Stool guaiac test

The stool guaiac test or guaiac fecal occult blood test (gFOBT) is one of several methods that detects the presence of fecal occult blood (blood invisible in the feces). The test involves placing a fecal sample on guaiac paper (containing a phenolic compound, alpha-guaiaconic acid, extracted from the wood resin of Guaiacum trees) and applying hydrogen peroxide which, in the presence of blood, yields a blue reaction product within seconds.

Stool guaiac test
Guaiac cards and bottle of developer that contains hydrogen peroxide
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HCPCS-L2G0394

The American College of Gastroenterology has recommended the abandoning of gFOBT testing as a colorectal cancer screening tool, in favor of the fecal immunochemical test (FIT). Though the FIT is preferred, even the guaiac FOB testing of average risk populations may have been sufficient to reduce the mortality associated with colon cancer by about 25%. With this lower efficacy, it was not always cost effective to screen a large population with gFOBT.

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