stool analysis

descripe what the stool analysis

1. Faculty of Science and Technology Hebron university Department of Biology Parasitology Show : Stool analysis Odai Rjoub (STUDENT)

2. Stool analysis Prepared by: Odai Rjoub

3. Stool analysis: is a series of tests done on a stool (feces) sample for differential diagnosis of certain diseases of digestive system and include infection (such as from parasites, viruses, or bacteria), poor nutrient absorption, or cancer. Clinical significance of stool analysis: 1-Diagnosis of digestive system infectious diseases: Bacteria, parasites, virus, and fungi. 2-Diagnosis of pancreas disorders (inflammation); which associated with malabsorption of nutrients.

4. 3-Primary screening test for some types of digestive system malignancy such as: Colon cancer. 4-Primary screening test for peptic ulcer disease, and some types of anemia. For whom Stool analysis is urgently required? 1-Patients with abdominal pain. 2-Patients with diarrhea. 3-Patients with anemia.

5. Other situations by which Stool analysis is non-urgently required: 1-Patients who is too thin or do not grow well. 2-Patient with stool color that is changed to abnormal color. How to Take a Stool Sample: *Preparing to Take the Sample: 1.Avoid medicine that will affect the sample

6. 2. Consult with your doctor 3.Prepare your toilet with a hat 4.Cover your toilet bowl with plastic wrap

7. 5.Lay a sheet of newspaper across your toilet bowl. 6. Defecate into the collection device:

8. *Handling the Sample: Deposit sample in the container 2.Dispose of your collection device

9. 3.Refrigerate the sample 4.Return the samples to your doctor as soon as possible.

10. Stool analysis procedure is divided into: (Techniques of stool analysis) 1.Microscopic Examination(stool examination) 2.Gross Stool includes:(macroscopic) 3.Chemical stool analysis

11. Techniques of stool analysis

12. 1.Microscopic Examination(stool examination) Explain : 1.Presence of Red Blood Cells. 2.Ova and parasites. 3.Presence of meat fibers and muscle fibers. 4.Presence of fat. 5. Presence of leukocytes

13. Concentration methods of fecal parasites There are two types of fecal Concentration techniques:- 1.Sedimentation techniques. 2.Flotation techniques.

14. 1- Sedimentation techniques: Fecal sedimentation is used to detect large or heavy ova such as many spirurid ova, many fluke eggs, and many tapeworm eggs that will not float in fecal flotation techniques. The sediment contains a lot of debris so examining these slides is quite tedious. Note: - you can use formalin as a preservative and ether or ethyl acetate as an extractor of fat and debris from faeces after filtration to leave the parasites in a sediment at the bottom of the tube after centrifugation.

15. 1- Advantages 1.Recovers most ova, cysts and larvae . 2. Morphology of most parasites is retained. 3. Less risk of infection from bacteria and viruses. 2- Disadvantages 1.Preparation contains debris. 2. Some parasites do not concentrate well. 3.Ether is flammable and formalin is an irritant . 4.Liquid faeces do not concentrate well .

16. Materials : 1.Stool samples 2.Glassslides 3.Coverslips 4.Pipettes 5.Stick Gloves 6.Microscope 7.Plastic container (with small amount of water). 8.Centrifuge. 9.Centrifuge tube

17. Procedure 4-Pour the strained preparation into a centrifuge tube. 3- Strain the mixture 1- Obtain about a one to two gram fecal sample 2-Mix it with water by stick.

18. . Note :- There are many variations on fecal sedimentation technique, many of which include a step using organic solvents (instead of water) to remove some of the material from the sediment. Note:- at step (11) :- A drop of stain of your choice could be mixed in before placing the cover slip. New Methylene blue or iodine solution enhances visualization of the parasite ova and oocytes. If there is a lot of debris, water may be added first.

19. . Examples of parasitic stages that might be seen under the microscope Entamoeba cysts . Faciola egg

20. 2- Flotation techniques: * A fecal flotation test uses the high specific gravity of a solution to float the lighter ova and cysts *It is a diagnostic test commonly performed in-house in most veterinary clinics as a way of diagnosing parasitism in animals.

21. Advantages &Disadvantages: 1- Advantages:- The concentrate is clear of debris 2- Disadvantages:- Delay in examination can result in distortion Larvae and some fluke eggs do not concentrate Frequent checking of specific gravity

22. > Materials (cont. ) The FECALYZER (fecal flotation test kit). The in-house fecal flotation 'Fecalyzer' (also spelled Fecalyser) apparatus. used by many veterinarians, consists of an outer casing (the white plastic capsule or outer casing) containing a green fecal filtration 'basket'.

23. . How to use the FECALYZER? (procedure ) 1- Remove the inner piece of the fecal float test kit and press it into the fecal sample until the end is full. 2- Place insert back inside the test container. 3- Locate the fill line on the side

24. . Procedure cont 4- Fill insert with fecal solution until it gets to the top. 5- Carefully add just enough solution to form a meniscus on top without allowing it to over flow. 6-Gently place the slide cover slip on top of the insert and let it sit for approximately 12 to 15 minutes.

25. . Procedure cont. 7-The glass coverslip (containing fecal float solution and, parasite (eggs/ oocystes ) is placed on top of the glass microscope slide. 8- Examine slide under microscope

26. The important points to be considered when performing a concentration technique are:

27. 2.Gross Stool (macroscopic):

28. This test help in discovered from many things :

29. 3.Chemical stool analysis;

30. Urobilinogen in Stool;

31. Bile in Stool

32. Trypsin in Stool

33. Porphyrins in Stool Normal value : Coproporphyrin 400-1200 g / 24hr Urophorphyrin 10-40 g / 24 hr. These values vary from Lab to Lab. *Clinical Implication: 1.Increased fecal coproporphyrin is associated with a. Coproporphyria (hereditary) b. Porphyria variegata c. Protoporphyria d. Hemolytic anemia 2. Increased fecal protoporphyrin is associated with a. Porphyria veriegata b. Protoporphyria c. Acquired liver disease

34. Various factors can limit the accuracy and significance of a faecal egg count. (a) There is a fairly regular fluctuation in faecal egg output. (b) Eggs are not evenly distributed throughout the faeces . (c) The quantity of faeces passed will affect the number of eggs per unit weight. (d) The egg output is influenced by the season of the year (large infections may be acquired during rainy seasons). (e) The resistance of the host can depress or entirely inhibit the egg production of parasites.

35. (f) Immature worms do not indicate their presence by producing eggs. (g) Immunity may result in a marked extension of the prepatent period and a lower egg output by female parasites. (h) An egg count often refers to the total number of eggs of a mixture of species, which differ widely both in their biotic potential and their pathogenicity. ( i ) Eggs may not be detected due to low numbers of them or to a low test sensitivity.