Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a retrospective study, jejunal mucosal disaccharidase and alkaline phosphatase activities have been investigated in 40 controls and patients with proven celiac sprue (n = 26), lactase deficiency (n = 26), osteoporosis or osteomalacia (n = 16), chronic pancreatitis (n = 12), giardiasis (n = 7), or Crohn's disease (n = 7). Apart from a nonselective reduction of mucosal enzyme activities in the sprue syndrome and a selective reduction of lactase activity in the patients with primary lactase deficiency, assays of mucosal disaccharidases revealed only inconstant or slight deviations from the control group and were not of diagnostic significance for any of the above-mentioned disorders. Isolated forms of enzyme deficiencies other than lactase deficiency, such as sucrase-isomaltase or trehalase deficiency were not present among 168 investigations carried out from 1972-1982. It is concluded that assay of small intestinal disaccharidase or alkaline phosphatase activities does not expand the diagnostic impact of morphological examination of small bowel biopsy specimens and modern noninvasive methods for the detection of carbohydrate malabsorption. Thus, the method does not appear a necessary or relevant investigation in routine clinical practice.
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PMID:Is the assay of disaccharidase activity in small bowel mucosal biopsy relevant for clinical gastroenterologists? 274 34

The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all patients with inflammation or resection of the terminal ileum over a length more than 20 cm. In 64% of these patients bile acid malabsorption could also be detected by the absence of a significant rise of the postprandial CG serum level but only if the loss of the ileal function exceeded 30 cm. Although less sensitive than the 75SeHCAT retention, the CG method is simpler to apply in terms of laboratory technology and does not involve exposure to radioactivity. The CG method appears to be of use to detect bile acid malabsorption in certain cases. In the case of negatively if still bile acid malabsorption is suspected more sensitive tests such as 75SeHCAT retention should be carried out to further evaluate bile acid malabsorption.
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PMID:Comparison of maximal postprandial serum cholylglycine concentration with the retention of 75Se-homotaurocholic acid in ileal dysfunction. 275 30

The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described.
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PMID:[Ileocystoplasty and enteropathies]. 276 94

Fecal fat excretion rate was determined by the method of Van de Kamer in 31 patients with Crohn's disease and six healthy controls, when fed by the diet containing 50 g/day of fat. Patients with jejuno-ileitis and those with partial and extensive resection showed a significantly greater excretion rate compared with patients with ileitis and healthy controls, however, there was no significant difference between patients with ileitis and healthy controls. In this study, the fecal excretion rate was less than 10 g/day in non-operated cases. Our results seems to be smaller than those in previous studies from the western countries. Fecal fat excretion rate was determined in 12 patients with non-operated Crohn's disease and six healthy controls, when fed by the additional 50 g/day butter fat during the elemental diet. With ingestion of the additional 50 g/day butter fat during elemental diet, fecal fat excretion rate was significantly increased in the patients with non-operated Crohn's disease than the results of the diet containing 50 g/day fat, but not significantly changed in the healthy controls. This result suggest that determination of fecal fat excretion rate with fed by the additional 50 g/day butter fat during elemental diet is a useful test for detecting a mild fat malabsorption in non-operated Crohn's disease.
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PMID:[Fecal fat excretion rate in patients with Crohn's disease--comparison of a diet containing 50 g/day of fat with elemental diet with an addition of 50 g/day butter fat]. 277 16

We report on a 42 year old male patient having been ill with pseudo-pobstruction and gastroinstestinal atonid for 24 years. He was thought to suffer from Crohn's disease and was treated conservatively. Since the therapy proved to be insufficient, explorative laparatomie was performed and parts of the small and large intestine which were thought to be inflamed, were removed. The histologic examination revealed the deposition of a significant amount of lipofuscin in the muscularis propria. This so-called brown bowel syndrome is known to be responsible for the development of gastrointestinal atonia. It is generally believed that this syndrome is caused by a vitamin E deficiency which may occur due to malabsorption. The brown bowel syndrome is treated sympomatically, and until now only one case achieving a remission of the disease has been reported.
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PMID:["Brown bowel" syndrome--lipofuscinosis of the intestine as a cause of atonia]. 281 78

Use of a special high molecular guar preparation in small bowel contrast studies results in a roentgenological detection of the villous architecture of the small intestine. A diffuse villous atrophy results in a loss of the normal granular pattern. Segmental loss of granular mucosal texture is found in chronic radiogenic enteritis. In active Crohn's disease a coarser diffusely distributed granular appearance of the mucous surface occurs in addition to the segmental inflammatory changes. A coarse granular mucosal pattern with only segmental involvement is seen in mild malabsorption syndrome in the upper jejunum. Radiological signs for an intestinal protein loss syndrome is a coarse and weakly contrasted granular mucosal pattern in the lower ileum with moderate thickening of the jejunal folds and increased liquid content of the bowel.
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PMID:[Roentgenological demonstration of pathological changes of the mucosa of the small intestine]. 303 41

It has been suggested that cyclosporin A might be of some benefit to patients with Crohn's disease. The clinical response and side-effects of cyclosporin A in Crohn's disease are described in a series of 13 adults. The majority of patients had ileal disease and all but one were started on an initial oral dose of 15 mg/kg per day. Duration of treatment ranged from 3 to 42 weeks. Of the 13 patients, 6 showed a response to therapy; the remainder showed no response or deteriorated. The commonest side-effect was hyperaesthesia, but one patient developed nephrotoxicity and one developed hepatotoxicity. Significant drug malabsorption occurred in one case. The side-effects were dose dependent and reversible. Cyclosporin A may have a part to play in the treatment of resistant Crohn's disease, and in our hands has been associated with a 46 per cent response rate; however, the precise role of cyclosporin A in the management of Crohn's disease awaits further study.
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PMID:Treatment of Crohn's disease in relapse with cyclosporin A. 306 76

Proteolytic and leucine aminopeptidase activity levels in faeces from patients with Crohn's disease and healthy subjects were compared and were found to be 2.5 and 6 times higher, respectively, in patients with Crohn's disease. Patients who had undergone partial bowel resection even showed a 12- and 40-fold increase of enzyme activities. A part of the elevated levels of faecal proteases probably results from ileal malabsorption. This was supported by studies in germ-free and conventional rats showing that the ileum is the major site of absorption of digestive proteolytic enzymes and leucine aminopeptidase. The other part of the increased protease activity was attributed to the abnormal anaerobic faecal flora of patients with Crohn's disease. Interactions between flora and enzymes were studied in rats. The resident flora of the caecum was found to stimulate absorption, or to inactivate the major part of the remaining enzymes. The elevated levels of faecal proteases in Crohn's disease may play a role in the damage of the intestinal mucosa.
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PMID:Increased proteolysis and leucine aminopeptidase activity in faeces of patients with Crohn's disease. 306 27

The double contrast enema is the most effective morphological screening method for the evaluation of the whole small bowel. Its sensitivity is 85%, its specifity 96.7%. In specific clinical problems the number of pathological roentgen findings rises: from 34.4% when all indications are taken into consideration to 58% in indications specific to the small intestine such as Morbus Crohn or the malabsorption syndrome. Search for tumours and the double contrast of the small bowel in unclear gastro-intestinal bleeding are unproductive. The weak point of this screening method is the lower part of the small intestine. Therefore, the selective peroral or retrograde analysis of the terminal ileum supplement the contrast method. A precondition for good results is an adequate technical standard. Besides the clinical results some technical results are therefore discussed such as contrast medium quantities, examination and X-ray time, radiation exposure and influences on the image quality.
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PMID:[Value of small bowel double contrast enema in clinical interventions]. 308 80

Diamine oxidase (DAO) is an enzyme located almost exclusively in villus tip enterocytes of mammals. Its plasma activity, normally very low, is enhanced by intravenous heparin, which releases the enyzme from small bowel enterocytes into the blood. Plasma postheparin DAO (PHD) values have been shown to be significantly reduced in patients with malabsorption and villous atrophy and inversely correlated with 24-h fecal fat, thus suggesting that PHD reflects the mature enterocytic mass. We have assayed PHD in 51 patients with small bowel Crohn's disease by measuring the area under the plasma DAO curve over a 120-min period after an intravenous bolus of 15,000 IU of heparin. Postheparin plasma DAO was significantly lower (p less than 0.001) in patients (328 +/- 175 U/ml.min) than in 20 normal subjects (508 +/- 101 U/ml.min; range, 391-749). Postheparin diamine oxidase values were inversely correlated with Crohn's disease activity index (CDAI), but no correlation was found with extent of disease assessed radiologically by either double-contrast small bowel enema or barium meal follow-through. In 6 patients with active disease (CDAI, 297 +/- 99) and low PHD values (188 +/- 100 U/ml.min), the assay was repeated after a clinically effective course of antiinflammatory drugs. A significant increase in PHD values (388 +/- 112 U/ml.min) was observed (p less than 0.005). These data indicate that mucosal involvement is common in small bowel Crohn's disease and that PHD may be useful in assessing and monitoring mucosal damage in these patients.
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PMID:Postheparin plasma diamine oxidase in patients with small bowel Crohn's disease. 314 Dec 38


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