Stool (Feces) Samples Overview
A stool analysis is a series of tests done on a stool (feces) sample to help diagnose certain conditions affecting the digestive tract. These conditions can include infection (such as from parasites, viruses, or bacteria), poor nutrient absorption, or cancer.
For a stool analysis, a stool sample is collected in a clean container and then sent to the laboratory. Laboratory analysis includes microscopic examination, chemical tests, and microbiologic tests. The stool will be checked for color, consistency, amount, shape, odor, and the presence of mucus.
The stool may be examined for hidden (occult) blood, fat, meat fibers, bile, white blood cells, and sugars called reducing substances. The pH of the stool also may be measured. A stool culture is done to find out if bacteria may be causing an infection.
Purpose of Stool (Feces) Sample
Your doctor or a healthcare professional may ask you for a stool sample to help them analyze and diagnose or rule out a particular health condition.
Stool (feces) contains bacteria and other substances that are in the digestive system. By testing the levels of these substances and bacteria in the stool sample, it’s possible to analyze and find out what’s happening in your digestive system.
For example, the stool (feces) samples can be tested to help diagnose the following:
- Gastroenteritis – a common condition that causes diarrhea and vomiting, and is usually the result of a bacterial or viral bug in the stomach.
- Inflammatory Bowel Disease (IBD): Such as Crohn’s disease, a condition that causes inflammation inflammation of the lining of the digestive system, and ulcerative colitis, a condition where the colon and rectum become inflamed.
- Help identify diseases of the digestive tract, liver, and pancreas. Certain enzymes (such as trypsin or elastase) may be evaluated in the stool to help see how well the pancreas is working.
- Help find the cause of symptoms affecting the digestive tract, such as prolonged diarrhea, bloody diarrhea, an increased amount of gas, nausea, vomiting, loss of appetite, bloating, belly pain and cramping, and fever.
- Screen for colon cancer by checking for hidden (occult) blood.
- Look for parasites, such as pinworms or Giardia.
- Look for the cause of an infection, such as bacteria, a fungus, or a virus.
- Check for poor absorption of nutrients by the digestive tract (malabsorption syndrome). For this test, all stool is collected over a 72-hour period and then checked for fat (and sometimes for meat fibers). This test is called a 72-hour stool collection or quantitative fecal fat test.
Preparation of Stool (Feces) Sample Collection
Many medicines can change the results of this test. You will need to avoid certain medicines depending on which kind of stool analysis you have.
You may need to stop taking medicines such as antacids, antidiarrheal medicines, anti-parasite medicines, antibiotics, laxatives, or nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 to 2 weeks before you have the test.
Be sure to tell your doctor about all the nonprescription and prescription medicines you take.
Be sure to tell your doctor if you have:
- Recently had an X-ray test using barium contrast material, such as a barium enema or upper gastrointestinal series (barium swallow). Barium can interfere with test results.
- Traveled in recent weeks or months, especially if you have traveled outside the country. This helps your doctor look for the parasites, fungi, viruses, or bacteria that may be causing a problem.
If your stool is being tested for blood, you may need to avoid certain foods for 2 to 3 days before the test. This depends on what kind of stool test you use. And do not do the test during your menstrual period or if you have active bleeding from hemorrhoids. If you aren’t sure about how to prepare, ask your doctor.
Do not use a stool sample for testing that has been in contact with toilet bowl cleaning products that turn the water blue.
Collection of Stool (Feces) Sample
Stool samples can be collected at home, in your doctor’s office, at a medical clinic, or at the hospital. If you collect the samples at home, you will be given stool collection kits to use each day. Each kit contains applicator sticks and two sterile containers.
A doctor or another healthcare professional, such as a nurse, should explain how to collect the stool (feces) sample. It should be collected in a clean, dry screw-top container.
You may need to collect more than one sample over 1 to 3 days. Follow the same procedure for each day.
Your doctor or a member of staff at the hospital will give you a plastic specimen container to use, although you can use any clean container as long as you can seal it.
To collect the sample:
- Label a clean, screw-top container with your name, your doctors name and the date sample was collected.
- Place something in the toilet to catch the stool (feces), such as empty plastic food container, or spread clean newspaper or plastic wrap over the rim of the toilet
- Make sure the stool (feces) doesn’t touch the inside of the toilet
- Use the spoon or spatula that comes with the container to collect the stool (feces), then screw the lid shut
- If you’ve been given a container, aim to fill around a third of it, that’s about the size of a walnut if you’re using your own container
- Place the plastic container you used to collect the poo in a plastic bag, so it can handed over to the health care professional for analysis.
- Take the sealed container to your doctor’s office or the lab as soon as you can. You may need to deliver your sample to the lab within a certain time.
- Any stool sample may contain germs that can spread disease. Make sure to carefully wash your hands with soap and use careful handling techniques to avoid spreading infection.
Follow any other instructions your doctor has given you.
Risks of Stool (Feces) Sample Collection
Sometimes a stool sample is collected using a rectal swab that contains a preservative. The swab is inserted into the rectum, rotated gently, and then withdrawn. It is placed in a clean, dry container and sent to the lab right away.
There is no pain while collecting a stool sample. If you are constipated, straining to pass stool may be painful.
If your health professional uses a rectal swab to collect the sample, you may feel some pressure or discomfort or pain as the swab is inserted into your rectum.
Results of Stool (Feces) Sample
Each lab has a different range for what’s normal. Your lab report should show the range that your lab uses for each test. The normal range is just a guide. Your doctor will also look at your results based on your age, health, and other factors. A value that isn’t in the normal range may still be normal for you.
A stool analysis may check values for pH, reducing factors, and fat.
Stool analysis test results usually take at least 1 to 3 days.
Abnormal Stool Test Values
- High levels of fat in the stool may be caused by diseases such as pancreatitis, inflammatory bowel disease (IBD), celiac disease, cystic fibrosis or other disorders that affect the absorption of fats.
- The presence of undigested meat fibers in the stool may be caused by pancreatitis.
- A low pH may be caused by poor absorption of carbohydrates or fat Stool with a high pH may mean inflammation in the intestine (colitis), cancer, or antibiotic use.
- Blood in the stool may be caused by bleeding in the digestive tract.
- White blood cells may be caused by inflammation of the intestines, such as ulcerative colitis, or a bacterial infection.
- Rotaviruses are a common cause of diarrhea in young children. If diarrhea is present, testing may be done to look for rotaviruses in the stool.
- High levels of reducing factors in the stool may mean a problem digesting some sugars.
- Low levels of reducing factors may be caused by sprue (celiac disease), cystic fibrosis, or malnutrition. Medicine such as colchicine (for gout) or birth control pills may also cause low levels.
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