Explanation

Consistency (feces): what is measured?

The laboratory describes how firm or loose the stool sent in is, from hard and lumpy to mushy or watery. The consistency depends on how much water the stool contains and how long it has been in the large intestine. It is a description, not a measurement of a substance.

What can it detect?

A sign of diarrhea or, on the contrary, constipation at the time of sample collection

Result

What does the result mean?

What the result tells you

A formed, soft stool is the normal result. Hard or lumpy stool fits slow passage through the gut or constipation, for example due to little fiber, drinking too little or too little exercise. Mushy or watery stool fits fast passage through the gut, for example due to a gut infection, diet or stress. Loose stool can affect the results of other tests in this panel, such as fats and starch.

After an abnormal result

Without symptoms, an abnormal result from this test usually needs no follow-up. With symptoms that fit poor digestion, the GP can request pancreatic elastase in the stool or a blood test for celiac disease, and if needed refer you to a gastroenterologist or internist (specialist in internal medicine).

Reliability

How reliable is the test?

Food remnants in a single stool sample mainly say something about what you have eaten and how quickly the food passed through the gut. How well the result shows or rules out poor digestion has not been well studied, neither in people without symptoms nor in people with bowel symptoms. If poor fat digestion (malabsorption) is suspected, the specialist may have fat measured in stool collected over a few days. For pancreatic function, pancreatic elastase in the stool has been studied better.

What can affect the result?

Food in the days before sample collection (fat, meat, raw vegetables, legumes, dairy, sugars) largely determines the result.
Diarrhea or, on the contrary, constipation changes the result, because the speed through the gut determines how much is digested.
One stool sample gives a snapshot; the composition differs from day to day.
Medicines such as laxatives, antibiotics, stomach acid inhibitors, pancreatic enzymes and weight-loss medicines that block fat absorption (orlistat) affect the result.

Who it is for

Who is the test useful for?

Useful for

Because diet strongly determines the result, this test says little in people without symptoms, and even with symptoms it does not identify a cause. With symptoms that may fit poor digestion, such as long-lasting fatty or mushy stools, unintended weight loss or long-lasting diarrhea, testing through the GP is the right route. Pancreatic elastase in the stool and a blood test for celiac disease are then more targeted first tests. With blood in the stool, unintended weight loss or new bowel symptoms after the age of 50, this test is no substitute for a visit to the GP.

How common is it?

There are no Dutch figures on how often an abnormal result for these tests occurs. Bowel symptoms themselves are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults. Conditions in which food is truly poorly digested, such as chronic inflammation of the pancreas, are much rarer.

Dutch medical specialists' guidelines (FMS) on irritable bowel syndrome (NHG and NVMDL) and chronic pancreatitis

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