Smear of duodenal fluid aspirate is an examination of fluid from the duodenum for a possible infection. Usually the health care practitioner is looking for either giardia or strongyloides.

The specimen is obtained by EGD (esophagogastroduodenoscopy), a flexible scope that is passed through the mouth and stomach to the duodenum in order to view the organs and obtain specimens.

The test may also be performed by passing a thin flexible tube into the small intestine. The position of the tube can be confirmed by the pH (acid-base balance) of the fluid or by an x-ray.

Fluid is aspirated (suctioned up) from the duodenum when the tube or the scope is in proper position. The fluid is placed on a microscope slide and stained for examination.

Do not eat or drink anything, even water, for 12 hours before the test.

You may have a gagging sensation as the tube is passed, but it is usually not painful.

The test is performed to diagnose infection of the small bowel. In most cases, this test is only done when stool examinations and a duodenal string test have been unable to confirm the diagnosis.

There should be no disease-causing organisms in the duodenum.

The results may show the presence of giardia protozoa and large white blood cells (called macrophages), or the intestinal parasite strongyloides, or another infectious organism.

The risks may include bleeding, perforation (hole), and infection. Certain pre-existing conditions may prohibit use of this test.

Other, less invasive, tests can often be performed to detect the presence of giardia and other infections.