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)

The authors report five cases of an association between osteomalacia and chronic calcifying pancreatitis. The pancreatic involvement, which was pain-free in four patients, resulted in all cases in enzyme insufficiency with steatorrhoea. The deficiency-type osteopathy was highly vitamin sensitive. Aetiological study of these cases of osteomalacia revealed the constant presence of factors aggravating the vitamin deficiency, playing a role by increasing deficient intake or malabsorption, or by increasing Vitamin D requirements. It thus appears that hypovitaminosis D alone, of particular severity, was sufficient to result in the appearance of clinically evident osteomalacia. Such a vitamin deficiency, necessary when the intestinal mucosa is intact, is only rarely encountered, which accounts for the extreme rarity of osteomalacia in association with chronic pancreatic disorders.
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PMID:[Osteomalcaia and chronic pancreatis. 5 cases]. 121 65

Biological and histological studies were performed in 42 cases of gastro-intestinal intolerance to cow's milk proteins. Hypoproteinemia was present in 2/3 of the cases, anemia in 3/4. Malabsorption syndrome (steatorrhea, xylose) was overt in less than 1 patient out of 2. Serum level of vitamin A was more frequently depressed than that of vitamin E and folinic acid. Intestinal biopsy, performed in 32 children, showed consistent abnormalities, a partial atrophy of the villi being most often seen (26 cases). Eosinophilia was present in 50% of the cases. A titer of anti-milk agglutinins of 1/64 or above was always found if the test was performed repeatedly when the diet of the children contained milk. Lymphocyte proliferation in culture, induced by milk proteins, was positive in 70% of the cases. None the less, no biological or histological findings were found to be specific for gastro-intestinal intolerance to milk proteins.
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PMID:[Digestive intolerance to cow's milk proteins in infants. Biological and histological study]. 124 Jul 51

We studied if the fecal fat concentration as measured by the near infrared reflectance analysis in a spot sample is an acceptable screening test for malabsorption. This measurement was compared with the more complex fat balance in 120 patients with a suspected malabsorption [53 with chronic pancreatic disorders (CP), 67 with other digestive disorders (nCP)]. The fecal fat concentration proved to be well correlated with steatorrhea in CP (r = 0.86) but not in nCP (r = 0.35). A fat concentration of 9 g% had a sensitivity and a specificity for steatorrhea of 88.8% and of 97.1% in CP, but only of 53.8% and of 94.4% respectively in nCP. The fecal fat concentration was significantly higher in CP than in nCP, even considering patients with steatorrhea only; however, the overlap between the two groups was too high to suggest a clinical usefulness of this test in the differential diagnosis of steatorrheas. It is concluded that the fat concentration in a small sample, easily obtained also in outpatients, is useful in the selection of patients with chronic pancreatitis to submit to a proper fat balance study.
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PMID:Fecal fat concentration in the screening of steatorrhea. 128 79

We reviewed the fecal fat excretion and alpha 1-antitrypsin clearance results of 160 patients with steatorrhea in whom a final diagnosis was obtained, based on history, physical examination, and radiological, functional and morphological tests. Twenty-two patients had pancreatic diseases and 138 had steatorrhea due to gastrointestinal diseases. alpha 1-antitrypsin clearance was invariably normal in chronic pancreatitis, but there was only a 23 to 50% of correct etiological classification when the combination of steatorrhea and normal alpha 1-antitrypsin clearance was present. However, none of our patients diagnosed of chronic pancreatitis had abnormal alpha 1-antitrypsin clearance. The combination of steatorrhea and normal clearance of alpha 1-antitrypsin was a modest clue for diagnosis of pancreatic malabsorption.
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PMID:Fecal alpha 1-antitrypsin clearance in the differential diagnosis of steatorrhea. 130 Aug 54

The efficacy of cholylsarcosine, a synthetic deconjugation-resistant and nonsecretory conjugated bile acid analog for the treatment of fat malabsorption caused by severe bile acid malabsorption, was assessed in an animal model. In two dogs, the ileum and ileocecal valve were resected, causing severe diarrhea, steatorrhea, bile acid malabsorption, and progressive weight loss. Cholylsarcosine was administered as the water-soluble sodium salt by mixing with the dog food. Various doses were explored as well as varying intakes of dog food. Fat absorption was assessed by gravimetric measurement of fecal fat; a nonabsorbable recovery marker (polyethylene glycol mol wt 4000) was used to correct for incomplete fecal collections. Cholylsarcosine caused a 5- to 30-fold increase in fat absorption but had no significant effect on weight loss or fecal weight. Duodenal content was collected during digestion of a meal via a surgically placed Thomas cannula; the aspirates were dilute, acidic, and had a low bile acid concentration. The bile acid concentration increased modestly when cholylsarcosine was administered, but remained below the critical micellization concentration. The results indicate that oral administration of cholylsarcosine improved dietary fat absorption in a canine model of severe bile acid malabsorption with associated steatorrhea and bile acid deficiency in the proximal small intestine. Studies with this compound in patients with nutritional problems because of steatorrhea and severe bile acid malabsorption appear warranted.
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PMID:Effect of replacement therapy with cholylsarcosine on fat malabsorption associated with severe bile acid malabsorption. Studies in dogs with ileal resection. 1050 37

Mild to moderate fat malabsorption is frequently present in patients with liver cirrhosis. We investigated the influence of lactulose or lactitol treatment on fecal fat excretion in 18 patients with liver cirrhosis. All patients were Child Pugh class A or B and had not taken any therapy that could have affected intestinal absorption in the previous months. The dose of lactulose or lactitol was individually adjusted to maintain two semiliquid bowel movements per day. Steatorrhea was determined before and after a minimum of 7 days, when the cathartic effect was stabilized. Treatment with nonabsorbable disaccharides induced mild to moderate steatorrhea in 50% of patients. No differences were observed between the effects of lactulose and lactitol, but fecal fat excretion exceeded 10 g/day in two patients taking lactulose. These findings indicate that treatment with nonabsorbable disaccharides may increase fecal fat excretion in patients with liver cirrhosis. This factor should be taken into consideration when a cirrhotic patient has to take these drugs for a long time.
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PMID:The effect of lactulose and lactitol administration on fecal fat excretion in patients with liver cirrhosis. 140 23

Pancreatic insufficiency is the second most important pathophysiological expression of cystic fibrosis (CF) and occurs in the majority of patients. It leads to fat malabsorption and high energy losses in the stools and is one of the major causes of malnutrition often seen in CF. Although the development of enteric-coated enzyme preparations offers a dramatic improvement in therapy, it is still difficult to achieve complete correction of fat malabsorption. The cause for this treatment failure is the relative acidic environment in the duodenum induced by a decreased pancreatic bicarbonate output. To improve the efficacy of enteric-coated preparations the dissolution of these preparations in the duodenum must be optimised in order to achieve a high intraduodenal enzyme concentration. With the aim to increase intraduodenal pH, additional therapy with H2-antagonists and oral prostaglandins has been tested without unequivocal success. Omeprazole, a gastric acid inhibitor with more potency and duration of action compared to H2-antagonists, improves the efficacy of enteric-coated capsules of pancreatin dramatically. With a daily dose of 20 mg in addition to Pancrease (3 x 4 capsules) near normalization of faecal fat excretion will be reached in most CF patients with persistent steatorrhoea.
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PMID:New modalities in the treatment of exocrine pancreatic insufficiency in cystic fibrosis. 147 Feb 78

The case of a young woman from Guadeloupe developing severe megaloblastic anemia is reported. She presented with fever and hemolysis (she had heterozygotic beta-thalassemia) after a six month history of diarrhea. She was shown to have folate deficiency, steatorrhea, vitamin K and B12 malabsorption. She responded well to intravenous folinic acid and tetracyclines. Diagnosis was based on the following criteria: a) no other cause of malabsorption was found despite a comprehensive inquiry, b) the pattern of the illness corresponded to the definition of disease. Three particular aspects are outlined: the acute onset, malabsorption of vitamin B12 requiring prolonged and combined treatment, and the unusual place in which the disease was contracted.
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PMID:[Tropical sprue revealed by severe anemia in a woman from Guadeloupe]. 158 43

Patients with ileectomy can present with severe steatorrhea due to bile acid depletion. While exogenous bile acid would seem to be ideal therapy for this condition, it is not often used because it is thought that the bile acid would be malabsorbed and would enter the colon, producing a secretory diarrhea. This report describes a patient who had an ileectomy and partial right colon resection for Crohn's disease and then developed severe steatorrhea due to bile acid malabsorption. Although steatorrhea was reduced from 134 to 9 g/24 hr with chronic ingestion of ox bile extract, stool weight did not increase with ox bile (stool weight 669 g/24 hr before therapy and 507 g/24 hr after therapy). In this patient, oral bile acid supplementation reduced fat excretion markedly, but did not aggravate diarrhea, even though the colon was still present. This result may have been due to impaired solubility of bile acid in fecal fluid due to an acid pH or to binding of bile acid with particles of solid stool. Ingestion of ox bile extract does not necessarily increase stool weight in patients with defective fat absorption due to bile acid malabsorption and can be tried with caution in an effort to diminish steatorrhea.
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PMID:Treatment of severe steatorrhea with ox bile in an ileectomy patient with residual colon. 158 99

In 96 consecutive patients who underwent a 72-h faecal fat determination because of suspected nutrient malassimilation (maldigestion and/or malabsorption) faecal chymotrypsin (F-Chym) was estimated with a commercial photometric test (Monotest Chymotrypsin), comparing F-Chym concentrations in the first 24-h stool with the total 72-h F-Chym output. In the first 24-h faeces, the F-Chym concentration, calculated as a mean of three random samples, did not significantly differ from a single value obtained after homogenization. In known pancreatic disease, a F-Chym concentration less than 3.0 U/g wet faeces distinguished well between steatorrhoic patients (n = 12) and nonsteatorrhoic (n = 13) (positive predictive value (PV), 91%; negative PV, 86%) but was less suitable as a screening test for pancreatic steatorrhoea in the unselected patient group (positive PV, 61%; negative PV, 98%). Although the estimation of 72-h F-Chym output could differentiate between various subgroups of patients to a certain extent, the positive PV for discovery of pancreatic steatorrhoea in a single patient was low. Four patients had excessively high F-Chym output and increased bile acid excretion after ileal resection (n = 3) and radiation ileitis (n = 1), respectively, possibly indicating the removal of an inhibitory mechanism of pancreatic and biliary secretion in these conditions.
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PMID:Determination of faecal chymotrypsin concentration and 72-hour faecal chymotrypsin output in the detection of pancreatic steatorrhoea. 177 36


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