Interpretation of coprogram - analysis of feces of a child
Coprogram for children assigned to determine the status and function of the digestive system. Such a study of feces helps to identify the presence of inflammatory and infectious lesions of the digestive system organs in a child. Also, using a coprogram in the stool can reveal hidden blood (to diagnose internal bleeding) and helminth eggs.
Norm
To be able to decipher the coprogram, one should know what characteristics of the stool are being investigated and what their normal values are. Note that in a small child the type of feeding affects the feces characteristics.
Indicator |
Young babies who are breastfed |
Infant-fed infants |
Children older than a year |
Quantity (grams per day) |
40 to 50 |
From 30 to 40 |
100 to 250 |
Coloring |
Yellow, possible greenish or mustard color |
Brown or yellow |
Brown |
Consistency |
Mushy |
Coarse |
Decorated (kolbasoobraznaya) |
Smell |
Slightly sour |
Pronounced, putrid |
Specific fecal, but not sharp |
PH (acidity) |
From 4.8 to 5.8 (slightly acid) |
From 6.8 to 7.5 (slightly alkaline) |
6 to 8 (slightly alkaline) |
Slime |
Can be detected in low quantities. |
Not |
Not |
White blood cells |
Can be single |
Can be single |
Single |
Sterobilin |
there is |
there is |
From 75 to 350 mg per day |
Bilirubin |
there is |
there is |
Must be absent |
Ammonia (in mmol / kg) |
Not determined |
Not determined |
From 20 to 40 |
Muscle fibers |
Can be determined in small quantities. |
Can be determined in small quantity. |
Not detected |
Blood |
Not detected |
Not detected |
Not detected |
Soluble protein |
Not detected |
Not detected |
Not detected |
Soap |
In small quantities |
In small amount |
In small quantity |
Connective tissue fibers |
Not detected |
Not detected |
Not detected |
Digestible Fiber Fibers |
Not detected |
Not detected |
Not detected |
Detritus |
In different quantities |
In different quantities |
In different quantities |
Starch |
Not detected |
Not detected |
Not detected |
Fatty acid |
In low quantity, represented by crystals. |
In low quantity, represented by crystals. |
Not detected |
Neutral fat |
In the form of drops |
In small quantity |
Not |
Possible causes of deviations
amount
The amount of stool can be influenced by the baby’s food - if he eats more plant foods, the volume of stool may increase, and when eating foods of animal origin, on the contrary, the volume of stool masses decreases.
Possible causes of a pathological change in stool volume are:
Above the norm (polyfecal) | Below the norm (oligofaecal) |
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Coloring
The color of the stool is influenced by the nutrition of the child and the use of drugs.
Colour |
Possible reasons |
Brown (dark shade) |
|
Brown (light shade) |
|
Green |
|
Light yellow |
|
Yellow bright |
Rapid evacuation of feces from the intestines (diarrhea). |
The black |
|
With a red tint |
|
Greenish black |
|
Whitish gray |
|
Rice Broth Colors |
Cholera |
Pea Soup Colors |
Typhoid fever |
Consistency
The consistency of bowel movements is determined by the amount of fluid in the baby’s stool. Approximately 70-75% of the excreta is represented by water, and the rest is cells from the intestine, food remains and dead microorganisms.
Consistency |
Possible reason |
Sheep feces (presented in the form of very dense lumps) |
|
Similar to mush |
|
Liquefied |
|
Mase-like |
|
Similar to foam |
Fermentation dyspepsia |
Smell
Normal stool odor is specific but not abrupt. It is caused by the fermentation processes that the normal bacterial flora causes in the intestine. The smell becomes weaker if the child has constipation or a vegetable diet, and when there is an excess of meat in the diet or diarrhea, the smell increases.
Presence of fetid pungent smell prompts that putrefactive processes predominate in the intestinal lumen.
The sharp sour smell of child feces indicates an increase in stool fatty acid levels.
Acidity
Acid-alkaline condition of feces associated with the bacterial flora that lives in the intestine. If the bacteria are in excess, the pH of the feces is shifted to the acidic side. Also, such a shift is typical for excessive consumption of carbohydrate products.
If a child consumes a lot of proteins, or he has diseases associated with impaired protein digestion (as a result, an increase in putrefaction is possible in the gut), then the acidity becomes more alkaline.
Stool Reaction (pH) |
Possible reasons |
Harshly sour (to 5.5) |
|
Sour (from 5.5 to 6.8) |
Problems with the absorption of fat in the small intestine |
Alkaline (8 to 8.5) |
|
Sharply alkaline (over 8.5) |
Putrid form of dyspepsia |
Slime
Epithelial cells in the intestines normally produce mucus to help the baby's feces move along the digestive tract. In the feces of a healthy child, visible mucus occurs only in the first 6 months of life when fed with breast milk.
In other cases, the presence of visible mucus in the stool indicates:
- Intestinal infections;
- Irritable bowel syndrome;
- Celiac disease;
- Malabsorption syndrome;
- Lactase deficiency;
- Hemorrhoids;
- Polyposis in the gut;
- Diverticula in the gut;
- Cystic fibrosis.
If a child secretes mucus without fecal masses, then this may be a sign of parasitic invasion, intestinal obstruction, or prolonged constipation.
White blood cells
Normally, such cells get into the child's feces in small quantities and can be represented in the field of view of the microscope up to 8-10 pieces. An increase in the number of white blood cells in the stool is characteristic of infectious and inflammatory lesions of the gastrointestinal tract. Read more about white blood cells in feces in children read in another article.
The type of leukocytes is also important for determining pathology:
If neutrophils are detected in a child, it can be: |
If an eosinophil is detected in a child, it may be: |
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Sterobilin
This bile pigment is responsible for the normal color of fecal masses. It is formed in the colon of bilirubin. The amount of stercobilin is determined in older children. With its increase, feces are called hypercholic. Such a chair is characteristic of enhanced secretion of bile and hemolytic anemia.
If stercobilin in the stool is less than the norm, such a chair is acholic. It is characteristic of hepatitis, pancreatitis and gall bladder problems.
Bilirubin
This pigment normally gets into the feces of a child only at an early age, especially when breastfeeding. It gives a greenish tint to the feces. In children older than one year with feces, only the decay products of this pigment are released.
If bilirubin is found in the stool, this can confirm problems with the intestinal flora (often it is dysbacteriosis after using antibiotics). Bilirubin is also detected in case of diarrhea, as the stool is quickly evacuated from the intestine.
Muscle fibers
Such fibers appear in the feces as a result of digestion of food of animal origin. Normally, when the digestive function is not impaired, a very small number of muscle fibers get into the feces, while they lose their transverse striation.
If this indicator is increased (this phenomenon is called a creator), then the child may have:
- Dyspepsia;
- Accelerated peristalsis (diarrhea);
- Pancreatitis;
- Achilia;
- Gastritis (it can be hypoacidic or anacidic).
Blood
Normally, the blood in the child’s stool should not be determined. It may appear in the stool in visible amounts with:
- Polyps in the rectum;
- Ulcerative colitis;
- Hemorrhoids;
- Anal fissures;
- Proctitis;
- Colon tumors;
- Crohn's disease;
- Ischemic colitis;
- Colon diverticulosis.
If the blood got into the feces in small quantities, it may be invisible externally, but it is revealed by a reaction to the hidden blood. If the reaction is positive, then it indicates the presence of:
- Gum disease;
- Peptic ulcer disease;
- Nasal bleeding;
- Varicose veins in the esophagus;
- Tumor process in the digestive tract;
- Mallory-Weiss Syndrome;
- Dysentery;
- Colitis;
- Intestinal tuberculosis;
- Worms;
- Hemorrhagic vasculitis;
- Typhoid fever etc.
Soluble protein
If such inclusions are detected in the feces, although they are not normally found, then the reason may be:
- Bleeding in the digestive tract;
- Inflammatory processes in the digestive system;
- Ulcerative colitis;
- Putrid form of dyspepsia;
- Celiac disease
Soap
This type of inclusions is normally present in small amounts in the baby's feces and represents residues from the digestion of fats.
If there are no soaps in the feces, then the function of processing fats in the digestive tract is impaired. This happens when:
- Pancreatitis when the function of enzyme production is impaired;
- Fermentation dyspepsia;
- Problems with the production of bile, as well as its entry into the small intestine (diseases of the liver and gallbladder);
- Accelerated advancement of feces in the digestive system;
- Impaired absorption of substances in the gut.
Connective tissue fibers in feces
If such fibers were found in the baby's feces, they indicate problems with the digestion of food of animal origin. Possible causes may be gastritis with reduced secretory function or pancreatitis, as well as diarrhea.
Plant fiber
In the analysis of feces take into account only the presence of fiber, which is digested in the intestine.Normally, this type of dietary fiber should be absent, in contrast to fiber, which is not digested (it happens in the feces and indicates the use of plant foods).
Digestible plant fiber is detected in the stool with:
- Pancreatitis;
- Ulcerative colitis;
- Anacid and also hypoacid gastritis;
- The use of herbal products in large quantities;
- Putrid dyspepsia;
- Accelerated passage of food through the intestines with diarrhea.
Detritus
So called part of the stool, represented by digested food, germs and epithelial intestinal cells. The more this indicator in the coprogram, the better the food is digested in the child.
Starch
This type of carbohydrate contained in cereals, fruits and vegetable dishes, normally in the stool should be absent. If it is found in feces, then, perhaps, in a child:
- Gastritis;
- Pancreatitis;
- Diarrhea;
- Fermentation dyspepsia;
Fatty acid
They are a product of digestion of fats. And if babies up to a year can have such acids in their stools, in older children their detection indicates:
- Disorders of the pancreas;
- Diarrhea (food leaves intestines too quickly);
- Problems with intestinal absorption;
- Problems with the production of bile, as well as its entry into the intestine;
- Fermentation dyspepsia.
Detection of neutral fat in feces
Its small amount is permissible for the analysis of feces of children of the first year of life, since their enzyme system is not yet fully developed. Older children should not have neutral fat in the stool, since it is completely processed by the body for energy. If neutral fat is found in the child’s feces, the reasons will be the same as when fatty acids are detected in the stool.
Other pathological inclusions
The presence of larvae, segments and eggs of helminths is detected in helminthiases, and the presence of lamblia in the fecal masses indicates giardiasis. Pus may enter the feces if there is an abscess or suppuration in the intestines.