Stool analysis for a coprogram is one of the first studies that a doctor prescribes for a patient with digestive disorders. The appearance, chemical composition and microflora of feces can tell a lot about the state of the gastrointestinal tract.
The contents of the large intestine not only consist of liquid and food debris, it includes elements of digestive juices, enzymes, bile, blood, bacteria.
General analysis of feces (coprogram) is aimed at a comprehensive study of excrement: physical, chemical and microscopic.
Indications
Coprogram analysis is performed for the following diseases:
- Haemorrhoids;
- Chronic constipation
- Stomach ulcer, duodenal ulcer;
- Pancreatitis;
- Intestinal diverticula;
- Crohn's disease;
- Colitis;
- Cirrhosis of the liver;
- Colon polyps;
- Irritable bowel syndrome;
- Malignant tumors;
- Helminthic invasions;
- Amebic dysentery;
- Acute intestinal infections (cholera, salmonellosis, etc.);
- Anemia and a number of other pathologies.
The reason for scatology is abdominal pain, cramps, bloating, nausea, heartburn, problems with bowel movements, excretion of blood in the feces and other symptoms that indicate disorders in the digestive tract.
A general analysis of feces according to a coprogram is prescribed for suspected poisoning, infection, helminthiasis - it allows you to quickly identify pathogens and make a diagnosis, which is especially important in such urgent cases as acute intoxication, the need to isolate a patient with an infectious disease.
Feces for the coprogram of children are handed over for any digestive problems, allergic reactions, suspicion of worms, with colic.
Coprogram is invaluable in diagnosing pathologies of the gastrointestinal tract... Those violations that this simple and painless analysis shows require additional examinations.
Stool examination helps the doctor to make a preliminary diagnosis and in the future to direct the patient to the necessary procedures.
What is analysis?
The technique for performing the analysis of feces for a coprogram provides:
- Visual study of excrement in terms of qualitative and quantitative parameters and the presence of foreign inclusions.
- Conducting chemical tests to determine impurities.
- Examination of the material under a microscope.
Let's take a closer look at what is included in the stool coprogram:
| Study | Indicators |
|---|---|
| Macroscopy | Stool volume |
| Consistency | |
| Form | |
| Color | |
| The presence of mucus | |
| Blood | |
| Purulent discharge | |
| Leftover undigested food | |
| Chemical | Gregersen reaction |
| Reaction to bilirubin | |
| Acid-base balance | |
| Stercobilin analysis | |
| Vishnyakov-Triboulet test | |
| Microscopy | The presence in the feces of muscle fibers, undigested connective tissue |
| Fats, fatty acids and salts | |
| Starch | |
| Cellulose | |
| Iodophilic microflora | |
| Leukocytes | |
| Eritoricites | |
| Epithelial cells | |
| Helminth eggs | |
| Protozoa and fungi | |
| Salt |
Normal indices of the coprogram
Normally, feces are a thick, shaped brown mass with a pronounced fecal odor, without admixtures of blood, mucus and pus, with a minimum amount of unprocessed food (insoluble fiber is allowed).
The nature of the diet, the intake of certain medications can significantly affect the physical indicators of feces: change color, texture, smell. Small deviations due to dietary habits are considered acceptable.
The rate of the compromise in adult patients is shown in the table:
| Indicator | Reference value |
|---|---|
| pH | 42588 |
| Reaction to occult blood according to Gregersen | negative |
| Vishnyakuva-Triboulet reaction to protein | negative |
| Stercobilin reaction | positive |
| Reaction to bilirubin | negative |
| Muscle fibers | absent, single fibers in the field of view |
| Undigested connective tissue | missing |
| Neutral fat, fatty acids | absent |
| Fatty acid salts | small amount is acceptable |
| Plant fiber | single cells |
| Starch | missing |
| Iodophilic flora | absent, a single presence of normal iodophilic microorganisms is permissible |
| Crystals | absent |
| Epithelium | absent, single cylindrical cells are allowed |
| Leukocytes | absent, single neutrophils are acceptable |
| Erythrocytes | absent |
| The simplest | absent |
| Worm eggs | absent |
| Yeast mushrooms | absent |
The norm in children differs from those in adults due to the dietary habits. This applies to the amount, consistency and other physical parameters of feces, as well as the level of acidity.
The norms of the coprogram in children under one year old have deviations in chemical composition, which is associated with the immaturity of the digestive tract, postpartum changes in the body of newborns, mainly with a dairy diet in infants.
| Indicator | Norms for babies | Coprogram results in children over a year old |
|---|---|---|
| daily amount of feces | 34 - 45 g | 58 - 215 g |
| consistency | sticky | mushy, decorated |
| color | light brown to pale yellow | Brown |
| smell | sourish | normal fecal |
| pH | 5,1 - 6 | 1,2 – 1,7 |
| bilirubin, ammonia | present | absent |
| stercobilin, muscle fibers | present | absent |
| fatty acids and salts | present | absent |
How to decipher the results?
A specialist should evaluate the results of the coprogram taking into account all conditions: patient complaints, characteristics of his diet, anamnesis, indicators of other studies.
Consider how to decipher deviations from the norm:
- Too little feces occurs with constipation, colitis, ulcerative conditions. An increase in feces indicates an accelerated evacuation, inflammation in the digestive tract.
- Very dense feces are formed with excessive absorption of fluid through the intestinal walls, constipation. Liquefied stools give active peristalsis, admixtures of inflammatory mucus. Oily consistency is a possible consequence of chronic pancreatitis. Foaminess indicates fermentation in the intestines.
- A large form of feces indicates a prolonged stay of the contents in the intestine, which may be associated with dysfunction of the colon with improper diet, a sedentary lifestyle, with diverticulosis, tumors. Small lumps (sheep feces) occur with intestinal cramps, hemorrhoids, anal fissures, starvation, peptic ulcer diseases. Excrement in the form of a tape, a thin column speaks of rectal stenosis, the presence of a neoplasm. Unformed stool is a sign of impaired digestion and absorption of food due to enzymatic deficiency.
- Color changes not associated with food staining are likely symptoms of disease. Discoloration of stool is caused by liver failure and blockage of the bile ducts. Tar-colored feces are a sign of bleeding in the upper gastrointestinal tract, if there is blood in the colon and rectum, the feces are red. A mushy green stool is excreted in typhoid fever. Yellow feces are produced by fermentation in the intestines.
- The mucus in the coprogram has a different consistency and shade, depending on the pathology. Gray inclusions, reminiscent of rice water, indicate cholera infection. Amebic dysentery is manifested by a jelly-like mucous mass of pink shades. When the rectum is damaged, mucus impurities in whole lumps, ribbons are found in the material. With colitis and constipation, mucus envelops the decorated feces from above, with inflammation of the small intestine, it mixes with the food masses and gives them a semi-liquid character.
- In some cases, blood does not stain feces, but is excreted along with them in the form of separate clots, veins. We are talking about bleeding in the lower digestive tract, ranging from fissures in the anus and ending with necrosis of a colon tumor. Latent blood in the feces is determined by the Gregersen test.
- A purulent discharge in the feces is a sign of severe inflammation, ulcers, abscesses, tuberculosis, or a disintegrating tumor. With infectious lesions, suppuration is supplemented with mucus and blood.
- Pieces of undigested food are called lienorrhea in stool analysis. It occurs when the stomach and pancreas are disrupted.
- Small elements of digested food mixed with the remains of bacteria and epithelial cells (detritus) are the normal contents of feces. Only a violation of their homogeneity with the isolation of individual particles, for example, an increased content of bacteria during the coprogram, makes it possible to suspect an inflammatory process. Detritus in the coprogram in combination with mucous and bloody impurities is an unambiguous sign of pathology. Detritus in the coprogram in an infant or child over a year old without accompanying symptoms is not a cause for concern.
- The iodophilic flora in the coprogram causes fermentation in the intestines. These bacteria are determined by staining with iodine and acid reaction of feces (pH 5.0-6.5). Pathological iodophilic flora (clostridia) leads to active fermentative dyspepsia.
- If yeast is found in the stool, antibiotic-induced candidiasis is possible.
- Muscle fibers in the coprogram can be detected both in digested and unchanged form, which is not the norm. The presence of muscle tissue in the feces is called creatorrhea and indicates poor digestion of proteins: impaired secretion of gastric juice, insufficiency of pancreatic enzymes. The same applies to the remains of connective tissue in the stool.
- Lipid digestion problems are expressed in steatorrhea. Neutral fat in the coprogram is released in case of pancreatic dysfunction and blockage of the pancreatic ducts. Disorders in the duodenum lead to poor absorption of fatty acids. Coprogrammed soaps are fatty acid salts in feces as a result of bile deficiency.
- Starch in the coprogram (amilorrhea) is a consequence of enzymatic deficiency and too active peristalsis. The release of intracellular carbohydrates indicates that the source of the pathology is the stomach: starch is not absorbed due to the fact that gastric juice does not process plant cells. Extracellular starch in the coprogram appears due to amylase deficiency.
- Leukocytes in the coprogram are not normally detected. Their presence indicates an infectious lesion of the intestine, enteritis, colitis, ulcerative lesions. The combination of leukocytes with erythrocytosis, a large number of squamous and columnar epithelium in the feces shows a coprogram in bowel cancer, polyposis, Crohn's disease. If leukocytes are found in the coprogram in a baby, you need to analyze the results in a complex. In the absence of other alarming symptoms, a positive analysis occurs in healthy children with an improperly organized diet.
How to prepare and pass?
Special preparation for the analysis of feces is not required, since material obtained in a natural way is taken for the study.
In order not to distort the results of the study, it is necessary to follow simple rules on how to prepare for the coprogram.
A week before delivery, refuse:
- Antibiotics;
- Iron preparations;
- Any laxatives;
- The use of rectal suppositories;
- Enema;
- Procedures through the anus;
- X-ray with barium.
Preparation for the coprogram includes dietary restrictions 4 - 5 days before stool delivery. The diet before the coprogram consists of the following menu:
- Milk products;
- Mashed potatoes;
- Lean meat;
- Porridge;
- Soft-boiled eggs;
- Fresh fruits;
- White bread with butter.
Preparing for a study with a suspicion of latent bleeding requires a complete rejection of meat, green vegetables, tomatoes, most fruits, otherwise the analysis may give a false result.
Preparing the patient directly for the delivery of the material consists in buying a container for analyzes and organizing hygienic conditions for defecation. It is forbidden to collect feces from the toilet - only from a clean surface. You need to take care of the pot or disposable liner in advance.
How to get tested correctly:
- Perform a natural bowel movement, avoiding the ingress of urine and discharge from the genitals;
- With a special spatula, pick up the material in an amount, how much feces are needed for analysis - about a third of the jar;
- For the best result of the study, it is advisable to follow the recommendations on how to collect feces for a coprogram - at least from three different sections of stool;
- Screw on and label the container.
How to properly pass a feces test so that the biomaterial does not deteriorate: take the biomaterial to the laboratory on the same day, no later than 12 hours after defecation. Place the container on the refrigerator shelf if necessary.
The stool coprogram in the baby is collected whenever possible, since it is difficult to control the frequency and time of the child's bowel movements. A teaspoon of biomaterial placed in a sterile container is enough for analysis.
If the child does not go to the potty, the problem of how to collect the feces from the baby is solved with the help of disposable diapers - the feces can be taken from their surface.
Where to get tested?
A general analysis of feces in the direction of a doctor is usually taken at the clinic. Research is carried out in many diagnostic centers, where you can make a coprogram:
- Sinevo,
- Hemotest,
- Invitro,
- Helix and others.
You can contact any laboratory where coprogram and scatology are presented - this is one and the same study.
How much is done and how much the analysis costs depends on the specific honey. center: the maximum period is 6 working days, and the average price is about 500 rubles.
Where to take the tests, the patient has the right to choose on his own, focusing on the cost, the declared period, how many days they make the coprogram, and the reviews of the laboratory's clients.
General analysis of feces is an important element in the diagnosis of diseases of the digestive system. It can be used to assess the state of the intestinal microflora, enzymatic activity, diagnose inflammatory processes, and more.
Rules for collecting and preparing for the delivery of material
How to properly prepare for a stool test:
Rules for collecting material for analysis:
Macroscopic and microscopic properties of feces
Quantity
In children under a month, the norm- 10-20 grams per day, from 1 month to 6 months - 30-50 grams per day. In some cases, there is an increased or decreased amount of feces in children and adults.
The main reason for this is constipation. The reasons for the increased amount: increased intestinal motility, pancreatitis, pathology of food processing in the small intestine, enteritis, cholecystitis, cholelithiasis.
Consistency
Normal stool consistency in breastfed children - mushy, if the child is fed with milk formulas, then normally the material should be putty-like, in older children and adults - formalized.
Changes in stool consistency occur for various reasons. Very dense material occurs with stenosis and spasm of the colon, with constipation, mushy - with hypersecretion in the intestine, colitis, dyspepsia, increased intestinal motility.
Oily feces are noted in diseases of the pancreas and gallbladder, liquid - with dyspepsia or excessive secretion in the intestines, with fermentative dyspepsia, frothy feces are noted.
Color
Material color depends on age. The norm of the color of feces in children who feed on breast milk is golden yellow, yellow-green, in children who are fed with milk formulas, it is yellow-brown. In adults and older children, the normal color is brown.
Reasons for color change:
- Black or tarry stool it is noted with internal bleeding, as a rule, in the upper gastrointestinal tract, as well as when eating dark berries, or when taking bismuth preparations.
- Dark brown feces it happens with putrefactive dyspepsia, disorders of food digestion, colitis, constipation, when eating a large amount of protein foods.
- Light brown feces - with increased intestinal peristalsis.
- Reddish feces noted in ulcerative colitis.
- Green feces indicates an increased content of bilirubin or biliverdin.
- Greenish black feces happens after taking iron supplements.
- Light yellow feces noted with dysfunction of the pancreas.
- Grayish-white - with hepatitis, pancreatitis, choledocholithiasis.
Smell
The main components of the smell are hydrogen sulfide, methane, skatole, indole, phenol. The normal smell in breastfed babies is sourish, in "artificial" - putrid. Older children and adults have a soft fecal matter.
The main reasons for the change in odor in the general analysis of feces in children and adults:
- A putrid odor is noted with colitis, putrefactive dyspepsia, gastritis.
- The sour smell of feces indicates fermentative dyspepsia.
- Fetid - with pancreatitis, cholecystitis with choledocholithiasis, hypersecretion of the large intestine.
- The smell of butyric acid is noted with the accelerated excretion of feces from the intestines.
Acidity
What should be the acidity in children and adults in the general analysis of feces:
- In infants who eat formula milk, it is slightly acidic (6.8-7.5).
- In children who are fed with mother's milk, it is acidic (4.8-5.8).
- In children over one year old and in adults, the acidity should normally be neutral (7.0-7.5).
Changes in fecal pH in children and adults changes in the intestinal microflora affect. When eating carbohydrate foods, due to the onset of fermentation, the acidity of feces can shift to the sour side. When eating protein foods in large quantities, or with diseases that affect the digestion of proteins, putrefactive processes sometimes begin in the intestine, shifting the pH to the alkaline side.
The reasons for the change in acidity:
- Weakly alkaline pH (7.8-8.0) is observed with poor processing of food in the small intestine.
- Alkaline pH (8.0-8.5) - with colitis, constipation, with dysfunction of the pancreas, large intestine.
- A sharply alkaline pH (> 8.5) is noted with putrid dyspepsia.
- Acidic pH (< 5,5) свидетельствует о диспепсии бродильной.
Slime
In the absence of pathology, there should be no mucus in the feces in children and adults. Small amounts of mucus in feces in infants is allowed.
The reasons for the appearance of mucus:
- Infectious diseases.
- IBS - Irritable Bowel Syndrome.
- Intestinal polyps.
- Haemorrhoids
- Malabsorption syndrome.
- Hypolactasia.
- Celiac disease.
- Diverticulitis
- Cystic fibrosis.
Blood
In the absence of pathology, blood in the feces in children and adults is absent.
The reasons for the appearance of blood in the analysis:
- Haemorrhoids.
- Anal fissures.
- Inflammation of the rectal mucosa.
- Ulcers
- Expansion of the veins of the esophagus.
- Nonspecific ulcerative colitis.
- Gastrointestinal neoplasms.
Soluble protein
In the feces, in the absence of disease, protein is not detected. The reasons for its appearance: inflammatory diseases of the digestive system, hypersecretion of the large intestine, putrefactive dyspepsia, internal bleeding.
Stercobilin in general analysis
Stercobilin- a pigment that stains feces in a specific color, it is formed from bilirubin in the large intestine. The rate of formation of stercobilin is 75-350 mg / day.
Increased content of stercobilin and in feces due to increased bile secretion, and is also noted in hemolytic anemia.
The reasons for the decrease in stercobilin are obstructive jaundice, cholangitis, cholelithiasis, hepatitis, pancreatitis.
Bilirubin in general analysis
Bilirubin to Stercobilin processed by the intestinal microflora. Up to 9 months, the microflora does not fully process bilirubin, therefore its presence in feces in children under 9 months of age is the norm. Children older than 9 months and adults should not have bilirubin during normal functioning of the digestive system.
The reasons for the appearance of bilirubin: antibiotic therapy, increased intestinal motility.
Ammonia
By the amount of ammonia in the analysis, one can judge the intensity of protein putrefaction in the toast intestine. The ammonia content in the general analysis of feces according to the norms in children and adults is 20-40 mmol / kg. Reasons for the increase in ammonia: inflammatory process in the toast intestines, hypersecretion.
Detritus
Detritus- small structureless particles consisting of bacteria, processed food and epithelial cells. A large amount of detritus indicates a good digestion of food.
Muscle fibers
Muscle fibers in feces Is a product of animal protein processing. Normally, there should be no muscle fibers in the feces of infants; in adults and older children, a small amount of them is allowed, but they must be well digested.
The reasons for the increase in muscle fibers in the analysis in children and adults:
- Dyspepsia.
- Gastritis.
- Achilia.
- Enhanced intestinal motility.
- Pancreatitis.
Connective tissue fibers
Connective tissue fibers- undigested food residues of animal origin. With the normal functioning of the digestive system, they should not be in the feces. The reasons for the appearance of connective fibers are gastritis, pancreatitis.
Starch
Starch found in plant foods. It is well digested and is normally absent from analyzes. The reasons for the appearance of starch: gastritis, pancreatitis, accelerated excretion of intestinal contents.
Plant fiber
Plant fiber is digestible and indigestible. Indigestible fiber may be contained, its amount has no diagnostic value. Normally, digestible fiber should not be found in the material.
Reasons for the detection of digestible plant fiber in the coprogram:
- Pancreatitis
- Gastritis.
- Ulcerative colitis.
- Accelerated withdrawal of intestinal contents.
- Putrid dyspepsia.
Neutral fat
A small amount of neutral fats can only be found in infants, since their enzyme system is not yet sufficiently developed. The presence of neutral fat in stool analyzes in adults and older children is a sign of some kind of disease.
Some reasons for the discovery of neutral fats:
- Dysfunction of the gallbladder.
- Disruption of the pancreas.
- Accelerated evacuation of intestinal contents.
- Syndrome of impaired absorption in the intestine.
Fatty acid
During normal bowel function, fatty acids are completely absorbed. A small amount of fatty acids in feces in infants is allowed.
The appearance of fatty acids in feces can be caused by the following diseases: fermentation dyspepsia, pancreatitis, hepatitis, cholecystitis.
Soap
Soap- these are the residues of fat processing. With the normal functioning of the digestive system, they should be analyzed in small quantities.
Lack of soap in feces- a sign of a number of diseases: accelerated evacuation from the intestinal contents, hepatitis, pancreatitis, gallbladder disease, impaired absorption of food elements in the intestine.
Leukocytes
Leukocytes- blood cells, normally the presence of single leukocytes is allowed only in infants. Sometimes leukocytes are found if the test was not collected correctly (leukocytes from the urethra).
The main reasons for the presence of leukocytes in feces: colitis, enteritis, rectal fissures.
If you suspect a disease of the gastrointestinal tract, the doctor, as a rule, immediately prescribes a coprogram to the patient - a study of physical, biochemical and microscopic indicators of feces. Any deviations from the norm can reveal serious violations of the digestive tract. This study requires special training, which will ensure high accuracy of the result.
Collecting feces for analysis is necessary according to specific instructions.
What is a coprogram and why is it done?
Coprogram is a laboratory diagnosis of feces, which is carried out to study its properties, physical and chemical composition, including color, odor, and the presence of modified substances. Feces are the result of food processing. This lengthy process begins in the mouth and ends in the large intestine. At the same time, complex reactions occur in each department, a violation of the process of which manifests itself in the form of changes in the basic indicators of feces.
Feces can contain undigested food debris, fibers, enzymes, coloring pigments, bacteria and epithelial debris from different parts of the gastrointestinal tract. Diagnosis of these indicators allows you to identify violations of the digestive tract, even in an infant.
The main indications for a general analysis of feces:
- acute and chronic form of gastric diseases;
- disorders of the liver, gallbladder and pancreas;
- neoplasms in the digestive tract;
- intestinal pathology;
- helminthiasis;
- the presence of an inflammatory process;
- intestinal microflora disorders, including intestinal colic.
The analysis is repeated after the baby undergoes the appropriate course of treatment. If the diagnosis is confirmed a second time, the doctor should not be limited to the coprogram and prescribe additional diagnostic methods.
How to collect biomaterial correctly?
In children from 1.5-2 years old
The algorithm for collecting feces in children is age-dependent. For a baby who goes to the toilet on a potty, it will not be difficult to collect biomaterial. The basic rule is that the pot must be clean. It must be thoroughly washed with baby soap and then rinsed with boiling water. Any chemical means for cleaning the pot is an absolute taboo. Secondly, the child must be washed after each bowel movement. Parents cannot always predict when they will be able to collect biomaterial, so the baby should always be ready for this.
Feces are collected with a special stick. The approximate amount of required biomaterial is 10-15 grams. The excrement is placed in a sterile jar and tightly closed, after which the analysis should be sent to the laboratory within a few hours. The maximum delivery time is 8-9 hours, provided that the feces are kept at a temperature not exceeding 5 degrees at all times. Biomaterial for the presence of helminths must be brought to the laboratory within 30-60 minutes.
When taking feces for analysis, you must take care of the sterile cleanliness of the pot. In babies
Particular attention should be paid to the issue of stool collection from infants. If the baby is breastfed, before the analysis, the mother should switch to a strict diet that excludes the following foods:
- fried, fatty and pickled foods;
- citrus;
- chocolate and its derivatives.
In this case, the excrement is collected from the diaper. If your baby has loose stools, it is best to place a disposable absorbent diaper under his butt. In infants with constipation, the use of a gas outlet tube is allowed (for more details in the article:). A coprogram in an infant is most often performed to confirm dysbiosis.
Analysis rules
Passing scatological analysis requires careful preparation, the main activities are aimed at adhering to a diet. The implementation of a few simple rules will ensure high accuracy of the result, allow you to correctly determine the indicators and identify problems in the gastrointestinal tract.
Before the coprogram, the child needs to adhere to a light diet for a couple of days. A patient who is going to take a coprogram, a few days before the analysis, must follow one of two diets:
- Diet according to Pevzner. According to her, children are allowed to consume no more than 3000 calories per day. The diet should be limited to black and white bread, fried or boiled meat, rice / buckwheat, potatoes, butter and fresh apples.
- Schmidt diet. The permissible norm of kilocalories per day is 2400. Permitted food products are dairy products, butter, eggs, meat products, potatoes and oatmeal.
If the baby needs to pass a fecal occult blood test, it is recommended to stop eating green vegetables and fruits, tomatoes, meat, fish and eggs (we recommend reading :). Before the coprogram, you should also refuse medications that contain iron.
Preparation for stool analysis provides for an exception:
- laxative drugs, including rectal suppositories;
- drugs that can change the color of stool (for example, barium sulfate);
- antibiotics and enzymes;
- conducting enemas;
- drinking coffee drinks.
If the newborn has problems with stool regularity and cannot go to the toilet, the parent should give him a massage (see also:). It is done to stimulate the colon.
Table with norms in children
Doctors, evaluating the results of stool analysis, start from generally accepted norms. It is interesting that most of the indicators of the norm in children of different ages differ significantly from each other. For example, the color of feces in a newborn cannot be the same as in a one-year-old baby. The norms of physical, biochemical and macroscopic parameters of feces in infants and children over a year are shown in the table:
| Parameter | Norm for babies up to 1 year | Norm for children from 1 year old |
| Color | Yellow, green, brown, black (when using iron preparations) | Brown |
| Quantity | 20-60 grams per day | 90-300 grams per day |
| Smell | Sour and putrid | Usual |
| Consistency | Gruelous or viscous | Decorated, sausage-like |
| Impurities (mucus, blood) | Up to 3 months mucus production in feces is possible | Not |
| Ph | 4,8-7,5 | 7-7,5 |
| Bilirubin | Possible positive reaction | Negative reaction |
| Stercobilin | 75-150 mg per day | 75-350 mg per day |
| Fatty acid salts | Not | Not |
| Erythrocytes | Not | Not |
| Leukocytes | The maximum allowable number is 1-2 | Up to 2-4 |
| Starch | Not | Not |
| Muscle fibers | Not | Single |
| Detritus | There is | There is |
The accuracy of the coprogram results will depend on the quality of the analyzes performed. Decoding indicators
Deviations of physical, biochemical and microscopic parameters in the coprogram may indicate a certain violation of the digestive tract:
- Changes in the consistency of feces. In infants, unformed loose stools are considered the norm (for more details in the article:). Dense feces in the form of lumps may indicate constipation, the same symptom is typical for children over a year old. Loose stools in a baby over 1 year old shows diarrhea, and frothy feces means the presence of an intestinal infection in the body.
- The presence of impurities in the feces. According to the decryption, in infants up to three months of age, the presence of mucus in the feces can be considered the norm. Fear in babies older than a year should be caused by the remnants of undigested food, indicating a malfunction of the pancreas, as well as blood, which is a sign of possible bleeding in one of the intestines.
- Violation of the acid-base environment. Doctors can decipher this indicator as follows. Excess ph occurs when protein decay occurs as a result of excessive consumption of meat. If the ph values are below normal, then there is reason to talk about impaired absorption of fatty acids and intolerance to dairy products.
- The presence of bilirubin. Bilirubin can only be detected in the analysis of an infant who is on HB. In all other cases, the reaction should be negative. If an older child has bilirubin in the feces, this indicates diarrhea, gastroenteritis or dysbiosis (see also :).
The attending physician is responsible for decoding the coprogram - The presence of stercobilin. Stercobilin is a breakdown product of bilirubin, therefore it is present in the feces of children in small quantities. Its excess is an indicator of disruption of the spleen, and a decrease indicates hepatitis, pancreatitis or cholangitis in acute form.
- The presence of muscle fibers. These inclusions are the remnants of undigested meat food. Their presence is a sign of pancreatic dysfunction.
- The presence of starch. Normally, starch in the body of a healthy child is completely processed. If starch grains are found in the feces, the doctor may diagnose acute pancreatitis or gastritis.
- The presence of erythrocytes and leukocytes. An excess of the norm of leukocytes occurs with helminthiasis, an ulcer, a polyp, or the formation of a tumor.
- Deciphering the coprogram also includes a study of fatty acid salts in the child's feces. Their presence signals the need for additional diagnostics of the pancreas.
- The presence of soap. Soaps are processed residues of fats, therefore, a small amount of them in the feces of babies of different age groups is considered the norm.
- Lack of detritus. Detritus is small particles of digested food. Its presence in the feces indicates proper nutrition, while the absence of detritus is an indicator of the body's rejection of certain foods or the development of intestinal infections.
- The presence of protein. Doctors unanimously decipher a positive reaction to protein with the following diagnosis - an inflammatory process in the intestine.
What does the change in the color and smell of feces indicate?
The interpretation of the results of stool analysis includes the determination of changes in the color and odor of the biomaterial. Normally, feces in infants are yellow, brown or gray.
Since babies who are breastfed produce bilirubin for up to six months, feces can turn green. When using preparations with iron, the excrement is black. The feces of the older child are predominantly brown. Deviations from the norm indicate the development of pathology:
- black is a sign of bleeding in the stomach or duodenum;
- yellow color is a symptom of fermentation in one of the parts of the intestine, sometimes due to excessive consumption of dairy products;
- discolored, white - manifestations of viral hepatitis, disorders of the duodenum or gallstone disease.
The smell of excrement can also indicate dysfunction of the digestive tract:
- too fetid odor helps to identify decay processes in one of the intestinal parts, as well as microflora disturbances;
- sour smell, with the exception of age under one year, indicates an excessive fat content;
- too little odor is noted with constipation.
The cost of the procedure
Stool analysis is carried out today in all public and private diagnostic centers. The cost depends on the city in which the study is carried out, as well as on the timing of completion. As a rule, the result of the coprogram can be obtained in 5-6 working days. In medical centers, if necessary, urgent tests are done, which are slightly more expensive. The average cost of research in the capital is approximately 400-600 rubles. In Kazan, the test can be taken for 300-400 rubles, and in Samara for 200-250.
- a comprehensive analysis of feces, which allows you to assess the work of the digestive system as a whole, and the functionality of each organ separately. In order for the research results to be accurate, it is necessary to adhere to certain rules for the preparation, collection and storage of material.
Coprogram helps to know the state of the digestive system
What is coprogram?
Coprogram is a method of laboratory examination of feces, which is prescribed to identify pathologies of the digestive system. The specialist conducts macro and microscopic, chemical, physical analysis of feces, after which he makes a detailed description of the composition of the feces.
What the general analysis of feces shows:
You can make a stool coprogram in a regular clinic for free, but in order to get a more accurate and detailed result, it is better to contact private laboratories, the average price is 370-420 rubles.
Indications for taking a coprogram
The analysis of feces must be taken as part of an annual preventive examination in order to recognize problems with the digestive tract in time and start treatment.
When scatology is prescribed:
- inflammation of the digestive system in acute and chronic form;
- hemorrhoids, cracks in the anus, chronic constipation;
- cirrhosis of the liver;
- irritable bowel syndrome;
- neoplasms in the gastrointestinal tract;
- poisoning;
- suspicion of helminthic invasion, amoebic dysentery;
- assessment of the effectiveness of drug treatment;
- before carrying out instrumental diagnostics of the digestive tract, surgical interventions.
Children are prescribed an analysis of feces for colic, with suspicion of intestinal infections, inflammatory processes, cystic fibrosis, lactose intolerance, dysbiosis, infection with worms.
You can not donate feces with bleeding hemorrhoids
How to collect feces
It is better to collect feces from an adult and a child in the morning, right after the morning toilet, to try to deliver it to the laboratory as quickly as possible. You need to collect material from different parts of feces, put them in a sterile container, or special disposable plastic containers that can be purchased at the pharmacy. Emptying should be natural, the use of laxatives, and even more so, enemas are prohibited.
You can collect baby feces directly from the diaper
An older child needs to prepare a pot, first it should be washed with laundry soap or soda.
When collecting material, you need to ensure that there is no urine in the stool.
How much feces do you need?
To carry out the analysis, you need to bring 15–20 g of material to the laboratory, which is approximately equal to 1 tsp. - this amount is quite enough to identify all the main indicators.
Can a stool sample be collected in the evening?
It is better to use the morning portion of feces for analysis, but if you are not sure that defecation will occur after waking up, you can collect the material in the evening, it should be stored in the refrigerator for no more than 10-12 hours, the container must be hermetically closed.
You can store feces for analyzes in the refrigerator for no more than 12 hours.
How much stool analysis is done
In terms of time, the coprogram takes 1-3 days, in some private clinics an urgent analysis is provided - the decryption is done in a few hours. As a matter of urgency, diagnostics are carried out in a hospital in case of a serious condition of the patient, if emergency surgery is required.
Decoding the results of scatological research
When the results are ready, the person will receive a form, which will indicate the normal indicators and the results obtained during the study of the material. It is better to consult a doctor for decoding, since even a deviation from the norm of several indicators does not always indicate the presence of pathologies.
Black - bleeding, neoplasms in the upper tract, ulcerative colitis;
· Reddish tint - bleeding in the lower gastrointestinal tract.
- affordable, inexpensive and informative analysis of human feces. To get a reliable result, you must adhere to the rules of preliminary preparation, collect, store and transport the material to the laboratory correctly.
Coprogram - a study of fecal contents to find out its properties, physical and chemical composition, the presence of pathological inclusions in order to diagnose diseases and monitor the dynamics of the disease, the treatment process.
Feces are formed when a food lump (chyme) passes through the entire human digestive tract from the oral cavity to the rectum. Therefore, these coprograms are most valuable in the diagnosis of diseases of the gastrointestinal tract.
What the coprogram shows
In the feces, microorganisms of various types and quantities, particles of undigested food, fecal pigments, and the epithelium of various parts of the intestine are found.
note : knowing these features, the laboratory assistant can determine pathological processes in certain parts of the intestine in some diseases.
Coprogram is shown when:
Coprological examination reveals (violation of the ratio of microorganisms and the reproduction of disease-causing forms).
Coprogram is rarely used as an isolated study, most often it is an additional, but at the same time informative diagnostic method.
Preparation for the test is not difficult, but some rules must be strictly followed.
If the patient is taking medications containing iron and bismuth, then they must be canceled. Also, you should not take laxatives, rectal suppositories. Bowel lavage with enemas is prohibited.
If the person under study underwent radiography with a contrast agent (barium), then the coprogram should not be done earlier than 7-10 days after the study. Barium can alter the properties of feces.
In the patient's diet for several days preceding the delivery of the test, excessive variety, exotic dishes, etc. should be limited.
Preparatory rule for passing feces for a coprogram:
How to collect feces for coprogram
Important : The collection rules are simple, but must be followed carefully.
To collect feces, you must:
- empty the bladder, conduct a thorough toilet of the genitals and anal area using warm water and neutral soap without aromatic additives. Then rinse the washed areas with warm, boiled water;
- in a previously prepared clean dish with a wide neck, using a spatula (which is available in pharmacy containers for collecting feces), collect material from different areas of the obtained feces;
- after collection, the feces are closed with a lid and signed with the name and surname of the patient, as well as the date of collection.
Do not use wooden boxes, food cans as dishes for feces. The total amount of collected material should be 15-20 grams (approximate volume of a teaspoon). Try to bring about the same amount of stool to the laboratory.
The feces should be collected in the morning and brought for examination as soon as possible.
Note: the faster the material is brought to the laboratory, the more accurate and reliable the coprogram results will be.
If necessary, the container with the biomaterial is placed in a 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.
If a child goes to the potty independently, then the same rules apply to him as to adults.
In infants, a diaper or oilcloth is used (if the stool is liquid).
In case of constipation, to stimulate bowel movements, it is necessary to massage the abdomen; in some cases, a gas outlet tube can be installed, which stimulates the act of defecation.
All materials must be clean, hands must be washed with soap and water before collection.
Decoding coprogram in adults
Initially carried out macroscopic examination of feces.
In decoding the coprogram in adults, it is assessed:
- appearance of bowel movements;
- the density of feces;
- staining (normal or pathological);
- the presence of a specific smell;
- the presence of bloody blotches, streaks, undigested food, purulent discharge, mucous lumps;
- the presence of mature forms of helminths;
- possible release of gallstones and pancreatic stones.
Microscopic analysis allows you to assess the ability of the gastrointestinal tract to digest food.
Microscopic examination may detect:
- squirrel , which appears during inflammatory processes in the digestive tract system, with ulcerative changes in the mucous membrane, polyposis formations, and oncological diseases. Normally, there is no protein in the feces;
- blood - appearing with latent intraintestinal bleeding, which can cause ulcers, tumors,. Altered blood speaks of processes in the upper intestines, unchanged - in the lower. Occult blood is characteristic of tumors;
- stercobilin ... It is a pigment that is a metabolite of bilirubin, which gives the stool a specific color. About 75-350 mg of this pigment is formed per day. An increase in the indicator in decoding the coprogram in adults is characteristic of hemolytic anemias. A decrease indicates a possible process of obstruction of the bile ducts (stones, swelling);
- ... The appearance of this chemical indicates an acceleration of the digestion process, as a result of which bilirubin does not have time to be metabolized into stercobilin. This situation occurs in acute inflammation and dysbiosis;
- slime ... Mucus performs a protective function in the intestines, therefore, its increased formation indicates strong inflammatory changes in the intestines in acute infectious pathology (salmonellosis, dysentery, infectious colitis, etc.);
- iodophilic flora ... The appearance of pathological bacteria in the decoding of the coprogram in children and adults is characteristic of dysbiosis;
- detritus ... Cellular degraded material that emerges from the intestinal epithelium. A decrease in the amount is observed when the digestive process is disturbed;
- neutral fats ... Excessive content is characteristic of insufficient excretion (production of bile), as well as the process of absorption of bile in the intestine;
- muscle fibers ... The appearance of these elements in an unchanged form (normally they change) indicates a painful process in the pancreas, due to violations of the composition of the juice, which is involved in the digestion of meat food;
- starch ... Normally, it undergoes a cleavage process, if during the study it is found in the form of grains, then one should suspect the accelerated passage of the food lump in the syndrome, this symptom also appears in chronic;
- soap ... Soapy substances are normally present in small quantities. An increase can be with digestive insufficiency of the small intestine, stomach and duodenum 12. These problems occur with inflammation of the pancreas, with stones in the gallbladder;
- leukocytes ... Normally they are not determined. Their appearance in the decoding of the coprogram speaks of inflammatory diseases of the digestive tract;
- fatty acids ... The secretions of a healthy intestine are absent. They appear with digestive and enzymatic insufficiency, disorders of the outflow of bile, accelerated intestinal activity;
- vegetable fiber ... If soluble fibers are noted in the decoding of the coprogram in adults, then we can talk about insufficient excretion of hydrochloric acid in the stomach. Normally, soluble fibers of plant fiber are absent in feces. Insoluble fiber (peel of fruits and vegetables, outer shell of grains and legumes) - refers to the normal contents of the intestine. Insoluble fibers remove indigestible foods, poisons, cholesterol from the intestines. The amount of these elements depends on the qualitative composition of the food;
- connective tissue fibers ... These fibers are formed from undigested animal food residues. Normally, they should not be. The appearance of fibers is characteristic of conditions in which the acidity of gastric juice decreases - (antacid gastritis). Also, these elements are noticeable with a decrease in the production of hydrochloric acid in the stomach, enzymatic deficiency that occurs with pancreatitis;
- ammonia ... An increase in the content of this chemical compound is characteristic of processes accompanied by putrefaction in the intestinal lumen. Normally, ammonia in feces contains 20-40 mol / kg. If an increased value of ammonia is indicated in the decoding of the coprogram in adults, then the presence of intestinal inflammation in a person should be suspected;
- pathological and conditionally pathological microorganisms causing bowel disease,.
The reaction of feces (pH) can be different (slightly alkaline, neutral, slightly acidic). This indicator depends on the nature of the diet.
Features of decoding coprograms in children
The main indicators of the coprogram in children are similar to those in adults. But there are some peculiarities.
Most children have a normal coprogram with a neutral or slightly alkaline reaction (in the pH range 6-7.6.
note : in infants, the reaction is most often sour, as a result of the dietary habits of this age group.
An alkaline reaction in children is determined by a violation of the absorption process, with increased putrefactive processes in the intestine, prolonged stay in the stomach and intestines of undigested food.
Up to the age of three months of the child with breastfeeding, the presence of bilirubin in the feces is a variant of the norm. After 3 months in decoding the coprogram in children, only stercobilin should normally be determined.
Lotin Alexander, medical columnist
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