Do you sometimes feel sick to your stomach, more tired than usual, or pale? There can be many reasons for these things. But sometimes, a very small amount of blood that is not visible to our eyes can also be a reason for this. Today, we are going to talk about a very simple but very important test that looks for hidden blood (occult blood), which is not visible to us.
What is an FOBT? Simply put...
The Sinhala meaning of Fecal Occult Blood Test (FOBT) is "test for hidden blood in the stool". As the name suggests, this is done to check for small amounts of blood in your stool that are too small to be seen by the naked eye. This is a very important test. Because this type of blood can be the first clue that there is something wrong with our digestive system.
The important thing is that this is a screening test, not a diagnostic test. This means that if it suggests a problem, further testing will be needed to determine the exact cause.
What condition could cause blood in the stool?
Blood in the stool is not normal. It means that there is bleeding somewhere in our digestive system, from the mouth to the anus. There are several conditions that can cause this.
| Possible medical condition | A simple explanation |
|---|---|
| Anemia | A decrease in the number of healthy red blood cells in the body. This can be caused by continuous bleeding. |
| Inflammation of the large intestine (Colitis) | Inflammation or injury to the lining of your large intestine. |
| Colorectal cancer | A cancer that occurs in the lower part of the digestive system, that is, the colon or rectum. The FOBT test is very important for early detection. |
| Diverticulosis | Small, bubble-like sacs protruding from the wall of the colon. These can bleed if injured. |
| Hemorrhoids | Swelling of the blood vessels inside or outside the rectum. These can cause bleeding during bowel movements. |
| Colon polyps | Small growths that form inside the large intestine. Some growths can turn into cancer over time. |
| Stomach or intestinal ulcers (ulcers) | Ulcers in the digestive system. These ulcers can bleed. |
Why is this test being done? Who is it important for?
There are two main reasons why your doctor might recommend this test.
1. Having symptoms: If you have symptoms such as stomach pain, fatigue, pain in the rectum, or blood in your stool, this test can help find the cause.
2. As a screening test for cancer: The main and most important reason for doing the FOBT test is to detect colorectal cancer early. Imagine how valuable it would be if we could catch a small hint of it before it becomes a major disease? That's what this test does.
It is generally recommended that people between the ages of 45 and 75 who are not at high risk for cancer have this test at least once a year . However, if you have a family history of this type of cancer or other risk factors, you should talk to your doctor about how often you should have it.
How is this test done? Are there types?
The best part is that you can do this at home. Your doctor will give you a special test kit for this. All you have to do is take a stool sample at home, prepare it according to the instructions, and take it to the lab or your doctor. It's very easy.
There are three main types of FOBT tests.
| Test type | How it works |
|---|---|
| Guaiac FOBT (gFOBT) | This is a somewhat old method. A chemical called Guaiac is used to detect blood in the stool. You need to be a little careful about what you eat and drink before this test. |
| Immunochemical FOBT (iFOBT or FIT) | This is a new and more accurate method. It uses something called antibodies and only detects human blood. This does not require any special dietary restrictions. |
| FIT-DNA Test | This not only looks for blood, but also for DNA changes in stool that may be linked to cancer. |
Do I need to prepare anything before the test?
Yes, this varies a bit depending on the type of test you are doing.
If you are doing the iFOBT/FIT test:
Good news! For this new type of test, you don't need to specifically restrict your diet . That's a big convenience.
You are doing the gFOBT test if:
If you are taking this old-fashioned test, you should avoid certain things for a few days before the test to reduce the chance of a false positive result.
- Red meat: Red meats like beef and pork.
- Some medications: Pain relievers (NSAIDs), such as aspirin and ibuprofen. Also, blood thinners .
- Some types of vitamins: Vitamin tablets containing vitamin C and iron.
Very important: Do not stop taking any medication without talking to your doctor. Be sure to seek medical advice before stopping anything, especially blood thinners .
Okay, now how do you use this test kit?
Don't worry, it's very simple. Usually, all you have to do is follow these few steps.
1. Read the instructions: First, read the instruction leaflet that came with the test kit you received carefully. Everything is clear in it.
2. Collect the sample: Collect your stool sample in a clean, dry container. Some kits come with a special paper that you can put in the toilet, and then flush it. The most important thing is to not let any water or urine get into the stool.
3. Apply the sample to the card: Use the applicator provided in the kit to take a small amount of stool and apply it to the appropriate area on the test card. Usually, you are asked to take two or three samples over two or three days.
4. Hand it in: Then, leave the card at room temperature, away from heat and humidity, and take it to the lab or to the doctor in person, as directed by your doctor.
Are there times when you should not take this test?
Yes. Avoid doing this test in such cases as the result may be incorrect.
- When you have your periods .
- If you are bleeding due to hemorrhoids .
- If you know that you are bleeding due to a condition such as peptic ulcers or gastritis .
In this case, it's best to talk to your doctor before getting tested.
How long does it take for the results to come back? What happens if it's positive?
It usually takes about a week for the results to come back, sometimes a little longer.
Okay, now the most important thing. If the test is 'positive' , meaning that you detect blood in your stool, don't panic .
A positive result does not mean you have cancer.
It just means that there's a little bit of bleeding somewhere in your digestive system. The cause could be anything from hemorrhoids, stomach ulcers, or polyps, which we talked about earlier, which aren't dangerous.
If the result is positive, your doctor will call you and tell you what to do next. The next step is usually to do a test like a colonoscopy to find out exactly where the blood is coming from and why. This uses a camera to look inside the colon and pinpoint the problem.
If you haven't heard back from the results even after two weeks of giving the sample, call your doctor or the lab and ask.
Take-Home Message
- FOBT is a simple test that can be done at home to look for hidden blood in the stool.
- This is a very important screening test for early detection of colorectal cancer.
- Don't be afraid of a 'positive' test result. It doesn't confirm that you have cancer. It just means that further testing is needed.
- Especially if you are having a gFOBT test, follow your doctor's instructions regarding diet and medication exactly.
- Do not stop taking any medication without medical advice.
- Talk openly with your doctor about your test results and any concerns.
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