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Query: UMLS:C0011991 (diarrhea)
 57,543 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intestinal complications following strenuous, protracted physical activity have been increasingly recognized. Diarrhea, sometimes associated with blood loss, described in marathon runners does not appear to be a common diarrhea but rather the clinical expression of ischemic enteropathy. On the basis of experimental evidence and some clinical data, it is suggested that prefeeding an elemental semi-hydrolyzed diet might reduce the incidence and severity of this intestinal handicap in marathon runners. Perhaps, more importantly, the potentially adverse effects of acute ischemic enteropathy on the cardiovascular system might be accordingly reduced.
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PMID:Marathon runners: the intestinal handicap. 209 Sep 28

The D-xylose and triglyceride absorption tests have been widely used as screening tests to characterize malabsorption and indicate intestinal biopsy. In this paper we report the efficiency of these tests in the differential diagnosis of the various causes of chronic diarrhea and their possible relationship to jejunal villous atrophy. Two hundred and fifteen children with chronic diarrhea were submitted to the D-xylose and triglyceride absorption tests, and small intestinal biopsy. The patients were divided into 5 groups, that is: I--celiac disease, 53; II--protracted diarrhea, 24; III--environmental enteropathy, 50: IV--celiac disease under gluten free diet, 11; V--irritable bowel syndrome, 77. D-xylose and triglyceride absorption tests were within normal limits in 3.8% and 4.2% patients belonging respectively to groups I and II. On the other hand, only 7.8% of the patients belonging to group V would be included in the group of patients that would have indication for intestinal biopsy, since both tests revealed abnormal results. Moreover, both tests showed an excellent relationship with the intensity of villous atrophy.
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PMID:[Efficiency of D-xilose and triglycerides absorption tests in the investigation of chronic diarrhea]. 213 89

The case is reported of a 39-year-old pregnant woman who presented with fever, abdominal complaints, and diarrhea. Laboratory investigation revealed mononucleosis in the peripheral blood. All microbiological studies were negative, with the exception of finding cytomegalovirus (CMV). Seroconversion was documented; the virus was cultured from urine and subsequently was demonstrated to be present in the inflamed mucosa of the rectum and distal sigmoid, which was found at sigmoidoscopy. This woman was delivered of a neonate with congenital CMV infection but without apparent malformations. The patient experienced recurrences of the bowel disease, in the first of which CMV could still be cultured from a biopsy specimen. In the follow-up period, an otherwise aspecific chronic inflammatory bowel disease remained present. No immunological abnormalities were found, and antibodies to human immunodeficiency virus were negative. This case demonstrates that inflammatory bowel disease can develop as a result of primary infection with CMV.
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PMID:Acute ulcerative proctocolitis associated with primary cytomegalovirus infection. 216 91

Activated T cells can be visualized in the intestinal lamina propria in a number of gastrointestinal diseases including food-sensitive enteropathy (coeliac disease), inflammatory bowel disease and intractable diarrhoea of infancy. Experimental studies have shown that T-cell activation in human intestinal lamina propria in vitro produces an increase in crypt cell proliferation, villous atrophy, increased HLA-DR expression on enterocytes, increased intra-epithelial lymphocyte numbers, and phenotypically, macrophage activation. All of these features are seen in human gastrointestinal disorders and it is proposed that T-cell activation to wheat (in coeliac disease), milk (cows' milk-sensitive enteropathy), and unidentified luminal antigens (Crohn's disease) plays a primary role in the pathogenesis of these disorders.
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PMID:The role of activated T lymphocytes in gastrointestinal disease. 219 36

Based on recent epidemiologic studies of functional intestinal disorders, we have attempted to answer the following two questions: a) what is the prevalence of functional intestinal disorder in the Western world, b) are there epidemiologic variations in the different modes of symptomatic presentation of functional intestinal disorders? The overall prevalence of functional intestinal disorders in the Western world ranges between 17 and 23 percent according to the country considered, and is between 14 and 18 percent for the irritable bowel syndrome and 4 to 8 percent for painless constipation. The "irritable intestine" group is characterized by a sex ratio of close to one, a median age near 40, a strong influence of stress on symptoms, and the frequency of complaints such as nausea, vomiting, migraine, and pyrosis. The syndrome is seen in active subjects, who believe that they are "sick", and as such, seek medical advice often. Anxiety and depression are frequently encountered. Patients are often athletes, smokers, and have diarrhea. On the other hand, "painless constipation" is characterized by a high prevalence of women and age over 50. Often these subjects do not have any active professional activity. Stress-related and extradigestive symptoms are rare. They do not consider themselves "sick" and do not seek medical advice very often. Conversely, they use laxatives frequently. Individualization of epidemiologically different groups suggests that the pathophysiology may differ between the two groups and perhaps that there are specific therapeutic and diagnostic approaches accordingly.
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PMID:[Epidemiology of the irritable bowel syndrome]. 221 Jan 92

In a group of nine children with postenteritis enteropathy (i.e., persisting small-intestinal mucosal damage and failure-to-thrive after an acute episode of gastroenteritis), absorption capacities for vitamin B12 and folic acid were studied and compared with hematological status in peripheral blood. The fractional absorptions of vitamin B12 (FAB12) and folic acid (FAFol) were determined by means of a double-isotope technique employing a single-stool-sample test. The children were examined when growth retardation was maximal, and examinations were repeated during the late recovery period. In spite of considerable small-intestinal mucosal damage, only the absorption of vitamin B12 was markedly affected, while that of folic acid was almost intact. When growth retardation was maximal, FAB12 was below the normal age-correlated range in half of the children. FAB12 was also severely reduced in all longitudinally observed children when compared with the results obtained during the late recovery period (p less than 0.005). FAFol was below the normal range in one fourth of the children, but the reduction was modest and insignificant when compared with the results of repeated examinations during the late recovery period. A moderate iron deficiency was detected in half the children. High levels of plasma vitamin B12, folic acid, and erythrocyte folate were detected at both early and later examinations, indicating that these parameters were not affected by the reduced absorption capacities. However, if malabsorption and chronic diarrhea are combined with low dietary intake of vitamin B12, as is the case for many children in the Third World, depletion of vitamin B12 stores may result.
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PMID:Vitamin B12 and folic acid absorption and hematological status in children with postenteritis enteropathy. 224 17

The associated factors in 80 children (less than 2 yrs) with protracted diarrhea (greater than 21 days duration) and weight loss were: secondary carbohydrate intolerance (36): enteric pathogens (non typhoidal salmonella (11), enteropathogenic E. coli 'EPEC' (6), giardia (4), and shigella (3); cow's milk protein intolerance (3), gluten intolerance (3); miscellaneous (5); and undiagnosed enteropathy (9). Three of the EPEC showed localised pattern of adherence in vitro with HEP-2 cells. Most patients with salmonella and EPEC had severe secretory diarrhea with large fecal sodium losses. All 6 patients who died had secretory diarrhea and very high fecal sodium. All but 4 patients could be effectively managed with a chicken puree-glucose-coconut oil based diet.
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PMID:Associated factors of protracted diarrhea. 225 91

Activated T cells can be identified immunohistochemically in the intestinal lamina propria in a number of gastrointestinal diseases including food sensitive enteropathy (coeliac disease) and intractable diarrhoea of infancy. Experimental studies have shown that T cell activation in human intestinal lamina propria in vitro produces an increase in crypt cell proliferation, villous atrophy, increased HLA-DR expression on enterocytes, increased intraepithelial lymphocyte numbers, and, phenotypically, macrophage activation. All of these features are seen in food sensitive enteropathy and it is proposed that lamina propria T cell activation to food antigens plays the primary role in the pathogenesis of these disorders by altering mucosal morphology and the rate of epithelial cell proliferation.
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PMID:The role of activated T cells in transformed intestinal mucosa. 226 61

Ten patients, who developed postenteritis enteropathy with chronic diarrhoea, failure to thrive and small intestinal mucosal damage after an episode of acute gastroenteritis, were studied prospectively. All patients experienced severe growth retardation. Maximum deviation of height and weight from mean values of age-correlated normal children were -1.7 and -3.1 SD (median values), respectively, as compared to -0.1 and 0 SD before onset of the illness. One child died after 14 months of illness. The long-term outcome was satisfactory for the 9 surviving children. For these children, treatment with an elemental diet (in some cases supplemented initially with parenteral nutrition) and later a lactose-free diet lead to resolution of diarrhoea within periods ranging from 0.5 to 10 months. The phase of catch-up growth lasted from 4 to 36 months, resulting in final height and weight deviating -0.6 and -0.8 SD (median values), respectively, from normal mean values. Attempt to predict duration of diarrhoea or length of catch-up growth phase by means of age, weight before illness, characteristics of small intestinal biopsy or maximum deviation of height or weight were unsuccessful. The incidence of postenteritis enteropathy for children of North European ethnic origin was estimated to be 7.6/1,000,000 children below 7 years of age/year, corresponding to 1.2/1,000 children hospitalized for acute gastroenteritis.
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PMID:Postenteritis enteropathy in infancy. A prospective study of 10 patients with special reference to growth pattern, long-term outcome and incidence. 226 21

The small intestine is a major target in HIV infection. Chronic diarrhoeal disease associated with malabsorption is the principal clinical manifestation of such infection. Reduced intestinal immunity and opportunistic enteric infections play a major role in clinical disease, but an enteropathy induced by HIV per se has also been implicated. The immunopathology of reduced intestinal immunity and its progression during HIV infection is poorly understood. HIV genome and proteins have been detected reproducibly in cells of the lamina propria resembling macrophages, but direct epithelial infection with HIV is controversial. Another factor which may contribute to diarrhoea is autonomic neuropathy within the jejunum. Small intestinal disease causes malabsorption of fat and disaccharides and may contribute to the weight loss seen in advancing HIV infection. However, malnutrition seen in HIV infection is multifactorial and may occur as a constitutional sign of infection in the absence of overt intestinal disease. Reduced food intake does not appear to be a causative factor in the weight loss in constitutionally well stage IV patients and there is some evidence that release of cytokines (TNF alpha/cachectin) into plasma or locally into tissue may mediate such events. The response of HIV-infected individuals to nutritional support is variable, but it is becoming increasingly apparent that the response is limited by the presence of severe systemic infection. However, aggressive nutrition is an important therapeutic mode which should be offered to all HIV-infected patients.
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PMID:Malabsorption, malnutrition and HIV disease. 228 81


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