Screening for Occult Gastrointestinal Bleeding in Hospital Patients

Abstract

Summary: Stools have been tested for occult gastrointestinal bleeding in 278 outpatients and '170 hospital inpatients using the Haemoccult and Haemastix methods. Seventeen outpatients (6.1%) and 42 inpatients (24.7%) were positive with the Haemoccult technique. Thirty-three outpatients (11.9%) and 93 inpatients (54.7%) were positive with the Haemastix test. Following investigation of the Haemoccult-positive patients, only 2 cases (3.4%) were considered false positives. However, the false positive rate with Haemastix was 22.9% which is unacceptable in a screening test. Haemoccult may be useful as a screening test for asymptomatic general practice patients, but a test of greater sensitivity is needed for hospital patients.

The clinical value of Haemoccult and Fecatwin in the detection of colorectal neoplasia in hospital and general practice patients

“…The value of Haemoccult in these circumstances has previously been documented and should not be neglected (Barrison et al, 1981).…”

“…The completed Haemoccult and Fecatwin packs were returned to the hospital by delivery van within 48 h for testing by the authors. The Haemoccult slides were stored for 24 h and 2 drops of peroxide developer were added to each window (without pre-wetting) and the appearance of any blue colour was taken to indicate a positive result (Barrison et al, 1981). The Fecatwin slides were tested as follows: 1 drop of the developing agent was added to each well and the results were declared positive if any blue colour appeared within 1 min.…”

Investigation of chronic upper gastrointestinal haemorrhage

“…The Haemoccult test which produces fewer false positive reactions (Ross & Grey, 1964) than the Haemostix test, is probably the best available (Barrison et al, 1981) but it fails to detect some colonic lesions which may be bleeding slowly or intermittently (Winawer, 1980). However, negative results from faecal occult blood testing can never exclude the possibility of intermittent blood loss and undue reliance on these tests can lead to a false sense of security about the absence of alimentary disease.…”