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  2. Tests
  3. Stool hanging drop test

What is stool hanging drop test?

The hanging drop test is used to check for the presence of motile microorganisms in the stool. It is mainly employed for the diagnosis of diarrhoeas and purulent enterocolitis. Enterocolitis affects the inner walls of the small intestine and colon and is one of the causes of inflammation in the digestive tract.

This test helps look for bacteria as well as certain other protozoans (single-celled animals) like Giradia.

Some bacteria that can cause diarrhoea include Bacillus cereus, Vibrio cholerae, Salmonella enteritidis, Escherichia coli.

Bacteria are tiny and colourless; therefore, they cannot be seen easily, even under a microscope. All bacteria have the Brownian movement, which is a vibrational movement due to the water molecules moving around in the sample. Motile bacteria have a structure known as flagella, which helps them to move. These bacteria will have a more prominent movement in the field of vision.

(Read more: Bacterial infection treatment)

  1. Why is stool hanging drop test performed?
  2. How do you prepare for stool hanging drop test?
  3. How is stool hanging drop test performed?
  4. What do stool hanging drop test results mean?

Why is stool hanging drop test performed?

Your doctor may order the test if you show the following signs and symptoms associated with diarrhoea:

This test may also be ordered if you have some of the following common symptoms of enterocolitis:

  • Swelling near the stomach
  • Diarrhoea
  • Nausea
  • Vomiting
  • Fever
  • Tiredness
  • A general feeling of being unwell

You may additionally have other symptoms such as rectal bleeding.

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How do you prepare for stool hanging drop test?

Consumption of certain medicines such as tetracyclines, anti-protozoal drugs, sulphonamides, laxatives, antacids, magnesium hydroxide, castor oil and barium sulphate, may affect the results of a stool test. These should be avoided for one to two weeks before the test. Do not stop taking any medicine unless your doctor suggests so.

How is stool hanging drop test performed?

A stool sample for this test should be collected during the acute stage of diarrhoea. A lab technician will give you a clean and disinfectant-free container or plastic cup with a tight-fitted lid to collect the sample. About five to six tablespoons of watery stools or 20-40 g of well-formed stools should be sufficient for the test. Multiple stool samples are required before the presence of an infection can be ruled out. 

Store the sample in a cool place and make sure that it doesn’t dry before you submit it to the lab. Label the sample properly with your name, age and gender and the date on which the sample was collected. Try to avoid contamination of the sample with urine and dirt particles. The samples should reach the laboratory for testing in half an hour of passing the stool as motile organisms are heat sensitive and may not be recognised after that time.

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What do stool hanging drop test results mean?

Normal results:

Brownian movement or no movement indicates that the sample is negative for motile micro-organisms.

Abnormal results:

The result may be positive if there is any zigzag, tumbling, darting or other organised movements. If the test is positive, it may show the presence of the following motile micro-organisms:

  • Salmonella spp.
  • Campylobacter spp.
  • Giardia lamblia
  • V. cholerae
  • E. coli
  • Entamoeba histolytica

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Department of Microbiology: Seth G. S. Medical College & K. E. M. Hospital [Internet]. Acharya Donde Marg, Parel (East), Mumbai; This Primary Specimen Manual
  2. Kotgire SA. Microbiological Stool Examination: Overview. J Clin Diagn Res. 2012 May;6(3):503-509.
  3. Biology: LibreTexts [Internet]; 15: Hanging Drop Wet Mount
  4. Farooq, P. D., Urrunaga, N. H., Tang, D. M., & von Rosenvinge, E. C. Pseudomembranous colitis. Dis Mon. 2015 May; 61(5): 181–206. PMID: 25769243.
  5. Khanna, S., & Pardi, D. S. Clostridium difficile infection: New insights into management. Mayo Clin Proc. 2012 Nov; 87(11): 1106–1117. PMID: 23127735.
  6. Guinane, C. M., & Cotter, P. D. Role of the gut microbiota in health and chronic gastrointestinal disease: Understanding a hidden metabolic organ. Therap Adv Gastroenterol. 2013 Jul; 6(4): 295–308. PMID: 23814609.
  7. Merck Manual Professional Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2019. Clostridioides (formerly, Clostridium) difficile –Induced Diarrhea
  8. Zani Augusto and Pierroa Agostino. Necrotizing enterocolitis: controversies and challenges. Version 1. F1000Res. 2015; 4: F1000 Faculty Rev-1373. PMID: 26918125.
  9. American College of Gastroenterology. [internet], Bethesda (MD); Diarrheal Diseases – Acute and Chronic
  10. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Rotavirus Vaccination
  11. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; When and How to Wash Your Hands
  12. Feldman M, et al. Diarrhea. In: Mark Feldman Lawrence Friedman Lawrence Brandt. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016
  13. National Health Service [internet]. UK; UK Standards for Microbiology Investigations - Motility Test
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