Stool microscopy in screening for steatorrhoea.

Ghosh, Salil; Littlewood, J M; Goddard, D. T.; Steel, A. E.

doi:10.1136/jcp.30.8.749

Cited by 24 publications

(8 citation statements)

References 6 publications

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“…The degree of steatorrhea was also not quantified; however, a positive Sudan III qualitative fecal fat test result generally corresponds to a %CoA of less than 94% 11 and quantitative steatorrhea in the range of 4 or more to 10 g of stool fat per 24 hours. 22 These data suggest that although the Sudan III qualitative test provides convenient, rapid, and noninvasive screening, a positive result represents broad ranges of quantitative steatorrhea. Therefore, the wide sensitivity range of the Sudan III qualitative test may have limited our ability to detect any associations between steatorrhea and growth patterns in this sample of children with perinatally acquired HIV infection.…”

Section: Discussionmentioning

confidence: 98%

“…The Sudan qualitative fecal fat test is reliable for detecting quantitative steatorrhea in the range of 35 mmol or more (approximately 10 g) per 24 hours of stool, 22 and when the %CoA is less than 94% 11 (normal, Ն93%). 10 The absence of EPI and hepatobiliary disease in our sample of children with HIV infection implied that the qualitative steatorrhea had other causes, eg, small-bowel enteropathy and bacterial overgrowth.…”

Section: Growth Assessmentmentioning

confidence: 99%

“…Qualitative steatorrhea was assessed using the Sudan III qualitative stain 11 (Mayo Clinic Laboratories, Rochester, Minn), which is specific for detecting triglycerides and fatty acids in the stool matrix 21 and reliable for excluding steatorrhea. 22 The FE-1 content of the spot stool specimen was measured using enzyme-linked immunosorbent assay (ScheBo-Tech, Wettenberg, Germany). After age 1 month, normal FE-1 levels are greater than 200 µg/g.…”

Section: Stool Studies and Hormone-stimulated Pancreatic Function Testmentioning

confidence: 99%

See 2 more Smart Citations

Association Between Steatorrhea, Growth, and Immunologic Status in Children With Perinatally Acquired HIV Infection

Sentongo

Rutstein²,

Stettler³

et al. 2001

Arch Pediatr Adolesc Med

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Section: Discussionmentioning

confidence: 98%

Section: Growth Assessmentmentioning

confidence: 99%

Section: Stool Studies and Hormone-stimulated Pancreatic Function Testmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Steatorrhea, Growth, and Immunologic Status in Children With Perinatally Acquired HIV Infection

Sentongo

Rutstein²,

Stettler³

et al. 2001

Arch Pediatr Adolesc Med

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“…The fat digestion and absorption test, stool fat staining, 72 h fecal fat assessment, oral fat loading test and 13 C‐mixed triglyceride breath test ( 13 C‐MTBT) are all used to evaluate exocrine pancreatic function. Microscope examination of fecal fat after Sudan III staining is usually used for the first screening test 74 . In children, Sudan III staining frequently produces false positive results due to the relatively high fecal fat level in healthy infants and younger children.…”

Section: Diagnosismentioning

confidence: 99%

Acute recurrent and chronic pancreatitis in children

Suzuki

Minowa

Isayama

et al. 2021

Pediatrics International

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Acute recurrent pancreatitis (ARP) is defined as two distinct episodes of acute pancreatitis (AP), whereas chronic pancreatitis (CP) is caused by persistent inflammation of the pancreas. In children they are caused by genetic mutations, autoimmune pancreatitis, congenital pancreatic abnormalities, and other conditions. Acute recurrent pancreatitis is frequently a precursor to CP, and both are thought to be on the same disease continuum. In particular, genetic factors are associated with early progression of ARP to CP. The diagnosis of CP, as in AP, is based on clinical findings, biochemical tests, and imaging studies. Findings of exocrine pancreatic dysfunction are also important in the diagnosis of CP. A step‐up strategy has become increasingly standard for the treatment of patients with CP. This strategy starts with endoscopic treatment, such as pancreatic sphincterotomy and stenting, and progresses to surgery should endoscopic therapy fail or prove technically impossible. Non‐opioid (e.g. ibuprofen / naproxen) and opioid (e.g. oxycodone) forms of analgesia are widely used in pediatric patients with AP or CP, whereas pancreatic enzyme replacement therapy may be beneficial for patients with abdominal pain, steatorrhea, and malnutrition. Despite the disparity in the age of onset, pediatric CP patients display some similarities to adults in terms of disease progress. To reduce the risk of developing pancreatic exocrine inefficiency, diabetes and pancreatic cancer in the future, clinicians need to be aware of the current diagnostic approach and treatment methods for ARP and CP and refer them to a pediatric gastroenterologist in a timely manner.

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“…Therefore, alternative procedures have been proposed and a number of indirect tests have been suggested to replace this cumbersome gold standard of fat malabsorption [1, 2], e.g. fecal fat estimation by microscopy [6, 7, 8, 9], fat tolerance tests with either measurement of triglycerides in blood [10]or of expiratory 14 CO 2 / 13 CO 2 following administration of 14 C/ 13 C-labeled triglycerides [5, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21]. Very recently, Lembcke et al [5]reported promising data with a breath test in patients with pancreatic steatorrhea using 13 C-hiolein as substrate.…”

Section: Introductionmentioning

confidence: 99%

Induction of Artificial Fat Maldigestion by Tetrahydrolipstatin Assessed by the <sup>13</sup>C-Hiolein Breath Test in Healthy Volunteers

Ashraf

Hildebrand²,

Meier³

et al. 2000

Digestion

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Background: ¹³C-hiolein is a purified algal triglyceride which is synthesized with 98% of all carbon atoms of the molecule uniformly ¹³C-labeled. Orlistat is the new name for tetrahydrolipstatin (THL), which is a specific and potent inhibitor of gastrointestinal lipases which induces artificial fat malabsorption in humans. The aim of the present study was to use the ¹³C-hiolein breath test (HBT) to assess THL-induced fat malabsorption in healthy volunteers. Methods: Eight healthy volunteers of normal body weight underwent 2 study periods of 4 days of diet with or without THL 120 mg t.i.d. On day 5, a HBT was performed. ¹³CO₂ recovery in breath samples was measured over 24 h by isotope ratio mass spectrometry. Results: The peak ¹³CO₂ excretion occurred only after 5 h in both treatment groups with little difference during the first 4 h between the groups. THL potently reduced fat digestion and absorption with the most pronounced effect observed after 8 h: 1.1± 0.2 vs. 2.3 ± 0.3% dose in control experiments (p < 0.05). The 24-hour cumulative ¹³CO₂ excretion was also significantly reduced by THL: 14.9 ± 2.2 vs. 28.4 ± 4.1% dose in control experiments (p < 0.05). In 6 of the 8 subjects, the cumulative ¹³CO₂ excretion was lower with THL 120 mg t.i.d. than with placebo. Conclusion: The HBT well reflects THL-induced artificial fat maldigestion in healthy volunteers.

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Stool microscopy in screening for steatorrhoea.

Cited by 24 publications

References 6 publications

Association Between Steatorrhea, Growth, and Immunologic Status in Children With Perinatally Acquired HIV Infection

Association Between Steatorrhea, Growth, and Immunologic Status in Children With Perinatally Acquired HIV Infection

Acute recurrent and chronic pancreatitis in children

Induction of Artificial Fat Maldigestion by Tetrahydrolipstatin Assessed by the <sup>13</sup>C-Hiolein Breath Test in Healthy Volunteers

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