I agree with William Marshall.
Moreover, when one considers tha lack of suitable Quality Assurance material
for test, the wide intra-individual variability of fat excretion and the
imprecision of the assay itself the conclusion must be that it has no place
in modern medicine.
Ian Barlow,
Principal Biochemist
> -----Original Message-----
> From: William Marshall [SMTP:[log in to unmask]]
> Sent: Tuesday, April 11, 2000 5:48 PM
> To: Graham Jones; [log in to unmask]
> Subject: Re: Faecal Fat
>
> We have long since stopped doing this unpleasant investigation. We used
> the triolein test for some time but have now dropped that also.
>
> In my experience, it is rarely necessary to establish whether fat
> malabsorption is present or not. If the patient has steatorrhoea or
> clinically has other evidence of malabsorption, it is more efficient to go
> straight to the most likely cause and perform the diagnostic test, e.g.,
> coeliac disease serology then small gut biopsy, plain Xray for pancreatic
> calcification then pancreolauryl test, etc. Even in patients in whom the
> evidence of malabsorption is not strong, simple tests for its effects
> followed by specific investigations for the most likely causes based on
> their relative frequencies avoids the need for faecal analysis.
>
> William
> At 11:24 AM 4/11/00 +1000, Graham Jones wrote:
> >I am writing for assistance from this discussion group regarding faecal
> fat
> >analysis.
> >
> >It is becoming very difficult to find a laboratory to perform this test
> in
> >Sydney. I presume the factors involved in this are the cost (MSB rebate
> >insufficient to cover costs) and the unpleasantness of the task.
> >
> >The clinicians here are keen to have this test available.
> >
> >I therefore have a few questions:
> >Does anyone have evidence of lack of utility of this test?
> >Are any alternatives available, suitable and cheap (eg trioliene breath
> >test, post fat-load triglycerides, faecal elastase analysis, acid
> steatocrit)?
> >Or are there ways of streamlining the handling by using a spot sample
> >(after appropriate diet) rather than a full 3 day collection?
> >
> >Thank you in advance for your assistance.
> >
> >
> >Graham Jones
> >
> >Staff Specialist in Chemical Pathology
> >St Vincent's Hospital, Sydney, Australia
> >Ph: (02) 9361-2170 Fax (02) 9361-2489
> >
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