Serum Lipid Levels following a Fatty Meal as a Test of Steatorrhoea

Penfold, W. A. F.

doi:10.1177/036985646700400706

Cited by 14 publications

(8 citation statements)

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“…The method is time consuming and unpleasant for both nursing and laboratory staff, and it is usually necessary to admit the patient to hospital. It has been estimated that up to 30% of faecal fat excretion results obtained from three to five-day collections are inaccurate for these reasons (Penfold, 1967). There is, therefore, a need for a simple, rapid, and accurate method for the measurement of fat excretion.…”

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Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker

Lee¹,

Temperley²,

Dick³

1969

Gut

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SUMMARY A method for the estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker is described. Results obtained from a single stool sample are in close agreement with those from a three-day collection using this technique. The method is simpler and more accurate than collections done without a marker.The estimation of faecal fat excretion plays an important part in the investigation of malabsorption. The standard technique commonly used involves the collection of all faeces passed during a period of three to five days, followed by measurement of the amount of fat in the sample. This method has several disadvantages. It is inaccurate, as it assumes that faecal flow rate and daily turnover are constant: therefore irregular bowel action and incomplete evacuation produce false results. Loss of stool, due either to incontinence or incomplete collection, produces further inaccuracies. The method is time consuming and unpleasant for both nursing and laboratory staff, and it is usually necessary to admit the patient to hospital. It has been estimated that up to 30% of faecal fat excretion results obtained from three to five-day collections are inaccurate for these reasons (Penfold, 1967). There is, therefore, a need for a simple, rapid, and accurate method for the measurement of fat excretion. PRINCIPLESThe use of a continuous marker obviates the necessity for quantitative faecal collections. An accurately weighed amount of an inert substance is given daily by mouth in divided doses. After a steady state has been reached in the bowel with respect to the marker, a stool sample is collected and the amounts of fat and of marker in the sample are measured. A ratio of fat to marker is thus obtained and from this figure the amount of fat equivalent to a day's intake of the marker is derived. This represents the corrected 24-hour fat excretion. Previous workers have described the detailed theory of this method (Stanley and Cheng, 1957) and the criteria for such a marker (Whitby and Lang, 1960). These criteria are that the marker should be uniformly dispersed in the faeces, that it should be readily estimated quantitativelyin the faeces, that it should befullyrecoverable from the faeces, and that it should not be toxic. We have used cuprous thiocyanate (CuSCN) as a continuous marker. Its advantages over other markers, the methods of its preparation and estimation in faeces, and experiments demonstrating full recovery of the copper from the faeces have been described in a previous paper (Dick, 1969). PRELIMINARY STUDIES PERIOD REQUIRED TO ESTABLISH A STEADY STATE FORCuSCN Faecal fat excretion was measured in 37 patients in a geriatric unit. In order to measure the bowel transit times in these patients, a single carmine marker was given at the start of the course of CuSCN. The time taken for transit by the carmine was assumed to approximate to that for CuSCN. That this is a valid assumption is shown by the results obtained. The carmine transit time varied between two and five days (mean three days). In...

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Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker

Lee¹,

Temperley²,

Dick³

1969

Gut

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“…It has become evident that threeor five-day faecal collections without a continuous marker can be quite erroneous. Penfold (1967) states that 'there is reason to believe that of 1,085 faecal fat determinations which we have carried out during the past three years, the collections may have been incomplete or unrepresentative in as many as 30% of the cases'. Hitherto most laboratories have been deterred from using conventional markers such as Cr203 or BaSO4 due to the considerable labour involved.…”

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Use of cuprous thiocyanate as a short-term continuous marker for faeces.

Dick¹

1969

Gut

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“…The increase in serum or plasma particulate fat after an oral fat load has been the basis of several tests for fat malabsorption (Frazer and Stewart, 1937;Goldbloom, Blake, and Cameron 1964;Osmon, Zinn, and Wharton, 1957;Mullinger, 1968;Fosbrooke and Rudd, 1966;Penfold, 1967;Penfold and Keynes, 1971). In recent years, however, Stone and Thorp (1966) have shown nephelometry to be a far more convenient method for estimating particulate fat in serum or plasma than those used previously, and results correlate well with those of established methods (Buckley et al, 1970;Stone and Thorp, 1966;Stone et al, 1970).…”

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Changes in plasma nephelometry after oral fat loading in children with normal and abnormal small intestinal morphology.

Robards¹

1975

Archives of Disease in Childhood

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. Changes in plasma nephelometry after oral fat loading in children with normal and abnormal small intestinal morphology. A standardized oral fat load has been given to 66 children having duodenal or jejunal biopsy, and to 10 children presumed normal. The rise in plasma light scattering intensity (LSI) measured by nephelometry between the fasting and 2-hour postload level (0-2 hour) showed good correlation with the small intestinal morphology in patients suspected of having coeliac disease. In those who had had recurrent diarrhoea and gastroenteritis, the fat load test did not predict small intestinal morphology.Serial studies in 5 treated patients with malabsorption showed increase in the 0-to 2-hour LSI, with corresponding improvement of small intestinal morphology and clinical state.The increase in serum or plasma particulate fat after an oral fat load has been the basis of several tests for fat malabsorption (Frazer

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Serum Lipid Levels following a Fatty Meal as a Test of Steatorrhoea

Cited by 14 publications

References 2 publications

Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker

Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker

Use of cuprous thiocyanate as a short-term continuous marker for faeces.

Changes in plasma nephelometry after oral fat loading in children with normal and abnormal small intestinal morphology.

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