title: Interference of plant peroxidases with guaiac-based fecal occult blood tests is avoidable.
abstract: Peroxidase-rich fruits and vegetables are reputed to interfere with guaiac-based fecal occult blood tests. We added horseradish peroxidase to fecal samples and tested them with Hemoccult, Hemoccult SENSA(R), and hydrated Hemoccult. Positivity rates with Hemoccult and Hemoccult SENSA decreased rapidly as the time between smearing (preparation) and development increased, whereas they remained high with hydrated Hemoccult. For samples with added blood, positivity rates did not decrease with time. When 61 volunteers were tested on a standard restriction and on a challenge diet high in plant peroxidase, no positive results occurred during standard restriction. During the challenge diet, one volunteer was positive with Hemoccult and Hemoccult SENSA when development was delayed 24 h, and no volunteers were positive when it was delayed 48 h and 72 h. However, with hydrated Hemoccult, positives occurred in 13 of 61 volunteers at 24 h, 8 of 61 at 48 h, and 5 of 61 at 72 h. Thus, peroxidase-rich plant foods do not need to be excluded from the diet with Hemoccult and Hemoccult SENSA if development is delayed for at least 48 h after smearing. A delay of this duration will not solve the problem of plant peroxidase interference with hydrated Hemoccult.
authors.affiliation: Department of Gastroenterology and University of Melbourne Department of Medicine, The Royal Melbourne Hospital, C/O Post Office, Victoria 3050, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Sinatra
authors.forename: D J
authors.initials: DJ
authors.lastname: St John
authors.forename: G P
authors.initials: GP
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet; D005260:Female; D005638:Fruit / Q000201:enzymology; D006138:Guaiac; D006801:Humans; D007202:Indicators and Reagents; D008297:Male; D009780:Occult Blood; D010544:Peroxidases / Q000008:administration & dosage*; D010945:Plants, Edible / Q000201:enzymology*; D011933:Reagent Kits, Diagnostic; D013997:Time Factors; D014675:Vegetables / Q000201:enzymology
chemical_list: D007202:Indicators and Reagents; D011933:Reagent Kits, Diagnostic; D006138:Guaiac; D010544:Peroxidases