The Online Meeting was presented by Dr. Marcio Alencar, a biologist graduated from São Judas Tadeu University with a postgraduate degree in Clinical Analysis and Toxicology. He currently works as a Senior Analyst at Hospital Israelita Albert Einstein and has experience in Parasitology, Microbiology, and teaching in Urinalysis and Parasitology through SBPC/ML.
The lecture covered the main aspects related to the functional coprological examination, including the principles and purpose of the test in gastrointestinal investigation, interpretation of the main fecal markers and their variations, recognition of microscopic structures and elements present in the sample, correlation between laboratory findings and digestive disorders, as well as analytical limitations and pre-analytical factors that impact laboratory routine activities.
Participants were trained to improve the interpretation of results in daily laboratory practice, correlate laboratory findings with gastrointestinal alterations, recognize the limitations and interfering factors of the examination, and use the functional coprological examination more strategically in the investigation of digestive disorders and malabsorption-related conditions, contributing to safer and more targeted analyses in diagnostic routines.
Questions & Answers
The following questions were not addressed during the Online Meeting.
Can medications interfere with fecal fat results?
Yes. Several medications can interfere with fecal fat testing, either by causing a true increase in fat content in the stool or by reducing falsely altered results. These include mineral oil, oily laxatives, oil-based enemas and suppositories, laxatives, antibiotics, among others.
Is it reactive for protein identification? (Note: At that moment, the discussion was about ammonia acid. Does that make sense to you?)
Yes. Increased fecal ammonia is related to the breakdown of proteins by bacteria. Ammonia is produced during protein putrefaction, when proteins and amino acids are metabolized by the intestinal microbiota.
Are fecal samples preserved with MIF suitable for performing a functional coprological examination?
Only for the microscopic portion, since the preservative may interfere with chemical reactions.
Are semi-digested fibers still reported, or only well- and poorly-digested fibers?
Well- and poorly-digested fibers remain important in the evaluation and are still reported. Semi-digested fibers are no longer commonly observed.
Could you provide an example of a modern/updated report?
A modern panel could include fecal elastase, fecal fat analysis (either qualitative or quantitative, depending on the laboratory’s criteria) to assess malabsorption and pancreatic digestion, calprotectin for intestinal inflammation, fecal occult blood testing for intestinal bleeding, parasitological examination focusing on giardiasis and coccidia, and molecular panels. Everything will depend on how much the laboratory’s patient population is able to pay for this testing profile. It is also important to remember that a specialist would be needed to develop explanatory notes for the report template, describing what each of these tests together could indicate to the clinician requesting the diagnosis. In fact, there are several possible profiles for structuring a coprological evaluation, and all of them are valuable when properly interpreted.
