Occult Blood in Stools and Necrotizing Enterocolitis

Routine fecal occult blood testing does not predict necrotizing enterocolitis in very low birth weight neonates

“…These results are similar to those of Abramo et al [2] who performed a prospective blinded study testing for occult hematochezia within the first six weeks of life in 95 neonates with birth weights <1800 g who were receiving at least some enteral feeds. Five of six infants (83.3%) diagnosed with NEC (as defined by clinical signs and presence of pneumatosis intestinalis on X-ray) had negative FOB testing the day before NEC developed (the 6th infant did not have any fecal testing results prior to NEC diagnosis), and none of the five had any positive results within the two days prior to diagnosis.…”

“…There does appear to be a link between gross rectal bleeding and NEC. Though they did not specify the exact number, Abramo et al did note gross rectal bleeding was seen on the day of NEC diagnosis in some infants [2]. Other studies have noted a low incidence of NEC in those premature infants with only microscopic blood detected in feces (0.47%), but a dramatic increased incidence in those who presented-with or progressed-to grossly bloody feces (63.3% and 89.6% respectively) [7].…”

The utility of guaiac stool testing in the detection of gastrointestinal complications in infants with critical congenital heart disease

“…This is supported by other studies that found that there is limited association between occult haematochezia and necrotising enterocolitis, and thus limited utility of routine faecal occult blood testing in infants. [10][11][12] Although there is no correlation between heme-positive stools and increased incidence of gastrointestinal emergencies, there were no gastrointestinal emergencies in the patients with hemenegative stools in our study.…”

Impact of Routine Gastric Aspirate Monitoring on Very Low Birth Weight Early Preterm Infants

“…Numerous screening strategies have been attempted including routine fecal occult blood (FOB) testing and RGA monitoring. While routine FOB testing has been largely debunked and is falling out of favor (13,14), RGA persists despite limited supportive evidence. Early studies of RGA monitoring seemed to indicate that more frequent and larger gastric aspirate volumes could be predictive of NEC (3,4).…”