Name of the Procedure:

Blood, occult, by peroxidase activity (e.g., guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening

Summary

This procedure involves a laboratory test that detects hidden (occult) blood in the stool using a chemical reaction facilitated by an enzyme called peroxidase. The test uses guaiac, a plant-derived substance, and is qualitative, meaning it determines the presence or absence of blood rather than measuring the amount.

Purpose

The procedure is used to identify hidden blood in the stool, which can be an indicator of various conditions like gastrointestinal bleeding, ulcers, inflammatory bowel disease, and other non-cancerous conditions.

Indications

• Unexplained anemia
• Chronic gastrointestinal discomfort
• Persistent or unexplained changes in bowel habits
• Abdominal pain or tenderness
• Known gastrointestinal disorders requiring routine monitoring for bleeding

Preparation

• Patients may be advised to avoid certain foods that can affect test results, such as red meat, certain vegetables (cauliflower, broccoli, turnips), and vitamin C-rich foods.
• Some medications might need to be paused, including aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Patients might also be instructed to avoid non-food sources of blood like dental procedures that could cause bleeding.

Procedure Description

1. The patient collects a small stool sample using a provided kit.
2. The stool sample is applied to a test card.
3. A guaiac solution is added to the stool sample on the test card.
4. The test card is evaluated for color change; the presence of blood will cause a blue color change due to peroxidase activity.
5. Multiple determinations may be done simultaneously to ensure accuracy.

Duration

The entire procedure, including sample collection and testing, typically takes less than 30 minutes. The actual interaction with the healthcare provider might only take a few minutes.

Setting

The procedure is usually performed in an outpatient setting, such as a clinic, laboratory, or doctor's office.

Personnel

• Primary Care Physicians
• Gastroenterologists
• Nurses
• Laboratory Technicians

Risks and Complications

• False positives can occur due to dietary factors or medications.
• False negatives might happen if the bleeding is intermittent.
• There are no significant physical risks associated with the procedure itself.

Benefits

• Non-invasive and simple to perform.
• Helps in early detection and management of gastrointestinal conditions.
• Provides valuable information leading to further diagnostic testing if necessary.

Recovery

• There are no recovery requirements for the test itself.
• Patients can resume normal activities immediately.
• Follow-up may involve additional tests or treatments depending on results.

Alternatives

• Fecal immunochemical test (FIT), which uses antibodies to detect blood.
• Endoscopic procedures like colonoscopy or sigmoidoscopy for direct visualization of the gastrointestinal tract.
• Imaging studies like capsule endoscopy.

Patient Experience

• The patient may feel minimal discomfort related to sample collection.
• The test involves handling stool, which some may find unpleasant.
• There is typically no pain involved.
• Any anxiety related to the results can be discussed with the healthcare provider.