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Research Stool Ova + Parasite Status
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Ova + Parasite Status

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Ova + Parasite Status indicates whether microscopic evidence of intestinal parasites was found in a stool sample.

  • “Not Detected / None Seen” means no parasitic eggs (ova), larvae, or protozoa were observed in the specimen examined.

  • “Detected / Positive” means parasite structures were seen and the lab will usually name the organism(s) (for example, Giardia duodenalis, Entamoeba histolytica, Ascaris, Trichuris, hookworm, Taenia species, etc.).

Because many parasites shed intermittently, a single negative sample does not fully rule out infection—especially if symptoms are ongoing.

Why it matters

Intestinal parasites can cause:

  • Diarrhea (acute or chronic), greasy stools, gas, bloating

  • Abdominal cramps, nausea, weight loss, poor appetite

  • Eosinophilia (elevated eosinophils on a blood count) with some helminths

  • Malabsorption and nutrient deficiencies in persistent infections

Timely diagnosis guides targeted therapy and helps prevent transmission to close contacts.

How the test works

A technologist examines preserved stool under the microscope using concentration and staining methods to look for:

  • Helminths: eggs (ova) and larvae from roundworms, whipworms, hookworms, tapeworms

  • Protozoa: cysts and trophozoites from organisms like Giardia and Entamoeba

Many labs also use adjunct methods (e.g., special stains or immunoassays) for specific parasites; however, some organisms (e.g., Cryptosporidium, Cyclospora, Cystoisospora, Microsporidia, Strongyloides) may require dedicated antigen tests, acid-fast stains, PCR panels, or serology. If clinical suspicion is high, your clinician may add these.

When to consider testing

  • Persistent or recurrent diarrhea (>7–10 days), especially after travel, camping, or untreated water exposure

  • Daycare outbreaks, household or sexual exposure to someone with a known parasitic infection

  • Eosinophilia without an obvious cause

  • Unexplained GI symptoms (bloating, malabsorption, weight loss)

  • Immunocompromised individuals with new GI symptoms

How to collect (and what can interfere)

Follow your kit’s instructions exactly; details matter for accuracy.

  • Number of specimens: Often 2–3 separate stool samples, collected on different days (e.g., every 24–48 hours), improve detection. Ask your clinician which your order requires.

  • Preservatives: Many O&P kits include vials with fixatives (e.g., formalin or SAF). Fill to the marked line and mix thoroughly.

  • Avoid contamination: Do not mix stool with urine or toilet water. Use the provided clean collection device.

  • Medication and procedure holds (if possible): Recent barium studies, certain antibiotics, antidiarrheals, or laxatives can interfere. Tell your clinician about all meds; they’ll advise whether any brief holds are appropriate.

  • Timing: Return the specimen(s) promptly as instructed, especially if an unpreserved sample is requested.

Understanding your result

1) Not Detected / None Seen / Negative

  • No parasites were seen in the sample(s) examined.

  • If symptoms have resolved, no immediate action is usually needed.

  • If symptoms persist, talk with your clinician about:

    • Repeat O&P with multiple specimens (if only one was tested)

    • Targeted tests (e.g., Giardia/Cryptosporidium antigen, acid-fast stains for Cyclospora/Cystoisospora, Microsporidia testing)

    • Stool PCR GI panel, stool culture, C. difficile testing, fecal calprotectin, or celiac/IBD evaluation depending on your history

2) Detected / Positive

  • Parasite structures were identified. The report often lists the organism and sometimes a semi-quantitative comment (e.g., rare/few/moderate/many).

  • Next steps typically include:

    • Prescription antiparasitic therapy suited to the organism (e.g., nitroimidazoles for giardiasis; different agents for helminths)

    • Household/close-contact assessment when indicated

    • Food/water hygiene counseling to prevent reinfection

    • Test-of-cure: For some infections (e.g., giardiasis), your clinician may re-test 1–2 weeks after finishing treatment if symptoms continue or per local guidelines.

3) “See Remark,” “Questionable,” or “Inadequate”

  • Sometimes the lab notes insufficient sample, preservative issues, or structures that are not clearly parasitic. Your clinician may request recollection or confirmatory testing.

Why false negatives happen (and how to reduce them)

  • Intermittent shedding: Parasites are not shed in every stool. Multiple specimens increase yield.

  • Early or light infection: Organisms may be below detectable levels.

  • Improper collection or delays: Wrong preservative, underfilling/overfilling vials, or late delivery can reduce detectability.

  • Non-covered species: Some parasites need special stains or specific assays (they’re not always seen on a routine O&P).

  • Recent treatment or antibiotics: Can temporarily suppress detection.

Best practice: If symptoms are strong, pair O&P with targeted antigen/PCR for high-suspicion organisms (your clinician will decide which).

Common parasites and typical exposures

  • Protozoa: Giardia duodenalis (camping, untreated water, daycare), Entamoeba histolytica (travel to endemic regions), Dientamoeba fragilis (often debated pathogenicity)

  • Helminths: Ascaris, Trichuris, hookworms, Taenia spp. (ingestion of eggs/larvae from contaminated food/soil; undercooked meats/fish for certain tapeworms)

Note: Cryptosporidium and Cyclospora are classically harder to see on routine O&P and often need acid-fast stain or antigen/PCR.

What to discuss with your clinician

  • Your travel history, food/water exposures, daycare or household outbreaks, animal exposures, and recent antibiotics

  • Your immune status and any chronic GI conditions

  • Whether to add Giardia/Cryptosporidium antigen, acid-fast stains, microsporidia testing, or a stool PCR GI panel

  • Whether you need repeat sampling (2–3 specimens)

  • Treatment options and whether a test-of-cure is recommended

Related and follow-up tests

  • Giardia & Cryptosporidium antigen (EIA) or PCR

  • Acid-fast stain for Cryptosporidium, Cyclospora, Cystoisospora

  • Microsporidia testing (specialized)

  • Stool culture (for bacteria), C. difficile testing

  • Stool PCR GI panels (broad pathogen detection)

  • Fecal calprotectin (inflammation), CBC with differential (eosinophilia), IgE (selected cases)

  • Serology for certain tissue-migrating parasites when stool is insensitive

Key takeaways

  • Positive O&P confirms a parasitic infection and usually identifies the organism—enabling targeted treatment.

  • Negative O&P does not fully exclude parasites; consider multiple specimens and targeted tests if symptoms persist.

  • Correct collection technique and timely specimen handling meaningfully improve accuracy.

Frequently asked questions

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