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

A metabolic and physiological assessment was carried out in 14 patients who had undergone restorative proctocolectomy with ileal reservoir more than six months previously. The haemoglobin was normal in all but one and plasma electrolytes and serum albumin, calcium, phosphorus, and red cell folate estimations were normal in all. Five patients had low serum iron levels of whom one had an iron deficiency anaemia. The 24 hour faecal fat output was normal in all patients and there was no case of vitamin B12 malabsorption as judged by the Schilling test, although four patients had marginally low values. These were not associated with increased bacterial counts in the faeces within the reservoir and there was no evidence to support a diagnosis of stagnant loop syndrome. Inflammation of the reservoir mucosa was, however, associated with higher counts of aerobic bacteria than in cases where inflammation was absent. Subtotal villous atrophy or inflammation was seen in biopsies of the reservoir in six patients. The mean faecal output per 24 hours was 659 +/- 259 g and the mean reservoir volume was 330 +/- 78 ml. Mean resting anal canal pressure was significantly lower in patients with a mucous leakage per anum than in those without, while manometry of the reservoir showed no alteration of pressure over a period of one hour before and after a meal. A positive rectosphincteric reflex was observed in nine patients.
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PMID:Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment. 726 23

The in vitro and in vivo production of hydrogen gas (H2) from various carbohydrates or proteins has been examined in normal rats and in rats infected with the nematode Nippostrongylus brasiliensis. Normal rat fecal homogenates were capable of producing H2 in vitro from glucose, sucrose, xylose, lactulose, bovine serum albumin, or casein hydrolysate. Direct injection of glucose, sucrose, xylose, lactulose, bovine serum albumin, or casein hydrolysate into the cecum of normal rats resulted in approximately twice as much H2 production in vivo than when these same carbohydrates or proteins were administered to the normal rats by gavage. Partial small intestinal villous atrophy was produced by infecting rats with the nematode N. brasiliensis. Impaired small intestinal cell function and evidence of malabsorption in the nematode-infected rats included: (a) decreased activity of intestinal cell lactase (-43%), sucrase (-33%), and alkaline phosphatase (-46%); (b) decreased gut sac uptake of 3-O-(methyl-3H]-D-glucose (-21%) or 1-[carboxyl-14C]-aminocyclopentane-1-carboxylic acid (-28%); and (c) increased (+ 64%-561%) 14CO2 production after D-[U-14C]xylose administration. These rats produced approximately twice as much H2 after gavage administration of glucose, sucrose, xylose, bovine serum albumin, or casein hydrolysate compared with normal rats. The present study suggests that H2 analysis may be useful in the evaluation of small intestinal malabsorption states in rats.
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PMID:Use of hydrogen gas (H2) analysis to assess intestinal absorption. Studies in normal rats and in rats infected with the nematode, Nippostrongylus brasiliensis. 728 87

Zinc deficiency is a potential complication of Crohn's disease and we have searched for evidence of this and assessed the possibility that malabsorption of zinc might be a cause. Serum zinc concentrations in 33 patients suffering from Crohn's disease were significantly lower than in 58 normal control subjects (9 . 18 +/- 2 . 3 mumol compared with 13 . 6 +/- 1 . 73 mumol, P < 0 . 0005). Serum zinc correlated well with serum albumin concentrations and the low serum zinc may simply reflect the low serum albumin. Thus its value as an indicator of zinc deficiency is poor. We studied zinc absorption in seven patients with Crohn's disease and compared it with the results obtained previously in five normal subjects using a new technique involving a short-lived isotope of zinc (69mZn). Plasma appearance curves, constructed after an oral dose of isotope, and disappearance curves, after an intravenous dose, were used in a deconvolution computer programme to calculate zinc absorption. Compared with normal subjects, zinc absorption was considerably impaired in patients with Crohn's disease (range 9--45%, compared with 38--75%). This abnormality is a potential cause of zinc deficiency in patients with Crohn's disease.
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PMID:Zinc absorption in Crohn's disease. 742 1

Massive intestinal resection is associated with transient hypergastrinemia and gastric hypersecretion. Gastric hypersecretion impairs intestinal absorption, but gastrin may be trophic during intestinal adaptation. Our aim was to determine if postresection hypergastrinemia correlates with malabsorption or adaptation. Ten dogs (13 to 19 kg) underwent 75% proximal intestinal resection. Intestinal remnant length and villus height was assessed at 12 weeks (n = 5) and 40 weeks (n = 5). Body weight and serum albumin, as well as stool fat, moisture, and weight, were measured preoperatively and at 4-week intervals for 40 weeks. Fasting serum gastrin values were measured by radioimmunoassay at similar intervals. Significant hypergastrinemia occurred between 4 and 28 weeks postresection. Hypergastrinemia did not correlate with increased intestinal remnant length (r = -.486, p = .407) or villus height (r = -.410, p = .584). Duration of hypergastrinemia (> 100 pg/ml) correlated with percentage of fecal fat at 12 weeks (r = .807, p = .015) and stool weight at 40 weeks (r = .881, p = .046). Thus, postresection hypergastrinemia correlates with early fat malabsorption and increased stool weight, but there is no correlation between hypergastrinemia and adaptation. These findings suggest that gastric hypersecretion, not hypergastrinemia, may be the more important pathophysiologic event after intestinal resection.
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PMID:Postresection hypergastrinemia correlates with malabsorption but not adaptation. 789 33

Deficiency of vitamin B12 is commonly reported in HIV-infected patients. We measured vitamin B12 levels in 36 HIV-infected patients with chronic diarrhea (> 3 stools/day for six weeks or more). Eight patients had an identifiable cause of diarrhea. Vitamin B12 levels were low in 39%. Sixteen of these patients were selected to undergo further testing, eight patients with low levels of vitamin B12 and eight with normal B12 levels. These 16 patients had both a stage II Schilling test and measurement of multiple serum D-xylose concentrations performed after both oral and intravenous doses of D-xylose. Integrated areas under the curves (AUC) for D-xylose concentration versus time were calculated for intravenous and oral doses, and D-xylose bioavailability was determined. Stage II Schilling tests were abnormal in 11 patients, (69%). D-Xylose bioavailability correlated closely with vitamin B12 absorption (r = 0.648, P < 0.01). Comparisons of mean values for CD4 count, serum albumin, Karnovsky score, six-month weight loss, 1-hr serum D-xylose levels and MCV failed to reveal a significant difference between those with and without abnormal serum vitamin B12 levels. These data indicate that below-normal levels of vitamin B12 are highly prevalent in HIV-infected patients with chronic diarrhea. Malabsorption of vitamin B12 occurs in the setting of an enteropathic process effecting both the proximal and distal small bowel. Since no risk factors for vitamin B12 deficiency could be identified, screening for vitamin B12 deficiency in HIV-infected patients with chronic diarrhea is strongly recommended.
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PMID:Malabsorption and deficiency of vitamin B12 in HIV-infected patients with chronic diarrhea. 792 36

Weight loss, chronic diarrhea and fat malabsorption are frequent after total gastrectomy. The aim of this work was to study parameters of intestinal absorption and the histology of jejunal mucosa in 26 patients subjected, at least one year ago, to total gastrectomy and without evidences of tumoral relapse. There was a mean weight loss of 9 kg (range 4 to 20) and 46% of patients had intermittent or episodical diarrhea. Hemoglobin was below 12 g/dl in 4 patients, serum albumin was below 3.5 g/dl in 3, serum carotene was below 40 micrograms/dl in 5 and serum iron was below 80 micrograms/dl in 5. Jejunal biopsies were normal and steatocrit was abnormal in all patients. Present findings suggest that fat malabsorption in these patients is intraluminal and due to an unequal mix of pancreatic and biliary secretions, as a consequence of Y en Roux transit reconstruction.
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PMID:[Intestinal malabsorption in patients treated with total gastrectomy]. 808 66

Jejunal diverticulosis is considered to be a generally asymptomatic condition in which the diverticula are pulsion mucosal herniations with walls lacking a muscle layer. These opinions in particular are examined in this review of 20 cases of jejunal diverticulosis treated during an 8 year period. The predominant complication in each case was inflammation or perforation (nine), diarrhoea or malabsorption (five), haemorrhage (three), chronic abdominal pain (two) and pseudo-obstruction (one). At least 10 patients had more than one complication, although this was often unrecognized. Ten patients complained of chronic abdominal pain, in eight of whom the cause was not diagnosed until other complications supervened. Unrecognized malabsorption may be common, as the mean serum albumin in 12 patients presenting acutely with inflammation, perforation or haemorrhage, was low (mean 32 g/L, normal 39-48 g/L). Histology sections were reviewed in the 12 cases that underwent resection, of whom 11 were suitable for classification. Four cases had narrow-mouthed pulsion diverticula with a thin or absent muscle coat, and had developed at the point of blood vessel penetration. Four cases had wide-mouthed diverticula in which the muscle layer was present, suggesting an abnormality of the intestinal wall. Two had features of both. In one case a Meckel's type diverticulum was located 10 cm from the duodenal-jejunal flexure. Seven had mucosal villous atrophy consistent with bacterial overgrowth. In conclusion, jejunal diverticulosis may be associated with complications more frequently than has been recognized and pathologically is a diverse condition.
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PMID:Jejunal diverticulosis. 1519 91

To investigate the pathogenesis of hepatic osteodystrophy (HOD) in parenchymal liver disease, we developed a laboratory model in animals using carbon tetrachloride (CCl4) and thioacetamide. Biochemical and histological parameters in the model were measured. In rats with both chronic non-cirrhotic liver injury and CCl4-induced cirrhosis, tibial bone volume was significantly lower than in controls. In CCl4-treated cirrhotic rats, the osteoid volume decreased while the urinary calcium/creatinine ratio increased. In all CCl4-treated rats, bone volume was significantly correlated with both the serum albumin concentration and the number of goblet cells reflecting intestinal villous atrophy. The serum concentration of vitamin D metabolites was not correlated with bone volume. Whole body retention of 47Ca was significantly lower in CCl4-treated cirrhotic rats than in controls. Furthermore, the bone volume in thioacetamide-treated cirrhotic rats was significantly lower than in controls. These data demonstrate that chronic parenchymal liver injury itself causes osteoporosis (i.e. HOD) due to a combination of low bone formation rates and high resorption rates, that HOD begins at the stage of chronic non-cirrhotic liver injury, that bone volume in HOD parallels liver damage and that the principal pathogenesis of HOD seems to be intestinal Ca malabsorption due to lower serum albumin and villous atrophy, while serum levels of vitamin D metabolites have little influence on the pathogenesis of HOD.
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PMID:Bone changes and mineral metabolism disorders in rats with experimental liver cirrhosis. 903 34

Nutritional insult after bone marrow transplantation (BMT) is complex and its nutritional management challenging. Enteral nutrition is cheaper and easier to provide than parenteral nutrition, but its tolerance and effectiveness in reversing nutritional depletion after BMT is poorly defined. Nutritional status, wellbeing, and nutritional biochemistry were prospectively assessed in 21 children (mean age 7.5 years; 14 boys) who received nasogastric feeding after BMT (mean duration 17 days) and in eight children (mean age 8 years, four boys) who refused enteral nutrition and who received dietetic advice only. Enteral nutrition was stopped prematurely in eight patients. Greater changes in weight and mid upper arm circumference were observed in the enteral nutrition group, while positive correlations were found between the duration of feeds and increase in weight and in mid upper arm circumference. Vomiting and diarrhoea had a similar incidence in the two groups, while fever and positive blood cultures occurred more frequently in the dietetic advice group. Diarrhoea occurring during enteral nutrition was not associated with fat malabsorption, while carbohydrate malabsorption was associated with rotavirus infection only. Enteral feeding did not, however, affect bone marrow recovery, hospital stay, general wellbeing, or serum albumin concentrations. Hypomagnesaemia, hypophosphataemia, zinc and selenium deficiency were common in both groups. In conclusion, enteral nutrition, when tolerated, is effective in limiting nutritional insult after BMT. With existing regimens nutritional biochemistry should be closely monitored in order to provide supplements when required.
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PMID:Enteral nutrition after bone marrow transplantation. 930 51

Patients with burn injuries exhibit multiple risk factors for the development of vitamin K deficiency, including malabsorption, limited enteral intake, antibiotic therapy, and multiple surgical procedures. A prospective evaluation of 48 children was conducted to evaluate serum vitamin K values during the first 4 postburn weeks. Serum levels were analyzed in relation to clinical course. Days of antibiotic (p < 0.02) and albumin therapy (p < 0.003), percentage body surface area excised (p < 0.006), and the administration of blood products (p < 0.05) were significantly correlated with serum vitamin K levels, and days of diarrhea approached statistical significance (p < 0.06). No relationship was found between serum values and prothrombin time, activated partial thromboplastin time, or serum albumin. Ninety-one percent of the children demonstrated serum values below expected norms. These data suggest a relationship between coagulopathy and an intact functioning gastrointestinal tract. However, the relative importance of dietary versus endogenous vitamin K produced by intestinal bacteria remains to be elucidated.
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PMID:A prospective analysis of serum vitamin K in severely burned pediatric patients. 950 29


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