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

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-enteri c fistula was suspected underwent the poppy seed test. We administered 250 gm. poppy seed orally in the evening and the urinary excretion of poppy see d 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 convent ional 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 explor ation in all. 11 patients. In the remaining 6 patients with a nonspecific c omplaint vesico-enteric fistula was excluded by conventional diagnostic tec hniques 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 de cision when conventional diagnostic tools fail.