Cobalamin absorption determined by the stool spot test. Reliability in patients with uremia or disorders of the ileum

Abstract

A cobalamin absorption test, the stool spot test (SST), which makes use of radioactive cobalamin and a nonabsorbable isotope, 51Cr-trichloride, has been shown to produce reliable results in patients with pernicious anemia and in healthy controls. The reliability of the SST in patients with bowel disorders and in patients with decreased renal function was investigated by comparing with both whole-body counting and the Schilling test. Fourteen patients with bowel disorders and eight patients with uremia joined the trial. The SST correlated highly significantly with the whole-body counting method. However, the precision of the SST was poor in patients with decreased bowel transit time and inferior to that in the uremic patients. In one of two patients with decreased bowel transit time the two isotopes were shown to have different transit times, thus invalidating the test. In patients with uremia the SST was significantly more reliable than the Schilling test. It is concluded that the SST is reliable also in patients with uremia but may not be reliable in patients with intestinal disorders and decreased bowel transit time. In these patients collection of larger stool samples is recommended.