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

Six patients with hyperphagia (ingestion of 5-11 000 Kcals/day) associated with severe malabsorption and steatorrhoea are described. The cause of the malabsorption was coeliac disease in three patients, Crohn's disease with ileal resection in two, and carcinoma of the pancreas in one patient. There was no evidence of neurological or endocrine disease (apart from mild diabetes mellitus in the patient with carcinoma of the pancreas) but three patients suffered from severe depression. This association may be commoner than previously realized and be revealed in patients with steatorrhoea of unexplained severity by careful dietary assessment. Its detection has therapeutic implications since restriction of caloric and fat intake decreased steatorrhoea without weight loss in several of the patients described.
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PMID:Hyperphagia in intestinal disease. 453 69

During a 9-year period, 204 infants younger than 12 months of age had 294 Broviac central venous hyperalimentation catheters inserted. Fifty-nine adult-size and 235 infant-size Broviac catheters were used. Catheter insertion was via the saphenous vein (267), external jugular (7), internal jugular (16), cephalic (2), and transthoracic right atrial veins (2). General anesthesia was used for all internal jugular, but for only 11 saphenous catheters. Catheter function ranged from 6 to 925 days (mean, 112 days). Forty-four infants had malabsorption syndromes, 36 had short bowel syndrome, 38 had intractable diarrhea, and 86 required nutritional support for a variety of other conditions. Fifteen of the 204 infants developed inferior (10) or superior vena caval thrombosis (2), or both (3). Thrombosis occurred in 13 of the 267 infants with saphenous catheters (4.9%), and five of the 25 with jugular or cephalic venous catheters (20.0%). Obstruction to normal catheter infusion was the first sign of caval occlusion. Transient mild leg edema (4) and prominent venous pattern over the legs (3) were present with inferior vena caval (IVC) occlusion, but no patient had renal vein obstruction or died as a direct result of this condition. Each of the two patients with superior vena caval (SVC) occlusion experienced mild to moderate edema and venous suffusion of the head and upper extremities, and one developed a pleural effusion. Each of the three infants with combined superior and inferior vena caval thrombosis died from pulmonary insufficiency within six months after SVC occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Complications of superior versus inferior vena cava occlusion in infants receiving central total parenteral nutrition. 644 Sep 68

Bile acid metabolism was examined in two children with bile acid malabsorption, who were being treated with intravenous hyperalimentation. Fecal bile acid excretion was 1,261 mumol/m2/day in a child with bile acid malabsorption of unknown origin, and 1,877 mumol/m2/day in a child with secondary bile acid malabsorption after an operation for long-segment aganglionosis. These values were approximately 10 times higher than those in diarrheal or nondiarrheal children without apparent abnormalities in bile acid metabolism. Fecal bile acids in these patients with bile acid malabsorption were almost completely conjugated, with little unconjugated bile acid present. It is possible that the disturbed bile acid deconjugation in the intestine might be caused by a rapid intestinal transit time, which was found in our patients with bile acid malabsorption. In the analysis of biliary lipid composition, children with bile acid malabsorption were shown to have a chenodeoxycholate-dominant pattern, an increased glycine- to taurine-conjugated bile acid ratio, and markedly supersaturated cholesterol. Such profiles may be related not only to bile acid malabsorption but also to cholestasis, presumably due to intravenous hyperalimentation.
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PMID:Fecal and biliary bile acid patterns in children with bile acid malabsorption. 673 82

During a five year period at UCLA Hospital, 118 Silastic, Broviac, central venous hyperalimentation catheters were inserted into 94 infants who were less than one year of age. The indications for total parenteral nutrition were malabsorption syndrome in 26, short bowel syndrome in 24, diarrhea in 15, nutritional support following operation in 11 and miscellaneous in 18. One hundren and two catheters were placed into the vena cava by way of the saphenous vein at the groin, and 16 were inserted through the external or internal jugular veins. The duration of catheter use varied from six to 925 days, a mean of 104 days. In six infants, obstruction of the vena cava developed, five in the inferior vena cava and one in the superior vena cava. Swelling of the extremity was minimal, and the thrombosis was insidious in each patient. None of the patients had pulmonary emboli. Although two of the six patients eventually died, in neither was thrombosis of the cava believed to be related. Thrombosis of the vena cava is a frequent sequela of long term central venous hyperalimentation in infants, but it is rarely fatal and produces remarkably few serious complications.
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PMID:Occlusion of the vena cava in infants receiving central venous hyperalimentation. 680 43

Total parenteral nutrition (TPN) carried out by the patient at home is a new concept in the treatment of intestinal failure. We describe a patient with Crohn's disease who has extensive involvement of the small intestine with resultant severe malabsorption, and who was therefore treated with 'home' TPN for 4 months. During this treatment there were no serious complications. The disabling symptoms present before hyperalimentation was commenced disappeared, and overall clinical improvement has been maintained for a further 6 months after TPN therapy. This case illustrates the feasibility of safe TPN at home in selected patients who have access to specialized hyperalimentation units.
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PMID:Home parenteral nutrition in a patient with Crohn's disease. A case report. 680 19

A review of the literature on the medical and nutritional use of medium-chain triglycerides (MCTs) since 1970 is presented with additional discussions on the various modifications and applications of the MCTs in the synthesis of certain structured lipids. The metabolism of MCTs in the liver and extrahepatic tissues is discussed along with further documentation of the use of MCTs in malabsorption and hyperlipidemia cases. Recent applications of MCTs and modified MCTs in hyperalimentation, deficiency in the carnitine system, epilepsy, obesity, and other special areas of application are cited. The use of medium-chain monodiglycerides for dissolving cholesterol gallstones is presented. The contraindications for the use of MCTs in ketosis, acidosis, and cirrhosis are also discussed. Suggestions for use of MCTs in a variety of medical and nutritional applications are presented.
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PMID:Medium-chain triglycerides: an update. 681 31

Clinical observation suggests that the natural history of intestinal cryptosporidiosis in patients with acquired immunodeficiency syndrome varies greatly. The relation between clinical, small-bowel functional, and nutritional status and the intestinal distribution of the organism was studied in 41 patients who had acquired immunodeficiency syndrome and cryptosporidiosis and who had undergone both proximal small-bowel and colonic biopsies. Two patterns of enteric cryptosporidiosis were identified: severe clinical disease with malabsorption in patients with cryptosporidia in proximal small-bowel biopsy specimens (61% of cases) and less severe clinical disease in patients with cryptosporidia only in the colon or stool (39% of cases). Patients with cryptosporidia in proximal small-bowel biopsy specimens had small-bowel crypt hyperplastic villous atrophy, lamina propria inflammatory infiltrates, poorer D-xylose absorption, greater weight loss, and shorter survival and more often needed intravenous hydration or hyperalimentation. Patients with cryptosporidia in the small-bowel villi only had less severe disease than those with cryptosporidia in the small-bowel crypts. In conclusion, the anatomic distribution of intestinal cryptosporidia in patients with acquired immunodeficiency syndrome varies, and this variation may explain differences in clinical course. Cryptosporidial infection of the proximal small bowel correlates with mucosal injury, malabsorption, dehydration, weight loss, and shortened survival.
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PMID:Variation in the enteric distribution of cryptosporidia in acquired immunodeficiency syndrome. 794 97

Wernicke's encephalopathy (WE) is a thiamine deficiency disorder and is characterized clinically by the triad of ocular abnormalities, ataxia and disturbances of consciousness. We report on 3 patients with WE, of whom 2 had insufficient thiamine substitution. In the first patient symptoms disappeared during thiamine substitution. In the second patient acute WE was the terminating event in the sequence of parenteral nutrition, lactic acidosis and cardio-pulmonary decompensation. Possibly due to hereditary deficits WE developed in the third patient despite sufficient thiamine substitution. Attention to thiamine deficiency should be paid in all patients with history of alcoholism, malnutrition, malabsorption, tumors, inflammation, other severe diseases and in parenteral hyperalimentation. In order to prevent WE thiamine should be substituted with at least 100 mg/day i.v. or i.m.
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PMID:Wernicke's encephalopathy--causes to consider. 804 22

We describe here an experience of successful treatment of systemic sclerosis (SSc) complicated with various gastrointestinal (GI) problems including pneumoperitoneum, pneumatosis cystoides intestinalis and malabsorption syndrome. A 35-year-old female had developed selerodactyly since February, 1990. She had been treated under the diagnosis of SSc at other hospital. She had required several hospitalizations because of nausea, vomitting and abdominal distension, but her GI symptoms had gradually deteriorated. In April 1993, she was referred to our hospital and admitted for the treatment of her GI problems. On admission, she had systemic cutaneous sclerosis and marked abdominal distension without peritoneal signs was recognized. Chest and abdominal roentgenograms demonstrated massive free air under the diaphragm, marked dilation of small and large bowels, and multiple intestinal cysts (pneumatosis cystoides intestinalis ; PCI). We treated her GI problems with various modalities combined with medications, oxygen breathing, intravenous hyperalimentation and hyperbaric oxygen therapy. Pneumoperitoneum and PCI had disappeared after 8 courses of hyperbaric oxygen therapy and her GI symptoms had been well controled by intravenous hyper alimentation. Thereafter, she has been on intermittent parenteral nutrition through subcutaneous port inplantation. During the courses of this treatment, she developed an episode of Wernicke-Kolsakoff (W-K) syndrome which was considered to associate with malabsorption syndrome. The W-K syndrome had recovered by intravenous administration of vitamin B1.
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PMID:[Systemic sclerosis with various gastrointestinal problems including pneumoperitoneum, pneumatosis cystoides intestinalis and malabsorption syndrome]. 872 Feb 72

Short-bowel syndrome is a state of severe malabsorption secondary to extensive bowel resection. The most common reasons for extensive bowel resection are Crohn's disease and mesenteric infarction. The pathophysiological consequences depend on extent and site of resection, integrity and adaptation of the remaining bowel, and secondary effects on other organs. Most extensively bowel resected patients can be adequately nourished by mouth, especially since they develop compensatory hyperphagia. For patients with colon in function a high-carbohydrate low-fat diet is beneficial compared to a diet with a normal fat content, because it results in decreased diarrhoea, decreased faecal mineral losses, and increased energy assimilation. The relative amount of dietary fat does not influence stool mass or energy assimilation in jejunostomy patients. Patients with jejunostomy have a high faecal output of water, sodium, and divalent cations, and they often need permanent parenteral supply of saline as well as calcium and magnesium if their small intestinal remnant is < 200 cm and parenteral nutritional support if they retain < 100 cm small bowel. In contrast, 50 cm of the jejunum often suffices for adequate oral nutrition if most of the colon is preserved. The majority of patients needing long-term intravenous supply are trained to administer parenteral nutrition at home (HPN). Most patients on HPN obtain a good or fair quality of life with hospital readmissions corresponding to an average of 10% of the HPN duration and an overall HPN related mortality of about 4%.
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PMID:Nutrition in short-bowel syndrome. 872 85


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