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Sensitivity and reproducibility of chemical tests for fecal occult blood with an emphasis on false-positive reactions

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Abstract

In 20 healthy volunteers ingesting 5 to 50 ml of51Cr-red cells, reaction intensities obtained with four chemical methods for fecal occult blood were compared with the “true” blood loss simultaneously determined by radioassay of each stool. Dilute tincture of guaiac reagent was found to have the same sensitivity and high frequency of false-positive reactions as the saturated guaiac reagent, but was more reproducible. HematestTM was slightly less sensitive but was poorly reproducible and yielded frequent false-negative as well as false-positive reactions. False-positive reactions by both methods were not eliminated by a meat-free diet; they were increased with guaiac reagents if stools were stored for 3 or more days. A new guaiac method (HemoccultTM) was found to be one-fourth as sensitive as the older tests, but was virtually free from false-positive reactions, even on an unrestricted diet and after storage of the stool specimens. It is recommended that the use of Hematest be abandoned and that Hemoccult be used preferentially if future studies confirm that its sensitivity is sufficient to detect most gastrointestinal lesions which are yielding occult blood.

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Authors and Affiliations

  1. Medical Service, University of Pennsylvania Division, VA Hospital, 19104, Philadelphia, Pennsylvania

    J. Donald Ostrow MD, Carl A. Mulvaney, John R. Hansell, Robert S. Rhodes & Patricia Weigand MT

  2. Radioisotope Service, University of Pennsylvania Division, VA Hospital, 19104, Philadelphia, Pennsylvania

    J. Donald Ostrow MD, Carl A. Mulvaney, John R. Hansell, Robert S. Rhodes & Patricia Weigand MT

  3. Department of Surgery, Case-Western Reserve University and University Hospitals, Cleveland, Ohio

    J. Donald Ostrow MD, Carl A. Mulvaney, John R. Hansell, Robert S. Rhodes & Patricia Weigand MT

Authors
  1. J. Donald Ostrow MD
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  2. Carl A. Mulvaney
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  3. John R. Hansell
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  4. Robert S. Rhodes
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  5. Patricia Weigand MT
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Ostrow, J.D., Mulvaney, C.A., Hansell, J.R. et al. Sensitivity and reproducibility of chemical tests for fecal occult blood with an emphasis on false-positive reactions. Digest Dis Sci 18, 930–940 (1973). https://doi.org/10.1007/BF01072436

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