Measurement of blood and iron loss in colitis with a whole-body counter

Quantitative measurement of faecal blood loss: comparison of radioisotopic and chemical analyses

Blood loss in faeces was assessed by three different methods in five patients with recurrent iron deficiency. In short term (12 day) studies chemical analysis of complete stool collections for haemderived porphyrins (HemoQuant) gave results closely correlated with those obtained by measuring stool loss of 51Cr-labelled red blood cells. Whole body counting for 59Fe was relatively insensitive to small blood losses but allowed losses to be followed up over longer periods. Chemical analysis of faecal porphyrins thus provides a satisfactory alternative to radioisotopic techniques in short term quantitation of faecal blood loss, while longer term whole body counting of 59Fe may still be appropriate in a few patients for the detection and quantification of intermittent blood losses.

The thyroid in ulcerative colitis and Crohn's disease. I. Thyroid radioiodide uptake and urinary iodine excretion

In order to investigate the prevalence of iodine depletion in chronic inflammatory bowel disease two separate studies have been performed. One was devoted to the 24-hour urinary iodine excretion and 50 patients with ulcerative colitis or Crohn's disease were examined and compared with 102 controls. In the other study the thyroid 131I uptake was compared in 38 patients and 36 controls. Ten of the 50 patients with chronic inflammatory bowel disease had a 24-hour urinary iodine excretion less than 40 mug, compared with 5 of the 102 controls (p greater than 0.01). Sixteen of the 38 patients had a 24-hour thyroid 131I uptake of 50% or more of the administered test does, compared with 4 of the 36 controls (p smaller than 0.01). These results are compatible with an increased occurrence of iodine deficiency in patients with chronic inflammatory bowel disease. Treatment with corticosteroids or Salazopyrin or a milk-free diet did not influence these findings. No evidence was found of an impaired absorption of inorganic iodide from the gut.?31

Assessment of acute blood-loss by determination of change in red-cell volume

A method is described for the quantitative measurement of acute blood-loss from any source by determination of change in the red-cell volume. The accuracy and sensitivity of this method have been assessed in 23 patients admitted to hospital with acute gastro-intestinal bleeding. The method was sufficiently sensitive to detect a change in red-cell volume of 3 per cent. Reproducible results were obtained, duplicate measurements of red-cell volume deviating from the mean by less than 4 per cent. Completely separate daily measurements, in subjects not undergoing further haemorrhage, deviated from the mean by less than 5 per cent.

The role of chronic blood loss in the pathogenesis of postgastrectomy iron-deficiency anaemia

The role of chronic blood loss in the pathogenesis of postgastrectomy iron-deficiency anaemia was assessed by measurements of blood loss over periods of up to three months, using a whole-body counter and (59)Fe. Eleven patients were investigated and eight of these were selected because of a history of iron-deficiency anaemia. Six were shown to be losing blood abnormally, five at a rate of over 150 ml per month. None of the three patients without a history of anaemia lost more than 60 ml per month. At gastroscopy contact bleeding from the mucosa of the gastric remnant was observed in four of the six patients losing blood. The results indicate that in some patients chronic blood loss plays an important role in the pathogenesis of postgastrectomy iron-deficiency anaemia.