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Gastroenterology clinic

How I deal with a positive faecal occult blood test

Jeremy Ryan

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Abstract

A positive faecal occult blood test is an important finding that may point to serious gastrointestinal disease. Here, Dr Jeremy Ryan outlines his approach to managing a patient with a positive test result.

Key Points

    Remember
  • By definition, the faecal occult blood test measures occult (invisible) bleeding.
  • A positive faecal occult blood test obtained using a newer test strip means there is detectable human haemoglobin in the stool. Unless the subject of the test is a cannibal, the result indicates gastrointestinal bleeding from anywhere in the gastrointestinal tract, from the mouth to the anus. Lower colon or rectal bleeding may present as obvious bleeding, rather than occult bleeding.
  • A positive faecal occult blood test should be taken seriously; colon cancer classically presents in this way. This is especially true of lesions on the right side of the bowel, which often do not produce a change in bowel habit until late.

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