Faecal analysis in Australia.

摘要

The recent article by Lust et al. raises the very contentious issue regarding the retention of the 72-h faecal fat testing. Some of the issues discussed deserve further amplification and input from the laboratory perspective.The 29% response rate is hardly representative of the gastroenterological community where responders are more likely to be academic, investigation oriented and perhaps have a special interest in faecal fat testing.The critical problem with this test, however, is the imprecision or lack of reproducibility. This imprecision is affected by many factors that have remained beyond the control of the laboratory. Optimal fat intake in preparation for the test is often lacking because of the time pressure on the clinician's part. The addition of a dietician would additionally be costly and add another level of complexity to the process. Many laboratories assist with this process by giving out instruction leaflets regarding the optimal fat consumption before the test, but they do not extend beyond this. The patients' compliance rate with advice is generally poor because in truly abnormal cases, many patients reduce the fat intake to avoid symptom recurrence, which on its own, negates the need for the test in the first place.