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Comment & Response
Less Is More
April 2019

Medication Effects on Fecal Occult Blood Testing—Reply

Author Affiliations
  • 1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
  • 2Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas
JAMA Intern Med. 2019;179(4):591-592. doi:10.1001/jamainternmed.2019.0129

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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