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From Wikipedia, the free encyclopedia

Human Feces (also faeces), also known as stools, is the waste product of the human digestive system and varies significantly in appearance, depending on the state of the whole digestive system, influenced and found by diet and health. Normally stools are semisolid, with a mucus coating. Small pieces of harder, less moist feces can sometimes be seen impacted on the distal (leading) end. This is a normal occurrence when a prior bowel movement is incomplete; and feces are returned from the rectum to the intestine, where water is absorbed.

Meconium (sometimes erroneously spelled merconium) is a newborn baby's first feces. Human feces are a defining subject of toilet humor.

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Fecal management

The management of feces is an issue of hygiene, since feces contribute to spreading of diseases and intestinal parasites. Toilets were known in ancient Persia and Northern India (dated as early as 2,500 BC), in Ancient Rome, Egypt and China, although the contemporary flush toilet originated in 19th century Victorian England.

Until the end of the 19th century, the primary concern of sewage collection and disposal in the Western world was to remove waste away from inhabited places, and it was common to use waterflows and larger bodies of water as a destination of sewage, where waste could be naturally dissipated and neutralized. With the increased population density this is no longer a viable solution, and special processing of sewage is required. The lack of the latter is a grave sanitary and public health problem in developing countries.

Laboratory testing of feces

Feces will sometimes be required for microbiological testing, looking for an intestinal pathogen or other parasite or disease.

Biochemical tests done on feces include fecal elastase and fecal fat measurements, as well as tests for fecal occult blood.

It is recommended that the clinician correlate the symptoms and submit specimens according to laboratory guidelines to obtain results that are clinically significant. Formed stools often do not give satisfactory results and suggest little of actual pathological conditions.

Three main types of microbiological tests are commonly done on feces:

  • Antibody-antigen type tests, that look for a specific virus (e.g. rotavirus).
  • Microscopic examination for intestinal parasites and their ova (eggs).
  • Routine culture.

Routine culture involves streaking the sample onto agar plates containing special additives, such as MacConkey agar, that will inhibit the growth of Gram-positive, thick membranes organisms and will selectively allow enteric pathogens to grow, and incubating them for a period, and observing the bacterial colonies that have grown.

Bristol Stool Chart

Bristol Stool Chart.png

The Bristol Stool Chart or Bristol Stool Scale is a medical aid designed to classify the form of human feces into seven categories. Sometimes referred to in the UK as the "Meyers Scale," it was developed by K.W.Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997.[1] The form of the stool depends on the time it spends in the colon.[2]

The seven types of stool are:

  1. Separate hard lumps, like nuts (hard to pass)
  2. Sausage-shaped but lumpy
  3. Like a sausage but with cracks on its surface
  4. Like a sausage or snake, smooth and soft
  5. Soft blobs with clear cut edges (passed easily)
  6. Fluffy pieces with ragged edges, a mushy stool
  7. Watery stool, entirely liquid.

Types 1 and 2 indicate constipation, with 3 and 4 being the "ideal stools" especially the latter, as they are the easiest to pass, and 5–7 being further tending towards diarrhea or urgency.[2]

Color variations of feces

Yellow

Yellowing of feces can be caused by an infection known as Giardiasis, which derives its name from Giardia, an anaerobic flagellated protozoan parasite that can cause severe and communicable yellow diarrhea. Another cause of yellowing is a condition known as Gilbert's Syndrome. This condition is characterized by jaundice and hyperbilirubinemia when too much bilirubin is present in the circulating blood.

Black

Feces can be black due to the presence of red blood cells that has been in the intestines long enough to be broken down by digestive enzymes. This is known as melena, and is typically due to bleeding in the upper digestive tract, such as from a bleeding peptic ulcer. The same color change (albeit harmless) can be observed after consuming foods that contain substantial proportion of animal bloods, such as Black pudding or Tiết canh. The black color is caused by oxidation of the iron in the blood's hemoglobin. Black feces can also be caused by a number of medications, such as bismuth subsalicylate, and dietary iron supplements, or foods such as black liquorice, or blueberries.[3] Hematochezia is similarly the passage of feces that are bright red due to the presence of undigested blood, either from lower in the digestive tract, or from a more active source in the upper digestive tract. Alcoholism can also provoke abnormalities in the path of blood throughout the body, including the passing of red-black stool.

Blue

Prussian blue, used in the treatment of radiation cesium and thallium poisoning, can turn the feces blue. Also, substantial consumption of products containing blue food dye (things such as blue koolaid or grape soda)[4]

Silver

A tarnished-silver or aluminum paint-like stool color characteristically results when biliary obstruction of any type (white stool) combines with gastrointestinal bleeding from any source (black stool). And it can suggest a carcinoma of the ampulla of Vater, which will result in gastrointestinal bleeding and biliary obstruction, resulting in silver stool.[5]

Fecal contamination

A quick test for fecal contamination of water sources or soil is a check for the presence of E. coli bacteria performed with the help of MacConkey agar plates or Petri dishes. E. coli bacteria uniquely develop red colonies at temperature of approximately 43 °C (109 °F) overnight. While most strains of E. coli are harmless, their presence is indicative of more serious fecal contamination, and hence a high possibility of more dangerous organisms.

Fecal contamination of water sources is highly prevalent worldwide, accounting for the majority of unsafe drinking water, which is the only water available to 1.1 billion people. In developing countries most sewage is discharged without treatment. Even in developed countries events of sanitary sewer overflow are not uncommon and regularly pollute the Seine River (France) and the River Thames (England), for example.

The main pathogens that are commonly looked for in feces include:

Utilization

See also

References








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