What is Fecalysis? Fecalysis is also known as stool analysis.

It refers to a series of laboratory tests done on fecal samples to analyze the condition of a person's digestive tract in general. Among other things, a fecalysis is performed to check for the presence of any reducing substances such as white blood cells (WBCs), sugars, or bile and signs of poor absorption as well as screen for colon cancer. To properly check for inadequate absorption, a fecal fat test may be required. This is a diagnostic procedure used to recognize problems with fat absorption. A quantitative fecal fat test is usually completed in three days and able to verify the amount of fat within a person's body. How Patients Prepare for Fecalysis? The accuracy of a fecalysis can be compromised if a patient has not been properly educated about what he can and can't do before or during the test. If he is taking any medications, these must be screened as some can affect test results. A patient is usually discouraged as well from taking aspirin, alcohol, vitamin C, ibuprofen and certain types of food if his fecal sample will be checked for any sign of blood. Recent travel and X-Ray tests can also affect the results of fecalysis. Sample Collection Process for Fecalysis It is up to the patient if he wishes to have fecal sample collected inside the doctor's office and with professional assistance or do it at home by himself. If he chooses the latter, he will need a stool collection kit to obtain and preserve the sample properly. The patient must urinate first to prevent any urine from mixing with his feces later on. He must also wear gloves when it's time to handle stool and transfer it to a safer container. This will prevent any possibilities of being contaminated or infected by bacteria found within the stool. Solid and liquid fecal samples are both acceptable as long as they do not have urine or other foreign substances like soap, water, and toilet paper mixed in them. If the patient is suffering from diarrhea, placing a plastic wrap and securing it under the toilet seat could facilitate the collection process. Collected samples must be brought to the doctor's office or laboratory as soon as possible. Delays could compromise the quality of the sample. Volume or amount is also important so the patient must be sure he has collected an adequate amount of stool. Results of Stool Analysis with a Fecalysis Microscope Results are normal if the fecalysis microscope shows that the sample does not contain any parasites, viruses, or bacteria as well as containing not more than 2mg per gram of sugar. Visual confirmation of the results should show that the patient's stool is brown and well-formed. Tactile confirmation should show that it's soft. Lastly, its pH level should be 6.

Results are abnormal if the fecalysis microscope shows that the sample contains mucus, blood, parasite, bacteria, virus, or pus as well as containing more than 5mg per gram of sugar. Visual confirmation of the results should show that the patient's stool is colored green, yellow, white, red, or black. It may either be liquid in form or extremely hard. Its pH level is either ower than 5.3 or higher than 6.8. Prepared by: Donald James Pathophysiology A. Characteristics 1. Pear-shaped flagellated protozoan B. Low inoculum: <10-25 cysts C. Causative Organisms 1. Giardia lamblia 2. Giardia intestinalis D. Transmission: Fecal-oral E. Life Cycle 1. Stage 1: Cyst transmitted via fecal-oral route a. May remain viable for months in moist environment b. Cyst develops into 2 trophozoites in acid stomach Stage 2: Disease-causing trophozoite . Trophozoites attach to wall of small intestine a. Trophozoites multiply and some transform to cysts b. Cysts are passed with feces to restart cycle

Pathophysiology of Giardia The pathogenesis of Giardia is not completely understood due to the extensive variation seen in disease expression. Clinical presentation ranges from asymptomatic cyst passage to chronic diarrhea, malabsorption, severe weight loss, and malnutrition.1 In asymptomatic patients, histologic exam of the duodenum often shows minimal changes or no abnormal representations. However, the major structural and functional changes associated with giardiasis when symptoms are present are usually found in the small intestine.2 Factors that influence the clinical presentation of the disease range from the host's immune response to the parasite, the parasite load in the small intestine, and the virulence of the infecting strain of Giardia. There are several proposed mechanisms of disease that involve both mucosal and luminal factors in patients who exhibit abdominal pain, diarrhea, and malabsorption symptoms. Actual invasion of the mucosa by organisms is a rare finding. The intestinal mucosa may be damaged by the trophozoite itself disrupting the epithelial brush border during attachment, or less likely by direct invasion.2 In addition, release of toxic substances from the organism itself may damage intestinal epithelium. Absorptive activities may also be blocked due to the trophozoites "blanketing" the intestinal mucosa and causing functional mucosal obstruction.3 Some studies have shown that immunologic mechanisms may also play a role since individuals with decreased gamma globulin levels have a higher prevalence of infection and reinfection. The luminal factors that could possibly explain the pathogenesis of symptoms are increased number of anaerobic and aerobic bacteria in the small intestine of the infected patient. Malabsorption may be due, in part, to bacterial overgrowth which leads to the deconjugation of bile salts. The bile salts are then taken up by the trophozoites, triggering encystations and stimulating parasite growth.4