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Fecal Occult Blood Tests (cont.)
Dennis Lee, MD
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In this Article
- What is a fecal occult blood test?
- Why is fecal occult blood testing done?
- How is a fecal blood test performed?
- How do the results of chemical fecal occult blood testing compare with immunologic fecal occult blood testing?
- How effective are fecal occult blood tests?
- How should fecal occult blood tests be used?
Why is fecal occult blood testing done?
A fecal occult blood test is done primarily to detect or prevent colon cancer in people without intestinal symptoms. Cancers of the colon are common and frequently produce fecal occult blood long before they cause other symptoms such as abdominal pain, rectal bleeding, or changes in bowel habits. In addition, some precursors of colon cancer, specifically, some types of colon polyps, also may bleed slowly and cause fecal occult blood. By finding the cancers early through fecal occult blood testing when the cancers are small and before they metastasize (spread to distant organs), patients may be cured of their cancers by removing them surgically. By removing precancerous polyps that are found through fecal occult blood testing, cancer may be prevented.
How is a fecal blood test performed?
For fecal occult blood testing, several (usually three) samples of stool are collected for testing. The reason for testing multiple samples is that bleeding from cancers and polyps often is intermittent and only one of the samples may show blood.
There are two types of fecal occult blood testing, 1) chemical and 2) immunologic.
- Chemical testing: For chemical testing, a solution containing the chemical guaiac and an oxidizing chemical is used. If blood is present in the sample of stool, the mixing of the solution with blood causes the guaiac to turn visibly blue. The blue color is caused by the interaction (promoted by the oxidizing agent) of the heme portion of the hemoglobin molecule, the oxygen carrying molecule in red blood cells, and the guaiac.
- Immunologic testing: For immunologic testing, a sample of stool is mixed with a solution that contains an antibody to globin, the protein part of the hemoglobin molecule. The antibody is combined with a small amount of gold. When the antibody/gold complex binds to the globin in stool, the antibody/gold/globin complex settles out of the solution as a visible line on the test strip.
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