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Bowel Screening

Doing the Faecal Occult Blood test at home

Almost all the people we talked to had done at least one set of Faecal Occult Blood tests (FOBt). Most thought the instructions with the test kit were excellent (see The instructions for using the FOBt kit) and that any effort, or embarrassment, involved in doing the test was well worth it.

People described how they managed to collect samples of their motion to smear onto the test card windows (small rectangles). Most people found it quite easy to do the test - it involved smearing only a very small amount of the stool on the card.

 

Doing the Faecal Occult Blood test was as easy as ABC.

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Age at interview: 65
Sex: Male
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Please could you explain for other people who might be wondering what they have to do when they do the test, could you explain exactly what you have to do?

You mean the test for'?

When the test kit came in the post to do at home.

Oh you just go to the toilet, you know, and the instruction was on the, you know in the kit you see and after, it was just easy you know the instructions it was just easy like A, B, C.

Is it?

Yeah it's just easy, you know.

Did you have to put a little bit of your bowel motion onto the card?

Yes onto, you know and seal it, easy.

It was quite easy?

Yeah, yeah.

And was it quite clear how much of the bowel motion you had to put on the card?

Yes it did, it explained, you know it explained on the, you know on the kit you know.

On the information?

Yes information.

And then what did you have to do with it after that?

You seal it you know and the, the thing that was, you put it into a disposal?

Into an envelope?

Yeah, you know, and then you wash your hands, that's right.

 
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She got some rubber gloves from the chemist before doing the test.

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Age at interview: 63
Sex: Female
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Well first of all go and get some rubber gloves from the chemist. I suppose everybody has their own way of dealing with it but I just really did what the information told you to do. I just got some toilet paper and caught some and took the spatula and took a sample. And I can't remember, I think you put it on a little thing, I can't remember, and then seal.

The little card?

A little card and then you seal it don't you, gosh I can't remember it. And that was it. And it really and truthfully was as quick as saying ABC.

Many people used several thicknesses of toilet paper to catch their motions before they hit the water in the toilet pan. A few people used rubber or disposable gloves when collecting the stool samples. Others said that taking the sample was not so different from wiping their children's bottoms.

 

He held some toilet paper underneath his bottom in order to catch his motion.

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Age at interview: 67
Sex: Male
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It depends on the individual but the thing is if your motions hit the water they can deteriorate, so the way that you have to do it is to make sure that you prevent your motions from going into the pan. You can do that however you like. In my instance I simply held the paper underneath my bottom and caught it on the paper. And then it, if I remember correctly, it asks you to take samples from different parts of the motions which is exactly as I said. You just take a small sample on a little wooden spatula which is provided and smear it onto a little round disc which you then fold the flap over and cover over. On the next time you pass motions again you do the same again and you repeat that three times. Then the whole thing is folded into the envelope and posted off. It's a simple, easy enough to do but, you know, some people might find that a bit disconcerting but I didn't find any problems at all.

 

He used masking tape to fix toilet paper across the rear half of the pan to catch his motion.

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Age at interview: 61
Sex: Male
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It took me about three weeks actually, I think it was, to actually get round to doing it. The screening kit arrived on 5th September and they sent me on 30th a reminder, and it took me until 4th October to get round to doing it so it was just on a month. Here of course one comes back to this reluctance and also the problems, the physical problems of how to collect the sample, which mustn't fall into the toilet. How does one actually do this? Now we had household jokes about Marigold gloves and one's wife catching the required sample, which is of course not pleasant and totally unrequired, but I solved the problem in the end by making up two almost like thick bandages of toilet tissue, and suspending them in a cross shape over the rear half of the toilet pan, having taped them with masking tape to the pan so they wouldn't drop in, so that when one went to the toilet the stool was caught at the back and one could pass water at the front without affecting the stool at the back. I was told afterwards that some people use Cling-film to catch the sample but it's not pleasant, to have to delve into one's dung to take a sample. The other thing that I did find; could have been better informed in the information pack, is how much of a sample does one have to actually put on the screen? There are two little sockets in each of the three windows, but how thick a smear does one have to give? I found that a slight problem because it's quite unpleasant to have to handle.

 
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She caught her motion with toilet paper and then with the cardboard stick spread samples onto the...

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Age at interview: 67
Sex: Female
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Well I put the card, is that what you call that [laughs], on the floor in front of me, with the first flap open, so that it revealed the two little circles. And then I managed to catch part of the motion on a piece of toilet paper and then used the stick to take a little sample of this and spread it thinly onto the first circle. And then I used a piece of toilet paper to hold that end where the motion had been on the stick and used the other end then to just pick up another small piece on the stick from a different part of that motion and then smeared that onto the second circle and then closed the flap. And then you have to write the date on of what, of when you did that first test. And I actually did them over three days so that, I didn't know whether that was what you had to do or just three different motions but at least I was at home, it was first thing in the morning and then, because if you're out you can't really take the kit [laughs]. So I found it easier to do it over the three days.

And then you post it on?

And then you post it on, put it back it back in the envelope and seal it, pop it into the post box.

One man found it easier to put newspaper on the floor in the bathroom, and strips of toilet paper on top of that, so that he could collect his bowel motion in that way.

 

He put newspaper on the floor and toilet paper on top of that so that he could collect a sample...

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Age at interview: 65
Sex: Male
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I think on the information leaflet they give you various ways that you might collect the sample.

Yes.

How did you, what did you find was the easiest?

Well, they talked about using a receptacle which you could throw away thereafter, or using a, a plastic glove and catching the sample, which I found almost amusing really, I just couldn't get to terms with that. So personally I found that just by putting the newspaper on the floor in the bathroom, putting strips of toilet paper on the floor, depositing the sample on the toilet paper, means that when I'd taken the sample and spread it onto the, onto the card, I could then pick up the toilet paper with the with the stools if you like, put in the toilet and flush it.

The only thing I would say, I mean this is, I don't know if this is worth mentioning, the actual things that you use to take the sample, which are like cardboard lollypop sticks is the best way to describe them, it would be nice if it was possible for those to be flushable. They do ask and you find that one, you've got to wipe the stick, so then you can fold them up, wrap them up, and put them in a bin etc etc. But it would be nice if it was possible at some stage to be able to put everything that you've used, everything, in the toilet and flush it away. That's my only comment.

(Note' The sticks used to be made of wood. They are now made of cardboard and can be flushed down the toilet)

Some people found it easier to use kitchen paper towels instead of toilet paper because it was stronger and 'more resilient'. Others used a container, such as a margarine pot, or a fruit basket from the supermarket, to catch their motions.

 

Because “kitchen roll” was stronger than toilet paper she used that to catch her motion.

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Age at interview: 66
Sex: Female
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It's very easy, but it is a little bit, I suppose you think, 'God this is unpleasant', because I mean, let's face it when you go to the toilet, it goes down the toilet and that's where you leave it.

And you don't deal with it at all do you? So I sort of read it and I thought, 'Oh flipping heck, I don't know whether I fancy doing, I don't think I fancy doing this.' So I went and got a piece of kitchen roll, so I thought, 'At least I can put it on there', you know, and I did it that way. And I thought, 'Oh, well it's not really very pleasant this'.

Because its not, in a way.

So you found kitchen roll was easiest?

I found, yes because its, its bigger, and I thought, 'Well that can go there, and then you can place it on that, and then put it onto your'' because you needed to put it down somewhere, because, you know the weight of the faeces, if you just used toilet paper, it would've split, and gone on your floor, on your working surface or on, in the bathroom obviously. So I thought; I felt that the kitchen roll was the best.

Yes, they do suggest different ways don't they?

Mm.

And other people have used kitchen roll as well.

Mm. For me, I found that was the best. And when my husband was doing his, I said to him, 'Make sure you get the kitchen roll'.

 

She used a margarine container to catch her motion.

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Age at interview: 72
Sex: Female
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I think on the information sheet they suggest different ways that you might manage to get a sample, either from the lavatory paper or from possibly a container inside the lavatory.

That's right yes.

Can you remember what you did?

Yes I did a container definitely yes, yes. I don't know whether I wore thin, thin gloves or not, possibly I did, but as long as one keeps the, the things and not touching other things that would mask any testing I think that's what I did.

Can you remember what sort of container you found useful?

Probably a small marg, well a margarine container possibly yes, a plastic container yes and then disposed of it afterwards, yes.

So the whole thing you found fairly straight forward?

Yes, yes.

One man used a supermarket bag and put that inside the toilet to catch his motion. He found it physically uncomfortable having to lean over the toilet to deal with his bowel motions. He said the smell made him feel sick.

 

A supermarket bag came in useful when he needed to catch some of his motion.

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Age at interview: 68
Sex: Male
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What did you make of the information, the little leaflet that came with the test kit telling you how to do it?

Oh it was all very clear.

Was it?

It was all very clear, but by, I found it uncomfortable having to lean over the toilet in my own excretia and fiddling around with it.

But again not painful but, and not embarrassing since it was a solo activity.

By uncomfortable do you mean physically uncomfortable or psychologically uncomfortable?

Well physically, I mean my mind goes back to changing the nappy of the children and the nausea of leaning over and smelling the excretia yes.

How did, I think they suggest various ways that you might do that.

They did yes, I mean I personally I got a supermarket bag and put that inside the toilet.

And then performed on top of it, so that was a barrier between me and the toilet water and then having taken the sample I could simply shake the bag into the toilet and with another bag put that bag into and dispose of it.

Most people we talked to found the test relatively easy, but a few found it more difficult. One man mistakenly collected all the six stool samples from one motion at the same time. A woman said that the first time she tried to do the test was a “complete disaster” because she wasn't sure how much of the motion she was supposed to smear onto the card and because the motion fell into the pan.

 

The first time she tried to do the Faecal Occult Blood test it was a “disaster”, but next time...

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Age at interview: 70
Sex: Female
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So I was a little bit apprehensive about the whole thing, didn't quite like the idea of it, but then I thought about the friends that I'd had that had had bowel cancer and it hadn't been diagnosed till much too late and I thought, 'No, this is a good idea, I should do it.' So with much trepidation, I may add, I tried for the first test and must admit that the first day that I tried it was a complete disaster because I didn't know the amount of faeces that they wanted and being as it was just such a small amount on the test paper. But the second day I had another go and it was quite successful. I had the rubber gloves to hand and just thought, 'This is, this is a good cause, I should be doing this,' even though I was sort of a bit turning my nose up a little bit. But eventually I managed to get the three and sent them away and was absolutely delighted when I did get the results through the post.

When you set out to do the testing did you make a plan beforehand or did you just sort of go into it without thinking too much about it?

Well I made what I thought was a plan, although it misfired on the first day because I didn't have my little table at the side, well actually it was a stool, I didn't have that at the side of me, and I didn't have everything to hand. And as I turned round to take the stuff off the cistern it just fell back in the pan and I had to start from scratch again. But after that I had it well planned, thought about it before I did it.

Several people worried that those with disabilities would find the test a bit difficult. One woman with rheumatoid arthritis found it a bit painful to collect the samples, but she managed it.

 

The painful joints in her fingers and thumbs made it hard to hold the cardboard sticks to...

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Age at interview: 70
Sex: Female
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Can you please tell me, given that you've got problems with rheumatoid arthritis, how this made it a little bit difficult for you, but you managed it?

The joints in my fingers and thumbs are very painful and to hold the spatula and to retrieve the sample and to use the toilet paper was painful but it can be done and I managed. The thumb and the finger to hold the spatula was the most painful I think, but I coped and you just, it's just momentarily, it goes off again, I have these pains any time, anywhere so' 

What did you have to do exactly with the spatula? Can you explain for people who are not sure what they have to do?

Well you have to retrieve a sample from the toilet paper that you have cleaned yourself with and put it into the, the sample pack that was sent. I did that three days in succession and in the morning, it can be done any time but I found it, that was when I moved my bowels and I did it then and while I thought about it.

So each day, each morning you took a sample, using the spatula, and put it in the test kit?

That's right.

A man who is very sensitive about dealing with bodily functions was not sure that he could face doing the test. His wife - who is a nurse and has a 'better stomach' than he has - helped him with the sample. Another man and his wife did their tests at the same time - she 'only had to perform and leave the room' and he would then sort it out for her.

 
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His wife helped him with the test because he couldn't face dealing with his motion. Handling his...

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Age at interview: 66
Sex: Male
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Husband' Well the point is when I had the kit and read it, what I had to do, I could hardly face the situation of doing it myself.

Okay.

Husband' That part of, that department I really don't like too much.

Husband' So without help off the assistant nurse [his wife] with me to guide me through I think I would have made a mess of the kit myself probably.

So what did your wife explain, what did she tell you that you had to do that you might not have done otherwise?

Husband' She talked me through it and says, 'Try and have a go at it,' which I still didn't have a go at it, she did because I was still tickled stomach over it.

Husband' Doing it.

Tickle stomached, that's the word you use.

Husband' Yes I think lots of them will grasp onto that.

Does that mean it turns your stomach thinking about it?

Husband' It does yes.

I see. So how did you manage it then, if she helped you did you put some bowel movement into a pot or did you catch it on paper or what did you do?

Husband' I caught it in paper with my eyes closed [laughs].

You caught it on some paper with your eyes closed?

Husband' And opened them, I didn't make a mess or anything like that.

And then, and then what happened? 

Husband' She proceeded from there.

Oh right.

Husband' Yeah and I disappeared [laughs].

So you passed it over to your wife?

Husband' Yes.

And she managed to put it onto the little widow in the test kit?

Husband' That's right, that's right, that's right.

Oh that's useful to know because I mean you know if you found it difficult other people might find it difficult.

Wife' Mm.

Husband' I definitely found it difficult with me.

Do you think that might've put some people off doing it?

Husband' Possible, that's quite a possibility there.

So it was useful having a nurse in the family.

Husband' Or somebody who's got a better stomach than mine, who could face up to the job.

And did your wife find the instructions quite clear?

Husband' Very much so, very much.

Did you have to make any plans before you went in the

Another man worried because he was constipated but he managed to do the three motions in the 14 days allowed.

 

He was worried because at times he was constipated. Having the Freephone help number reassured him.

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Age at interview: 65
Sex: Male
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Another thing please, the test kit says that you've got 14 days to complete the three samples.

Yes.

What did you think about that?

Well I was a bit worried at first because I thought I couldn't get three samples in fourteen days and I thought, 'Well about if you're a bit slow going to the toilet', you know, 'fourteen days'. So I was a bit worried but I needn't have worried in the end. I mean you do do three samples in fourteen days, they must have thought it out very well when they put fourteen days I think so yeah. But it is a bit worrying, you see fourteen and you think, 'Oh am I going to go to the toilet three times in fourteen days,' so.

Did that make you wonder whether or not to try?

Well I didn't bother about that; I thought well if it takes longer than fourteen days I shall have to get in touch with them and do something about it.

Because I thought, 'Well I've got a phone number I can always phone and explain to them'. That's why I think as long as, there's always a get out, if they give you a phone number you can always phone and you know get in contact.

Good idea.

Talk to someone who knows something about it [laughs].

  

Some people were concerned about putting the samples in the post - one man wondered if there was some kind of law against it and others were worried about it being opened by mistake, or possible hygiene issues. Others commented on the secure foil and plastic wrappings for the kit, which they believed were quite sterile and secure.

It is important to note that no one is excluded from the FOB test because of disability. If people have any difficulties, perhaps due to poor dexterity or poor eyesight, they can contact the help line by calling Freephone 0800 707 6060. Someone will give advice and if necessary help with the FOB test at home. 


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Last reviewed May 2016.

Last updated October 2010.

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