PT  - JOURNAL ARTICLE
AU  - Carol Hutchinson
AU  - Catherine A Geissler
AU  - Jonathan J Powell
AU  - Adrian Bomford
TI  - Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis
AID  - 10.1136/gut.2006.108613
DP  - 2007 Sep 01
TA  - Gut
PG  - 1291--1295
VI  - 56
IP  - 9
4099  - http://gut.bmj.com/content/56/9/1291.short
4100  - http://gut.bmj.com/content/56/9/1291.full
SO  - Gut2007 Sep 01; 56
AB  - Background and Aims: During the long-term treatment of patients with hereditary haemochromatosis (HH) the authors observed that proton pump inhibitors (PPI) reduced the requirement for maintenance phlebotomy. Gastric acid plays a crucial role in non-haem iron absorption and the authors performed a case review and intervention study to investigate if PPI-induced suppression of gastric acid would reduce dietary iron absorption in C282Y homozygous patients. Methods: Phlebotomy requirements to keep serum ferritin ∼50 μg/l before (mean 6.1 (SE 0.6) years) and during (3.8 (0.9) years) administration of a PPI were evaluated in seven patients and a post-prandial study was performed to determine whether PPIs reduce absorption of non-haem iron (14.5 mg) from a test meal in a further 14 phlebotomised patients with normal iron stores. Results: There was a significant reduction (p<0.001) in the volume of blood removed annually before (2.5 (0.25) l) and while taking (0.5 (0.25) l) a PPI. Administration of a PPI for 7d suppressed absorption of non-haem iron from the meal as shown by a significant reduction (all p<0.01) in: area under the serum curve (2145 (374) versus 1059 (219)), % recovery of administered iron at peak serum iron (20.5 (3.2) versus 11.0 (2.0)%) and peak serum iron (13.6 (2.4) vs 6.1 (1.2) µmol/l) (all values are before vs during PPI). Conclusions: Administration of a PPI to patients with HH can inhibit the absorption of non-haem iron from a test meal and the habitual diet.