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)

Presently there are no specific laboratory tests to diagnose inflammatory bowel disease (IBD). Nonspecific tests to differentiate diarrhea due to mucosal injury from that occurring in patients with normal bowel mucosa (eg, fecal occult blood, leukocytes, etc) are not helpful. Tests to exclude infections agents are very important, since the clinical and radiological appearance of these may mimic IBD, and patients with IBD may suffer from superinfection. There are no laboratory tests which can differentiate Crohn's colitis from ulcerative colitis (UC). The tests used in the assessment and management of severely ill patients (Hgb, WBC, electrolytes, etc) are important, since abnormalities need to be corrected on an ongoing basis. The tests used to assess nutritional status are of little clinical value, since "clinical assessment" is as good as the laboratory assessment. Estimation of disease activity by tests is rarely better than the judgment of the clinician. Workup for malabsorption in Crohn's disease and the assessment of absorptive capacity of the terminal ileum are important for proper planning of management. Laboratory tests are also useful in clarifying the nature of some complications (eg, anemias and joint diseases).
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PMID:Laboratory assessment of inflammatory bowel disease. 331 56

This study was prospectively carried out to evaluate the frequency and clinical significance of pancreatic impairment in the course of chronic inflammatory bowel disease (CIBD). Twenty-seven patients affected by ulcerative colitis or Crohn's disease were submitted to a secretin-cerulein test, oral glucose test (OGT) and to indirect immunofluorescence (IFL) for detection of autoantibodies against exocrine and endocrine tissue. A bicarbonate plus enzyme or only an enzyme insufficiency was found in 11/27 patients, whereas isolated lipase decrease was observed in 18 subjects. In the results of the OGT and the indirect IFL test there was no difference between patients and controls. These data demonstrate that pancreatic impairment is a far more frequent occurrence than generally recognized in clinical practice. The decrease of lipase secretion could worsen the consequences of malabsorption in Crohn's disease of the small intestine. Therefore we think that a pancreatic assessment is advisable, at least in Crohn's disease patients with steatorrhea.
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PMID:Pancreatic function in chronic inflammatory bowel disease. 336 Nov 59

The intestine is a unique immunologic organ that comprises an afferent and efferent compartment and provides the host with the ability to respond through several different effector mechanisms against environmental factors. We discuss mechanisms in three intestinal diseases in this overview of the mucosal immune system. Genetic and immunologic factors are important in the pathogenesis of celiac disease, which is characterized by damage to the mucosa of the small intestine with resultant malabsorption. Pathogenic microbes are important environmental agents that interact with the intestinal mucosa and initiate local immune responses. Advances in the understanding of the mucosal immune response to these pathogenic microbes have produced a clear picture of the way in which this specialized immune system works in concert with systemic immunity. As to the autoimmune nature of inflammatory bowel disease, no specific antigen has been shown to incite the inflammatory reactions and neither the target cells nor the effector mechanism involved have been identified. Several factors exist, however, to suggest an autoimmune mechanism and the role of mucosal immunologic factors in this disease.
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PMID:Immunologic mechanisms in intestinal diseases. 355 3

We have compared the incidence of inflammatory bowel disease (IBD) to the prevalence of lactose malabsorption (LM) in several countries. Our observations indicate that IBD is rare where LM is highly prevalent. The correlation between incidence of Crohn's disease and LM is -0.93, p less than 0.01, the correlation between incidence of ulcerative colitis and LM is -0.89, p less than 0.01. We, therefore, propose that LM results in the formation of volatile fatty acids which may inhibit multiplication of potentially pathogenic organisms.
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PMID:Primary adult lactose intolerance protects against development of inflammatory bowel disease. 363 1

Malnutrition and growth failure are frequent complications of inflammatory bowel disease in childhood owing to inadequate dietary nutrient intakes, excessive intestinal losses, malabsorption, and increased nutrient requirements. Aggressive nutritional therapy is indicated for primary and supportive management of disease activity, drug nutrient interactives, individual nutrient abnormalities, and the overall complications of inflammatory bowel disease, malnutrition, and growth failure. The prevention of nutritional disorders in inflammatory bowel disease is accomplished by monitoring anthropometric and biochemical indices and by instituting appropriate enteral or parenteral nutritional therapy when indicated.
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PMID:Nutritional management of inflammatory bowel disease. 392 33

We assessed the nutritional status of 119 patients with chronic gastrointestinal symptoms due to organic disorders (inflammatory bowel disease, IBD; peptic ulcer, PU; malabsorption syndrome, M; and malignant gastrointestinal tumours, T), by standard anthropometry and marker proteins (albumin; retinol-binding protein, RBP; and thyroxine-binding prealbumin, TBPA). We also studied 31 patients with irritable bowel syndrome (IBS) and 75 age-matched healthy controls (C). Compared with healthy controls, patients with organic bowel disease had significant abnormality of two or more anthropometric measurements (P less than 0.05). Plasma albumin was reduced in patients with IBD, M and T (P less than 0.001), but RBP and TBPA measurements were lower in all patient categories (P less than 0.01) including IBS. Stepwise discriminant analysis of the patient data alone, using three to six parameters, correctly separated 65 per cent PU patients, 66 per cent IBD and M, 72 per cent IBS and 88 per cent patients with T from other disease categories. We conclude that patients with chronic gastrointestinal symptoms often have some nutritional disturbances and that simple anthropometric and protein measurements might help us to distinguish patients with functional bowel disease from those with organic bowel disease.
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PMID:Nutritional assessment in patients with chronic gastrointestinal symptoms: comparison of functional and organic disorders. 392 30

We developed a test procedure for the clinical evaluation of the absorption of vitamin D. Serum vitamin D concentrations were evaluated in seven patients with intestinal fat malabsorption syndromes and in seven healthy, normal subjects, after being given a single oral dose of 50,000 IU (1.25 mg) vitamin D2. In the normal subjects, serum vitamin D concentrations rose from a baseline of less than 5 ng/ml to a peak of over 50 ng/ml by 12 h, gradually falling to baseline levels by 3 days. In five of the seven patients with intestinal fat malabsorption, oral administration of 50,000 IU vitamin D2 did not raise serum vitamin D concentrations above 10 ng/ml. Two patients with severe inflammatory bowel disease had a normal absorption pattern, however. These findings suggest that an oral vitamin D absorption test may be of value for determination of patients at risk for development of vitamin D deficiency. They also raise questions about the efficacy of oral vitamin D preparations in patients with intestinal fat malabsorption.
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PMID:Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. 405 Jul 23

In order to determine whether oral prednisolone efficiency in inflammatory bowel disease may be limited by impaired absorption, seven patients were studied. These were children with active disease, localized or extensive on the small and/or the large bowel. Serum prednisolone concentrations were compared within each subject after oral and intravenous administration of the same dose. Absorption was found complete, and its rate similar to that in nine normal adults. Thus prednisolone malabsorption did not limit treatment efficiency. In one patient, an alternative explanation was poor compliance with the treatment. Less complete studies in nine other children with active inflammatory bowel disease suggested the same conclusion. Prednisolone malabsorption in children with inflammatory bowel disease, if it exists, could only be transitory or exceptional.
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PMID:Normal absorption of oral prednisolone in children with active inflammatory bowel disease, including cases with proximal to distal small bowel involvement. 407 15

In order to assess the effectiveness and potential limitations of continuous enteral nutrition (CEN) to correct denutrition related to underlying digestive diseases, 10 nutritional criteria were measured weekly in 92 under-nourished patients fed with CEN for a 3-7 week period. All the patients received a standard non-elemental diet providing a mean daily energy intake of 52.8 kcal/kg BW (36.5 kcal/kg BW by tube feeding and 16.3 kcal/kg BW orally). The influence of preexisting intestinal malabsorption, hypercatabolic status, and post-radiation or inflammatory bowel disease was studied by an a posteriori classification of patients in one of the six following groups: I (no limiting factor), II (malabsorption), III (catabolic disease), IV (catabolic disease and malabsorption), V (colitis), VI (enteritis). During CEN, 8 patients had transient and one had persistent vomiting while 3 developed bronchopneumonia. Gains in body weight, triceps skinfold, midarm muscle circumference, creatinine-height index, urinary sodium and serum transferrin were significant as early as the 2nd week of CEN. Serum albumin and cholesterol, hemoglobin, and total count of lymphocytes were not significantly affected. Sixty-five patients (71 per cent) had an objective nutritional improvement and mean spontaneous oral intake increased from 17.8 to 28.7 kcal/kg BW per day. Significant increase of oral intake and objective nutritional improvement were observed in each group, but a longer period of CEN was necessary to achieve this result in groups II, IV and VI.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Does continuous enteral nutritional deficiencies in digestive system diseases? Results of a longitudinal study of 92 consecutive patients treated for 3 to 7 weeks]. 642 Feb 21

We have compared the 7-day retention of the radioisotope bile salt analogue SeHCAT (75Se-23-selena-25-homotaurocholate), by whole body counting and by uncollimated gamma camera measurement, in phantoms and in 25 patients with inflammatory bowel disease. The results correlate with a linear correlation coefficient of 0.96. An uncollimated gamma camera can be used to assess bile acid malabsorption when a whole body radioactivity monitor is not available.
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PMID:A comparison between the use of a shadow shield whole body counter and an uncollimated gamma camera ain the assessment of the seven-day retention of SeHCAT. 642 5


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