{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:02:13Z","timestamp":1790881333169,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1981,6]]},"abstract":"<jats:p>Only two (2.5%) of 80 outpatients with histologically proven ulcerative colitis had folate deficiency associated with anaemia or macrocytosis. Mean folate absorption, measured using micrograms\/kg body weight of a tritium-labelled physiological folate derivative, 5-methyltetrahydroteroylglutamic acid, in six newly diagnosed patients was 76.7% (normal greater than 95%) but fell to 69.4% after three months' treatment with sulphasalazine. Mean difference in individual patients was 7.5% +\/- 5.2% (SD) (p less than 0.02). Mean folate absorption in four patients with megaloblastic anaemia or macrocytosis which developed during treatment with sulphasalazine was 66.3%. This rose to 82.4% after the drug was stopped. Mean difference in individual patients was 16.6 +\/-  6.6% (SD) (p less than 0.001). All patients who developed anaemia or macrocytosis with sulphasalazine had additional reasons for folate deficiency. These included coeliac disease, severe nutritional deficiencies, and haemolysis. It was concluded that sulphasalazine impairs folate absorption but this only becomes significant if other reasons for folate deficiency are also present.<\/jats:p>","DOI":"10.1136\/gut.22.6.456","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"456-461","source":"Crossref","is-referenced-by-count":43,"title":["Role of sulphasalazine in the aetiology of folate deficiency in ulcerative colitis."],"prefix":"10.1136","volume":"22","author":[{"given":"C M","family":"Swinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lumb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J","family":"Levi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1981,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1136\/bmj.1.6077.1638","article-title":"Megaloblastic anaemia associated with sulphasalazine treatment","volume":"1","author":"Schneider, R.E.; Beeley, L.","year":"1977","unstructured":"Schneider RE, Beeley L. Megaloblastic anaemia associated with sulphasalazine treatment. Br Med J 1977; 1:1638-9.","journal-title":"Br Med J"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1136\/bmj.2.6097.1287-a","article-title":"Megaloblastic anaemia associated with sulphasalazine treatment","volume":"2","author":"Kane, S.P.; Boots, M.A.","year":"1977","unstructured":"Kane SP, Boots MA. Megaloblastic anaemia associated with sulphasalazine treatment. Br Med J 1977; 2:1287-8.","journal-title":"Br Med J"},{"key":"ref_3","first-page":"164","article-title":"M6canisme d'action de la salicylazosulfapyridine (Salazopyrine) sur l'activite de l'acide folique dans la rectocolite ulc6rohemorragique. Acta Gastroenterol Belg 1979; 42: 73-81. 4van Hees PAM. Clinical and pharmacological aspects of sulphasalazine","author":"Lederer, J.; Kumps, J.","year":"1979","unstructured":"Lederer J, Kumps J. M6canisme d'action de la salicylazosulfapyridine (Salazopyrine) sur l'activite de l'acide folique dans la rectocolite ulc6rohemorragique. Acta Gastroenterol Belg 1979; 42: 73-81. 4van Hees PAM. Clinical and pharmacological aspects of sulphasalazine. (Thesis) Gist-Brocades nv Delft, 1979: 164-7.","journal-title":"(Thesis) Gist-Brocades nv Delft"},{"key":"ref_4","first-page":"\"844","article-title":"The assay of tritium-labelled folate in faeces by the oxygen flask combustion technique followed by liquid scintillation counting","volume":"27","author":"Steytler, J.G.","year":"1974","unstructured":"Steytler JG. The assay of tritium-labelled folate in faeces by the oxygen flask combustion technique followed by liquid scintillation counting. J Clin Pathol 1974; 27:844-7. (;Hurdle ADF, Barton D, Searles IH. A method for measuring folate in food and its application to a hospital diet. Am J Clin Nutr 1968; 21:1202-7.","journal-title":"J Clin Pathol; Hurdle ADF, Barton D, Searles IH. A method for measuring folate in food and its application to a hospital diet"},{"key":"ref_5","article-title":"Experimental designs, Second edition","author":"Cochran, W.G.; Cox, G.M.","year":"1957","unstructured":"Cochran WG, Cox GM. Experimental designs, Second edition. New York: Wiley, 1957."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1136\/gut.16.3.181","article-title":"Red cell abnormalities associated with sulphasalazine maintenance therapy for ulcerative colitis","volume":"16","author":"Pounder, R.E.; Craven, E.R.; Henthorn, J.S.; Bannalyne, J.M.","year":"1975","unstructured":"Pounder RE, Craven ER, Henthorn JS, Bannalyne JM. Red cell abnormalities associated with sulphasalazine maintenance therapy for ulcerative colitis. Gut 1975; 16:181-5.","journal-title":"Gut"},{"key":"ref_7","first-page":"517","article-title":"Impaired folic acid absorption in inflammatory bowel disease: effects","volume-title":"of salicylazosulfapyridine (Azulfidine). Gastroenterology 1973; 64","author":"Franklin, J.L.; Rosenberg, I.H.","unstructured":"Franklin JL, Rosenberg IH. Impaired folic acid absorption in inflammatory bowel disease: effects of salicylazosulfapyridine (Azulfidine). Gastroenterology 1973; 64:517-25."},{"key":"ref_8","first-page":"1019","article-title":"Folate deficiency in chronic inflammatory bowel diseases","volume":"14","author":"Elsborg, L.; Larsen, L.","year":"1979","unstructured":"Elsborg L, Larsen L. Folate deficiency in chronic inflammatory bowel diseases. Scand J Gastroenterol 1979; 14:1019-24.","journal-title":"Scand J Gastroenterol"},{"key":"ref_9","article-title":"Report by the Committee on Medical Aspects of Food Policy. Recommended daily amounts of food energy and nutrients for groups of people in the","year":"1979","unstructured":"Report by the Committee on Medical Aspects of Food Policy. Recommended daily amounts of food energy and nutrients for groups of people in the Uni,ted Kingdom. 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Br Med J 1965; 1:827-31.","journal-title":"Br Med J"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1172\/JCI108921","article-title":"Inhibition of folate enzymes by sulphasalazine","volume":"61","author":"Selhub, J.; Dhar, G.J.; Rosenberg, I.H.","year":"1978","unstructured":"Selhub J, Dhar GJ, Rosenberg IH. Inhibition of folate enzymes by sulphasalazine. 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