• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjclinpharmLink to Publisher's site
Br J Clin Pharmacol. Jan 1992; 33(1): 33–38.
PMCID: PMC1381196

Gastrointestinal blood loss after non-steroidal anti-inflammatory drugs. Measurement by selective determination of faecal porphyrins.


1. A method for the detection of gastrointestinal blood loss based upon the selective measurement of faecal porphyrins was tested in two studies in healthy volunteers. 2. In the first study subjects (n = 6) received intragastric autologous blood (saline, 2 and 6 ml as a single dose) resulting in a dose dependent increase in faecal porphyrins. 3. In a subsequent placebo controlled cross over study in 12 subjects acetylsalicylic acid (ASA), nabumetone (a new NSAID) or placebo were administered for 5 days with a washout period of 9 days. They were no dietary restrictions. 4. All faeces were collected during the treatment period and both the full faecal homogenate and a random faecal sample were analyzed for deutero- and pemptoporphyrin content by h.p.l.c. Additionally a benzidine reaction was performed. 5. There was a highly significant correlation (r = 0.95) between the values obtained from random samples and the full homogenate. ASA increased the faecal porphyrin excretion (P less than 0.001) compared with placebo in contrast to nabumetone. Complaints of dyspepsia were most common after ASA. 6. Measurement of faecal porphyrins is useful for monitoring NSAID induced upper gastrointestinal blood loss and lacks some of the practical constraints of other methods.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (998K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ahlquist DA, McGill DB, Schwartz S, Taylor WF, Owen RA. Fecal blood levels in health and disease. A study using HemoQuant. N Engl J Med. 1985 May 30;312(22):1422–1428. [PubMed]
  • Beukeveld GJ, Wolthers BG, van Saene JJ, de Haan TH, de Ruyter-Buitenhuis LW, van Saene RH. Patterns of porphyrin excretion in feces as determined by liquid chromatography; reference values and the effect of flora suppression. Clin Chem. 1987 Dec;33(12):2164–2170. [PubMed]
  • Bjarnason I, Williams P, So A, Zanelli GD, Levi AJ, Gumpel JM, Peters TJ, Ansell B. Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal anti-inflammatory drugs. Lancet. 1984 Nov 24;2(8413):1171–1174. [PubMed]
  • Carson JL, Strom BL. The gastrointestinal side effects of the nonsteroidal anti-inflammatory drugs. J Clin Pharmacol. 1988 Jun;28(6):554–559. [PubMed]
  • Caruso I, Bianchi Porro G. Gastroscopic evaluation of anti-inflammatory agents. Br Med J. 1980 Jan 12;280(6207):75–78. [PMC free article] [PubMed]
  • Friedel HA, Todd PA. Nabumetone. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in rheumatic diseases. Drugs. 1988 May;35(5):504–524. [PubMed]
  • Frommer DJ, Kapparis A, Brown MK. Improved screening for colorectal cancer by immunological detection of occult blood. Br Med J (Clin Res Ed) 1988 Apr 16;296(6629):1092–1094. [PMC free article] [PubMed]
  • Goldschmiedt M, Ahlquist DA, Wieand HS, McGill DB, Taylor WF, Ellefson RD. Measurement of degraded fecal hemoglobin-heme to estimate gastrointestinal site of occult bleeding. Appraisal of its clinical utility. Dig Dis Sci. 1988 May;33(5):605–608. [PubMed]
  • Henry DA, Johnston A, Dobson A, Duggan J. Fatal peptic ulcer complications and the use of non-steroidal anti-inflammatory drugs, aspirin, and corticosteroids. Br Med J (Clin Res Ed) 1987 Nov 14;295(6608):1227–1229. [PMC free article] [PubMed]
  • Hunt JN. A procedure for measuring gastric bleeding caused by drugs. Dig Dis Sci. 1979 Jul;24(7):525–528. [PubMed]
  • Lanza F, Peace K, Gustitus L, Rack MF, Dickson B. A blinded endoscopic comparative study of misoprostol versus sucralfate and placebo in the prevention of aspirin-induced gastric and duodenal ulceration. Am J Gastroenterol. 1988 Feb;83(2):143–146. [PubMed]
  • Lanza FL, Royer GL, Jr, Nelson RS, Chen TT, Seckman CE, Rack MF. The effects of ibuprofen, indomethacin, aspirin, naproxen, and placebo on the gastric mucosa of normal volunteers: a gastroscopic and photographic study. Dig Dis Sci. 1979 Nov;24(11):823–828. [PubMed]
  • Lussier A, Davis A, Lussier Y, Lebel E. Comparative gastrointestinal blood loss associated with placebo, aspirin, and nabumetone as assessed by radiochromium (51Cr). J Clin Pharmacol. 1989 Mar;29(3):225–229. [PubMed]
  • Prichard PJ, Poniatowska TJ, Willars JE, Ravenscroft AT, Hawkey CJ. Effect in man of aspirin, standard indomethacin, and sustained release indomethacin preparations on gastric bleeding. Br J Clin Pharmacol. 1988 Aug;26(2):167–172. [PMC free article] [PubMed]
  • Prichard PJ, Kitchingman GK, Walt RP, Daneshmend TK, Hawkey CJ. Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin. BMJ. 1989 Feb 25;298(6672):493–496. [PMC free article] [PubMed]
  • Ryan JR, Riley WA, Vargas R, Offen WW, Gruber CM. Enteric coating of fenoprofen calcium reduces gastrointestinal microbleeding. Clin Pharmacol Ther. 1987 Jul;42(1):28–32. [PubMed]
  • Silvoso GR, Ivey KJ, Butt JH, Lockard OO, Holt SD, Sisk C, Baskin WN, Mackercher PA, Hewett J. Incidence of gastric lesions in patients with rheumatic disease on chronic aspirin therapy. Ann Intern Med. 1979 Oct;91(4):517–520. [PubMed]
  • Somerville K, Faulkner G, Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet. 1986 Mar 1;1(8479):462–464. [PubMed]
  • Standefer JC, Vanderjagt D. Use of tetramethylbenzidine in plasma hemoglobin assay. Clin Chem. 1977;23(4):749–751. [PubMed]
  • Wilson JH, Koole-Lesuis H, Edixhoven-Bosdijk A, van den Berg JW, van Essen HA. Determination of haemoglobin in gastric aspirates. J Clin Chem Clin Biochem. 1985 Dec;23(12):841–844. [PubMed]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society


Related citations in PubMed

See reviews...See all...


  • Compound
    PubChem Compound links
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...