Coprogram: preparation for analysis and decoding
Coprogram is a study of fecal contents for clarifying its properties, physical and chemical composition, the presence of pathological inclusions for the purpose of diagnosing diseases and monitoring the dynamics of the disease, the treatment process.
Fecal masses are formed when a food lump( chyme) passes through the entire digestive tract of a person from the oral cavity to the rectum.Therefore, these coprograms are most valuable in the diagnosis of diseases of the gastrointestinal tract.Table of contents: What does the coprogram show How to take a coprogram How to collect feces for coprograms Features of the collection of feces in small and infants Decoding of the coprogram in adults Features of deciphering the coprogram in children
What the coprogram ofshows
In fecal masses various in appearance and quantityMicroorganisms, particles of undigested food, fecal pigments, epithelium of various parts of the intestine.
Note : Knowing these features, the lab technician can determine pathological processes in certain areas of the intestine in certain diseases.
Coprogram is shown with:
- acute and chronic gastric pathology;
- diseases of the duodenum;
- pathology of the small and large intestine( including sigmoid and rectum);
- problems in the liver, gallbladder and bile ducts;
- pancreatic diseases;
- helminthic invasions( parasitic infections);
- infectious processes;
- assessing the effectiveness of treatment, corrective therapy activities.
Coprological examination allows to reveal a dysbacteriosis( disturbance of a parity of microorganisms and reproduction of pathogenic forms).
The coprogram is rarely used as an isolated study, most often it is an additional, but at the same time informative diagnostic method.
How to take the
preparation for the analysis is not difficult, but some rules must be strictly observed.
If the patient takes medicines containing iron and bismuth, then they must be canceled.Also, do not take laxatives, rectal suppositories.Do not wash the intestines with enemas.
If the examined person underwent radiography with a contrast agent( barium), then the coprogram should not be done 7-10 days after the test.Barium can change the properties of the stool.
In the patient's diet, for several days prior to the analysis, excessive variety, exotic dishes, etc. should be limited.
Preliminary rule for putting a feces on a coprogram:
- For 2 days before collection of the material, you should completely discard tomatoes, tomato juice, pasta, beets and other vegetables and fruits containing colorants in their composition.
- For 3 days before the collection of stool, it is necessary to refuse the intake of antibiotics, drugs that cause changes in the motor function of the intestine, drugs based on enzymes.
- Food should consist of vegetables, fruits, cereals, sour-milk products, the amount of food should be within normal limits.
- It is necessary to refrain from fatty products, smoked products, spicy and pickled.
- Women should not take an analysis during menstruation.
- Cal should be collected so that it does not get urine.
- Evacuation of stool for analysis should occur naturally, without the use of stimulants and enemas.
How to collect feces for koprogram
Important : the collection rules are simple, but they should be done carefully.
To collect stale weights:
- protein , which appears in the inflammatory processes in the digestive system, with ulcerous changes in the mucosa, polyposis, oncological diseases.Normally, there is no protein in the stool;
- blood - appears with hidden intestinal bleeding, which can cause ulcers, tumors, polyps, worms.The altered blood speaks of processes in the upper intestine, unchanged in the lower parts.Hidden blood is characteristic of tumors;
- sterbilin .This pigment, which is a metabolite of bilirubin, which gives the feces a specific color.Over a day, about 75-350 mg of this pigment is formed.An increase in the index in decoding the coprogram in adults is characteristic of hemolytic anemia.Reduction indicates a possible process of obstruction of the bile ducts( stones, tumor);
- bilirubin .The appearance of this chemical testifies to the acceleration of the digestive process, as a result of which bilirubin does not have time to be metabolized into sterbilin.This situation occurs with acute inflammation and dysbiosis;
- slime .Mucus performs a protective function in the intestine, so increased its formation indicates a strong inflammatory bowel changes in acute infectious diseases( salmonellosis, dysentery, infectious colitis, etc.);
- iodophilic flora .The appearance in the decoding of the coprogram in children and adults of pathological bacteria is characteristic of dysbiosis;
- detritus .Cellular degraded material that appears from the intestinal epithelium.A decrease in the amount is observed when the digestive process is disturbed;
- neutral fats .Excessive content is characteristic for insufficient isolation( production of bile), as well as the process of absorption of bile in the intestine;
- muscular fibers .The appearance of these elements in an unchanged form( normally they change) indicates a painful process in the pancreas, due to a violation of the composition of the juice, which is involved in the digestion of meat foods;
- of starch .Normally, it undergoes a cleavage process, if it is found in the form of grains during the investigation, then it is necessary to suspect an accelerated passage of the food lump in the syndrome of malabsorption, also this symptom appears in chronic pancreatitis;
- soap .The soapy substances are normally present in small amounts.The increase may be with digestive deficiency of the small intestine, stomach and duodenum.These problems occur with inflammation of the pancreas, with stones in the gallbladder;
- of white blood cells .Normally not determined.Their appearance in the decoding of the coprogram indicates inflammatory diseases of the digestive tract;
- of fatty acids .There are no healthy intestinal secretions.Appear with digestive and enzymatic insufficiency, violations of bile outflow, accelerated intestinal activity;
- of plant fiber .If the decoding of the coprogram in adults shows soluble fibers, then we can talk about the inadequacy of the secretion of hydrochloric acid in the stomach.Normally, soluble fibers of plant fiber are absent in the feces.Insoluble fibers( the skin of fruits and vegetables, the outer shell of grains and legumes) - refer to the normal contents of the intestine.Insoluble fiber removes from the intestines indigestible products, poisons, cholesterol.The number of these elements depends on the qualitative composition of the food;
- fibers of connective tissue .These fibers are formed from undigested animal food residues.In the norm they should not be.The appearance of fibers is characteristic of conditions in which the acidity of the gastric juice decreases( antacid gastritis).Also, these elements are noticeable with a decrease in the production of hydrochloric acid in the stomach, enzymatic insufficiency arising in pancreatitis;
- ammonia .The increase in the content of this chemical compound is characteristic of processes accompanied by decay in the lumen of the intestine.The norm of ammonia in the stool contains 20-40 mol / kg.If the decoding of the coprogram in adults indicates an increased ammonia value, one should suspect the presence of an inflammatory bowel in a person;
- pathological and conditionally pathological microorganisms , causing bowel disease, dysbiosis.
- to empty the bladder, to conduct a thorough toilet of genital organs and anal area with the application of warm water and neutral soap without aromatic additives.Then rinse the washed areas with warm, boiled water;
- in prepared clean dishes with a wide neck using a spatula( which is available in pharmacy containers for collection of feces) to collect material from different parts of the obtained bowel movements;
- after collection of feces is closed with a lid and signed with the patient's name and surname, as well as the date of collection.
Do not use as wooden utensils for stools, wooden boxes, food cans.The total amount of collected material should be 15-20 grams( approximate amount of a teaspoon).Try to bring about such a volume of feces into the laboratory.
Cal should be collected in the morning and delivered to the study as soon as possible.
Note: the faster the material is brought to the laboratory, the more accurate and reliable the results of the coprogram will be.
If necessary, the container with biomaterial is placed in the refrigerator, where it can be stored for no more than 8 hours, at a temperature of about 5 degrees Celsius.
Coprogram results are usually obtained within 2-3 days, sometimes the analysis takes 5-6 days.
Features of the collection of stool in small and infants
If the child walks alone on the pot, then the same rules apply to him, as to adults.
Infants use a diaper or an oilcloth( if the stool is liquid).
In case of constipation for stimulation of defecation, a stomach massage should be performed, in some cases it is possible to put a gas outlet tube that stimulates the act of defecation.
All materials must be clean, hands before the fence procedure must be washed with soap.
Collecting feces from diapers is not recommended.
Decoding of the coprogram in adults
Initially, the macroscopic examination of the feces is performed.
The decoding of the coprogram in adults is evaluated:
- appearance of the bowel movement;
- fecal matter density;
- staining( normal or pathological);
- presence of a specific odor;
- presence of bloody impregnations, veins, undigested food, purulent discharge, mucous lumps;
- presence of mature forms of helminths;
- possible allocation of biliary and pancreatic stones.
Microscopic analysis of allows an assessment of the ability of the gastrointestinal tract to digest food.
Microscopic examination possible:
The reaction of the stool( pH) can be different( slightly alkaline, neutral, weakly acidic).This indicator depends on the nature of nutrition.
Features of decoding coprograms in children
The main indicators of coprogram in children are similar to those in adults.But there are some features.
Most children have a normal coprogram with a neutral or slightly alkaline reaction( pH range 6-7.6.)
Note : Infants are most often acidic, as a result of the nutritional characteristics characteristic of this age group.
alkaline reaction in children is defined by malabsorption process, reinforced putrid processes in the intestine, a long stay in the stomach and intestine undigested food.
Up to three months of age when the child grbottom-feeding existence of bilirubin in the feces is a variant of the norm. After 3 months in deciphering coprogram in children should normally be determined only stercobilin.
Lotin Alexander, a medical columnist