Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011991 (diarrhea)
 57,543 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new high pressure liquid chromatography (HPLC) method has been used to measure urinary sugar levels for the intestinal permeability test with cellobiose and mannitol (C/M test). Urinary specimens have been prepared by simple filtration through a Millipore membrane. The method is highly sensitive (minimal detectable concentration of urinary sugars = 0.01 mg/ml) and reproducible (coefficient variation between samples = 0.47% for cellobiose and 0.25% for mannitol). By this method a C/M test has been performed in a large series of gastroenterological patients. High values of mean urinary C/M percentage recovery ratio (C/M%) were found in 30 children with active gluten-sensitive enteropathy compared with controls (0.42 +/- 0.66 versus 0.014 +/- 0.005). In 44 treated celiacs and 34 children with chronic nonspecific diarrhea the mean C/M%s were 0.027 +/- 0.018 and 0.021 +/- 0.012, respectively. The results of this study confirm that the C/M test is a valuable investigation in the diagnostic studies of children with chronic diarrhea. The simple HPLC method described for the determination of urinary sugar levels should allow a wider diffusion of this test.
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PMID:Clinical application of a simple HPLC method for the sugar intestinal permeability test. 190 34

Acute radiation enteropathy is usually self-limited and rarely requires surgical intervention. Chronic radiation enteropathy may occur months, years, or decades after treatment. Patients may present with crampy abdominal pain, diarrhea, or cachexia or may present acutely with bowel obstruction or fistula. The bowel and its mesentery are shortened, and mucosal ulceration and submucosal fibrosis are present. The vasculature of the bowel is markedly compromised by progressive endarteritis. Ideally, nutritional support should be given and surgery performed electively. Regardless of presentation, both large and small bowel must be evaluated for concurrent problems. At surgery, resection and restoration of continuity of the gastrointestinal tract is optimal management. Recurrent obstruction and fistulae are real risks, and optimal management is resection of bowel damaged by radiation and anastomosis using bowel spared from irradiation. However, if the patient is unstable or necessary dissection and mobilization of the bowel judged too morbid, bypass of the affected loop is acceptable. Occasionally, only diversion of the bowel by enterostomy is possible.
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PMID:Surgical management of radiation enteropathy. 192 57

Twenty-five patients with abdominopelvic malignant tumors receiving irradiation were studied. The following items were assessed before, during, and at the end of the radiation period: 1) clinical symptoms, scored on the basis of their severity; 2) orocecal transit time (lactulose-H2 breath test); and 3) absorption of lactose and bile salts. Ninety-two percent of the patients showed clinical symptoms suggestive of acute radiation enteropathy, mainly diarrhea. A significant acceleration of the orocecal transit was observed during the study: 70 +/- 6.9 min vs 63.3 +/- 6.3 min vs 44.3 +/- 5.1 min (F = 5.49, p = 0.008), being faster in patients with severe diarrhea (F = 3.25, p = 0.05). Forty-four percent and 57% of the patients developed lactose and bile salt malabsorption, respectively. A decrease in the transit time was observed, independent of the absorption or malabsorption of such substances. However, the orocecal transit was faster in those lactose malabsorbers with severe diarrhea, than in those with mild diarrhea (F = 4.2, p = 0.03). The results suggest that acceleration of orocecal transit may be a major factor in the pathophysiology of radiation-induced diarrhea, whereas lactose malabsorption may contribute to the severity of the diarrhea.
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PMID:Acute effects of abdominopelvic irradiation on the orocecal transit time: its relation to clinical symptoms, and bile salt and lactose malabsorption. 196 21

Children with protracted diarrhoea, circulating enterocyte autoantibodies, and an enteropathy showing features of inappropriate HLA molecule expression on the jejunal crypt epithelium, often present with persistent blood and mucus in their stools. Eight children with autoimmune enteropathy were investigated for the presence of associated colonic disease. Six children with protracted diarrhoea, no circulating autoantibodies, and an enteropathy (in five of them) undergoing colonoscopy were used as control subjects. In all eight patients, but not in the control subjects, there was macroscopic and microscopic evidence of an accompanying colitis of variable severity, thus indicating that a more generalised intestinal disorder was present, which might affect the whole intestine. Aberrant expression of DR molecules on the colonic surface and crypt epithelium was also detected. Autoimmunity may play a role in the colitis.
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PMID:Autoimmune enteropathy and colitis: is there a generalised autoimmune gut disorder? 199 36

Factor XII deficiency and impaired prekallikrein activity were diagnosed in a 1-year-old Chinese Shar Pei. The dog experienced repeated episodes of intestinal hemorrhage and diarrhea. Laboratory findings were compatible with blood loss (iron deficiency anemia and hypoproteinemia). Necropsy findings suggested mild infiltrative bowel disease that could have been responsible for the dog's diarrhea, but no explanation for the severe recurrent gastrointestinal hemorrhage could be found. Factor XII deficiency is uncommon in the dog and is not associated with hemorrhagic tendencies. The factor XII deficiency in this case may have contributed to the gastrointestinal hemorrhage.
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PMID:Factor XII and partial prekallikrein deficiencies in a dog with recurrent gastrointestinal hemorrhage. 199 70

Animal models of allergic gastroenteropathy have defined both morphologic and physiologic changes that accompany the immune-mediated reaction to a dietary protein. In such models a broadening of the allergic response to other dietary proteins present in the gastrointestinal tract may occur during the localized anaphylactic reaction. The characteristic histologic intestinal findings of food protein-induced enteropathy may develop in selected infants with protracted diarrhea after infectious enteritis. Mechanisms underlying the induction of this response remain to be explained, but they may in part be similar to the broadening of the hypersensitivity response seen in experimental models of allergic enteropathy.
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PMID:Milk protein enteropathy after acute infectious gastroenteritis: experimental and clinical observations. 200 51

Gastric acid secretion was studied in 13 Basenji dogs with immunoproliferative enteropathy. Considerable variation in the severity of gastritis and enteritis existed among dogs. Basenji dogs were categorized into two groups on the basis of postmortem gastric and intestinal histology (group I, gastritis and enteritis; group II, only enteritis). Pentagastrin-induced gastric acid secretory capacity was increased (P less than 0.002) in group II dogs as compared to healthy Beagle controls. Gastric acid secretory capacity of Basenji dogs with gastritis and enteritis (group I) was not different from that observed in control dogs. Basal serum gastrin concentrations and secretin-stimulated serum gastrin concentrations of either group of Basenji dogs did not differ from controls. On the basis of symptomatology, Basenji dogs with diarrhea had significantly increased basal and postsecretin stimulation gastrin concentrations (P = 0.01) when compared with asymptomatic Basenji or healthy control dogs. These findings support a potential role for altered gastric acid secretory capacity in the pathogenesis of immunoproliferative enteropathy of Basenji dogs. Results of the secretin stimulation studies support previous pathologic studies that failed to detect gastrin-secreting tumors. Incorporated into this investigation was a trial to determine whether the combination of oxymorphone and acepromazine could be used for acid secretory studies. Compared to pentobarbital, which has been frequently used for acid secretory studies in a research setting, the drug combination resulted in increased gastric fluid volumes, a comparative increase in acid secretion, and a rapid uneventful recovery. We conclude that the combination of oxymorphone and acepromazine provides an acceptable means of restraint in dogs undergoing acid secretory studies.
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PMID:Gastric acid secretion in Basenji dogs with immunoproliferative enteropathy. 202 13

We describe a child with circulating anti-epithelial cell antibodies, autoimmune enteropathy with intestinal villous atrophy, and membranous glomerulonephritis. The patient had persistent diarrhea at 6 months of age, and a small bowel biopsy showed active enteritis, villous atrophy, and crypt hyperplasia. When the patient was, 10 months of age, nephrotic syndrome developed because of membranous glomerulonephritis. Results of tests for circulating immune complexes were negative. Indirect immunofluorescence studies revealed a circulating antibody directed against renal epithelial cells. Circulating antibodies directed against normal small intestine epithelial cells were also detected by the immunoperoxidase technique. Western blot and immunoprecipitation identified a 55-kd antigen, in both small bowel and kidney, that reacted with an antibody in the patient's serum. High-dose prednisone therapy induced a clinical remission, resolution of the small bowel injury, and diminished serum anti-epithelial cell antibodies; after dose reduction, clinical relapse occurred with villous atrophy and reappearance of anti-epithelial cell antibodies. When the patient was 45 months of age, persistent diarrhea recurred despite intravenous administration of corticosteroids, cyclosporine, and total parenteral nutrition. Autoantibodies to a 55-kd epithelial cell protein are temporally related to the development of enteropathy and nephropathy. Study of similar patients is needed to determine the role of such antibodies in this disorder.
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PMID:Autoimmune enteropathy and nephropathy with circulating anti-epithelial cell antibodies. 155 11

D-Xylose absorption was studied in 12 patients with acquired immunodeficiency syndrome (AIDS) or advanced AIDS-related complex who had had diarrhea for more than 8 weeks, averaged an 11% (range, 3% to 21%) body weight loss during the previous 6 months, and had had negative stool examinations for enteric pathogens. Patients were evaluated by duodenal aspiration and biopsy and received both 25 gm oral and 10 gm intravenous doses of D-xylose. Kinetic analysis of D-xylose absorption was characterized by an absorption rate constant (ka) and a rate constant (ko) reflecting nonabsorptive loss. Extent of D-xylose absorption averaged 18.4% +/- 9.3% (+/- SD) in the 12 patients (normal greater than 60%). Percentage of weight loss during the previous 6 months was negatively correlated with ka (r = -0.69; p = 0.018) in the 11 patients in whom this parameter was reduced but was not correlated with either ko or extent of D-xylose absorption. In these patients with human immunodeficiency virus enteropathy, ka was reduced out of proportion to the minor histologic changes present in the duodenal biopsy specimens.
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PMID:Kinetics of D-xylose absorption in patients with human immunodeficiency virus enteropathy. 206 Feb 52

Gut epithelial cell autoantibodies have been considered a hallmark of autoimmune enteropathy, a disorder occurring in children with protracted diarrhea of unknown etiology. Four patients (two male and two female) with such autoantibodies were studied. Immunofluorescence analysis showed two different disjunctive staining patterns: complement-fixing apical (three of four) and cytoplasmic (the remaining fourth one), which are shown to be directed against different structures. All three patients positive for complement-fixing apical gut epithelial cell autoantibodies had abnormal T-cell responses in vitro, one of them with an immunoglobulin G2 immunoglobulin deficiency and another with an immunoglobulin A deficiency. An immunoglobulin A deficiency without T-cell alterations was also diagnosed in the cytoplasmic gut epithelial cell autoantibody-positive patient. These findings suggest that different immunologic alterations (either a T-cell abnormality or immunoglobulin deficiency) may favor the appearance of gut epithelial cell autoantibodies (complement-fixing apical or cytoplasmic, respectively). Furthermore, these autoantibodies should not be considered a specific marker of autoimmune enteropathy, because they may not always be associated with such a disease: two patients with apical gut epithelial cell autoantibodies showed no signs of intestinal lesion or diarrhea.
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PMID:T-lymphocyte dysfunctions occurring together with apical gut epithelial cell autoantibodies. 206 15


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