FECALYSIS

Fecalysis is a series of test done on a stool (feces)

sample to help diagnose certain conditions affecting
the digestive tract.
Examination of stool or Fecal Sample
• Typical stool collection protocol consist of 3 specimens.
• One specimen collected every other day or a total of 3
collected in 10 days.
The best way to collect fecal
sample is in clean, wide
mouthed containers made of
waxed card board or plastic
with a tight-fitting lid to ensure
retention of moisture and to
prevent accidental spillage.
Certain Medications
• Barium This may interfere with
• Bismuth the detection of
• Laxatives parasites. All of these
drugs have been found
• Antacids
to leave crystalline
• Anti-diarrheal residues that can
interfere with the
identification of
parasites.
Stool samples should be
collected a week after the last
intake of any of these drugs.
Intake of antibiotics decreases
the number of protozoans for
several weeks.
Routine stool examination
requires a thumb-sized six of
formed stool or about 5-6
tablespoons of watery stool.
Age of stool sample is very
important for diarrheic
specimens since trophozoites it
may contain are likely to die.
 Liquid specimens be examined
within 30 minutes
Semi formed specimens be
examines within 1 hour .
Formed stool specimens are not
likely to contain trophozoites,
they can be held for 24 hours
following collection
 • Liquid stool • Blood and mucus in
Protozoan trophozoites soft or watery stools
may possibly yield the
• Formed stool presence of
Cysts trophozoites.
• Any type of consistency • By gross examination ,
Helminth eggs and larvae tape worm proglottids
and adult nematodes
may be found on the
stool sample
• Temporary storage of
fecal samples in a
refrigerator (3-5C) is
acceptable.
 Prolonged refrigeration can
bring about desiccation.
Trophozoites are killed by
refrigeration.
Never freeze stool samples.
Never keep them in incubators
Stool Preservatives
• When selecting a fixative, the possibility of preparing a
permanently stained slide should be considered Preservative
proportion 1 part stool:3 parts preservative
FORMALIN
• All purpose fixative. Buffered with sodium phosphate to
preserve morphological characteristics
• 5% concentration is recommended for protozoan cyst.
• 10% concentration is recommended for helminth eggs and
larvae.
Schaudinns solution
• Use to preserve fresh stool/ fresh fecal specimen in
preparation for staining the stool smears.
• Provide excellent preservation of protozoans trophozoites and
cyst.
• For many years , considered GOLD STANDARD
• Contain mercuric chloride; which is highly toxic in humans
POLYVINYL ALCHOHOL (PVA)
• Plastic resin that serves to adhere a stool sample onto a slide.
• Normally incorporated into the schaudinn’s solution.
• Main advantage : preservation of protozoans cyst and
trophozoites for permanent staining.
• Stool preserved in PVA can be concentrated using FECT.
• Disadvantage: use of mercuric chloride; some replaced with
cupric sullfate.
MERTHIOLATE IODINE FORMALINE
(MIF)
• Component both fix and provide stain color
• Contains merthiolate (THIMEROSAL)and iodine that acts as
staining components
• Formalin act as the preservative
• Useful to the fixation of intestinal protozoans, helminth eggs,
and larvae
• Disadvantage : Contains mercury compounds (THIMEROSAL)
stainong of preserved stools and MIF yields unsatisfactory
result or not as good as schaudinn’s fluid
SODIUM ACETATE ACETIC ACID
FORMALIN (SAF)
• Advantage: does note contain mercuric chloride; long shelf life
• Disadvantage: image are not sharp after staing as compared
with does fixed in PVA or schaudinn’s solutions
 TEST STOOL EXAM
SYNONYMS FECALYSIS, STOOL ANALYSIS
LAB SECTION CLINICAL MICROSCOPY
AVAILABILITY DAILY ( 24 hours )
TURN AROUND TIME STAT : WITHIN 2 hours
ROUTINE : WITHIN 4 hours
PATEINTS PREPARATION NONE
SPECIMEN FRESH DIARRHEAL STOOL ,
ESPECIALLY WITH BLOOD AND
MUCUS
VOLUME OF SPECIMEN THUMB SIZE ( 3-5 grams)
CONTAINER
CLEAR, CLEAN DRY ,WIDE MOUTH SCREW CAP CONTAINER
COLLECTION AND TRANSPORT
1 Collect fresh , diarrheal stool in a clean ,dry bed pan or a plastic , leak proof
container.
2 those portion of stool containing blood and mucus are especially significant and
should be transferred in to the container .
3 The patient should understand that the specimen should not be contaminated with
urine and toilet water that may contain chemicals
4 Label the specimen with patient’s full name , date and time of collection .
SPECIMEN STABILITY
Specimen must arrive at the laboratory within one hour of collection
METHODOLOGY
direct light microscopy