What does fecal analysis show - coprogram? Collection of feces for a scatological study and its analysis Analysis of scatology shows what.

The first thing a doctor will do if you contact him with complaints of digestive problems will give a referral to general analysis feces. The study of physical, chemical and microscopic indicators of feces gives the most complete picture of the state of the digestive system as a whole and each organ separately. Next, we will consider what kind of analysis “Coprogram of feces” is, why is it so informative, how to pass and how to decipher the results of the study?

What the analysis shows

Fecal matter is the end product of human life. Incoming food travels a long way from oral cavity to the section of the large intestine, where it is formed in the feces. In each of the departments and organs of the digestive tract, a number of complex biochemical reactions are observed, knowing which a specialist, even in the appearance of feces, can tell a lot about the digestive capacity of each organ of the gastrointestinal tract and the existing pathologies.

After all, excrement contains undigested food residues and fibers, water and metabolic products, bacteria and fragments of the epithelium from various parts of the intestine, coloring fecal pigments, blood, enzymes, digestive juices and much more.

Indications for appointment

Fecal analysis is prescribed as part of the general diagnostic study in the detection of diseases:

• stomach in acute or chronic stage;
• any of the sections of the intestine;
• liver;
• gallbladder and its ducts;
• pancreas;
• helminthic invasion;
• cancerous tumors;
• dysbiosis.

A fecal examination is prescribed if you suspect:

• hemorrhoids and anal fissures;
• chronic constipation and Crohn's disease;
• colitis and ulcers;
• polyps in the large intestine;
• acute intestinal infections;
• pancreatitis and cirrhosis of the liver;
• anemia and amoebic dysentery.

And this is not the whole list of diseases that are not only diagnosed, but also observed during general therapy.

Usually, at the first visit, the patient complains of pain in the abdomen, constipation or diarrhea, excessive gas and bloating, cramps, colic, blood and mucus in the stool.

To quickly identify the pathogen in case of poisoning, a general fecal analysis is also prescribed.

For children, such a diagnosis is carried out with allergic reactions, suspicion of helminths, and any other digestive disorders.

How to prepare for a stool test

Preparation for the delivery of feces for a coprogram takes several days. It is not difficult, but if you want to get accurate results, you still need to follow some simple rules. Then the laboratory will be able to see the most accurate picture of the state of the digestive tract.

Preparatory measures are, first of all, the observance of a special diet aimed at cleansing the intestines. The faeces should not contain impurities of food and dietary fiber.

The diet should be balanced and consist of a ratio of proteins, fats and carbohydrates.

For these purposes, two diets have been developed and are most often used.

Diet according to Pevzner

It provides for the use of up to 3 thousand kilocalories per day. The diet is allowed to include:

• bread made from rye or wheat flour;
• meat, boiled or fried;
• porridge made from rice or buckwheat;
• butter;
• potatoes, cooked as you like;
• fresh apples.

Schmidt's diet

Here, fewer daily calories are allowed - only 2400. And the products are mostly dairy, including eggs and butter. Also allowed:

• oatmeal;
• potato;
• meat.

Meals are fractional, in small portions, 5-6 times a day.

Often fecal examinations need to be done quickly and there is not much time to prepare. In this case, at least 24 hours before the collection of feces, it is necessary not to take alcoholic drinks do not drink tea and coffee.

What is strictly prohibited before the examination

• cleanse the intestines with an enema;
• take laxatives and antidiarrheal drugs so as not to disrupt the process of intestinal motility;
• administer rectal suppositories;
• take drugs that include bismuth, barium or other components that change the color of feces.

If you are having a stool test for occult blood:

1. Eliminate green vegetables, meat and fish products, tomatoes and chicken eggs in any form. Their residues can show a false positive result.
2. Don't take medicines that contain iron.

It should be remembered that when menstrual cycle it is necessary to wait with the diagnosis, as well as after the procedure of colonoscopy or X-ray with the use of a contrast agent.

How to properly collect feces for a coprogram

Some simple tips how to properly donate feces for a coprogram will increase the chances of diagnostic accuracy:

1. Prepare a pot or any convenient container.
2. In the morning after urination, empty it there.
3. It is better to use a disposable stool container. It is inexpensive, sold at any pharmacy and equipped with a special spatula, which is very convenient to collect feces.
4. The container must be new, clean, dry and tightly closed with a lid.
5. If the biomaterial is collected the night before, because you do not hope for the morning, then it should be stored in the refrigerator. Shelf life - a maximum of 10 hours, no more.
6. Worm egg droppings need to be still warm to get accurate readings, so they need to be taken to the lab right away.
7. Material for bacteriological examination is taken in the laboratory with a special instrument. This is done by the lab.
8. The amount of feces for research should not exceed the volume of a teaspoon, this is quite enough.
9. If you suffer from chronic constipation, try a colon massage.
10. If this does not help, then you will have to do an enema and collect solid pieces from the water.

Sometimes for analysis you need to collect feces during the day. In this case, you need to store the already collected material in the refrigerator.

How to collect material for analysis in children

If the child has already learned how to use the potty, then it will be quite easy to do this, just like an adult.

Just a few rules for the accuracy of the analysis:

1. Wash the pot thoroughly with baby soap and pour over boiling water. Do not use cleaners containing chemicals.
2. Stop taking any medication prescribed by your doctor 48 hours before collection.
3. Bathe your baby daily and wash your baby after every bowel movement.
4. If the feces are collected for the presence of pinworms or other helminths, then it should not be washed away, their larvae are in the perineum. Washing them off can lead to a false negative result.

Stool collection from babies

The collection of feces from a newborn has its own characteristics. If he is on breastfeeding, then mommy should also follow a certain diet for several days:

• eliminate foods from the diet causing allergies- eggs, oranges, chocolates, as well as fried, fatty, smoked and pickled foods;
• do not drink alcohol, do not smoke;
• give preference to meat dishes and steamed vegetables, oatmeal and rice porridge, light soups on vegetable broths.

It is best to collect feces from a diaper diaper. If this is not possible, then take it from above without touching the surface.

If the stool is too loose, lay an oilcloth under the baby's ass, and only then collect feces from it.

When constipated, do light massage or install a gas outlet pipe.

All tools, like the mother's hands, must be clean.

In infants, the fecal coprogram is often the most informative analysis, the results of which are sufficient to make sure that the child has dysbacteriosis.

In older children, the detection of helminths - pinworms or worms - also joins it.

Where to do a fecal analysis for a coprogram and how long to wait for the results

Today, such an analysis can be passed not only in the local clinic. There are many specialized laboratories and clinical centers where you can go with or without a doctor's referral. One of them is the "Invitro" laboratory, where coprogram or coproctology is presented, which, in fact, are one and the same fecal analysis.

The maximum study period is 6 days, but usually it is 1-2 days, the price is 500 rubles. How much analysis is done depends on the specific medical center.

A form is issued with the results of micro-, macro- and chemical studies, which are deciphered by the doctor.

Before you go somewhere, take an interest in the terms, price, reviews of other patients.

Deciphering the coprogram in adults

Macroscopic analysis of feces allows you to determine:

• the state of appearance in general;
• volume;
• form;
• density and consistency;
• Colour;
• smell;
• the presence of streaks of blood, mucus, pus, helminths, undigested food;
• stones from the bile ducts, intestines or pancreas.

The norm of feces, examined visually, will show the following results:

• Brown color;
• dense texture;
• specific smell of feces;
• without impurities.

Although the food consumed the day before the test or medications taken may change the appearance of bowel movements, small deviations from the norm are considered acceptable.

Abnormal fecal color

1. Light- with liver failure or blockage of the bile ducts;
2. Colorless- cirrhosis, hepatitis, problems with gallbladder and ducts, adhesions, inflammation.
3. black- blackcurrant, cherry, rowan, bleeding in the stomach or duodenum, cirrhosis of the liver, blockage of the vein of the spleen, taking medications with bismuth or iron.
4. Brown, dark- the use of meat, the decay of neoplasms or the release of stones from the gallbladder.
5. Red-blood is secreted from the rectum or colon.
6. Greens in the form of pea soup - with typhoid fever.
7. yellow, bright- senna grass, fermentation process in the intestines, diarrhea.
8. yellow, light – overuse milk or dairy products

Deviations from the norm in consistency, density, quantity in adults

1. Too dense feces- liquid is absorbed through the intestinal walls in large quantities, constipation.
2. liquid form- mucus content, inflammation, high peristalsis.
3. gel-like appearance speaks of a possible chronic pancreatitis.
4. Foamy feces are caused by fermentation in the stomach.
5. Large, bulky feces- violations in the digestion of food, its long stay in the thick section. Associated with improper diet, sedentary lifestyle, tumors, diverticulosis.
6. Small, sheep, feces- spasms, hemorrhoids, anal fissures, ulcers, starvation.
7. thin tape– stenosis direct department intestines, the presence of neoplasms.
8. Unformed feces- enzymatic deficiency, problems associated with the digestion and absorption of food.
9. A small amount of feces is associated with constipation, colitis, ulcerative conditions.

Deviations from the norm in the smell of feces

1. Too weak - eating too many foods plant origin with diet, constipation.
2. Reinforced - with diarrhea, meat diet.
3. Fetid, sharp - the processes of decay in the intestines.
4. Sour - with a high fat content.

The presence of impurities in the stool

1. Leftover undigested food- pathologies of the pancreas, chronic gastritis in a precancerous form, diarrhea caused by accelerated peristalsis.
2. White lumps- high fat content as a result of the pathology of the pancreas, its insufficient functions. Fecal masses become gel-like, acquire a characteristic luster.
3. Mucous inclusions- infectious and non-infectious inflammation of the intestine, suspicion of salmonellosis, dysentery, ulcerative colitis. They can be on the surface of feces or inside them.
4. Scarlet blood- indicates bleeding in the upper or lower intestines. Invisible to the eye, occult blood, determined by the microscopic method.
5. Pus- a running inflammatory process associated with the presence of an abscess in the intestines. Often occurs with dysentery, tuberculosis.
6. Helminths- can come out with feces in whole or in part, for example roundworms or pinworms.
7. Fecal stones, pancreas or from the bile ducts.

Norm and deviations in a chemical study

After a macroscopic, visual, laboratory assistant conducts a chemical study of excrement.

What shows:

• acid-base balance;
• occult blood according to the Gregerson reaction;
• bilirubin content;
• soluble protein;
• stercobilin;
• soluble mucus.

Acid-alkaline environment

The norm is from 6.87 to 7.64, neutral or slightly alkaline.

From 5.49 to 6.79 - acidic, the absorption of fatty acids in the intestine is impaired.

Less than 5.49 - sharply acidic, fermentation occurs in the intestine, a reaction to lactose.

From 7.72 to 8.53 - alkaline, fermentation of proteins with the abuse of meat products.

From 8.55 - sharply alkaline, decay processes in the thick, and sometimes in the thin sections.

Gregerson occult blood test

Often the presence of blood cannot be determined visually and even with a microscope. chemical method allows you to recognize red blood cells, the hidden content of which indicates:

Often the analysis is false positive with improper preparation: meat and fish, sausages in the diet, medicines with iron, which the patient has not stopped taking, injury to the gums when brushing teeth, passing feces during menstruation.

Normally, it should not be detected.

positive reaction are inflammatory processes in the organs of the gastrointestinal tract:

• pancreatitis;
• enteritis;
• colitis;
• gastritis;
• ulcers;
• polyps;
• proctitis;
• cancer tumor.

Acute pancreatitis is usually accompanied by nausea, vomiting, painful sensations under the ribs, bloating, flatulence and a sharp fetid smell of feces.

Soluble Protein says also:

• about the presence of dysbacteriosis;
• chronic congenital inflammation small intestine in which he does not take the vegetable protein of cereals, celiac disease.

Bilirubin

It is considered normal to appear in the feces of a newborn who is on breastfeeding. This substance gives the feces a greenish or brown color and ideally appears in them only as decay products, for example, stercobilin. Otherwise it points to:

• diarrhea
• dysbacteriosis in advanced severe form;
• acute gastroenteritis.

Sterkobilin

The breakdown product of bilirubin is found in bile and a small amount is excreted along with it from the duodenum.

The norm is from 75 to 100 mg of this substance per 100 g of feces.

Reduced content at:

• disturbed work of the spleen, excessive functions;
• intoxication in case of poisoning with drugs or poisons, in which the breakdown of red blood cells occurs.

Increased content:

• pathology of the pancreas;
• stones in the bile ducts;
• the presence of hepatitis;
• pancreatitis in the acute stage;
• enlargement of the lymph nodes.

Fecal analysis for coprogram: microscopic examination

Shows how well the food consumed is digested.

What reveals norms and deviations

Muscle fibers- undigested residues meat dishes. Normally, there are altered fibers. An unchanged appearance indicates a pathology of the pancreas, in which an insufficient amount of digestive juice is produced or its composition changes. As a result, food is not digested or digested poorly.

It may also refer to:

• diarrhea
• processes of putrefaction or fermentation in the intestines.

fibers connective tissue - leftovers meat products, are normally absent. The presence indicates:

• gastritis with low acidity;
• pancreatitis, insufficient production of enzymes.

plant fibers- fiber is soluble and insoluble.

Insoluble is excreted with feces in the form of peels of fruits and vegetables, cereal shells, and legumes. This is the norm and contributes to the removal of toxins, toxins, the rapid movement of decay products through the intestines.

Starch- normally absent, completely recycled. Detection in the form of grains indicates increased peristalsis, too fast movement of the food bolus, high absorption, lack of enzymes and is caused by:

• acute pancreatitis;
• gastritis.

Iodophilic flora- causes fermentation in the intestines. It is determined by staining with iodine and the acidity of feces from 5 to 6.5. Indicates a violation of the microflora, the presence of pathogenic microorganisms that interfere with the digestion of food.

Neutral fat- with a healthy gastrointestinal tract, it is absorbed almost completely, therefore it is not included in the study. The excess speaks of problems with the pancreas, blockage of its ducts and pathologies of the duodenum caused by:

• insufficient production of bile;
• problems with intestinal absorption;
• synthesis disorder digestive enzyme lipases.

Detritus- a mixture of digested food with bacteria and epithelial cells. Normally, it should be present in feces. Low content is associated with indigestion and inflammation of the intestinal mucosa, especially if blood or mucus is present.

Leukocytes- in normal healthy person not detected during analysis. The presence indicates pathologies of the gastrointestinal tract:

• bowel oncology;
• polyps;
• ulcers and colitis
• Crohn's disease;
• proctitis and paraproctitis;
• intestinal tuberculosis;
• helminthic invasion, etc.

red blood cells- are not included in the norm. The presence indicates bleeding into the gastrointestinal tract from other internal organs.

Fat, fatty acids, salts of these acids- normally absent. An increased content indicates insufficient synthesis of bile, diseases of the pancreas, diarrhea.

Ammonia– the normal content is from 20 to 40 mol/kg. Deviation upward - inflammatory processes and decay of food debris in the intestines.

pathogenic microorganisms- Normally, dysenteric bacillus, Trichomonas, Giardia and Balantidia are absent.

Worm eggs, yeast, fungi, pathogenic bacteria- talk about the presence of helminthic invasion or candidiasis.

Coprogram: decoding the norm in adults in the table:

Features of decoding the coprogram in children

Analysis of feces for coprology in children is not much different from an adult. Although there are some differences, especially in newborns and babies up to a year. This is due to the peculiarities of age and nutrition - an immature gastrointestinal tract, breast or artificial feeding:

• ph norm acidic or slightly alkaline environment from 6 to 6.7;
• pH is acidic in children under three months of age;
• bilirubin in the feces up to 3 months is the norm, after this age only stercobilin should be observed in the feces;
• an alkaline environment is a sign of violations of the processes of digestion of food;
• protein - inflammatory processes in the intestines;
• The volume of faeces depends on the diet. But an increase or decrease may indicate violations of the functions of the pancreas;
• color and texture - the norm is their change depending on the food consumed;
• analysis of feces for occult blood is positive - bleeding with peptic ulcer;
• vegetable fiber and starch - disturbances in the work of the small intestine;
• yeast fungi - dysbacteriosis, candidiasis.

Coprogram in children: decoding the norm in the table:

Not always any deviations in the analysis of feces in a child indicate pathologies. Only a doctor will decide if they are symptoms of a disease or if this condition is normal for your baby.

At least once in a lifetime, every person takes a stool test. This is a very important study: it helps to evaluate the functioning of the digestive system or track the effectiveness of early prescribed therapy. In order for the results to be as accurate as possible, you need to properly prepare for this diagnostic procedure.

Methods for the study of feces

The scientific name of this medical manipulation- coprogram. It provides various ways excrement research. The fecal coprogram includes the following procedures:

• general analysis;
• biochemical research;
• bacteriological analysis;
• microbiological research.

General analysis of feces

During such a survey, the main indicators of excrement are evaluated. The study of feces includes the following aspects:

1. Biological material color- in a healthy person, feces are colored brown. A change in shade can be triggered by foods present in the diet. For example, blueberries give a brown color, and beets give a brown-reddish color. In addition, there is a relationship between the color of feces and human pathologies. At cholelithiasis feces acquire a whitish tone, and with cirrhosis of the liver - black.
2. Consistency of waste products– Normally, the structure should be dense. If the feces are too dry, this indicates frequent constipation, accompanied by excessive absorption of water. Ointment-like consistency is a sign acute form pancreatitis. The waste product has a liquidish structure when intestinal motility is strongly activated. Foamy mass is observed with excessive release of carbon dioxide.
3. acidity of feces- Normally, this indicator should be neutral. hesitation given value in a big way may indicate that the diet is dominated by foods rich in carbohydrates. The value of the indicator below the norm often happens when a person is on a protein diet. In addition, a decrease in acidity is a sign of pancreatic dysfunction, colitis and constipation.
4. The presence of mucus in biological material- if the analysis of feces shows the presence of this component, most likely the patient has polyps in the intestines. Also, the presence of this component indicates lactose intolerance, hemorrhoids or an intestinal infection.

• trichomonas;

Bacteriological examination of feces

This analysis helps to identify all microorganisms living in the intestine. It contains a huge number of bacteria that are actively involved in the digestion of food and the absorption of valuable substances. The following groups of microorganisms can live in the intestine:

1. "Normal"- these include lacto- and, Escherichia. These microorganisms take part in the work of the digestive tract.
2. Conditionally pathogenic are candida, staphylococci. Under certain circumstances, for example, due to a decrease in immunity, these bacteria become pathogenic. They provoke the development of various diseases.
3. Pathogenic- Shigella belongs to this group of microorganisms. After entering the body, they provoke the occurrence of serious infectious diseases.

Microbiological examination of feces

This analysis determines the degree of digestion of food. In addition, feces can be examined for the intestinal group and for the presence of protozoa. During the procedure, the following elements are analyzed:

1. Detritus - small particles. They are a product of the breakdown of cells and food debris. The better the food is digested, the greater the proportion of detritus in the feces.
2. Muscle fibers - their amount depends on the food consumed in food. The presence of an abundant amount of meat in the diet increases their content.
3. Connective fibers - these include the remains of cartilaginous tissues, ligaments and blood vessels. Outwardly, they are similar to mucus. To distinguish the first from the second, a drop is added to the biological material during the study. acetic acid. Under its influence, the connective tissue swells and loses its structure.

At the same time, such an analysis of feces is aimed at identifying the following indicators:

• starch;
• bilirubin;
• stercobilin;
• neutral fats;
• leukocytes;
• vegetable fiber
• fatty acids;
• ammonia.

Biochemical study of feces

Such an analysis is carried out in order to identify hidden bleeding in the digestive tract. In the future, these disorders can provoke the development of inflammatory, ulcerative and tumor processes. Such delivery of feces for analysis allows you to evaluate the following indicators:

• acidity of biological material;
• the presence of digestive enzymes, fats and proteins in it;
• content minerals etc.

What does a stool test show?

Only a doctor can accurately interpret the results of the study. He knows what the coprogram shows and how to explain possible deviations. If necessary, the doctor will refer the patient to additional examination. Here is what the feces show on the coprogram:

This study is more often performed after a powerful hormonal or antibiotic therapy. During such treatment, both pathogenic and vital microorganisms die. The study of feces for dysbacteriosis helps to analyze the composition of the microflora, its ratio and in time to detect those bacteria that should not be here. To do this, the biological material is checked for the following indicators:

• lactobacilli;
• fungi;
• bifidobacteria;
• staphylococci;
• enterobacteria;
• salmonella;
• coli and so on.

Analysis of feces for worm eggs

• roundworm;
• necator;
• tapeworm unarmed;
• small ribbon;
• whipworm;
• lamblia.

Analysis for occult blood in the stool

This diagnostic procedure very much in demand. The study of feces for occult blood is carried out by two methods:

1. Gregersen reaction- involves the exclusion of meat from the diet, since the reagents used react with red blood cells present in food. The study helps to identify the problem in any part of the gastrointestinal tract.
2. Immunochemical method- does not include food restrictions. Reagents react only on human hemoglobin. This method helps to identify pathologies only in the lower part of the digestive tract.

How to take a stool test?

To obtain complete and reliable information, it is important to accurately collect biological material. In addition, you need to thoroughly understand how to take a stool test. Any violations will negatively affect the results. Deciphering such an analysis takes a different time. The result for some studies is ready the very next day, and for others - in a week.

Fecal analysis - preparation

This stage begins a few days before the upcoming study. If a coprogram is prescribed, the preparation includes the following activities:

1. 4-5 days before the analysis, you need to give up meat dishes, tomatoes, beets and red fish. Otherwise, the study will give a false positive result. You can eat dairy products, mashed potatoes and cereals.
2. If the patient had an x-ray using barium or a colonoscopy, donate feces should not be earlier than a week after that.
3. The consumption of antimicrobial and anti-inflammatory drugs should be suspended. In addition, you can not take drugs for anemia and sorbents. It is recommended to stop taking laxatives, including rectal suppositories, a couple of days before. If any medicines cannot be canceled, this must be reported to the doctor.

How to collect feces for analysis?

The collection of biological material is performed as follows:

1. Need to empty bladder(there should be no impurities in the feces).
2. Wash with soap and dry with a dry towel. Do not use sanitary napkins!
3. Before emptying, the toilet must be lined with clean, thick paper, on which excrement will linger.
4. Fecal masses must be received naturally. The use of enemas is prohibited!
5. After the spatula, the biological material is separated and transferred to a special container. How much feces is needed for analysis depends on the study being conducted. More often they rent 10-15 g. It is important to remember that the biological material should not occupy more than a third of the capacity.
6. The container must be tightly closed and a piece of paper with information about the patient (last name, first name, patronymic, age and date of collection) must be glued to it. After the container with the contents should be taken to the laboratory. Here they will analyze freshly collected feces. The maximum shelf life of such biological material at room temperature is 3 hours.
7. If the patient does not have the opportunity to immediately go to the research center, the biological material should be placed in a refrigerator. How much feces can be stored for analysis depends on the temperature inside the chamber. You should be guided by the fact that at +5 ° C the material will be “fresh” for 8 hours.

Coprogram - transcript

A fecal analysis for a coprogram is one of the first studies that a doctor prescribes to 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 content of the large intestine consists not only of liquid and food debris, it includes elements of digestive juices, enzymes, bile, blood, and 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;
• Diverticula of the intestine;
• Crohn's disease;
• Colitis;
• Cirrhosis of the liver;
• colon polyps;
• irritable bowel syndrome;
• malignant tumors;
• Worm infestations;
• amoebic dysentery;
• Acute intestinal infections (cholera, salmonellosis, etc.);
• Anemia and a number of other pathologies.

The reason for coprology are abdominal pain, cramps, bloating, nausea, heartburn, problems with defecation, blood in the stool and other symptoms that indicate disorders in the digestive tract.

A general analysis of feces according to the 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 the diagnosis of pathologies of the digestive tract. Those violations that this simple and painless analysis shows require additional examinations.

The study of feces helps the doctor to make a preliminary diagnosis and subsequently refer the patient to the necessary procedures.

What is an analysis?

The technique for performing fecal analysis for a coprogram provides:

• Visual study of excrement by qualitative and quantitative parameters and the presence of foreign inclusions.
• Carrying out chemical tests to determine impurities.
• Examination of material under a microscope.

Let us consider in more detail what is included in the fecal coprogram:

Study	Indicators
macroscopic	Volume of feces
	Consistency
	The form
	Colour
	Presence of mucus
	Blood
	Purulent discharge
	Leftover undigested food
Chemical	Gregersen reaction
	Reaction to bilirubin
	Acid-base balance
	Analysis for stercobilin
	Vishnyakova-Tribule test
Microscopy	The presence in the feces of muscle fibers, undigested connective tissue
	Fats, fatty acids and salts
	Starch
	Cellulose
	Iodophilic microflora
	Leukocytes
	erythorocytes
	epithelial cells
	helminth eggs
	Protozoa and fungi
	salt

Normal indicators of the coprogram

Normally, stool is a thick, shaped mass. Brown with a pronounced fecal odor, without impurities of blood, mucus and pus, with a minimum amount of unprocessed food (insoluble fiber is allowed).

The nature of nutrition, the intake of certain medications can significantly affect the physical parameters of feces: change color, texture, smell. Small deviations related to nutritional characteristics are considered acceptable.

The norm of the comp program in adult patients is shown in the table:

Indicator	Reference value
pH	42588
Gregersen occult blood reaction	negative
Vishnyakuwa-Tribulet reaction for protein	negative
Reaction to stercobilin	positive
Reaction to bilirubin	negative
Muscle fibers	absent, single fibers in the field of view
Undigested connective tissue	is absent
Neutral fat, fatty acids	missing
Salts of fatty acids	small amount allowed
vegetable fiber	single cells
Starch	is absent
Iodophilic flora	absent, single presence of normal iodophilic microorganisms is acceptable
crystals	missing
Epithelium	absent, single cylindrical cells are allowed
Leukocytes	absent, single neutrophils are acceptable
red blood cells	missing
Protozoa	missing
worm eggs	missing
yeast mushrooms	missing

The norm in children differs from the indicators in adults due to the characteristics of nutrition. 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 the milk diet in infants.

Indicator	Norms for babies	The results of the coprogram in children older than a year
daily amount of feces	34 - 45 g	58 - 215 g
consistency	sticky	mushy, decorated
Colour	light brown to pale yellow	brown
smell	sourish	regular stool
pH	5,1 - 6	1,2 – 1,7
bilirubin, ammonia	present	missing
stercobilin, muscle fibers	present	missing
fatty acids and salts	present	missing

How to decipher the results?

The results of the coprogram should be evaluated by a specialist, taking into account all the conditions: the patient's complaints, the characteristics of his diet, the available history, indicators of other studies.

Consider how to decipher deviations from the norm:

1. Too little feces happens with constipation, colitis, ulcerative conditions. An increase in stool indicates accelerated evacuation, inflammation in the digestive tract.
2. Very dense feces are formed with excessive absorption of fluid through the intestinal walls, constipation. Liquefied stools give active peristalsis, impurities of inflammatory mucus. Ointment-like consistency - a possible consequence chronic pancreatitis. Foaminess indicates fermentation in the intestines.
3. A large form of feces indicates a long stay of the contents in the intestine, which may be associated with colon dysfunction due to malnutrition, a sedentary lifestyle, diverticulosis, and tumors. Small lumps (sheep feces) occur with intestinal spasms, hemorrhoids, anal fissures, starvation, peptic ulcers. Excrement in the form of a tape, a thin column indicates stenosis of the rectum, the presence of a neoplasm. unformed chair- a sign of impaired digestion and absorption of food due to enzymatic deficiency.
4. Color changes not associated with food coloring are likely symptoms diseases. Discoloration of feces is caused by liver failure and blockage of the bile ducts. Tar-colored feces - a sign of bleeding of the upper gastrointestinal tract, if it bleeds in the colon and rectum - red feces. Mushy green stools are excreted in typhoid fever. Yellow feces are produced during fermentation in the intestines.
5. The mucus in the coprogram has a different consistency and shade depending on the pathology. Gray inclusions resembling rice water indicate cholera infection. Amoebic dysentery is manifested by a jelly-like mucous mass of pink hues. When the rectum is damaged, mucus impurities are found in the material in whole lumps, ribbons. With colitis and constipation, mucus envelops the formed feces from above, with inflammation small intestine- mixes with food masses and gives them a semi-liquid character.
6. In some cases, blood does not stain the feces, but is excreted along with them in the form of separate clots, veins. We are talking about bleeding in the lower digestive departments, starting from anal fissures and ending with necrosis of the colon tumor. Hidden blood in the feces is determined by the Gregersen test.
7. Purulent discharge in the stool is a sign of severe inflammation, an ulcer, abscess, tuberculosis, or a decaying tumor. With infectious lesions, suppuration is supplemented by mucus and blood.
8. Pieces of undigested food in the analysis of feces are called tentorrhea. Occurs in violation of the stomach and pancreas.
9. Small elements of digested food mixed with the remains of bacteria and epithelial cells (detritus) are the normal contents of stool. Only a violation of their homogeneity with the isolation of individual particles, for example, an increased content of bacteria during a coprogram, makes it possible to suspect an inflammatory process. Detritus in the coprogram in combination with mucous and bloody impurities is an unequivocal sign of pathology. Detritus in a coprogram in a baby or a child older than a year without accompanying symptoms is not a cause for concern.
10. The iodophilic flora in the coprogram causes fermentation in the intestines. These bacteria are determined by staining with iodine and the acid reaction of feces (pH 5.0-6.5). Pathological iodophilic flora (clostridia) leads to active fermentative dyspepsia.
11. If found in feces yeast mushrooms, candidiasis caused by antibiotics is possible.
12. 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: a violation of the secretion of gastric juice, pancreatic enzyme insufficiency. The same applies to the remnants of connective tissue in the stool.
13. Problems with lipid digestion are expressed in steatorrhea. Neutral fat in the coprogram is released with pancreatic dysfunction and blockage of the pancreatic ducts. Disorders in the duodenum lead to poor absorption of fatty acids. Soaps in the coprogram are fatty acid salts in the feces as a result of bile deficiency.
14. 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 recycle plant cells. Extracellular starch in the coprogram appears due to amylase deficiency.
15. Leukocytes in the coprogram are not normally detected. Their presence indicates infectious lesion intestines, enteritis, colitis, ulcerative lesion. The combination of leukocytes with erythrocytosis, large quantity flat and cylindrical epithelium in the feces shows a coprogram for intestinal cancer, polyposis, Crohn's disease. If leukocytes are found in a coprogram in an infant, it is necessary 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 the material obtained naturally 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 a coprogram.

A week before the date, refuse:

• antibiotics;
• Iron-containing preparations;
• Any laxatives;
• Applications of rectal suppositories;
• Enema;
• Procedures through the anus;
• X-ray with barium.

Preparation for the coprogram includes dietary restrictions 4 to 5 days before stool delivery. The diet before the coprogram consists of the following menu:

• Milk products;
• Mashed potatoes;
• Lean meat;
• Kashi;
• Soft-boiled eggs;
• Fresh fruits;
• White bread with butter.

Preparation for the study with suspected occult 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 lining in advance.

How to take the test correctly:

• Perform a natural bowel movement, avoiding the ingress of urine and discharge from the genitals;
• With a special spatula, collect the material in an amount as much as you need feces for analysis - about a third of the jar;
• For best result research, it is advisable to follow the recommendations on how to collect feces for a coprogram - at least from three different parts of the stool;
• Screw and sign the container.

How to pass a fecal analysis correctly so that the biomaterial does not deteriorate: take the biomaterial to the laboratory on the same day, no later than 12 hours after defecation. If necessary, place the container on a refrigerator shelf.

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. For analysis, a teaspoon of biomaterial placed in a sterile container is sufficient. If the child does not go to the potty, the problem of how to collect feces from the baby is solved with the help of disposable diapers - feces can be taken from their surface.

Where to take the analysis?

A general analysis of feces in the direction of a doctor is usually taken at a polyclinic. Research is being carried out in many diagnostic centers where you can make a coprogram:

• blue,
• Hemotest,
• Invitro,
• Helix and others.

You can contact any laboratory where coprogram and coprology 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 tests, the patient has the right to choose independently, focusing on the cost, the declared period, how many days the coprogram is done, and the reviews of the laboratory's clients.

- a comprehensive analysis of feces, which allows you to evaluate the work of the digestive system as a whole, and the functionality of each organ separately. In order for the results of the study 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 a coprogram?

Coprogram is a method of laboratory examination of feces, which is prescribed to identify pathologies of the digestive system. The specialist conducts a macro and microscopic, chemical, physical analysis of the feces, after which he makes detailed description composition of faeces.

You can make a stool coprogram in a regular clinic for free, but to get a more accurate and detailed result, it is better to contact private laboratories, the average price is 370–420 rubles.

Indications for the delivery of a coprogram

Fecal analysis should be done annually preventive examination in order to recognize problems with digestive tract, start treatment.

When is coprology prescribed:

• inflammation of the digestive system in acute and chronic form;
• hemorrhoids, fissures anus, chronic constipation;
• cirrhosis of the liver;
• irritable bowel syndrome;
• neoplasms in the gastrointestinal tract;
• poisoning;
• suspicion of helminthic invasion, amoebic dysentery;
• evaluation of the effectiveness of drug treatment;
• before the instrumental diagnostics organs of the gastrointestinal tract, surgical interventions.

Children are prescribed a fecal analysis for colic, if they are suspected of having intestinal infections, inflammatory processes, cystic fibrosis, lactose intolerance, dysbacteriosis, infection with worms.

Fecal analysis should be taken when neoplasms appear in the intestine

How to donate feces

In order for the diagnostic results to be reliable, it is necessary to perform several simple conditions.

Rules for preparing for a coprogram:

1. 3-5 days before the examination, stop eating meat, tomatoes, beets, vegetables Green colour, red varieties of fish - when analyzed for occult blood, they can become the culprits of a false positive result.
2. The diet should include dairy products, mashed potatoes, low-fat meat, kazhi, boiled eggs, cereals.
3. One week before the analysis, you need to stop taking Activated carbon, drugs based on bismuth, iron, antibacterial, anti-inflammatory drugs, antacids - they change the color of feces. Do not drink laxatives, use rectal suppositories, do enemas.
4. Sometimes the doctor prescribes special diet, which details the daily amount of proteins, carbohydrates, lipids - this is necessary in order to maximize the load digestive system, which will help to detect even the slightest failures in its operation.
5. The coprogram can be carried out no earlier than 5-6 days after the x-ray with barium, colonoscopy, cleansing procedures.
6. You can not donate feces during menstruation, bleeding hemorrhoids.

Any deviation from the rules will distort the results of the coprogram.

You can not donate feces with bleeding hemorrhoids

How to collect feces

It is better to take feces from an adult and a child in the morning, immediately after the morning toilet, and try to deliver it to the laboratory as quickly as possible. Collect material from different parts feces, put them in a sterile container, or special disposable plastic containers that can be purchased at a pharmacy. Emptying should be natural, the use of laxatives, and even more so it is forbidden to do enemas.

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?

For 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.

Whether it is possible to collect the analysis of a calla in the evening?

It is better to use the morning portion of feces for analysis, but if there is no certainty that defecation will occur after waking up, you can collect the material in the evening, store it in the refrigerator for no more than 10-12 hours, the container should be hermetically sealed.

You can store feces for analysis in the refrigerator for no more than 12 hours.

How much is a fecal analysis done

In terms of time, the coprogram takes 1-3 days, in some private clinics an urgent analysis is provided - the transcript is done in a few hours. Urgently, the diagnosis is carried out in a hospital in a serious condition of the patient, if an emergency is required. surgical intervention.

Deciphering the results of a scatological study

When the results are ready, the person will receive a form that will indicate the normal indicators and the results obtained during the study of the material. For decoding, it is better to consult a doctor, since even a deviation from the norm of several indicators does not always indicate the presence of pathologies.

black - bleeding, neoplasms in upper divisions tract, ulcerative colitis;

reddish tint - bleeding in the lower gastrointestinal tract.

- affordable, inexpensive and informative analysis of human feces. To obtain a reliable result, it is necessary to adhere to the rules of preliminary preparation, to collect, store and transport the material to the laboratory correctly.