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

In 24 patients with malabsorption, [14C]triolein breath tests were conducted before and together with the administration of pancreatic enzymes (Pancrease, Johnson and Johnson, Skillman, N.J.). Eleven patients with pancreatic insufficiency had a significant rise in peak percent dose per hour 14CO2 excretion after Pancrease, whereas 13 patients with other causes of malabsorption had no increase in 14CO2 excretion (2.61 +/- 0.96 vs. 0.15 +/- 0.45, p less than 0.001). The two-stage [14C]triolein breath test appears to be an accurate and simple noninvasive test of fat malabsorption that differentiates steatorrhea secondary to pancreatic insufficiency from other causes of steatorrhea.
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PMID:Two-stage triolein breath test differentiates pancreatic insufficiency from other causes of malabsorption. 691 37

The physiological absorption of vitamin B12 is a complex process which requires the interaction of several macromolecules. Mediated by the glycoprotein, intrinsic factor (IF), this process requires formation of a primary complex between vitamin B12 and IF (IF-B12), the recognition and binding of this complex to specific ileal receptors and the transport of vitamin B12 across the ileal cell. As a measure of this overall process, the vitamin B12 absorption test has helped to identify abnormal vitamin B12 absorption in patients with exocrine pancreatic insufficiency and familial vitamin B12 malabsorption (Immerslung-Grasbeck syndrome). Progress into understanding the role of proteolytic enzymes in promoting vitamin B12 absorption as well as the molecular events of vitamin B12 transport across the ileal cell has been brought about by recent investigation based upon this determination.
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PMID:Intrinsic factor mediated cobalamin absorption. 700 31

In 138 mongrel dogs given renal transplants, 10 developed postoperative intussusceptions. The sites were jejunojejunal (seven), ileo-ileal (two) and ileocolic (one). In 30 puppies given intrasplenic autografts of dispersed pancreatic fragments after total pancreatectomy, five developed jejunojejunal intussusceptions. Presenting signs included vomiting, failure to eat, periodic attacks of pain, straining with the passage of bloodstained mucous, dehydration, weight loss, abdominal wall rigidity and an abdominal mass. The majority of dogs presented within the first seven days following transplantation, occasionally as late as the third week. Early operative intervention was essential to save the dogs and at laparotomy eight of nine intussusceptions were successfully reduced manually; one small bowel resection was performed for irreducibility. Recurrence was not observed in this series but reoperation in the puppies was invariably fatal. Factors contributing to the development of intussusception in the puppies included round worm infestation, recent dietary change following weaning, malabsorption and diarrhoea due to pancreatic insufficiency following pancreatectomy and respiratory infections suggesting an infective origin for the intussusceptions.
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PMID:Canine intestinal intussusception following renal and pancreatic transplantation. 701 80

Three substrates labeled with nonradioactive 13C have been employed to establish a trilogy of noninvasive breath tests to detect fat malabsorption in children and then to differentiate the etiology of the steatorrhea. Administration of 17 mg/kg of (13C)triolein Lipomul (The Upjohn Co., Kalamazoo, Mich.) resulted in a peak excretion rate of 13CO2 greater than 2.7% dose/h in 10 normal subjects (mean value 4.96 +/- 2.2% dose/h) whereas all 17 subjects with fat malabsorption were below this value (mean value, 0.75% +/- 0.63% dose/h); p less than 0.001). For the detection of fat malabsorption, the discriminative value of (13C)triolein was superior, 100% sensitive, and 89% specific, while the use of (13C)palmitic acid (17 mg/kg) or (13C)trioctanoin (7.5 mg/kg) alone yielded both false-positive and false-negative results. In 6 out of 6 cases, pancreatic insufficiency could be differentiated from mucosal disease (7 patients) or bile salt deficiency (4 patients) by the presence of abnormal triolein or trioctanoin breath tests, or both but normal palmitic acid breath tests. However, further differentiation of mucosal disorders from bile salt disorders could not be achieved using either a single- or a multiple-substrate breath test. The use of the single triolein breath test in children offers an attractive, sensitive alternative to conventional fecal fat measurements to establish the presence of steatorrhea, and when using 12C-lipid with multiple substrates, the tests are capable of providing additional insight into the mechanism of fat malabsorption.
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PMID:Diagnosis and differentiation of fat malabsorption in children using 13C-labeled lipids: trioctanoin, triolein, and palmitic acid breath tests. 706 Sep 13

Serum folate and vitamin B12 concentrations have been measured in 53 dogs presented for an investigation of malabsorption. Abnormal concentrations have permitted the differentiation of animals with small intestinal disease into three main groups, each with distinct biochemical abnormalities in the jejunal mucosa. The first group had reduced folate and vitamin B12 concentrations. Jejunal biopsies revealed marked villous atrophy and generalised biochemical abnormalities in the brush borders, lysosomes and endoplasmic reticulum. The second group had reduced folate but normal vitamin B12 concentrations and although histological changes were minimal there were specific biochemical changes confined to the brush borders. In the third group, increased folate and reduced vitamin B12 concentrations suggested a bacterial overgrowth in the proximal small intestine. Minor histological changes were accompanied by marked biochemical changes in brush borders and lysosomes. A group of animals with severe exocrine pancreatic insufficiency had increased mean folate but reduced mean vitamin B12 concentrations. These changes are consistent with bacterial overgrowth, but could be due to defective degradation of a B12-binding protein.
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PMID:Role of serum folate and vitamin B12 concentrations in the differentiation of small intestinal abnormalities in the dog. 708 78

We used a rat model to investigate the phenomenon of increased steatorrhea associated with administration of calcium or magnesium containing antacids in humans with pancreatic insufficiency. Adult male rats with bile and pancreatic duct ligation were fed test meals containing 56 mumol [14C]triolein (0.5 ml), synthetic human bile (1.0 ml, 100 mumol bile salts, 75% glycine and 25% taurine conjugates, and 14.5 mumol lecithin), pancreatic enzymes (0.5 ml), and antacids (1.0 ml). The percent lipid malabsorbed when antacids were fed in addition to the test meal was: control 19.3 +/- 1%, NaHCO3 15.3 +/- 1% (P less than 0.05 vs. control), Al(OH)3 18.3 +/- 2%, Mg(OH)2 38.2 +/- 2% (p less than 0.001 vs. control), and CaCO3 42.4 +/- 1% (p less than 0.001 vs control). With NaCl, Al(OH)3, and NaHCO3 the malabsorbed fat was primarily triolein, whereas with Ca++ or Mg++ the majority of the lipid recovered was oleic acid. Calcium or magnesium administration was associated with precipitation of glycine-, but not taurine-, conjugated bile salts in the small intestine. When calcium was administered to animals in which the bile consisted entirely of glycine-conjugated bile salts, the lipid recovered (64.0 +/- 3% malabsorption) was almost entirely triolein suggesting reduced lipolysis. These studies suggest that these divalent cations exert their deleterious effect on replacement enzyme therapy by formation of poorly soluble calcium or magnesium soaps and precipitation of glycine conjugated bile salts.
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PMID:Mechanism of increase in steatorrhea with calcium and magnesium in exocrine pancreatic insufficiency: an animal model. 709 67

Previous data from this laboratory have shown good correlation between plasma cationic trypsin(ogen) and levels of pancreatic function in older cystic fibrosis (CF) patients with and without malabsorption. In the present study a radioimmunoassay for human anionic trypsin(ogen) has been employed in the assessment of pancreatic function in older patients with CF. Immunoreactive anionic trypsin(ogen) levels correlated poorly with pancreatic function due to an apparent elevation of this enzyme in many older CF patients with malabsorption (CF + M). When plasma from three older CF + M patients is examined for the molecular size of the apparent immunoreactive material detected, no free anionic trypsinogen is observed. Instead, a broad peak of apparent immunoreactive material appears in the gammaglobulin region. However, only free anionic trypsinogen could be detected in plasma from two CF patients without malabsorption (CF - M), who had not received pancreatic enzyme supplements. It appears possible that a human plasma immunoglobulin G (IgG) to porcine pancreatic enzyme in the CF + M patients might interfere in the assay by binding TLCK--anionic trypsin tracer. It is unclear why such an effect does not appear to occur in the cationic trypsin(ogen) assay. The results of the current study suggest that, for assessment of pancreatic insufficiency in CF, the radioimmunoassay for cationic trypsin(ogen) is more useful than the presently available radioimmunoassay for the anionic form.
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PMID:Plasma immunoreactive anionic pancreatic trypsin in cystic fibrosis. 718 46

To identify gastric factors likely to contribute to fat maldigestion and malabsorption in cystic fibrosis (CF), gastric emptying time, secretion rate, and preduodenal lipolytic activity were studied. Gastric emptying of a liquid test meal and gastric acid secretion were determined in five CF teenagers with pancreatic insufficiency and in five healthy controls. During the first hr, the rate of gastric emptying exhibited a linear pattern in both CF patients and controls. Neither the emptying time nor the gastric secretion rate was different. Lingual lipase activity was measured in eight other CF patients with pancreatic insufficiency and in eight controls. Lipase activity was higher (P less than 0.05) in CF patients than in controls with values (mean +/- S.E.) of 34.48 +/- 11.59 and 12.65 +/- 5.60 mumole butyric acid min-1 ml-1, respectively. No correlation with age or body surface was observed. Intragastric lipolysis of a butterfat triglyceride test meal was fast in both groups, but more extensive (P less than 0.05) in CF patients than in controls. The data show that in CF with pancreatic insufficiency, gastric factors contributing to the first step of fat digestion are preserved. In fact, lingual lipase activity was found to be increased, and a more complete intragastric lipolysis was documented.
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PMID:Gastric emptying and lingual lipase activity in cystic fibrosis. 720 53

The absorption of vitamin B12, labelled with radioactive 58Co, was measured in 19 patients with cystic fibrosis and one child with the Shwachman-Diamond syndrome using the whole body counting technique. We found vitamin B12 absorption reduced to 7.97 on average, compared to 59.2% for the control group. The low vitamin B12 absorption correlated well with the reduced fat retention coefficients. After adding 0.212 pancreatin to the radioactive vitamin B12 test dose, the absorption quotas improved in all cases, the average being 61%. A meal poor in vitamin B12 tended to increase the absorption of the radioactive test dose to 23% on average. As yet there is no satisfactory explanation for the effect of the diet on the absorption of vitamin B12 in exocrine pancreatic insufficiency. This could be the reason why the malabsorption of vitamin B12 in patients with EPI can go unnoticed for many years and could possibly explain why vitamin B12 malabsorption in exocrine pancreatic insufficiency does not cause symptoms and signs of vitamin B12 deficiency for many years.
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PMID:Vitamin B12 absorption and exocrine pancreatic insufficiency in childhood. 721 91

Lundh tests of pancreatic exocrine function were performed on twenty unselected patients with systemic sclerosis. Three patients had very low levels of tryptic activity in their intestinal juice and only nine had results which were unequivocally normal. Eight patients had biochemical steatorrhoea, but in six this was associated with intestinal bacterial overgrowth and a seventh had primary biliary cirrhosis. The remaining patient had no cause for steatorrhoea other than the marked pancreatic insufficiency which had been demonstrated. Although pancreatic damage may contribute to malabsorption in systemic sclerosis, it appears to be less important than other factors such as intestinal bacterial overgrowth.
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PMID:Pancreatic exocrine function in systemic sclerosis. 728 47


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