Excretion of Endogenous Non‐haem Iron by the Gastrointestinal Tract in Human Subjects and its Influence on the Size of Body Store of Iron with Particular Reference to Coeliac Disease

Abstract

The present study demonstrates that there is continuous loss of endogenous non‐haem iron by the gastrointestinal tract in man, and underlines its importance in patients with coeliac disease and in those with iron overload. The findings suggest that this loss occurs mainly as a result of desquamation of villous epithelium. The faecal loss of endogenous non‐haem iron is markedly increased in patients with coeliac disease in whom the cell turnover of the small intestinal mucosa is increased and it seems that it could be mainly responsible for the causation of iron deficiency amongst a considerable number of these patients. In subjects with normal mucosal structure of the small intestine this loss increases progressively with iron load at high levels of labile iron store and thus reduces the total iron store in the body.

Non-dietary lipid in the intestinal lumen

“…In the coeliac syndrome, net intestinal loss has been established for protein, calcium (Melvin, Hepner, Bondier, Neale, and Joplin, 1970), and iron (Singh, 1970). Rowntree (1930) found coeliac children to be in negative balance for vitamin A.…”

Thalassemia Intermedia With Iron Deficiency

“…The fecal loss of endogenous nonheme iron is markedly increased in CD and it could be mainly responsible for iron deficiency. 4 In selected thalassemia cases which do not show improvement with treatment, or show growth retardation or progressive decrease in Hb, tissue transglutaminase/endomysial antibody with small intestinal biopsy should be performed even in absence of gastrointestinal symptoms. …”