Stool guaiac test

Definition

The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself. It is the most common type of fecal occult blood test (FOBT).

Guaiac is a substance from a plant that is used to coat the FOBT test cards.

Alternative Names

Colon cancer - guaiac test; Colorectal cancer - guaiac test; gFOBT; Guaiac smear test; Fecal occult blood test - guaiac smear; Stool occult blood test - guaiac smear

How the Test is Performed

Usually, you collect a small sample of stool at home. Sometimes, a doctor may collect a small amount of stool from you during a rectal examination.

If the test is done at home, you use a test kit. Follow the kit instructions exactly. This ensures accurate results. In brief:

Be sure to keep the stool away from any urine. Mixing of urine and stool can spoil the sample.

How to Prepare for the Test

Some foods can affect test results. Follow instructions about not eating certain foods before the test. These may include:

Some medicines may interfere with the test. These include vitamin C, aspirin, and NSAIDs such as ibuprofen and naproxen. Ask your health care provider if you need to stop taking these before the test. Never stop or change your medicine without first talking to your provider.

How the Test will Feel

The at-home test involves a normal bowel movement. There is no discomfort.

You may have some discomfort if the stool is collected during a rectal exam.

Why the Test is Performed

This test detects blood in the digestive tract. It may be done if:

Normal Results

A negative test result means that there is no blood in the stool.

What Abnormal Results Mean

Abnormal results may be due to problems that cause bleeding in the stomach or intestinal tract, including:

Other causes of a positive test may include:

If the stool guaiac results come back positive for blood in the stool, your doctor will likely order other tests, often including a colonoscopy.

The stool guaiac test does not diagnose cancer. Screening tests such as colonoscopy can help detect cancer. The stool guaiac test and other screenings can catch colon cancer early, when it is easier to treat.

Risks

There can be false-positive and false-negative results.

Errors are reduced when you follow instructions during collection and avoid certain foods and medicines.

References

Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the US Multi-Society Task Force on colorectal cancer. Am J Gastroenterol. 2017;112(7):1016-1030. PMID: 28555630 pubmed.ncbi.nlm.nih.gov/28555630/.

Savides TJ, Jensen DM. Gastrointestinal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 20.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed May 27, 2022.


Review Date: 2/7/2022
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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