In-vivo intestinal mucosal uptake of iron, body iron absorption and gastric juice iron-binding in idiopathic haemochromatosis.

Abstract

SummaryNormal gastric juice possesses considerable iron‐binding properties. In patients with idiopathic haemochromatosis gastric juice iron‐binding did not differ significantly from normal and venesection therapy resulted in only minor changes in the iron‐binding ability.In‐vivo intestinal mucosal uptake of iron and body iron absorption (retention) were both significantly increased in patients with haemochromatosis after venesection therapy but the results showed no significant relationship to the degree of gastric juice iron‐binding in either patients with haemochromatosis or normal subjects. Neutralized gastric juice from patients with idiopathic haemochromatosis did not significantly affect intestinal mucosal uptake or body iron absorption in subjects with histamine‐fast achlorhydria when compared with normal, neutralized gastric juice. In four patients with idiopathic haemochromatosis who had not been subjected to venesection treatment, the results for mucosal uptake were within the normal range whereas body iron absorption was significantly increased.These findings do not support the hypothesis that the increased iron absorption in patients with idiopathic haemochromatosis results from a defect in gastric secretion. On the contrary, they point to a mucosal rather than a luminal abnormality in this disease.