Definition

Flushable reagent stool blood test is an at-home test to detect invisible blood in the stool.

Alternative Names

Stool occult blood test - flushable home test; Fecal occult blood test - flushable home test

How the Test is Performed

This test is performed at home with disposable pads. You can buy the pads at the drug store without a prescription. Brand names include EZ-Detect, HomeChek Reveal, and ColoCARE.

You do not handle stool directly with this test. You simply note any changes you see on a card and then mail the results card to your health care provider.

To do the test:

• Urinate if you need to, then flush the toilet before having a bowel movement.
• After the bowel movement, place the disposable pad in the toilet.
• Watch for a change of color on the test area of the pad. Results will appear in about 2 minutes.
• Note the results on the card provided, then flush the pad away.
• Repeat for the next two bowel movements.

The different tests use different ways to check for water quality. Check the package for instructions.

How to Prepare for the Test

Some medicines may interfere with this test.

Check with your provider about changes in your medicines you may need to make. Never stop taking a medicine or change how you take it without first talking to your provider.

Check test package to see if there are any foods you need to stop eating before doing the test.

How the Test will Feel

This test involves only normal bowel functions, and there is no discomfort.

Why the Test is Performed

This test is mainly performed for colorectal cancer screening. It may also be done in the case of low levels of red blood cells (anemia).

Normal Results

A negative result is normal. It means you have no evidence of gastrointestinal bleeding.

Normal value ranges may vary slightly among different labs. Talk to your provider about your test results.

What Abnormal Results Mean

Abnormal results of the flushable pad mean there is bleeding present somewhere in the digestive tract, which may be caused by:

• Swollen, fragile blood vessels in the colon that may result in blood loss
• Colon cancer
• Colon polyps
• Enlarged veins, called varices, in the walls of the esophagus (the tube that connects your throat to your stomach) that bleed
• Inflamed or swollen lining of the stomach or the esophagus
• Infections in the stomach or intestines
• Hemorrhoids
• Crohn disease or ulcerative colitis
• Ulcer in the stomach or first part of the intestines

Other causes of a positive test, which do not indicate a problem in the gastrointestinal tract, include:

• Coughing up and then swallowing blood
• Nose bleed

Abnormal test results require follow-up with your doctor.

Risks

The test can have false-positive (the test indicates a problem when there actually is none) or false-negative (the test indicates there is not a problem, but there is) results. This is similar to other stool smear tests which can also give false results.

References

Garber JJ, Chung DC. Colonic polyps and polyposis syndromes. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 126.

National Cancer Institute website. Colorectal cancer screening (PDQ) health professional version. www.cancer.gov/types/colorectal/hp/colorectal-screening-pdq. Updated March 2, 2023. Accessed April 5, 2023.

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

US Preventive Services Task Force. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Updated May 18, 2021. Accessed February 20, 2023.

Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018;68(4):250-281. PMID: 29846947 pubmed.ncbi.nlm.nih.gov/29846947/.