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Test Code Fecal Occult Blood Occult Blood

Important Note

It is recommended that patient submit specimens from bowel movements collected on three separate days.

Test cards are best developed no sooner than 3 days after sample application. This allows fruit/vegetable peroxidases present in the sample to degrade.

Additional Codes

Cerner NextGen

Occult Blood Fecal 1st Specimen

Occult Blood Fecal 1st Specimen

Occult Blood Fecal 2nd Specimen

Occult Blood Fecal 2nd Specimen

Occult Blood Fecal 3rd Specimen

Occult Blood Fecal 3rd Specimen

Useful For

The Hemoccult Sensa test is a qualitative guaiac method for detecting fecal occult blood. It is recommended for professional use as a diagnostic aid, only, during routine physical examinations, to monitor for bleeding in patients with iron deficiency anemia or recuperating from surgery, peptic ulcer, ulcerative colitis and other conditions, and in screening programs for colorectal cancer when the Patient Instructions are followed.

Methodology

Hemoccult Sensa test is based on the oxidation of guaiac by hydrogen peroxide to a blue colored compound.  The heme portion of hemoglobin, if present, has peroxidase activity which catalyzes the oxidation of alpha-guaiaconic acid (active component in the guaiac paper) by hydrogen peroxide (active component in the developer) to form a highly conjugated blue quinone compound.

Patient Preparation

7 days prior and throughout the specimen collection:

  • No more than one adult aspirin (325 mg) a day.
  • Do not take other NSAID drugs (ibuprofen, Motrin, Advil, etc).
  • Acetaminophen may be taken as needed.

3 days prior and throughout the specimen collection:

  • No red meat (beef, lamb, or liver)
  • Avoid Vitamin C in excess of 250 mg from supplements (including iron supplements), citrus fruits, and juices.

Eat a well-balanced diet including fiber such as bran cereals, fruits and vegetables.

Collection Instructions

Fecal Occult Blood Collection Instructions

  1. Remove slide. Using ball point pen, write your name (first and last) and date of birth on the front of the slide.
  2. Fill in sample collection date on section before a bowel movement.
  3. You may use any clean, dry container to collect your sample. Let stool fall into container.
  4. Use one stick to collect a small sample. Apply a thin smear covering box A.
  5. Collect a second sample from a different part of the stool sample with the same stick. Apply a thin smear covering box B.
  6. Discard stick in a waste container.
  7. Close and secure front flap section by inserting it under tab. Allow sample to dry.
  8. Return completed slide no later than 14 days after collection

Specimen Requirements

 

Minimum Volume

Enough specimen to cover both test boxes with a thin layer.

Container

Hemoccult Cards (preferred)

 

or plastic specimen container without preservative

Stability
  • After specimen has been applied, hemoccult test cards are stable up to 14 days at 15-30⁰C; do not refrigerate or freeze.
  • Stool specimen submitted in plastic container should be applied to test card within 4 hours of collection. 

Rejection Criteria
  • Unlabeled specimen containers or Hemoccult test cards.
  • Specimens exceeding stability or expired test cards.
  • Test cards that have been refrigerated or frozen.
  • Visible blood in specimen (menstruation, actively bleeding hemorrhoids).
  • Contamination from toilet bowl water or toilet bowl cleaners.
  • Specimens exposed to light, heat, or volatile chemicals (i.e., ammonia, iodine, bleach, cleaners).

Result Reporting and Reference Values

Occult blood is reported as Negative or Positive

Normal patient population is negative for occult blood.

Limitations

  • Hemoccult tests are designed for preliminary screening, only, as an aid to diagnosis.
  • Iron supplements WILL NOT produce false-positive test results with Hemoccult Sensa.
  • Acetaminophen is not expected to affect test results.
  • Negative results may occur in patients where disease is present. Bowel lesions, including some polyps and colorectal cancers, may not bleed at all or can bleed intermittently. Additionally, blood that is present may not be distributed uniformly in the fecal specimen.
  • Positive results may occur from healthy patients. This may be due to interfering substances in the diet or to medications. It may also be due to low but detectable levels of blood loss, common to both healthy adults and patients with gastrointestinal disease.
  • Substances causing False Negative Results:
    • Ascorbic acid (Vitamin C) in excess of 250 mg/day.
    • Excessive amounts of Vitamin C enriched foods, citrus fruits and juices.
    • Iron supplements which contain Vitamin C in excess of 250 mg/day.
  • Substances causing False Positive Results:
    • Red meat (beef, lamb, liver)
    • Aspirin in excess of 325 mg/day and other NSAID such at ibuprofen, indomethacin, naproxen.
    • Corticosteroids, phenylbutazone, reserpine, anticoagulants, antimetabolites, and cancer chemotherapeutic drugs.
    • Alcohol in excess.
    • The application of antiseptic preparations containing iodine.