Portal hypertensive colopathy (PHC) is a newclinical entity in patients with liver cirrhosis. In this study, colonoscopic findings and clinical features including upper gastrointestinal endoscopy and hepatic hemodynamics were prospectively investigated among 35 PH patients with a hepatic venous pressure gradient (HVPG) of greater than 12 mmHgdue to chronic liver diseases. Colonoscopy was also performed in 100 patients without liver disease as non-PH controls. The colonoscopy revealed vascular ectasias, vascular irregularity, vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in 26, 32, 30, 25, 10 and 25, respectively, of35 PH patients compared to 3, 7, 3, ll, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27 of 35 PHpatients according to our criteria. These patients with PHCwere more frequently associated with esophageal varices and portal hypertensive gastropathy, and had higher HVPG than PHpatients without PHC. Portal hypertension is an important factor in the etiology of PHC. (Internal Medicine 34: 153-157, 1995)

To clarify the significance of serum iron and ferritin as indicators of iron loss caused by continuous bleeding, and, thus, to determine their value as markers of colorectal cancer, values for the two were compared in male patients with early and advanced colorectal cancer and age-matched male controls. The mean value of serum iron levels in patients with advanced colorectal cancer was significantly decreased compared with values in patients with early colorectal cancer and controls, 50.5 +/- 38.6 micrograms/dl vs 93.0 +/- 32.1 micrograms/dl and 107.1 +/- 32.9 micrograms/dl, respectively (p < 0.001). The mean value of serum ferritin levels in patients with early and advanced colorectal cancer was also significantly decreased compared with controls, 80.5 +/- 35.0 ng/ml (p < 0.01) and 48.8 +/- 72.8 ng/ml (p < 0.001), respectively, vs 117.1 +/- 46.8 ng/ml. However, there was no significant difference between mean serum iron levels in patients with early colorectal cancer and controls. Eighteen (78.3%) of the 23 patients with advanced colorectal cancer and 3 (16.7%) of the 18 patients with early colorectal cancer had serum iron levels below 85 micrograms/dl and serum ferritin levels below 60 ng/ml. Levels of both serum iron and ferritin, without clinically evident anemia, are useful indicators of advanced colorectal cancer.

The urinary excretion rates of nitrate (NO₃) and nitrite (NO₂) were monitored in 14 patients with active ulcerative colitis during treatment using hydrocorti-sone and sulfasalazine. During the active phase of the disease, the NO₃ excretion was significantly higher in the patients than in healthy controls (n – 6, p < 0.05), although it varied considerably among the patients. During the healing phase, the NO₃ excretion decreased concurrently with improvement of symptoms and colorectal ulceration, but the NO₂ excretion increased. During the inactive phase of the disease, the NO₃ and NO₂ excretions were significantly lower than during the active phase, and the NO₂/NO₃ ratio resembled that in the healthy controls. In contrast, a patient who failed to respond to treatment showed continuously high NO₃ and NO₂ excretion rates. These results indicate that urinary NO₃ and NO₂ excretions vary with the disease state in ulcerative colitis.

We conclude that decreased serum iron and ferritin levels are related only to adenoma size and that adenomas > or = 1 cm may bleed steadily, resulting in iron deficiency. However, low dietary intake of iron and fiber may be one of the causes of low serum iron and ferritin.

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