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

Side effects are common in individuals who have undergone small-bowel bypass surgery for morbid obesity. Most of these side effects subside after a few months. More serious complications may require reestablishment of the bypassed loop. Rarely have vitamin deficiencies been observed. Development of vitamin A deficiency in a patient was characterized by phrynoderma and night blindness. This was promptly reversed by oral treatment with vitamin A. There was no improvement in low to subnormal serum levels of fat-soluble vitamins after a course of tetracycline hydrochloride. Studies suggested presence of a malabsorption state probably due to rapid transit time through the small bowel and reduced absorptive surface.
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PMID:Vitamin A deficiency following small-bowel bypass surgery for obesity. 36 88

The serum 25-OHCC concentration was measured in 151 patients in order to evaluate the potential use of this determination in the management of gastrointestinal disorders. Patients with functional bowel disease had lower serum mean 25-OHCC levels than normals. The results were divided into normal (greater than 21 ng/ml), low normal (12-21 ng/ml), and low levels (less than 21 ng/ml). Two thirds of patients with malabsorption had low serum 25-OHCC. Most patients following jejunoileal bypass surgery for morbid obesity had low levels despite supplemental oral calciferol therapy. In patients with chronic liver disease, cholestasis more than parenchymal cell disease appeared responsible for low serum 25-OHCC levels. Measurement of serum 25-OHCC may be an ancillary screening test for fat malabsorption and in patients with intraluminal bile salt deficiency. Furthermore, repeated measurements may be useful in monitoring therapy with vitamin D products in patients with chronic malabsorption and cholestasis.
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PMID:Significance of serum level of 25-hydroxycholecalciferol in gastrointestinal disease. 62 77

A patient is presented who developed a granulomatous hepatitis and pleuritis approximately 7 months after an ileal bypass procedure for morbid obesity. Although the etiological agent was presumed to be Mycobacterium tuberculosis no pathogenic organism was grown from the liver, pleura, bone marrow, sputum, or gastric aspirate. The possibly increased susceptibility of these patients to mycobacterial infections is discussed. The value of obtaining serum levels of ethambutol, isoniazid, and rifampin, in patients with malabsorption is stressed. Although this patient seemed to respond to antituberculous therapy, other possible causes for the granulomatous process are explored.
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PMID:Granulomatous hepatitis and pleuritis after ileal bypass for obesity. 71 72

The relation between malabsorption of bile acids, the bile lipid composition, and biliary stones was examined in 8 patients subjected to ileal resection (particularly for Crohn's disease), 6 with ileal bypass for morbid obesity, and 10 healthy controls. The 1-14C-cholylglycine breath test was employed to detect of the absorption and deconjugation of bile acids. Bile lipid composition was expressed according with Metzger's saturation index. Healthy subjects gave normal findings in all respects, whereas ileal resection was accompanied by malabsorption, increased deconjugation, and faecal loss of 14C. These changes, particularly malabsorption, were more evident after ileal bypass. Preoperative saturation values rose to more than 1 in all cases, especially after resection. Liver disease (steatosis and cirrhosis) 6 months after bypass, together with cholesterol lithiasis in 2/6 patients.
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PMID:[Correlation of malabsorption of bile acids, bile lipid composition and calculi]. 90 52

Jejunoileal bypass operation was originally done to promote weight loss for treatment of morbid obesity. We used such a model to determine if dietary vitamin absorption is compromised by such an operation. Six rats were subjected to a jejunoileal bypass, 6 control rats were pair-fed to bypassed rats; and 6 were fed ad libitum. Vitamin content of folic, B6, riboflavin, nicotinate, pantothenate, thiamin, biotin, B12, vitamins A, E, and carotene in blood and liver was determined after 8 postoperative weeks. Aside from riboflavin, blood vitamin levels were significantly depressed in bypassed rats. The deepest depression was seen for B12, carotene and vitamin E. Liver vitamin stores of folate, riboflavin, thiamin, B12, clearly were significantly depressed in the bypassed animals compared to the pair-fed and ad libitum-fed controls. This model can serve for rapidly studying micronutrient depletion due to malabsorption without dietary manipulation or antibiotics for gut sterilization.
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PMID:A jejunoileal bypass rat model for rapid study of the effects of vitamin malabsorption. 158 7

Morbid obesity is a life-threatening disorder associated with medical and psychological complications. The failure of medical therapy has led to the development of a new surgical discipline called bariatric surgery, which has evolved over the past three decades. Initial techniques created malabsorption to produce weight loss. Due to complications, later techniques limited oral intake to produce weight loss. Currently, most bariatric surgeons perform either gastric bypass or gastric partition (vertical banded gastroplasty or vertical ring gastroplasty). However, other techniques are also being evaluated, including a modified intestinal bypass, gastric banding, and a new gastric balloon. Only with continued follow-up will we determine the ultimate risk/benefit ratio of these procedures and their place in the management of the morbidly obese. In the setting of an experienced multidisciplinary team committed to long-term follow-up, surgical therapy can be considered.
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PMID:Surgical approach to the obese patient. 164 Feb 13

Morbid obesity is a complex disease, the etiology of which is clearly multifactorial. The weight loss produced by intestinal shunting procedures has been profound and the etiology of the weight loss is clearly more complex than rapid intestinal transit and gross malabsorption of foodstuffs. The best known surgically produced malabsorptive procedure for the treatment of morbid obesity is the jejunoileal bypass. This procedure produces substantial weight loss but has been associated with late postoperative complications that make its use problematical. Other procedures (biliary bypass, biliopancreatic diversion, and long limb Roux-en-Y gastric bypass) have not been associated with liver dysfunction. Varying degrees of malnutrition are frequently associated with these procedures. Careful study of the patients with these procedures is warranted.
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PMID:Gastrointestinal malabsorptive procedures. 173 28

Sideropenic anemia is a common long-term complication of surgical bilio-pancreatic bypass for morbid obesity, and is frequently resistant to oral iron therapy. To study the pathogenesis of this phenomenon we investigated 7 such patients clinically and biologically, with special emphasis on iron absorption. Our results show that sideropenia, consistently present and frequently complicated by anemia, is due to deficient iron absorption and that this malabsorption is non-selective. Replacement therapy, when indicated, should therefore use the parenteral route.
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PMID:[Biliopancreatic bypass and disorders of iron absorption]. 175 51

In this study designed to investigate the nutritional state induced by biliopancreatic bypass in the rat, the pancreatico-biliary secretions were diverted via the duodenum and jejunum into the distal ileum, the remaining intestine being directly anastomosed to the stomach after antrectomy. Bypassed animals lost weight: it was only 56 percent of that of controls after 36 days and death by cachexia resulted within two months of the procedure. The reduced food intake (16 percent less than control) at the 36th postoperative day cannot by itself explain the weight loss, since pair-fed rat weights did not differ statistically from controls at 36 days. Protein-energy malabsorption occurred: drops in serum protein concentration (25 percent less than control), triglycerides (40 percent less) and total cholesterol (28 percent less) were recorded from the 12th postoperative day on. Biliopancreatic bypass may be an adequate procedure of treatment for morbid obesity simultaneously aggravated by metabolic disorders.
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PMID:Malnutrition and body weight loss after biliopancreatic bypass in the rat. 201 Feb 58

Enteric hyperoxaluria due to malabsorption syndromes has been well documented to cause renal calculi and chronic tubulointerstitial renal damage. Rarely, in the setting of intestinal bypass operations for morbid obesity, enteric hyperoxaluria has produced acute renal failure. We report two patients who suffered acute deterioration of renal function associated with increased intestinal absorption and renal excretion of oxalate associated with steatorrhea. One patient had a large portion of his small bowel resected many years prior to the onset of the renal failure and the second patient had chronic pancreatitis causing steatorrhea. Both patients had renal biopsy documentation of the acute nature of the tubular damage produced by oxalate deposition. The mechanisms of their deterioration of renal function may relate to sudden increases in steatorrhea in association with episodes of volume depletion. Enteric hyperoxaluria may be an easily overlooked and potentially preventable etiology of acute renal dysfunction.
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PMID:Acute deterioration of renal function associated with enteric hyperoxaluria. 222 62


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