Stools are a key diagnostic tool when a doctor needs to find out whether a person is suffering from any kind of a digestive tract disorder. More often than not, stools should be devoid of any blood cells. However, if a pathologist finds leukocytes in the stool, then it could signify a variety of diseases that may be affecting the gastrointestinal tract. When a person has diarrhea, which is not receding with the help of regular antibiotics, then the doctor usually asks for stool sample analysis. A stool sample helps to know what kind of disease is affecting the person. Usually, the results are classified as 'few', 'moderate' and 'many' white blood cells in the stool sample. The exact values of each vary from one laboratory to another. Generally, 'few' indicates less than or equal to 2/oil immersion microscopic field (OIF), 'moderate' indicates 3/OIF to 9/OIF, and 'many' indicates greater than or equal to 10/OIF.
Absence of Leukocytes
At times, a person, despite suffering from diarrhea, may end up not showing any leukocytes in his stool sample. This is mostly indicative of diarrhea that is being caused due to a virus. Viral diarrhea is mostly caused due to Norovirus, and this is a type of infectious diarrhea. Besides viral diarrhea, the absence of leukocytes, along with all symptoms of diarrhea, may also be seen in patients that are suffering from diseases such as cholera and diarrhea due to parasites such as E. coli. However, if a person has no leukocytes, but still has lots of red blood cells in stool, that is, there is visible blood in stool, then it may be a case of amebiasis.
What do white blood cells in stool mean? Moderate presence of polymorphonuclear leukocytes in the stool of a person may signify a pathogenic infection of the digestive tract. Shigellosis, commonly known as bacillary dysentery, is a common cause of leukocytosis of the stool and is also one of the leading watery diarrhea causes. Shigella infection is usually caused due to fecal-oral contamination. Besides diarrhea, fever, vomiting, stomach cramps, and body ache are also common symptoms of shigellosis.
The presence of many leukocytes in the stool is mostly a sign of a severe intestinal tract infection. This condition is characterized by severe abdominal pain and the infamous typhoid fever. The predominant type of leukocytes seen in stools in typhoid fever is monocytes. Other conditions where there may be high levels of white blood cells in the stools include ulcerative colitis, invasive E. coli infection, at times untreated shigellosis, etc. However, in most cases, if the white blood cell count is between moderate to many, then a temporary diagnosis of shigellosis or salmonellosis is usually made. At times, even gastroenteritis caused due to Campylobacter jejuni can be a cause of the presence of numerous white blood cells in the stool.
The presence of white cells in stool does not lead to a change in the stool color, so, the person will need to investigate it in the pathology laboratory. At times, even a non-pathogenic related cause of bowel problems may be responsible for false positive fecal leukocytes. This includes inflammatory bowel disease, ischemic or radiation-induced colitis, diverticulitis, or ulcerative colitis. Inflammatory diarrhea with such a noninfectious cause can be positive for stool leukocytes. Thus, the mere presence or absence of leukocytes in feces should not be reason enough to reach a conclusive diagnosis of any disease. Hence, a final diagnosis of a condition can be made only after taking into consideration different signs, symptoms, and test results.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.