Phuket, the biggest island in Thailand, is an ideal getaway for anyone searching for a tropical island vacation. It has all the essentials to make your visit amazing: beautiful hotels, deserted beaches, an international airport, delicious cuisine, stunning scenery, a rich cultural scene, and lively nightlife.

Phuket also has fascinating local traditions and some fantastic food experiences. Phuket caters to visitors of all ages, backgrounds, financial means, and areas of interest.

Tourists may enjoy the benefits of the varied opportunities offered by the three distinct seasons. We’ll help you find the best time to visit Phuket to help you plan your trip and make the most of your time there.

Overall Best Time to Visit Phuket

Phuket often experiences temperatures between 23 to 31 degrees Fahrenheit. After the monsoons have ended, this is the coolest time of year in Phuket.

Almost the year has mild temperatures, with the warmest months being April – May and September – October. However, there is a noticeable variance in rainfall between each month. The southwestern monsoon causes September and October to be the wettest months.

There will still be plenty of time in the sun, even during the monsoon, since rain comes in brief, with scattered showers. Because of the favorable weather between November and February, this is when the greatest number of visitors come to Phuket.

This is the best time of year to enjoy water activities in the calm sea and unwind on one of Phuket’s stunning beaches. Afterward, go to one of the numerous nightclubs and dance till dawn.

The sights and sounds of the island’s sun-kissed beaches, lush jungles, and green mountains will transport you to a world unlike any other. The most admirable aspect about Phuket, especially during peak season, is that it’s suitable for every vacation.

Whether you’re a group of friends on a trip, a honeymooning couple, a solitary traveler searching for excitement and new experiences, or a family just trying to get away from it all, you will surely enjoy the place.

Least Busy Time to Visit Phuket

Start from April! After the peak season (November – Febuary), when most visitors have left Phuket, it is a great time to go. It’s constantly hot, even in the monsoon season, with an average temperature of roughly 30 degrees Celsius.

Rainfall is heavier but short-lived during these months, leaving plenty of time to take in the sights, relax by the hotel pool, and experience the dazzling sunsets that this time of year is known for.

If you end up with some rainy days, you won’t be bored since there are many enjoyable options. If you’re expecting European-style precipitation, you’ll be sorely disappointed.

When it finally does rain in Phuket, everyone is relieved since the showers provide a welcome reprieve from the scorching heat. Since the weather seldom fluctuates much, you can get by with only shorts and a t-shirt all year round.

This allows for greater purchases on vacations and less packing hassle at home. One drawback of swimming in the ocean during the off-season is the risk of rip currents. Please pay close attention to the warning signs at beaches and do not enter the water if they are there.

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Songkran Festival Phuket happens on April 13, 2023. The dates vary depending on Thailand’s regions, and the festival can last several days in the north.

Songkran festival on a normal year

If you choose to come to Phuket or Thailand in April in a ‘normal year’, you’d better know what this event is about. Songkran is the Thai New Year, which occurs when the sun moves from Pisces to Aries. According to the Thai calendar, we are already in the year 2565. The country gets many days off, and most Thai people will go back home to celebrate Songkran with their families.

Where is the Best Place?

You can join Songkran wet street parties from early morning if you are of the first kind. It starts rather gently in Phuket Town around 10 am, turns to water dogfights in the afternoon in Patong, Kata and Karon, and ends in a hectic, full-scale wet war zone in Bangla Road until late night.

Shops and supermarkets make fortunes selling all kinds of colourful and humongous water guns. But the best weapon remains the good old plastic bowl and a big tank of icy cold water! Everybody will join the Songkran festivities, kids, teens, adults and tourists, divided into two camps: the ‘Strategically Ambushed‘ by the roadside with plenty of water ammunition and the ‘Mobile Units‘ fully loaded at the back of pickup trucks.

Cops doing traffic and security on the road are always the favourite targets for everyone, but they are used to this and keep a smile all day or even play along.

Survival Tips for Songkran Day

• Don’t drive a bike if you can avoid it: it’s slippery, and the tendency to close your eyes when people throw water at you might lead to a crash with the car in front of you. And many drunk people will be out there partying, including you :D.
• Get a waterproof camera; the chance of ruining yours is pretty high!
• If you are unfortunate enough to go to Phuket airport on that day, go as early as possible, preferably in the morning. Beware of major traffic jams in towns, mostly in Patong Beach. It might take you several hours to cross it.
• Don’t carry anything that is not water-resistant.
• Don’t wear expensive clothing; I’m not sure how easy it would be to wash some teens’ colour powder thrown at you.
• Beware of the Sun! If you are on the back of a pickup truck, get a cap and water-resistant sunscreen, or you will pay a painful price the days after!
• Have fun! Don’t take it too seriously; it’s good fun (if you choose to go out there).

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While there are countless things to do in Phuket, Thailand, the following are some top-rated activities.

7. Visit the old Phuket town

You’ll find a vast range of restaurants, bars, and shops in Phuket Town. A food tour of The Old Town comes highly recommended! 

Here you can taste the best local delicacies and get the inside scoop on all the history. The town has a historic vibe with its narrow streets, alleyways, and century-old Sino-Portuguese townhouses. 

Some of the top places to visit in Phuket’s Old Town are Phuket Weekend Market, Phuket Thai Hua Museum, and Night Sunday Market.

6. Chill out on sandy beaches

Relaxing on one of the many beaches is undoubtedly one of the best things to do in Phuket. You can sunbathe and chill at several beaches, including Kata Beach, Banana Beach, and Bang Tao Beach. The beaches are a great way to spend an afternoon.

5. Hang out with friends at nightclubs in Phuket

If you’re looking for a fun, energetic night out with friends, then a nightclub is the best place to go in Phuket. 

All the bars and clubs in Phuket are tourist friendly and serve food and drinks. There are a plethora of popular nightclubs, such as Hollywood Phuket and Tiger Nightclub.

4. Appreciate the great architecture at the buddha statue

The Big Buddha is one of the best attractions in Phuket. If you catch a sightseeing boat, it will take you around the island and provide an excellent view of this massive statue. 

You can view the monument from anywhere on the island. However, it’s exceptionally breathtaking at night. The Buddha appears golden because of the lights reflecting off its surface, making it among the best things to do in Phuket at night.

3. Enjoy the Phuket Fantasea Show

Are you curious about Thailand’s customs and history? Visit the Phuket FantaSea theme park! This cultural theme park boasts a 45-minute light and musical extravaganza showcasing traditional Thai culture and folklore. 

The Fantasea Show is fun for all ages and another one of the great things to do in Phuket at night. You can enjoy an evening of water acrobatics, dancing, and explosions set to popular songs.

2. Watch the sunset at Promthep Cape

Are you looking for the best romantic spot in Phuket? Promthep Cape is one of them!

Located in Rawai, Mueang Phuket District, it’s an ideal location where you can get panoramic views of the entire island. 

Don’t forget to take sweet sunset selfies with your loved ones here and catch the golden sunset.

1. Explore Phuket’s history at the Trickeye museum

Are you looking for great things to do in Phuket with your family and friends of all ages?

Head to the Phuket Trickeye Museum and immerse yourself in optical illusions and an interactive 3D painting exhibition. It’s Phuket’s first interactive 3D museum focusing on how life was centuries ago on this beautiful island.

Keeping track of your Phuket itinerary

Whether you’re there for a quick getaway or an extended stay, Phuket is the jewel of southern Thailand and is definitely worth visiting. 

This region is attractive for reasons other than the sun, beach, and sea. You can also find some great cultural experiences in Phuket and all across Thailand.

With so many appealing things to do in Phuket, it’s easy to get caught up in browsing and researching. The trick is keeping track of all your ideas.

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In the mood for a beachy holiday at a luxury resort and self-care spa days? Don’t forget this beach vacation packing list! Or maybe you’re ready to party and explore the famous nightlife. 

There’s so much to choose from! And the good news is that many of these awesome things to do in Phuket don’t cost a great deal of money.  

Where is Phuket?

Phuket is Thailand’s largest province in the southern region. It’s an exotic paradise located​​ in the Andaman Sea, spanning an area of 543 km². It’s also home to the country’s largest island, Phuket Island.

What you should know about Phuket

If you’re looking to travel somewhere beautiful while still staying within your budget, Phuket should be at the top of your list! But why?

What’s Phuket best known for?

It’s hard to mention one specialty of Phuket because it’s well-known for many things. 

But in a nutshell, this is what you can expect:

• Unique beaches
• Exciting nightlife
• Eye-catching street markets
• Mouth-watering cuisine a
• Giant white marble Buddha
• Scuba diving

What are the dos and don’ts in Phuket?

Any place you travel to expects you to follow the local laws. Phuket is no exception. In Phuket, these are some common things to do and avoid:

• Show respect for the Thai National Anthem
• Respect Thai customs and culture
• Avoid touching the head of Thai people
• Avoid underdressing in public
• Remove your shoes when visiting temples or someone’s home
• Dress appropriately at mosques. 
• If you visit a mosque, men should wear a hat, and women should dress modestly and wear a head covering such as a scarf or a shawl. 
• What can you do in Phuket in 4 days?
• Hiking 
• Scuba diving 
• Mountain climbing
• Visit the beaches!

Tips for visiting Phuket

Phuket has earned the title “The Pearl of the Andaman” because of its stunning beaches. When visiting a beach paradise, you can expect the weather to be scorching hot. 

So it’s ideal to have sunscreen in your backpack at all times. 

The Thai Baht is Phuket’s national currency, and you’ll find countless money exchange stores nearby. 

Finally, if you plan on visiting attractions, remember that people in most places in Phuket don’t speak English fluently. Consider hiring a translator to help you communicate. 

Doctor Karon clinic locate at : 470/5 Patak Rd, Karon, Phuket 83100 or Google Directions
Contact us at : 076-396266 or 064-4022666 Or go to Contact Us Page

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There are many places to celebrate the New Year in Phuket – too many to individually list. Fortunately, they can be broken down into general areas, based on the types of parties they provide. There’s a certain amount of variety available, but they all offer a fun and friendly atmosphere, making for a memorable evening.

There’s no special significance about New Year in Thai culture. This is mostly because Thai and Buddhist New Year is Songkran, which comes around in April. However, the local people love any excuse to have a party, meaning that there are sure to be plenty of special events organised all over Phuket for the New Year. Being the heart of the island’s nightlife, most will be in and around Patong. Even so, that doesn’t necessarily mean anyone staying on other beaches needs to miss out, as you’ll see below.

1. Phuket’s beaches

Each December, the more popular beaches around Phuket become effectively giant parties. Hundreds gather on the sand to see in the new year. Patong Beach usually has organised music and entertainments, but most of the others don’t. However, with people bringing their own fireworks, floating lanterns, drinks and more, it creates a very festive atmosphere and a fun place to be. 

Patong Beach is definitely the most popular choice, but you’ll also find celebrations on Karon, Kata, Kamala and Bangtao beaches, among others

2. Phuket beach clubs

For those who want the beach party atmosphere with a little more coordination, a beach club is a great place to celebrate New Years in Phuket. The beach clubs around Phuket are already great places to party, so they naturally make excellent places to be on 31st December, with first-class DJ sets, fine food and fancy cocktails. Among the best are Catch Beach Club, Café Del Mar Phuket and Paradise Beach Club.

3. Bangla Road

Phuket’s party central comes to life for New Year celebrations in a way you won’t see at any other time, except possibly for Songkran. While Patong’s popular nightlife street is busy most evenings, it’s absolutely packed on the last one of the year. Every bar is busy and the atmosphere is one of rowdy exuberance. Expect loud music, drinks flowing and big crowds. Spots like Red Hot and Aussie Bar are likely to be among the more popular choices.

4. Nightclubs in Phuket

Arguably the highlight of Bangla Road – and worthy of a separate mention – are the nightclubs. The main ones each have special events for New Year, featuring great guest DJs and drinks offers. They’ll often have some kind of theme for the night, so check out their Facebook pages to properly prepare yourself. The best places to party are likely to be Illuzion and White Room.

5. Paradise Plaza

The heart of the gay nightlife in Patong, Paradise Plaza is a lively place on any evening of the year. Just like Bangla Road, it’s especially fun on 31 December. It’s a fun place to party, whatever your orientation (so long as you’re open-minded and have a robust sense of humour), and a great place to celebrate the New Year in Phuket. Among the most popular venues are Boat Bar and Zag Club.

6. Hotels in Phuket

Many hotels around Phuket will have special gala dinners and parties for the New Year celebrations. In some cases, this requires a mandatory additional cost, which can come as an unpleasant shock. Be sure to check what your hotel is planning in advance. In some cases, the cost is entirely justified by an exceptional meal, fireworks, music and dancing. This is certainly the most family-friendly way to celebrate the event.

Doctor Karon clinic locate at : 470/5 Patak Rd, Karon, Phuket 83100 or Google Directions
Contact us at : 076-396266 or 064-4022666 Or go to Contact Us Page

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Weather in Phuket in October

October is approaching the end of the rainy season in Phuket. This means that while there are several showers a  month, there are many dry days and it is a great opportunity to explore. It is moderately hot during the day, with temperatures between 30 and 34 degrees Celsius.

1. As mentioned earlier, rainfall is still wide, with average rainfall reaching 280 mm, much less than the monsoon peak in September. It rains an average of  23 days a month.
2. This means that there are seven days of full rain in October and a few moderately hot days with moderately heavy showers throughout the day.
3. Thanks to this combination of precipitation and high temperatures, October is one of the wettest months in Phuket, with an average humidity of about 82%. Fortunately, the average temperature of the ocean is around 29 degrees Celsius, making it ideal for escaping from hot, humid days.

Also Read: Phuket in September – Weather, Places to visit and Things to do

Places to visit in Phuket in October

1. Thalang district 

Known for its vast beaches and brightly painted temples, the Thalang district is a great place to explore when it’s raining in Phuket. Visit the famous Wat Sri Sandton Temple or Peranakans Phuket Museum to find out why the Thalang district is special. If temples and museums don’t fascinate you, it’s one of the night markets in the district! If you’re lucky enough to stumble on a sunny day during your visit, consider biking through the countryside of Phuket and exploring the landscapes that are often left behind on Instagram posts.

2. Sirinat National Park 

Sirinat National Park is located in the Thalang district at the northern end of Phuket Island. From exotic birds like kingfishers to one of the most diverse collections of turtles, from nesting turtles, leatherback turtles and hawksbill turtles, Sirinat National Park is an absolute pleasure for nature lovers. 

3. Patong Beach

Your trip to Phuket will not be completed without a visit to Patong Beach Resort. Known for its vast sandy beaches, thriving beach bars and ultra-luxury resort complex, Patong is a paradise on earth. On bright sunny days, you can enjoy a variety of water sports and buy beach vendor handicrafts. On less sunny days, you can shop until you stop at Patong Shopping Complex or Jungceylon Mall. If none of them is attractive, head to Bangla Road where there are neon lights dotted with nightclubs, massage parlours, go-go bars and beer bars.

4. Muang

The Muang district of Phuket, home to some of the world’s largest water parks, seems to have been born out of a child’s dream. This means that the rides in these water parks are not children’s play. The infamous Splash Jungle Water Park is probably the most famous in the area. But another big candidate, Rawai Kids Park, boasts to be the largest children’s water park in the world.

Things to carry to Phuket in October

The weather in October alternates between very rainy days,  heavy rains, and hours of sunshine every day, so packing for a visit during this time can be difficult. Don’t worry. Here’s a list of essentials you should keep in your bag when visiting Phuket in October

Essentials

1. Umbrella – It is also advisable to wear a raincoat, but this can be difficult on humid days. On such days, the umbrella is your best friend and protects you from both the rain and the bright sun. 

2. Sunscreen – preferably packed with SPF 24 or above. Even in October, it gets quite warm during the day and the sun under the scorching sun mandates skin protection. 

3. Also, if you are planning a lot of outdoor activities, it is advisable to always carry mosquito and insect repellent with you. Like most other tropical destinations, Thailand is home to some insects and bugs, and it is a wise idea to wear protective equipment. 

Clothing and accessories 

1. Wear comfortable shoes that can be worn for long periods. At the same time, don’t forget to pack hiking shoes for these jungle hikes to the hidden waterfalls. 

2. Sunscreen devices such as long-sleeved clothing, sunglasses, hats and hats. 

3. Swimsuit! Your visit to Phuket will not be completed without spending time on the beach, and you will need some nice looking swimsuits for the Instagram photos!

Festivals in Phuket in October

Awk Phansa

The three-month Buddhist celebration is almost over this day. Monks are allowed to leave the temple, and people gather for a month-long ritual called Thot Kathin to bring them food and offerings. Various events and celebrations are held all over Thailand. Traditionally made of banana trees and bamboo, boats are adorned with flowers and lamps and filled with offerings such as glutinous rice confectionery wrapped in banana leaves. 

Chulalongkorn Day

Every October 23, Thai people celebrate the life and reign of King Chulalongkorn on the anniversary of King Chulalongkorn’s death in 2010. Most restaurants, shops and other businesses are open, but government offices are closed on this holiday. Throughout Thailand, many Thais show respect for the great monarch by placing garlands and flowers on their equestrian statues in their hometown. In Phuket, local governments often celebrate the day with an orchestra playing the Thai National Anthem outside the State Capitol, with a wreath on the monument to King Chulalongkorn.

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How effective are the RT-PCR tests when screening for COVID-19?

Most importantly, the only recognized Covid19 testing method by the World Health Organization and the US Centers for Disease Control and Prevention is testing through Real-Time PCR (RT-PCR test). This test is the most effective test to detect the SARS-CoV-2 virus. The ability of PCR to produce millions of copies of a target sequence from a trace amount of DNA allows for a very small sample of DNA to be amplified to a large enough amount to study in detail. Hence, PCR is an extremely powerful diagnostic tool.

A RT-PCR is the test of choice in these situations because it is more accurate at diagnosing an infection.
Consider a rapid antigen test if you:
1. Are planning to visit a sensitive site (for example, an aged care facility)
2. Are planning to have contact with someone at high risk from COVID (for example, an elderly person or someone on immunosuppressive treatment), and you want to protect them.
3. Have COVID symptoms but can’t get to a PCR testing site.

How often should I take a rapid antigen test?
It depends on the reason you are taking the test. If you’re part of a surveillance program, take the test when you are asked to.

Ordinarily, a RT-PCR test indicates whether or not you have a SARS-COV-2 infection but not which variant you have. Genome sequencing is needed to find that out.

However, some PCR tests look for a specific genetic sequence that is missing in the Omicron variant (called S gene target failure). Those particular RT-PCR tests can not only detect a positive result but also whether it’s likely to be the Omicron variant.

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For a stool analysis, a stool sample is collected in a clean container and then sent to the laboratory. Laboratory analysis includes microscopic examination, chemical tests, and microbiologic tests. The stool will be checked for color, consistency, amount, shape, odor, and the presence of mucus. The stool may be examined for hidden (occult) blood, fat, meat fibers, bile, white blood cells, and sugars called reducing substances. The pH of the stool also may be measured. A stool culture is done to find out if bacteria may be causing an infection.

Stool Examination – Part 1 – Stool Analysis , Stool for ova and parasite, Complete Stool studies

1. Sample

• A random stool sample can be taken.
  • More than 2 grams of the stool is needed
• To rule out worm infestation three consecutive stools are tested.
  • Collect three stools in the span of 10 days.
  • Two samples on alternate days.
  • One sample after purgation.
• Collect the sample in clean, dry urine free container.
• In the case of Infants, collect from the diaper.

Precautions

1. Advise patients for the following things for at least 48 hours before the collection of the stool:
   1. Avoid mineral oils.
   2. Do not take bismuth.
   3. Antibiotics like tetracyclines.
   4. Anti-diarrheal drugs which are non-absorbent.
   5. Avoid anti-malarial drugs.
   6. The patient should not have a barium swallow examination before the stool examination.
   7. For occult blood stop iron-containing drugs, meat and fish at least 48 hours before the collection.
2. Warm stools are better for the ova and parasites.
3. Don’t refrigerate the stool for ova and parasites.
4. Stool for ova and parasites can be collected in formalin and polyvinyl alcohol. These are used as a fixative.
5. If there is blood or mucus, that should be included in the stool. Because most of the pathogens are found in this substance.
6. Exam the stool before giving antibiotic or other drugs.
7. Semi-formed stool should be examined within 60 minutes of collection.
   1. Liquid stool should be examined within the first 30 minutes.
   2. Solid stool should be examined within the first hour of collection.
8. Trophozoites degenerate in liquid stool rapidly, so exam the stool within 30 minutes.
9. In the case of constipated cases, use non-residual purgative on the night before the collection of the stool.

Stool preservatives are:

1. Preservatives for the wet preparation are:
   1. 10% formol-saline for the wet preparation. This is best preservatives as it kills the bacteria and preserves the protozoa and helminths.
   2. Sodium acetate formalin.
   3. Methionate iodine formalin. This is a good preservative for the field collection of the stool.
2. For staining use Polyvinyl alcohol.
3. Avoid preservatives for the culture of stool.
   1. Usually three parts of the preservatives and one part of the stool.

Indication

1. To evaluate the function and integrity of the GI tract.
2. To rule out the presence of WBCs and RBCs.
3. To find ova or parasites.
4. To see the presence of fat for malabsorption syndrome.
5. For screening of colon cancer.
6. For asymptomatic ulceration of GI tract.
7. Evaluate diseases in the presence of diarrhea and constipation.
8. Summary of stool studies are done to evaluate:
   1. Intestinal bleeding.
   2. Infestation.
   3. Inflammatory diseases.
   4. Malabsorption.
   5. Different causes of diarrhea.

Pathophysiology

1. The stool is examined:
   1. Grossly.
   2. microscopically.
   3. Chemically.
2. Gross Stool examination includes:
   1. Color.
   2. Consistency.
   3. Quantity.
   4. Odor.
   5. Mucous.
   6. Helminths.
   7. Concretions (gallbladder stone rarely may be found).
3. Microscopic examination includes:
   1. Presence of leukocytes (pus cells).
   2. Presence of Red Blood Cells.
   3. Ova and parasites.
   4. Presence of meat fibers and muscle fibers.
   5. Presence of fat.
   6. Yeast and molds.
   7. Bacteria.

1. The chemical examination includes:
   1. Stool pH.
   2. Reducing substances.
   3. For occult blood.
   4. Presence of fat, carbohydrate, and proteins.

Normal components of the stool:

1. Undigested food particles like:
   1. Vegetable cells.
   2. Vegetable fibers.
   3. Muscle fibers.
   4. Starch granules.
   5. Fishbones.
2. Water.
3. Bacteria.
4. Desquamated epithelial cells.
5. Digestive tracts products like:
   1. Enzymes.
   2. Mucus.
   3. Bile pigments products.
6. Digested but not absorbed food.
7. Products produced by the decomposition of the stool are:
   1. Skatole.
   2. Indole.
   3. Various gases like H₂S, CO₂, and nitrogen.

The consistency of the Stool may be:

1. Normal is soft and formed.
2. Loosely formed stools.
3. watery stools.
4. Thin stools.
5. Pellet-like stools.
6. Dry or hard stools found in constipated patients.
7. Puttylike stools.
8. small round hard stool is due to habitual constipation.
9. Pasty stools are due to high-fat contents and seen in:
   1. common bile duct obstruction.
   2. Celiac disease. stool looks like aluminum paint.
   3. Cystic fibrosis due to pancreatic involvement and are greasy.
10. Diarrheal stools are watery.
11. Steatorrhea stool is:
    1. Large in amount.
    2. Frothy.
    3. Foul smelling.
12. Constipated stools are firm and may see spherical masses.
13. Ribbon-like stool suggests the spastic bowel, rectal narrowing, stricture, or partial obstruction.
14. The very hard stool is due to excessive absorption of water due to prolonged contact with colonic mucosa.

Color

1. Normal color is due to the presence of stercobilinogen.
2. Yellow or yellow-green color is seen in diarrhea.
3. Black and tarry (related with consistency) stools are due to bleeding of upper GI tract from tumors.
4. Maroon or pink color is from lower GI tract due to tumors, hemorrhoids, fissure, or inflammatory process.
5. Clay-colored stools are due to biliary tract obstruction.
6. Mucous in the stool indicate constipation, colitis or malignancy.
7. Pale color with greasy appearance is due to pancreatic deficiency leading to malabsorption.

Quantity

1. Normally there is 100 to 200 G/day.
   1. With vegetable diet may be 250 g/day.
2. Many disorders cause large, bulky stools even in people who don’t eat a lot.
   1. Like malabsorption syndrome, and carbohydrate indigestion.
3. The size of your stools has more to do with how well you digest your foods than how much you eat.
4. Some types of foods produce larger stools because they don’t break down completely.
5. Some gastrointestinal disorders also cause poor food breakdown and absorption, which leads to large, bulky stools.

Odor

1. The foul odor is caused by the undigested protein and by excessive intake of carbohydrate.
   1. Stool odor is caused by indole and skatole which are formed by the bacterial fermentation and putrefaction.
2. A bad odor which is sickly produced by undigested lactose and fatty acids.
3. The odor is increased due to excess intake of proteins.
4. The putrid odor is due to severe diarrhea of malignancy or gangrenous dysentery.

Mucous

1. Mucous is produced by the mucosa of the colon in response to parasympathetic stimulation
2. Pure mucous is translucent gelatinous material clinging to the surface of the stool. This may be seen in:
   1. Severe constipation.
   2. Mucous colitis.
   3. Excessive straining of the stool.
   4. emotionally unstable patient.
3. Mucous in diarrhea with microscopically present with RBCs and WBCs is seen in:
   1. Bacillary dysentery.
   2. Ulcerative colitis.
   3. Intestinal tuberculosis.
   4. amoebiasis.
   5. Enteritis.
   6. Acute diverticulitis.
   7. ulcerating malignancy of the colon.
4. Mucus with blood which is clinging to stool is seen in:
   1. Malignancies of the colon.
   2. Inflammatory lesion of rectal canal.
5. An excessive amount of mucus seen in:
   1. Villous adenoma of the colon.
   2. This depends upon the dietary intake.

PH

1. Normally stool is slightly acidic or alkaline or neutral.
   1. pH is 7.0 to 7.5 depending on the diet.
   2. Newborn pH = 5.0 to 7.5.
2. pH of the stool depends upon the diet and bacterial fermentation in the small intestine.
3. Carbohydrate changes the pH to acidic while the protein breakdown changes to alkaline.
   1. Breastfed infants pH has a slightly acidic stool.
   2. Bottle fed infants have a slightly alkaline stool.
4. pH stool test helps to evaluate carbohydrate and fat malabsorption.
5. pH stool also helps to know disaccharidase deficiency.
6. Alkaline (Increased pH) stool is seen in:
   1. Colitis.
   2. Villous adenoma.
   3. Diarrhea.
   4. Antibiotic therapy.
   5. Excess intake of proteins.
7. Acidic (Decreased pH) stool seen in:
   1. Fat malabsorption.
   2. Disaccharidase deficiency.
   3. Carbohydrate malabsorption.
   4. Excess intake of carbohydrates.
8. Precautions for pH estimation:
   1. Barium intake and laxatives change the pH.
   2. If the specimen is contaminated with the urine, will need to discard the sample.

Reducing Substances

• Please see details of Reducing substances in the stool on the following link.
  • http://www.labpedia.net/test/128

Microscopic Examination

• This is the preliminary examination to find the cause of diarrhea.

1. Presence of Leukocytes Normally there are no WBCs.
   1. WBCs only appear in infection or inflammation.
   2. Their presence is important in case of diarrhea or dysentery.
   3. >3 WBCs /high field are seen in ulcerative colitis and bacterial infection.
   4. Greater numbers of WBCs indicate invasive pathogens.
2. Virus and parasites don’t cause WBCs in the stool.
3. Increased number of WBCs in the stool.
   1. Bacillary dysentery.
   2. chronic ulcerative colitis.
   3. Shigellosis.
   4. salmonella infection.
   5. Yersinia infection.
   6. Invasive E.coli diarrhea.
   7. Fistula of anus or rectum.
   8. Localized abscess.
4. Few WBCs are seen in amoebiasis.
   1. Also, WBCs are seen in typhoid.
5. The absence of WBCs seen in some of the diarrhoeal conditions alike:
   1. Cholera.
   2. Viral diarrhea.
   3. Drug-induced diarrhea.
   4. Amoebic colitis.
   5. Non-invasive E.coli diarrhoea.
   6. Parasitic infestation.
   7. Toxigenic bacterial infection.
6. Presence of Red Blood Cells in the stool.Blood in the stool can be:
   1. Bright red from the bleeding in the lower GI tract.
   2. Maroon in color.
   3. Black and tarry from bleeding from the upper GI tract.
   4. Occult blood (not visible to the naked eye).
   5. Causes of blood in stool:
      1. Hemorrhoids.
      2. Cancer.
      3. Dysentery.
7.  Make smear from the mucus area or from the watery stool.
   1. Please see more details in the occult blood.

1. Ova and parasites. Normally there are no parasites or eggs in the stool sample.
   1. Multiple stool sample is needed to rule out the parasitic infestation, at least three consecutive days.
   2. An abnormal result means parasites or eggs are present in the stool. Such infections include:
   3. Roundworms: Ascaris lumbricoides.
   4. Hookworms: Necator americanus.
   5. Pinworms: Enterobius vermicularis.
   6. Whipworm: Trichuris trichiura.
   7. Tapeworms: Diphyllobothrium latum, Taenia saginata, and Taenia solium
   8. Protozoa: Entamoeba histolytica (an amoeba), and Giardia lamblia (a flagellate)
   9. Strongyloidiasis.
2. Presence of Fat. The fat in the stool shows the possibility of :
   1. Malabsorption.
   2. Deficiency of pancreatic digestive enzyme.
   3. Deficiency of Bile.
3. Meat fibers. and muscle fibers are seen in the stool. Their presence show defect in the digestion.
   1. The increased amount of meat fibers are found in:
      1. Malabsorption syndrome.

A pancreatic functional defect like cystic fibrosis

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