Management of Obscure Alimentary Bleeding

Faecal Occult Blood and Ferrous Fumarate

“…Our results confirm the observations of Kay (1962) that patients suspected of alimentary bleeding should be adequately prepared before testing the faeces for occult blood. In particular, the patients must be on a strict meatfree diet for at least three days prior to faecal collections.…”

“…Consequently it is important to have a simple and reliable test for the determination of occult blood in the faeces. The difficulties and fallacies in the interpretation of the chemical tests in common use have been reviewed recently by Kay (1962) and the comment made, based on reports by Illingworth (1959) and Holliday and Cuthill (1960), that ferrous fumarate medication might interfere with the tests for occult blood in the faeces. The possibility that ferrous fumarate might cause actual bleeding seemed unlikely in the light of the experimental work of Berenbaum et al (1960).…”

Gastrointestinal haemorrhage from small bowel duplication

“…The success rate for showing rare lesions in the small bowel by small bowel follow-through examination is even less accurate. The use of the fluoroscein string test (Kay, 1962) has not stood the test of time, neither has the use of 51Cr-labelled red blood cells been accurate in identifying the bleeding site. The two current investigations in vogue for elucidating this difficult diagnostic problem are fibre-optic endoscopy and superior mesenteric angiography.…”