Stool guaiac test

The stool guaiac test looks for hidden (occult) blood in a stool sample.
It can find blood even if you cannot see it yourself. It is the most
common type of fecal occult blood test (FOBT).

Guaiac is a substance from a plant that is used to coat the FOBT test
cards.

How the Test is Performed

Usually, you collect a small sample of stool at home. Sometimes, a
doctor may collect a small amount of stool from you during a rectal
examination.

If the test is done at home, you use a test kit. Follow the kit
instructions exactly. This ensures accurate results. In brief:

You collect a stool sample from 3 different bowel movements.

For each bowel movement, you smear a small amount of the
stool on a card provided in the kit.
You mail the card to a laboratory for testing.

DO NOT take stool samples from the toilet bowl water. This can cause
errors.

For infants and young children wearing diapers, you can line the diaper
with plastic wrap. Place the plastic wrap so that it keeps the stool away
from any urine. Mixing of urine and stool can spoil the sample.

How to Prepare for the Test

 Some foods can affect test results. Follow instructions about not eating
certain foods before the test. These may include:

Red meat
Cantaloupe
Uncooked broccoli
Turnip
Radish
Horseradish

Some medicines may interfere with the test. These include vitamin C,
aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen and naproxen. Ask your health care provider if you need to
stop taking these before the test. Never stop or change your medicine
without first talking to your provider.

How the Test will Feel

The at-home test involves a normal bowel movement. There is no
discomfort.

You may have some discomfort if the stool is collected during a rectal
exam.

Why the Test is Performed

This test detects blood in the digestive tract. It may be done if:

You are being screened or tested for colon cancer

You have abdominal pain, changes in bowel movements, or
weight loss
You have anemia (low blood count)
You say you have blood in the stool or black, tarry stools
 Normal Results
A negative test result means that there is no blood in the stool.

What Abnormal Results Mean

Abnormal results may be due to problems that cause bleeding in the
stomach or intestinal tract, including:

Colon cancer or other gastrointestinal (GI) tumors

Colon polyps
Bleeding veins in the esophagus or stomach (esophageal
varices and portal hypertensive gastropathy)
Inflammation of the esophagus (esophagitis)
Inflammation of the stomach (gastritis) from GI infections
Hemorrhoids
Crohn disease or ulcerative colitis
Peptic ulcer
Other causes of positive test may include:

Nosebleed
Coughing up blood and then swallowing it

If the stool guaiac results come back positive for blood in the stool,
your doctor will likely order other tests, usually including
a colonoscopy.
The stool guaiac test does not diagnose cancer. Screening tests such
as colonoscopy can help detect cancer. The stool guaiac test and other
screenings can catch colon cancer early, when it is easier to treat.

Risks
There can be false-positive and false-negative results.

Errors are reduced when you follow instructions during collection and
avoid certain foods and medicines.
Alternative Names
gFOBT; Guaiac smear test; Fecal occult blood test - guaiac smear; Stool
occult blood test - guaiac smear

References
National Comprehensive Cancer Network. NCCN clinical practice
guidelines in oncology (NCCN Guidelines): colorectal cancer
screening. www.nccn.org/professionals/physician_gls/pdf/colorectal_scr
eening.pdf. Version 1.2015. Accessed February 2, 2016.
Savides TJ, Jensen DM. Gastrointestinal bleeding. In: Feldman M,
Friedman LS, Brandt LJ, eds.Sleisenger and Fordtran's Gastrointestinal
and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders;
2016:chap 20.
U.S. Preventive Services Task Force. Draft recommendation statement:
colorectal cancer: screening. October
2015. www.uspreventiveservicestaskforce.org/Page/Document/draft-
recommendation-statement38/colorectal-cancer-screening2. Accessed
February 2, 2016.
Review Date 1/28/2016
Updated by: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal
Specialists of Georgia, Austell, GA. Review provided by VeriMed
Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla
Ogilvie, PhD, and the A.D.A.M. Editorial team.