Validity of Stool Test for Occult Blood in the Early Diagnosis of Necrotizing Enterocolitis

Sharanabasavesh Mangalgi, Vishwas Subbaiah Narayana Reddy, Pradeep Gejjegenahalli Channabasappa Maralusiddappa, Deepthi Ramu

Abstract

Background and Aim: Stool test for occult blood was introduced as a potential aid in the early diagnosis of necrotizing enterocolitis (NEC). Validity of this test with respect to NEC and its indirect consequences were not evaluated formally. This study aimed to assess the validity of stool occult blood as a marker in the early diagnosis of NEC.

Materials and Methods: The study included 100 preterm neonates with feed intolerance. Stool was tested for occult blood on the day of feed intolerance. In these neonates, a feed was skipped and then continued with the same amount if there were no other significant signs of NEC. Neonates were followed up throughout the course in the neonatal intensive care unit (NICU) for the development of NEC.

Results: The incidence of stool occult blood positivity was 37%. None of them developed NEC. In neonates with negative stool occult blood, 2% (n = 2) developed NEC. The sensitivity and specificity of this test were 0% and 60%, respectively, with a 96% negative predictive value.

Conclusion: Stool test for occult blood alone is not a valid marker in the early diagnosis of NEC. Stopping feeds only on the basis of stool occult blood positivity hampers nutrition and prolongs hospital stay.

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