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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper focuses on recent advances by the Indonesian Pediatric Gastroenterology in the field of diarrheal diseases: 1) the 'ROSE' system as the principle of treatment of diarrhea. It has been proven to be effective in reducing mortality rate of acute gastroenteritis, particularly cholera. R stands for rehydration, preferably with Ringer's lactate solution. O for Oralyte or oral glucose electrolyte, S for simultaneous rehydration (intravenously and orally), and E for educating parents in oral rehydration. 2) MCT and low lactose-containing formula in low birthweight infants give good to excellent results in improving fat malabsorption, elimination of diarrhea, and increase of body weight. 3) the use of the pediatric Enterotest duodenal capsule to study the upper intestinal microflora. The capsule consists of a number 1 size gelatin capsule (20 mm x 6 mm) containing a silicone rubber bag with an attached fine yarn line 90 cm long. The free end of the line is taped to the cheek and the patient swallows the capsule. After a certain period of time, the line is pulled out and intestinal secretions are scraped from the line and immediately examined under the microscope. Enterotest is particularly useful where radiologic examination is not available. 4) this report is the 1st to document virus particles in fecal specimens from Indonesian children, and suggests that viruses may be important etiological agents in diarrheal diseases in Indonesia, where malnutrition and diarrhea are important health problems.
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PMID:Recent advances in the Indonesian paediatric gastroenterology. 65 63

Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency.
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PMID:Gastroenterological emergencies in the tropics. 176 26

Almost all segments of the gastrointestinal tract have been used as urinary tract substitutes. The specific nutritional and gastrointestinal complications depend on the particular portion of bowel that is removed from the alimentary tract. The use of stomach theoretically may predispose the patient to hypergastrinemia and peptic ulcer disease, hypocalcemia, and iron deficiency or megaloblastic anemia. Resection of a large amount of jejunum causes malabsorption. Limited use of colon segments usually is well tolerated, but loss of large parts of the colon directly decreases available absorptive area, resulting in diarrhea. Resection of the ileum and ileocecal valve can lead to several disease states. One is mixed secretory-osmotic diarrhea. Decreased ileal reabsorption of bile salts results in fat malabsorption and steatorrhea. The presentation of increased amounts of bile salts and fatty acids to the colon decreases water absorption and stimulates active chloride and water secretion, producing a cholera-like high-volume secretory diarrhea. The loss of the ileocecal valve and ileum segment accelerates intestinal transit time, which does not allow for complete digestion and absorption of food. Water and electrolytes remain associated with undigested food particles and may overwhelm the absorptive capacity of the colon, resulting in an osmotic diarrhea. A second problem is vitamin B12 deficiency. Surgical reduction of sites in the terminal ileum for active and exclusive uptake of vitamin B12 might lead to hypovitaminosis. If this is unrecognized, patients may develop irreversible neurologic injury. A third problem is cholelithiasis. Derangements in bile salt metabolism can occur when as little as 10 cm of ileum is resected, and the propensity to form gallstones is increased. Pigment gallstones appear to be the predominant stone associated with ileal resections. The fourth possible problem is urolithiasis, the etiology of which is multifactorial in patients with ileal resections. With decreased availability of bile salts, fat malabsorption occurs. Fatty acids bind with calcium and magnesium to form soaps, resulting in increased levels of free oxalate available for absorption. Moreover, fatty acids directly increase colonic permeability to oxalate.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Nutritional and gastrointestinal complications of the use of bowel segments in the lower urinary tract. 194 6

Diarrhea affects approximately 330,000 travelers from industrialized nations each year. Diarrhea is a reflection of inadequate hygiene or waste disposal in the countries visited, usually developing countries. The greatest incidence occurs in 20-29 years olds who take the most dietary risks. Some foods that pose the greatest risk in descending order include raw oysters, steak tartare, ice cubes, washed vegetables, cold milk, puddings, and sandwiches with mixed fillings. 40% of all travelers have a self limiting and rarely grave diarrheal illness caused by local enterotoxigenic Escherichia coli (ETEC). Following an incubation period of 5-9 days, symptoms appear (cramps, fever, and 10 or more diarrheal episodes/day). 5% are infected with Giardia lamblia and 4% with Entamoeba histolytica. Giardiasis occurs worldwide and is characterized by grumbling diarrhea, cramps, and flatulence. E. histolytica causes a severe illness characterized by colitis with bloody stools, anorexia, malaise, sweats, weight loss, and epigastric pain. Only 10-100 Shigella bacteria are required by cause shigellosis. Symptoms include blood and mucus in the diarrhea and malaise. A traveler who ingests food with 100,000 Salmonella bacteria in it most likely will fall ill 48 hours after eating the contaminated food. Typhoid and paratyphoid fevers have an incubation period of about 12 days and may be fatal. Initial symptoms consists of headache, malaise, fever, and pain and 2 weeks later bloody diarrhea appears. Additional common diarrheal illnesses include cholera, post infectious tropical malabsorption, and those caused by Vibrio parahaemolyticus and Campylobacter species. Another disease common in areas of poor hygiene is poliomyelitis with fever, sore throat, and headache present in mild forms. If the virus invades the central nervous system, however, paralysis occurs.
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PMID:Exotic diarrhoeal problems and poliomyelitis. 259 59

Net electrolyte and water transport and unidirectional Na+ fluxes were examined in ligated colonic loops of clinically normal pigs and in pigs with swine dysentery (etiologic agent Treponema hyodysenteriae) in the presence or absence of theophylline. In normal pigs, theophylline abolished net Na+ absorption via a reduction in the lumen-to-blood flux, decreased Cl- absorption, and increased HCO3- accumulation in the lumen. In infected pigs, all net ion transport was abolished, with the addition of theophylline producing little effect. The absence of net Na+ absorption in infected pigs was also the result of a decreased lumen-to-blood flux. Seemingly, colonic malabsorption may be the primary transport alteration in swine dysentery. Concentrations of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were measured in samples of colonic mucosa from normal and infected pigs after in vitro exposure to a Ringer's solution containing 0 or 20 mM theophylline. Basal values of cAMP or cGMP did not increase in infected colonic mucosa. There was a diminished capacity of the infected mucosa to respond to theophylline. Alterations in ion transport in conjunction with measurements of cAMP and cGMP indicated that the pathogenic mechanism(s) in swine dysentery were not similar to those of Salmonella, Shigella, Vibrio cholerae, or Escherichia coli diarrhea.
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PMID:Pathophysiologic features of swine dysentery: cyclic nucleotide-independent production of diarrhea. 630 41

The gastrointestinal hormones, which are continuously increasing in number, have certain effects which could play a part in the pathogenesis of infectious diarrhoea. This refers especially to VIP, motilin, and enteroglucagon, the plasma concentrations of which are elevated in acute infectious diarrhoea, cholera, and tropical malabsorption. They may act by stimulating intestinal secretion, inhibiting absorption, and altering intestinal motility. In addition, there are some hormonal effects such as those caused by glucagon on motility, by enkephalins on secretion, and by somatostatin on both, which have a therapeutic potential and deserve further investigation.
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PMID:Infectious diarrhoea and gastrointestinal hormones: potential therapeutic implications. 635 26

Fluid therapy took nearly a century to gain acceptance in human medicine, despite excellent early work demonstrating its rationale and its effectiveness. Progress in veterinary fluid therapy lagged behind, partly because of skepticism and partly because of real practical difficulties. From the earliest to the most recent developments, human cholera has provided the impetus for much of the progress in fluid therapy. The challenge of treating such a severe diarrhoea in primitive surroundings with severe limits on cost and supervision has led to the emergence of oral fluid therapy as the prime technique. It is not simply an alternative to parenteral treatment but, in most cases, a superior approach relating more directly to the underlying problem--electrolyte malabsorption. Similar principles can be applied to other forms of diarrhoea and in various species. The example is clear for those concerned with veterinary fluid therapy. Repair of extracellular fluid volume is the key objective in all forms of fluid therapy; oral hydration offers not only a practicable way of achieving this in farm animals but one with the potential for outstanding clinical and economic success.
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PMID:Fluid therapy for alimentary disease: origins and objectives. 637 32

This study compared, in children with cholera-like severe diarrhea, an oral glucose-electrolyte solution with an oral sucrose-electrolyte solution in equimolar amounts (WHO formula) in a double-blind manner. Of 111 patients, 55 were given sucrose and 56 glucose solutions. An absence of the need to use unscheduled intravenous therapy defined the success rate, which was similar in both groups: 73 and 77%, respectively, in the sucrose and glucose groups. Purgation rates also showed no difference between groups. The main determinant of success for oral fluid regardless of the sugar used was the purging rate. 1 failure of therapy in the sucrose group was attributed to sucrose malabsorption. It is concluded that sucrose is an effective alternative to glucose for oral rehydration therapy, but if the diarrhea has caused severe dehydration before the start of treatment, intravenous supplementation must also be used.
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PMID:Oral therapy in children with cholera: a comparison of sucrose and glucose electrolyte solutions. 735 Mar 10

This randomized trial compared the efficacy of a rice-based (50 g/L) oral rehydration solution with the standard glucose-based WHO/UNICEF solution in the treatment of 100 hospitalized infants, ages 3-18 months, with acute dehydrating diarrhea. The main outcomes examined were stool output and duration of diarrhea. Patients were placed on a "metabolic" bed so that intake and losses could be measured accurately throughout the study. Overall, 89% of patients were successfully rehydrated orally; the rehydration failure rate was similar in the two groups and it was significantly associated with infection by specific E. coli serotypes. Stool output in the first 24 h was 11% lower in the rice group (112 versus 126 ml/kg), but this difference was not significant. Neither stool output in the second 24 h nor total stool output were different between groups. The median duration of diarrhea was 3.8 days in the rice group and 3.9 days in the glucose group (p = NS). Other (secondary) outcomes, such as fluid intake, urine output, emesis losses, weight change, and electrolyte balance were also similar between the two groups. Some evidence of carbohydrate malabsorption was detected in 61% of the rice group versus 45% of the glucose group (p = NS) and was not associated with any particular treatment outcome. These results show that a rice-based oral rehydration solution is as efficacious as, but not better than the standard glucose-based solution in the treatment of infants with acute dehydrating diarrhea not associated with cholera.
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PMID:Comparison of an oral rice-based electrolyte solution and a glucose-based electrolyte solution in hospitalized infants with diarrheal dehydration. 763 84

The article describes two female patients with severe diarrhoea. Both patients were suspected of having an organic diarrhoea syndrome and underwent extensive investigations. No specific diagnoses such as inflammatory bowel disease, pancreatic cholera, malabsorption and surreptitous ingestion of laxatives could be established. Histologic examination of biopsy specimens from apparently normal colon revealed microscopic changes characteristic of "microscopic colitis" in one of the patients, and of collagenous colitis in the other. The authors discuss similarities between these two microscopic abnormalities in colonic mucosa and their close association with chronic watery diarrhoea.
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PMID:["Microscopic colitis" and collagenous colitis. Unusual explanation of diarrhea of unknown origin]. 848 Feb 90


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