Coprogram (general analysis of feces). Decryption, normal values. Coprogram of a child, newborn and infant. How to properly prepare, collect material for stool analysis? Macroscopic examination of feces
| Age and type of feeding | ||||
| Analysis indicators | Breast-feeding | Artificial feeding | older children | adults |
| Quantity | 40-50 g / day. | 30-40 g / day. | 100-250 g / day. | 100-250 g / day. |
| Consistency | sticky, viscous (mushy) | putty consistency | decorated | decorated |
| Color | yellow, golden yellow, yellow green | yellow-brown | brown | brown |
| Smell | sourish | putrefactive | Fecal, not sharp | Fecal, not sharp |
| Acidity (pH) | 4,8-5,8 | 6,8-7,5 | 7,0-7,5 | 7,0-7,5 |
| Slime | absent | absent | absent | |
| Blood | absent | absent | absent | absent |
| Soluble protein | absent | absent | absent | absent |
| Sterkobilin | present | present | 75-350 mg / day. | 75-350 mg / day. |
| Bilirubin | present | present | absent | absent |
| Ammonia | 20-40 mmol/kg | 20-40 mmol/kg | ||
| Detritus | Various quantity | Various quantity | Various quantity | Various quantity |
| Muscle fibers | Little or none | absent | absent | |
| Connective tissue fibers | absent | absent | absent | absent |
| Starch | absent | absent | absent | absent |
| Plant fiber (digestible) | absent | absent | absent | absent |
| Neutral fat | Drops | A small amount of | absent | absent |
| Fatty acid | Small amount of crystals | absent | absent | |
| Soaps | In a small amount | In a small amount | Minor amount | Minor amount |
| Leukocytes | single | single | single in the preparation | single in the preparation |
Quantity.
The amount of feces can be estimated according to the patient. Normally, 100–200 g of feces are excreted per day, depending on the nutritional structure (protein food reduces the amount of feces, vegetable food increases). A decrease in the amount of feces occurs with constipation. More than the norm is allocated in the following cases:
- violations of the flow of bile
- accelerated evacuation of feces from the small and large intestines;
- disorders of food digestion in the small intestine (inflammatory processes, fermentative and putrefactive dyspepsia,)
- inflammatory bowel disease (including colitis with diarrhea, colitis with peptic ulcer)
- pancreatic insufficiency (up to 1 kg of feces per day can be excreted).
Consistency of feces.
The consistency of feces is determined by the content of water, fat and mucus in it. With normal bowel movements, the water content reaches 80–85%, with constipation it decreases to 70%. With diarrhea, feces contain up to 95% water. Inflammatory processes in the large intestine and increased mucus content give the feces a liquid consistency. A large amount of undigested fats makes the feces greasy or pasty.
The norm is a dense decorated feces.
Ointment feces are formed when the secretory activity of the pancreas is disturbed, with poor flow of bile into the large intestine.
Liquid stool characterizes insufficient digestion in the small intestine (enteritis, accelerated evacuation) and large intestine (ulcerative colitis, putrefactive colitis, or increased secretory activity)
Mushy feces are characteristic of accelerated evacuation from the colon; colitis accompanied by diarrhea; chronic enteritis.
Feces in the form of dense balls are formed during constipation.
Ribbon-like feces are formed with spasms of the sphincter, hemorrhoids, in the presence of a tumor of the sigmoid or rectum.
Smell of feces. The breakdown of proteins is the cause of the characteristic odor of feces. With painful processes of the digestive tract, a change in smell can be distinguished.
A decrease in the characteristic odor (up to complete disappearance) occurs with constipation, due to the absorption of aromatic substances, and with the use of antibiotics; with accelerated evacuation in the intestines.
A fetid odor (rancid oil) characterizes impaired pancreatic secretion, obstructed flow of bile into the intestines. In this case, fat and fatty acids are decomposed, mainly due to the activity of bacteria.
A putrid smell (hydrogen sulfide) occurs with ulcerative colitis, insufficient gastric digestion, fermentative dyspepsia (digestion disorder characterized by bloating, rumbling and transfusion in the intestines, a feeling of heaviness, paroxysmal pain).
A sour smell is formed with fermentative dyspepsia.
stool color. The color of feces is normally brown, and it is due to the presence in the feces of the substance stercobilin, the end product of the breakdown of bilirubin. Nutrition affects the color of feces: meat food stains dark brown, dairy food makes the color less intense, vegetables add their own pigment.
Color changes in diseases of the gastrointestinal tract:
- Dark brown color is characteristic of insufficient gastric digestion, colitis with constipation or ulceration, for increased secretory function of the large intestine; appears with constipation and putrefactive dyspepsia (increased processes of putrefaction in the large and partly in the small intestine).
- Light brown color appears with accelerated evacuation from the large intestine.
- A red tint is characteristic of ulcerative colitis.
- The yellow color appears from insufficiency of digestion in the small intestine and fermentative dyspepsia (an indigestion characterized by bloating, rumbling and transfusion in the intestines, due to a carbohydrate diet).
- Gray or light yellow color is characteristic of insufficient activity of the pancreas.
- White color (clay) with infectious lesions of the liver, with stagnation of bile or complete blockage of the bile duct with cholelithiasis or tumors.
- Black or tarry color is a sign of gastrointestinal bleeding.
fecal reaction.
Normal is considered a neutral or slightly alkaline reaction of feces. Such a reaction corresponds to the vital activity factor of the large intestine flora (pH 6.8–7.6).
Deviations of the reaction of feces from the norm:
- An alkaline reaction (pH 8.0–8.5) is characteristic of poor functioning of the stomach and small intestine. Proteins in this case are susceptible to putrefaction due to the activation of the corresponding intestinal flora. As a result, ammonia and other alkaline components are formed.
- A sharply alkaline reaction (pH over 8.5) is characteristic of putrefactive dyspepsia (increased putrefaction processes in the large intestine) with colitis.
- An acidic reaction (pH 5.5–6.7) is formed when fatty acids are not absorbed in the small intestine.
- A sharply acidic reaction (pH less than 5.5) is observed during the formation of carbon dioxide and organic acids as a result of fermentative dyspepsia (digestion, characterized by bloating, rumbling and transfusion in the intestine, due to a carbohydrate diet). This occurs as a result of the activation of the fermentative flora (normal and pathological).
Mucus in stool
Jelly-like mucus is formed in the intestines for better evacuation of food, to reduce friction. However, mucus is normally not detected in feces without a microscope, since it mixes with feces. The abundance of mucus indicates:
- Inflammation of the large intestine (colitis).
- Irritable Bowel Syndrome.
- Poisoning, infectious diseases of the intestine (for example, dysentery, but in this case the symptoms are multiple: pain, diarrhea, and others).
stool blood. Normally, blood is not present in the feces. Blood visible to the naked eye (as well as occult blood) is an alarming symptom that is observed:
- With exacerbation of colitis.
- With bleeding from any part of the gastrointestinal tract, including ulcers.
- With intestinal polyps.
- With hemorrhoids and varicose veins of the digestive tract.
- With malignant tumors in the gastrointestinal tract.
A positive test for occult blood has the same causes
Leftover undigested food
With proper preparation for stool collection, undigested food should not normally be found. If undigested fiber is found, this may indicate a low acidity of gastric juice or an excessively rapid evacuation of food. In the diagnosis of diseases of the gastrointestinal tract, the remains of plant foods do not matter. The remains of undigested meat food are examined under a microscope.
Soluble protein in feces should normally be absent. The causes of the appearance of soluble protein in the feces can be: inflammatory processes in the gastrointestinal tract (gastritis, colitis, enteritis, pancreatitis), ulcerative colitis, putrefactive dyspepsia, excessive secretion of the large intestine, bleeding from the gastrointestinal tract
Sterkobilin A pigment that gives feces a characteristic dark brownish tint. This pigment is a product of the transformation of bile pigments and, at the same time, the result of the exchange of bilirubin.
The reasons for the increase in the amount of stercobilin in the feces: hemolytic anemia, increased bile secretion.
The reasons for the decrease in the amount of stercobilin in the feces: obstructive jaundice, cholangitis, cholelithiasis (cholelithiasis), acute pancreatitis, chronic pancreatitis, viral pathologies of the liver.
Bilirubin in feces in children older than 9 months and in adults should not be. The reasons for the appearance of bilirubin in the feces: treatment with strong antibiotics, intestinal dysbacteriosis, increased intestinal motility, accelerated evacuation of feces from the intestines.
Ammonia, as a product of decay, is formed by the action of bacteria on food protein residues and digestive juices in the lower intestine. An increase in ammonia in the feces indicates hypersecretion and inflammatory exudation in the colon.
Detritus- These are small particles of food that has been digested by the body, and destroyed bacterial cells.
Muscle fibers are a product of processed food of animal origin. The fewer of them in the feces, the better the digestive system works. Normally, a small amount of muscle fibers can be found in the feces, they must be digested and have lost their transverse striation.
The reasons for the increased content of muscle fibers: hypoacid gastritis or anacid gastritis, achilia, dyspepsia, acute or chronic pancreatitis, increased intestinal motility.
Connective tissue fibers in feces- the remains of animal products that the body could not digest. In a healthy person, the analysis does not detect these fibers. And their presence indicates the development of gastritis or pancreatitis.
Starch found in large quantities in vegetables, fruits and cereals. But normally, starch should not be in the feces, since it should be completely broken down in the digestive tract. However, there are a number of cases when starch is found in feces. The causes of the appearance of starch in the feces: pancreatitis, fermentative dyspepsia, accelerated evacuation of intestinal contents, gastritis.
plant fiber in feces It can be of two types: digestible and indigestible. Digestible fiber normally should not be in the feces. The content of indigestible fiber in the stool has no diagnostic value. The reasons for the appearance of digestible fiber in the feces: the use of large volumes of plant foods, accelerated evacuation of the contents of the large intestine, gastritis, putrefactive dyspepsia, ulcerative colitis, pancreatitis.
Neutral Fats(or triglycerides) in the feces should be absent, as they must be completely processed. In infants, there may be a small amount of neutral fats in the feces, since their enzyme system is not fully developed. Causes of the appearance of neutral fats in the feces: accelerated evacuation of intestinal contents, pancreatitis, impaired bile production and impaired flow of bile into the small intestine, malabsorption in the intestine.
Fatty acid are completely absorbed in the intestines, so they should not be in the feces. Causes of the appearance of fatty acids in the feces: fermentative dyspepsia, impaired secretory function of the pancreas (pancreatitis), impaired bile production and impaired bile flow into the small intestine (liver and biliary tract diseases), malabsorption in the intestine, accelerated evacuation of intestinal contents. The same applies to neutral fats.
Soaps are recycled fats. Normally, they should be present in the feces in a small amount. The reasons for the absence of soaps in the feces: fermentative dyspepsia, violation of the secretory function of the pancreas (pancreatitis), violations of the production of bile (liver disease) and violation of the flow of bile into the small intestine (cholelithiasis), malabsorption in the intestine, accelerated evacuation of intestinal contents.
Leukocytes- these are cells that are able to "digest" microorganisms, bind and break down foreign protein substances and decay products that are formed in the body during life. Sometimes the presence of white blood cells in the stool can be the cause of improperly collected feces for analysis (leukocytes can enter the stool from the urethra or from the vagina). In infants, single leukocyte cells may occur, this is the norm and has no diagnostic value. Usually, the presence of leukocytes in the feces can indicate the presence of any inflammatory processes in the gastrointestinal tract: gastrointestinal infections, colitis, enteritis, enterocolitis, ulcerative colitis, rectal fissures.
The site administration site does not evaluate recommendations and reviews about treatment, drugs and specialists. Remember that the discussion is not only conducted by doctors, but also by ordinary readers, so some advice may be dangerous to your health. Before any treatment or taking medications, we recommend that you consult a specialist!
Feces are formed in the large intestine. It consists of water, the remains of food taken and the discharge of the gastrointestinal tract, the products of the transformation of bile pigments, bacteria, etc. For the diagnosis of diseases associated with the digestive organs, the study of feces in some cases can be of decisive importance. General analysis of feces (coprogram) includes macroscopic, chemical and microscopic examination.
Macroscopic examination
Quantity
In pathology, the amount of feces decreases with prolonged constipation caused by chronic colitis, peptic ulcer and other conditions associated with increased absorption of fluid in the intestine. With inflammatory processes in the intestines, colitis with diarrhea, accelerated evacuation from the intestines, the amount of feces increases.
Consistency
Dense consistency - with constant constipation due to excessive absorption of water. Liquid or mushy consistency of feces - with increased peristalsis (due to insufficient absorption of water) or with abundant secretion of inflammatory exudate and mucus by the intestinal wall. Ointment-like consistency - in chronic pancreatitis with exocrine insufficiency. Foamy consistency - with enhanced fermentation processes in the colon and the formation of a large amount of carbon dioxide.
Form
The form of feces in the form of "large lumps" - with a long stay of feces in the colon (hypomotor dysfunction of the colon in people with a sedentary lifestyle or who do not eat coarse food, as well as with colon cancer, diverticular disease). The form in the form of small lumps - "sheep feces" indicates a spastic state of the intestine, during starvation, a stomach ulcer and duodenal ulcer, a reflex character after appendectomy, with hemorrhoids, an anal fissure. Ribbon-like or "pencil" shape - in diseases accompanied by stenosis or severe and prolonged spasm of the rectum, with tumors of the rectum. Unformed feces are a sign of maldigestion and malabsorption syndrome.
Color
If staining of feces with food or drugs is excluded, then color changes are most likely due to pathological changes. Grayish-white, clayey (acholic feces) occurs with obstruction of the biliary tract (stone, tumor, spasm or stenosis of the sphincter of Oddi) or with liver failure (acute hepatitis, cirrhosis of the liver). Black feces (tarry) - bleeding from the stomach, esophagus and small intestine. Pronounced red color - with bleeding from the distal colon and rectum (tumor, ulcers, hemorrhoids). Inflammatory gray exudate with fibrin flakes and pieces of the colonic mucosa ("rice water") - with cholera. Jelly-like character of deep pink or red color in amoebiasis. With typhoid fever, the feces look like "pea soup". With putrefactive processes in the intestines, the feces are dark in color, with fermentative dyspepsia - light yellow.
Slime
When the distal colon (especially the rectum) is affected, the mucus is in the form of lumps, strands, ribbons, or a vitreous mass. With enteritis, the mucus is soft, viscous, mixing with feces, giving it a jelly-like appearance. Mucus covering the formed feces from the outside in the form of thin lumps occurs with constipation and inflammation of the large intestine (colitis).
Blood
When bleeding from the distal colon, the blood is located in the form of veins, shreds and clots on the formed feces. Scarlet blood occurs when bleeding from the lower parts of the sigmoid and rectum (hemorrhoids, fissures, ulcers, tumors). Black feces (melena) occur when bleeding from the upper digestive system (esophagus, stomach, duodenum). Blood in the stool can be found in infectious diseases (dysentery), ulcerative colitis, Crohn's disease, decaying tumors of the colon.
Pus
Pus on the surface of the feces occurs with severe inflammation and ulceration of the mucous membrane of the colon (ulcerative colitis, dysentery, decay of the intestinal tumor, intestinal tuberculosis), often along with blood and mucus. Pus in large quantities without the admixture of mucus is observed at the opening of paraintestinal abscesses.
Leftover undigested food (lientorrhoea)
Isolation of the remnants of undigested food occurs with severe insufficiency of gastric and pancreatic digestion.
Chemical research
fecal reaction
An acidic reaction (pH 5.0-6.5) is noted with the activation of the iodophilic flora, which forms carbon dioxide and organic acids (fermentative dyspepsia). An alkaline reaction (pH 8.0-10.0) occurs with insufficient digestion of food, with colitis with constipation, sharply alkaline with putrefactive and fermentative dyspepsia.
Reaction to blood (Gregersen's reaction)
A positive reaction to blood indicates bleeding in any part of the gastrointestinal tract (bleeding from the gums, rupture of varicose veins of the esophagus, erosive and ulcerative lesions of the gastrointestinal tract, tumors of any part of the gastrointestinal tract in the stage of decay).
Reaction to stercobilin
The absence or a sharp decrease in the amount of stercobilin in the feces (the reaction to stercobilin is negative) indicates obstruction of the common bile duct by a stone, compression of it by a tumor, strictures, choledochal stenosis, or a sharp decrease in liver function (for example, in acute viral hepatitis). An increase in the amount of stercobilin in the feces occurs with massive hemolysis of red blood cells (hemolytic jaundice) or increased bile secretion.
Reaction to bilirubin
The detection of unchanged bilirubin in the feces of an adult indicates a violation of the process of restoring bilirubin in the intestine under the influence of microbial flora. Bilirubin can appear with rapid evacuation of food (a sharp increase in intestinal motility), severe dysbacteriosis (a syndrome of excessive bacterial growth in the colon) after taking antibacterial drugs.
Vishnyakov-Tribulet reaction (for soluble protein)
The Vishnyakov-Tribulet reaction is used to detect a latent inflammatory process. The detection of soluble protein in feces indicates inflammation of the intestinal mucosa (ulcerative colitis, Crohn's disease).
microscopic examination
Muscle fibers - with striation (unchanged, undigested) and without striation (altered, digested). A large number of altered and unchanged muscle fibers in the feces (creatorrhoea) indicates a violation of proteolysis (protein digestion):
- in conditions accompanied by achlorhydria (lack of free HCl in gastric juice) and achilia (complete absence of secretion of HCl, pepsin and other components of gastric juice): atrophic pangastritis, condition after gastric resection;
- with accelerated evacuation of food chyme from the intestine;
- in violation of the exocrine function of the pancreas;
- with putrefactive dyspepsia.
Connective tissue (remains of undigested vessels, ligaments, fascia, cartilage). The presence of connective tissue in the feces indicates a deficiency of proteolytic enzymes of the stomach and is observed with hypo- and achlorhydria, achilia.
Fat is neutral. Fatty acid. Salts of fatty acids (soaps)
The appearance in the feces of a large amount of neutral fat, fatty acids and soaps is called steatorrhea. This happens:
- with exocrine pancreatic insufficiency, a mechanical obstruction to the outflow of pancreatic juice, when steatorrhea is represented by neutral fat;
- in violation of the flow of bile into the duodenum and in violation of the absorption of fatty acids in the small intestine, fatty acids or salts of fatty acids (soaps) are found in the feces.
vegetable fiber
Digestible - found in the pulp of vegetables, fruits, legumes and grains. Indigestible fiber (skin of fruits and vegetables, plant hairs, epidermis of cereals) has no diagnostic value, since there are no enzymes in the human digestive system that break it down. It occurs in large numbers with rapid evacuation of food from the stomach, achlorhydria, achilia, with a syndrome of excessive bacterial growth in the colon.
Starch
The presence of a large amount of starch in the feces is called amylorrhea and is observed more often with increased intestinal motility, fermentative dyspepsia, less often with exocrine insufficiency of pancreatic digestion.
Iodophilic microflora (clostridia)
With a large amount of carbohydrates, clostridia multiply intensively. A large number of clostridia is regarded as fermentative dysbiosis.
Epithelium
A large amount of columnar epithelium in the feces is observed in acute and chronic colitis of various etiologies.
Leukocytes
A large number of leukocytes (usually neutrophils) is observed in acute and chronic enteritis and colitis of various etiologies, ulcerative-necrotic lesions of the intestinal mucosa, intestinal tuberculosis, dysentery.
red blood cells
The appearance of slightly altered erythrocytes in the feces indicates the presence of bleeding from the colon, mainly from its distal sections (ulceration of the mucous membrane, a decaying tumor of the rectum and sigmoid colon, anal fissures, hemorrhoids). A large number of erythrocytes in combination with leukocytes and columnar epithelium is characteristic of ulcerative colitis, Crohn's disease with damage to the colon, polyposis and malignant neoplasms of the colon.
worm eggs
Eggs of roundworm, broad tapeworm, etc. indicate the corresponding helminthic invasion.
Pathogenic protozoa
Cysts of dysenteric amoeba, Giardia, etc. indicate the corresponding invasion by protozoa.
yeast cells
They are found in feces during treatment with antibiotics and corticosteroids. Identification of the fungus Candida albicans is carried out by inoculation on special media (Saburo's medium, Microstix Candida) and indicates a fungal infection of the intestine.
Calcium oxalate (lime oxalate crystals)
Detection of crystals is a sign of achlorhydria.
Tripelphosphate crystals (ammonia-magnesium phosphate)
Tripelphosphate crystals found in faeces (pH 8.5-10.0) immediately after defecation indicate increased protein putrefaction in the colon.
Norms
Macroscopic examination
| Parameter | Norm |
| Quantity | In a healthy person, on average, 100-200 g of feces are excreted per day. Normal feces contain about 80% water and 20% solids. With a vegetarian diet, the amount of feces can reach 400-500 g per day, when using easily digestible food, the amount of feces decreases. |
| Consistency | Normally, formed feces have a dense texture. Mushy feces can be normal, and is due to the intake of predominantly plant foods. |
| Form | Normally cylindrical. |
| Smell | Normally, feces have a mild smell, which is called fecal (normal). It can increase with the predominance of meat products in food, with putrefactive dyspepsia, and weaken with a dairy-vegetarian diet, constipation. |
| Color | Normally, feces are brown in color. When eating dairy foods, feces turn yellowish-brown, and meat foods turn dark brown. The intake of plant foods and certain medications can change the color of feces (beets - reddish; blueberries, blackcurrants, blackberries, coffee, cocoa - dark brown; bismuth, iron color feces black). |
| Slime | Normally absent (or in scarce amounts). |
| Blood | Normally absent. |
| Pus | Normally absent. |
| Leftover undigested food (lientorrhoea) | Normally absent. |
Chemical research
| Parameter | Norm |
| fecal reaction | Normally neutral, rarely slightly alkaline or slightly acidic. Protein nutrition causes a shift in the reaction to the alkaline side, carbohydrate - to the acidic. |
| Reaction to blood (Gregersen's reaction) | Normally negative. |
| Reaction to stercobilin | Normally positive. |
| Reaction to bilirubin | Normally negative. |
| Vishnyakov-Tribulet reaction (for soluble protein) | Normally negative. |
microscopic examination
| Parameter | Norm |
| Muscle fibers | Normally absent or single in the field of view. |
| Connective tissue (remains of undigested vessels, ligaments, fascia, cartilage) | Normally absent. |
| Fat is neutral. Fatty acid. Salts of fatty acids (soaps). | Normally, there are no or a meager amount of salts of fatty acids. |
| vegetable fiber | Normally, single cells in p/z. |
| Starch | Normally absent (or single starch cells). |
| Iodophilic microflora (clostridia) | Normally, it is single in rare cases (normally, the iodophilic flora lives in the ileocecal region of the colon). |
| Epithelium | Normally, there are no or single cells of the cylindrical epithelium in the p / s. |
| Leukocytes | Normally, there are no or single neutrophils in p / s. |
| red blood cells | Normally absent. |
| worm eggs | Normally absent. |
| Pathogenic protozoa | Normally absent. |
| yeast cells | Normally absent. |
| Calcium oxalate (lime oxalate crystals) | Normally absent. |
| Tripelphosphate crystals (ammonia-magnesium phosphate) | Normally absent. |
Diseases for which the doctor may prescribe a general fecal analysis (coprogram)
Crohn's disease
In Crohn's disease, blood can be found in the stool. The Vishnyakov-Triboulet reaction reveals a soluble protein in it. Crohn's disease with lesions of the colon is characterized by the presence in the feces of a large number of red blood cells in combination with white blood cells and columnar epithelium.
Colon diverticulosis
In diverticular disease, due to the long stay of feces in the colon, it takes the form of "large lumps".
Duodenal ulcer
With a duodenal ulcer, the feces are in the form of small lumps (“sheep feces” indicates a spastic state of the intestine).
stomach ulcer
With a stomach ulcer, the feces are in the form of small lumps (“sheep feces” indicates a spastic state of the intestine).
Chronic pancreatitis
In chronic pancreatitis with exocrine insufficiency, feces may have a greasy consistency.
Hemolytic anemia
With hemolytic jaundice (anemia), due to massive hemolysis of red blood cells, the amount of stercobilin in the feces increases.
Benign neoplasms of the colon
With a tumor accompanied by bleeding from the distal colon, feces may have a pronounced red color. In decaying tumors of the colon, blood can be found in the stool. Pus on the surface of the feces occurs with severe inflammation and ulceration of the mucous membrane of the colon (disintegration of the intestinal tumor), often along with blood and mucus. With a tumor of the colon in the stage of disintegration due to bleeding, the reaction to blood (Gregersen's reaction) is positive.
Intestinal helminthiases
With helminthic invasion in the feces there are eggs of ascaris, a wide tapeworm, etc.
Cirrhosis of the liver
With liver failure, including cirrhosis of the liver, the feces are grayish-white, clayey (acholic).
Ulcerative colitis
With colitis, mucus is noted that covers the formed feces from the outside in the form of thin lumps. In ulcerative colitis, blood may be found in the stool; pus on the surface of the stool, often with blood and mucus; soluble protein in the Vishnyakov-Tribulet reaction; a large number of leukocytes (usually neutrophils); a large number of erythrocytes in combination with leukocytes and columnar epithelium.
Constipation
With prolonged constipation caused by chronic colitis, peptic ulcer and other conditions associated with increased absorption of fluid in the intestine, the amount of feces decreases. With constant constipation due to excessive absorption of water, the consistency of feces is dense. With constipation, mucus can be noted that covers the formed feces from the outside in the form of thin lumps.
Malignant neoplasm of the colon
The form of feces in the form of "large lumps" - with a long stay of feces in the colon - is noted in colon cancer. Pronounced red feces - with a tumor, accompanied by bleeding from the distal colon and rectum. Blood in the stool can be found in decaying tumors of the colon. Pus on the surface of the feces occurs with severe inflammation and ulceration of the mucous membrane of the colon (disintegration of the intestinal tumor), often along with blood and mucus. A positive reaction to blood (Gregersen's reaction) indicates bleeding in a colon tumor in the stage of disintegration. A large number of erythrocytes in combination with leukocytes and columnar epithelium is characteristic of malignant neoplasms of the colon.
irritable bowel syndrome, chronic colitis
With colitis with diarrhea, the amount of feces increases. The amount of feces decreases with prolonged constipation caused by chronic colitis. Mucus covering the formed feces from the outside in the form of thin lumps is found in colitis. Alkaline reaction (pH 8.0-10.0) occurs in colitis with constipation. A large number of leukocytes (usually neutrophils) is observed in colitis of various etiologies.
Cholera
In cholera, the stool looks like an inflammatory gray exudate with fibrin flakes and pieces of the colon mucosa (“rice water”).
Amoebiasis
With amoebiasis, the feces are jelly-like, rich pink or red.
Typhoid fever
With typhoid fever, the feces look like "pea soup".
Peptic ulcer of the stomach and duodenum
With prolonged constipation caused by peptic ulcer, the amount of feces decreases. With an ulcer of the duodenum and stomach, the feces are in the form of small lumps (“sheep feces” indicates a spastic state of the intestine).
In order for the baby to grow up healthy, it is important to prevent diseases or recognize them in time. For such purposes, mothers are asked to collect the baby's feces and take it for analysis. It is feces that give a more complete picture of the state of internal organs, metabolic processes, the work of the intestines, stomach and allow you to observe the entire etiology, as well as prescribe a full-fledged treatment. The coprogram will also show salt crystals, in particular, oxalates. Why, why and how to treat oxalates in the feces - this is worth talking about in more detail.
Coprogram - why do it?
Diagnosis of gastrointestinal diseases, pathologies of the kidneys and ureter in a young child is a problem. Determination of diseases is often impossible with the methods used for adults, so laboratory diagnostics remains one of the most productive methods. When collecting feces for analysis, mothers themselves do not always expect the results that come to light. For example, the presence of oxalate crystals is frightening, alarming and makes you immediately look for the best treatment.
What does the study of feces:
- detection of violations of acid-forming and enzymatic activity of the stomach, intestines, pancreas;
- malfunctions of the liver;
- instability of the evacuation of juice from the stomach / intestines;
- the presence of inflammatory processes;
- disorders of the intestinal microflora, stomach;
- the presence of inflammatory processes of internal organs.
With this analysis, it is easy to identify if there are crystals, what kind they are, what they are associated with and choose the desired treatment option. Under normal life processes, there should be no oxalate crystals in the feces.
Oxalates in feces: why do they appear?
The cryptogram reveals the presence of several groups of formations, which are "fragments" of cells subjected to destruction during digestion. Thus, there are crystals:
- Epithelial. These are the remains of epithelial cells that are destroyed under the influence of gastrointestinal enzymes. A small accumulation does not cause concern, an increased level means the presence of an inflammatory process of the colon mucosa.
- Scharko-Leiden. Formed from cells responsible for allergic-type reactions, indicate the presence of helminthic invasion.
- Tripelphosphates. They occur with an accelerated reaction of the evacuation of the contents of the intestine and may mean massive bleeding of the gastrointestinal tract.
- Oxalates. Crystals have minimal diagnostic value and appear due to low acidity of gastric juice, as well as from the use of vegetarian food.
Important! The absence of free hydrochloric acid converts calcium oxalate to calcium chloride and is detected by the formation of crystalline formations that precipitate in feces.
Symptoms, treatment
The symptoms of the presence of oxalates in the feces in children are not pronounced, rather, it looks like a general clinical picture of stomach diseases with low acidity. The manifestations are:
- General decrease in appetite;
- Frequent belching;
- Possibly bad breath;
- constipation;
- Disorders of the intestine, while the consistency of the stool can be dense;
- The appearance of nausea, vomiting immediately after eating;
- bloating, flatulence;
- The presence of undigested food in the feces.
Important! It is difficult to distinguish between symptoms in young children, but if the baby cries after eating, this may mean pain, heaviness in the stomach - such symptoms may also indicate the absence of free hydrochloric acid, which leads to the formation of oxalate crystals.
If the disease is not treated, it can lead to some complications that affect the work of the gastrointestinal tract, in particular:
- Slowing down the breakdown and digestibility of products, which increases the risk of infection, the development of fungal, viral pathologies.
- The formation of crystalline fractions indicates the destruction of cells, and this is a signal of insufficient intake of vitamins and minerals into the body.
- Violations of digestibility lead to the occurrence of allergic reactions, a decrease in immunity.
Important! Treatment of oxalate crystals in feces is prescribed only by a specialist! In no case should you resort to unauthorized forms, try diets or introduce animal products into the child's diet (if the reason is vegetarian food). Such decisions will lead to the development of many pathologies.
Standard oxalate crystal healing therapy includes:
- Selection of the optimal diet, which will have to be observed constantly;
- Prescribing medications;
- Perhaps herbal medicine, alternative methods (folk).
As for alternative healing options, they are used as an aid. Most often, these are vegetable bitterness, infusions of secretory-gastric herbs and other fees. Honey and butter in equal proportions, taken before meals for half an hour, helps very well. Plantain, honey water, bitter wormwood - there are a lot of options. However, their choice entirely depends on the amount of oxalates, the state of the gastrointestinal tract and the presence of complications, pathologies.
Oxalate crystals in the feces of a child are a reason to consult a doctor to identify possible gastrointestinal diseases. Despite the fact that the crystals do not represent a diagnostic value, an excess of the quantity norm indicates the development of pathologies. Therefore, it is necessary to treat the baby, but only a specialist will tell you which diet, medicines to prescribe or choose folk remedies.
Research includes several stages of study:
- Physical properties of feces;
- Chemical research;
- Microscopic examination;
- Bacteriological research;
Physical properties.
Chemical study of feces.
It includes determining the content of blood in the feces, which is not visible to the naked eye, bilirubin, stercobilin, and other substances.
Bacteriological examination of feces.
If the stool becomes black, tarry consistency (melena), then these are signs or duodenal ulcers. This happens as a result of a rupture of a blood vessel at the bottom of the ulcer. Varicose veins of the esophagus, occurs in people with. If blood from the veins of the esophagus enters the stomach, then black, tarry stools appear.
The appearance of fresh blood in the stool.
If, during a visual examination, fragments of fresh blood are visible, this indicates diseases such as anal fissures,.
Change in stool odor.
The sharp, unpleasant smell of feces is the result of extensive reactions of decay or fermentation. They occur with a disease such as chronic pancreatitis. The disease is characterized by insufficient production of pancreatic juice, which is involved in the digestion of fats, proteins and carbohydrates. Insufficiently digested food contributes to an increase in the intestines of putrefactive bacteria that produce malodorous substances. In addition to the putrid smell, the feces contain many visible fragments of undigested food.
Dysbacteriosis, a disease in which the ratio of normal and pathological intestinal microflora is disturbed. The stool becomes mushy, with a sharp unpleasant odor, and a high content of leukocytes.
Presence of protein in feces.
The presence of muscle fibers in the feces.
By muscle fibers are meant elements of meat food that are not digested in the digestive tract and enter the feces. If the presence of muscle fiber exceeds the norm, then this phenomenon is called creatorrhea. They are found in diseases such as: Chronic atrophic gastritis - a decrease in the acidity of the stomach. At the same time, the release of hydrochloric acid is disturbed, and the elements of meat food are not subjected to the necessary processing, which further reduces their quality of digestion in the lower parts of the digestive tract.
Normally, when examining feces, the result should be negative. This indicates that eggs, cysts, worm larvae are absent. With a positive result, it is indicated which type of helminths was found.
Presence of Giardia in stool.
In children under one year of age who receive solid food, an increased content of muscle fibers, fats, and carbohydrates in the feces is allowed. As they grow older, food begins to be digested almost completely, digestion returns to normal.
