Fecal Occult Blood Test Results: When to Consider a Colonoscopy

Fecal occult blood test (FOBT)

Hello doctor, I had a fecal immunochemical test for occult blood last week, and today I received the report with a value of 56.9, while the normal range is below 30.
The doctor has recommended a colonoscopy, but I had a colonoscopy at Tri-Service General Hospital in April this year due to constipation, and the results were normal.
So I would like to ask what the standard normal value is and whether I should go for a colonoscopy.

Chen Afu, 40~49 year old female. Ask Date: 2019/10/25

Dr. Cai Jinji reply Gastroenterology and Hepatology

Hello Mr.
Chen, I would like to know if the bowel preparation for your colonoscopy in April was thorough.
Additionally, do you have any issues with hemorrhoids? If the bowel preparation was not adequate or if you are still concerned about potential colon issues, you may consider undergoing another examination.
It is also possible to discuss the results of your fecal occult blood test with your physician, as there may be inconsistencies in testing methods or equipment that could lead to different standards.
Therefore, I recommend that you return for a consultation with your doctor.
Thank you.

Reply Date: 2019/10/25

More Info

Understanding the results of a fecal occult blood test (FOBT) is crucial for determining the next steps in your healthcare journey, especially when it comes to potential gastrointestinal issues. In your case, a result of 56.9 ng/ml indicates a positive finding, as the normal range is typically considered to be below 30 ng/ml. This means that there is blood present in your stool, which can be a sign of various conditions, some of which may require further investigation.

When to Consider a Colonoscopy
Given your positive FOBT result, your doctor has recommended a colonoscopy. This is a common and important next step for several reasons:
1. Rule Out Serious Conditions: A positive FOBT can be indicative of several conditions, including polyps, colorectal cancer, diverticulosis, or gastrointestinal bleeding from other sources. A colonoscopy allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities.

2. Previous Normal Colonoscopy: While you mentioned that you had a normal colonoscopy in April, it is important to note that conditions can develop over time. The presence of blood in your stool, even after a normal colonoscopy, warrants further investigation to ensure that no new issues have arisen.

3. Symptoms and Risk Factors: If you are experiencing any additional symptoms such as changes in bowel habits, abdominal pain, weight loss, or changes in stool appearance, these factors further justify the need for a colonoscopy. Additionally, if you have a family history of colorectal cancer or other risk factors, this increases the importance of timely screening.

Understanding Normal Values
The normal range for FOBT can vary slightly depending on the laboratory and the specific test used, but generally, a result below 30 ng/ml is considered negative. Your result of 56.9 ng/ml is above this threshold, indicating a need for further evaluation. It is essential to follow your doctor's advice regarding the colonoscopy, as they can provide you with the best guidance based on your individual health history and current symptoms.

Conclusion
In summary, your positive FOBT result suggests that a colonoscopy is warranted, even if your previous colonoscopy was normal. This procedure is a vital tool in diagnosing potential issues within the gastrointestinal tract. It is understandable to feel apprehensive about the process, but it is a routine procedure that can provide valuable information about your health.
If you have any concerns or questions about the procedure itself, including preparation, risks, or what to expect, do not hesitate to discuss these with your healthcare provider. They can help alleviate any fears and ensure that you are well-informed about the next steps in your care. Remember, early detection and intervention are key in managing gastrointestinal health effectively.

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