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A stool collection device: the first step in occult blood testing.

D A Ahlquist¹, S Schwartz, J Isaacson

¹Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Annals of Internal Medicine

|April 1, 1988

Summary

Fecal occult blood testing is hindered by uncontrolled stool collection. A new, inexpensive stool collector improves patient compliance and prevents errors caused by toilet water contamination.

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Area of Science:

Clinical Chemistry
Gastroenterology
Medical Devices

Background:

Fecal occult blood testing is crucial for early disease detection.
Current stool sample collection methods are often uncontrolled and lead to errors.
Toilet water contamination and sanitizers can interfere with test accuracy.

Purpose of the Study:

To investigate patient methods for stool collection.
To assess the impact of toilet water on fecal blood sample integrity.
To develop and evaluate a novel stool collection device.

Main Methods:

A survey of 250 patients assessed stool collection techniques.
Laboratory experiments evaluated blood leaching and sanitizer interference.
An inexpensive, disposable stool collector was designed and tested.

Main Results:

Most patients (56%) collected stool from the toilet basin, leading to significant blood loss (4-75% in 4-12 minutes).
Toilet sanitizers caused false-positive guaiac reactions.
The developed stool collector achieved 97% patient compliance.

Conclusions:

Uncontrolled stool sampling introduces significant biochemical artifact.
A dedicated stool collection device is essential for accurate fecal occult blood testing.
Incorporating a collection device into the testing process is recommended.