Fecal Analysis

Group 1 | BSMT 3

Jillian Brabante
Salud Cureg
Emily Coballes
Aila De Dios
Alfie Gumabay
Maryrose Mansibang
Shella Tejada
Editha Valerio
 CONTENTS

Physiology Diarrhea Steatorrhea

Routine Fecal examination
Macroscopic
Microsccopic
Chemical analyses

Detection of:
• Gastrointestinal bleeding
• Liver and biliary duct disorders
• Maldigestion/malabsorption syndromes
• Inflammation
• Causes of diarrhea and steatorrhea
• Detection and identification of pathogenic bacteria and
parasites
PART 01

Physiology
 Physiology

 Bacteria
 Cellulose
 Undigested food
 Gastrointestinal secretions
 Bile pigments
 Cells from intestinal walls
 Electrolytes
The normal fecal  water
specimen contains:
 Physiology

Bacterial metabolism
• Strong odor associated with
feces and flatus in the stomach
• Lower intestine – where
carbohydrates
(oligosaccharides) that pass
through the upper intestine
unchanged are metabolized
• Lactose-intolerant individuals
 Physiology

Alimentary Tract
- Where digestion of ingested
Small intestine
proteins, carbohydrates, and fats
- Primary site for final breakdown takes place
and reabsorption

Digestive enzymes
- This includes:
 Trypsin
Liver
 Chyotripsin - Provides bile salts that aids in the
 Amino peptidase digestion of fats
 Lipase
 Physiology

Approximately 9000 mL of
ingested fluid, saliva, gastric,
liver, pancreatic, and intestinal
secretions enter the digestive
tract each day.

Large intestine – 500-1500 mL

Feces – 150 mL
PART 02

Diarrhea
 Diarrhea
increase in daily stool weight above 200 g with increased
liquidity and frequency of more than three times per day

Classification Acute Diarrhea Chronic Diarrhea

• Duration of illness Diarrhea Diarrhea

• Mechanism lasting less persisting for
• Severity than 4 more than 4
• Stool characteristics weeks weeks
 Secretory Diarrhea
- Bacterial, viral, and protozoan infections produce increased secretion
of water and electrolytes, which override the reabsorptive ability of
the large intestine
- Enterotoxin-producing organisms can stimulate these water and
electrolyte
- secretions.
- Other causes of secretory diarrhea are drugs, stimulant laxatives,
hormones, inflammatory bowel disease, endocrine disorders,
neoplasms, and collagen vascular disease.
 Osmotic Diarrhea
- Incomplete breakdown or reabsorption of food presents increased fecal
material to the large intestine, resulting in the retention of water and
electrolytes in the large intestine which in turn results in excessive
watery stool.
- Maldigestion and malabsorption
- The presence of unabsorbable solute increases the stool osmolality and
the concentration of electrolytes is lower, resulting in an increased
osmotic gap.
- Causes of osmotic diarrhea include disaccharidase deficiency,
malabsorption, poorly absorbed sugars, laxatives, magnesium-containing
antacids, amebiasis, and antibiotic administration.
Laboratory testing of feces is frequently performed to aid in determining
the cause of diarrhea
DIFFERENTIAL FEATURES FOR DIARRHEA
 Altered Motility
- describes conditions of enhanced motility (hypermotility) or slow
motility (constipation)
*Irritable bowel syndrome (IBS)
-Intestinal hypermotility
* excessive movement of intestinal contents through the GI tract
that can cause diarrhea because normal absorption of intestinal
contents and nutrients cannot occur.

* caused by enteritis, the use of parasympathetic drugs, or with

complications of malabsorption.
Rapid (accelerated) gastric emptying (RGE)

-dumping syndrome describes hypermotility of the stomach and the shortened

gastric emptying half-time, which causes the small intestine to fill too quickly
with undigested food from the stomach.

- It is the hallmark of early dumping syndrome (EDS)

Note: Healthy individuals have a gastric emptying half-time range of 35 to 100

minutes, which varies with age and gender.

***A gastric emptying time of less than 35 minutes is considered RGE.

-RGE can be divided into early dumping and late dumping depending upon how
soon after a meal the symptoms occur.
PART 03

Steatorrhea
 Steatorrhea

 Absence of bile salts that

assist pancreatic lipase in
the breakdown and
subsequent reabsorption of
triglycerides produces an
increase in stool fat that
exceeds 6 g per day.
What is steatorrhea?
 Physiology

Steatorrhea
• pancreatic disorders,
association
including cystic fibrosis,
chronic pancreatitis, and
carcinoma that decrease the
production of pancreatic
enzymes
 D-xylose test
- D-xylose is a sugar that does not need to be digested but does need
to be absorbed to be present in the urine.
- Steatorrhea may be present in both maldigestion and
malabsorption conditions and can be distinguished by the D-xylose
test.
- A normal D-xylose test indicates pancreatitis. If urine D-xylose is
low, the resulting steatorrhea would indicate a malabsorption
condition.
- Malabsorption causes include bacterial overgrowth, intestinal
resection, celiac disease, tropical sprue, lymphoma, Whipple
disease, Giardia lamblia infestation, Crohn disease, and intestinal
ischemia. A normal D-xylose test indicates pancreatitis.
Thank you for listening