Coprogram: transcript, fecal analysis rate,how to prepare an adult child

Update: December 2018

Feces, like urine, is the end product of life
person It is formed in the large intestine as a result of the whole
ряда биохимическtheir процессов. AT состав испражнений входит вода,
undigested food residues, metabolic by-products,
bacteria and so on.

Do not underestimate the study of feces. Sometimes it is this
анализ позволяет выявить у adults и детей патологию
пищеварительного тракта, болезни печени, pancreas.
Assign this examination not only for the purpose of diagnosis
diseases, but also to control the treatment.

What shows the coprogram (stool analysis):

  • исследование физическtheir и химическtheir свойств кала (цвет,
    consistency);
  • material microscopy;
  • bacteriological examination (detection of disease-causing
    микробов и анализ кишечной microflora);
  • detection of helminth eggs;
  • detection in the feces of hidden blood.

How to prepare for the analysis of feces?

Предварительная подготовка к сдаче материала у детей и adults
normally lasts 3-4 days. It is aimed at cleansing the intestines and
prevention of fecal residues of food, muscle and
vegetable fiber. Subject to special training
technicians will be able to detect even a small degree of violation
эвакуаторной и переваривающей функции digestive tract.

The essence of the preparation is to follow a special diet with
specific protein, fat and carbohydrate content. For this purpose
Two types of diets are suitable: according to Pevzner and according to Schmidt.

Pevzner Power Mode

It provides for the consumption of black and white bread,
meat (boiled or fried), sauerkraut, rice and
гречневой каш, свежtheir яблок, картофеля (в любом виде), сливочного
oils. The total energy value is about 3000 kcal per
day.

Schmidt diet

She is gentle. It is recommended to eat 5 times a day,
mostly dairy products (milk, butter), steamed
eggs, meat, potatoes, porridge (slimy decoction). Daily
caloric content should be limited to 2200-2400 kcal.

Fecal occult blood

  • Before examining feces for latent bleeding, patients do not
    It is recommended to eat foods that can cause
    false positive reaction to blood. These include: all
    varieties of green vegetables (cucumber, cabbage), fish, meat, eggs,
    tomatoes
  • Also больным следует воздержаться от приема медикаментов,
    содержащtheir железо (феррум-лек, феррумбо).

AT случае, когда необходимо срочно сдать анализ или соблюдать
diet does not allow health, it is recommended at least for
day not to drink alcohol, tea, coffee.

It is strictly prohibited before the survey.

  • make a cleansing and siphon enema;
  • take medications that affect intestinal motility
    (laxatives or antidiarrheal);
  • administer suppositories or other forms of drugs in
    anus;
  • apply drugs that change the color of the material (sulphate
    barium, bismuth preparations).

How to take a coprogram?

The material must be collected in a clean dish after the morning.
self emptying of the intestines. Enough for research
10-15 g of feces. AT редкtheir случаях врач может назначить суточное
feces research. AT таком случае больному необходимо
collect feces within 24 hours.

If the patient suffers from prolonged constipation and cannot
empty yourself, it is recommended to have a thick massage
guts. If this procedure has not brought results, the patient should
make a cleansing enema. AT этом случае из промывных вод
take a hard piece of feces.

Methods of collecting analysis:

  • in the morning after sleep, the patient is recommended to defecate in the pot
    or ship
  • then a special stick or spatula selects a small
    the amount of feces in a clean, dry jar and tightly closed
    a lid.
  • It is advisable to deliver the analysis immediately to the laboratory. Extreme
    Term – 8-10 hours. After this time, the material may deteriorate and
    become unsuitable for examination.
  • stool is stored at temperature
    3-60С.

When testing for worms eggs, the material should be completely
fresh, that is, delivered to the laboratory in the form of heat.

Bacteriological examination of stool is performed with
using a lab technician. The patient is asked to lie on the right side or in
standing position lean forward. Laboratory assistant throws buttocks
patient and enters into the anus a metal loop with
wadded on it with a cotton swab. ATведение должно осуществляться
rotational movements, very carefully, so as not to damage
the mucous membrane of the anus. ATыводят петлю также осторожно, помещая
then into a sterile tube.

Coprogram analysis

Norm of indicators

Microscopic examination

  • Consistency
Dense
  • Muscle fragments with striation
Absent
  • The form
Decorated
  • Muscle fragments without striation
Single
  • Colour
Brown
  • Connective tissue
Absent
  • Smell
Unsharp, specific fecal
  • Neutral Fats
  • Reaction
From 6.01 to 8.01
  • Fatные acids
  • Slime
A small amount of
  • Fatty acid salts
A small amount of
  • Blood
Absent
  • Digested plant fiber
Single fiber
  • Undigested food residues
  • Intra-and extracellular starch
Missing
  • Stercobilin Reaction
Positive
  • Normal iodophilic intestinal microflora
Small number
  • Reaction to bilirubin
Negative
  • Pathological microflora
  • Cylindrical epithelium
  • Flat epithelium
  • White blood cells
  • Red blood cells
  • Simplest
  • Helminth eggs
  • Yeast Fungi
Absent
  • Protein reaction
  • Reaction to hidden blood

Deciphering stool analysis in middle and older children and
adults

amount

  • Normally, a person produces 150-200 g of feces per day for 1-2
    times.
  • For children, the mass of feces is 80-150 g per day.

The amount of bowel movements depends on the amount of food eaten and its
quality composition. For example, if a person eats meat or
dairy products, then the amount of feces is reduced. Vegetable
food on the contrary increases its volume. Pathological causes
changes in the amount of feces in the table:

Polyfecal (increased stool volume)

Oligophaecalia (decrease in feces)

  • Crohn’s disease;
  • nonspecific ulcerative colitis;
  • pancreatitis;
  • enteritis;
  • obstructive jaundice;
  • colon cancer.
  • myxedema;
  • chronic colitis;
  • peptic ulcer and 12 duodenal ulcer.

Consistency and form

Cal is considered normal palate consistency, decorated
(sausage). Liquid, unformed chair called
diarrhea Usually this condition is accompanied by an increase in defecation and
polyfecalia. Diarrhea can happen:

  • osmotic – happens due to osmotic violation of absorption
    active substances (potassium, sodium) and proteins – pancreatitis, disease
    Krone, sprue, taking magnesia sulphate;
  • secretory – usually caused by inflammatory processes in
    intestines (enteritis, colitis);
  • motor – occurs with increased peristalsis
    digestive tube (laxative medication);
  • mixed – due to all of the above
    factors.

A peculiar ribbon-like form of feces can be caused
spasms in the rectum and sigmoid colon. In case of violation of the evacuation of food
From the intestines of a person there are constipation. Feces in this case
becomes solid, dense, similar to sheep balls. Hardness
It is caused by excessive absorption of water.

Colour

Normal feces are colored brown. This is due to
the presence of stercobilin in it – a product of the breakdown of bilirubin, which
with bile excreted into the intestines. The change in color of the material may
be due either to various factors:

Colour кала What caused
Light yellow Occurs when using a large number of dairy
products.
Bright yellow The reason is the accelerated evacuation of food from the intestines
(diarrhea of ​​infectious and non-infectious origin) or treatment
drugs from the Seine.
Dark brown (playhochromia)
  • excessive consumption of meat food;
  • hemolytic jaundice;
  • resolution of obstructive jaundice (elimination of gallstones,
    disintegration of the tumor).
Black (tarry) – melena
  • eating black currant, blueberry, black chokeberry,
    cherries;
  • gastrointestinal bleeding (black due to
    hemoglobin with hydrochloric acid, which is called
    hematin) – a bleeding gastric or duodenal ulcer,
    bleeding from the dilated veins of the esophagus;
  • cirrhosis of the liver;
  • treatment with bismuth and iron preparations;
  • thrombophlebitis of the splenic vein.
Greenish Eating a variety of lettuce leaves, asparagus,
celery, sorrel.
In the form of “rice broth” Transparent stool with flakes is observed with cholera.
In the form of “pea soup” Such material indicates the presence of typhoid fever in
the patient.
Red, reddish Occurs when bleeding from the lower intestinal tract (direct
and colon).
Bleached, clayey (acholic) Feces lose their color due to termination of admission
sterkobilina in the intestines. This happens when:

  • cirrhosis of the liver;
  • viral hepatitis;
  • gallstone disease;
  • pancreatic head cancer;
  • cancer of the Fater papilla of the duodenum;
  • adhesions of the common bile duct.
Light coloured
  • abundance of undigested fat in the feces – steatorrhea – (due to
    pancreatic dysfunction in pancreatitis,
    malignancy);
  • admixture of large amounts of pus and mucus (Crohn’s disease,
    nonspecific ulcerative colitis);
  • after contrast radiography of the digestive tract (due to sulfate
    barium);
  • increased fermentation processes in the intestines.

Smell

The chair normally has an unsharp peculiar smell. This is due to
bacterial fermentation processes that occur in the gut. AT
In the process of protein breakdown, indole, skatole, phenol and cresol are formed,
they form the smell of feces.

The smell of stools is weakened by a vegetable diet and constipation, and
increases with meat diet and diarrhea.

Sharp fetid odor speaks of putrid processes in
intestines. The sour scent of excrement indicates the presence of
increased amount of fatty acids (propionic, butyric).

ATидимые примеси

AT норме в стуле не должно быть крови, слизи, остатков
undigested food, stones, worms and so on. Availability their
talks about the pathological process in the digestive tract.

Impurity Which means
Undigested Food Lumps
  • dysfunction of the pancreas;
  • atrophic gastritis;
  • accelerated bowel motility (diarrhea).

AT норме в фекалиях могут содержаться мелкие кости, кожура овощей
and fruits, cartilage, cucumbers, nuts.

Fat This may be due to insufficient function.
pancreas. AT этом случае фекалии становятся блестящими,
oily, with white lumps.
Slime

AT норме допускается небольшое количество слизи в испражнениях.
Its abundance indicates inflammatory processes in the intestine, as
infectious (dysentery, salmonellosis) and non-infectious
(nonspecific ulcerative colitis).

Slime может быть перемешана с калом либо располагаться на его
surface.

Blood

ATыделение малых порций крови обычно незаметно для человеческого
eyes, it can only be detected by microscopic
research.

Impurity алой крови говорит о кровотечении из нижнtheir отделов
intestine or from the initial divisions, if the motility is enhanced.

Pus Pus появляется в фекалиях при тяжелых воспалительных
pathologies (dysentery, intestinal tuberculosis), an abscess breakthrough in
lumen of the intestine, tumor suppuration.
Worms Some helminths (whipworm, pinworms, roundworm) may
stand out with the whole chair or fragments.
Stones Coproliths (fecal stones), bilious, pancreas.

pH

In a healthy person with a normal diet, feces have
нейтральную или слабощелочную реакцию (pH 6,87-7,64). Изменение pH
kala:

  • кислая реакция (pH 5,49-6,79) – возникает при нарушении
    absorption of fatty acids in the small intestine;
  • резко-кислая реакция (pH менее 5,49) – бывает при чрезмерной
    fermentation microflora activity or lactose intolerance;
  • щелочная реакция (pH 7,72-8,53) – имеет место при гниении
    proteins (heavy meat consumption);
  • резкощелочная реакция (pH более 8,55) – говорит о гнилостной
    dyspepsia.

Reaction to hidden blood

Hidden call the blood that is not visible to the human eye
(macroscopically) and under the microscope. AT норме реакция может быть
positive in the use of meat, fish, blood sausage,
preparations of iron, vigorous brushing, falling into the feces
menstrual blood. Pathologies causing the appearance of blood in
faeces:

  • gum disease (gingivitis, periodontal disease);
  • peptic ulcer and 12 duodenal ulcer;
  • заглатывание крови из верхнtheir дыхательных путей (носовые
    bleeding);
  • bleeding tumors;
  • varicose veins of the esophagus and rectum;
  • синдром Меллори-ATейса;
  • worm infestation;
  • intestinal tuberculosis;
  • dysentery;
  • colitis;
  • hemorrhagic vasculitis;
  • Stevens-Jones syndrome;
  • hemorrhoids;
  • intestinal polyposis;
  • typhoid fever.

Protein reaction

AT норме реакция на белок всегда отрицательная. Positive she
maybe with:

  • inflammatory diseases of the digestive tract (gastritis, duodenitis,
    enteritis);
  • dysbacteriosis;
  • celiac disease

Stercobilin Reaction

Sterobilin is a breakdown product of bilirubin, which gives
feces brown coloring. ATыделяется он в 12-перстную кишку с
bile. AT норме в 100 г фекалий содержится 75-100 мг стеркобилина.
Changes in the content of stercobilin in the stool can be at different
diseases:

Stercobilin Enhancement Decrease or absence of stercobilin
  • hemolysis of erythrocytes in case of poisoning with poisons, drugs;
  • excess function of the spleen.
  • камни в желчевыводящtheir путях;
  • swelling of the pancreatic head;
  • tumor of the Vater papilla;
  • увеличение лимфатическtheir узлов (лимфоаденопатия);
  • acute hepatitis;
  • acute cholangitis;
  • acute pancreatitis.

Reaction to bilirubin

Bilirubin can normally be found in the baby’s feces,
fed with breast milk. It gives the fecal greenish
coloring. In an adult with feces only stand out
bilirubin degradation products. Detection in the stool bilirubin happens
with:

  • diarrhea;
  • severe dysbacteriosis with antibiotics.

Microscopic examination of feces

What is found Which pathology points
Muscle fibers with striation and without striation
(creatorrhea)
  • achilia;
  • disruption of the pancreas;
  • fermenting and putrid dyspepsia;
  • diarrhea.
Connective tissue (connective tissue fibers) ATыявляется при недостаточности пепсина в желудочном соке и
diarrhea. Detection of bone and cartilage in the stool is not
pathology.
Vegetable клетчатка
  • achilia;
  • diarrhea of ​​any nature.
Starch
  • atrophic gastritis;
  • острый pancreatitis;
  • diarrhea.
Fat и его продукты (жирные acids, соли жирных кислот)
  • disruption of the pancreas;
  • lack of bile flow to the intestine;
  • diarrhea.
Intestinal epithelium (flat and cylindrical)
  • intestinal mucositis
White blood cells Neutrophils:

  • colitis;
  • enteritis;
  • intestinal tuberculosis;
  • proctitis and paraproctitis.

Eosinophils:

  • nonspecific ulcerative colitis;
  • амебная dysentery;
  • worm infestation.
Red blood cells Обнаружение their говорит о кровотечении в просвет
digestive tract.
Crystal formations Human feces may contain:

  • hematoidin crystals (bleeding);
  • tripel phosphates (putrid dyspepsia);
  • oxalates (decrease in gastric acidity juice);
  • Charcot-Leiden crystals (allergies, worms invasion);
  • cholesterol crystals.
Simplest
  • dysentery amoeba;
  • трtheirомонада;
  • balantidia;
  • Giardia.
Helminth eggs When helminthiases with feces excrete
Ascaris, pinworms
Bacteria and fungi

Bacteria in the feces are pathological (intestinal
stick, proteus) or part of the normal microflora (lacto
and bifidobacteria).

Among fungi, the detection of mycelium is of diagnostic importance.
Candide.

Coprogram of the newborn and infant

 Features of the chair after childbirth

  • AT первые пару дней после рождения малыша у него выделяется
    a special feces called meconium. Meconium has a dark green
    or olive color and is a dense homogeneous
    mass of
  • A week later, mucus, lumps, and stools appear in the baby’s feces.
    becomes more frequent and fluid. The color of feces also changes:
    dark green is replaced by yellow and yellow-brown.

Analysis of feces of children of such a small age has a number of features.
The intestines of a child at birth are still underdeveloped and not
adapted to the reception of ordinary adult food. Therefore very important
factor in the development of the baby is its proper feeding.

AT первые дни жизни младенец с материнским молоком получает все
essential trace elements, nutrients and vitamins. Also
during feeding, the intestines of the infant become infected with lacido and
bifidobacteria that are necessary for the production of feces.

If a pediatrician prescribes a baby to pass a stool test, mommy
it is necessary to follow a certain diet within 2-3 days, since
what mom eats necessarily enters the body of a child with
milk

Features of mommy’s diet (see what you can eat
mother):

  • eliminate all possible allergens (eggs, citrus,
    chocolate);
  • do not drink alcohol, do not smoke;
  • It is preferable to eat porridge (oatmeal, rice),
    vegetable soups, steam patties;
  • do not abuse fatty foods, easily digestible
    carbohydrates.

However, the mother may not always provide the infant with sufficient
amount of milk. AT последнее время грудчников начинают
feed mixtures from the first months or immediately transferred to
artificial feeding.

The main differences

Coprogram with natural and artificial feeding of babies
may differ. No matter how balanced the mix is, she never
its quality does not replace breast milk. This is reflected in
the work of the digestive system of infants, whose product
is cal.

Options

When feeding with mixtures

When feeding with milk

Daily amount Up to 35-45 grams A normal amount is 45-55 grams.
Colour Light brown Yellow with a greenish tinge (this color is due to the presence in
kale bilirubin, which is considered a variant of the norm)
Smell More putrid More sour
pH Slightly alkaline (7.58-7.74) Slightly acidic (5.52-5.89)
Fatы и жирные acids Neutral fat drops Fatные acids и their соли (обеспечивают кислую реакцию
chair)
Slime Missing или небольшое количество
Blood Missing
Undigested food residues ATозможно небольшое количество из-за несформированной кишечной
microflora
Stercobilin Reaction Positive
Reaction to bilirubin
Protein reaction Negative
Reaction to hidden blood
Muscle fibers ATозможно в небольшом количестве
White blood cells AT небольшом количестве
Intestinal epithelium
Red blood cells Absent

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