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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen patients with severe scleroderma bowel disease began receiving home central venous hyperalimentation (HCVH) between 1979 and 1987. The major reasons for instituting HCVH were intestinal pseudo-obstruction, malabsorption, and malnutrition. Eleven patients had an improved quality of life. Serious complications encountered over these 15,700 catheter-use days were 2 episodes of septicemia and 2 episodes of superior vena cava obstruction. Seven patients died, but none directly from their gastrointestinal disease or from the HCVH.
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PMID:Home central venous hyperalimentation in fifteen patients with severe scleroderma bowel disease. 249 54

From 1980-1986 intestinal mucosal lymphangiectasia was diagnosed histologically in eight patients (6 weeks to 16 years; four males/four females; seven white). The presenting features were diarrhea (six/eight), vomiting (four/eight), and growth deficit (seven/eight). Additional conditions in these patients included asthma, urinary tract infection, esophageal atresia, hydrops fetalis, inflammatory bowel disease, malabsorption syndrome, and thymic hypoplasia. Hypoalbuminemia and edema (four/eight) were more prominent in those patients under 5 years of age. Two had systemic lymphangiectasia and lymphopenia. The patients responded variably to hyperalimentation and dietary supplements, depending on the extent of their lymphangiectasia and the age at onset of symptoms. Dilated lymphatics were seen in the small intestinal mucosa under the surface epithelium. Lesions were often focal, requiring several biopsies or serial sections for detection. Other common findings were mild to moderate lymphoplasmacytic inflammation and mild to moderate villous injury with blunting and edema. Mild inflammation without lymphangiectasia was also present in esophageal, gastric, or colonic biopsies. Diagnosis should be made on the basis of endoscopic findings or in small-intestinal inflammatory conditions even in the absence of a classic clinical picture. Histologic confirmation may require more than one serially sectioned biopsy. This study confirms the diversity of disorders that may be associated with intestinal lymphangiectasia and shows that the disease in infants is more severe and generalized.
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PMID:Intestinal lymphangiectasia in children: a study of upper gastrointestinal endoscopic biopsies. 274 90

Sixteen patients given total pancreatectomy were experienced, and the essential points of postoperative management were reported. The morbid states after total pancreatectomy consist of: a deficiency of pancreatic endocrine function, a deficiency of pancreatic exocrine function, loss of the duodenum and upper jejunum, the influence of partial or total gastrectomy, and the influence of dissection around the superior mesenteric artery. These states influence each other and become more complicated. The management period is divided into five parts as follows; a period of intravenous nutrition, the early half; water replacement period, the late half; hyperalimentation period, a period of intravenous and enteral nutrition, a period of enteral, intravenous and oral nutrition, a period of oral and enteral nutrition, and a period of oral nutrition. In each period, a special form of management is needed. The essential points of long-term management are as follows: The use of suitable doses of pancreatic enzyme and antidiarrheal agents for the cure of severe maldigestion and malabsorption. Also, intermittent IVH or elemental diet are effective for recovery from deteriorative malnutrition. For the prevention of hypoglycemic attack, training of the patients and the maintainance of good nutrition are important. These patients have a high incidence of infection, and so speedy treatment must be given if this occurs. Fatty liver must be treated by intermittent IVH or elemental diet. As total pancreatectomy imposes a severe burden on the patient, including self-injection of insulin, the indications of this operation must be decided carefully giving due consideration to its radicality.
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PMID:[Postoperative management of total pancreatectomy]. 309 14

It is a common clinical practice to initiate enteral hyperalimentation using low flow rates or diluted formula. These adjustments are made in an effort to minimize patient intolerance. Using complex and elemental enteral formulas, we investigated whether various flow rates or osmolalities effected clinical intolerance or carbohydrate malabsorption in 20 healthy volunteers. Our infusion rates ranged between 50 and 150 kcal/hr and the osmolalities ranged between 325 and 690 mOsm/Kg of water. Even at the maximal flow rate and osmolality, our results show that both types of enteral formulas were well tolerated as assessed by the frequency of abdominal pain, bloating, passage of rectal gas and stooling. No carbohydrate malabsorption was detected as measured by breath hydrogen. In well nourished subjects, our findings do not support the common clinical practice of initiating alimentation with low flow rates or diluted formula.
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PMID:Effect of enteral formula infusion rate, osmolality, and chemical composition upon clinical tolerance and carbohydrate absorption in normal subjects. 309 2

Lipids are an essential component of our body composition and necessary in our daily food intake. Conventional fats and oils are composed of glycerides of long chain fatty acids and are designated as long chain triglycerides (LCT). Body fat as well as the fats and oils in our daily intake fall into this category. In enteral and parenteral hyperalimentation, we can identify such LCT fats and oils. Soy, corn, safflower and sunflowerseed oils are typical of the LCT oils. In the search for alternative noncarbohydrate fuels, medium chain triglycerides (MCT) are unique and have established themselves in the areas of malabsorption syndrome cases and infant care and as a high energy, rapidly available fuel. Structure lipids with a MCT backbone and linoleic acid built into the triglyceride molecule have been developed to optimize the triglyceride structure that is best for patients, particularly the critically ill. Structured lipids with built-in essential fatty acid components or other polyunsaturated fatty acids promise greater flexibility in patient care and nitrogen support.
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PMID:Medium chain triglycerides and structured lipids. 311 86

Common variable hypogammaglobulinemia (immunodeficiency), a disorder characterized by late-onset immunoglobulin deficiency and lack of humoral immunity, has a variable association with bronchiectasis, cholelithiasis, nodular lymphoid hyperplasia, gastrointestinal neoplasia, megaloblastic anemia, and malabsorption. The patient described in this report had all of the above except neoplasia. In addition, he had calcium oxalate renal stones probably secondary to his malabsorption. The first case demonstrating the beneficial effect of home hyperalimentation in patients with severe malabsorption refractory to other treatments is described. Home hyperalimentation overnight allows the patient freedom for daily activities while also being more cost-effective than in-hospital parenteral nutrition.
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PMID:Home hyperalimentation for common variable hypogammaglobulinemia with malabsorption secondary to intestinal nodular lymphoid hyperplasia. 311 40

The hypermetabolic state observed in thermally injured patients warrants aggressive nutritional management. Enteral support is the preferred route of nutrient delivery, however diarrhea is reported to be a persistent complication of continuous nasogastric or nasoduodenal hyperalimentation. Diarrhea adds to problems in patient care, disturbs fluid and electrolyte balance, and worsens nutritional status. There has been the impression that tube feeding hyperosmolality, antibiotics, and low serum albumin induce diarrhea. However, in view of the sparsity of published work, a prospective study was undertaken to determine the incidence of diarrhea and to define factors associated with its cause. Of the 50 patients studied, 16 (32%) developed diarrhea. Stool cultures were negative for pathogenic organisms. Although the risk of diarrhea was associated with antibiotics (p less than 0.005), several nutrients also had an impact. Results demonstrated a significant relationship between dietary lipid content (p less than 0.05) or vitamin A intake (p less than 0.001) and diarrhea. Implementation of tube feeding within 48 hrs postburn was also associated with a decreased incidence of diarrhea (p less than 0.001). This paper describes a modular tube feeding program in which diarrheal frequency is lessened (p less than 0.0001). Surprisingly, tube feeding osmolality, drugs used to prevent stress ulcers, or hypoalbuminemia did not have an adverse effect on intestinal absorption. The cause of diarrhea in burn patients is obviously multifactorial. It is concluded that a low fat (less than 20% of caloric intake), vitamin A enriched (greater than 10,000 IU/day), early enteral support program maximizes conditions which promote tube feeding tolerance while minimizing nutrient malabsorption during the nutritional rehabilitation of thermal injury.
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PMID:Diarrhea in tube-fed burn patients: incidence, etiology, nutritional impact, and prevention. 313 42

Cystic fibrosis children tend to have a low birth weight and their mean height and weight during childhood is below that for the general population. They also tend to have a delayed bone age and puberty. The degree of underweight correlates more closely with the respiratory condition than with the degree of malabsorption. There is evidence that their nutritional requirements are increased, perhaps up to 150% of the recommended daily allowance, but in later childhood their food intake is frequently low and maybe the major reasons for their poor growth and development. Specific deficiencies of vitamins, minerals and essential fatty acids occasionally present as clinical problems. New approaches to nutrition include increasing dietary fat, which was traditionally low because of malabsorption, and this change has been made possible with the development of modern pancreatic supplements. Supplementary nutrition with elemental diets or intravenous hyperalimentation have given promising results in some studies and might be expected to improve the patient's resistance to infection as well as his nutritional state. The place of oral essential fatty acid supplements is still being evaluated, but intravenous infusions of fat emulsion are not justifiable in themselves.
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PMID:The nutritional state and nutrition. 390 27

Nutritional intake or absorption may be compromised by radiation therapy (RT) when large portions of the gastrointestinal tract are treated. Dietary counseling, oral supplements, tube feedings and intravenous hyperalimentation (IVH) have been employed to limit weight loss and lessen intestinal RT side effects. Unfortunately, no prospective study reviewed has shown improved tumor control or patient survival. Special diets and IVH have also been employed in select patients to relieve chronic malabsorption from severe radiation enteritis.
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PMID:Critical evaluation of the role of nutritional support for radiation therapy patients. 391 59

A 50% small bowel bypass was performed in diabetic rats (streptozotocin-treated) and in normal rats. Normal rats and diabetic rats were used as controls. Values of fasting blood glucose and oral glucose tolerance test showed a normalization and the disappearance of glycosuria, polyuria, polydipsia and hyperphagia in diabetic rats after surgery. Mean loss of weight 3 months after surgery was 9.1% in normal bypassed rats and 60.5% in the diabetic controls. After an initial postoperative weight loss of 33.4%, the diabetic bypassed rats gained subsequently their previous weight plus an increase of 7.2%. Improvement in carbohydrate metabolism appears to be independent of loss of weight and decrease in food intake in lean diabetic rats. Amelioration of diabetes after jejunoileal bypass is the result of several metabolic consequences, particularly the malabsorption of carbohydrates, fats and amino acids.
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PMID:Observations on the metabolic effects of partial jejunoileal bypass in streptozotocin-treated rats. 397 2


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