Measurement of degraded fecal hemoglobin-heme to estimate gastrointestinal site of occult bleeding appraisal of its clinical utility

M. Goldschmiedt, D. A. Ahlquist, H. S. Wieand, D. B. McGill, W. F. Taylor, R. D. Ellefson

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Hemoglobin-heme is variably converted to porphyrin during enterocolic transit. This intestinal converted fraction, as measured by HemoQuant, was elevated as a predictor of the occult bleeding site in 152 patients with discrete lesions. The intestinal converted fraction, expressed as the percentage of total fecal hemoglobin, was similar with upper gastrointestinal and proximal colon lesions. Within the colon, values trended downward with more distal location: means ± standard deviations were 18±14 proximal colon, 16 ±15 sigmoid, and 10±10 rectum. The amount of fecal blood also affected the intestinal converted fraction; correcting for hemoglobin concentration improved separation by site. Corrected intestinal converted fraction values were significantly lower with rectal (P< 0.0005) and sigmoid (P<0.02) lesions than with proximal colon lesions. Unfortunately, large within-site variation caused considerable overlap between sites. We conclude that the intestinal converted fraction is influenced by the site and amount of bleeding. However, its clinical utility is compromised by substantial individual differences in luminal hemoglobin metabolism.

Original languageEnglish (US)
Pages (from-to)605-608
Number of pages4
JournalDigestive Diseases and Sciences
Volume33
Issue number5
DOIs
Publication statusPublished - May 1 1988
Externally publishedYes

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Keywords

  • hemoglobin degradation
  • HemoQuant
  • occult gastrointestinal bleeding

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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