Essay Example: Fecal Occult Blood Test

The fecal occult blood test is useful to detect blood in stool samples in a lab test (Soin et al., 2019). A patient does not need to perform an occult blood test at a lab or medical facility, but they can buy test kits at pharmacies and do it at home. Occult blood may be an indicator of the presence of polyps or colon cancer in the rectum or colon, even though not all of them bleed. The presence of occult blood in a stool sample may indicate other conditions including blood vessel abnormalities in the digestive tract, diverticular disease, Crohn's disease, ulcerative colitis, inflammation in the digestive system, and fissures on the anal area (Soin et al., 2019). Occult blood is only detectable by specific chemicals during the fecal occult blood test because it occurs in small amounts. However, the fecal occult blood test does not indicate the source of bleeding; therefore, more tests are necessary to determine the source of the occult blood (Soin et al., 2019). However, if a patient displays colon cancer symptoms, the fecal occult blood test is not recommended.

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Risks, Limitations, and Results

The fecal occult blood test is useful as an alternative to screening colon cancer. It is necessary if a patient does not show colon cancer symptoms, or they have a moderate risk of getting the disease (Li & Yuan, 2019). It is recommended that an individual performs the fecal occult blood test yearly. The fecal occult blood test has its risks and limitations as it is not accurate and may lead to more tests, and it is not precise because the results may be false-negative or false-positive. False-positive means that the fecal occult blood test reads positive, yet the individual does not have cancer, polyps, or hemorrhoids (Li & Yuan, 2019). The blood may be as a result of ingested blood or a stomach ulcer. The false-negative result occurs when it reads negative, yet the patient may have polyps or cancer; however, without any signs of bleeding (Li & Yuan, 2019).

Preparation

Before a patient goes in for a fecal occult blood test, they should avoid certain foods, medications, and supplements three days before the process (Mikkelsen et al., 2018). It is because they may make the result inaccurate, either returning a false-negative or false, positive result. Therefore, a patient should follow instructions carefully to avoid pain relievers like ibuprofen and aspirin, Vitamin C supplements, red meat, vegetables, and fruits like turnips and broccoli, vitamin-based beverages, iron supplements, bowel movements medications, and antacids (Mikkelsen et al., 2018). A patient can continue taking the above foods, supplements, and drugs after completing the fecal occult blood test. However, to avoid inflammation that may result in bleeding, a patient may have to discontinue some.

The Fecal Occult Blood Test

The test requires three stool blood samples collected within three days, 24 hours apart. There are different ways of performing the test, including an immunochemical fecal occult blood test, Guaiac fecal occult blood test, and flushable reagent pad or tissue (Singal et al., 2018). Additionally, the stool samples may require different chemical tests or microscope scans. The presence of occult blood is evident with test card or tissue color change. A collection of the stool samples during the immunochemical fecal occult blood test is in a collection container (Singal et al., 2018). It usually has its test kit, and a patient may send the stool samples to a lab or their doctor personally or through the mail. It is the most sensitive fecal occult blood test among the three. It is because the patient does not also need to follow any dietary instructions. The sample testing can be random, unlike the others, which require up to three times (Singal et al., 2018).

The Guaiac fecal occult blood test occurs as a patient gets a test card, which they collect and smear stool samples at different intervals. The stool samples should be in a clean container as provided by the doctor and the stool smeared on an indicated test card area using an applicator stick (Pioche et al., 2018). After spreading, it should be left to dry and the samples sent back to the doctor or lab. The flushable reagent tissue or pad is available in drug stores, and one does not need a prescription to get one. After a bowel movement, the individual places the tissues in the toilet bowl. If the tissue changes color, then occult blood is present and vice versa (Pioche et al., 2018). An individual should repeat the test for three consecutive days at a minimum to improve the accuracy of the results. The accuracy of the results also depends on how a patient collects the stool samples and safe delivery (Pioche et al., 2018).

Conclusion

The results of the fecal occult blood test can either be positive or negative. A negative fecal blood test result means that there was no blood detected in the samples. If the patient faces a potential risk for colon cancer, the test should recur every year. The test can be in a specific interval depending on the degree of the risk. A positive result means that occult blood is present in the stool sample. Therefore, the patient requires more results to determine the bleeding source because the fecal occult blood test does not identify any. An example of an additional examination is a colonoscopy.

References

Li, J. N., & Yuan, S. Y. (2019). Fecal occult blood test in colorectal cancer screening. Journal of Digestive Diseases, 20(2), 62-64. https://doi.org/10.1111/1751-2980.12712

Mikkelsen, E. M., Thomsen, M. K., Tybjerg, J., Friis-Hansen, L., Andersen, B., Jørgensen, J. C., Baatrup, G., Njor, S. H., Mehnert, F., & Rasmussen, M. (2018). Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program. Clinical Epidemiology, Volume 10, 1649-1655. https://doi.org/10.2147/clep.s181204

Pioche, M., Ganne, C., Gincul, R., De Leusse, A., Marsot, J., Balique, J., Fond, A., Bretagnolle, M., Henry, L., Billaud, Y., Malezieux, R., Lapalus, M., Chambon-Augoyard, C., Del Tedesco, E., Scalone, O., Montoy, J., Russias, B., Detry, A., Veniat, F., … Ponchon, T. (2018). Colon capsule versus computed tomography colonography for colorectal cancer screening in patients with positive fecal occult blood test who refuse colonoscopy: A randomized trial. Endoscopy, 50(08), 761-769. https://doi.org/10.1055/s-0044-100721

Singal, A. G., Corley, D. A., Kamineni, A., Garcia, M., Zheng, Y., Doria-Rose, P. V., Quinn, V. P., Jensen, C. D., Chubak, J., Tiro, J., Doubeni, C. A., Ghai, N. R., Skinner, C. S., Wernli, K., & Halm, E. A. (2018). Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States. American Journal of Gastroenterology, 113(5), 746-754. https://doi.org/10.1038/s41395-018-0023-x

Soin, S., Akanbi, O., Ahmed, A., Kim, Y., Pandit, S., Wroblewski, I., & Saleem, N. (2019). Use and abuse of fecal occult blood tests: A community hospital experience. BMC Gastroenterology, 19(1). https://doi.org/10.1186/s12876-019-1079-9