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Collect random specimen from a single defecation.
Additional Information: Patient should be instructed to refrain from red meat and aspirin for 3 days prior to specimen collection.
Heme from ingested red meat will increase HemoQuant test values. Patients should be advised to avoid eating red meat for 3 days before collecting specimens. Fish and poultry may be substituted.
The elevated porphyrins of lead intoxication, erythrocytic protoporphyria and variegate porphyria may raise HemoQuant values in the absence of gut bleeding.
Recent studies have indicated that cancerous lesions in their early stages often do not bleed or bleed only intermittently.
Several noninvasive tests are available to detect gastrointestinal (GI) bleeding. However, guaiac type and immunochemical tests for occult bleeding are affected by the presence of reducing or oxidizing substances and are insensitive for the detection of upper GI tract (esophagogastric) bleeding, where most clinically significant occult GI bleeding occurs.
The HemoQuant test is the most reliable, noninvasive test currently available for detecting bleeding of the esophago-GI tract. Unlike other tests for blood in feces, this test detects both intact heme and porphyrins from partly degraded heme. Additionally, test results are not complicated by either the water content of the specimen or the presence of reducing or oxidizing substances. Furthermore, HemoQuant testing is sensitive to both proximal and distal sources of occult GI bleeding. HemoQuant is the most appropriate fecal occult blood test to use in the evaluation of iron deficiency.
Normally, one gram of feces may contain 0.0 - 2.0 mg hemoglobin (Hb); this corresponds to a daily loss of up to 2-mL blood. A demonstration of increased Hb in feces indicates bleeding in the alimentary tract (or ingestion of anticoagulants, aspirin, or red meat).