First of all, many thanks to those who responded. Congratulations to the one
laboratory who also sent a six page SOP for the procedure!
The majority of laboratories (n=8)used a similar procedure to ourselves with
some minor variations, namely homogenisation of the traditional pea sized
sample of stool in water to a smooth consistency. This was then either tested
directly with Clinitest, or allowed to settle/filtered or centrifuged, and then
tested.
One laboratory used Benedicts reagent (from BDH)instead of Clinitest
Two laboratories opted for direct TLC of a faecal extract without the use of
Clinitest as a screen.
One laboratory had negotiated with the local paediatricians to only perform the
test on obvious diarrhoea.
Acceptable times for receipt of sample varied from immediate to 4 hours
maximum. Samples were frozen if they were unable to be dealt with there and
then.
Clinical usefullness was not felt to be high, with some respondents pointing
out that it could be difficult separating out a transient disaccharidase
deficiency due to infection from a more permanent deficiency.
Our own experience here is that the majority of such requests are triggered by
an acute paediatric admission to casualty where diarrhoea is a feature of the
presenting illness. We occasionally find that there will be a trace of reducing
substances present, but almost invariably, there is not any followup.
I think that there has been one lactose deficiency found in the last few years.
Dr D G Williams
FRCPath
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