scholarly journals Faecal immunochemical tests (FIT) in the assessment of patients presenting with lower bowel symptoms: Concepts and challenges

The Surgeon ◽  
2018 ◽  
Vol 16 (5) ◽  
pp. 302-308 ◽  
Author(s):  
Callum G. Fraser
Keyword(s):  
Lower Bowel ◽  
Bowel Symptoms

scholarly journals Do Men Know Which Lower Bowel Symptoms Warrant Medical Attention? A Web-Based Video Vignette Survey of Men in Western Australia

2016 ◽  
Vol 10 (6) ◽  
pp. 474-486
Author(s):  
Devesh V. Oberoi ◽  
Moyez Jiwa ◽  
Alexandra McManus ◽  
Richard Parsons
Keyword(s):  
General Practitioner ◽  
Help Seeking ◽  
Public Awareness ◽  
Health Belief ◽  
Medical Attention ◽  
Early Presentation ◽  
Lower Bowel ◽  
Remote Areas ◽  
Bowel Symptoms ◽  
Belief Model

The current study aims to explor how men would advise other men about seeking help for lower bowel symptoms and also to determine the factors that may influence help seeking. A purposive sample of Western Australian men aged 18 years and older was recruited for the study. Participants completed 8 of the 28 randomly assigned video vignettes (video clips) displaying men (older or younger) with various combinations of one or more lower bowel symptoms. Participants were asked if the person in the vignette should seek health advice. Subsequently, the participants answered a set of questions based on the Health Belief Model. A total of 408 participants (response rate = 51%) answered 3,264 vignettes. Participants younger than 50 years, participants who were not tertiary educated and those who had lower incomes, or those living in regional or remote areas were less likely to advise help seeking from general practitioner (GP). Participants who visited their general practitioner less frequently were also less likely to advisehelp seeking. There was a trend to consider unintentional weight loss and diarrhea as minor symptoms not necessitating medical attention compared with rectal bleeding. The findings suggest for a need to improve public awareness among men about the need to seek timely medical advice for lower bowel symptoms in primary care. The importance of early presentation of persistent lower bowel symptoms must be specifically targeted at men younger than 50 years, those with lower incomes, or residing in regional or remote areas.

scholarly journals A self administered reliable questionnaire to assess lower bowel symptoms

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Barbara-Ann Adelstein ◽  
Les Irwig ◽  
Petra Macaskill ◽  
Peter H Katelaris ◽  
David B Jones ◽  
...  
Keyword(s):  
Lower Bowel ◽  
Bowel Symptoms

Men's Help-seeking Behavior with Regards to Lower Bowel Symptoms

2015 ◽  
Vol 39 (2) ◽  
pp. 212-221 ◽  
Author(s):  
Devesh V. Oberoi ◽  
Moyez Jiwa ◽  
Alexandra McManus ◽  
Rupert Hodder
Keyword(s):  
Help Seeking ◽  
Help Seeking Behavior ◽  
Lower Bowel ◽  
Bowel Symptoms ◽  
Seeking Behavior

scholarly journals Appraisal of the faecal haemoglobin, age and sex test (FAST) score in assessment of patients with lower bowel symptoms: an observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jayne Digby ◽  
Judith A. Strachan ◽  
Craig Mowat ◽  
Robert J. C. Steele ◽  
Callum G. Fraser
Keyword(s):  
Primary Care ◽  
Bowel Disease ◽  
Added Value ◽  
Advanced Adenoma ◽  
Individual Risk ◽  
First Year ◽  
Lower Bowel ◽  
Bowel Symptoms ◽  
Group A ◽  
Group B

Abstract Background Many patients present in primary care with lower bowel symptoms, but significant bowel disease (SBD), comprising colorectal cancer (CRC), advanced adenoma (AA), or inflammatory bowel disease (IBD), is uncommon. Quantitative faecal immunochemical tests for haemoglobin (FIT), which examine faecal haemoglobin concentrations (f-Hb), assist in deciding who would benefit from colonoscopy. Incorporation of additional variables in an individual risk-score might improve this approach. We investigated if the published f-Hb, age and sex test score (FAST score) added value. Methods Data from the first year of routine use of FIT in primary care in one NHS Board in Scotland were examined: f-Hb was estimated using one HM-JACKarc FIT system (Kyowa Medex Co., Ltd., Tokyo, Japan) with a cut-off for positivity ≥10 μg Hb/g faeces. 5660 specimens were received for analysis in the first year. 4072 patients were referred to secondary care: 2881 (70.6%) of these had returned a FIT specimen. Of those referred, 1447 had colonoscopy data as well as the f-Hb result (group A): 2521 patients, also with f-Hb, were not immediately referred (group B). The FAST score was assessed in both groups. Results 1196 (41.7%) of patients who returned a specimen for FIT analysis had f-Hb ≥10 μg Hb/g faeces. In group A, 252 of 296 (85.1%) with SBD had f-Hb > 10 μg Hb/g faeces, as did 528 of 1151 (45.8%) without SBD. Using a FAST score > 2.12, which gives high clinical sensitivity for CRC, only 1143 would have been referred for colonoscopy (21.0% reduction in demand): 286 of 296 (96.6%) with SBD had a positive FAST score, as did 857 of 1151 (74.5%) without SBD. However, one CRC, five AA and four IBD would have been missed. In group B, although 95.2% had f-Hb < 10 μg Hb/g faeces, 1371 (53.7%) had FAST score ≥ 2.12: clinical rationale led to only 122 of group B completing subsequent bowel investigations: a FAST score > 2.12 was found in 13 of 15 (86.7%) with SBD. Conclusions The performance characteristics of the FAST score did not seem to enhance the utility of f-Hb alone. Locally-derived formulae might confer desired benefits.

scholarly journals Do other variables add value to assessment of the risk of colorectal disease using faecal immunochemical tests for haemoglobin?

2019 ◽  
Vol 56 (4) ◽  
pp. 472-479 ◽  
Author(s):  
Jayne Digby ◽  
Robert JC Steele ◽  
Judith A Strachan ◽  
Craig Mowat ◽  
Annie S Anderson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Inflammatory Bowel Disease ◽  
Family History ◽  
Bowel Disease ◽  
Odds Ratios ◽  
Lower Bowel ◽  
Bowel Symptoms ◽  
History Of ◽  
Inflammatory Bowel

Background Faecal immunochemical tests for haemoglobin have been recommended to assist in assessment of patients presenting in primary care with lower bowel symptoms. The aim was to assess if, and which, additional variables might enhance this use of faecal immunochemical tests. Methods Faecal immunochemical test analysis has been a NHS Tayside investigation since December 2015. During the first year, 993 patients attending colonoscopy were invited to complete a detailed questionnaire on demographic background, symptoms, smoking status, alcohol use, dietary fibre, red and processed meat intake, physical activity, sitting time, dietary supplement use, family history of colorectal cancer, adenoma, inflammatory bowel disease and diabetes. Significant bowel disease was classified as colorectal cancer, advanced adenoma or inflammatory bowel disease. Results A total of 470 (47.3%) invitees agreed to complete the questionnaire and 408 (41.1%) did. Unadjusted odds ratios for the presence of significant bowel disease compared with undetectable faecal haemoglobin increased with increasing faecal haemoglobin and for faecal haemoglobin 10–49, 50–199, 200–399 and ⩾400 μg Hb/g faeces were 0.95 (95% CI: 0.16–5.63), 2.47 (0.55–1.03), 6.30 (1.08–36.65) and 18.90 (4.22–84.62), respectively. Rectal bleeding and family history of polyps were the only other variables with statistically significant ( P < 0.05) odds ratios greater than 1.00, being 1.88 (1.13–3.17) and 2.93 (1.23–6.95), respectively. Odds ratios adjusted for all other variables showed similar associations, but only faecal haemoglobin and family history of polyps had significant associations. Conclusions Faecal haemoglobin is the most important factor to be considered when deciding which patients presenting in primary care with lower bowel symptoms would benefit most from referral for colonoscopy.

scholarly journals Investigating lower bowel symptoms in general practice.

BMJ ◽  
1992 ◽  
Vol 304 (6841) ◽  
pp. 1521-1522 ◽  
Author(s):  
R. Jones
Keyword(s):  
General Practice ◽  
Lower Bowel ◽  
Bowel Symptoms
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