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)

Exocrine pancreatic function and fat absorption were determined using a 'tubeless' test in 25 human immunodeficiency virus (HIV) antibody positive subjects (23 males, two females), CDC criteria groups II (four), III (one), and IV (20). In 12 fat absorption was poor but in only three of these were the results indicative of pancreatic insufficiency and in all three this was mild. In nine of the cases the results were compatible with small intestinal malabsorption. Mild, but not severe, exocrine pancreatic insufficiency may occur in acquired immune deficiency syndrome; however fat malabsorption is more commonly associated with a small intestinal cause.
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PMID:Fat absorption and exocrine pancreatic function in human immunodeficiency virus infection. 232 34

The absorption of rice flour and the mouth-to-cecum transit time of a nonabsorbable carbohydrate were measured by breath hydrogen excretion technique in 10 patients with alcoholic pancreatic insufficiency, to evaluate the underlying mechanisms of carbohydrate malabsorption. Breath hydrogen excretion after ingestion of rice pancakes was significantly higher in patients than in 10 controls, suggesting malabsorption of carbohydrates. Mouth-to-cecum transit time was not significantly different between the two groups. Pancreatic enzyme therapy significantly reduced both fecal fat excretion and the degree of carbohydrate malabsorption, but, in contrast, did not significantly change mouth-to-cecum transit. There was no correlation between the degree of carbohydrate or fat malabsorption and mouth-to-cecum transit time. Carbohydrate malabsorption is common in pancreatic insufficiency and is markedly improved by enzyme supplementation. Mouth-to-cecum transit, however, does not play a major role in carbohydrate or fat malabsorption in these patients.
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PMID:Carbohydrate malabsorption in alcoholic pancreatic insufficiency. The effect of pancreatic enzyme therapy on intestinal transit time. 246 May 19

Steatorrhea can result from maldigestion or malabsorption. As the pathophysiology underlying impaired digestion differs from impaired absorption, it is important to differentiate these two disorders. It is generally accepted that patients with maldigestion excrete an excessive amount of triglyceride and patients with malabsorption excrete an excess of the lipolytic product of triglyceride, fatty acid. The two-step Sudan stain has been used as a simple test to differentiate these disorders. The validity of the test has not yet been established. In this study, fecal fatty acid and triglyceride were measured after extraction and thin-layer chromatographic separation. Our results indicate that in adult patients with pancreatic insufficiency, the fecal triglyceride content does not differ from the controls. However, a fivefold to sixfold increase in fecal fatty acid content in patients with pancreatic insufficiency was revealed. As patients with maldigestion do not excrete an excess of undigested triglyceride, it is not possible to differentiate maldigestion from malabsorption by quantifying fecal triglyceride and fatty acid.
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PMID:Fecal triglyceride excretion is not excessive in pancreatic insufficiency. 274 66

The effect of high fiber diet on fat malabsorption was evaluated in twelve patients with exocrine pancreatic insufficiency secondary to chronic alcoholic pancreatitis. Additionally, the effect of dietary fiber on pancreatic enzymes was examined in vitro, employing different concentrations of cellulose, pectin, and wheat bran incubated with amylase, lipase, and trypsin. Ingestion of a high fiber diet was associated with a small but significant (p less than 0.01) increase in fecal weight and fecal fat excretion. All patients complained of increased abdominal flatulence with high fiber diet, however, no significant increase in frequency of bowel movements was noted. In vitro studies demonstrated reduction in pancreatic enzyme activity by increasing concentration of dietary fiber and its components. These data suggest that steatorrhea may be enhanced with the ingestion of high fiber diet in patients with exocrine pancreatic insufficiency on oral pancreatic enzyme therapy. Increase in fecal fat excretion may, in part, be related to reduction in the activity of pancreatic enzymes by the dietary fiber.
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PMID:Dietary fiber in pancreatic disease: effect of high fiber diet on fat malabsorption in pancreatic insufficiency and in vitro study of the interaction of dietary fiber with pancreatic enzymes. 257 39

Diarrhea induced by exocrine pancreatic insufficiency in relation to chronic pancreatitis, pancreatic cancer, or partial pancreatic excision is generally moderate without modification of the nutritional status of the patient. However, when the malabsorption of lipids is severe diarrhoea with steatorrhea can lead to an important weight loss. Exocrine pancreatic insufficiency is managed with diet and pancreatic enzyme replacement. In patients with alcoholic chronic pancreatitis, abstinence from alcohol is the most important measure. The new enteric coating pancreatic extracts have a good efficacy and a better acceptability.
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PMID:[Diarrhea caused by exocrine pancreatic insufficiency in adults]. 260 94

Fat malabsorption in patients with chronic alcoholic pancreatitis and cystic fibrosis may lead to vitamin and essential fatty acid deficiency in addition to steatorrhea. In clinical practice it can be difficult to achieve complete correction of malabsorption and elimination of steatorrhea. The earliest treatment methods used the oral administration of porcine pancreatic enzyme preparations. These conventional enzymes, however, were unstable in the acidic intragastric environment. Subsequently, medications to neutralize or reduce gastric acidity (H2-blockers, antacids, or bicarbonate) were added to improve the stability of the conventional enzymes. Enteric-coated enzyme preparations were then developed that would release only in an alkaline milieu, protecting the enzymes from acid denaturation. The newest and potentially most exciting modalities for the treatment of fat malabsorption are acid-stable lipases, obtained either from a fungal source or through the expression of cloned genes for the enzymes utilizing recombinant DNA techniques. The advantages and disadvantages of the various medications for the therapy of fat malabsorption in pancreatic insufficiency are reviewed.
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PMID:Enzyme therapy for malabsorption in exocrine pancreatic insufficiency. 266 33

Prevention of malnutrition, a consequence of elevated energy requirements, increased losses and low caloric intake, is one of the main goals in the treatment of cystic fibrosis. Caloric stool losses, catch-up growth and an elevated energy expenditure, even in the absence of overt lung disease and malabsorption, have led to recommendations for a caloric intake of 120-150% of the recommended daily allowances. A high energy intake with a fat content of at least 40 calorie % and adequate pancreatic supplementation has shown to improve growth and median age of survival. As a rational treatment of the fundamental disturbance in cystic fibrosis, a decrease in chloride permeability across epithelia, is not yet available, treatment should be concentrated on adequate nutritional support in combination with optimal correction of those gastrointestinal abnormalities including faecal bile acid loss, small intestinal abnormalities, pancreatic insufficiency, hormonal abnormalities and disturbances in gastrointestinal motility, which may aggravate maldigestion and malabsorption.
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PMID:Gastrointestinal dysfunction and its effects on nutrition in CF. 270 29

Pancreatic enzyme therapy may be beneficial to all patients with chronic pancreatitis, even those in whom the condition is very mild. The goal of enzyme therapy should be to restore normal gastrointestinal physiology as completely as possible. Monitoring of body weight is recommended as the main measure of treatment efficacy. Most pancreatic enzyme preparations presently employed are porcine in origin and must meet certain standards of quality for human consumption. The amount of active lipase in the duodenum determines the quantity of enzymes to be given. An appropriate diet is also important for relieving symptoms of pancreatic insufficiency and improving nutritional status. Although administration of large amounts of proteases has provided pain relief in some patients, the rationale for using enzymes to relieve pain in chronic pancreatitis has not been generally accepted. Gastric acid plays a role in malabsorption, since administered enzymes may be destroyed by gastric acid. Also, acidic conditions in the duodenum decrease the efficacy of pancreatic enzymes administered with meals. Histamine-H2-receptor antagonists may decrease gastric acidity but there are certain drawbacks to long-term use of these agents. The use of enteric-coated microspheres overcomes many of the problems associated with enzyme destruction. Patients with chronic pancreatitis display considerable individual variation in their treatment requirements. Therapy must be tailored to meet the need for adequate disease control as well as for social and emotional acceptability by the patient. The attending physician and the patient share the responsibility for maintaining appropriate therapy.
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PMID:Theory and practice in the individualization of oral pancreatic enzyme administration for chronic pancreatitis. 270 51

Three cats were thin despite eating well. Steatorrhoea was confirmed in each by 72-hour fat assimilation tests. Fat digestibility in all 3 increased twofold when the diet was supplemented with pancreatic enzymes, suggesting the possibility of exocrine pancreatic insufficiency. However, examination of stained faecal smears gave evidence of both maldigestion and malabsorption of fat, without maldigestion of starch, and only one case had indications of protein maldigestion. In the latter cat, fat digestibility normalised with pancreatic enzyme supplementation and exocrine pancreatic insufficiency was considered likely. However, at post-mortem examination enteropathy and pancreatitis, but not exocrine pancreatic insufficiency, were found. The cause of fat malassimilation in these cats was unknown. The evaluation of malassimilation in cats is difficult because investigative tests used in other species are either unsuitable or have not been evaluated in cats.
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PMID:Fat malassimilation in three cats. 273 Apr 75

14C triolein breath tests are highly sensitive in detecting fat malabsorption in adults, but experience in the elderly is sparse. We have evaluated 48 'normal' subjects over the age of 65 years and compared the results with those of 46 normal subjects under 65 from a previous study. Results were calculated as eight hour cumulative values and expressed as percentages of the administered dose. Reference ranges have been calculated separately for the following age groups: 65 years or less (201 to 460), 66 to 75 (182 to 405) and over 75 (141 to 336). A clear age related decline in eight hour cumulative values was noted. The values fell by 23% between the ages of 17 and 65 years and by 25% between the ages of 65 and 87 years. Pancreatic insufficiency or bacterial colonisation of the small bowel is unlikely, but delayed intestinal absorption or the effects of slower metabolic rate cannot be excluded. This test is simple and practicable in the elderly and the study emphasises the importance of age in the interpretation of results.
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PMID:14C triolein breath test: an assessment in the elderly. 276 5


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