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

The author made a review about the origin, the biochemistry the physiological and pathological roles of gastrointestinal peptide hormones. They originate from the APUD cell system, chemically from the ancient growth hormone, or placental lactogen. The theoretical prosecgastrin's first sequencies form the "secretin family", the tail sequencies form the "gastrin family". The author describes many details of their effects on the different gastrointestinal organs, they behave mainly antagonistic way to each other. Finally a discussions is given about their role in the development of peptic ulcer, in the WDHA syndrome and in malabsorption.
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PMID:Physiological and pathophysiological aspects of gastrointestinal peptide hormones. 2 50

Gastric surgery has undergone continuous evolution since the 19th century. At present it is a highly sophisticated technique which provides symptomatic relief for the vast majority of patients operated upon for peptic ulcer disease. Although the overall incidence of complications has decreased, a variety of complications continues to occur and radiological examination plays a critical role in their detection, evaluation, and management. Knowledge of the variations in surgical terminology and commonly used eponyms provides the basic framework for discussion. Familiarity with the radiological appearance of the normal postoperative stomach together with an understanding of its physiology are essential prerequisites to the recognition of possible complications. Operative techniques may result in a radiographic appearance which simulates disease. Conditions as diverse as bezoars, afferent and efferent loop problems, marginal ulceration, anastomotic leakage, prolapse, and intussuception may all be characterized by distinct and highly specific radiographic changes. Physiologic problems such as dumping and malabsorption may also reflect their presence by X-ray changes. The radiographic features in a large number of surgical complications are discussed and illustrated. The importance of the radiographic examination in the postsurgical stomach is emphasized.
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PMID:Sequelae of stomach surgery. 40 Sep 15

Three hundred twenty-three of 473 questionnaires sent to hospital dietitians in 50 states and Puerto Rico concerning diet therapy for adult lactose malabsorption were returned and analyzed. Only 42% of the responding dietitians stated that their hospital diet manuals contained a diet for adult lactose malabsorption, with less than 1% having a diet specific for patients with peptic ulcer disease and lactose malabsorption. Physicians in almost half of these hospitals rarely considered lactose malabsorption when prescribing a diet for patients with peptic ulcer disease or rarely modified diets for suspected lactose malabsorption. The responding dietitians supplied pertinent portions of their diet manuals in 99 instances, which was 72% of those having such diets. Many of the submitted diets were too rigid, frequently restricting foods that did not contain lactose. On the basis of the survey and a review of the literature, a more reasonable approach to the therapy of adult lactose malabsorption is suggested.
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PMID:Diet therapy in adult lactose malabsorption: present practices. 63 35

The records of a series of 700 patients with inflammatory bowel disease, 498 with Crohn's disease and 202 with ulcerative colitis, have been analyzed to determine the relative incidence and characteristic features of their extra-intestinal manifestations. The group with Crohn's disease included 62 with colitis, 223 with ileocolitis, and 213 with regional enteritis. A consideration of the clinical patterns and an understanding of their pathophysiology suggested a subdivision into two main groups: one "colitis related" and one related to the pathophysiology of the small nonspecific third group. Group A, colitis related, comprises joint, skin, mouth, and eye disease. The complications might be immunologically determined, were closely associated with active inflammation, and often responded to medical or surgical treatment of the underlying bowel disease. They occurred in 36% of the entire series of patients: joints were involved in 23%, skin in 15%, and mouth and eye each in 4%. Pyoderma gangrenosum was observed most often in ulcerative colitis and erythema nodosum most often in granulomatous colitis. The incidence of Group A complications was higher in disease involving the colon (42%) than in disease restricted exclusively to the small bowel (23%). There were interrelationships among the various members of Group A, with multiple manifestations occurring in a third of affected patients. Group B, related to small bowel pathophysiology, includes malabsorption, gallstones, kidney stones, and non-calculous hydronephrosis and hydroureter. Disorders in this group were generally related to the severity of the disease in the small bowel and tended to persist even in the absence of active inflammation. In contrast to Group A, this group occurred most frequently in small bowel disease, and least in colonic disease. Malabsorption was virtually confined to the patients with small bowel disease (10% incidence), while gallstones and renal stones were also both more frequent in Crohn's disease (11% and 9% respectively), the latter usually in association with small bowel resection or ileostomy. Group C, found in a small percentage of patients, consists of nonspecific complications, including osteoporosis (3%), liver disease (5%), peptic ulcer (10%), and amyloidosis (1%).
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PMID:The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients. 95 99

The complications after intestinal bypass operations in 103 massively obese subjects were recorded postoperatively for a maximum of 5 years. The surgical procedures were jejuno-ileostomy, end-to-side (op. I) in 35, and end-to-end with ileocaecostomy (op. II) in 68 cases. Wound dehiscence was the cause of the sole early postoperative death. The early complications found were those commonly seen after abdominal surgery, namely wound infection (n=24), wound dehiscence (n=5), anastomotic leak (n=2), leg thrombosis (n=2). One of the latter 2 patients probably also had pulmonary embolism. In 6 cases early intestinal obstruction occurred; 3 of them required reoperation. The late complications were divided into unspecific and specific in relation to the surgically induced malabsorption. Their incidence was analysed in 80 subjects observed for longer than 1.5 years after the operation. Unspecific late complications consisted of intestinal obstruction in 5 cases and incidional hernias in 18 cases. Intussusception was not seen. There seemed to be no increase in the incidence of gallstone disease or gastroduodenal ulcer after the operation. Specific late complications were electrolyte disturbances (ED) in 13, signs of liver injury (LI) in 9, urinary-tract calculi (UTC) in 15, and immunopathy (IM) in 19 cases. The IM group had skin rashes, arthralgia, and fever. Besides these somatic complications, a number of specific pyschictric complications were also observed (not published). Three subjects died after the operation with signs of liver insufficiency. The following factors were found to be of importance in the occurence of the specific complications ED and LI: 1. The presence of preoperative abnormalities in serum-electrolyte concentration and pathological liver tests, mainly occuring in the heavies patients. 2. Most ED and LI occurred during the period of main weight loss, in general during the first postoperative year. ED and LI did not appear after body weight had stabilised. 3. The rate of weight loss: ED and LI occurred, with a few exceptions, in the subjects with a rate of weight loss higher than 0.0130 weight-index units per week during the period of constant weight loss (see article).
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PMID:Some somatic complications after small intestinal bypass operations for obesity. Possible factors of significance in the incidence. 121 45

In a collection of 3,571 patient's files admitted in the University Teaching Hospital and the Yaounde General Hospital, we studied 27 patients suspected of chronic pancreatitis. 20 patients with calcified chronic pancreatitis benefited from a detailed history, physical examination and a complete paraclinical work-up. From the data collected, chronic alcoholism seemed to have been the main aetiology. Industrial beer from barley alone and/or associated with other traditional liquors was most consumed. The majority of patients were heavy alcoholics and daily consumption varied from 75 to 124 g of pure alcohol. The natural history of the disease and physical examination were identical to that observed in the western countries. Associated pathology was observed in 10% of the patients. This included peptic ulcer disease, cirrhosis and bile stones. Complications included diabetics, obstructive jaundice, and malabsorption syndrome. As a conclusion, chronic pancreatitis is a pathology whose prevalence seems to be progressing constantly.
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PMID:[Chronic pancreatitis in Cameroon. Analysis of etiological and clinical aspects]. 151 63

The causes of fat malabsorption after gastric resection were studied in patients randomized to Billroth I gastroduodenostomy or Roux-en-Y gastrojejunostomy after antrectomy and selective gastric vagotomy for intractable prepyloric peptic ulcer. Eighteen patients were studied 2 years or more postoperatively. Assessment of food intake concerning protein, fat, carbohydrate, vitamins and minerals showed deficiency in seven cases, but without significant difference between the two operation types. Postoperative weight loss did not differ significantly between the two study groups, but the faecal excretion of fat was significantly larger (p less than 0.05) after gastrojejunostomy than after gastroduodenostomy. Since both the oro-caecal transit time and the breath excretion of hydrogen after a standardized test meal showed no intergroup difference, the results suggest that duodenal exclusion may be of particular pathophysiologic importance for the observed malabsorption of fat after gastric resection.
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PMID:Malabsorption of fat after partial gastric resection. A study of pathophysiologic mechanisms. 167 31

Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency.
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PMID:Gastroenterological emergencies in the tropics. 176 26

Diseases presenting with dyspepsia fall into two general categories: organic and functional. Overall, most patients with dyspepsia have no underlying identifiable disease process. The diagnostic yield of organic causes is less in younger patients, and, conversely, serious organic lesions are common in elderly dyspeptic patients. The commonest organic causes of dyspepsia are peptic ulcer disease, gastroesophageal reflux, biliary tract disease, and gastric cancer. Symptoms and physical signs may help to differentiate these organic causes from functional dyspepsia but endoscopic or radiographic/ultrasound studies are usually necessary to ensure the appropriate diagnosis. Less common organic causes of dyspepsia not to be overlooked include drugs, pancreatitis, malabsorption syndromes, metabolic disorders, ischemic heart disease, and collagen vascular disorders.
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PMID:Dyspepsia: organic causes and differential characteristics from functional dyspepsia. 189 24

Almost all segments of the gastrointestinal tract have been used as urinary tract substitutes. The specific nutritional and gastrointestinal complications depend on the particular portion of bowel that is removed from the alimentary tract. The use of stomach theoretically may predispose the patient to hypergastrinemia and peptic ulcer disease, hypocalcemia, and iron deficiency or megaloblastic anemia. Resection of a large amount of jejunum causes malabsorption. Limited use of colon segments usually is well tolerated, but loss of large parts of the colon directly decreases available absorptive area, resulting in diarrhea. Resection of the ileum and ileocecal valve can lead to several disease states. One is mixed secretory-osmotic diarrhea. Decreased ileal reabsorption of bile salts results in fat malabsorption and steatorrhea. The presentation of increased amounts of bile salts and fatty acids to the colon decreases water absorption and stimulates active chloride and water secretion, producing a cholera-like high-volume secretory diarrhea. The loss of the ileocecal valve and ileum segment accelerates intestinal transit time, which does not allow for complete digestion and absorption of food. Water and electrolytes remain associated with undigested food particles and may overwhelm the absorptive capacity of the colon, resulting in an osmotic diarrhea. A second problem is vitamin B12 deficiency. Surgical reduction of sites in the terminal ileum for active and exclusive uptake of vitamin B12 might lead to hypovitaminosis. If this is unrecognized, patients may develop irreversible neurologic injury. A third problem is cholelithiasis. Derangements in bile salt metabolism can occur when as little as 10 cm of ileum is resected, and the propensity to form gallstones is increased. Pigment gallstones appear to be the predominant stone associated with ileal resections. The fourth possible problem is urolithiasis, the etiology of which is multifactorial in patients with ileal resections. With decreased availability of bile salts, fat malabsorption occurs. Fatty acids bind with calcium and magnesium to form soaps, resulting in increased levels of free oxalate available for absorption. Moreover, fatty acids directly increase colonic permeability to oxalate.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Nutritional and gastrointestinal complications of the use of bowel segments in the lower urinary tract. 194 6


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