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

Giardia Lamblia is considered as the most important cause of parasitic diarrhoea in children and adults. The epidemiology of the infection is determined by environmental and regional factors. The sensitivity of man for this infection depends on factors related to man himself and his environment. Structural changes of the gut such as cellular infiltration and villous atrophy, and functional derangements like malabsorption can explain part of the symptoms. The application of different procedures for the parasitological diagnosis with a variable degree of sensitivity is the cause of difference in recorded prevalence data. This infectious disease can be treated with a number of drugs; single dose treatment is to be preferred especially in childhood. Results of treatment i.a. with a single dose ornidazole are reported.
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PMID:[Giardiasis]. 726 56

Stool samples from 775 patients with diarrhoea referred to a hospital over an 18-month period were cultured for Campylobacter fetus ssp. jejuni, and in 55 patients (7.1%), infections were identified. In addition, one asymptomatic patient had a positive stool sample and serological evidence of a current infection. The patients were aged between 11 and 76 years, the majority being in the age group 15 to 39 years. The symptoms included diarrhoea (in almost 100%), fever (in 80%) and abdominal tenderness (in 35%). Almost half the patients vomited. The total leucocyte count was usually normal, but half the patients showed increased numbers of juvenile neutrophils. Eosinopenia and high serum C-reactive protein were frequently seen in the acute phase of the illness. Complications included haematemesis, pancreatic affection, carditis, reactive arthritis, urticaria, and transient malabsorption in one patient who had had a previous Billroth II operation. Invasive disease was occasionally suggested by clinical manifestations of extensive mesenteric lymphadenitis, septicaemia and focal bone necrosis.
Infection 1981
PMID:Clinical and serological studies in patients with Campylobacter fetus ssp. jejuni infection: I. Clinical findings. 733 78

Whipple's disease is a chronic systemic infectious disease caused by Tropheryma whippelii that typically involves the small intestine and causes malabsorption. Extraintestinal manifestations such as arthritis and fever are common and often exist prior to the onset of gastrointestinal symptoms. Involvement of the central nervous system can occur and lead to permanent sequelae. Weight loss, hyperpigmentation, and lymphadenopathy are frequent findings. The definitive diagnosis is made by biopsy of the small intestine mucosa which reveals infiltration of the lamina propria of the small intestine with periodic acid-Schiff positive macrophages. Treatment with trimethoprim combined with sulfamethoxazole for 1 year usually results in clinical remission and an excellent prognosis. Recent advances using molecular techniques to identify the uncultured bacillus of Whipple's disease should lead to a better understanding of the pathophysiology and allow for the development of a sensitive noninvasive diagnostic test.
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PMID:Whipple's disease. 758 31

Goldberger discovered human pellagra was a non-infectious disease, affecting mostly the small and the timid in overcrowded institutions. Symptoms were diarrhoea, dermatitis and dementia. The staff and older children escaped the disease. They ate the meat and left the small and timid with the gravy. The 'Goldberger syndrome' is observed during competitive feeding of livestock, in ketotic animals and in the zinc depleted which are lethargic and pick all day at their feed. The pellagra preventative factor was later found to be nicotinic acid, derived from the amino acid tryptophan. Deficiencies of copper, magnesium, vitamin B6 (activated by a zinc kinase) inhibit the conversion of tryptophan to nicotinic acid. Stresses, including liver diseases, malabsorption, iron overload, porphyria, marasmus, cold stress, pregnancy, lactation, antibiotics and sulfa drugs, all increase dietary needs of nicotinic acid. Elevated free fatty acids and ketone bodies in the blood are associated with ketosis, zinc depletion and the pre-diabetic state. There is a diminished uptake of glucose by the tissues, a condition also found in parturient paresis of dairy cows when elevated hydrocortisone promotes insulin resistance and hyperglycaemia. This defect in insulin response leads to a diabetic-like state. The major predisposing factor in parturient paresis of dairy cows is hypocalcaemia. Gut absorption of dietary calcium may not meet the primary demands of lactation initiation until bone calcium mobilisation is established.
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PMID:Metabolic disorders of cattle. 839

We report a case of isolated levothyroxine malabsorption in the course of chronic intestinal giardiasis, leading to severe hypothyroidism. Infection with Giardia lamblia was proved histologically by jejunal biopsy. Treatment with metronidazole resulted in complete elimination of parasites and recovery of regular intestinal thyroid hormone absorption. Stable euthyroidism was accomplished with common replacement doses of orally administered levothyroxine.
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PMID:Chronic intestinal giardiasis with isolated levothyroxine malabsorption as reason for severe hypothyroidism--implications for localization of thyroid hormone absorption in the gut. 874 Sep 44

The pathophysiology and treatment of colonic motility disorders are reviewed. Colonic dysfunction is a common reason for patients to seek medical care, although patients' perceptions may not reflect abnormal function. Abnormalities in colonic function can result from a primary disorder of the large intestine or from metabolic, neurologic, collagen vascular, neoplastic, or infectious diseases. Irritable bowel syndrome, a common disorder of colonic motility, can be caused by alterations in colonic neuromuscular functions, afferent neural function, or psychosocial factors. Colonic dysmotility can also result from malabsorption of carbohydrates. The most severe form of altered colonic motility is acute colonic pseudo-obstruction. Diagnostic studies should be limited to tests appropriate for the patient's symptoms and apparent severity of disease. Most motility disorders are functional disorders and do not result in abnormal studies. Pharmacotherapy should be directed by objective measures, the most useful of which are measurement of whole gut transit time and quantification of the water content of stools. Treatment should be determined by the nature of the disorder and the symptoms involved. For constipation, treatment should begin with changes in diet, fluid and fiber intake, and concurrent medications. Irritant laxatives can have damaging effects and should not be used habitually; however, polyethylene glycol-based purgatives can be helpful. Newer prokinetic agents, such as cisapride, have been shown to promote colonic motility. For selected patients with intractable constipation, surgery has a good success rate. For patients with functional diarrhea, opioid analogues can increase fluid absorption and delay transit.
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PMID:Challenges in the treatment of colonic motility disorders. 893 27

Our objective was to determine whether a medium-chained triglyceride (MCT)-based diet, compared to a long-chain triglyceride (LCT)-based diet, conveys a beneficial effect on diarrhea and fat malabsorption in human immunodeficiency virus (HIV)-infected individuals with chronic diarrhea and weight loss. A secondary objective was to evaluate the pathogens associated with the diarrhea and to evaluate whether the etiologic agent was a determinant of response to the nutritional intervention. Prospective, randomized double-blind comparative trial was conducted in 24 adult patients with HIV, diarrhea of greater than 4-wk duration, fat malabsorption, and loss of 10-20% of ideal body weight, these patients were recruited from our outpatient infectious disease clinic. Evaluations of diarrheal pathogens were made by complete stool examination, upper and lower endoscopy with quantitative culture, and biopsy. Body composition determinations, and measurements of fat, carbohydrate, and vitamin absorption pre- and postintervention. Patients were randomly assigned to one of two complete nutritional products with either medium- or long-chain triglyceride fat exclusively for 12 d followed by treatment of infectious pathogens. Ten patients were found to have Microsporidium and 9 patients had no identifiable pathogen. All patients responded to intervention with both nutritional products overall with 45% fewer stools, decreased stool fat and weight, and a significant increase in urine nitrogen. The group that received the MCT product demonstrated significantly decreased stool number (mean 4 to 2.5), stool fat (mean 14 to 5.4 g), and stool weight (mean 428 to 262 g) compared with baseline (P < 0.01 for all). Patients with both species of microsporidia and with pathogen negative diarrhea had good response. We found that HIV patients with diarrhea, regardless of etiology, and documented fat malabsorption may benefit symptomatically from a diet composed of an MCT-based liquid supplement.
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PMID:A medium chain triglyceride-based diet in patients with HIV and chronic diarrhea reduces diarrhea and malabsorption: a prospective, controlled trial. 897 2

Interactions between undernutrition, infection, and growth and development are complex, and are reviewed in this article, giving particular emphasis on the importance of diarrheal infection in this process. The effects of diet, nutrition and infection on the nutritional status of a child can vary according to the disease ecology, the age of the child, patterns of feeding and types of food consumed. There are two possible ways in which this relationship can begin; one in which poor nutritional status leads to impaired immunocompetence and reduced resistance to infection, and the other in which exposure to infectious disease can lead to appetite loss and anorexia, malabsorption, and elevated metabolism of energy and other nutrients. Once started, the interactions between these two major environmental stressors becomes increasingly complex, with the nature of the disease ecology influencing the balance of immunoparesis and adaptive immunity and its effect on subsequent disease experience. Furthermore, the disease ecology influences the type and extent of associated physiological phenomena including anorexia, fever, and malabsorption, all of which have an impact on nutritional status. Of disease categories, diarrhea has particularly potent effects in this relationship. The predicted impact of HIV infection among newborn infants is the earlier onset of the undernutrition-infection cycle, as low CD4+ T lymphocyte counts soon after birth are likely to predispose such infants to earlier opportunistic infection.
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PMID:Transdisciplinarity in the study of undernutrition-infection interactions. 922 95

Previous investigations showed that Schistosoma mansoni infection aggravates protein malabsorption in undernourished mice and this can be reverted by administration of casein hydrolysate. The present study was undertaken to evaluate the effects of ingestion of casein hydrolysate for long periods. Albino Swiss mice were divided into eight groups. Diets contained 5% (undernourished) or 20% (controls) casein levels. For each group there were sub-groups ingesting whole or hydrolysed casein for 12 weeks. Infection with S. mansoni developed in half of the animals under each diet. All undernourished mice developed malabsorption. Low albuminemia was detected in infected animals independently of the protein level in the diet. However, albuminemia was lower in infected controls than in undernourished non-infected mice, suggesting a deficient liver protein synthesis. Infected mice fed on a 20% protein hydrolysed diet exhibited low weight gain and high mortality rates. On the other hand, non-infected mice ingesting the same diet had the highest body weights. We are investigating the hypothesis that infected mice, even when fed normal diets, are unable to metabolise large amounts of amino acids due to the liver lesions related to schistosomiasis and as a result die of hepatic coma. In some of them, the excessive accumulation of ammonia in the blood enhances the outcome of an encephalopathy.
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PMID:A long-term intake of a protein hydrolysate seems to increase the risk of encephalopathy in mice infected with Schistosoma mansoni. 992 50

Patients with acquired immunodeficiency syndrome (AIDS) often suffer from weight loss manifested by a loss of body cell mass (BCM). The causes of human immunodeficiency virus (HIV)-associated wasting may include anorexia, malabsorption, and a variety of altered metabolic states. Malabsorption and diarrhea may result from gastrointestinal tract opportunistic infections or from direct effects of HIV on the gastrointestinal tract. Infection with HIV may produce metabolic derangements that alter nutrient utilization, resulting in loss of BCM. Nutritional assessment of the patient with AIDS should include an evaluation of BCM and physical and psychosocial functioning. Antiretroviral therapy and eradication of opportunistic infections do not always reverse wasting. Treatment should include nutritional counseling. Total parenteral nutrition is sometimes of benefit, particularly in patients with damaged gastrointestinal tracts. Dronabinol and megestrol acetate may promote weight gain; however, dronabinol may have adverse effects, and most of the gain with megestrol acetate is in fat rather than BCM. If gonadal dysfunction is present, testosterone replacement therapy should be included in the treatment plan. Some studies suggest that oral anabolic steroids may improve muscle strength and body composition. In randomized, placebo-controlled trials, mammalian-derived human growth hormone (rhGH[m]) has produced sustained weight and BCM gains in AIDS patients. If a patient continues to lose BCM after the above factors have been addressed and corrected, a 12-week course of rhGH[m] is indicated. Halting the progression of HIV-associated wasting may improve survival, enhance physical and social functioning, and enrich quality of life.
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PMID:Treatment guidelines for HIV-associated wasting. 1076 94


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