAECES

1. REST OF FOOD

CARBOHYDRATE

A. CARBOHYDRATE : LUGOL
AMYLUM / CH + IODIUM BLUE
DEXTRIN

B. 30 % ACETIC ACID

RED MUSCLE
VEGETABLE
CONECTIVE
TISSUE

C. FAT

2. AMOEBA

SUDAN III
RED BALL STRUCTURE
+ EOSIN AS NEGATIVE STAINING

(BACKGROUND : RED COLOUR)

AMOEBA
ERY / LEUKO

COLOURLESS

3. ERYTHROCYTE / LEUKOCYTE : EOSIN (1 - 2%)

MORPHOLOGY APPEAREANCE
SAME LIKE IN THE SEDIMENT OF URINE

K
E

4. THE EGGS OF WORM

A. DRY PREPARATION

STREAK THE FAECES

ALLOW TO DRY ALL

OF THE FAECES
COVER WITH
PARAFIN LIQUIDIUM
THROUGH OUT THE FAECES

MICROSCOPIC
EXAMINATION

ADVANTAGE OF USING PARAFIN LIQUIDUM :

1. THE SLIDE IS CLEAN AND NOT DIRTY
2. THE SLIDE IS GOOD SMELLING
3. THE PANORAMA IN THE MICROSCOPE IS MORE CLEAR
MAKE ATTENTION TO THE EGGS OF WORM OF :

ASCARIS
LUMBROCOIDES

TRICHOCEPHALUS

ANKYLOSTOMA
DUO DENALE

C. CHEMICAL EXAMINATION
1. OCCULT BLOOD EXAMINATION
SMALLER INCREASES IN BLOOD CONTENT MAY NOT ALTER
APPEAREANCE OF THE STOOL
1.A. BENZIDINE TEST
METHOD :

FILTER

FILTRAT

FAECES SUSPENSION

ml
2

1 gr
BENZIDIN
3 ml
ACETIC ACID 3 ml

: GREEN TO BLUE
READ WITHIN 5
H2O2 3%

BENZIDIN TEST :
- VERY SENSITIVE = 10 - 1000 TIMES MORE SENSITIVE THAN
GUAIAC TEST
- THE PATIENT SHOULD HAVE DONE THE BENZIDINE DIET
- OR A MEAT FREE DIET FOR 3 - 5 DAYS

B. CONCENTRATION TEST
ESPECIALLY FOR DETECTION THE EGG OF ANKYLOSTOMA

PRINCIPLE :
SPECIFIC GRAVITY OF THE EGG IS LESS THAN THE SPECIFIC
GRAVITY OF NaCl SOLUTION SO THAT THE EGGS ARE FLOATING
ON THE SOLUTION AND ATTACHED TO THE COVER GLASS

METHOD :

MICROSCOPE

1.B. GUAIAC TEST

GUAIAC IS 20 TIMES LESS SENSITIVE THAN BENZIDINE
GIVE + RESULT WHEN 24 HOURS FAECES CONTAIN A HALF
ml OF BLOOD
GUAIAC HARS IS DIFFICULT TO GET, NEVER BE DONE

PROCEDURES :
MIX
WELL

MIX
WELL

0.5ml
Gl.A A

2 ml WATER
0.5 gr FAECES

1+

2 ++

3 +++

2 ml GUAIAC
SOLUTION

MIX
STARTING
TIMER

OBSERVE FOR 2 MINUTE

RECORD THE MAXIMAL BLUE COLOUR

TRACE

MIX
WELL

4 ++++

2 ml H2O2 3%

2. STERCOBILIN
UROBILIN
PALE RED

5 ml HCl
CONCENTRATE
FAECES 1 - 3 gr

STAND FOR
SEVERAL HOURS
(ONE NIGHT)

BOIL
READ SOON

BILIRUBIN
BLUE COLOUR