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Stool Analysis and Culture

Stool analysis and culture — investigation of gastrointestinal infections and parasites.

A laboratory test that investigates microbes, parasites, and signs of digestive disorders in a stool sample. It is used to identify the cause of diarrhea and abdominal complaints.

Indication

  • Investigation of acute or chronic diarrhea
  • Suspected bacterial enteritis (Salmonella, Shigella, Campylobacter)
  • Suspected parasitic infection (Giardia, Entamoeba, helminths)
  • Gastrointestinal complaints after travel abroad
  • Investigation of food-borne poisoning
  • Evaluation of malabsorption (fat, fiber analysis)
  • Post-antibiotic diarrhea (suspected C. difficile)

Preparation

  • Use of antibiotics and antiparasitic medications is reported to the physician 2-3 days in advance
  • After radiologic studies with barium, a 1-week wait is required
  • The stool container must be clean and dry
  • Samples are not collected during menstruation
  • Samples on 3 different days may be requested for parasite testing

How it's performed

  1. A stool sample is collected in the sterile container provided to the patient (it must not be mixed with urine)
  2. The sample is delivered to the laboratory within 1-2 hours
  3. Direct microscopic examination evaluates parasites, eggs, and cells
  4. For bacterial culture, the sample is plated on special media and incubated for 24-72 hours
  5. Antibiogram (antibiotic susceptibility) testing is performed on bacteria that grow
  6. If needed, C. difficile toxin testing and viral PCR analysis are added

Post-procedure

  • Results are used in treatment planning
  • If positive, appropriate antibiotic or antiparasitic treatment is started
  • A control culture may be needed after treatment
  • In recurrent cases, further investigations (colonoscopy, biopsy) are performed

Risks

  • There is no procedural risk (the sample is collected by the patient)
  • False-negative results (intermittent shedding of parasites)
  • Results may be impaired in samples that are delivered late
  • Antibiotic use may inhibit bacterial growth

FAQ

How long does it take to get results?

Microscopic examination is reported the same day, bacterial culture in 2-3 days, and parasite testing within 1-3 days.

Is one sample enough?

A single sample may be sufficient for bacterial culture. However, for parasite testing, samples on 3 different days are recommended because parasites are shed intermittently.

What kinds of microorganisms can be detected?

Bacteria such as Salmonella, Shigella, Campylobacter, and E. coli; parasites such as Giardia and Entamoeba; rotavirus; and C. difficile toxin can be detected.

Should I get tested if my diarrhea has resolved quickly?

Mild diarrhea may resolve on its own. However, testing is recommended in cases of fever, bloody diarrhea, prolonged complaints, or following travel.