Stool Examination
Stool examination is an important diagnostic test that can provide insight into the health status of the digestive tract. It is frequently used to detect diseases such as infections, inflammations, digestive disorders, or even tumors in the gastrointestinal area at an early stage. During a stool examination, various aspects such as bacteria, blood, parasites, or undigested food are analyzed to identify possible causes of symptoms.
What is a Stool Examination?
Stool examination is a diagnostic procedure in which a stool sample is tested for various parameters and pathogens. It has become an important method in medical diagnostics to gain more detailed information about the condition of the digestive system. Both microscopic and chemical analyses can be performed to detect bacteria, viruses, parasites, blood, inflammatory markers, or other abnormalities.
Stool examination plays a central role in the diagnosis of gastrointestinal diseases, such as bacterial infections with Salmonella or Campylobacter, parasitic diseases like Giardiasis, as well as chronic inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. It can also be used to test for the presence of blood in the stool, which can be an important early indicator of colorectal cancer or other gastrointestinal tumors.
Furthermore, microbiological stool examinations can analyze the microbiome in the intestines and identify imbalances that may be associated with various digestive or metabolic disorders.
Stool Examination - What Gets Tested?
A stool analysis examines various parameters that provide insight into the health of the gastrointestinal tract, digestive function, and microbial populations in the intestines. Stool examination can enable early detection of conditions such as inflammation, infections, or cancer. Typical values checked in a stool examination usually include pH level, presence of blood, fat content, presence of bacteria or parasites, and presence of leukocytes.
- pH Value: This shows the acid-base balance in the intestine. A lower pH value may indicate impaired digestion or bacterial infections, while a high pH value is usually attributed to malabsorption or other digestive disorders.
- Blood in Stool: The presence of blood in stool can usually indicate gastrointestinal diseases such as colorectal cancer, stomach cancer, inflammatory bowel diseases, or polyps.
- Fat Content: An elevated fat content indicates problems with fat digestion, often associated with pancreatic diseases such as pancreatitis.
- Elastase: A low elastase value in the stool suggests pancreatic dysfunction, which often occurs with chronic pancreatitis or exocrine pancreatic insufficiency.
- Bacterial and Parasitic Infestations: Microorganisms such as Salmonella, Campylobacter, or Giardia in stool indicate bacterial or parasitic infections.
- Leukocytes: An elevated leukocyte count usually confirms bacterial infection or inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
- Digestive Enzymes: Reduced enzymatic activity of digestive enzymes such as amylase or lipase in stool can indicate dysfunction of the pancreas or liver.
- Microbial Flora: An analysis of the intestinal flora helps identify changes such as dysbiosis, which can be associated with conditions like irritable bowel syndrome and inflammatory bowel diseases.
Stool Sample: How Does It Work?
The stool examination is a common method for detailed diagnosis of digestive tract disorders. It can be conducted either at home or in a doctor’s office. The collected sample is sent to a laboratory where it is analyzed for various parameters.
Here is a brief guide on how to perform the stool sampling:
- Home sample collection: You will receive a special container from your doctor or directly from the laboratory for collecting the sample. Usually, a small sampling device, such as a spoon, is also provided. Make sure that the sample goes directly into the container and does not come into contact with flush water or other liquids.
- Sample collection at the doctor’s office: If you provide a stool sample at the practice, the collection process will usually be explained to you and you’ll use a sterile container. You can also provide the sample directly there.
- Laboratory: After collection, the sample is sent to the laboratory where it is examined for various parameters.
Important information about conducting the test:
- The stool sample should be collected as fresh as possible, as bacteria and other microorganisms change over time, which can distort the test results.
- It is therefore advisable to bring the sample to the laboratory within 24 hours.
- When is a stool sample unusable? A stool sample can become unusable if it comes into contact with toilet flush water or disinfectants, or if it is stored for too long. Incorrect storage can also affect the results.
- Depending on the test, analysis can take anywhere from a few days to up to a week.
The exact handling procedure will typically be explained to you in detail by your doctor or laboratory to ensure the most substantial results possible.
When is a stool examination useful?
A stool examination is particularly useful when noticeable changes in bowel movements are observed or when used as a preventive measure for certain diseases of the digestive tract. It can help detect early signs of diseases related to the digestive organs or intestinal flora.
Typical reasons for a stool examination:
- Diarrhea: When diarrhea persists over an extended period, a stool examination for bacteria, parasites, or viral infections can be useful to determine the exact cause. Common causes may include Salmonella or Campylobacter.
- Blood in the stool: The detection of blood in the stool is an important indicator of gastrointestinal diseases such as stomach or colon cancer, hemorrhoids, or inflammatory bowel diseases like Crohn's disease or ulcerative colitis.
- Abnormal stool: If the stool appears unusual, e.g., fatty, or if the smell and color change significantly, this could indicate a digestive disorder.
- Changes in frequency or consistency of bowel movements: A sudden increase or decrease in frequency, as well as changes in stool consistency, may warrant a stool examination for clarification.
In preventive care, stool examinations are often performed to detect hidden signs of serious diseases that do not yet cause obvious symptoms. This examination is frequently used as part of a check-up, especially for older individuals for early cancer detection.
Blood in Stool in Women and Men
Blood in stool can indicate various causes in both women and men that should always be medically evaluated. One of the most common causes of blood in stool is colorectal cancer, especially in older people or those with a family history. Hemorrhoids are also a frequent cause of blood in stool, particularly in people suffering from chronic constipation. Additionally, irritation of the intestinal or rectal mucosa, such as from inflammatory bowel diseases, can lead to bleeding. A stool test for blood (occult blood) is a common method to detect even the smallest traces of blood in stool that are not yet visible to the naked eye. If blood is detected in the stool, the exact cause should be determined as quickly as possible and appropriate treatment initiated.
Mucus in Stool in Women and Men
Mucus in stool can indicate various health problems in both women and men. These can be caused by harmless issues, but also serious conditions. A common cause of mucus in stool is irritable bowel syndrome, where the intestine reacts sensitively and produces excessive mucus. Food intolerances, such as lactose or gluten intolerance, can also lead to increased mucus discharge in stool. Infections with bacteria, viruses, or parasites can likewise cause mucus in stool, often accompanied by diarrhea and abdominal pain.
Mucus in stool should always be taken seriously and should be examined by a doctor, especially if it occurs repeatedly or in conjunction with other symptoms such as blood in stool or abdominal cramps, to determine and specifically treat the underlying cause.
Significance of Stool Examination in Diagnostics
Stool examination is an essential diagnostic procedure for evaluating the digestive tract. It enables early detection and diagnosis of various diseases, including infections, cancers, inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, as well as digestive disorders resulting from enzyme deficiencies or food intolerances. Chronic conditions like irritable bowel syndrome and pancreatic diseases can also be identified through the analysis of specific markers in stool. Stool examination can be used not only for diagnosis but also for monitoring treatment progress, verifying the success of therapies, or detecting relapses more quickly. Due to its non-invasive nature, it represents a valuable method for health monitoring and prevention.
Stool Examination for Colorectal Cancer
Stool examination is an important, essential procedure for the early detection of colorectal cancer. The occult blood test plays a central role in this process, as it can detect blood in stool that is not visible to the naked eye. Blood in stool can be an indication of colorectal cancer but may also point to other conditions such as hemorrhoids, intestinal inflammations like ulcerative colitis and Crohn’s disease, intestinal polyps, or gastrointestinal ulcers.
A stool examination is classified as abnormal when certain changes in the stool occur that may indicate health problems. Particularly important is the detection of blood in the stool, either in visible form or as hidden blood that can only be detected through special tests. In addition, persistent changes in stool consistency, such as recurrent alternation between diarrhea and constipation without an identifiable cause, should be medically evaluated. Another important indicator can be the color of the stool. Particularly noteworthy is very dark or black stool, also known as tarry stool, which may indicate bleeding in the upper digestive tract. Additionally, mucus in the stool may indicate inflammation or pathological changes in the intestinal mucosa. The occurrence of accompanying symptoms such as unintentional weight loss, persistent abdominal pain, or chronic fatigue should also be taken seriously, as they may indicate a serious illness like cancer.
If a stool examination shows abnormal findings, a colonoscopy is typically recommended for further evaluation. This procedure directly examines the intestinal mucosa and allows for early detection and removal of polyps or tumors. This is of great importance as colorectal cancer often grows without symptoms for many years before initial complaints occur. Therefore, people aged 50 (men) or 55 (women) and older are recommended to undergo regular stool examinations as part of colorectal cancer screening.
Stool Examination in Liver Diseases
A stool examination can provide important indicators of liver diseases, particularly when changes in color, consistency, or composition of the stool occur. The cause is usually impaired bile production or bile flow obstruction. This commonly results from conditions such as liver cirrhosis, hepatitis, or bile duct blockages. These conditions lead to less bile pigment reaching the intestine, resulting in clay-colored stools. Another typical sign of liver disease is fatty stool (steatorrhea). Fatty stools occur due to impaired fat digestion. This happens when the liver or pancreas doesn’t produce enough bile acids or enzymes to properly process fats. Consequently, the stool appears pale, shiny, and difficult to flush. In stool examinations, fatty stools typically show elevated fat levels, indicating impaired fat digestion due to liver or biliary tract disease.
Stool Examinations in Pancreatic Diseases
A stool examination can also provide valuable information about pancreatic dysfunction, particularly related to digestion. A central laboratory value is the determination of pancreatic elastase. Elastase is an enzyme produced in the pancreas and excreted in the stool. A decreased elastase value indicates exocrine pancreatic insufficiency, where the pancreas no longer produces enough digestive enzymes. This commonly occurs in chronic pancreatitis, cystic fibrosis, or pancreatic cancer. A lack of digestive enzymes can contribute to the development of fatty stools (steatorrhea). Fatty stools are typically shiny, voluminous, and foul-smelling. The stool elastase test is therefore an important tool for early detection of pancreatic insufficiency and initiating targeted therapy.
Leaky Gut Syndrome Stool Examination
Leaky gut syndrome is a condition in which the intestinal mucosa becomes more permeable, allowing toxins, bacteria, or undigested food particles to enter the bloodstream more readily. Consequently, digestive disorders and inflammation can develop, which can easily become chronic and lead to impaired nutrient absorption.
During stool examination, characteristic parameters that may indicate impaired intestinal barrier function are analyzed. These include calprotectin and alpha-1-antitrypsin as markers for inflammation and permeability of the intestinal mucosa. Additionally, the intestinal flora is examined in more detail through microbiome analysis, as an imbalance between healthy and pathogenic bacteria can contribute to leaky gut syndrome. The pH value of the stool and the presence of mucus or undigested food residues can also provide indications of impaired intestinal function.
Stool Examination of Intestinal Flora: Dysbiosis
The stool examination of intestinal flora provides more detailed insights into the microbial balance in the intestine. A healthy intestinal flora consists of a variety of beneficial bacteria that support digestion, the immune system, and metabolism. However, when the natural balance is disturbed, known as dysbiosis, it can lead to digestive problems, inflammation, or a weakened immune system. Through intestinal flora analysis, the existing bacterial strains can be identified, the ratio of health-promoting to potentially harmful microbes can be analyzed, and possible fungal burdens can be checked. If dysbiosis occurs, intestinal cleansing to restore a healthy intestinal flora may be beneficial. This involves the targeted use of probiotics (living, beneficial bacteria) and prebiotics (nutrients for good intestinal bacteria). They provide support by rebalancing the microbiome in the intestine. Therefore, an individually tailored therapy can significantly reduce digestive disorders, bloating, irritable bowel syndrome, or susceptibility to infections.
Med. pract. Dana Hreus M.A.
When ordering and evaluating stool tests, the doctor's experience is an important basic requirement in order to avoid misinterpretation of the laboratory results.
Frequently Asked Questions About Stool Examinations
In the following section, we aim to answer your most common questions about stool examinations to provide you with a better understanding of how this diagnostic method works and what information it can provide.
The duration of a stool examination depends particularly on the type of test. Simple examinations, such as detection of blood or pH value measurements, can be available within a few hours to days. Microbiological tests for bacteria or parasites, however, usually require several days as cultures need to be established. Specialized analyses, such as intestinal flora or enzyme examinations, may take up to two weeks.
Yes, a stool examination can also be conducted through your primary care physician. Typically, you will receive a stool sample test kit with instructions for specimen collection, which is then sent to a laboratory. Depending on your symptoms, your physician can request various tests, e.g., for blood, bacteria, or digestive enzymes. The results are subsequently evaluated, and further examinations or treatments may be initiated if necessary.
Before a stool examination, you should carefully review and follow the instructions provided by your physician or laboratory. Generally, the stool should not come into contact with urine or toilet water, making clean collection particularly important. Additionally, the sample should be delivered to the laboratory as fresh as possible or stored according to the provided guidelines.
Yes, a stool sample can usually be collected comfortably at home. For this purpose, you will receive a special sample container from your doctor or laboratory with instructions for proper collection. It is important that the sample is collected hygienically. Subsequently, it should be delivered to the laboratory promptly.
Further information
Further information intended to give a better overview of the topic.