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

The changes in pH and concentration of electrolytes in the jejunal lumen after a hypertonic fluid meal have been studied after truncal vagotomy and drainage, with and without diarrhoea. The results show that, in these respects, there are no specific changes in the jejunal content associated with post-vagotomy diarrhoea, but that these measurements are markedly affected by the completeness of vagotomy, as judged by the insulin test.
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PMID:Post-prandial changes in PH and electrolyte concentration, in the upper jejunum after truncal vagotomy and drainage in man. 0 56

A 59 year old woman with insulin-dependent diabetes mellitus and chronic diarrhea was found to have mild steatorrhea, selective plasma IgA deficiency and adrenal insufficiency. Significant adrenal secretion of corticosteroids resulted only after prolonged stimulation with large doses of exogenous ACTH. Plasma ACTH levels were not elevated during clinical adrenal insufficiency or after metyrapone administration but did respond normally to vasopressin and insulin-induced hypoglycemia. These studies were interpreted as showing both primary adrenal insufficiency and impaired pituitary reserve for ACTH secretion in response to the feedback stimulus. No deficiency was found in secretion of other pituitary tropic hormones. Jejunal biopsy showed a lack of IgA-containing plasma cells. With cortisone replacement, diarrhea subsided and a malabsorption pattern on a film of the small bowel was no longer seen. IgA deficiency has been noted frequently with steatorrhea but rarely with diabetes and only once previously with adrenal insufficiency.
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PMID:Atypical adrenal insufficiency with failure of the pituitary feedback receptor. A case with associated diabetes mellitus and selective IgA deficiency with steatorrhea. 17 48

A case of chronic secretory diarrhea with elevated plasma vasoactive intestinal peptide (VIP) and serum gastrin levels is described. Plasma secretin, glucagon, insulin, and cyclic adenosine and guanine monophosphate (cAMP and (CGMP) concentrations were normal. Administration of a prostaglandin synthetase inhibitor failed to decrease the volume of diarrhea. There was no evidence of laxative abuse, antral cell hyperplasia, gastric hypersecretion, or pancreatic hypersecretion. The pancreatic histology was interpreted as islet cell hyperplasia. Jejunal tissue cAMP and cGMP concentrations were in the same range as those obtained from three control subjects. This report suggests that cyclic nucleotides may not mediate intestinal secretion in hormone-induced diarrhea.
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PMID:Normal jejunal cyclic nucleotide content in a patient with secretory diarrhea. 21 Jul 31

Verner and Morrison, in 1958, reported non-insulin-secreting tumours of the pancreas that were associated with a syndrome of refractory diarrhea, achlorhydria and hypokalemia. Surgical resection of such tumours results in rebound acid hypersecretion and cessation of the watery diarrhea. The authors report the case of an 84-year-old man who had three of the four major criteria for diagnosis of the Verner Morrison syndrome. Hypokalemia was absent, but this was possibly due to the large doses of potassium chloride that he was taking in conjunction with diuretics. After resection of the tumour severe obstipation with resultant bowel obstruction developed in addition to rebound hypersecretion and relief of watery diarrhea. Treatment, consisting of bulk laxatives in appropriate amounts, alleviated the obstipation.
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PMID:Recurrent obstipation as a complication of partial pancreatectomy for non-beta cell adenoma of the pancreas. 22 19

In blind studies the effects of a new alpha-glucosidase inhibitor (BAY g 5421) were tested in normal weight and overweight male volunteers after oral application of 75, 150, or 300 mg of BAY g 5421 or placebo per os before three standardized main meals of one day. Before and three hours after each meal blood glucose, serum insulin, and serum triglyceride levels were determined. In addition, safety studies were performed. BAY g 5421 induced a statistically significant, in part dose-dependent inhibition of the postprandial increase of blood glucose- and serum insulin levels. The reduction of the postprandial increase of serum triglyceride levels was variable. Routine blood chemistry and hematology tests have revealed no adverse side effects; but the application of the drug was frequently associated with intestinal effects, such as flatulence and diarrhea, which were substrate (carbohydrate) and, in part, dose-dependent.
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PMID:The effects of the alpha-glucosidase inhibitor BAY g 5421 (Acarbose) on meal-stimulated elevations of circulating glucose, insulin, and triglyceride levels in man. 37 42

Lesser curve superficial seromyotomy has been investigated in the dog and in man. The anatomical basis for the operation, which produces an easily performed denervation of the parietal cell mass, is discussed. Acid studies in the dog confirmed that the operation was capable of producing secretory inhibition in keeping with vagotomy of the parietal cell area. A consecutive series of 25 patients with chronic duodenal ulcer has been treated by lesser curve myotomy without a drainage procedure. The operation has the advantages of being easily performed and the risk of damage to the nerve of Latarjet or of ischaemic necrosis of the lesser curvature is obviated. In 20 insulin tests performed within the first month postoperatively all patients have been negative within the first 75 min and there were 4 late positive responses. Early clinical results have been encouraging, there has been no dumping or diarrhoea and all patients are well. It is suggested that further investigation of lesser curve myotomy is warranted.
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PMID:Lesser curve superficial seromyotomy--an operation for chronic duodenal ulcer. 50 50

Fourteen adults in whom diabetes mellitus and coeliac disease coexist, are described. In no patient was coeliac disease diagnosed (biopsy proven) before the age of 28 years. Diabetes was recognized before coeliac disease in all except one. Diabetic control was very unstable and hypoglycaemia particularly troublesome before treatment with a gluten free diet. Following gluten restriction, insulin requirement increased in six patients, and diabetic control became more stable. Diarrhoea due to coeliac disease in a patient with coexisting diabetes, may be mistakenly diagnosed as 'diabetic diarrhoea'. However, certain clinical and laboratory features should arouse suspicion that the diarrhoea is not of diabetic origin. These included a history of gastrointestinal symptoms preceding the diagnosis of diabetes, the occurrence of repeated hypoglycaemia, absence of neuropathy, anaemia, low serum folate, low serum albumin and a malabsorption pattern on small bowel radiography. A definitive diagnosis of coeliac disease can be made only jejunal biopsy. The opportunity to diagnose coeliac disease in adult diabetics will usually fall to the diabetologist and wider use of jejunal biopsy in diabetics with chronic or recurrent diarrhoea is suggested.
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PMID:Diabetes mellitus and coeliac disease: a clinical study. 67 52

The decreased glucsoe utilization in diabetes mellitus justifies the use of sugar substitutes ("diabetic sugar") if two conditions are fulfilled: 1)The sugar substitute should be a carbohydrate which does not lead, or only to a slight degree, to hyperglycaemia and thus, in this respect, differs distinctly from sugars such as glucose and saccharose. 2) The sugar substitute must not cause undesired side-effects. The absorption, utilization and side-effects of the sugar substitutes fructose, sorbitol and xylitol were investigated. They were found to be more slowly absorbed than glucose and thus to offer the advantage of better utilization under conditions of limited insulin production. However, the particularly slow passive absorption of sorbitol and xylitol can sometimes be a disadvantage, since osmotic diarrhoea may occur after administration of high oral doses. The sugar substitutes enter the metabolism enzymatically and are utilized mainly in the liver. The peripheral state was investigated after intravenous, intraduodenal and oral administration of glucose and fructose to healthy subjects. Liver metabolism was examined (Dietze) by comparing hepatic venous and arterial concentrations after intravenous administration of the sugars. Also, diabetic patients received glucose and fructose orally. As previously demonstrated, the investigations using several techniques showed a smaller influence on blood glucose and serum insulin concentrations after administration of fructose, sorbitol and xylitol than after glucose. If no metabolic changes occur after intravenous administration of high doses, no such changes need be expected after oral administration of small doses. Nor did measurements in hepatic venous blood (Dietze) show any marked effect of fructose on the blood glucose level. The healthy subjects showed no significant changes in blood glucose or serum insulin concentration after either intraduodenal or oral administration of fructose, whereas they showed a considerable increase after glucose administration. Investigations in adult-type diabetics revealed a better utilization of fructose than glucose. With correct dosage, sugar substitutes are able to increase the carbohydrate tolerance and, under certain conditions, to achieve a relative stabilization of the metabolism of unstable diabetics. The antiketogenic activity of sugar substitutes is particularly pronounced. Side-effects such as high blood levels of urea, lactate, triglycerides and bilirubin or a decrease in hepatic adenin nucleotides do not occur after oral administration, nor are they of importance after intravenous administration with correct dosage. The osmotic diarrhoea occurring after intake of sorbitol or xylitol is caused by their slow absorption and limits the consumption of these sugar substitutes. In the often obese adult-type diabetics, the calorie intake inherent in the consumption of diabetic sugars may have an unfavourable influence on their weight...
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PMID:[Sugar substitutes in the diabetic diet]. 78 58

In 24 diabetic children treated with insulin xylitol was used as a sugar substitute for four weeks in an amount of 30 gms/day. In one case only the xylitol application was terminated before the end of the dietetic period because of diarrhoea. The other children tolerated xylitol fairly well, three of the children found the polyol too sweet. Because of incomplete data, the values of only 18 children were compiled. A significant increase of serum uric acid concentration measuring 1 mg/100 ml was the main side effect of xylitol usage. This effect was favoured by the fact that diabetic children do not use sucrose. As was shown earlier, a sucrose free period is the precondition for the possibility to find a xylitol induced hyperuricemia. In metabolically healthy children the existence of a sucrose induced hyperuricemia is also to be expected, this xylitol effect is, therefore, obviously without pathophysiological significance. Xylitol is suited for use as a sugar substitute in diabetic diet and in caries prophylaxis if the limited dose is observed.
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PMID:[Use of xylitol as sugar substitute in diabetic children]. 83 37

Twenty-four insulin-dependent diabetics, including seven with diabetic diarrhoea, were studied by means of the 14C-glycocholate (14C-GCA) test and various tests for autonomic dysfunction. The breath component of het test was abnormal in four of the seven patients with diarrhoea and one of the other diabetics. Three patients with diarrhoea and a positive breath test result responded to antibiotics, whereas two with diarrhoea and a negative test result did not. High faecal 14C, suggesting bile acid malabsorption, was found in only one patient with diarrhoea and he had previously failed to respond to cholestyramine. These results suggest that bacterial overgrowth in the small intestine does occur in some but not all patients with diabetic diarrhoea and that the 14C-GCA test can predict the response to antibiotics. All the patients with diabetic diarrhoea had good evidence of autonomic dysfunction.
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PMID:The 14C-glycocholate test in diabetic diarrhoea. 97 31


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