• J C Mangla, M Pereira, and J Murphy.
• J Am Geriatr Soc. 1981 Oct 1; 29 (10): 473-5.

AbstractIn a long-term care facility, the fecal guaiac test for occult blood was used as a screening method to detect gastrointestinal (GI) bleeding lesions. The study involved 450 chronically ill hospitalized patients whose average age was 70 years. Each underwent 6 fecal guaiac tests for three consecutive days while receiving a standardized meat-free, high-fiber diet. The 21 patients in whom the fecal hemoccult test yielded positive findings were further studied with x-ray upper GI series, barium enema, and fiberoptic examination of the upper and lower GI tract when necessary. In 4.7 percent of this population, the guaiac test gave positive results, which usually involved only 1 or 2 of the 6 guaiac slides. On further study it was found that 2 patients had large-bowel tumors, 5 had duodenal ulcers, 1 had gastric cancer, and 7 had diverticulosis. The incidence of colon cancer in this population was the same as that reported in other studies, but the incidence of duodenal ulcers was high. In 20 of the 21 patients with positive test findings, a lesion of the GI tract was found. The therapeutic implications of such screening are important. This study emphasizes the value of routine fecal hemoccult testing of whole institutional populations once or twice a year.

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