Oral intake of poppy seed: a reliable and simple method for diagnosing vesico-enteric fistula

Abstract

Purpose: In up to 50% of patients with vesico-enteric fistula conventional diagnostic methods fail. We report a simple and low cost diagnostic method that involves the oral intake of poppy seed.

Materials and methods: From 1994 to 1999, 17 patients in whom vesico-enteric fistula was suspected underwent the poppy seed test. We administered 250 gm. poppy seed orally in the evening and the urinary excretion of poppy seed was evaluated during the next 2 days.

Results: Of the 17 patients 11 excreted the black seeds in the urine for 2 days after oral intake of the seeds. The diagnosis was supported by conventional diagnostic methods in 9 of the 11 cases, while in the remaining 2 the poppy seed test was the only preoperative diagnostic procedure that proved the existence of a fistula. The diagnosis was confirmed by surgical exploration in all 11 patients. In the remaining 6 patients with a nonspecific complaint vesico-enteric fistula was excluded by conventional diagnostic techniques and by the success of nonoperative therapy.

Conclusions: The oral intake of poppy seed is a simple and ready available method for diagnosing vesico-enteric fistula. It may support the surgeon decision when conventional diagnostic tools fail.