Examination of stool by modern and ayurveda Technique

This presentation provides a detailed insight into the laboratory examination of stool (feces) — a vital diagnostic tool for evaluating gastrointestinal (GI) disorders, parasitic infestations, malabsorption syndromes, and intestinal infections.

It covers the collection, physical, chemical, and microscopic examination of stool specimens, along with interpretation of abnormal findings. Designed for medical and paramedical learners, this presentation bridges theory with practical diagnostic value.

🔍 Overview:

Stool examination helps detect abnormalities in the digestive system, identify intestinal pathogens (bacteria, parasites, fungi), and assess digestive function.
A properly collected and examined stool sample can reveal:

Parasitic infestations (e.g., Entamoeba histolytica, Giardia lamblia)

Bacterial infections (e.g., Salmonella, Shigella)

Malabsorption and steatorrhea

Occult gastrointestinal bleeding

🧪 Key Topics Covered:

Introduction

Definition and purpose of stool examination

Clinical significance in gastrointestinal and systemic diseases

Specimen Collection

Ideal method and timing of sample collection

Use of preservatives (formalin, SAF, PVA)

Common errors in collection and their prevention

Macroscopic (Physical) Examination

Colour: clues to bile pigment disorders, bleeding, diet, or infection

Consistency: normal vs. diarrhoeal or constipated stool

Odour and quantity

Presence of mucus, pus, blood, or worms

Microscopic Examination

Saline Wet Mount: detection of ova, cysts, larvae, trophozoites

Iodine Mount: highlighting internal structures of cysts

Staining Techniques: Lugol’s iodine, trichrome, acid-fast stain (for Cryptosporidium, Cyclospora)

Red and White Blood Cells: indication of infection or inflammation

Undigested food particles and fat globules: assessment of digestion

Chemical Examination

Occult blood test (Guaiac test)

pH, reducing substances, and fat estimation

Detection of bile pigments and bile salts

Common Findings and Interpretation

Protozoal, helminthic, and bacterial infections

Diagnostic importance of specific findings in clinical correlation

Precautions and Biosafety

Handling infectious material safely

Disposal and disinfection protocols

Conclusion

Stool examination remains a simple, non-invasive, yet powerful diagnostic tool for evaluating gastrointestinal health.

🎯 Learning Outcomes:

After viewing this presentation, you will be able to:

Collect and process stool samples correctly

Identify normal and abnormal findings microscopically

Correlate stool abnormalities with disease conditions

Apply biosafety measures in diagnostic microbiology

👨‍⚕️ Best Suited For:

Medical and Paramedical Students (BAMS, MBBS, BSc MLT, Nursing)

Microbiology and Pathology Laboratory Staff

Public Health Workers and Researchers

Clinical and Diagnostic Laboratories

📌 Keywords:

Stool examination, fecal analysis, ova and cysts, parasitology, intestinal infection, GI disorders, occult blood, micros

1. Stool Examination Presented By:-Dr. Nayan Mehar MD 1 st Year Department Of Roga Nidan Evum Vikriti Vigyan

2. General Consideration Laboratory diagnosis of parasitic infection is mainly based on microscopic examination of the stool specimen. Sometimes gross examination of specimen may be helpful. Depending on the nature of parasites, the microscopic observation include the identification of cysts, ova, trophozoites , larvae or portion of the adult structure.

3. Collection of stool specimen Use dry containers (50 ml), various types of containers are used Disposable wide mouth plastic or glass bottle Waxed cardboard box Glass jar with fitting lid Collect sufficient quantity of the specimen : morning specimen at least 5-6ml capacity is collected in 50 ml clean and dry containers

4. Precautions After Collection Of Stool Specimen The specimen container should be labeled indicating identification number. The name of the paient , date and time of specimen collection are entered in the register meant for stool examination Stool specimen should not be left uncovered. It is necessary to prevent drying effect Stool specimen should be examined within 1 hr of collection Specimen should be disposed off properly after the examination

5. Examination of stool specimen Gross or Physical examination Consistency Colour Mucus Blood Parts of parasite and adult parasite Chemical examination Reaction pH Occult blood

6. Examination of stool specimen Microscopic examination Protozoans Nematohelminths Platyhelminths Plant cells & fibres Meat fibres Crystals Fat globules Yeast cells Bacteria Erythrocytes Pus cells

7. Examination of stool specimen Physical Examination Consistency and Form Normal Abnormal Clinical condition Well formed Pale , bulky, frothy Steatorrhoea (Poor fat digestion) Hard Constipation Flattened & Ribbon like Obstruction in lumen of bowel Semisolid Mild diarrhoea , After taking Laxatives, Digestive upsets Watery Bacterial infection, Purgative Rice water stools (Copious thin with white flakes Cholera

8. Examination of stool specimen Physical Examination ( Colour ) Normal Abnormal Clinical condition Light to dark brown (due to presence of bile pigments) Black Bleeding in upper GIT, Iron administration Bright red Bleeding in lower GIT, Bleeding piles, Contamination with Menstrual blood Fresh blood & mucus Amoebic dysentery Clay coloured Post hepatic jaundice, Obstruction to flow of bile White After barium meal

9. Examination of stool specimen Physical Examination Presence of adult worm or their parts Large round worms Pin worms Whip worms Tap worms Hook worms

10. Examination of stool specimen Chemical examination Reaction or pH Normal stool are slightly acidic, neutral or slightly alkaline pH values range from 5.8 – 7.5 Strongly acidic (<5.5) Excess of carbohydrate in diet (Non-pathogenic) Fermentation due to lactose intolerance (Pathogenic) Strongly alkaline (>7.5) Excess of protein in diet (Non-Pathogenic) Occult Blood ( Benzidine test ) Positive test indicates presence of blood in stool

11. Microscopic examination Detection Normal Abnormal Condition Image Pus cells Present, few Many Ulcerative colitis Bacillary dysentery Epithelial cells Present , few Many Inflammation of bowel Erythrocytes Absent Present Lesion in the colon, rectum or anus. They clump in amoebiasis Calcium oxalate & Triple phosphate crystals Present due to ingestion of spinach,tomato - Charcot leyden crystals Absent Present Ulcerative conditions Amoebiasis Hematoidin crystals Present Intestinal hemorrhage

12. Microscopic examination Detection Normal Abnormal Condition Image Vegetable cells, spirals, fibers hairs etc Present, residual constituents - - Animal matter Muscle fibers, elastic tissue Present , residual content or undigested fibers - - Undigested ingredients Starch Absent Present in high proportion Indigestion Fat Absent Present in high proportion Indigestion Yeast cells Present especially Blastocystis hominis - - Bacteria Gram negative prominating bacteria High % of Gram positive bacteria Suggest Intestinal ulceration

13. Microscopic examination Organism Type Image Entamoeba histolytica (Cyst & Vegetative form) Pathogenic Entamoeba coli (Cyst & Vegetative form) Non pathogenic Giardia lamblia (Cyst & Vegetative form) Pathogenic Balantidium coli (Cyst form) Pathogenic Endolimax nana (Cyst form) Non pathogenic Intestinal Protozoa

14. Microscopic examination Organism Type Image Taenia solium & Taenia saginata ( Tapewrom ) Pathogenic Trematodes Schistosoma hematobium Pathogenic Schistosoma mansoni Pathogenic Schistosoma japonicum Pathogenic Platyhelminths

15. Ayurvedic Approach to Physical Examination of Stool Colour Froth Consistency Odour Volume Associated symptoms Special examination of Stool Jala Nimajjan Pariksha ( Sama / Nirama pariksha )

16. Thank you

17. Ayurvedic approach to Physical examination of Stool Abnormal Colour of stool Krishna Varna Shyava ArunVarna Shukla Varna Rakta Varna Vataja Jwara Vatika Udara roga Shlesmika Jwara , Pittolvana Kaphahina Sannipataja Jwara Vatika Arsha Vatika Arsha Shlesmika Udararoga Kamala Vatika Pandu Vatika Atisara Shlesmika Arsha , Pittaja Atisara Vatika Gulma Vata Prakopa Shlesmika Pandu Raktapitta Kumbha kamala Rakta pitta Shakhashrita Kamala Sahaja Arsha Paittaka Atisara Vataja Gulma Shlesmika Atisara , Pittaja Jwara Vatika Arsha Vataja Arsha Sahaja Arsha Chhidrodara Vata Prakopa Vataja Jwara Jalodara Vataja Pandu Kaphaja Gulma

18. Ayurvedic approach to Physical examination of Stool Odour Diseases Durgandhita Shlesma Atisara, Paittika Pandu, Asadhya Sannipataja Chhardi , Ama purisha, Purishavaha Srotodusti, Samaatisara , Vid Vighata Atidurgandhita Paittika Atisara, Paittika Arsha Amagandhi Ama Atisara Visragandhi Paittika Arsha, Shleshmika Atisara Kunapagandhi Chhidrodara , Sahaja Arsha Nirgandha / sagandha Aagantuja Atisara Altered odour of stool in pathological conditions

19. Ayurvedic approach to Physical examination of Stool Touch Diseases Shita Ajirna , Shleshmika Atisara Singdha Shleshmika Arsha, Kaphaja Atisara Ushna Paittika Arsha Ruksha Vataja jwara , Vataja Atisara Altered touch of stool in pathological conditions

20. Ayurvedic approach to Physical examination of Stool Quantities/Frequencies Diseases Alpa Sannipataja jwara , Vatika Arsha, Pandu, Vataja Atisara Vataja Pakva Atisara, Purishavaha dushti,Devaunmat Purusha Alpa-Alpa Vatika Atisara, Shlesmika Atisara, Pravahika, Vatika Grahani, Chhidrodara , Purishavaha Dusti Atipravriti Paittika Atisara, Ama Atisara, Sannipataja Atisara Asadhya Atisara Muhrmuhu Vataja Grahani, Vataja Atisara Sanga Vataja Gulma, ApanaVayuavrudha , Atisara Purva Rupa, Shuska Yoni, Udararoga, Asamyak Virechana , Vata Ashthila , Mutra Jathara , Udararoga, Baddhodara Bheda Kshayaja Yakshma , Ayathabala Yakshma , Vegasandharana Yakshma Abnormal quantity of stool in pathological conditions

21. Ayurvedic approach to Physical examination of Stool Pain Diseases Sashula Ama Atisara Sashula Pravahana Kaphaja Arsha, Kaphaja Atisara, Pravahika Sashula Sadaha Paittika Atisara Parikartika Vataja Atisara Pravahna Pravahika Kunthana Sama Atisara, Visamagni Shula, Gudasrava Jalodara Chirat Dukham Vataja Grahani Associated symptoms during defecation

22. Special examination of Stool Standardization of Jala - Nimajjan Purisha Pariksha in terms of physical parameters Testing container Quality of water Volume of water Height of the stool from where it should be dropped Amount of stool Duration between collection and performance of test Dispensing of stool Jala Nimajjan Purisha Pariksha ( Sama / Nirama pariksha )