Fecal Occult Blood Testing in Hospitalized Patients with Upper Gastrointestinal Bleeding

Mathews, Benji; Ratcliffe, Temple; Sehgal, Raj; Abraham, James; Monash, Bradley

doi:10.12788/jhm.2773

Cited by 13 publications

(18 citation statements)

References 20 publications

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“…False-positive FOBT results can occur via a variety of mechanisms including swallowed blood from nasopharyngeal or pulmonary sources, gastrointestinal (GI) inflammatory conditions (such as inflammatory bowel disease), medications (aspirin, NSAIDs), alcohol, ingestion of meats (which contains heme) and some fruits or vegetables containing peroxidase. False negatives can result from slow or intermittently bleeding lesions, proximal GI tract lesions, or high doses of vitamin C ingestion [4,6].…”

Section: Discussionmentioning

confidence: 99%

A Case for Abandoning Inpatient Fecal Occult Blood Testing

Brennan

Parsons

2020

Cureus

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Section: Discussionmentioning

confidence: 99%

A Case for Abandoning Inpatient Fecal Occult Blood Testing

Brennan

Parsons

2020

Cureus

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“…These factors include, but are not limited to, aspirin, NSAIDs (non-steroidal anti-inflammatory drugs), or anticoagulant use. Patients with active or history of upper and lower GI bleeding were excluded from this study [24].…”

Section: Adr Based On Type Of Screening (%)mentioning

confidence: 99%

“…The American Society for Gastrointestinal Endoscopy (ASGE) and the ACG have recommended using ADR as the number one quality indicator for colonoscopies [21][22][23][24][25]. As of 2015, the ASGE and ACG recommend enforcing an average minimum ADR of 25% (30% for males and 20% for females) as a standard for physicians performing colonoscopies.…”

Section: Adr Based On Type Of Screening (%)mentioning

confidence: 99%

Improving Adenoma Detection Rates: The Role of the Fecal Immunochemical Test

Nwankwo

Lines

Trehan

et al. 2021

Cureus

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Background There is limited knowledge about adenoma detection rates (ADRs) in patients with a positive fecal immunochemical test (FIT). We hypothesized that colonoscopy performed after FIT would result in higher ADRs. Methods We reviewed ADRs for colonoscopies performed after a positive FIT test and compared them to ADR rates for routine colonoscopy performed without an initial FIT test between November 2014 and March 2017 at multiple endoscopy sites. Results A total of 979 patients underwent a FIT testing in the Texas panhandle, of whom 12.1% (n=119) tested positive. Also, 32.8% (n=39) were found to have one or more tubular adenomatous polyps on final pathological examination. Among these patients, the majority were female (64.1%; n=25). Of the patients, 15.9% (n=19) had a hyperplastic polyp, 1.7% (n=2) had findings consistent with ulcerative colitis, and 0.8% (n=1) were positive for an adenocarcinoma. In the control group of 2,603 patients in whom routine colonoscopy was performed as the initial tool for screening, 719 were found to have one or more tubular adenomas, with an ADR rate of 27.5%. In this group, the cancer rate was found to be 1%. Conclusions There was a significant increase in the ADR when colonoscopy is conducted after a positive FIT test. Recommending colonoscopies after a positive FIT test will not only improve ADRs significantly but also lower the overall healthcare cost for screening colon cancer in this era of escalating healthcare costs.

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“…9 The FOBT is endorsed by the US Preventive Services Task Force and the American College of Gastroenterology for colorectal cancer screening. 10 However, its use as a diagnostic tool for suspected acute upper GI bleeding lacks validation in literature. 10 Three types of fecal occult tests are available: chemical; immunochemical; and deoxyribonucleic acid testing.…”

Section: Salisbury Et Almentioning

confidence: 99%

“…10 However, its use as a diagnostic tool for suspected acute upper GI bleeding lacks validation in literature. 10 Three types of fecal occult tests are available: chemical; immunochemical; and deoxyribonucleic acid testing. Deoxyribonucleic acid testing is less commonly available, and clinical utility is limited by its high cost.…”

Section: Salisbury Et Almentioning

confidence: 99%

The Case of the Lime-green Stool: A Case Report and Review of Occult Blood Testing in the Emergency Department

Salisbury

Goodrich

McManus

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: Food dyes mimicking gastrointestinal (GI) hemorrhage have been described in literature. However, reports of food additives causing melanotic stools and falsely positive fecal occult blood tests (FOBT) are uncommon in literature. Case Report: We present a case of a 93-year-old with FOBT positive melanotic stool, felt to be falsely positive due to food additives. Conclusion: Evaluation for GI bleeding accounts for 0.3% of yearly visits to the emergency department (ED).1 While FOBT is commonly used, its clinical validity in the ED is not supported by guidelines. We showcase the limitations of the FOBT and review the causes of false positive FOBT.

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Fecal Occult Blood Testing in Hospitalized Patients with Upper Gastrointestinal Bleeding

Cited by 13 publications

References 20 publications

A Case for Abandoning Inpatient Fecal Occult Blood Testing

A Case for Abandoning Inpatient Fecal Occult Blood Testing

Improving Adenoma Detection Rates: The Role of the Fecal Immunochemical Test

The Case of the Lime-green Stool: A Case Report and Review of Occult Blood Testing in the Emergency Department

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