In Reply We thank Dr Wu for his comments on our article1 and agree with him that multiple food items and medications can affect the interpretation of fecal occult blood testing (FOBT), thus making the test even more useless than we had alluded to in the article. It is very difficult to control for medications and diet in the hospital, a home diet history often is not obtained, and over-the-counter medications are frequently missed in a reconciliation. For this reason, we favor completely unadopting the test in the inpatient setting. This can help provide appropriate patient care and reduce direct and downstream costs that result from inappropriate medical care. This has been done at our academic center.2
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Bangaru S, Agrawal D. Medication Effects on Fecal Occult Blood Testing—Reply. JAMA Intern Med. 2019;179(4):591–592. doi:10.1001/jamainternmed.2019.0129
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