Are you here: Children's games

In case of violations in the work of the digestive system, the specialist prescribes a general analysis of feces - a coprogram. It focuses on the chemical, physical and microscopic study of excrement. Chyme (digestive gruel) passes through the entire gastrointestinal tract and is already formed in the large intestine into excrement. During the movement of food gruel through the digestive system, splitting and absorption of substances occurs. The composition of the excrement can determine the violations in digestion. The coprogram is prescribed for diagnosing many diseases.

The coprogram allows you to diagnose diseases such as dysbacteriosis, colitis, inflammatory processes in the digestive tract, malabsorption of substances; malfunction of the secretory function of the stomach, pancreas and intestines.

Indications for appointment

Indications for the study of feces for a coprogram are:

An analysis of excrement for a coprogram is prescribed for any deviations in the functioning of the digestive system.

In children, this analysis allows you to identify problems such as:

lactose deficiency.
Dysbacteriosis.
Intestinal lesions (inflammatory and infectious).
Cystic fibrosis.

After examining the feces, the specialist can make the correct diagnosis and prescribe the correct treatment.

How to pass?

Some special preparation for the test is not required, but in order for the results to be correct, meat products, products containing dyes (beets, tomatoes), and red fish should be abandoned in a few days. When these products are taken, fecal occult blood tests may give an incorrect result.

You also need to refuse to take medications: antibiotics, anti-inflammatory drugs, any laxatives, iron-containing drugs.

And also you need to avoid enemas, the use of rectal suppositories, any procedures through the anus.

Women should not take a coprogram test during menstruation. If a person has bleeding hemorrhoids, then the collection of feces should also be postponed.

It is best to collect feces from the morning portion. If you donate excrement from the evening portion, then you need to store them in the refrigerator, no longer than 10 hours. Excrement should be collected in a special container or glass jar. Disposal containers must be clean. For analysis, 15 grams of feces is enough.

How to take the test correctly:

Defecation should be natural.
During bowel movements, urine and discharge from the genitals should not be allowed to enter.
Using a special spatula, collect excrement into a container. It is desirable to collect feces from three different parts of the stool.
Close container and sign.

Feces from an infant are collected whenever possible, since it is impossible to control defecation. It is not advisable to collect excrement from the diaper. To do this, it is better to use a clean baby diaper or oilcloth.

If the baby suffers from constipation, then you can massage the stomach or use a gas tube. Wash your hands thoroughly before collecting feces.

With older children, things are a little better. If the child goes to the potty, then thoroughly wash it before starting a bowel movement. Be careful not to get urine in the feces.

If the fecal analysis involves occult blood tests, it is recommended to exclude the same products as adults.

Please be aware that certain foods and medications can affect test results.

The result after the delivery of excrement will be ready within 1-2 days. A form is issued with the data of the study. The interpretation of the analysis data is carried out by the doctor, on the basis of which he can draw a conclusion about disorders in the digestive system.

Some diseases can be diagnosed by appearance, color, density, smell. Thanks to macroscopic studies, blood, mucus, pus, gall and intestinal stones, and worms can be found in excrement.

Microscopic examination determines the digestibility of food. A chemical study determines acidity, bilirubin, protein, occult blood, soluble mucus.

Protein.

Excrement analysis is considered normal if it does not contain protein. If a protein is found in the feces, then this indicates that an inflammatory process is taking place in the digestive tract. Protein in excrement is detected in cancer, ulcers, proctitis.

Blood.

Blood in the stool indicates the presence of a bleeding ulcer in the duodenum or stomach. At the time of passage of food, the mucous membrane, which has tumors, is damaged, and blood comes out of it. Helminths can also damage the mucous membrane. When analyzing feces for occult blood, tumors can be diagnosed at an early stage.

Sterkobilin. The pigment gives the excrement a brown color. The normal amount of substance formation is from 75 to 350 mg per day. If the level of stercobilin rises, then the production of pigment decreases. This is due to the blockage of the bile ducts by stones. To confirm the diagnosis, you need to undergo an examination of the gallbladder.

Bilirubin.

The detection of bilirubin in feces indicates an accelerated process of passing food. With an accelerated process, bilirubin does not have time to convert to stercobilin. The presence of bilirubin in the feces indicates the presence of dysbacteriosis or acute gastroenteritis.

Slime.

The mucus produced by the cells performs a protective function. If there is an increased separation of mucus, then this indicates inflammatory changes in the intestines. Mucus in the feces is present in infectious colitis, dysentery, etc.

Iodophilic flora.

The iodophilic flora indicates that the microflora in the intestine is disturbed. Violation of the intestinal microflora can occur with dysbacteriosis.

Detritus.

Detritus is the destroyed material of the cells of the intestinal epithelium. If there are problems associated with poor digestion of food, then the amount of detritus in the feces will be small.

Neutral fat.

A fecal analysis is considered normal if there is no neutral fat in the excrement. If all the digestive organs are working normally, then the digestibility of fat is 90%. The presence of neutral fat in the stool indicates that there is a problem with bile production and intestinal absorption.

Muscle fibers.

The presence of muscle fibers in the feces indicates that the production of digestive juice is reduced. Food from meat is not fully digested and the fibers remain unchanged. In the normal state of the digestive tract, the fibers change. This deviation indicates the presence of pancreatitis.

Starch.

The analysis is considered normal if starch is not detected. The presence of starch indicates the rapid movement of feces. The presence of starch indicates chronic pancreatitis or malabsorption.

Soaps.

Under normal conditions, the content of soap in the excrement should be in small quantities. If there is an increase in soap indicators, then this indicates digestive insufficiency in the stomach and small intestine. An increased content of soap indicates pancreatitis or gallstone disease.

Leukocytes.

The presence of leukocytes in the feces indicates the inflammatory process of the digestive tract. The analysis is considered normal if no leukocytes were detected.

Fatty acid.

If the digestive system is working normally, then fatty acids are absent. The presence of fatty acids may indicate an insufficient supply of bile, the rapid movement of food, an inactive digestive enzyme.

vegetable fiber.

Plant fiber is divided into two types:

Connective tissue fibers.

Connective tissue fibers are the remnants of undigested food of animal origin. During normal functioning of the gastrointestinal tract, the presence of connective tissue fibers in excrement should be absent. If the presence of fibers is detected, then this indicates a decrease in the acidity of gastric juice or a lack of enzymes responsible for the breakdown of meat food. In diseases such as gastritis and pancreatitis, connective tissue fibers are present in the feces.

Ammonia.

The normal content of ammonia is considered to be from 20 to 40 mol/kg. If the ammonia content exceeds the norm, then this indicates the process of decay in the intestines. This happens during a period of increased protein production as a result of inflammation of the intestinal walls. In order to accurately determine the diagnosis, additional studies are prescribed.

Pathological and conditionally pathological microorganisms.

The presence of such microorganisms indicates intestinal diseases. With dysbacteriosis, fecal analysis for a coprogram indicates the presence of opportunistic and pathological microorganisms.

The indicator of the reaction of feces can be any. It depends only on the nature of the food taken.

Deciphering the coprogram in children

When deciphering the analysis of feces for a coprogram in a child, the main indicators are the same as in an adult. But there are several features.

A neutral or slightly alkaline reaction in most children is the norm. In infants, the reaction is most often sour. This speaks to the nature of nutrition.

Until the child reaches the age of three months, with breastfeeding, the presence of bilirubin in the feces is the norm. After the child reaches three months, only stercobilin should be present in the excrement.

Colitis is a disease of the mucous membrane of the large intestine of various etiologies. The cause of the disease is the penetration of pathogenic bacteria into the body, exposure to harmful substances, allergens, and malnutrition. Colitis can occur both in acute, transient, and chronic form, which requires longer treatment. This disease can have two varieties - specific, caused by certain factors, and non-specific, in which it is difficult to find out the cause of the pathology. Each form has its own symptoms. If colitis is suspected, the doctor sends the patient for blood and stool tests for diagnosis. What tests for colitis will help a specialist determine the type of disease and prescribe the correct treatment will be described below.

According to statistics, people of both sexes are ill with colitis with the same frequency, regardless of race and social status. Most often it develops in men after 40 years, in women - after 20.

The following groups of patients are at the highest risk of developing colitis:

having a history of gastritis, stomach ulcers and other diseases of the gastrointestinal tract;
taking antimicrobials;
abusing the intake of laxatives, enemas;
having a hereditary predisposition.

When the first symptoms of colitis appear - abdominal pain, stool disorders, flatulence, loss of appetite, the presence of mucus in the feces - you should contact a gastroenterologist for advice and treatment.

Types of colitis

There are several varieties of the disease: allergic, ischemic, pseudomembranous, toxic, etc. Each of them is characterized by special causes, course and specific symptoms.

Toxic

The disease develops due to poisoning with toxic substances - mercury, phosphorus, lead, etc. Toxic colitis is characterized by acute pain in the large intestine, nausea, abdominal pain, headaches, vomiting, and weakness.

Drug

This type of colitis develops against the background of taking medications that disrupt the intestinal microflora - antibiotics, hormonal drugs, cancer drugs. The main symptoms are frequent stools, dehydration, pain in the navel, mucus, and sometimes blood in the stool. In case of severe intestinal damage, a high temperature is possible up to 39-40 degrees.

Allergic

This type of pathology appears under the influence of allergens on the body. In most cases, it develops in infants with the introduction of complementary foods. According to clinical manifestations, it does not differ from other types of colitis, but abdominal pain intensifies immediately after eating food containing allergens.

Mechanical

Occurs with frequent constipation, abuse of enemas, rectal suppositories. As a result, the intestinal walls are often mechanically irritated.

Chronic

The most common type of the disease, occurring in 50% of all cases. The disease is characterized by a series of remissions and exacerbations. Most often occurs in the presence of pre-existing diseases of the digestive system.

Congenital

This type is associated with congenital anomalies in the structure of the intestine or genetic mutations during the period of intrauterine development of the fetus.

Alimentary

This type of colitis is associated with an unhealthy diet consisting of spicy, fatty foods, lacking fiber, due to the abuse of fast food. In addition, the disease may be associated with a low content of proteins and vitamins in the food consumed.

Infectious

Diagnostics and tests for colitis

If colitis is suspected, the gastroenterologist conducts a conversation with the patient, collecting an anamnesis. After that, the patient is referred for diagnostic procedures, which include blood tests, fecal masses, coprogram, colonoscopy, irrigoscopy, intestinal ultrasound, fecal culture.

Macro- and microscopy of feces

Microscopic and macroscopic examination of feces allows you to assess the condition of the digestive tract. To pass the analysis, it is required 3 days before the study to stop taking all medications if possible, follow a diet: eat 5-6 times a day in small portions, include cereals and fiber in the diet.

Put about 30 g of feces into a sterile container after self-emptying of the intestine and deliver it to the laboratory as soon as possible. If this is not possible, then the biomaterial can be stored in the refrigerator for 8 hours.

Macroscopic examination is aimed at assessing the physical properties of feces. With various diseases of the intestine, changes in the physical properties of the biomaterial occur. With colitis, feces have a mushy texture. This is due to excess secretion of mucus by the walls of the colon. At the same time, it covers the feces with thin lumps.

Normally, blood and pus should not be present in the feces, but with colitis of various etiologies, this phenomenon is not uncommon. A small amount of blood and pus in the analysis indicates ulcerative colitis and Crohn's disease.

Microscopic examination of feces allows you to evaluate its chemical properties and detect problems. Epithelium and leukocytes are not found in the feces of a healthy person, but if a person suffers from acute or chronic colitis, columnar epithelium and neutrophils will be present in his feces. If, along with these indicators, a large number of red blood cells are present, then the patient suffers from ulcerative colitis, Crohn's disease, or colon oncology.

The results of the study are known in 2-3 days, and if there is a laboratory in the locality where the tests were taken, in the afternoon of the same day.

Coprogram

The coprogram is a general analysis of feces, which consists of macro-, microscopic and chemical analysis of feces. The first two components of the coprogram were described above.

Chemical analysis for colitis of any kind shows the presence of an alkaline reaction (pH 8-10). The presence of unchanged bilirubin also informs about problems with the large intestine associated with a violation of the microflora when taking various medications.

Identification of helminth eggs

If 3 times in a row, as a result, there is a mark that helminths were not detected, then a person can be sure of the accuracy of the diagnosis. If at least one time out of three there is a positive answer, then the patient is sick with helminthiasis.

Research is carried out as follows:

Macroscopically.

To do this, the feces are mixed with water and examined under strong light for the presence of eggs or larvae. If they are found, they are transferred to a special glass and further examined.

Microscopically.

Using special reagents, the feces are placed under cellophane and examined under a microscope. This technique allows you to detect the presence of helminths even at the initial stage of infection.

The analysis is prepared within 2-5 days after the delivery of the biomaterial to the laboratory. Preparation for it is the same as for a coprogram.

Bakposev of fecal masses

Bacterial culture of feces is very informative in colitis. It provides information about pathogens. Most often they are bacteria.

Biomaterial is collected in the morning. 30 g of feces is placed in a sterile test tube and delivered to the laboratory, where colonies of microorganisms that have become the causative agents of the disease are grown under special conditions for 7-10 days. Along with this, the sensitivity of bacteria to antibiotics is determined. This is necessary for the treatment to take place quickly and efficiently.

Normally, pathogenic microorganisms in feces should not be more than 10 4 CFU (colony-forming units), in children - 10 3 . If in the analyzes their content is greater than this figure, then the colitis was caused by this particular agent. It can be:

golden staphylococci;
clostridia;
mushrooms of the genus Candida.

General blood analysis

A blood test can show, in the presence of a disease, an increased number of leukocytes and an increased ESR (erythrocyte sedimentation rate).

The number of leukocytes in an adult is 10X10 9 and in a child from 4.5 - 9, ESR - from 3 to 15 mm / h in an adult and 4-12 mm / h in a child indicates the presence of inflammation.

3 days before taking capillary blood from a finger, it is recommended to exclude stress, the use of fatty and spicy foods, and stop taking medications that can affect the results. Blood is taken for analysis in the laboratory in the morning on an empty stomach. The last meal should be no later than 10 hours before the analysis. The results will be ready on the same day.

Contrast irrigoscopy

Contrast irrigoscopy is a diagnostic method that can be used to assess the condition of the large intestine in various diseases, including colitis. To do this, a barium-based contrast agent is injected into the anus through an enema. Then a series of x-rays is taken at various positions of the body. After the bowel is naturally cleared of the contrast fluid, another series of images is taken to give an idea of the relief of the bowel and its ability to contract. The results are issued immediately after the examination to the hands of the patient.

With colitis of various origins, the pictures show a narrowing of the lumen of the colon, obstruction of barium due to spasm of the muscles.

The procedure takes from 10 to 50 minutes. It is less traumatic, therefore it is indicated for those patients who, for various reasons, cannot undergo a colonoscopy. However, the procedure is contraindicated in the following group of patients:

pregnancy;
severe cardiovascular diseases;
perforation of the intestinal wall.

Conducting contrast irrigoscopy requires the patient to have serious preparation, which is carried out 3 days before the study. You need to follow a diet that excludes cereals, fruits and vegetables, legumes. The last meal should be no later than 15-20 hours before the procedure.

In addition, three days before barium enema, cleansing enemas should be performed daily until clean water appears and a laxative should be taken.

Colonoscopy

This method is indicated for suspected nonspecific colitis. This procedure is very painful and traumatic, but it is informative in determining the causes of the disease, which is important in differential diagnosis.

The doctor inserts a flexible tube with a camera along the entire length of the large intestine into the patient's anus. When the tube is advanced, air is forced into the intestine so that the walls do not stick together. The doctor examines the organ and can make a diagnosis immediately based on the examination. Along with this, a piece of tissue of the large intestine is taken for histological analysis in case of suspicion of oncological and some other diseases.

Preparation for the study, as with irrigoscopy, consists in following a diet, cleansing the intestines with castor oil, enemas or special medications. This should be done 2-3 days before the colonoscopy.

The procedure is contraindicated in:

intestinal perforations;
serious cardiovascular diseases;
pregnancy;
bleeding;
peritonitis.

Due to the fact that the procedure is difficult to tolerate, recently it has been practiced under anesthesia.

Histological examination

Histology is the analysis of organ tissue. Most often, it is carried out in order to detect or refute the presence of cancer cells. In colitis, histology is not indicated, but for differential diagnosis (with the exclusion of colon cancer), this analysis is required.

Biomaterial is taken during colonoscopy. For this, a small piece of the mucous membrane of the colon is taken. It is placed in a special solution and transported to the laboratory, where, using reagents and dyes, the tissue is examined under a microscope.

The result of the analysis is prepared for a long time - usually 10-14 days.

Finger examination of the anus

This is one of the simplest and most painless types of research that is carried out by a proctologist if colitis is suspected to exclude hemorrhoids, rectal fissures and other diseases. For this, on the eve of the patient at home, he makes a cleansing enema.

On examination, the doctor inserts a finger into the rectum of the patient, who lies on his side, bending his legs. The doctor evaluates the quality of peristalsis, the presence of formations on the walls, the general condition of the rectum.

Prevention of colitis

Prevention of colitis is aimed at eliminating the causes of the disease. To do this, you need to eat right, visit the dentist regularly, treat chronic diseases of the digestive system, move more and avoid exposure to harmful substances, including antibiotics. These recommendations will reduce the risk of developing the disease.

Such a serious disease as colitis needs to be monitored and treated by a specialist. In the absence of proper therapy, colitis leads to peritonitis, necrosis of the intestinal wall, intestinal obstruction, and even death.

Coprogram - what is this study? Indications, sampling technique and interpretation of the results of the coprogram

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is a coprogram ( general analysis of feces)?

Coprogram is a laboratory study of fecal masses ( fecal analysis ), during which their physical, chemical, biological and microscopic characteristics are evaluated. A detailed study of the composition and structure of feces allows you to identify some diseases of the gastrointestinal tract, in which a person’s digestion or absorption of nutrients is disturbed.

The methodology for studying the functions of internal organs by the nature of feces is scientifically substantiated. The fact is that the food taken by a person in the process of passing through the gastrointestinal tract undergoes intensive processing.
It is crushed mechanically, after which it is mixed with saliva, gastric juice and other digestive enzymes that are produced by the liver and pancreas. All this contributes to the breakdown of food products into simple substances that are absorbed through the intestinal mucosa into the human body. Unabsorbed food debris, water and microorganisms ( which are permanent inhabitants of the large intestine, also taking part in the processes of digestion) form feces.

If all organs of the digestive system are functioning normally, the composition and characteristics of feces in humans will be approximately the same ( adjusted for the nature of the food that the patient took some time before the analysis). If any organ of the gastrointestinal tract does not work properly, it disrupts the absorption of food products and other important processes in the body, which will affect the composition, consistency and other characteristics of feces.

Indications for coprogram

As mentioned above, the analysis of the characteristics of feces can help in the diagnosis of diseases of various organs of the digestive system.

The coprogram allows you to diagnose:

diseases of the stomach;
bowel disease;
liver disease;
diseases of the pancreas;
surgical diseases of the gastrointestinal tract;
unreasonable weight loss and so on.

These pathologies can manifest themselves with a wide variety of signs, and therefore the analysis should be prescribed only by a doctor after a thorough questioning and examination of the patient. Also, this study can be prescribed in the treatment of various diseases of the digestive system to evaluate the results of therapy and monitor its effectiveness.

Coprogram - specialist consultation

How to donate feces for a coprogram?

In order for the results of the coprogram to be as accurate and informative as possible, fecal sampling for research must be carried out according to certain rules. Strict observance of these rules will allow to deliver to the laboratory a clean material, not contaminated with foreign substances and bacteria, which will guarantee the quality of the research results. At the same time, it will prevent the spread of infection to foreign objects or people, ensuring their safety.

Do I need special preparation before taking feces for analysis?

Special preparation before the coprogram is not required. At the same time, there are a number of limitations that should be considered before prescribing this analysis.

Before taking material for a coprogram, you should:

Avoid any enemas or other bowel lavages. These procedures will distort the results of the study. Material sampling should be carried out no earlier than 24 hours after the last enema.
Exclude rectal ( through the anus) drug administration. Administration of medications including candles) in a similar way will distort the results of research, as it will violate the physical state of feces and their chemical composition.
Avoid taking drugs that affect digestion. These drugs include activated charcoal ( interferes with the absorption in the intestine of almost all substances), enzyme preparations ( can hide diseases of the pancreas or liver), drugs that speed up or slow down intestinal motility, and so on ( a more detailed list of medications should be checked with a doctor). Limit the intake of these medications should be 2 - 3 days before the analysis.

Do I need to follow a diet before a coprogram?

In general, it is not necessary to follow a diet before a coprogram. Only those patients who are suspected to have bleeding in the gastrointestinal tract should be on a special diet before taking the material ( that is, during the analysis of feces, the laboratory assistant will look for traces of blood in them). If the patient consumes certain foods before this, this can lead to a distortion of the results of the study.

If bleeding is suspected before a coprogram, the following should be excluded from the diet:

meat products;
fish products;
eggs ( any);
green vegetables and/or fruits;
iron preparations;
magnesium preparations;
bismuth preparations.

Also, the day before the sampling of the material, such patients should not brush their teeth, since traumatizing the gums with a toothbrush can lead to blood entering the gastrointestinal tract and distorting the results of the study.

How to properly collect feces for a coprogram?

The material can be collected by the patient himself at home. The material should be collected after an independent act of defecation ( not after an enema). To take the material should be purchased at the pharmacy ( or take it to the lab) a special sterile container with a screw cap, to which a special spoon is attached ( putty knife). The use of this equipment will prevent contamination of the collected material.

Immediately after the act of defecation, you should remove the lid from the container and immediately draw stool into the container with a spatula ( it should be filled approximately 25 - 30%). At the same time, it is important to ensure that traces of urine, menstrual flow or water from the toilet bowl do not get into the collected material, as this can lead to a significant distortion of the study results.

Close the lid on the container immediately after stool collection. The resulting material should be delivered to the laboratory as soon as possible. If this cannot be done immediately for example, the material was taken in the evening when the laboratory is closed), the container can be stored in the refrigerator ( at temperatures from +4 to +8 degrees) within 8-12 hours.

When collecting feces for analysis, it is unacceptable:

Use non-sterile utensils. It is forbidden to collect feces in matchboxes or cardboard boxes, as this may change the appearance of the feces, and foreign matter may also get into it. In addition, this method of collecting, storing and transporting feces poses a danger to others ( increased risk of contamination and bacterial infection).
Store feces at a temperature above +8 degrees. High temperature stimulates the growth of bacteria, as well as the processes of putrefaction and fermentation. If the feces are stored at room temperature, even for 2 to 3 hours, this can significantly distort the results of the analysis.
Store stool for more than 12 hours. During long-term storage of the material, its chemical properties change, the quantity and nature of the microflora and other indicators change. If the collected material cannot be delivered to the laboratory within 12 hours, it should be destroyed. To collect new material, you should take a new one from a pharmacy or laboratory ( sterile) container. Do not rinse the old container and use it to collect a new portion of feces.

How much is a coprogram done?

The results of the analysis can be obtained approximately 5-6 days after the delivery of the material to the laboratory. During this time, the laboratory assistant performs a macroscopic and microscopic examination of the feces, reveals the presence of impurities, pathogenic bacteria and other harmful substances in the feces.

What does the coprogram show in the norm in adults and children?

When assessing the characteristics of fecal masses, the laboratory assistant performs their macroscopic ( visual) and microscopic examination. Also, if necessary, a number of chemical tests are performed to identify certain deviations in the composition of the feces.
Macroscopic description of feces ( norm)

Index	Norm in an adult	The norm in the baby
*Quantity*	100 - 200 grams per day.	Up to 50 grams per day.
*The form*	Cylindrical ( sausage-shaped).	Mushy chair.
*Consistency*	Soft ( dense), dense.	Mushy chair.
*The presence of foreign inclusions*	Small amounts of undigested food predominantly vegetable).	None.
*Color* *(depends on the nature of the food)*	Light brown or yellowish ( milk diet).
	Dark brown ( meat diet).
	Brown with a greenish tint plant based diet).
	Brown red ( when eating beets, carrots, watermelon and other "red" foods).
*Smell*	Characteristic unpleasant smell of feces.
*Acidity* (pH )	Neutral reaction ( 7,0 – 7,5 ).	acid reaction ( 5,0 – 6,0 ).
*Slime*	Missing.
*Blood*	Missing.
	None.

Microscopic description of feces ( norm)

Index	Norm in an adult	The norm in the baby
*leftover food*	A small amount of digested muscle fibers.	There are no muscle fibers and other food debris.
*indigestible fiber* *(coarse parts of plants)*	Present in unchanged form.	May be present if appropriate foods are included in the child's diet.
*Digestible fiber* *(plant food)*	Missing.	Missing.
*Starch*	Missing.	Missing.
*Fats*	They can be found in small quantities.	Very few or absent.
*Soaps*
*Fatty acid*
*Leukocytes* *(immune system cells)*	Single leukocytes may be detected.	Single.
*red blood cells* *(red blood cells)*	None.	None.
*tumor cells*	None.	None.
*calcium oxalates*	May occur when eating a large amount of fresh vegetables.	None.
*Cholesterol crystals*	Present ( excreted in the intestine along with bile).	Can be defined.
*Detritus*	The main substance that makes up the feces.
*Microorganisms* *(bacteria)*	Normal intestinal microflora makes up about 40% of feces.	Mostly lactic acid bacteria.

Deciphering the results of the coprogram ( by quantity, shape, color, smell, acidity, microscopic characteristics)

Changes in the external, macroscopic and microscopic characteristics of feces may indicate the presence of certain diseases of the digestive system, liver, pancreas, biliary tract. Also, changes in feces can be characteristic of metabolic disorders in the body and other diseases.
A change in the amount of feces may indicate:

malabsorption in the intestine;
enteritis ( inflammatory diseases of the small intestine);
amyloidosis of the small intestine;
colitis ( inflammatory bowel disease);
eating disorders;
pancreatitis).

A change in the shape of stool may be a sign of:

rectal cancer;
polyp ( benign tumor) rectum;
hemorrhoids;
spasm of the anal sphincter;
colon lesions ( colitis).

Changes in the color of feces may indicate:

the nature of the food taken;
taking certain medications;
liver failure;
diseases of the biliary system ( cholangitis, stones in the bile ducts);
diseases of the pancreas ( lack of digestive enzymes);
dysbacteriosis ( development of pathogenic bacteria in the intestine);
accelerated intestinal motility;
bleeding in the gastrointestinal tract;
typhoid fever;
cholera.

Changes in the smell of feces can be observed with:

excess protein food;
dysbacteriosis;
the collapse of the tumor in the intestine;
strengthening the processes of putrefaction and fermentation in the intestines.

A change in the acidity of feces may indicate:

excess protein in the diet;
increased processes of decay in the intestines;
enteritis ( inflammation in the small intestine);
putrefactive colitis ( inflammation in the large intestine);
pancreatitis ( pancreatic injury);
liver damage;
mechanical jaundice ( biliary tract injury);
dysbacteriosis.

The presence of undigested muscle fibers and connective tissue in the stool can be a sign of:

pancreatitis;
pancreatic insufficiency;
insufficient secretion of gastric juice;
increased peristalsis ( motility) stomach and/or intestines;
poor chewing of food.

The presence of a large amount of digestible fiber in the feces indicates:

on accelerated motility of the gastrointestinal tract;
for anacid gastritis ( inflammatory disease of the stomach, accompanied by a decrease in the production of gastric juice).

The presence of starch in the stool can be a sign of:

malabsorption in the small intestine;
enteritis ( inflammation of the small intestine);
increased intestinal peristalsis;
dysfunctions of the pancreas.

The appearance in the feces of neutral fats, fatty acids and soaps can be observed with:

diseases of the biliary tract;
liver diseases;
diseases of the pancreas;
accelerated intestinal motility;
enteritis ( inflammation of the small intestine);
thyroid disease ( thyrotoxicosis).

The appearance of a large amount of mucus in the stool indicates:

enteritis ( inflammation of the small intestine);
colitis ( inflammation of the large intestine);
dysentery;
intestinal ulcer.

The appearance of a large amount of cylindrical epithelium in the feces is a sign of:

enteritis;
colitis;
benign tumors of the intestine;
malignant tumors of the intestine.

The appearance of leukocytes in the feces indicates:

enteritis;
colitis;
gastritis;
dysentery;
nonspecific ulcerative colitis;
tuberculous lesions of the intestine;
other infectious diseases of the gastrointestinal tract.

The appearance of traces of blood in the stool may indicate:

bleeding in the gastrointestinal tract;
ulcerative lesions of the intestinal mucosa;
inflammation of the gastrointestinal tract ( gastritis, enteritis, colitis);
disintegration of the tumor in the intestine;
anal fissure;
haemorrhoids;
damage to the gums when brushing your teeth.

Pathogenic microorganisms appear in feces when:

dysbiosis;
dysentery;
antibiotic treatment;
strengthening of fermentation processes in the intestine;
fungal infections of the intestines and so on.

Pathological indicators of the coprogram

As mentioned earlier, the composition, shape and consistency of feces can change significantly in various diseases of the gastrointestinal tract. If the digestion process does not occur in full, a lot of undigested products will be excreted in the feces. At the same time, with other diseases, blood impurities, pathogenic bacteria, mucus and other substances that normally should not be there may appear in the feces. The detection of these substances allows you to suspect a particular disease or even make an accurate diagnosis.
Macroscopic description of feces in various diseases

Index	Characteristic	Possible diseases
*Quantity*	*enlarged*	damage to the pancreas ( due to a lack of digestive enzymes, food is not digested and is excreted unchanged).
*Quantity*	*enlarged*	bowel disease ( food products are not absorbed through the affected intestinal mucosa, being excreted in the feces).
*The form*	*filiform* *(thin)*	May indicate the presence of an obstruction in the path of feces ( rectal tumor, hemorrhoid).
*The form*	*unformed* *(liquid, mushy stool)*	It is observed when there is a violation of the absorption of fluid in the intestine.
*Color*	*Grayish* *(clayey)*	Diseases of the liver and biliary tract, in which bile ceases to flow into the intestines and take part in the digestion of food. Because of this, the feces become discolored.
	*Grey*	Damage to the pancreas, in which the secretion of digestive enzymes is disrupted.
	*Yellow*	Accelerated passage of food through the gastrointestinal tract.
		Lack of bile.
		Destruction of the intestinal microflora by antibiotics or infection.
	*Black*	Bleeding from the upper gastrointestinal tract ( esophagus, stomach, duodenum). The blood is digested by digestive enzymes, causing it to turn black.
	*Red* *(scarlet)*	Bleeding from the lower gastrointestinal tract ( blood is not digested by digestive enzymes and is excreted in pure form with feces).
	*Type of "pea soup"*	Typhoid fever.
	*Type of "rice broth"*
*Smell*	*Fetid*	It indicates an increase in the processes of decay in the large intestine.
*Smell*	*Sour*	It indicates an increase in fermentation processes in the large intestine.
*Acidity* (pH)	*alkaline reaction* *(8,0 – 8,5* )**	Increased putrefaction in the intestines.
		The presence of an inflammatory disease of the stomach or intestines.


		*The worms themselves or their eggs can be found on the surface of the feces.*

Microscopic analysis of feces for various diseases

Index	Characteristic	Possible diseases
*undigested muscle fibers*		dysfunction of the pancreas ( iron does not produce enzymes that are necessary for the digestion of muscle fibers, as a result of which they are excreted unchanged along with feces).
		The lack of gastric juice also disrupts the process of digestion of muscle fibers.
		Increased intestinal motility contributes to the too rapid movement of food through the gastrointestinal tract, as a result of which the muscle fibers do not have time to be digested and absorbed.
*Connective tissue*	*Present*	Lack of gastric juice.
		Violation of the functions of the pancreas.
		Poor chewing of food.
*digestible plant fiber*	*Present in large numbers*	Violation of the secretion of gastric juice is accompanied by insufficient loosening of fiber, as a result of which it does not mix well with digestive enzymes and is excreted unchanged in the feces.
*digestible plant fiber*	*Present in large numbers*	The accelerated motility of the gastrointestinal tract contributes to the release of fiber, since it does not have time to be digested.
*Starch*	*Present*	Malabsorption in the small intestine.
		Insufficiency of the pancreas.
		Accelerated intestinal motility.
*Neutral Fats*	*Present*	Diseases of the pancreas in which the secretion of the lipase enzyme is impaired. Lipase is responsible for the digestion of fats. With its deficiency, fats are not digested.
*Neutral Fats*	*Present*	Diseases of the liver and / or biliary tract, in which there is insufficient flow of bile into the intestines. Bile is essential for fats to be digested and absorbed in the intestines. Without it, fats will also be excreted with feces.
*Soaps*	*Present*	Liver disease, accompanied by insufficient production or secretion of bile.
*Slime*	*Present in large quantities*	Inflammatory diseases of the small intestine ( enteritis) or large intestine ( colitis).
*Cylindrical cages*	*Present* *(in slime)*	Inflammatory bowel disease.
*Cylindrical cages*	*Present* *(in slime)*	Tumor diseases of the intestine.
*Leukocytes*	*Present in large numbers*	The number of leukocytes ( immune system cells responsible for fighting infections) in feces increases in inflammatory and infectious diseases of the gastrointestinal tract.
*Unaltered erythrocytes* *(red blood cells)*	*Present*	Inflammatory processes in the lower intestines.
		Bleeding from the lower intestines or from the perianal region ( with hemorrhoids, anal fissure).
		Disintegration of the tumor in the lower intestines.
*Charcot Leiden Crystals*	*Present*	Allergic process in the gastrointestinal tract.
*Charcot Leiden Crystals*	*Present*
*pathogenic microorganisms*	*Present*	Detection of pathogenic microorganisms ( different from the normal intestinal microflora) is performed using microscopy. If necessary, bacteriological culture is performed, which allows you to determine the type of pathogen and select the most effective antibacterial treatment.
*Iodophilic flora* *(special bacteria that are detected when treating feces with special solutions)*	*Present*	Strengthening the processes of fermentation in the intestines.
	*Present*	Acceleration of motility of the gastrointestinal tract.
*yeast cells*	*Present in large numbers*	A large number of yeast cells in the stool indicates that the stool has been stored for too long. The reliability of the analysis in this case may be questionable.
*Bilirubin*	*Present*	An integral component of bile that appears in the feces with severe diarrhea ( diarrhea) .

Fecal occult blood test

This analysis allows you to identify even the smallest traces of blood in the feces. This is necessary in cases where the doctor suspects that the patient has hidden or extremely minor bleeding. At the same time, it will be impossible to detect blood in the feces with the naked eye or with the help of microscopy, however, a special chemical treatment of feces will make it possible to determine its presence.

The essence of the analysis is that the feces are treated with a special substance that reacts with hemoglobin ( a pigment present in red blood cells). If there is hemoglobin in the feces, after a chemical reaction, the feces change their color. If hemoglobin ( and therefore blood) is not present in the feces, no color change will occur. This test is extremely sensitive and allows you to detect even the smallest traces of blood.

Where to make a coprogram?

A coprogram can be done in almost any major hospital, clinic or laboratory in the city. If a referral for analysis was issued by a doctor, it can be performed free of charge ( under the compulsory health insurance policy). In other cases, you will have to pay for the analysis ( on average from 60 to 600 rubles, depending on the city, clinic and laboratory).

In Moscow

Clinic name	Address	Telephone
*Medical Center "Miracle Doctor"*	st. School, house 11.	7 (495 ) 967-19-78
*SM Clinic*	st. Clara Zetkin, house 33/28.	7 (499 ) 519-38-82
*Medical Center "On Clinic"*	st. Vorontsovskaya, house 8, building 6.	7 (495 ) 927-02-85
*Medical and diagnostic center "MedCenterService"*	Prospect Vernadsky, 37, building 1a.	7 (495 ) 927-03-01
*Scandinavian Health Center*	st. 2 Cable, house 2, building 25.	7 (495 ) 125-22-36

In St. Petersburg

In Voronezh

Clinic name	Address	Telephone
*City polyclinic number 7*	st. Writer Marshak, house 1.	7 (473 ) 263-09-60
*Medical Diagnostic Center "Health"*	Leninsky prospect, house 77.	7 (473 ) 248-15-92
*Healthy Family Medical Center*	Leninsky prospect, house 25/1.	7 (473 ) 261-46-21
*Medical laboratory "Invitro"*	st. Vladimir Nevsky, house 55a.	7 (473 ) 261-99-10
*Voronezh Regional Clinical Consultative and Diagnostic Center*	Lenin Square, 5a.	7 (473 ) 202-02-05

In Krasnodar

Clinic name	Address	Telephone
*Laboratory "Hemotest"*	Prospect Chekistov, house 12, building 1.	7 (861 ) 265-09-00
*Medical laboratory "Helix"*	st. Korenovskaya, house 21.	7 (861 ) 992-45-17
*Medical and Diagnostic Center "Health Corporation"*

Coprogram (fecal analysis)- a necessary laboratory study of human feces.

The study also helps evaluate levels of beneficial bacteria, gut immune function, gut health, and markers of inflammation.

Rules for the delivery and preparation of the patient for the collection of feces

Step-by-step preparation for a coprogram:

Some of these groups of drugs can give a false result of the study.

Notify the doctor if there have been trips abroad, changes in food and climate, and the risk of bringing protozoa (a type of single-celled animal) with you also affect the outcome of the analysis;
It is not allowed to select a fecal analysis for a coprogram for menstruation or damage to the large intestine;
If the material has been touched by various liquids such as urine, water, or disinfectant solutions in the toilet bowl, it is considered unsuitable for testing.

How to take the test correctly:

wash the genitals and sphincter with soap and warm water, for the purity of the analysis;
analysis of feces for a coprogram is taken into a plastic cup with a spoon purchased in advance at a pharmacy. Enough 3 - 5 cubic centimeters, about a teaspoon;
the dishes are covered with a lid, put their initials and, with an accompanying document, are taken to the center for research;
such material is stored for no more than 8 hours at a temperature of +3 °C-+5 °C.

How to donate feces to a baby for a coprogram

The coprogram of feces in an infant is taken whenever possible, since it is impossible to regulate the act of defecation in a baby. If possible, you can collect from the diaper.

If a disease is suspected, a general analysis of feces is necessary

What does the coprogram show- the totality of all found anomalies and pathologies gives an idea of the intestinal microflora at a given point in time, and the ability to identify latent digestive diseases.

Microscopic, chemical and macroscopic examination of feces

The size.

The norm is:

in a month-old child - from 10 to 20 grams per day is allocated;
from one month to six months, the amount of feces per day is 30 - 50 grams;
the norm in adults is 150 - 400 grams.

There are deviations from the usual amount of feces in both adults and children. This happens with irregular stools. Volumetric excretion of feces - observed with increased contractions of the cilia of the intestine (inflammation of the intestine, the walls of the gallbladder, the presence of stones in the bile duct and its ducts, digestion deviations in the small intestine).

The structure of the feces.

during breastfeeding, the stool is mushy;
from ready-made mixtures, feces takes the form of putty;
in older children and an adult, the feces should be fully formed.

Changes in appearance and shape:

Dense feces can occur with narrowing of the rectum, its spasm, obstruction. Liquidish with increased secretion by the intestine, inflammation of the mucous membrane of the large intestine, eating disorder, increased bowel contraction.

In the form of an ointment - for pancreatitis and. With excessive work of the digestive glands and diarrhea, loose stools are noted. If the fermentation process joins, the feces will foam.

Coloring.

Varies by age group:

in children fed on mother's milk - yellowish gold or yellow with a transition to green;
babies sitting on baby food - yellowish-brown;
the norm in adults is brown.

expansion of the veins of the anus;
cracks and ulceration of the anus;
diseases of the rectum;
varicose veins in the esophagus;
atypical inflammation of the intestine accompanied by ulcerative processes;
tumors in the gastrointestinal tract.

fibrinogen.

You will not see it in the stool of a healthy patient. Concomitant factors for the appearance of protein are:

inflammation of the digestive system;
enhanced secretory function of the colon;
internal damage;
putrid diarrhea.

Bile pigment stercobilin.

What is stercobilin. It gives the feces a brown color. It originates from bilirubin in the large intestine. During the day it is formed from 75 to 350 mg. Its increased production is due to increased bile secretion and increased destruction of red blood cells. A decrease in its release occurs when:

angiocholitis;
infectious diseases of the liver;
the presence of stones in the gallbladder;
obstructive jaundice.

Bilirubin in the coprogram.

The formation of bilirubin into stercobilin is carried out by intestinal microorganisms. Up to 9 months, the intestines are not able to fully convert bilirubin, so its presence in the feces is normal.

In the body older than 9 months, this enzyme in the feces should not be observed. Finding bilirubin in the study indicates the possible use of antibiotics or increased work of the intestinal tract.

Hydrogen nitrite or ammonia.

Its increased production indicates diseases in the rectum or increased secretion of its glands.

detritus particles.

Very small parts that do not have a clear structure, their composition is composed of epithelial cells, bacteria and pieces of digested food.

Muscle.

The pieces of muscle tissue found in feces are the result of the breakdown of animal protein by the body. Children under one year old should not have them in the feces; a small part of such inclusions is allowed for an adult body, provided that they are well digested.

The excess of muscle fibers in the stool of a child and an adult indicates:

diarrhea;
inflammation of the stomach;
lack of hydrochloric acid and pepsin enzyme in gastric juice;
increased contractions of the intestines;
inflammation of the pancreas.

Connective tissue and its fibers.

When eating food of animal origin (meat), its connective tissue enters the body, which, after the processing process, can come out in the form of tiny fibers. In a healthy body, everything must be digested. Their presence in the feces means chronic inflammation of the stomach and pancreas systems.

Starch and its particles.

This substance is found in plant products. It is possible to detect it in the feces only with pancreatic dysfunction, problems with the stomach and frequent withdrawal of intestinal contents to the outside. In the stool of a person without these problems, it should not be.

Cellulose of vegetable origin.

Vegetable fiber can be either digestible or indigestible. The latter may be present, its quantity does not attach much importance. But the one that should be digested should not be detected in a general analysis of feces.

Its detection in the analysis indicates:

inflammation of the stomach;
diseases of the pancreas;
colitis with ulcerative manifestations;
frequent bowel movements;
diarrhea accompanied by a putrefactive process.

neutral fats.

A small amount of them can be found in children under one year old due to the fact that their enzymes responsible for digestion are underdeveloped. In a grown-up child, finding them in the general analysis of feces is a sign of illness.

Possible reasons for the detection of fats:

disruption of the gallbladder;
poor functioning of the pancreas;
rapid excretion of the contents of the intestine;
failure of absorption of substances in the intestine.

Residues of fatty acids.

The functionality of the intestine is such that they must be completely split; when they are isolated on a coprogram, one should be checked for diseases such as:

inflammation of the pancreas and liver;
cholecystitis;
fermentative dyspepsia.

Soap inclusions.

After the processing of fats in the feces, soap residues should be found. The content of soap in the feces is normal and insignificant. Their complete absence indicates incontinence of intestinal masses, inflammation of the stomach, pancreas and gallbladder, a change in the rate of absorption of nutrients by the intestines.

bodies of leukocytes.

White blood cells are present in the feces of infants in very small quantities. There are errors and they are found in adults if urine got into the feces during the selection of the analysis. You can see them in the feces with such pathologies as enteritis, inflammation of the stomach, ulceration of the rectum.

Coprogram decoding in a child and an adult in the table

Categories for which the survey is carried out	Breastfed babies	Children on artificial nutrition	Children over 1 year old
Mass of faeces per day	About 40 - 50 grams	Somewhere around 30-40 grams	0.1 - 0.25 kg
Stool coloring	Varies from yellow-green to golden	yellowish brownish	brown saturated
Structure	in the form of a porridge	Ointment	formed
Smell	Sour	rotten	Not pronounced fecal
faecal pH	Weak acidic from 4.8 to 5.8	Weak alkaline 6.8 to 7.5	Neutral 7.0 - 7.5
Mucus secretion	Acceptable in small parts	Ruled out	not allowed
Stercobilin pigment	Not controlled	Not controlled	on average 75 – 350 mg within 24 hours
Bilirubin	Available	Available	Should not be located
Ammonia	Not researched	Not researched	20 - 40 mmol per kg
muscle fiber	Acceptable in smallest size	Acceptable	not allowed
fibrinogen	negative	negative	negative
Blood	Absence	Absence	Absence
Soaps	Partially yes	Partially yes	Partially yes
plant fiber is digestible	Can't be found	Not detected	Not detected
Connective tissues, fasciae and their fibers	–	–	–
Detritus	Negative	Negative	Small part allowed
The presence of starch	Not found	Not found	Not found
Neutral fat	Can be found	Can be found	Do not detect
Leukocyte bodies	In single manifestations	In single manifestations	With pathologies

Many chronic disorders are due to digestive problems and inadequate absorption of nutrients. Proper function of the gastrointestinal tract is essential to eliminate toxic substances, pathogenic microbes, and undigested food particles from the body to prevent health problems.

Nutrients need a specific internal environment to properly digest and transport them throughout the body.

Abnormal intestinal microorganisms in the gastrointestinal tract are known to cause many different diseases. Studies show the relationship between the gastrointestinal tract and the neurological, hepatic and immune systems.

For example, excessive yeast produces toxic substances that can cross the blood-brain barrier and alter neurological functioning, causing brain fog, behavioral problems, and learning difficulties. In order to realize this, it is necessary to undergo a coprogram once every half a year.