Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Mar 7, 2010; 16(9): 1110-1114
Published online Mar 7, 2010. doi: 10.3748/wjg.v16.i9.1110
Prediction of flare-ups of ulcerative colitis using quantitative immunochemical fecal occult blood test
Motoaki Kuriyama, Jun Kato, Koji Takemoto, Sakiko Hiraoka, Hiroyuki Okada, Kazuhide Yamamoto
Motoaki Kuriyama, Jun Kato, Koji Takemoto, Sakiko Hiraoka, Hiroyuki Okada, Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan
Author contributions: Kuriyama M performed planning, data collection, statistical analysis and drafted the manuscript; Kato J performed planning, clinical examination, statistical analysis, manuscript direction and drafted the manuscript; Takemoto K performed the clinical examination; Hiraoka S performed the clinical examination; Okada H performed the clinical examination; Yamamoto K carried out the manuscript direction.
Correspondence to: Dr. Jun Kato, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan. katojun@cc.okayama-u.ac.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: November 12, 2009
Revised: January 4, 2010
Accepted: January 11, 2010
Published online: March 7, 2010
Abstract

AIM: To examine the feasibility of predicting the flare-up of ulcerative colitis (UC) before symptoms emerge using the immunochemical fecal occult blood test (I-FOBT).

METHODS: We prospectively measured fecal hemoglobin concentrations in 78 UC patients using the I-FOBT every 1 or 2 mo.

RESULTS: During a 20 mo-period, 823 fecal samples from 78 patients were submitted. The median concentration of fecal hemoglobin was 41 ng/mL (range: 0-392 500 ng/mL). There were three types of patients with regard to the correlation between I-FOBT and patient symptoms; the synchronous transition type with symptoms (44 patients), the unrelated type with symptoms (19 patients), and the flare-up predictive type (15 patients). In patients with the flare-up predictive type, the values of I-FOBT were generally low during the study period with stable symptoms. Two to four weeks before the flare-up of symptoms, the I-FOBT values were high. Thus, in these patients, I-FOBT could predict the flare-up before symptoms emerged.

CONCLUSION: Flare-up could be predicted by I-FOBT in approximately 20% of UC patients. These results warrant periodical I-FOBT in UC patients.

Keywords: Flare-ups; Immunochemical fecal occult blood test; Inflammatory bowel disease; Prediction; Ulcerative colitis